The following will give you some ideas of ways in which you can begin to take care of yourself
Don’t feel under pressure to do everything - not all the suggestions will be right for your particular way of living or even your personality. Choose the things you feel comfortable with, but remember that the fitter and healthier you are, the better you will be able to cope, both physically and emotionally, with the demands of caring.
Looking after your health - as a carer you need to be as healthy as possible. You probably have a lot to cope with at the moment. Your caring load may be at its maximum now, or it may be gradually increasing. Either way, keeping an eye on your health will make a real difference to the way you cope and how you feel.
Stay in control - your health is in your hands. Although your life is busy and your attention focused on the health of the person you care for, don’t ignore your own health needs. Try not to miss your own medical appointments; attend regular check-ups and screenings when you are called. As soon as you begin caring, inform your own doctor. If they know you are a carer and likely to be under pressure at times, they will find it easier to diagnose and treat you in future and offer the advice and support you need.
Eat well - a good, well-balanced diet will not only give you the energy you need to carry on caring, it will also boost your immune system and reduce your risk of falling ill. Obviously, your priority is to ensure that the person you care for has nourishing meals. However, if they have difficulty eating or are fussy about food this can affect the way you eat. For instance, you may not find time to have a proper meal or you may have little appetite. The cost of food may be a problem or it may be hard to get to the shops regularly. Essential foods No single food or food group contains all the nutrients your body needs so the key is to eat a variety of different foods. Each day choose foods from the following four main groups:
- Starchy foods – breads, breakfast cereals, potatoes, pasta, rice. Try to centre your meals on these. They are filling, a good source of nutrients and cheap and they don’t provide too many empty calories that may make you put on weight. Choose wholegrain varieties, if you can, for extra nutrients.
- Dairy foods – milk, yogurt, cheese. Try to have two or three servings a day. A serving is a third of a pint of milk, a pot of yoghurt, a small piece of cheese.
- Meat, poultry, fish and other proteins. Keep portions small – two to three ounces of meat or four to five ounces of chicken or fish. Non-animal proteins (beans, nuts, lentils) are a cheap and healthy option. Added to soups they can turn them into a nourishing main course. If you can’t get out to buy fresh fish, tinned fish is a good alternative.
- Vegetables and fruit. Try to eat five portions each day – fresh, frozen, tinned or dried. This may sound a lot, but if you eat some fruit with your breakfast, two vegetables with your main meal, fruit for pudding and a piece of fruit or raw vegetable for a snack, you can easily achieve five helpings. Fruit juices are a good substitute for whole fruit, although you will miss out on the additional fibre.
Enjoying your food - food is not just a list of nutrients but a wonderful mix of tastes, smells, textures and colours. Mealtimes can be social occasions shared with family and friends or they can be a solitary pleasure shared with a good book or radio programme. However, it’s not easy to enjoy your food if you are rushed off your feet or worried. Think about the following:
- You don’t have to have three meals a day – snacks can be just as nutritious and perhaps less stressful than trying to eat a main meal at the same time as you supervise the person you care for.
- Choose raw fruit and vegetables, toast, sandwiches, dried fruits, nuts and seeds for snacks rather than biscuits, cakes, crisps or chocolate.
- Try to make one meal of the day a relaxed occasion when you sit down quietly to eat. It need not be a main meal: a bowl of home-made soup or a mixed salad with a chunk of bread will give you the nutrients you need.
A good night's sleep - carers often go short of sleep – either because the person they care for needs attention during the night or because they have too much on their minds to be able to relax. In some circumstances a mild sleeping pill may be advisable. Taken over a very short time, sleeping pills can help break a cycle of insomnia. Before you ask your GP for that prescription, however, try the following:
- If you have trouble getting to sleep, don’t go to bed too early.
- Don’t snooze during the day unless you know you are going to be kept awake at night.
- Establish a good bedtime routine. Avoid alcohol, have a warm drink and a bath and make sure the bedroom isn’t overheated.
- If you like to read before going to sleep, choose something soothing. If you like to listen to the radio, play some music rather than listen to the late-night news.
- After you switch out the light, try some visualisation techniques to occupy your mind. For instance, imagine an idyllic beach scene. The sun is warm, the sea is blue, you can feel the sand on your bare feet.
- If you wake in the night and find your head is full of worries, try spending an hour or so out of bed, or sitting up with the light on if you sleep alone.
- You can read, do the ironing, watch television or write down everything that’s on your mind. You’ll find these are preferable to tossing and turning in the dark.
Be fit to care
You may feel tired, but regular, moderate exercise will actually give you more rather than less energy. As a bonus you’ll sleep better too. You may feel you haven’t the time but if you can create just a twenty-minute gap in the day, preferably not just before bedtime, it will be worth it.
The secret of effective exercise is to choose an activity that is right for you – one that you enjoy. Simplest of all is a regular, daily walk – round the block, to the nearest park, or to the shops. The closer to home the exercise is, the easier you will find it to do regularly.
However, if you can join a class you will get the benefits of exercise and company and a chance to switch off from your caring role. If you are tense and worried you will also find exercises such as yoga relaxing. If you can’t get to a class, you can do these exercises at home with a video or book. However, it is important not to feel pressured. If you simply haven’t got the time or energy to exercise, or if it’s difficult to leave the person you care for, then do some simple stretching and flexibility exercises at home. Swing your arms, reach above your head, lean to one side then the other from the waist and, for cardiovascular exercise, march on the spot, swinging your arms. Each day, try to stand at an open window or, door and take ten deep breaths. Remember If you have taken no exercise for some time, or are over 50, you should check with your GP before taking up any form of exercise.
Take care of your back
Back pain is common among carers. Nurses and care assistants never lift anyone on their own but most of the time, as a carer, you will have no choice. Even helping someone to dress or move from bed to chair can take its toll on your back. Ask your GP to refer you to the district nurse or community physiotherapist. They can visit to assess your needs and also show you the correct way to lift and move someone safely and minimise the risks.
When you lift or move someone:
If you’re ill
Carers tend to carry on regardless through colds, coughs, headaches, stomach upsets, flu and worse, but don’t put off seeing your doctor if your headache or cough persists, if you feel faint or dizzy or if you have unexplained pains. Even with a minor illness, try to take some extra rest. Your body will have a better chance of making a quick recovery and there will be less chance of complications or the illness lingering on.
While you are ill, it may help to take a general multi-vitamin supplement and additional vitamin C to boost your immune system and make up any deficit, particularly if you are not eating a great deal. And, of course, the sooner you see the doctor about unexplained symptoms, the more quickly and effectively they can be treated.
Acknowledge your feelings
Carers often have to cope with many conflicting feelings. Being a carer can be rewarding but it can also be demanding and frustrating. Along-side the positive moments there may be many painful feelings. Often the way you feel may be influenced by how you began caring – was it a choice you were able to make freely or are you in a situation that arose from circumstances? It’s important to recognise that you can love someone and still feel angry, guilty, depressed or resentful. These feelings are normal. You may find you can deal with them by acknowledging, ‘Yes, I feel angry because…’ Or you may prefer to seek some-one objective to talk to such as a trained counsellor or another carer.
At the same time you may have positive feelings, of love or satisfaction that you are doing your best, and it helps to share these too.
Looking after your emotional needs
When you are a carer it often seems as if everything revolves around the person you care for. It’s useful to remember that you also have some basic needs – privacy, a little personal space, time to be with friends and time to laugh and have fun.
Here are a few ideas:
Recognising the signs
We all need a certain amount of stress in our lives to give us the stimulation to keep going. In a positive way, stress keeps us alert and interested. In a stressful situation, the body responds by preparing to resist or avoid danger – the ‘flight or fight’ response. The heart beats faster to ensure oxygen is reaching all parts of the body and the muscles tense for action. Once the threat has passed the body returns to normal. However, in everyday life, we do not often need to use our ‘flight or fight’ response literally. When there is no physical outlet, the body can remain in this state of extreme alertness for a long time. Eventually the effects of this bottled-up stress are felt both emotionally and physically.
Physically, prolonged exposure to stress can cause headaches, insomnia and digestive problems. It can raise blood pressure and contribute to the development of heart disease. It can make an existing problem such as eczema or asthma worse. It may also lower resistance to infection. Emotionally, when you are constantly under stress you may feel exhausted, confused, depressed and agitated and find it hard to make decisions.
(See section: When caring becomes a crisis. )
What you can do
There may be problems that need solving and feelings that need to be expressed, but in the mean time both exercise and relaxation techniques can help relieve stress. Exercise allows you to channel some of that pent-up frustration into physical activity and can help overcome tension and sleep problems.
Massage can relieve a great deal of tension. A massage once or twice a month with soothing oils from a trained masseur would be the ideal, but self-massage is also helpful. Sitting quietly in a chair and placing your hands on either side of your forehead and rotating them gently can soothe a stressful headache.
Exercise like yoga, with its emphasis on relaxed breathing, can help.
Relaxation techniques are a really good way for carers to take time out for themselves (see below).
Choose what is right for you, what you feel comfortable with. Some people find it easier to deal with stress through physical effort – for them relaxation through sitting still is hard to achieve. For others, simply learning how to remain still for 10 or 15 minutes can bring a sense of peace and calm.
A simple relaxation technique
It’s hard to unwind properly when life is fraught, but a good relaxation technique can make a difference. Rather like physical exercise, relaxation recharges your batteries and offers you a little space in the day that is just for you.
There are many different techniques that you can learn. Some of them involve tapes or joining a class. The following is a simple form of meditation that you can try at home:
- Set aside some time when you know you will not be interrupted.
- Make sure you are warm and wear comfortable, loose-fitting clothes.
- Take off your shoes.
- If it’s daytime, draw the curtains and perhaps light a candle and an incense stick.
- Either sit in a comfortable chair or lie on the bed or floor on a thick blanket.
- Take several deep breaths, each time breathing more slowly and deeply until you feel comfortable holding the breath for a count of three before letting go.
Then choose one of the following:
Tense and relax each part of your body. Start by tensing up your feet, hold the muscles tightly for a moment, then let go. Do the same for the muscles in your legs, then your stomach and bottom, hands and arms, your shoulders and finally your face and neck muscles. Each time you let go, breathe slowly two or three times and concentrate on how heavy your limbs feel, before moving on to the next part of your body. When you relax your face, make sure your lips are slightly open and your tongue is resting lightly on the upper teeth.
- Keeping your eyes open, use the lighted candle or a single flower to focus on. Examine it closely, watch the way the flame moves as you breathe or the way the petals are formed, their colour and texture. Imagine yourself in the centre of the candle or flower – warmed by the flame, enveloped by the petals.
- Choose a word or phrase that either has meaning for you, such as a prayer or the first line of a poem – or a sound that you can repeat that has resonance such as ‘aaah’ or ‘om’. Repeat the phrase or sound over and over until your head is filled with little else. It isn’t easy at first and other thoughts intrude, but in time, if this form of relaxation is right for you, the thoughts will go away.
Complementary therapies can work well alongside conventional medicine and help us to overall health. Practitioners of complementary therapies use a holistic approach, in which the whole person is looked at, not just a particular symptom. This is particularly suitable for carers, for whom ill health may be closely connected to the strains and stresses of their caring role.
The idea of homeopathy is to boost the body’s defence system by using diluted natural substances. Treatment is gentle and the doses are safe. Although homeopathic remedies can be bought in most pharmacies and health stores, the treatment is most effective when prescribed specifically for you by a homeopathic practitioner who, as well as talking to you about your medical symptoms, will also note details of other factors such as your personality and lifestyle. Homeopathic remedies seem to be particularly effective for stress-related problems, allergies such as hay fever, irritable bowel syndrome and migraine.
Institute for Complementary Medicine,
PO Box 194, London SE16 1QZ.
For information send an sae and two loose first class stamps.
British Homeopathic Association,
27a Devonshire Street, London W1N 1RJ.
Tel 0171 935 2163.
Osteopathy and chiropractic
These are the best known therapies for back pain – one of the most common problems for carers. Both therapies specialise in the diagnosis and treatment of disorders of the joints and muscles. They use manipulation techniques to reduce pain and improve mobility and function. There may also be additional beneficial effects for people suffering from constipation, irritable bowel syndrome, migraine or headaches as muscle spasm is released. It may be possible to be referred for this treatment by your GP.
Osteopathic Information Service,
PO Box 2074, Reading, Berkshire RG1 4YR.
Tel 0118 951 2051.
Send an sae for a list of local practitioners.
British Chiropractic Association
29 Whitley Street, Reading RG2 0EG.
Tel 0118 9757 557.
Acupuncture forms part of traditional Chinese medicine and involves placing needles at certain points in the body. The theory is that by unblocking the meridians (pathways) that distribute energy (chi) throughout the body, acupuncture re-establishes the balance between yin and yang and thus allows energy to flow freely through the body.
Acupuncture seems to be particularly effective for pain relief but some people find it helps relieve migraine, asthma, joint pain such as arthritis and digestive disorders. Others have reported that it has also helped with emotional problems such as anxiety and depression.
Park House, 206-208 Latimer Road, London W10 6RE.
Tel 0181 964 0222.
(Send an sae for a list of local therapists.)
The healing properties of essential oils extracted from flowers, leaves, seeds, fruit and bark can alleviate stress and tension. An aromatherapy massage is one of the best treats of all. Failing that, the essential oils can be used in various ways at home. A few drops can be added to bath water to give a relaxing or revitalising bath or the oils can be used in a burner. Remember, essential oils are very strong and must never be swallowed or used undiluted.
Aromatherapy Organisations Council,
3 Latymer Close, Braybrooke, Market Harborough LE16 8LN.
Tel 01858 434242.
Send an A5 sae for information.
Who can help you ?
Often carers feel very isolated but there are people out there who can help. However, in most cases, you will have to make the first approach.
If you have the same GP as the person you care for it will be easier for them to be up to date with what’s going on. However, you may prefer to have a different GP as you may feel more at ease talking about things that worry you. Your GP is the gatekeeper to other health professionals such as consultants and hospital specialists.
They can also help organise specialist nursing care at home or in a residential setting as well as respite care. They can refer you to, or you can contact directly: district nurses; health visitors (increasingly they no longer specialise just in care of young children); community psychiatric nurses; occupational therapists; and physiotherapists. Your GP practice or health centre may also have a social worker attached to it.
(health and social services trust in Northern Ireland; social work departments in Scotland)
Your local social services department is the place to go for information and general advice. You will find the number and address in the local telephone directory. Among the staff provided by social services are:
- Care managers (sometimes called case managers) who specialise in care in the community and co-ordinating services.
- Social workers who can also tell you what is available locally and organise practical supportive services such as meals on wheels, a break from caring and advice on adapting or altering the home. They should also be able to tell you what allowances and benefits you and the person you care for are entitled to.
- Physiotherapists, occupational therapists and speech therapists.
Under the Carers Act you, the carer, are entitled to ask social services for an assessment of the care you provide. This is called a carer’s assessment. You can ask for a carer’s assessment when the person you are caring for is being assessed. If they have already been assessed, but the situation has now changed because they need more help or you are finding it difficult to manage, ask social services to carry out a reassessment (a review of their needs).
While the Carers Act entitles you to your own assessment, services are provided to the person you care for. However, if they are provided with a good range of services, these in turn will support you.
(See section How to get my carer’s assessment) or call the CarersLine on 0345 573 369.
Other carers are in a good position to offer advice and support. Those who are caring for someone with the same illness or disability are likely to have good ideas and tips on making life easier. Local CNA branches or carers’ groups are not only places where you can meet people, they often also hold talks and training sessions on subjects such as lifting, coping with incontinence, difficult behaviour or feeding.
CNA has a UK-wide network of branches and groups.
Call the CarersLine on 0345 573 369 (Monday-Friday, 10am-midday and 2-4pm) or your nearest CNA office and they will be pleased to put you in touch with the branch or group nearest to you.
If the person you care for suffers from a particular illness or disability, find out if there is a voluntary organisation that can help. At the very least you may be able to get leaflets and brochures or a helpline. Again, you can speak to one of CNA’s experts by ringing the CarersLine on 0345 573 369. They will be able to send you information and let you know which other organisations can help you.
Making the most of what’s available
In an ideal world carers, and those they care for, would receive exactly what they needed, when they needed it. Sadly life isn’t like that, so here are some tips on making the best of often scarce resources.
- Try to think ahead. Ask for help or register a need before a crisis arises.
- Think about what you need. Be flexible in your thinking and be prepared to offer alternatives.
- Make your needs clear so that you are not forced to accept an unnecessary or unsuitable service as this can be embarrassing or irritating.
- Don’t hesitate to ask for help from different sources – family, friends, voluntary groups, local place of worship. .Don’t take no for an answer – ask and keep asking
Taking a break
You need to take the occasional break. Often this is hard to organise if you are caring on your own and have no family or friends to take over. You may also get into the habit of not having time off or you may feel strongly that you are the only person who can do the caring job. The person you care for may also make things difficult by refusing to let anyone else but you do the caring. These problems need to be resolved because having time off, even just a few hours, is important. Respite care is available for carers.
However, provision may be thin on the ground and you may have to fight for it. It can range from someone coming in to be with the person needing care for a few hours, to day-care away from the home once or twice a week, to a residential break or holiday in adapted accommodation for the person needing care. If the person you care for disturbs your sleep night after night, you may be able to have a night-sitting service once or twice a week to allow you to catch up on your rest.
There are also schemes known as Home from Home run by social services departments in which carefully vetted local families take elderly people into their own homes as though they were part of the family and offer long- or short-term care. Remember Plan ahead. Don’t wait until there is a crisis or until you are too exhausted to carry on. Get your request for respite in well before you need it.
Who to approach
To find out about respite care, contact your local social services department and local groups such as Age Concern, Crossroads and Community Service Volunteers. You will find their addresses and telephone numbers in your local directory.
(See section Taking a break )
or call the CarersLine on 0345 573 369 or write to your nearest CNA office.
The benefits maze
Many carers who are entitled to claim benefits and allowances, for themselves or the person they care for, fail to do so either because it seems so complicated or because it feels like asking for charity. Here are four golden rules:
- It is always worth checking to see if there are benefits you can get.
- One benefit often acts as a passport to others.
- Apply for benefits as soon as you can – many cannot be backdated.
- If your claim is turned down or you receive less benefit than you feel you are entitled to, you can appeal.
Finding out more
The Benefits Agency produces a general guide Which Benefit?
You can find copies in post offices, libraries, Citizens Advice Bureaux and social security offices. There are also booklets and leaflets on individual allowances and benefits.
Carers National Association (CNA) offers information and support. The staff on the CarersLine on 0345 573 369 (Monday-Friday, 10am-midday and 2-4pm) can offer practical advice on caring, financial help and local carers’ groups. They also publish a wide range of booklets on all aspects of caring, including the benefits available to carers.
Age Concern has a book Your Rights available from branches nationwide or from head office (address below).
For general advice on benefits you can approach your local Benefits Agency or social services office. The numbers are in the local telephone directory.
Benefits Enquiry Line (BEL) is for disabled people and their carers and will give advice and help with form-filling in a limited way. Their number is 0800 882 200 (0800 220 674 for Northern Ireland).
If the person you care for has a specific illness or disease you will be able to find help, advice and support from specialist organisations. There may also be a local branch or support group. The following national organisations can also offer general help and guidance and should be able to refer you on to other organisations for more specialised advice.
Age Concern England,
Astral House, 1268 London Road,
London SW16 4ER.
Tel: 0181 679 8000.
British Association for Counselling,
1 Regent Place, Rugby, Warwickshire CV21 2PJ.
Tel: 01788 550899.
Crossroads Caring for Carers,
10 Regent Place, Rugby, Warwickshire CV21 2PN.
Tel: 01788 573653.
Disabled Living Foundation,
380-384 Harrow Road, London W9 2HU.
Tel: 0171 289 6111
for general information and guidance on aids and equipment.
Disability Information Trust,
Mary Marlborough Centre,
Nuffield Orthopaedic Centre,
Oxford OX3 7LD.
Tel: 01865 227592.
Tests and reports on a variety of equipment for elderly and disabled people.
Help the Aged,
16-18 St James’ Walk,
London EC1R 0BE.
Tel: 0171 253 0253.
5 Tavistock Place,
London WC1H 9SN.
Tel: 0171 916 6055.
Samaritans National Helpline 0345 909090
(or see phone book for local numbers).
Carers National Association
If you’re looking after a sick, disabled or elderly relative or friend, you’ll find Carers National Association (CNA) can help you.
Giving you the information you need
We believe that all carers have a right to the best information possible. That’s why our CarersLine is staffed by leading experts in carers’ rights. They answer over 20,000 enquiries a year. A quarter of these calls are from carers who learn about benefits they didn’t even know they were entitled to.
Offering you the support you want
Other carers are in a good position to offer information and support. Carers National Association can put you in touch with your nearest CNA branch or local support group. We also have offices in different parts of the UK which can tell you about the carer support services in your area.
Working to give you a better deal
Perhaps you want to know what is being done by Carers National Association to win a better deal for carers. CNA campaign on behalf of all carers. They have had their successes too. As recently as 1996 CNA campaigned for the Carers Act which gave carers legal recognition for the first time. They are now working to make sure it brings real improvements to carers’ lives, and they know much more needs to be done.
By joining Carers National Association you will be joining the carers’ movement and helping us to speak with a stronger voice. Join today!