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Julie Cheney RN

Burning out - Lets think about carers.


Although Australia is considered to have a broad ranging and world class health and aged care system in many circles, it is struggling to cope with the unprecedented numbers of older people. That is larger numbers of people who are up to a decade older than they have ever been in history. This is rapidly being boosted by the numbers of people who are now entering their later years from the Baby Boomer era.

If you’ve lived longer than about three decades you will have lived through the times when health and aged care were mostly free or low cost, to the ‘user-pays’ themes of more recent decades. This means lots of implications for us all. From the people running services, the agencies and departments supporting the services, the workers and educational institutions providing the workforce and taxpayers. But, most of all, it has implications for carers.

Those, mostly, adult children of ageing parents who give their time and energy to caring for their ageing loved ones. Family carers can vary in the way they deliver such care from being full-time, live-in support, through to many variations of time such as a few hours or a few days a week.

Any of us who have been family carers know, no matter how wonderful your relationship with your loved one, the role presents difficulties. For the most part we are committed to providing support and safety for those we love. This can be a fulfilling experience. However, the impacts can change our lives in other ways. It can mean ceasing work or at least reducing hours. It can mean changes in financial security and impacts on quality of life. It can cause tensions and changes to family dynamics. These are all stressors which affect people differently depending on their unique circumstances. Carers supporting older people who have dementia, for example have been shown by research to experience the highest levels of stress and related concerns.

The trouble is that having many stressors, for prolonged periods, in a changing environment such as a person with chronic illness often experiences, can lead to people becoming excessively tired and overwhelmed. This is often called burnout. It can also be more common, and with greater impacts for all parties when there is relationship strain.

Unfortunately, it can mean the older person, often the more vulnerable, receives care that is less than ideal, and the carer ends up with significant mental, social and physical health changes. The positive outcome of studies that have so far investigated the issues is that family relationships reflecting love and support appeared to decrease any physical and mental health issues.

In anticipation of such concerns there are some actions already underway to seek improvements for the rolling tide of carers of older people pushing at our shores. Melbourne’s Deakin University Families in Later Life Study, is looking at long term effects on relationships in carer situations. Additionally, the Minister for Social Services, Dan Tehan, has announced additional funding to support measures and services via the Carer Gateway website. These will include peer support, counselling, coaching and educational resources.

What we can do as carers is acknowledge that we are as essential and worthwhile to the bigger picture of caring for older people as the person themselves. As we worry about their health and well-being, so should we be concerned with our own. We need to sustain ourselves to enable us to also sustain our loved ones.

Some signs to look out for are: feeling constantly exhausted, changed sleeping and eating patterns, headaches, constant illnesses and increased alcohol and drug intake, constant feelings of helplessness, negativity, cynicism, poor motivation and social withdrawal. These are all signs that a person is not coping with the level of stress they are constantly experiencing.

If you experience these symptoms for any length of time, you need help right away. Depression can be the next step. If you feel they could be developing, you need to act right away. If you don’t feel the symptoms but are a carer for an older person who has a lot of needs and takes any amount of time in addition to your busy life, you need to act right away.

Support from others in a similar situation can reduce your feelings of isolation and give you both support and strategies to deal with your carer role. This might be friends, others around the services your loved one is involved with or even a support group. You also need to maintain health via your nutrition and exercise levels, keeping alcohol and drug use to a minimum, and ensuring you sleep enough quality sleep. Putting boundaries around your time and your activities can also help to maintain some control. Then, ensuring there are times for you and your friends and family will help meet your own social needs.

If we were coaching a sporting team, we would be talking about how everyone in the team matters. We would coach for the way the team works, the way the team interacts, the impacts of family and friends, of lifestyle and health, of being integral to each other’s achievements. Caring is a lot like being a team. Whether a team of 2 or a team of family and friends who are working toward the best possible outcomes for all involved, we need to remember the team needs back-up and a managed approach.

Set yourself up for a better experience. Recognise how important you are and put in the work on yourself too.

And… thanks for what you do.

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