Pouring From an Empty Cup: Why self-care for caregivers is essential

Being a caregiver who provides unpaid care to a family member or loved one with health or functional needs is a vitally important, demanding job. And many families are caring for their loved ones at home. Many have no other option. As of 2020, there were over 53 million adult caregivers in the United States, and with the Boomer generation retiring and medical advancements, that number is only expected to grow. In addition to the stress of managing a life-altering diagnosis or losing a loved one, the physical labor and related complications and logistics of care can take a toll on the mental and physical well-being of the person providing the caregiving. Just as we are instructed on airplanes, we must put on our own oxygen mask before helping others with theirs. It is important to take care of yourself when caring for others to help prevent or reduce burnout. 

Why you need to care for yourself

You may think: “But I don’t have any time to take care of myself! Every last minute is spent taking care of Mom or Dad.” I invite you to consider what might happen if something were to happen to you. What if you became incapacitated due to an injury or stress-induced illness and were unable to provide necessary care for your loved one? What if you were unable to ensure the safety of a vulnerable loved one? This is why it is important to make time to take care of yourself. As the saying goes, you cannot pour from an empty cup.

Start small. By taking a few minutes each day or a few times a week, you can create some support for yourself and fill your own cup back up. Here are a few self-care examples that can help.

Simple, doable self-care actions for caregivers

Practice Gratitude and Cultivate a Positive Mindset

How you think about your current caregiving situation can impact how you feel about it, and the resulting levels of stress that you experience. By focusing on things that you are grateful for, you can “boost [the] neurotransmitter serotonin and activate the brain stem to produce dopamine”, both naturally occurring ‘feel good’ chemicals in your brain. Look for things to be grateful for, even if it is as simple as being able to breathe, a pretty cloud on your drive, or for another day with your loved one. As you practice finding and acknowledging gratitude, you will notice even more things to be grateful for and the feedback loop will continue. Related to gratitude is cultivating a positive mindset. Looking for the silver lining in situations, being gentle with yourself, using affirmations, finding humor in life - these are all ways to cultivate a positive mindset. “When your state of mind is generally optimistic, you're better able to handle everyday stress in a more constructive way” and this can lead to better health outcomes. All it requires is a conscious effort, so why not give it a try?

Breathing Exercises

Our physical bodies are amazing things, and our breath, while providing life-giving oxygen to our bodies, also is directly linked to our nervous system. By focusing on our breath, and by practicing specific breathing patterns, you can affect your nervous system, which can then in turn affect how you feel and how calm your mind can be. 

One really simple and easy to remember breathing exercise is called Box Breathing, and it is so effective “that US Navy Seals use it to remain calm under pressure”. Think of a box, with 4 sides, and then as you breathe, each part of the breath is held to the count of 4. 

Inhale…2…3…4…Hold…2…3…4…Exhale…2…3…4…Hold…2…3…4…Inhale…and repeat that pattern at least 4 times. You can count to four as quickly or slowly as you like, however the slower you are able to count the more relaxed you can become. 

Another key thing to remember about breathing is that if you are able to increase the length of your out-breath, or exhalation, you can stimulate the ‘rest & digest’ response in your body (versus the ‘flight or fight’ response, which is the hallmark sign of stress). Sitting still, perhaps while watching a favorite show, and focusing on slowing down your breathing, with exhalations longer than your inhalations, can help reduce stress. 

Guided Relaxation or Meditation Programs

As mindfulness and meditation become increasingly more popular, there are a variety of ways to practice this on your own. From Apps to YouTube videos to books to classes (online or in-person) you can learn how to meditate and reap the benefits. 

For beginners, a guided meditation or relaxation practice might be an easier practice to start. A simple search on YouTube for “guided relaxation meditation” yields more videos than you could ever explore - just pick one and if you don’t like it, pick a different one. A visit to your local library or bookstore will yield a multitude of books on mindfulness meditation. Your local yoga studio will likely have recommendations as well. Insight Timer is a free app with over 80,000 guided meditations that you can listen to on your phone. For those wanting to make an investment in their meditation practice, Headspace or Calm are very popular apps that help with learning how to meditate, reduce stress, and improve sleep. 

Most meditation practices will center on the breath, so you can also start with a few rounds of your preferred breathing exercise, and then settle into a few minutes of quietly watching the gentle rise and fall of your natural breath. Just notice, and allow whatever thoughts that arise to gently subside back into the ocean of your mind, while gently bringing your awareness back to your breath. Try this for a few minutes, and work your way up to 5 or 10 minutes each day. 

Respite Care and Government Resources

The last piece of self-care is perhaps the most important. As a caregiver, you will find that there are times when you either need a serious break or you have other responsibilities to attend to and are not able to provide around-the-clock care for your loved one. It is ok to ask for help, and very normal to need help when providing full-time care. Often caregivers are with their loved one 24/7, and all relationships can benefit from time apart. Respite care also allows the caregiver to return to caregiving refreshed, and often allows for better care in the long run.

Other family members and close friends of the loved one are often a first consideration. Depending on how strong and healthy those relationships are, this can be a great way to include others in the care. Perhaps you can make it a regularly scheduled weekly or monthly occurrence so you can count on a break and they can be a part of this phase of your loved one’s life. 

Hiring a caregiver or home health aide is another common consideration. Medicare may cover some or all of these costs, depending on your particular situation. Another option is a drop-off adult day care, or overnight facility for short term stays. These services are often underutilized, either due to mistrust of others' ability to care for your loved one, or confusion about how to navigate the various state and federal systems that exist to help. 

Do know that each state has an agency dedicated to support aging adults and people with disabilities. Many states have grants available to provide respite care and regular care in addition to whatever care Medicare and/or private health insurance covers. In Vermont, the agency is called the Adult Services Division for Disabilities, Aging, and Independent Living. In Massachusetts it is called the Executive Office of Elder Affairs. These government agencies can help you find respite care and can provide other resources and services to help with the caregiving needs of your loved one. The National Care Planning Council has a list of all the agencies in each state that can help with respite care and other services and resources. You can also check in with your loved one’s primary care physician - some practices offer support in navigating these various state agencies and applying for aid. 

As a caregiver, you can only do so much as a single person. By taking care of yourself, you can help ensure that you are able to provide the best care you can, while not depleting your own reserves. Respite care is an often underutilized resource that can make a huge difference in your own quality of life, as well as in the quality of life of your loved one. Remember to take it one day at a time, look for the positives and humor in life, and do what you can to support your body and nervous system to function properly. 

Start Small. Start Now.

Remember to start small. By taking a few minutes each day for self-care, you can create some support for yourself and fill your own cup back up.