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Posted: July 07, 2004

Professional Caregiving

Caregiver, Heal Thyself! Or At Least Seek The Help That Can Help You Too!

I have been there. When my mother had her third bout with breast cancer, I was the only daughter in town, and there was no question as to who would provide the care my mother needed.

After the surgery and hospital stay, I went to her house every morning before work, helped her with her bandaging, cleaning the burned skin from the radiation, assisting her with dressing, housekeeping and meals. I called throughout the day, often picking up medicine from the pharmacy, or dropping by during the day, just to see her when her voice sounded low during our afternoon phone chat.

She was lucky, and determined to get back on her feet, and did in time. Yet, while she was recuperating from her surgery, and recovering strength during her chemotherapy and radiation treatments, I was ?on-call,? designated by no one but myself, but never would I have thought of myself as a ?caregiver.? I was simply stepping in to be there for my mother as she had, while raising us and then again, when my father became ill.

I felt very lucky to work in an environment, a community center, that recognized that family caregiving, when needed, was the right thing to do. My frequent calls, my absences due to her doctor?s visits, or late arrivals due to difficult morning bandage changes were not only tolerated, but acknowledged and supported. I was lucky. I also had the benefit of knowing the resources -- in-home workers, meal and pharmacy delivery, to name a few ? that we took advantage of when I was not able to be there.

Ironically, many businesses in today?s eldercare industry, where the primary target market is the caregiver, forget to look inside their own walls for signs of caregiver/worker stress in its own staff. Just because we work with the elderly or disabled, it doesn?t mean we don?t have families who experience the same stressors as those of our customers or clients. Actually, we are sometimes even less likely to see these considerations within our organizations than we would like to admit.

I have heard nurses say they are the ?worst? patients. Well, I don?t know if I would venture to say that professionals working in aging are less likely to access community resources, but I will say, anecdotally, those in the helping professions seem to have a harder time accepting help themselves in their private lives than the general population.

And that?s my point: We think we can do it all, but we obviously can?t. We all need to give ourselves permission to use resources that will allow us to maintain our own ability to care for our families and perform in our formal caregiving jobs without suffering the health and well-being damage caregivers, who don?t ask for help, experience!

I guess I never thought of myself as a ?working caregiver,? but I certainly fit the bill. Sandwich Generation? Who me??? Children on one end, me at work in the middle and parent care at the other. The distraction, stress and exhaustion related to my mother?s need for care and attention created the same identifying symptoms to which managers and supervisors should be sensitive. The sandwich -- with me as the baloney, turkey or melted cheese, depending on my stress that day -- is harder to identify close up than it is when looking at others.

Picking up on the myriad of changes caused by juggling caregiving with full-time work can save businesses valuable financial, human and production resources. In 2002, the Alzheimer?s Association computed the financial cost of caregiving to the business industry -- $37 billion in lost worker productivity, and that is just for caregivers of the 4.5 million Alzheimer?s sufferers! Seems like we, as business owners, managers or consultants, and potential family caregivers ourselves, should take this very seriously.

What should the attentive employer be looking for? And what should they do if they suspect an employee is dangerously burning the candle at both ends due to doubling up on work and temporary or long-term caregiving?

1. Observe

When employers see either incremental or abrupt changes in everyday worker performance, it is a red flag that something is going on. Have work habits changed? Have arrival/departure times become less predictable? Is productivity -- as seen in initiative, energy or leadership -- declining? Has the employee returned from vacation more exhausted than when they left? Maybe they relieved a caregiving sibling for that important week?

A sensitive manager will invite the employee in for a discussion on what his or her observations have been, and what resources the company could offer to lessen the worker?s stress or burden, if expressed.

2. Provide

Instructions by flight attendants, given in the event of oxygen loss in the airplane cabin when flying with a child, apply in caregiving situations: First, your own mask must be put on before that of the person you are caring for. Likewise, the employer can have the most powerful impact on the worker, if they readily hand the ?oxygen mask? to the working caregiver when symptoms show up.

Providing access to caregiving resources, education and support, preferably on-site, can have significant impact on the worker. It has been noted that nearly one third of all workers have some caregiving responsibility, whether direct or long-distance. Calls, care arrangements, doctor?s appointments and face-to-face help translate into exhaustion in the workplace. Worry, stress and day-to-day family demands affect the worker?s ability to focus, be productive and take initiative.

As a matter of fact, a mind full of worries can fuel depression, which can further diminish the worker?s ability to perform in his or her job. It is known that Sandwich Generation caregivers are often too busy to find the resources that would relieve some of their biggest burdens. How is it we can bring these resources to them?

One of the adult day programs with which I am involved offers monthly information/education or support programs during the lunch hour at local businesses. Having a ?user? of the center advocate for the need for this with their employer is the toe in the door that might be needed for this offer to be considered seriously by the decision-making person at their place of work. The concept is simple, and no one loses -- the benefits for the employee, employer and the service provider are shared.

When free, on-site resources are offered, the employee does not have to make other arrangements after work or on the weekend to get information and support. And if they did, at least half wouldn?t. The worker will also feel their situation is being acknowledged and supported by their employer, and this makes for a more trusting, open relationship as they come to see they don?t have to hide or deny the source of their stress. I can personally say that I was much more appreciative of my employer as a result of their sensitivity to my situation than I would have been, had I had to hide or deny the stress for fear of losing my job.

3. Support

If the employer brings the right resources to their working caregivers, they play a role in being part of the solution many employed caregivers need. Informational fairs, access to geriatric care managers through EAP, support groups and flex time can be made available at little or no cost, considering the enormous alternative cost of ignoring it.

Because we, in the elder-caregiving industry, understand caregiving, caregivers and their family members? issues, we should ensure the accessibility of these same resources for our own employees ? and ourselves.

Our industry should be the model for the rest of the business world, demonstrating that what we help others access, we will need as well if we find ourselves caring for a loved one. It is a powerful and validating message about the impact our work can have on us, just like it has on our clients. All of us need these supports to do right by our families and clients when a family member needs care.


Sylvia Nissenboim is a licensed clinical social worker and who has been working in the field of adult day services in the St. Louis area. She is the director of four adult care and enrichment centers for the American Red Cross and also operates a personal and professional coaching firm, LifeWork Transitions, specializing in caregiving concerns, adult day care management and other aging services, such as virtual coaching and family care giving support groups. She co-authored The Positive Interactions Program, is a national speaker, and has served as president of the Missouri Adult Day Care Association and as a member of the Missouri Governor's Advisory Council on Aging..

© 2004 Pederson Publishing, Inc. All Rights Reserved.
Commercial use, redistribution or other forms of reuse of this information is strictly prohibited without the prior written permission of Pederson Publishing.

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