Caregiver Care

The alarm on my iPad goes off at 7:00 am. I’ve been awake for a little while, which often happens when the days are long, but the alarm signals the start of my daily routine. Two months ago the routine started with escorting Cindy to the bathroom, but circumstances call for a change.

I go into our spare bedroom and do “yoga” exercises. My brand “yoga” combines stretching exercises with deep breathing to accomplish the same purpose as yoga. That purpose is to lower my blood pressure.

When I am done with “yoga” I take my blood pressure with a monitor. Over the course of two months my blood pressure has decreased from 150/110 to an average of 125/90, some mornings a little less, some mornings a little more. The first ten points came off in two weeks; the next ten points took six weeks; the trend suggests my blood pressure will decrease a few points further.

Lowering my blood pressure would seem to be a difficult task without medicine. Some factors cannot be changed, such as the challenges of my situation. Some factors I already control, such as abundant exercise. There remain two things I can do to lower my blood pressure: a return to regular “yoga”/meditation and tailoring my diet.

That is why the menu this morning featured beet juice for me, along with prune juice for Cindy. As the beet juice goes down I can well imagine a preference for blood pressure medicine over diet, but that is not my preference. My preference is caring for myself naturally and holistically. I am not worried about side effects from blood pressure medicine, but my approach provides additional benefits, from minimizing arthritis to maximizing my immune system. So I distastefully sip my beet juice, figuring a caregiver needs that extra edge of wellness.

When I first reported on our final journey, after returning from our PCT hike, a few folks advised me to “take care of yourself.” This concern of others went into remission, no longer expressed even if still felt, until my recent “Heat Wave” post. Some may think I do not heed this advice, since I’ve never taken whole days off, but in reality I attend to my own care more than most people can imagine.

I constantly consider the “what,” “why,” and “how” of what is needed for caregiver care. People and situations are different, calling for different approaches. My answers to these questions explain why only now I seek to take ten days off before the end of the year. My answers would not be the same as another caregiver’s, but hopefully I can illuminate why “take care of yourself” does not require simply taking time off.

After breakfast a friend comes over to spend time with Cindy as a companion. Midway through the morning he alerts me that Cindy has had an accident and I jump into action. When our final journey began I thought I would need breaks from caregiver chores to take care of myself, based on the caregiver experiences with my Mom. However, a man bathing his wife is different than a man bathing his mother.

I am aware that a bigger, stronger spouse has an advantage over a smaller, weaker one in tackling some caregiver chores. Cindy likely would be in greater need for taking a break if our situations were reversed, but not me. I have worked harder jobs; I have worked more stressful jobs. I have done things more repugnant than cleaning up after accidents, such as when I cleaned chicken coops during the summers of my college years (now that’s a chore requiring breaks). Escaping caregiver chores is not why I now need a break.

The accident seems to affect Cindy’s mood well into the afternoon, though I cannot really tell what she is thinking these days. Glancing back as I pedal the pedicab she appears dazed, but this is a common appearance for her now. Still, she never gives off a negative vibe, unlike her father did with dementia. He stayed with a us for just a very short time, as we could not have him continue to throw chairs at our children’s friends.

An aura of negativity and hostility erodes health. Even without kids to raise I would need regular breaks from caregiving if Cindy was like her father. But Cindy is not like her father at all and exudes only a positive aura, to the extent that she exudes any aura these days. I do not need a break from the caregiver/patient relationship.

Neither my caregiver chores nor relationship provides a reason why I should take a break; the pedicab provides a reason why I have not. Cindy may often be in a fog but, even so, I know that being transported outside does her more good than sitting at home all day. Who else will pedal her around when the weather permits? Indeed, I’ve cut down on the companion hours from an agency during the summer in order the maximize the flexibility of transporting Cindy, whether with the pedicab or datemobile. That’s good for her; it’s good for me. When the season is over I will expand the hours again.

In the evening an exclamation point was placed on the reason I have not taken a break before now. We were “dancing” as we do often throughout the day. I said: “you belong here (meaning in my arms).” Cindy uttered “Yes!” The word was hardly audible to anyone not “dancing” cheek-to-cheek, but nevertheless emanated the greatest enthusiasm from her that day.

In one word Cindy confirmed the impact I had on her will to live, just one word in a whole day. Such an image contrasts mightily with the lasting image I have of my Mom, spending her last days of fog in a nursing home, her hand held at the end by a person she never knew. I get some type of confirmation every day that I make a difference in Cindy’s will to live. That is an undeniable “high” I would miss if I’m not around. Avoiding sadness is not the reason I need a break.

I realize the advantages of my particular situation. I am not bathing my mother, or moving a bigger spouse, or caring for a hostile father-in-law. I get the exercise and positive vibes I need to stay healthy. I make a notable difference as a caregiver. I can lower my blood pressure significantly in two months when the need arises.

I lay in bed breathing deeply, ending the day and transitioning to sleep with meditation. Lowering my blood pressure naturally enhances my mood. I no longer feel a “woe is me” threat in the present moment, like I did during the heatwave, but reflect on the “what” that still beckons me to take a break before that happens.  I cannot help marveling at just how long an adventurous spirit like me has gone without days off. For the time being I marvel more than mope, but without a break I eventually will resent my constraints, despite all the advantages of my caregiver situation.

The wisdom I hope to impart is that “taking care of yourself” is more complicated than simply taking breaks. You need to know from “what” you need a break. Threats to your physical health? The chores? The relationship? The sadness? The boredom? All of the above? The “what” determines “why” you need a break, or if you need one, and “how” you should take one.

With the advantage of hindsight I probably should have taken a one week break every year, or even every six months, but for my particular situation a weekly break probably would have done more emotional harm than good. Each caregiver’s solution should be different, just as health, chores, relationships and other factors differ among us all. Just make sure you tune in to the requirements of your body, your mind, your heart.

And make sure you keep your blood pressure down.