Caregiving: 5 signs you need a respite break

 When you are taking care of a loved one, putting yourself on the back burner happens naturally. Your primary focus is on the person you are taking care of and their health needs. You put yourself on automatic pilot to get things done. The only time you think about how exhausted you are is when you climb into bed at the end of the day. As the days turn into weeks, months, and maybe even years, the likelihood of reaching burnout is almost inevitable, especially if you don't take care of yourself too. As a caregiver, how do you know if and when it's time for a respite break?

What is a respite? 

The dictionary defines respite as a delay, cessation of time, or an interval of relief. Essentially, it's time away from the day-to-day of being a caregiver. You can think of it as "me" time, vacation, or a time out to rest, recharge, and recover.

You can plan your respite break, or the need could arise from a sudden emergency due to health or any number of personal reasons. The length of your respite break is up to you. It depends entirely on your situation. For some, it could be a few hours, days, weeks, or even a month.

Why is it important for caregivers?

Here are some interesting facts from the "Caregiving in the U.S. 2020" report from AARP Public Policy Institute and the National Alliance for Caregiving (NAC):

• There are 53 million caregivers in the United States, which is up 10% since 2015.
• More than a third of family caregivers say that their job is highly stressful, especially emotionally.
• Nearly 1 and 5 caregivers report that they have high levels of physical strain. 
• More Americans (23%) say caregiving has made their health worse.
• Nearly one in five are providing unpaid care to an adult with health or functional needs.

What about with COVID? That's a whole other wrinkle, where caregiving has increased around the world. If you cannot be there with them, you are doing your best to stay in touch and coordinate care from a long distance. Coordinating care from a distance adds a whole other layer of difficulty and stress. The bottom line, caregiving can impact you physically, emotionally, mentally, physically, financially, and even spiritually.  

What tasks fall under respite care?

The tasks that fall under respite care vary from person to person. It comes down to what you do regularly, how long you will be on a break, and assessing the health needs of your loved one. Here are some questions to help you think through the type of tasks you might need assistance with should you take a respite break.

• Do you need someone to provide supervision?
• Do you need someone to be there as a companion?
• Do they need health with activities of daily living (ADLs) such as dressing, bathing, going to the bathroom, walking, standing, and eating?
• Do they need help with medical care? Do they have specific requirements?
• Do you need help with household tasks such as running errands, laundry, cleaning, or yard maintenance?
• Do you need help with transportation to and from doctor's appointments, running errands, or going to church?
• Do you need someone to help with cooking and preparing meals?

When considering a respite break, here are some additional questions to think through regarding coordinating care.

• What length of time will you be gone?
• What things do you need someone to do? (ex. cooking, cleaning, medications)
• Are there any doctor's appointments happening during your break?
• Can another family member help out?
• Do you need to hire someone professionally?
• If so, how will that expense be covered (should there be other family members involved)? Does your health or life insurance cover any costs?

Discuss with your loved one and family members. Find out what the individual receiving care wants and what their comfort level is with each option. Discuss the options with everyone involved in the decision-making process, determine who can pitch in and help, assess the current needs, and select a plan. You can create this blueprint because you realize you need a break, or you can think about it and create a "just in case" action plan should you ever need some time away. Having a high-level idea of what you might do could be valuable during your journey. You can always create a plan now and make tweaks should circumstances become different regarding the level of care required.

What are the types of respite care available? 

There are different types of respite care available. It all comes down to what you need for your situation. The questions in the section above hopefully gave you an idea of what you might need.

You will also want to consider the length of time you for your break. Is it for a few hours a week, a few days, or weeks?

Based on your answers, you can start researching the types of care in your area. Here are a few ideas:

• Family Member or Friend
• Hire Professional Services for care, cleaning, cooking, etc.
• Private Duty Nurses
• Adult Day Care
• Assisted Living Facilities

No matter what option you choose, you will want to do your homework. You will want to look for reviews, conduct interviews, and do on-site tours for any facilities. It would be best if you determined your needs first. Then, start the search process. You'll want to play detective a la Sherlock Holmes to find the right option for you.  

• What's their experience level? 
• What's their plan of action or care?
• How do they handle emergencies?
• What's their background and training?
• Do they have references?
• Do they have special qualifications for this job?
• How much does it cost? 

What are their requirements for you? What will you need to do to make sure things run smoothly?

There is a lot to think through, especially if you cannot find another family member to help out and have to hire professionals. Look at all the options and determine what's best for you.

Search tip: If you want to go on Google and see what comes up, here are some suggestions to type into the search engine. For example, if you lived in Tampa, Florida. You can go to Google and type in "respite care in Tampa, Florida" or narrow down your search options further by typing in your zip code instead of city and state. Other terms: "adult daycare near me"," respite care near me", "assisted living respite care", "senior respite care", "short-term respite care for elderly", etc.

Here are five signs you need a respite break. 

Between the doctor appointments, errands, cleaning, cooking, laundry, and the list goes on. When do you find time for yourself? Let's face it; you don't. You are the cook, chauffeur, gardener, personal assistant, maid, nurse, etc. Your goal is to keep paddling, so you keep your head above water. Here are five signs it's time for a respite break.

1. You have compassion fatigue.

Does this mean you don't have compassion? No.

Does this mean you don't care about your loved one? Absolutely not.

Does this mean you want to walk out the door and never return? Nope (but you may have thought about it, kidding)

It means you need a break, especially if you find yourself impatient and easily annoyed. It's when you have a short fuse, and the little things trigger you. I get it on a personal level. When you see the same behavior day in and day out, it can get challenging. You try to be positive. You try to lift their spirits. All they know is that their health is declining, and their independence is lost. That's not an easy pill for anyone to swallow. You feel bad for them, and you wish their circumstances were different. You try to encourage them, but you end up doing this over and over again. Hello, short-term memory loss. 

After a while, you may slowly find yourself less and less optimistic.

You are tired, barely sleeping, and trying your best to hold it (and your sanity) altogether. You start to get a little attitude or give short replies because you are exhausted and overwhelmed, which is a sign you need to take time out for yourself.

2. Your Own Physical Health is Suffering

Caregivers tend to ignore their health needs because they are busy managing the health of their loved ones. When this happens, the caregiver's health can suffer. No one intends for one's health to take a back seat, but it happens. Existing conditions can worsen, or new ones pop up. If anything, goes unchecked it could grow into something more serious, especially if caregivers miss their doctor appointments or annual checkups due to a lack of time.

When you're busy taking care of someone else, you are stressed, restless, and worried. That lovely combination can lead to poor sleep and shoves your body into survival mode where you are operating on autopilot. It can be a slow progression, a headache here, and a sinus infection there. Of course, let's not forget about the aches and pains, especially if you are doing a lot of lifting.  

It's easier said than done. When taking care of my grandparents, we would rush around to appointments, do errands, and we wouldn't even get to sit down all day. On those days, we would grab something quick to eat. Then, there were other days where we would cook, do laundry, and sit around staring out the back porch windows. In between the rushed and the hushed moments was managing their health and making sure they took their medication, drinking enough water, getting rest, and making sure they were getting from one room to the next safely.

It's easy not to focus on your health during these times. Let me ask you this question. What would happen if you become ill or injured? What happens to your loved one? It may not be something you want to think about; however, if you are a caregiver for any length of time, you may want to consider how you can take care of yourself in the process, which may include a respite break. Remember, it's in the small things that add up to making a big difference over time!

3. Your Life's Feels Like It's On-Hold.

As a caregiver, have you ever had thoughts that you are missing out on life? Maybe you feel like you had to press the pause button or that your life is in a holding pattern. After all, when's the last time you did anything fun? When's the last time you had "me" time for yourself? Do you feel isolated from the world? We all probably feel that way with the COVID pandemic.

Feeling like your life's on hold is one of the unspoken feelings that many caregivers may not admit to, at least out loud. I found myself feeling ashamed and guilty when these feelings would pop up. Can you relate? As hard as it was, I'm grateful for that time. It's time with them that I can't get back. At the end of the day, I have no regrets.

It does make you think about your life in different ways. What have you given up so that you can take care of your loved one? It takes sacrifice to help your family. Maybe your family doesn't know what you had to do to be there for your loved one. When I think about the times I took care of my grandparents; I did have to sacrifice. I wasn't the only one. Many family members did so. But I don't think any of us regret taking the time and sacrifice.

If you are struggling with the fact that your life is on hold, perhaps you could make a list of what you want to do with your life. What have the experiences you are going through taught you? Have they shifted any of your priorities? Does it make you want to prioritize seeing your friends more or being outside in nature? Has it made you think about your health differently? Going through these types of questions can help you bring awareness and clarity.

In addition, try and find some time where you can get away. Even going out to dinner with friends or family might be a refreshing break. Take some time for yourself. It may seem like it's selfish, but taking time for you can help you be a more patient, loving, and present caregiver.  

4. Your Relationships Are Struggling. 

Caregiving can be stressful on relationships. Stress, sacrifice, time away, etc., all can impact your relationships with your spouse, family, and friends. You don't have as much time. You are trying to focus on managing your loved one's health and everything else. It's exhausting and leaves little mental, emotional, and physical energy for dealing with much else.

In stressful times when juggling a lot and forgetting things, even with post-it notes as reminders, it's essential to be open and over-communicate. Yep, over-communicate. Why? Because when you are updating multiple family members and friends daily, you forget who you told what. Sometimes a person might say, "wait, I didn't know that happened" or "you already told me that, twice."

Or maybe you are having a hard day when they almost fell – ten times! Or perhaps they are dependent on you to get up and down or to use the bathroom. Or maybe your head is swimming with questions after you visited with the doctor or perhaps considering if it's the right time for palliative or hospice care. Oh, and you need to cook dinner, do laundry, and mow the yard.

If no one has told you, you're doing a fantastic job. It's hard juggling it all, so sometimes relationships can slip through the cracks. It's not intentional on either side, but I believe it's critical to communicate with your spouse, kids, etc., how you are feeling or what's going on so that they understand what's on your mind. No one is a mind reader. If someone wants to call you, but it's not a good time. Call them back or text them later, perhaps scheduling a call around your schedule. No matter what, try to extend and show grace to yourself and others. Don't be easily offended because everyone is doing the best they can. But if your relationships are in trouble or an ultimatum stage, perhaps you need a short break to re-open the lines of communication, reset expectations, and get things back on track.

5. Your Anxiety and Stress Are Overwhelming

It's normal to be anxious, stressed, and worried when you are caring for someone else. You might even be going through anticipatory or early grief because you know what's coming. It's easy to have days where you are depressed and overwhelmed. Many times, you feel you have to hide it. After all, you want to be encouraging to your loved one. You don't want them to see you upset. For me, I would cry in the shower and talk (or vent) to a trusted few. It's crucial for your mental health to journal or vent to someone so that you don't bottle or hold everything inside. If you get to a point where your emotions are becoming too much, you feel disconnected and not fully present; then it may another sign that it's time for a respite break.

Takeaway

Think about this: If you take a couple of days or weeks off, how would that improve your life? How would that improve your mood? Would that make your caregiving to-do's a bit easier? Imagine if you had a few days off to sleep, have fun with friends, or go to a doctor's appointment.

Overall, taking a respite break is not a sign of weakness. It's not a sign that you can't handle being a caregiver. It's brave and courageous to admit when you need a little help. Granted, to take a respite break is a lot easier said than done. There is no point in denying that fact. There is a lot to coordinate and many factors to consider.

If you've been caregiving a long time, you might already recognize the need for a break. Hopefully, this article gives you a few ideas on how to make that happen. If you have more questions, you can always ask your loved one's primary care doctor for help and additional resources.

If you are new to your caregiving journey, this may be an excellent time to plan ahead. There could come a time where you need a break or an emergency comes up that could pull you away. In these instances, you want to have a plan in place to take care of yourself and your loved one.

We cannot do everything on our own, and caregiving is no exception. Lean into the help you have around you. If you don't have family, friends, or anyone to support you, then reach out to your doctors to discuss. They can point you in the right direction. Caregiving is no joke, and breaks are sometimes needed. Either way, thank you for being you and being there for your loved one.