REACH VA - Caregiver Notebook - Stress Management

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Caring for a dementia patient can be very stressful. Long term stress is harmful to the body and mind. There are stress management strategies that can help you learn to relax and help you to plan events that bring you pleasure. Learning these strategies can help you cope with the daily challenges you face. Learning to reduce stress and using these new strategies takes practice.


Here are some stress management strategies that you can use:
• Signal Breath • Music Relaxation Exercise • Stretching Relaxation Exercise • Pleasant Events

How to deal with your stress…


Some effects of stress…
Potential physical effects of stress.
When a stressor continues for a long time, it can take a toll on your health. As caregiving can be a long-term stressor, you could be at risk for High blood pressure. Heart problems. Increased susceptibility to colds and flu.

Potential psychological effects of stress.
When left untreated, stress can cause depression, anxiety, anger, and irritability. Some people feel that they do not have the energy to do routine tasks and start to feel hopeless and helpless and cry often. Some people may feel exhausted and empty. Stress can take away from quality of life, by lowering a person’s ability to experience pleasure and a sense of accomplishment.

Potential social effects of stress.
Your friendships and relationships can suffer due to the challenges of caregiving. Forming and maintaining social support can relieve stress by giving you a chance to discuss your thoughts and feelings. It is common for caregivers to feel that no one understands what they are going through. However, caring for someone with memory problems does not have to be a lonely experience.

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As the behaviors and care needs change in the person with dementia, let friends and family members know when you need help, or even just a break. Caring for a loved one with dementia is too big a job for one person. Support groups can give you a chance to meet others who have similar experiences. Caregiver stress can lead to illness or burnout if you do not take steps to prevent it.

Steps you can take.
Take a walk or make time for other types of exercise. Make time to spend with friends and family you enjoy. Call friends, neighbors or family on the phone to stay in touch with others. It’s still important to laugh! Use your sense of humor. Listen to tapes, records, television or people that help you laugh. Talk things out with a friend or get professional help if needed. Learn and practice relaxation techniques. Maintain religious or spiritual practices that are important to you. Try to solve problems as they come up rather than avoiding them. Ask for help or let others help you. Establish priorities and organize time more effectively. Let the small stuff go. Stop running negative thoughts and attitudes through your mind and learn healthier ways of thinking about yourself and your situation.

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Take time for your physical health.
Keep your own doctor, dentist, and other healthcare appointments. 
 Take prescribed medications as suggested by your doctor. 
 Try to get enough sleep and rest. Talk with your doctor and other 
 caregivers about ways to get enough rest. 
 Avoid smoking or relying on alcohol or drugs to feel better. 

Learning to relax...
Learn to rate your level of tension or stress.
It is helpful to learn to rate your level of tension both before and after a relaxation exercise. Doing these ratings helps you find out which strategies work best for you. Before the relaxation exercise, I feel (Rate from 1 to 5).

Re-rate your level of tension after the exercise. After the relaxation exercise, I feel (Rate from 1 to 5). It typically takes time and practice to benefit from relaxation exercises.

Use this Scale to Rate Your Level of Tension 1 = Not at all tense 2 = Slightly tense 3 = Moderately tense 4 = Really tense 5 = Terribly tense

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Relaxation exercises… 

Try to use a relaxation exercise daily. Practicing can help you gain more control over your tension allowing you to better manage stressful situations.

Signal breath.
1. Rate your current level of tension. 2. Take a deep breath and hold it for a few moments – about 3 or 4 seconds. Don’t breathe so deeply or hold it so long that it is uncomfortable. 3. Breathe out slowly while saying a word or phrase to yourself. 	You may want to use the words “Relax” or “Peace” or the phrase “Calm down.” Any word or phrase will do as long as it is comforting to you. 4. While exhaling, try to let your jaw, shoulders, and arms go loose and limp. 5. Repeat these steps 2 more times. 6. After the signal breath, rate your current level of tension. NOTE: 	Practice the signal breath several times a day. Do it WHEN YOU ARE NOT TENSE. When you feel stress BEGINNING, catch it early.

Power of music.
1. Find the type of music that you find relaxing. 2. Sit down in your favorite chair. 3. Rate your level of tension. 4. Find a comfortable position in your chair and close your eyes. 5. Listen to a short tape or CD of some music that you find relaxing or find a radio station playing that type of music. 6. Let your mind and body relax with the sound of this music. 7. After the music session, rate your current level of tension. Stress Management…261

1. Stand or sit, whichever is most comfortable for you. 2. Rate your current level of tension. 3. Take a deep signal breath, down to the bottom of your stomach. 4. Let it out slowly, feeling the tension drain away. 5. Take one more breath and hold it. 6. Let it out slowly. 7. Gently reach your arms out to the side. 8. Relax your shoulders down and stretch yourself a little. 9. Gently reach your arms out in front of you. 10. Feel the muscles in your back and shoulders loosen up. 11. Stretch out in front a little farther. 12. Now reach up as high as you can. 13. Push your arms up higher. 14. Bring them down to your sides. 15. Repeat (Steps 7-14). 16. Roll your shoulders back slowly three times. 17. Roll your shoulders forward slowly three times. 18. Shrug your shoulders, lifting them up and pressing them down slowly three times. 19. Take another signal breath. 20. Take a final signal breath. 21. After the stretching session, rate your current level of tension.

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Use this Scale to Rate Your Level of Tension
1 = Not at all tense 2 = Slightly tense 3 = Moderately tense 4 = Really tense 5 = Terribly tense

For each day select one situation to record. Try to do a relaxation exercise (Signal Breath, Music or Stretching) while you are in a stressful situation. If you can’t do that, record as much of this as you can anyway.
DATE STRESS COMMENTS (Important details about the situation, why I felt this way, and what worked or did not work etc.) Situation: ___________________________ Comments: _________________________ Situation: ___________________________ Comments: _________________________ Situation: ___________________________ Comments: _________________________ Situation: ___________________________ Comments: _________________________ Situation: ___________________________ Comments: _________________________ Situation: ___________________________ Comments: _________________________ Situation: ___________________________ Comments: _________________________

Before technique: ______ After technique: ______

Before technique: ______ After technique: ______

Before technique: ______ After technique: ______

Before technique: ______ After technique: ______

Before technique: ______ After technique: ______

Before technique: ______ After technique: ______ Before technique: ______ After technique: ______

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Pleasant events… 

Pleasant events don’t have to be big activities that require a lot of 
 They can be small activities that you do on your own, with friends, 
 or with your relative. 
 Even though these activities may only last 15 minutes, taking this 
 time out for yourself is important for your well-being.
 Anything you like to do is a pleasant event! 
 Start small and keep it simple! 
 Choose events that you can do everyday or a few times a week. 
 You may enjoy traveling, but realistically you cannot take a trip 
 every day. Go on a day trip to the mall, bike or walk. 
 Here are examples of events that you might find pleasurable: 
 Listen to music Window shop Read Do crafts Rent a video Go for a car ride Enjoy flowers Take a nap Listen to the radio Have friends over Be with your children Stress Management…264 Take a walk Buy something for yourself Write letters, cards Exercise Go to the movies/a museum Have a picnic in the park Garden Look at the moon and stars Watch your favorite TV show Cook your favorite foods Go out to eat with a friend

Figure out pleasant events that you or you and your loved one could do on a regular basis. Create a list of possible activities and write them down on these lists below. MY LIST OF PLEASANT EVENTS

☺ ☺ ☺ ☺ ☺ ☺ ☺ ☺ ☺ ☺ ☺ ☺ ☺ ☺ ☺
1. 2. 3. 4. 5. 6. 7. 8. 9. 10. LIST OF PLEASANT EVENTS FOR US 

☺ ☺ ☺ ☺ ☺ ☺ ☺ ☺ ☺ ☺ ☺ ☺ ☺ ☺ ☺
1. 2. 3. 4. 5. 6. 7. 8. 9. 10. Stress Management…265

Pleasant Event to Do This Week Pleasant event for me this week is: Pleasant event for us this week is: Plans for Scheduling This Week 1. I need the following materials to do
(chosen pleasant event)


(chosen pleasant event)

will take place at the following location: be done?
(chosen pleasant event)

3. When and how often can 4. How much time will
(chosen pleasant event)

take? are:
(chosen pleasant event)

5. The steps I need to take in order to complete a. c. b. d

I will do my pleasant event on the following day(s) and time(s):
Day Monday Tuesday Wednesday Thursday Friday Saturday Sunday Time (circle) am/pm am/pm am/pm am/pm am/pm am/pm am/pm

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