Caregiver Injuries....

It's a beautiful Spring Saturday morning - sunny, clear and bright with the scent of lilacs, azaleas and rhododendrons wafting in on the cool air from the garden. I'm sipping a mug of my favourite Dutch coffee and savouring the pre-lawnmower quiet.

I haven't posted here for the past week because a "caregiving injury" has severely restricted the use of my right hand. I am cat-sitting for a few weeks and the poor old thing has renal failure which necessitates frequent feedings and the administration of a small pill every morning. 

During one of our pill-encounters, Si nipped my finger, leaving an all but invisible puncture wound. By six o'clock that evening, my finger (and the rest of my hand) was hot, red, swollen and exquisitely tender and off I went to the clinic for antibiotics and a tetanus shot.  The young doctor there informed me that about 80% of cat bites become infected, some very quickly and seriously. If my infection increased at all I was to go to the emergency department for IV antibiotics. (!) Fortunately, the oral medications have worked well and I'm able to type quite comfortably this morning.

All this did make me think, though, about how often caregivers are injured while doing simple, everyday caregiving tasks - sometimes because we're tired, sometimes because we're preoccupied  and sometimes because we lack information about what we're doing.

While caring for my husband during his bed-bound years, I spent much more time than usual on my feet at home. Like many people, I tended to kick off my shoes at the front door and go barefoot or push my feet into a pair of comfortable old slippers. Little did I know that spending hours on my feet in poorly supporting foot wear would result in a case of bilateral plantar fasciitis that took two years and hundreds of dollars (orthotics) to heal! So, here's a piece of advice that you probably won't find in any other writings for caregivers - Be sure to wear well-fitting and supportive shoes whenever engaged in caregiving that requires extra time on your feet. It's well worth the effort!

Also worth the effort, whether you're a helping professional or a family carepartner, is taking the time to assess the things you do regularly while caring for others. 

- Do you  make an effort to stay in the moment, present to the task at hand, or are you already three steps ahead, planning for something else entirely? 

- Are you practicing good self care so that your body is fit and well rested for the tasks you have to undertake?

- Are you asking for help when you need it? (It can be annoying to wait for someone to help you lift a wheelchair into the trunk of the car, but not nearly as annoying as being laid up for six weeks with a back injury!).

- Is your work area set up for good ergonomic functioning? 

- Do you know how to do caregiving tasks correctly - good body mechanics, proper care of needles and other sharps, correct procedures for handling aggressive behaviour? Again, asking for information can save injury both to yourself and to your care recipients.

So, if we all do our best to remain mindful, fit and rested, and informed in our caregiving, we are far less likely to become numbered among the "cared for". Is there one thing you could change this week to make your caregiving safer for you? 

      

What's Up....?

May has been a busy month and I have just finished the last of the workshops scheduled for the Spring. As always, I have been deeply moved by the response of family caregivers and helping professionals to information about Compassion Fatigue and Chronic Sorrow. Heads nod and eyes tear as people come to understand that their distressing symptoms are normal responses to trauma and loss.

My plans for the summer include some vacation time on Vancouver Island and in Oregon state and also a lot of writing. In the pipeline are articles for the Well Spouse Foundation and the Victoria Caregivers Network Society and I will be starting an ebook on Chronic Sorrow for family caregivers and the helping professionals who support them. In order to have a base from which to distribute the ebook, there will also be a website to design.  And the weekly blog posts will continue for the weeks that I'm in town. Fortunately, I'm, one of those people who still writes with pencil and paper (!) so I can go pretty well anywhere from mountaintop to sea shore to do my writing and I expect to do both.

The first fall workshop bookings are coming in now so, if there is a particular date that would work best for your organization, please feel free to contact me to hold it for you.

  

BC Family Caregivers Week - May 9 - 13...

This week is Family Caregivers Week in BC and I am fortunate to be taking part in the Caregivers Program for the Family Caregivers' Network Society in Victoria on Friday and in the annual Caregivers Association of BC Caregivers Fair at Robson Square in Vancouver on Saturday.  It is always a privilege to speak to family caregivers and, in turn, to learn from their stories and experiences. I'm really looking forward to the weekend.

I think that Caregivers Week is a good time to remember that family caregiving is not just confined to middle aged women caring for aging parents, though that is certainly a large and growing segment of the caregiving population. We tend to forget that there are millions of young adults and children who are providing part time or full time care to grandparents, parents, siblings and, in some cases, to their own children. 

While countries like England have focused on the needs of "young carers" for several years, we in North America have been slower to acknowledge their important contribution to the stability of families coping with chronic and serious acute illnesses and injuries. These young people have all the needs of older carepartners plus the added needs of their own developmental stages.

As Carol Levine, director of the Families and Healthcare Project at United Hospital Fund and lead author on a study of young adult caregivers, said in 2005 - 

To provide any kind of meaningful assistance to young adult caregivers, who are

at a critical stage in their life and development, we need to carefully consider the

impact of their responsibilities on employment, education and social life. Services

developed for older women are not going to be appropriate for younger men and

women.

She goes on to say that -

The young adults who are caregivers now are, we suggest, only the first wave

of the future. With social changes such as delayed childbearing and smaller

families, aging parents will have to look for help to children still in their 

formative years. The...grandparents currently raising one or more grandchildren

will need help when these children are in their twenties. We speculate that, in the

future , care recipients will be even older than they are now and caregivers will be 

even younger. What this may mean for a youth-oriented but aging society is a 

crucial, but an open, question.

As we move ahead in acknowledging and creating programs to support older adult carepartners, let us not forget the needs of this younger and at least equally vulnerable group.    

Compassion Fatigue Recovery...

Recovering from Compassion Fatigue can be a slow and difficult process, particularly when there is a significant amount of personal loss and trauma, (primary traumatic stress), to work through. At the same time, it is a journey that can yield true joy and wellness if we're willing to do the work of becoming self aware and self caring.

Yesterday was one of those days of joy and wellness in my own recovery process.

Since sunny childhood mornings spent weeding with my mother, gardening has been a great source of peace, creativity and comfort in my life. But after the experience of maintaining a trauma therapy practice while caring for my husband and then for my mother during her brief terminal illness three months after his death, I didn't want to take even one step through the garden gate. The thought of caring for anything or anyone in any way was overwhelming. I couldn't even care for myself very well.

That was almost five years ago and so much has changed since then. With intention, effort and patience I made space for my body, mind and spirit to heal. I found a good grief counsellor to be a companion and "emotional container" as I grieved and, later, I did body work to release the traumatic stress stored in my muscles and sinews. I walked every day by the Lake, allowing Nature to do her healing work. I meditated and prayed and I waited in the stillness until I was able, finally, to store enough energy to interact with others again. Then I began to spend time with selected loved ones who gently led me back to life. I journalled, I listened to Mozart and Abba and I read my favourite authors and poets. Gradually, I remembered the things that authentically refresh and sustain me.

But, still, I didn't want to garden. The very thought of it made my chest tight and and my limbs heavy  with inertia. As I sat with these feelings, I came to believe that the return of my desire to garden would announce my emergence from this last severe episode of Compassion Fatigue.

So, imagine my delight when I woke at 4:20 yesterday morning with plans for springtime plantings swirling about in my head. New roses to replace those damaged by the winter's cold. More container vegetables this year. Sweetpeas for the trellises. I was up and perusing gardening books by 5:00 and at the garden center when it opened at 9. This morning, there are three new bushes in the rose garden and a row of sweetpeas along the fence. This afternoon, the tomatoes and swiss chard will be bedded and the first batch of mesclun sown.

But, best of all, is the knowledge that in waiting and trusting my own process, I have allowed my energy to accumulate to a point of abundance again. I have healed and filled myself up and now that energy can overflow into healthy caregiving - of both plants and people. It has been more than worth the effort and the wait and now I have my garden as both a source of joy and beauty and as an early warning system for encroaching compassion fatigue in the future.

  

 

  

  

Personal Boundaries....

When we grow up in families of trauma, we may lack the opportunity to develop healthy personal boundaries. (A personal boundary is an imaginary line of demarkation between me and not me.). When our boundaries are poorly differentiated, we run the risk of overextending ourselves in our helping roles.

As James Miller expresses so clearly in The Caregiver's Book -

To be close, you must establish boundaries.

When the needs of someone you care for are great, 

or when you have become part of the other's life in so many ways,

you may desire to draw as close as possible.

You may be inclined to keep that person always at the forefront of your thoughts.

You may try to keep yourself always within easy reach of their grasp.

You may find yourself almost merging with the other person,

so whatever happens to them happens to you.

Whatever they feel, you feel.

Whatever upsets them, upsets you.

Whatever their pain, you take it on as your own.

Identifying so completely with another

is an ideal some caregivers have sought

But it is less than ideal.

We all need healthy personal boundaries.  We need to be able to maintain a separate self with our own experiences, limits, sense of privacy, supportive relationships, and times of reprieve and refreshment.  When we create a separate space for ourselves, we allow the people we care for to have their own space as well.  As Miller says, -

They need it as much as you - perhaps even more. For they may not have the 

strength or clarity to create that space on their own.

And as Rainer Maria Rilke has said, -

Love consists in this:  That two solitudes protect and border and salute each other.

Are there ways that you can create your own space today? Define your own limits? Take some time out? Nurture supportive relationships? It will make a healthy difference to you and to all those for whom you care.

    

Letting Go...

Sometimes it feels as though letting go, surrendering control, will allow the world to fall apart. What if something goes wrong? What if someone makes a mistake? What if there's a mix-up?

And yet, carrying the burden of responsibility for everything turning out right is exhausting. We become drained, anxious and irritable when we try to hold life together by sheer force of will. I spoke with a woman this week who is a helping professional who is also caring for her mother, a woman living with cancer. She told me that although she speaks about "letting go"  all the time in her work, she'd never realized to what depths and repeatedness this act was required of family caregivers.

So, what would happen if we didn't try so hard to control things in advance? Could we lighten up, just a little, and respond to circumstances as they arise instead? Kate, the beloved adolescent character of Jean Little's writings, understood about the need to let go, at least occasionally:

Today

Today I will not live up to my potential.

Today I will not relate well to my peer group.

Today I will not contribute in class.

I will not volunteer one thing.

Today I will not strive to do better.

Today I will not achieve or adjust or grow enriched

or get involved.

I will not put up my hand even if the teacher is wrong

and I can prove it.

Today I might eat the eraser off my pencil.

I'll look at clouds.

I'll be late.

I don't think I'll wash.

I need a rest.

Perhaps we could all let go, just a little, in our own ways, today, and have a rest...?

I will be doing just that on Friday when I travel to southern California for a week. And after that comes Easter weekend so you will not be seeing a blog post here for the next two weeks. Until then - Happy Easter!

Jan 

 

   

The Promise of Spring...

I encountered these crocuses under a tree by the lake yesterday, a reminder of the hope and the promise of Spring.

I think that early recovery from Compassion Fatigue is a little like the coming of spring. The signs of early recovery are subtle at first - being wakened one morning by a whisper of optimism, hearing yourself laughing for the first time in a very long while, feeling a longed-for gathering of energy and interest. Gradually the bud inside you begins to swell and grow, creating the new weller-than-well person you are becoming.

The process of recovery is not a direct line from A to B though, rather, a meandering route of two steps forward and one step back. As James E. Miller says of Spring in Winter Grief, Summer Grace:

This season cannot be all brightness and glow, however. You still feel sad sometimes.

You get caught off guard by sudden rushes of painful emotions.  That's the nature of 

Spring - The gradual warming punctuated by brief stabs of chill. Yet as you  let your 

feelings evolve in ways most fitting to you, you promote the natural unfolding of your 

grief, the natural unfolding of your life.

He goes on to describe this natural unfolding in more detail:

You can begin to direct more and more what is happening around you.

You can decide about those things you want to start doing again.

You can experiment with things you've never tried before, realizing that something

within you now is eager to try.

You can begin to turn your attention more to others,

offering what you have to give, welcoming what is there to receive.

You have every reason to do both,

and every right.

In fact, James Miller is speaking about the process of recovery from bereavement but I believe he's got it right for those of us recovering from compassion fatigue as well. There is a seasonal flow to both experiences and the season of Spring brings the warmth, showers, budding and blossoming that equate to the Springtime of our recovery.

Most of you who have heard me speak more than once, know that I use a beautiful haiku by Jean Little, as a closing for all my workshops.  Over the years it has become my "signature", a blessing for those courageous enough to be beginning their own recovery. It goes like this:

Surprise

I feel like the ground in winter,

Hard, cold, dark, dead, unyielding,

Then hope pokes through me like a crocus.

So, bouquets of crocuses to each of you as you take the next step toward recovering from the

"gift" of compassion fatigue.

* Both books I've quoted today would make beautiful gifts for yourself or for someone you

love. Winter Grief, Summer Grace has wonderful photographs and poignant prose with

unintrusive Christian overtones and Hey World, Here I Am! by Jean Little makes a

great gift for an adolescent or pre-adolescent girl - or anyone who ever was one!