No one ever said that being a caregiver is easy. And it becomes twice as hard for those who are juggling those duties with their careers. It has only been over the past dozen years or so that anyone has told caregivers that it’s all right to take time out to watch a movie and savor a cup of coffee.
Barbara Stender, coordinator of the senior wellbeing program at Greater Trenton Behavioral HealthCare, has made it her job to remind caregivers that it’s OK — no, necessary — to take some time for themselves. Her reasoning? If the caregiver of one sick person burns out, who will now care for two sick people?
Stender leads a free support group program for caregivers of seniors on Wednesdays from 1:30 to 3 p.m. at Mercer County Connection, located in the Hamilton Square Shopping Center on Route 33 at the intersection of Paxson. Avenue. The program runs most Wednesdays through October 31. Call 609-396-6788, ext. 241, or visit www.gtbhc.org.
Stender became intimately familiar with senior caregiving when her mother grew ill in the 1990s. At the time, Stender’s father, an Army cavalryman, had died, leaving any care for her mother to Stender and her sister.
Stender, who grew up in Bergen County, was living in North Carolina when her mother decided to leave Florida for California, and the main responsibility of looking after her landed largely on Stender’s sister. Her sister, who had never had children, was not sure how to cope with taking care of someone else, Stender says.
The process of caring for their mother was arduous, but relatively easy, Stender says. Her mother voluntarily asserted that she should move to a nursing home and had already bought and paid for everything that she would need for the end of her life. There were none of the major issues of guilt or arguments that accompany so many instances of senior care. “And it was still really hard,” she says.
Stender, 72, spent much of her adult life in an educational role. She earned a bachelor’s in home economics from University of Delaware (today the degree would be called “family life”), served two years in the Peace Corps in Colombia, taught special education, and ran a Montessori School when her son was of school age.
And after what she calls “an eclectic background” post-Montessori, she became involved in gerontology when her mother took ill. She earned her master’s in the subject from North Carolina State University, and began working in senior caregiving in 2002, while she was living near horse country in North Carolina. “My father wanted us to love horses,” she says. The lessons stuck, because Stender has been a horse trainer. In 2004 she got offered a position at GTBHC and returned to New Jersey.
“It’s a very challenging job,” Stender says. “But its such a rewarding one.”
The issues. When a spouse gets to the point of needing constant care, the responsibility usually falls on the shoulders of the other spouse. The trouble is the spouse who ends up providing the care usually is also old and often dealing with personal health issues, Stender says.
On top of the healthcare they provide, spouses now also have to start doing the chores and work that their mates used to do. “It becomes double the housework, double the bills, double everything,” Stender says.
This dynamic rather quickly isolates a person, leading to fatigue and the inevitable cycle of depression, Stender says. The person being cared for becomes depressed over his own health issues and then becomes more depressed because of the burden he feels he is placing on his wife. The wife in turn feels depressed because she has become isolated and because she has had to give her entire self over to her husband, whose depression is frustrating.
When the responsibility of caregiving lands on adult children, there are frictions that show because these children have jobs and families and lives of their own. The energy drain, Stender says, is huge, as people try to juggle being providers to their parents and their own families. Often there are arguments, brought on by a combination of the adult children trying to work on a schedule and the parents trying not to be a bother.
Coping. Stender operates support groups, workshops, and programs to reach people who need to understand how to cope with the harsh realities of caregiving. The main reason for doing these programs, she says, is to put caregivers in the presence of other caregivers; to let people interact with someone who knows what caregivers are going through.
A lot of caregivers, Stender says, forget the importance of company other than the people for whom they are caring. They don’t take time to interact with anyone outside the immediate situation, and when they get a few minutes to themselves, rather than doing something enjoyable or taking the time to chat with someone else, “they’d rather do nothing,” she says.
And while “getting together with other people is really important,” Stender says, what is equally important is to appreciate the little things. The new “psychology of happiness,” she says, has looked into what it takes to stay positive, and, surprise, it’s not the great big moves — it’s the small stuff.
It is having a long cup of coffee by yourself in the yard. It is going for a walk around the neighborhood. It’s the little things that we always like doing, because they’re just life’s little pleasures.
Stender also teaches coping skills, particularly relaxation methods and exercises, for caregivers. Deep breathing exercises and muscle relaxation techniques can go a long way, she says, especially when a stressful situation comes to a head.
“What you don’t want to do is argue,” she says — particularly when dealing with someone who is suffering from dementia or Alzheimer’s disease. If it gets to the point at which an argument is about to happen, she says, walk away and come back.
Count Your Blessings. Also good for the mental health of a caregiver is the gratitude journal, a concept Stender admits can sound silly to some. But the idea is that every night before bed or every day before getting out of bed, write three things for which you are grateful.
Any three things, large or small, and repeats are welcome over the days. The whole point is to remind yourself that there is good in the world and that you don’t have to feel guilty for finding small joys amid a dire situation.
“It isn’t selfish to take care of yourself,” Stender says. “After all, what happens when you wear out?”