The Meaning of Self-Care for Family Caregivers
By: Amy Blackburn, Msg
Tags: Dimensions Of Wellness, Caregiver Burnout, Caregivers, Aging In Place, Smart Goals

Self-care is a term used for family caregivers because they tend to forget about caring for themselves. Self-care is a good way to cope with the emotional and physical burden that results from being a family caregiver. Self-care is a way to bring back balance into the caregiver’s unbalanced life of focusing on the loved one they are helping. That balance can happen with one small goal at a time to improve quality of life.

What does quality of life (QOL), or life satisfaction mean to you? It can be broken down into the leisure activities you used to enjoy; having a peaceful, comfortable living environment; making new friends who are caregivers or spending time with family; improving your health rating from “fair” to “good”; improving your finances or budgeting so that you can go on a vacation. If you prioritize each of these QOL areas by what is most important to you at this time, you can break them down into smaller goals with intentions of enhancing the meaning in your life and your overall happiness.

Each of the QOL areas of leisure, living environment, friends/family, health, and finances can be categorized further into the six dimensions of wellness. Are the leisure activities you used to enjoy such as taking walks what brought you physical health? Did painting or writing in a journal strengthen your emotional health? Did taking a class allow you to enhance your intellectual health, or is that where you would meet new friends? Perhaps reading the Bible helped with your spiritual and emotional wellness. You were happy in your career, so your vocational wellness was strong, but now that you are retired you might need to volunteer somewhere to find meaning in this area again. One new activity can strengthen one or a few of each aspect of wellness.

Once you have figured out what will bring your life meaning again, the best way to add self-care back into your life is to set small goals. Why do we often set goals that we soon forget about or do not accomplish? As a family caregiver, it happens easily because you get busy with helping your loved one. To start purposefully practicing self-care and coping skills, you need to make a conscious effort to set one goal at a time. The best way to do this is to set S.M.A.R.T. goals, originally developed by George Doran in the 1981 issue of Management Review. The acronym stands for Specific, Measurable, Achievable, Relevant, and Time-bound.

For a New Year’s resolution, you might have a goal to “be healthier,” or “exercise more,” or “walk more,” as each of these goals become more Specific. You can Measure “walking more” when you set your goal for a certain amount of time, and 10 minutes to start is Achievable. Even if you decide the time will be 60 minutes and it is not achievable, you can modify your goal, so you can achieve it. If walking is hurting your feet, change the specific exercise to a stationary bike. Anytime you are not reaching any part of your S.M.A.R.T. goal, check-in with yourself to see what is not working and adjust the goal, but don’t quit it completely.

Relevant goals depend on what you are targeting. If you are concentrating on the dimensions of wellness, pick a goal that will enhance your physical, intellectual, emotional, spiritual, sociological, or vocational health. If you want to generally improve your quality of life or overall life satisfaction, this might take some serious introspection. Many caregivers will say, “I just need a vacation!” What does that mean? Do you truly want to go somewhere, or do you simply need a break from your caregiver duties? It would also be relevant during this time in your life if you have the money for a vacation. Maybe you are missing things in your life such as time with family or friends; leisure activities you used to enjoy; a living environment where you were happier, perhaps if you had to move in with your loved one; your finances have diminished; or general health is deteriorating and you have not been able to go to the doctor yourself. Pick a goal that is relevant and real to you at this time in your life, where it can make a difference in your QOL, meaning in life, and overall satisfaction.

Time-bound goals are the number of days, weeks, months, or years. Achievable goals that you are just starting might be a few days and they can turn into weeks. As a family caregiver, it might be difficult to create long term goals for months or years; but these can be in the back of your mind for the future as you accomplish your shorter-term goals. You could set a goal to walk 10 minutes three days for the next week to enhance your physical health, and possibly your emotional well-being because it would help ease your caregiver burden when you take a break. Once you complete your small goals, if you are comfortable with them, stick with it, or gradually build upon them. The next week, walk for 15 minutes three days, or 10 minutes four days. Figure out what is more important, to have more time or more small breaks throughout your day. If it is the brief pauses in the day, make it six days for five minutes.

A goal to improve intellectual well-being that would be relevant to a family caregiver helping a loved one with dementia might be to attend a caregiver training workshop on the progression of Alzheimer’s disease (specific). Caregiver training is typically for a certain number of days or hours, so signing up and completing a course is easily measurable. Make sure it is achievable by fitting it into your schedule and requesting respite from your Family Caregiver Support Program (FCSP) during the times of these classes. It is relevant because it is helping you as the caregiver and, in turn, helping your loved one long-term. Most of these evidence-based caregiver training courses are time-bound and will last six to eight weeks. You could also target social wellness and make it a goal to find a new friend who is a family caregiver, which is probably doable in a class series where many times there is a small group discussion.

If you do not know what is most important or are unable to choose a relevant goal you think might be the most beneficial, then choose something based on research that has been found regarding family caregivers. Many caregivers end up with high blood pressure and high cholesterol because the emotional burden has become a physical burden, or caregivers do not have time to exercise or eat healthy. Family caregivers end up having a stroke or heart attack and are in worse-off condition than the person they have been caring for, or the caregiver dies first. Who will care for your loved one then?

Many family caregivers end up having chronic depression or chronic stress and might turn to alcohol or drugs. Caregivers end up with sleep disturbance, either because their loved one is waking them at night, or they are unable to sleep because of the burden associated with being a family caregiver. Caregivers might experience physical ailments like back or neck pain, arthritis, or acute injuries that become chronic because they were not properly treated. Any number of these things can be a focus for S.M.A.R.T. goals.

Be mindful of the purpose and motivation for developing specific, measurable, achievable, relevant, and time-bound goals. Are you doing it for yourself or so that you can be healthy enough to care for your loved one? Both motivations are fine, because even if your sole purpose is so you can continue caring for your loved one, in the end, you are also helping yourself.

There is no need to overwhelm yourself, but when you do start to achieve small goals, you will improve your well-being. If you keep the goals relevant to your self-care needs or relevant to your role as a family caregiver, you will be helping yourself as well as the person you are caring for. It is a win-win situation, so it should not feel overwhelming or create any more stress than you are already experiencing; and in the end, it should relieve your stress. If you do start to feel more stress, either change the goal to something else or decrease the number of goals you are trying to accomplish.

If you are receiving ongoing caregiver support services with an organization that has the FCSP, you can also discuss the QOL measures and address S.M.A.R.T. goals with your case manager. One or two goals could be added to your care plan, and your case manager would be able to monitor your progress and help you modify your goals as needed. Remember to use those resources in any way that will help with your coping skills, self-care, and your ability to provide quality care for your loved one.