Helping caregivers take care of themselves

According to ASHA, the American Senior Housing Association, nearly 40 million Americans are providing unpaid care for another adult. The “average” caregiver, says ASHA, is a 49-year-old woman who has a job and also provides 24.4 hours per week of care to a parent, most likely her mother.

More than a quarter of these caregivers still have a minor child at home, more than half are helping financially support a grown child. They probably live within 20 minutes of the person depending on their care, but not always.

It’s National Caregivers’ Month here in the US, and because a large percentage of caregivers are women in midlife, we want to pay special attention to your needs. Too many women suffer physical injury or emotional distress from the extra responsibility, so we would like to offer a bit of help.

We went to our Doctors of Physical Therapy,  Dr. Meagan Peeters-Gebler and Dr. Brianna Droessler-Aschliman, to ask for tips on taking care of the caretakers.

What are the dangers to caregivers?

Back pain

Probably the most common injury they see caregivers suffer, says Bri, is lower back pain from moving the person they’re helping around.

“Transferring someone from wheelchair to a stationary chair, from chair to bed, into or out of the bath, if you’re not using good body mechanics, you can easily hurt your back,” says Bri. “If you’re going to be moving someone a lot, learn how to do it right.”

How do you do that? First, have a wide base of support by keeping your feet planted at least shoulder width. Don’t lock your knees. Lift with your strongest muscles: legs, hips, quads, and glutes, not with your back. Keep the person you’re lifting close to you, and don’t pull on their outstretched arms, which can hurt their arms or shoulders and also keeps you further from their center of mass, making you both unsteady.

Set up yourself up for success, Meagan adds: if you’re moving someone from wheelchair to recliner, get the chairs as close together as possible. And make sure you set the brake on the wheelchair!

Also, says Meagan, there are adaptive devices that can ease the strain on you: a slide board is a highly polished plank of wood or plastic for transferring patients. Position it between the chairs, help them get one butt cheek on it, and let them shimmy their way across as you keep them safe. You take far less of their body weight and can more easily assist if they lose balance.

Pelvic floor strain

Also, we know women in midlife need to be particularly conscious of pelvic floor strength and strain. When you’re putting a lot of extra strain on your pelvic floor by lifting or moving another person, you need to be sure you’re doing it correctly. “Breathe while lifting, Kegel while lifting,” says Meagan.

Also, be conscious of your posture. If you’re talking or reading to someone in bed, it can be easy to twist sideways and stay in that position for too long. “Shift position now and again,” Meagan advises. “Sit facing them straight-on as much as possible.”

Falls

If the person you’re caring for starts to go down, they may just take you with them, so it’s important to minimize the risks of that happening.

When someone starts to fall, our instinct is to grab and catch them. That might be possible, in some cases, but often it isn't, and trying will only hurt you both. Know what you can realistically do.

If the person is mobile and can walk with aid, consider equipping them with a gait belt. This wide band is worn around the waist and gives you a place to hold for stability while moving or grab if they start to wobble. Because it’s close to their center of mass, you have more control of their balance. Also, it stops you from grabbing an arm that could get wrenched or clothing that can tear and give and not be any help at all. It’s best if you and the person you’re caring for work with a nurse or other professional to learn the best ways to use the gait belt.

“I tell my patients that if they start to fall, I’m probably not able to catch them, but I will do my best to slow their descent and protect their head,” says Meagan. “If they’re bigger than I am, I don’t have the strength to catch them, but I can probably make the fall less impactful.”

Clear your environment, says Bri; remove tripping hazards like cords or rugs, be sure they have traction on slick floors like hardwoods. If you’re physically helping someone, try to convince them not to put their hands around your neck or shoulders, since they can easily pull you off balance.

Emotional burn-out

One of the hardest parts of being a caregiver is the emotional strain. If they’re a loved one like a parent or spouse, of course that gives caregiving an extra layer of emotional stress. Find ways to take a moment for yourself when you need it.

“Take a break,” says Bri. “Go for a walk. Ask for help. You need to understand how impactful this is on your mind as well as your body and respond to your needs as well as theirs. It’s mentally and physically exhausting, and if you’re fatigued, there’s a greater chance you or they can get hurt.”

Make it easier on you

This person needs you, and you want to be there for them as much as you can. We want to help you do that safely. So here are some additional tips from Meagan and Bri:

1. Get stronger. Strength through the hips and shoulders will make it easier for you to do more with less risk of injury. Squats and bridges mixed with rowing will strengthen hip girdle and shoulder girdle, says Meagan, and those can help protect your spine.
2. Pec stretches are great for those who spend a lot of time bent over another person (or a computer, or a book, or prepping meals).
3. Help them help you. If you’re lifting someone from a chair, ask them to scoot as far forward as they can while still feeling safe and supported. Have them push their feet back against the chair, then lean forward to bring their “nose over their toes,” Meagan says. That helps pop their backside up so you’re not pulling them from the back of their chair, which takes a lot more strength from you.
4. Position yourself wisely. If they’re pretty mobile but need stability help, stay to one side (the non-cane side, if they use one) and put a hand on their gait belt. If they need more help to get up from a chair, position yourself in front and keep your hands at their hips. Make sure their cane or walker is within easy reach when they’re up.
5. Let them be as independent as possible. If they can order groceries from the store, great! If they’re able to do some errands on their own, terrific! If they can do more, they’ll feel more independent and you’ll have time for other things.
6. Think two steps ahead. If you’re driving someone who uses a walker, collapse it for travel (rather than wrestling it into the trunk), and retrieve it and set it up before helping your person out of the car.
7. Get a bed rail. Not the long rail that runs the length of the bed, but a U-shaped handle that extends between the mattress and box springs and gives the person something to grasp for stability when moving in or out of the bed. They can also use it to position themselves while in bed, using their own arm strength. In the bathroom, a hand rail for getting on and off the toilet or in and out of the shower can be a huge help. Stair railings as well as non-slip flooring are really great for preventing bad falls.
8. Speaking of showers, a shower chair or bench that allows the person to be safely seating during bathing is a great idea. You don’t have to manage their body weight or hold a soap-slippery person, and they get to retain a bit more dignity in an often-challenging situation.
9. Ask for help. If you need assistance, ask for it. Call in another family member to give you a break, or if possible, hire a part time aide to carry some of the load. If you aren’t comfortable having someone else care for your loved one, hire someone to do laundry, clean, prep meals – anything to give you time back.

Finally, Meagan says, check with your local Lion’s Club. Many accept donations of lightly used equipment such as walkers, shower chairs, etc., and you may be able to find one at a more affordable price or free. You can find additional resources from the Caregiver Action Network and the American Nursing Informatics Association.  

This caregivers’ month and all the year ‘round, thank you for the care you give to those in need. We hope you’ll come tell us about your experiences and share even more tips in the Gennev community forums.