6 Ways to Ease Caregiver Strain

When the latest issue of Nursing 2013 arrived in my mailbox a decade ago, the title article caught my eye immediately:

Easing the burden on family caregivers

I'd been a full-time caregiver of a high-level quadriplegic son for sixteen years at the time. I loved my job, but I was always eager to learn anything to ease the workload. I grabbed magazine and scanned past the clinical stuff to get to the end. I wanted to see what their ideas were for "easing the burden."

As I guessed, there was no magic bullet, no miraculous new methods for helping family caregivers. There were, however, some things worth noting. Today, twenty-six years into caregiving, I've pulled out some of their ideas and added a few things we've learned over the years to share with those who care for loved ones.

1. Don't be afraid to ask others for help.

Caregiving is a marathon. No one can take on the crush of duties day after day after day without some respite or assistance. It's hard to ask for help, to feel needy. But those around you may wish they could help somehow and just not know what to do. If you're not comfortable with having them take over the actual caregiving duties, you could see if they would be willing assist you in chores once in a while. If you have the financial resources, you can also pay for such chores as yard work and picking up groceries to save valuable time and energy.

Getting help not only relieves the physical burden, it allows both caregiver and patient a chance to interact with others, a vital necessity for both physical and emotional health.

2. Think in terms of team-building,

After Kevin's initial injury and the weeks in the hospital and rehab, we all felt like victims of the system. A lot of good people worked hard to help our son survive. The medical system is an institution, though, and institutions often must sacrifice individual attention to accomplish the most general good. 

In the process, Kevin - and we - often felt marginalized and manhandled. We responded by closing ranks around him and getting home as soon as possible. As he improved, we couldn't wait to get to the safety of home and do things in a way best for us and our son. 

At home, we developed our own schedule and cared for our son by ourselves for many years. After more than a quarter century of caregiving and suffering some health challenges of our own, we knew it was time to get help. Though we still do most of the work, we now have a nurse come in once a week. She, in turn, has been able to find us others to help ease the burden. She is, in fact, the one who has championed the idea of developing a "team." 

Depending on the type of home situation you have, let others make whatever contribution you feel comfortable relegating to them. Homes certified by the state will need to have substitute caregivers meet certain qualifications.

But by all means, let others mow the grass and bring you groceries. 

3. Adapt an assertive coping style early on. 

This is probably the most crucial thing we had to learn. Everybody needs an advocate when they are seriously ill or injured. In the fog of a medical crisis, it's easy to accept whatever the medical providers tell you, because they are the professionals. But they don't know your loved on like you do and won't care nearly as much. Being assertive will actually reduce your sense of vulnerability and helplessness. Just be sure you listen to both your loved one and the professionals and understand the landscape before you charge in.

Those who are naturally more passive are more susceptible to crumbling under the burden of caregiving. They tend to stay isolated, worry more, ask fewer questions, and develop a negative attitude. A healthier coping lifestyle involves actively taking charge of the situation, asking questions and pursuing the answers that will benefit both the caregiver and the patient.

4. Learn all you can.

Understanding what is happening to your family member is crucial to providing the best care with the least amount of emotional strain. Research the disease process or injury, available treatments, and the usual prognosis. It's especially important to know such basic techniques as how to correctly turn a person in bed, infection control, and bed sore prevention. Find out what, if any, community, church, and government resources are available.

5. Be kind to yourself.

Caregivers often put the needs of others ahead of their own. In order to take good care of a loved one, you need to be good to yourself, as well. This is easier said than done, since it's often hard to find time for anything besides work. Try to give yourself permission to care for you. Your family member needs for you to be well.

Hospital emergency departments employ a term called "triage" to decide which patients should be treated first. The idea is to put the most important cases at the front of the line. Do this with your life. Develop your own triage system to care for the most crucial chores in your day. If something can wait until tomorrow and you're exhausted, put it at the end of the line. This works well for emotional issues, too. Don't waste your tears on things that aren't worth your energy.

6. Talk to someone.

Develop an emotional support system. Have at least one or two people who you can call when you need to cry, vent, or just talk. Don't just run to those who will agree with everything you say, though. Develop friendships with those who will listen and speak the truth. It's a two-way street; engaging with others gives our lives new perspective. It may even ignite a fresh appreciation for all we have gained through our own situations.

 Photo Courtesy Erik Thorson 2023

God's Rest for Uncertain Days

The recent COVID-19 pandemic has now blown America from complacency into full-blown panic. At special risk are senior citizens and those with medical conditions that compromise their immunity.

Like many caregiving families, we have struggled to keep ourselves and loved ones safe without giving in to the fear. Our household consists of a vulnerable adult who is being cared for by two at-risk seniors. We recognized the risks early on and quickly ensured that we were as ready as possible for a serious outbreak of this virus.

No, we didn't hoard toilet paper.

Yes, we bought the proper medical supplies and household needs for a few weeks of possible isolation. We already had most of this in place before the crisis hit.

At this time, we are instituting our own policy of social isolation that we will evaluate on a week-by-week basis until the course of the virus appears to be waning. We use stringent infection control measures in our home. We've done all we can for now.

Still, the uncertainty has cast a pall upon our home as the seriousness of this pandemic is commanding the airwaves. We worry about our loved ones around the country. Our beloved granddaughter is facing the very real possibility of having to postpone her much-anticipated wedding. From serious illness to financial strain to personal loss, people are experiencing trials on many levels.

In the midst of anxiety, there is one place we can run.

When I read this Psalm, the image that comes to my mind is that of a hen sheltering her chicks under her wings. I remember fondly the little banty hens we had when I was growing up. The chicks always knew to run to their mamas if they were threatened. The hens spread their wings over their babies and pecked anyone who got near. There was something so comforting in watching the little ones sleeping under their mothers' wings.

In some Bible versions, the word abide in verse one is translated as "rest." When trouble descends upon us, we can rest in God's shelter. It's supposed to be the place we live. God is strong and mighty and a loving Father. He is our deliverer and the keeper of our souls.

So as we live out a long, hard winter, we can do two things:
Exercise infection control  
Live in rest.


PSALM 91

He who dwells in the shelter of the Most High
Will abide in the shadow of the Almighty.

2 I will say to the Lord, “My refuge and my fortress,
My God, in whom I trust!”

3 For it is He who delivers you from the snare of the trapper
And from the deadly pestilence.

4 He will cover you with His pinions,
And under His wings you may seek refuge;
His faithfulness is a shield and bulwark.

5 You will not be afraid of the terror by night,
Or of the arrow that flies by day;

6 Of the pestilence that stalks in darkness,
Or of the destruction that lays waste at noon.

7 A thousand may fall at your side
And ten thousand at your right hand,
But it shall not approach you.

8 You will only look on with your eyes
And see the recompense of the wicked.

9 For you have made the Lord, my refuge,
Even the Most High, your dwelling place.

10 No evil will befall you,
Nor will any plague come near your [c]tent.

11 For He will give His angels charge concerning you,
To guard you in all your ways.

12 They will bear you up in their hands,
That you do not strike your foot against a stone.

13 You will tread upon the lion and cobra,
The young lion and the serpent you will trample down.

14 “Because he has loved Me, therefore I will deliver him;
I will set him securely on high, because he has known My name.

15 “He will call upon Me, and I will answer him;
I will be with him in trouble;

I will rescue him and honor him.

16 “With a long life I will satisfy him
And let him see My salvation.”

https://www.biblegateway.com/passage/?search=Psalm+91&version=NASB

Is Your Phone Making Someone Sick?

At a busy doctor's office recently, I got in line to check my son in for a routine visit. Instead of the old-school clipboard they used to update patient information, the receptionist handed me an electronic tablet. I took it reluctantly, scrolled through the prompts with the stylus, and confirmed the information on the display. I stood back in line and handed it in.

Then I went to the bathroom and thoroughly washed my hands.

Am I paranoid about getting sick? Yes, I am. As a caregiver to a son with high medical needs, I can't afford to be sick for even one day. Although we have grown children who help us a lot, I am the only one who does all the skilled nursing treatments required by my son's high-level spinal cord injury. And because we operate a certified nursing home to care for our son, regulations define who can come in to assist us.

Our son's fragile respiratory status, his father's commitment to watch him every night while he is on the ventilator to sleep, and our youngest daughter's struggle to juggle caregiving with a full-time job, makes the health of our household a vital concern.

A cold for others is an inconvenience. For us, it is a disaster.

According to a recent issue of RN Idaho, a magazine published by the American Nurses Association of Idaho for Idaho's nurses, my concerns about mobile devices are well-founded. In the article, "Mobile Bugs: Are Pathogens on Your Devices?" the authors assert that mobile devices are, indeed, potential reservoirs for pathogens.

Every year more than 90,000 people die in the United States from healthcare acquired infections, also known as HAIs. HAIs are infections acquired during a stay in a hospital. Researchers have found that up to 95% of phones in hospitals were colonized with bacteria, of which 5% were pathogenic. Some pretty nasty bugs were found on them, including MRSA, E. coli, Acinetobacter, Enterobacter, Klebsiella, and Pseudomonas. Viruses like rotavirus and adenovirus were also discovered.

The most disturbing news was that most healthcare providers reported that they didn't regularly clean their mobile devices. Although a direct connection between contaminated mobile devices and HAI's has not been established, it should be treated as a real possibility.

And even though research has concentrated on HAIs in a hospital setting, common sense would suggest that community settings - and especially ones in which sick people are concentrated - should be treated as potential infection pools, as well.

Prevention from infection can be as simple as regularly cleaning our own mobile devices at home and those we use on the job. It should, of course, become a habit to wash our hands before feeding or otherwise giving care to those in our charge. And we should speak up when we see a healthcare provider forget to wash up before providing care to us or a loved one.

Breaking the cycle of infection is an important way to keep ourselves and those we love healthy.





Callegos, Cara; Hong-Engelhard, Cindy; McDuffee, Veronica; Boeck, Caitlyn (2017, August, September, October). Mobile Bugs: Are Pathogens on Your Devices? RN Idaho, 5.

Sort It Out: Triage in Caregiving

Not long ago, Carole Bradley Bursack of Aging.com posted “10 Caregiver Confessions: Secrets We Aren’t Proud Of,” in which she listed ten “non-angelic” thoughts she had heard caregivers express over the years. They are the dark confessions of people under stress.

Loving, devoted, committed people get burned out caring for their loved ones. 

It doesn’t make them evil. It makes them human.

Is it possible to survive and even thrive as a caregiver? I believe the answer is, “Yes.”

After we received the call about Kevin’s accident, we drove through the night from Idaho to meet him in Calgary. Shortly after we arrived, we had to fight back a push for euthanasia. He was on life support and needed surgery to stabilize his spine and provide an access point for the tube into his airway. Until the surgery, he had to have the tubes in his mouth. After surgery, the tube to the ventilator was attached to a tube in a hole in his neck, called a tracheostomy.

He was flown back to the United States for rehabilitation and nearly died twice before making it to rehab. In rehab, Kevin learned how to live in his new body. We learned how to care for him. We went through an intensive program, because we had to convince the hospital we could care for him at home. This hospital had never released a person with this high of a spinal cord injury home. 

They told us in the beginning it would be “impossible” to care for him due to his fragile condition and high medical needs.

For us, there was no doubt. We would be taking him home.

During rehab, he surprised the doctors by gaining back some function and feeling. Eventually, he was able to return home to live. Although he gained back more than was first expected, he still was mostly disabled.

He came home on life support and required 24-hour care. At first, the state of Idaho provided nursing care for him under the Katie Beckett program. After two years, when he turned 21, the program ended for him, and we became his full-time caregivers.

I quickly realized why we were told at the rehab hospital that it would be “impossible” to care for him at home. Everything fell into pieces around us as we spent all day and all night, every day, keeping Kevin alive. Emotionally and physically, we were soon exhausted.

I knew that if our lives centered around Kevin and his care alone, we weren’t going to make it. We were committed to keeping him at home, but we had to do something differently.

So I began to employ the principle of triage. Now, I wasn’t a nurse at the time. This was something I did instinctively at first.

According to Taber’s Cyclopedic Medical Dictionary, the term triage comes from the French and denotes “sifting” or “sorting.” Keep those words in mind. They are important words to remember. It is thought to have been developed during the Napoleonic Wars and further developed during World War I by French doctors.

The medical definition of triage is enlightening:

1:  The screening and classification of casualties to make optimal use of treatment resources and to maximize the survival and welfare of patients.

Although triage originated in the military as a way to allocate scarce resources on the battlefield, today it has been expanded for use in disasters and emergency rooms. 

Triage has evolved into sophisticated models but still strives to address the dilemma of how to allocate scarce resources in urgent circumstances in a way that is both fair and compassionate. These models are based upon the so-called “primitive” model, in which patients were usually divided into one of three categories:

Category 1. Those who will not survive, even with treatment.

Category 2. Those who will survive without treatment

Category 3. Those whose survival depends upon treatment

Out of those three categories, who is going to get treatment first when catastrophe strikes and resources are scarce? 

Imagine being one of the first responders on an earthquake scene and the ambulances haven’t arrived yet. 

You find three people in the rubble. One person is obviously dying. You do what you can to make him comfortable and move on to the next person. This second person has a superficial scrape. Again, you make him comfortable and move on. The third person requires your immediate care to live.

This is the one you treat first, because he is the one whose survival depends upon you.

I love this comparison. When you have gone through a catastrophic illness or injury with a loved one, you feel like you have been on a battlefield. Life literally becomes a daily fight for survival.

But I think we’re made for more; not just to survive life’s challenges, but to conquer them.

Life is a battlefield. Your loved one is the wounded. You are the scarce resource.

Now let’s take this and direct to the sorting and sifting of life’s issues in order to learn how to care for your loved one, your other relationships and duties, and yourself without falling apart.

Remember Tabor’s definition of triage as a way to maximize survival and welfare? 

This is our goal in “sorting” out our lives according to a system of priorities. Remember, we are not deciding who lives and who dies. We are applying this system to prioritize our lives.

When we first brought Kevin home from the hospital, our goal was survival. But as the years have gone by, we have come to a place where I can honestly say we’re happy. We’ve moved beyond mere survival to a place of well-being.

Sometimes people ask us how we’ve made it so long caring for Kevin. My first response is that we have been granted the strength by the grace of God. Remember that they told us it would be “impossible” to care for Kevin at home. Through God’s grace and prioritizing our lives, we have been able to accomplish “the impossible” every day for nearly two decades.

But I also know it has been the result of a daily process of learning to sort out our lives.

So how do we employ triage as caregivers? 

Let’s take those three categories and use them to “sort” or “sift” out our lives:

1. Those situations that cannot be salvaged, no matter how much time and energy we invest in them.

2. Those situations that will resolve themselves without our help.

3. Those situations for which we are uniquely qualified and which will only improve with our attention and resources.

We are only human. We can’t waste our energy, time, and tears on those things which are beyond our control (category 1) or which will resolve by themselves (category 2). The trick is to know which is which!

Here’s my formula:

1. I made sure Kevin isn’t the center of my world, even though his care needs are extensive. Kevin felt very guilty about what he had done to our lives. That was too much pressure for any one person to bear. For our family, we established our faith as our center. That means we are all serving something beyond ourselves. It gives us a reason to work together toward a common goal. It eased Kevin’s guilt and gave us a sense of destiny and purpose. Our situation became a vehicle for moving forward in hope instead of idling at a dead end filled with regrets.

2. Next I “sorted” through our lives and decided how I was going to spend my energy and time. I knew that Kevin would die if he were sent to an institution, because his medical needs demand one-on-one monitoring day and night. I thought about what that would cost me and made the conscious decision to put my energy into helping him live. My next priorities were my husband, children, and grandchildren –my most important relationships. 

3. I have tried over the years to keep a solid boundary around those priorities. As Kevin has improved (He’s off the vent on days now and can move and even walk with help), I have been able to add new activities, such as writing and speaking. But these aren’t in the same category for me. I know I can cut them out should our situation change.

4. I understand that my health is also in the third category. Because of this, respite is crucial for us. I know it isn’t that simple. We always hear people telling caregivers to “take care of yourselves.” That’s easier said than done. Getting respite for most us is difficult.

Sometimes respite is more of a change in attitude than a change of scene. When the weather’s nice, my husband and I will sit out on the deck with cheese and crackers and pretend we are at a street café in France. We’ll have coffee in the breakfast nook and ignore the fact that it’s noon and Aaron just awakened from a night of watching Kevin. Because we love the ocean, we painted our bedroom in colors that remind us of the Caribbean and put an aquarium in there. It was a struggle at first to learn how to enjoy life again without feeling guilty. But that came, too.

5. After I determined what priorities are non-negotiable, I experienced a sense of freedom in knowing that it wasn’t up to me to take care of everything that came my way. I began to sift through the other events in my life and choose those things upon which to spend my energy. I learned to allow other people to make us dinner in our house (I used to have a hard time turning my kitchen over to others). I tried not to worry if the toilets had mold in them and someone stopped by unannounced for a visit. I also learned to speak up and ask others not to come over if they were sick. Drawing boundaries helps us stay sane.

6. I gave myself permission to say no to things that I don’t have the energy for. I have discovered that they will survive without me.

7. I try to save my heart for the truly important things in life and not waste emotional energy and tears on things I can’t change.

Caregivers are nurturers. 

It’s in our nature to fix everything. We keep going until we crash.

But by sifting through the many demands on our time and resources, we can sort out what’s really important and live beyond simple survival. 

In medical triage, patients are periodically reassessed for possible reclassification.

It’s crucial that we do this, too. By periodically reassessing our roles as caregivers, we can forestall potential problems, keep our loved ones safe, and stay centered.

We can maximize our survival and our welfare and the welfare of those we love.

15 Inexpensive Ways To De-Stress As A Caregiver: Part 3

11. Need some serious quiet time? Pull out your Bible (or Bible Study), grab a favorite drink (tea or coffee), and find a comfortable chair. In case you like to write down your thoughts, be sure to include a notebook and pen for any spiritual revelations. Finding the time to read God's Word is not only relaxing for the body, but it's also refreshing to the soul. When you can combine both physical and spiritual rest, this is the key to a full and complete de-stress.

12. Take the time to catch up with old friends or close family members. Put aside a little free space from your schedule to talk on the phone with a loved one. Don't just call up anyone, call that one person that makes every day brighter - the one that listens - the one that makes you laugh - the one that understands you. Are you more of a writer? Find someone who would like to be your pen pal, and start writing some letters back an forth. It says in the Bible that "a cheerful heart is good medicine." What better way to de-stress than to laugh away the problems with a good and faithful friend/family member?

13. If you own a pet (whether it be a cat, dog, bird, etc.), buy it a new toy to play with. You can find pet toys anywhere - at a grocery store, pet store, online at Amazon.com. You don't have to spend much on the gift - just get one that you and your pet will really enjoy. This is a fun and effective way to alleviate stress. Not to mention, your furry friend will love it too!

14. Do you feel better when tasks are completed? Don't be afraid to ask someone for a little help with your home. If there's a certain individual that you know would be happy to offer assistance (and has mentioned it to you before), go ahead and call them up. Set up a day and time that works best for the both of you. You and your friend can clean, laugh, and catch up on life. Be hospitable. Provide a delicious snack and tea/coffee for a well-deserved break.

15. Put on some of your favorite music (a playlist is best) and light up an airy-scented candle. Set the mood for peace and tranquility in a secluded space in your home. Following the music, do a line of easy aerobics and stretches (don't over do it!). Remember, take it slow with each solid movement. Doing this every day will not only make you feel happier, but your physical body should feel more at ease.

As a young Caregiver, I hope this 3-part series benefited everyone in some way. Through the process of brainstorming ideas for this article, I learned new stuff myself. Curious... do you have any tips for Caregiver stress? I'd love to hear them! Leave a comment on this post with your suggestions. *Thanks*

15 Inexpensive Ways To De-Stress As A Caregiver: Part 2

6. Are you a music lover? CMADDICT.com (a Christian music website) offers free downloadable songs from their website (legal and 100% free). There's also online radio stations that offer a streaming of popular Christian tracks (all free): K-Love, Effect Radio (Christian Rock), Positive Life Radio, NRT Radio One - this is a selective list only, there's many more available online (especially, if you search for it on the web).

Looking for more? YouTube is the perfect way to discover new music. Type your criteria in the search field for what you want, and listen to your heart's content. There's music videos from artists themselves, lyric videos, instrumental music, and so much more!

7. Do you enjoy playing games? Bigfishgames.com offers a variable string of games (for PC and mobile devices, alike). Prices for games vary between $6.99 and up (this depends on if you buy the standard edition or collector's edition). Be sure to check their website regularly - they offer great deals on titles. You can also join a monthly membership for $6.99 - this provides one game of your choice for each month plus special offers/discounts.

Amazon.com includes a wide range of games for purchase - downloadable PC games, platform titles, and gaming apps. Don't want to spend the money? Big Fish Games allows a downloadable free trial play on most of their titles (you will need to download their game manager app to play). *Note* If you search "free games" online (Big Fish Games should be safe - I've used it), always be careful about downloading them - you could unknowingly add a malicious bug to your computer.

8. If you like to cook, Pinterest is your place. Unfamiliar with this site? Pinterest is an online community with "pins" from all sources imaginable (online or uploaded from users). You can find photos, videos, self-help articles, art, and etc. - this includes a number of recipes! Take the time to search for a meal that makes your mouth water, and save the recipe to your board (if you have one) or write it down on a piece of paper. Gather the needed ingredients, and cook yourself/family a delicious new serving of food. Want to save money? No problem. Pinterest also offers pins with meals on a tight budget.

9. Are you a sociable type, but can't leave the house? Blogs are a constructive avenue to connect with others like yourself. You can start your own blog with blogger.com or wordpress.com (both free), and share your ideas, life, and adventures. Without creating your own blog, another way to connect is to search the internet for like-minded bloggers/writers. Narrow your search down with what interests you (motherhood, photography, books...), and spend some time within that community. You can do so much on a blog - enter a giveaway, read articles, and chat with people.

10. Take up a hobby or pursue one of your favorites pastimes. You can scrapbook, piece a puzzle together, take photographs, sketch, read a book - do what brings you joy! You'll find that these are some of the best ways to de-stress from any situation.

Next week: Part 3 of 15 Inexpensive Ways To De-Stress As A Caregiver

15 Inexpensive Ways To De-Stress As A Caregiver: Part 1

1. Soak your feet in a plastic tub (whichever you have that would work) of warm water (you could also put in a little Epsom Salt). After a few minutes, dry your feet with a towel. Use your favorite lotion and give your feet a gentle massage. Once you're done, take the time to paint your nails with a fun color. If this is something you enjoy doing on a regular basis, be sure to buy some new nail polish to use (this is an inexpensive way to relax and your feet will thank you as well).

2. Like to read? Stop by the library and pick up a book. Are you a slow reader like me? Consider buying a used book from Amazon.com - check the shipping prices on each item. Compare the overall price with the new book from Amazon itself (ask yourself, is it cheaper to buy it used or new?). Like to read e-books? You can scan Amazon.com's listing of Kindle book deals or free e-books to download. When you read, don't forget to grab a delicious drink (tea, coffee, lemonade, and etc.). Finally, pick out a comfy chair in a secluded nook and escape for a few chapters.

3. Ready for a movie night? Rent a title from Amazon.com (prices range from $1.99-5.99 - Standard Version). Without first watching it, a rental should last from 15 to 30 days. Once you begin watching the rental, it usually lasts 48 hours. Be sure to finish it! Another option is to pick up a movie from RedBox - these are usually found interspersed within a town/city. Prices range from $1.50 a day for standard edition to $2.00 for Blu-ray a day (sometimes you can find a great deal on these!). Of course, none of this would be complete without a couple of your favorite snacks - popcorn and candy bars.

4. This can be the same as above, but with a television series instead. I love buying episodes from Amazon.com - standard version is only $1.99 per episode for 59 minutes or less. I usually try to stay away from buying an episode that's only 21 minutes long - doesn't seem like much for $1.99. Be careful, though. Because of the price, you may be tempted to buy one episode right after the other. Savor them and make the experience last - buy an episode every so often of your favorite show. This is nice because you can re-watch the episodes over and over again.

5. Not willing to spend the money? That's okay. There's ways to watch in a legal and free manner. Visit youtube.com and be random with your viewing experience. Spend your time watching funny cat videos, music videos, or even of a traveler in a different country (the possibilities are endless!). The videos on youtube are without limits, so type out a line in their little search box. And watch away! You can spend countless minutes without spending a single dime.

Next week: Part 2 of 15 Inexpensive Ways To De-Stress As A Caregiver