This past week I had an opportunity to speak to a small gathering of nurses about how to engage in conversation with family caregivers about self-care.  Using the framework of my book, Self-Care Strategies for Family Caregivers, I offered the 5-part model that includes these arenas for self-care: Educational, Emotional, Spiritual, Physical and Grieving.

I explained that when I talk to family caregivers I tend to start with these simple and non-sexy areas just because they don’t align with what the modern messages the health & wellness industry tends to offer us.  If you listen to commercials, the ads on social media and the common vernacular for self-care, you’re rarely going to hear such meat-and-potatoes language. 

The media would have us believe that self-care is mainly about taking exotic supplements, drinking the latest effervescent beverage laced with just the perfect mix of herbs and minerals to replenish our electrolytes, or making reservations at the spa for our full-body massage with a clay mask application from the ever-so-special hot springs nearby.  While each of these things may be lovely, these are not the strategies most of us need or welcome when we’re overwhelmed with the responsibilities of caring for someone who is ill. Nor are they the activities we turn to for sustaining ourselves over the long-haul of most caregiving journeys.

The five arenas I offer are designed to jolt us (caregivers) back into the reality of everyday life and are intended to lay the groundwork for deeper work in self-care, once the caregiver has begun to address these simple, everyday areas of life.

•  Educational Needs – These are the most basic needs any of us will encounter when we take on the role of family caregiver.  What do we need to know about the family member’s condition? What are the specifics that will help the family cope with the journey that’s about to unfold? How can we become proficient in understanding the basics of the diagnosis and what is the prognosis we can expect?  Without this kind of basic knowledge, we’re left in the dark and frequently surprised by next turn in the path, or blindsided by the presence of new symptoms, or worried about what is about to happen next.  It is an act of essential self-care to become fluent in the language of the illness or condition your loved one is facing.  To be afraid to learn what lies ahead is to try to cope with one’s head in the sand.
• Emotional Needs – In every caregiving situation there will be an emotional component.  It may come from the magnitude of the information you absorb in managing your educational needs – that sense of overwhelm that it’s just too much to manage – or it may come from the exhaustion of sleepless nights, too many things rapidly added to your to-do list when a family member is discharged from a care facility, or the burden of having to manage it all.  Our emotions are slippery things.  They bubble up when we least expect them and take over our whole being.  They may bring on an angry reaction for the slightest sort of upset or make us weep uncontrollably without even knowing why.  Emotions are rarely something we’re comfortable discussing, so to become familiar with your own array of emotional states and to give language to them is valuable for navigating the journey of family caregiving.
• Spiritual Needs – Religious or not, we all have spiritual needs.  A family illness, the realization that you’ve become a caregiver, the presence of an intrusive illness in the house, will reveal them eventually.  Spiritual needs are sometimes hard to tease apart from other kinds of needs, especially emotional needs.  They can feel very similar.  For me, spiritual needs are distinguishable by these three characteristics…

1. Does it gnaw at my sense of self? Does it make me question who I am, whether I’m sufficient to do the tasks before me, whether I will survive the experience?
2. Does it separate me from my sense of community? Does it make me feel isolated, disconnected, or distant from those I love and those I know care for me?
3. Does it make me question my beliefs? Does it make me doubt what has sustained me for a lifetime, to wonder if there is any justice in the world or to ask, “Why me?”

If I can answer yes to any of these three (and certainly if I answer yes to all of them) then the need is, at its core, a spiritual need.

• Physical Needs – By this I mean the most basic of human needs; things like adequate nutrition, hydration, activity, rest and especially sleep. These can get very compromised when you step into the role of caring for someone else’s needs. For proof, look at any first-time parents in the weeks following the birth of their newborn.  Everything feels off kilter. No one is managing self-care; all attention is focused on the demands of the new family member.  It can be that way when a loved one becomes ill. Your own routines and rituals disintegrate and will need to be rebuilt within the confines of a new schedule, a new set of tasks and a new rhythm to family life.
• Grieving Needs – Illness brings grief. They are partners that travel together.  There is the grief that comes from a disrupted life of everyday expectations. There is the grief of having to alter plans, to give up attending celebrations, to abandon plans for a vacation, or to rearrange life as we knew it for a life we are only beginning to understand.  And, for the person who is ill, there can be a separate layer of grief for lost capacity, loss of health, or a stark realization of mortality. Grief comes to set up camp in our midst; learning to sit with it is challenging for any caregiver.

Self-care is every conscious action you take that feeds your soul, nourishes your body, nurtures your spirit, or replenishes your relationship with yourself!

The role of family caregiving will certainly bring these needs to your attention, whether you can name them or not. Learning to attend to them as they reveal themselves will strengthen your self-care muscles and put you on a path to better outcomes for yourself and those who look to you for leadership and wisdom amid a family illness.  I think it was the late First Lady, Eleanor Rosalynn Carter, who said, “Each of us will either know a caregiver, be a caregiver or need a caregiver. There is no escaping it!”

If you are struggling as a caregiver or know someone who is, please share this email with them and invite them to subscribe as you have to my bi-monthly messages.  There is a pathway through even the most difficult journey of caregiving, but it is built on solid self-care practices that we must invest in and learn. And as always, let me know if I can help!