- The Washington Times - Monday, September 19, 2005

Jim Moriarty Jr. knows his limits. He says he can’t take care of anyone else until he takes care of himself.

The 61-year-old Alexandria resident has become the primary caregiver for his mother, Mary Moriarty, who has had two strokes in the past two years.

Although Mrs. Moriarty needs continual attention, her son plans regular breaks for himself, such as walks in the woods by the Potomac River, visits to art galleries and nights out to weekly singles events including salsa and Brazilian parties. Occasionally, he takes a weekend trip to Virginia Beach.

“I can go about six innings, but then I need a break,” Mr. Moriarty says. “I can’t go a full nine. If I’m not in good health, I can’t give good care.”

Caregivers can be so busy attending to a sick family member or friend that they often overlook their own needs. Although they are looking after someone else, they need to allow time for rest and recuperation for themselves.

A visiting nurse, a physical therapist, Meals on Wheels, church members, other family members and friends share Mr. Moriarty’s load in caring for his mother.

“I couldn’t do it alone,” Mr. Moriarty says. “I need the nurse that comes at night.”

Accepting help when it is offered is vital for any caregiver, says Jenna Crawley, senior social worker at Washington Hospital Center’s Medical House Call Program in Northeast.

When assistance is offered, it’s usually best to delegate specific tasks. For instance, assign someone to do laundry every Wednesday at 10 a.m.

Although many caregivers prefer to do things themselves to make sure they are done properly, they should learn to entrust their loved ones to other people, Ms. Crawley says.

If a caregiver is feeling tired, overwhelmed and stressed, their blood pressure could rise and they could become depressed, she says.

Joining a support group may help alleviate stress, she says. Sometimes it is helpful for caregivers to know they aren’t the only ones with struggles. Group members also can share coping skills.

If a substitute caregiver can’t be found to give the person a break, telephone and Internet support groups might be an alternative, Ms. Crawley says.

“Caregivers benefit from support,” Ms. Crawley says. “It can be time-intensive, labor-intensive and emotionally draining.”

Many people feel so obligated to the ill family members that they don’t know how to get the support they need, she says.

If someone else is partially responsible for the physical caregiving, such as giving baths, it can be easier to provide emotional caregiving, which is usually what a loved one needs most.

“There can be a sense of guilt that they are well and the other person is sick,” Ms. Crawley says. “It is absolutely very difficult.”

Caregivers aren’t supposed to be all-powerful, says Robin Fiorelli, national director of bereavement and volunteer services with VITAS Healthcare Corp., whose corporate office is in Miami.

“Everyone has limits,” Ms. Fiorelli says. “It doesn’t mean you love your loved one any less.”

Simple things like getting a haircut, having coffee with a friend and going to the grocery store can prevent burnout, she says. Deep breathing, visual imagery of a peaceful place, taking a warm bath and listening to music can help a person relax.

It’s very important to eat right, sleep well and exercise, she says. Finding someone who is good at listening also is beneficial.

“Even though it might be hard and you might be torn, once you start doing those things, you realize how important it is and how much relief you get,” Ms. Fiorelli says.

Low self-esteem can be a problem for many caregivers, she says. Because many chronically ill people never recover, it’s common for caregivers to feel as though they aren’t doing enough to fix the problem.

“We recommend that people do a lot of positive self-talk,” Ms. Fiorelli says. “Be realistic, and look at all you’re really doing.”

In some instances, financial reimbursement is available for caregiving-related expenses, says Marla Lahat, executive director of Homecare Partners Inc. in Northwest.

The private, nonprofit organization is funded through various sources, including the District of Columbia Office on Aging in Northwest. It runs a caregivers support program that provides education, reimbursement for supplies, respite care and spring cleaning services. The reimbursement is not in lieu of employment.

The funding for the District’s Office on Aging caregiving programs comes from the National Family Caregiver Support Program through the U.S. Administration on Aging in the Department of Health and Human Services, she says.

Other states have similar programs to distribute the funds set aside for caregiving. For specific details, residents should consult their local agencies on aging. Eldercare Locator, 800/677-1116, can help find the nearest agency.

Further, the 17th Annual Well Spouse Conference is scheduled for Oct. 21 through 23, at the Key Bridge Marriott Hotel in Arlington. This conference is sponsored by the Well Spouse Association, a national nonprofit organization with headquarters in Freehold, N.J., that offers assistance to adults who provide unpaid care for an ill or disabled spouse or partner.

“In this country, family members are still providing the majority of care for elders,” Ms. Lahat says. “It’s important to support the family members so they can support the relatives. Without the family members, you’d see a lot more people who would need nursing home care.”

On top of everything else, caregivers need to deal with their own grief, says Naomi Naierman, president and chief executive officer of the American Hospice Foundation in Northwest.

Anticipatory grief, knowing full well that the person being cared for may soon die, can occur while caring for the person. Emotions from past losses also can spill over into a current circumstance.

“Grieving isn’t an option,” Ms. Naierman says. “It’s not an option if you want to be a nurturing caregiver. Grief can catch you unaware, without being aware of what you’re grieving.”

Finding a therapist or at least a good friend who will listen is crucial, she says. Allowing pent-up emotions to come to the surface is normal.

“You need someone to be willing to listen to you complain,” Ms. Naierman says. “You need to know it’s OK to be angry and resentful, especially if you’re doing this at the expense of doing other things that you would like to do.”

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