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When loving hurts: How to keep caregivers from burning out

To many of us, Candy Crush is an amusing time waster at best. But to Madam Wee, 70, Candy Crush is a life-saver.

Madam Wee is the main caregiver for her 80-year-old husband, who suffers from anxiety disorder and depression. Since 2011, her husband has been hospitalised five times because of anxiety and depression.

For Madam Wee, Candy Crush is a chance to escape, albeit briefly, to a place where she does not have to worry about her husband's medical condition. It also helps that her husband is also a big fan of the game.

"Mom introduced the game to Dad and it is heartwarming sometimes seeing the both of them playing and discussing the game together like two small kids after dinner," said Ms Helen Lim, their 41-year-old daughter.

Ms Lim also gives her mother a break by taking over some of the duties of the caregiver. "When mom needs a break, I will bring Dad to do some reading at the neighbourhood library which he enjoys and a meal at the kopitiam after,” she said. “I also bring Dad and mom out weekly or fortnightly to the museum or for a meal so they are not cooped up at home all the time."

Experts say that even as caregivers strive to provide the best care possible for their loved ones who are ill, it is just as important that caregivers also take care of themselves. This is because caregivers themselves are under a lot of stress and if they over-stressed, that will affect the care they give.

Said medical social worker Ms Karen Teo: "Just like how, on a plane, we are told to put on our own masks in times of emergency before we can help others, caregivers need to look out for early signs of burn out so that they can journey longer with their loved ones."

The stress from looking after a mentally ill spouse or parent can be very great because of the chronic nature of mental illness. But stress can also come from other issues as well. Ms Lim and her mother were worried about the medical bills, for example. "Luckily the social workers at the hospital helped us out financially with regards to outpatient and inpatient bills," she said.

Most caregivers end up being thrust into the role of caring for the family member and are thus ill-prepared for their role. Fortunately, caregivers do have access to training. Caregivers’ training and workshops that talk about self-care and how to support loved ones are provided at the Institute of Mental Health and VWOs such as the Singapore Association for Mental Health and Caregivers Alliance Limited.
Families who need a break can also turn to nursing homes that provide respite care. Ms Lim admitted that she and her mother suffered from burnout last year when her father proved too much to handle. The family managed to have her father admitted, which gave the mother and daughter time to recover.

On a day-to-day basis, it is important to find ways to de-stress as well. While Mdm Wee relies on her daughter and Candy Crush for a temporary break, Ms Lim, her daughter de-stresses in other ways. "I exercise mainly which keeps me balanced and happy; church and friends help too," she said.

Her advice to other caregivers is to turn to the hospital if they feel overwhelmed. Said Ms Lim: "When patients suffer from mental health problems, the situation pulls the entire family down. It is a roller coaster ride that can be mentally draining on family members too." In her case, she felt that the doctors, social workers, case manager and psychologist who were caring for her father worked very well together to give her and her family much needed support.

"Dad had a couple of relapses the past few years and it was a very tough time. His care team helped us a lot. I highly recommend family of patients to voice out their problems to their care team. They can be of tremendous and effective assistance and support."

On the issue of burnout, Ms Lim advises people to turn to others for help. "If faced with burnout, don't handle it alone. Speak to professionals who are always there to provide support and also appropriate solutions to problems."

(Note: We have used pseudonyms for the patient and family in order to protect their privacy.)

Ways to take care of yourself

1. Find a trusted friend to vent to, who will understand that you still love your family member but need to be able to express your negative feelings safely too.
2. Move exercise and sleep to the top of your to-do list as essential to keep you healthy.
3. Share the responsibilities: make a list of tasks and start delegating. Be realistic and accept that other people may not do a great job, but good enough still helps.
4. Learn about your loved one's condition so you know what helps and what won't, and what to expect in the future.
5. Talk to a professional, especially if you're already burned out and exhausted.
6. Join a support group! You can make your own by meeting up with friends in similar caregiving positions just to chat over coffee.
7. Do something you love that nourishes you emotionally: whether it's curling up with a good book, cooking your favourite recipes or watching the latest movies with friends. Take time each week to do something just for you that leaves you smiling and refreshed.

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