Finding balance: Tips for managing caregiving and self-care

By Sarah Cormell 

The COVID-19 pandemic taught people that caring for the caregiver is part of caring for one another — and it's necessary to take time for self-care and recharging so you can continue to give.

As a caregiver, you and your loved one are going through this experience together.

These tips can help you navigate caregiving and self-care:

Take time to plan

Taking time for planning can be an effective tool for reducing stress.

If you're taking on the role of the primary caregiver, spend time reflecting on and planning for how caregiving affects your other roles. For example:

• What supports are available to your nuclear family when you're occupied with caregiving tasks, such as laundry, housecleaning or child care?
• What will your work schedule look like, and how much time away will you need? Can you speak to your supervisor and human resources department about your new responsibilities, and seek Family and Medical Leave Act benefits if needed?
• What can you do to address the needs of your nuclear family as you care for your loved one?
• What are the expectations of you as the primary caregiver? This should include expectations from the loved one and other family members. Before you accept a caregiver role, consider discussing these expectations at a family meeting.
• Can other family members take shifts, and how will that look? Having this conversation as a family is ideal. Remember, you're all in this together. Effective communication can smooth the transition into a caregiver role and reduce everyone's stress.
• What's the anticipated timeline for caregiving, and what are the next steps in care for a loved one who needs more support? This could include moving in with a family member, transitioning to an assisted living facility or nursing home, or bringing professional caregiving or nursing support into your home.

Reflect on your capacity. You can't provide care 24/7. You need time for yourself.

Be mindful of your needs and emotions

Your intentions for becoming a caregiver are good, and it can be a rewarding experience. It can be a blessing to be the go-getter, responsible, loving family member who wants to do all you can for your loved one. Yet take time to regularly check in with yourself to ensure your needs are met.

Writing down your list of needs is a good way to organize your thoughts and check off what's important to you. Are you making time for self-care, including time with your friends and interests, or getting enough exercise or rest? Are you taking steps to avoid getting to the point of distress? Do you have support from other family members or friends involved in the care plan? If family isn't an option, what public and private support resources are available to give you time to recharge?

If you're the primary caregiver and don't have additional support, pay attention to red flags that you're stressed, including:

• Always putting your wants or needs on the back burner
• Becoming impatient
• Becoming short-tempered or frustrated
• Experiencing fatigue or low energy
• Facing a sense of loneliness or isolation
• Feeling anger or resentment toward the loved one
• Feeling disorganized or overwhelmed
• Feeling nervous or anxious
• Having racing thoughts
• Weeping or crying frequently, which isn't associated with the grieving process

Do you feel supported? Are you easily irritable? Angry? Sad? Resentful? Frustrated? Tired? Impatient? Hungry? Feeling guilty? Does your body ache? Are you having frequent headaches? How is your appetite? What physical things are going on with your body? How are you feeling about being able to manage everything?

Take time each day to reflect and focus on your feelings and emotions. It's OK to feel them. That doesn't mean you are what you feel.

Paying attention to how you feel emotionally and physically when managing stressors is important because those feelings can be the first clues to your needs. Then you can take steps to process, manage and attend to the wants and needs behind the feelings.

Map it out

Once you know your feelings and needs, you can communicate them to other supporters or your loved one. If you started caring for an aging parent recently, you've probably adjusted to what that caregiving looks like for you and your parent. Now you can communicate what's helpful to keep you going, whether it's having others take shifts so you can get away for a weekend, getting help with errands or taking time to exercise each day.

Make a list of resources in your personal and professional networks to find support. This could include siblings, family, friends, neighbors, your loved one's friends, or local aging and disability resource centers. Another option is hiring support services, such as a social worker or nurse, for in-home or transitional care. Remember, finding solutions is essential so you can continue to give and take care.

Make the ask

It can be a heavy responsibility to carry most of the caregiver role; no one should be alone in the experience. It also can be difficult or uncomfortable to ask for help.

You may also be making unhelpful negative assumptions, such as:

• Assuming you already know the response or feel you shouldn't have to ask — "They should just know and be helping."
• Feeling it has to be you to help and know what is right for your loved one.
• Wanting to avoid being a bother.
• Worrying that others won't remember specifics about medications, allergies or your loved one's preferences.

Now is the time to set aside assumptions or family dynamics and simply make the ask. I often tell caregivers: "Let's test it. You ask or state what's needed, and let them say yes or no." The answer might be yes, and what a relief that would be. If it's no, you still have narrowed the options based on fact, not assumptions.

Be specific when you ask for help. Instead of asking, "Could you come over and sit with Mom sometime?" or "It would be nice to have help around here," rephrase it to: "Could you sit with Mom for two hours on Saturday morning? I'll need to know by Wednesday," or "Can you mow Dad's lawn on Sunday afternoon?" or "Can you do the laundry on Friday while I pick up my daughter?"

You also can make a to-do list and place it where others can see it. The point is to make the communication clear. Even if the answer isn't immediately "Yes, of course," it can be the starting point for planning to meet everyone's schedule.

Building trust and allowing others to take on roles is also important. As you share the responsibility and trust others, your mood will improve, and you'll feel more supported and recharged.

Set boundaries

Sometimes, you must set boundaries of acceptable behaviors or requests with the loved one you're caring for. It's not uncommon for them to develop a preference for your care over others or expect that you stay with them despite having other caregivers available.

Good boundary setting means respectfully and clearly communicating your expectations, limits and needs. Think about your loved one's capabilities. Is the request appropriate? If not, discuss what you will or won't do. When talking about expectations, state facts, such as: "Mom, I need to go to my daughter's house and see the grandbaby. Janelle is going to be with you when I'm gone. You know I love you, but it's hard for me when you get mad when I take time to see others."

You should acknowledge choices and allow the person autonomy within their capabilities. An example might be offering them a choice between using a walker versus a wheelchair to move from the bedroom to the front porch.

Boundary setting is a type of self-care as well. Some people think good caregivers give whatever their loved one needs or wants. Yet many caregivers are so busy caring for their loved ones that they neglect their own physical, emotional and mental needs. Setting boundaries so you can take time to exercise, eat well, get enough sleep or socialize with friends or loved ones helps you recharge.

Finally, boundary setting helps when managing intense emotions. Stressful situations and strong emotions often go together. Notice and acknowledge your feelings but remember you don't need to become the emotion.

You can be empathetic and supportive of your loved one and have your boundaries and values respected while not allowing your emotions to dictate how you react to stress.

For example: "David, you said you would be with Dad today. I'm sorry, but I can't leave work early to come to Dad's house now. I have next Tuesday and Thursday off from work to be with Dad, and I'll use up part of that vacation time if I come now," or "Mom, I made arrangements for the church volunteers to clean your yard today. Please don't ask them to leave. I appreciate that you'd prefer that I do it, but they do this for free, and it will give me the time to get other things done."

Seek professional help

Many caregivers can benefit from professional mental health counseling to help them cope with the stress and challenges of the role. Therapists can help you work through your experience and identify your stressors. For instance, if family dynamics contribute to your stress, a therapist can help you develop scripts for talking with loved ones about the situation and possible solutions. They also can help you develop solution-focused action plans for managing other challenging caregiving circumstances.

Be gentle with yourself and patient with this ever-evolving process.

You may have never done this before, and it might be messy and need adjustments. It's appropriate to:

• Ask for help from your family and friends
• Ask questions
• Be mindful of and communicate your wants and needs
• Involve others
• Plan and organize
• Set appropriate boundaries, including with your loved one
• Use any and all resources

Many caregivers reflect on their time and wonder if they did all they could for their loved ones. You're taking time to provide for your loved one's safety, emotional, physical, spiritual and psychological needs. If you did all you could by taking care of your loved one, taking care of yourself and using your available resources, you did do enough. The best measure of caregiver success is if you did your best with what you had at that moment. Just remember you don't have to go it alone.

Learn more

Join the Caregivers Support Group on Mayo Clinic Connect, an online community connecting patients and caregivers.

Read these articles:

• "Cancer caregivers: 3 tips for communicating with your loved one’s care team"
• "Cancer and the holidays: Tips for understanding and coping with your emotions"
• "What to expect when caring for someone with cancer"

Take an online course:

• "Nutrition during cancer treatment"
• "Stress management for cancer"

Find additional resources in the Stephen and Barbara Slaggie Family Cancer Education Center's video library.

Sarah Cormell is a licensed clinical social worker in Psychiatry and Psychology in Menomonie, Wisconsin.

A version of this article was originally published on the Mayo Clinic Health System blog.