CAREGIVER BURN-OUT
                                                                    and
                                                  BYSTANDER BURN-OUT

                                      Tips for Family Members and Friends

     As we see larger numbers of people living longer, more of us find ourselves in
the role of caregiver.  It is estimated that about 80 million Americans find themselves
being a caregiver at some point in our adult lives, often for several years at a time.  
"Caregiver burn-out" is a common phenomenon, especially when only one person is
doing the in-home nursing job that would typically be done by a team of people in a
long term care facility. The professionals who do this work get to go "off duty" and
get days off, but the in-home family member is on the caregiving job 24/7.  As a
result, the caregiver's own energy becomes depelted. The signs of "caregiver
burn-out" become obvious to the people around them, even though the caregivers
think they are holding up just fine.

                                                     CAREGIVER BURN-OUT

      The warning signs of "caregiver burn-out" are, among other things: irritability;
being easily angered; feeling continuously tired; loss of interest in social activities
and hobbies; confusion; feeling like you are carrying the whole world on your
shoulders; hopelessness; and resentment.

      Paradoxically, caregivers often complain that no one is helping them to care for
the ill or disabled loved one, and yet they may not realize how willing other people
are to help, or how often the caregivers have rejected offers of help.  This may lead
to "bystander burn-out" -- a sense of anger, resentment and frustration as the
bystander family members and friends try to cope with what they see as the
caregiver's irrational expectations or conflicting signals.
    
      If you, as a bystander, feel you are in a double bind, expected to help somehow
but having your advice or offers of help rejected, or simply not having a clear idea
of what role the caregiver wants you to play, below are some excellent tips for
accepting your role of bystander without feeling that you are a "helpless" bystander.
 Here is how to be "help-full" -- ready and able to help -- without being so "helpful"
that the caregiver feels you are more of an obstacle than a real help.
   
                                   HOW TO AVOID "BYSTANDER BURN-OUT"

It is a particularly difficult path to tread lightly when dealing with a husband and wife
patient-caregiver situation.

Some folks just don't know the difference between someone interfering and
someone helping with love.

Others feel threatened by what they see as a bond that began long before theirs did,
at birth, and of which they are not a part and never can be, for example, the
parent-child relationship, or the connection between brothers and sisters.

Others, there are simply no explanations for their reactions to offers of help.

What to do?  

Show up, when someone needs you.  Sometimes just the fact that you are there,
without saying anything, much less doing anything, is enough for the caregiver.  
Just knowing you are there, "just in case," may be all the comfort the caregiver
really wants at this time.
             
Help the caregiver understand what has been happening in medical terms, if you do
understand that part better than they do.  

Encourage them.  If they seem receptive, mention a different vision, different
options, an alternative way of looking at the choices that are available to them.  But
do not insist that the choice you would make is the choice they "should" make.  Just
present information.  Not all of your suggestions will be welcome at a given time.  
Let the caregiver tell you what help or resources they would welcome.

Then stand back, and stand by.

Indicate you are always available to help.

If the caregiver whines and sighs or drops hints or complains that he or she is so
tired or overwhelmed, ask them what -- specifically -- they would like you to do.  But
do not be played like a fish on a line, whipped around emotionally by the caregiver's
guessing games, much less any drama.

Finally, find peace in your own mind:  know that you genuinely tried and that your
heart is in the right place.  Then...

Stand back, and stand by.  Lovingly.
                   PAMELA ROYCE, ATTORNEY AT LAW
                                    626 - 285 - 8987

                                          CAREGIVING
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