05/14/2010 09:24 am ET Updated Nov 17, 2011

Providing Home Care Without Self-Sacrifice

You Don't Understand ... I Just Can't Right Now!

"With all the time I spend shuttling my father to his appointments, it's no wonder I haven't been to my own doctor!" These are the words of Brian, a 69-year-old retired mechanic who has been a live-in caregiver for his 94-year-old father for 12 years. Pressed further, Brian admits that he hasn't just missed his yearly doctor appointments; he hasn't had a dental cleaning, a colonoscopy or a cholesterol screening since his caregiving responsibilities became intense five years ago. "I was never one to go to a doctor to begin with, and luckily have always been healthy. But now, finding the time to take care of myself is impossible."

Sound familiar? Unfortunately, neglecting one's own health is a very common problem among our nation's 44 million family caregivers. And missing cholesterol screenings, flu shots, mammograms, eye exams, and dental cleanings takes its toll. According to the Family Caregiver Alliance, caregivers report chronic conditions (including heart disease, cancer, diabetes and arthritis) at nearly twice the rate of non-caregivers. When compared to non-caregivers, those who care for family members in the home suffer from increased rates of physical ailments (such as acid reflux and headaches), have higher levels of obesity, and diminished immune response leading to frequent infections and an increased risk of cancer.

When asked if he would like to pay more attention to his own health, Brian hesitates. "I know I should eat better and have a blood test. But this is not the time for me. My father's situation is much more urgent, and I can't leave him long enough to get my own appointments in." It's clear that compounding Brian's inability to focus on his own health is the reality that his father would flounder without him for even a very short time.

Is it possible to take care of yourself while caring for a family member? "It sure is," says VNSNY Clinical Caregiver Advocate, Ralph Parmegiani, "though you may have to get creative." Parmegiani is a licensed social worker who runs a support program for the family caregivers of VNSNY patients in Staten Island. He is well aware of the problems faced by many caregivers who are house-bound by the daily demands of caregiving. And he's seen some caregivers who have managed to stay healthy.

"We have a caregiver in our program who leaves the house only a few hours per week to do the grocery shopping. But she has managed to maintain her own health by cooking and eating healthy meals, doing exercise tapes in her living room, and changing doctors to the same ones her mother goes to, so at least she can get her check-ups in. They even had mother-daughter mammograms this year."

Here are some ways experts suggest you as a caregiver can stay healthy*:
  • Watch what you eat. Take the time to cook wholesome meals for yourself and your family member. If you can't get to the grocery store on a regular basis, find a store with an affordable home delivery service. You may find that your family member also benefits from this focus on healthy eating.
  • Exercise every day. We now know that most people require an hour of exercise daily to prevent weight gain as they age. But this exercise doesn't need to be intense. Take a walk or squeeze in an exercise class if you can. Enlist a friend for support, someone who will be a good walking buddy, and help you get out the door. Or if you can't leave, do an exercise video in your living room, by yourself or with a friend. You may even be able to make an exercise corner in one room, with inexpensive weights, bands, and balls, and perhaps even a stationery bicycle. And remember, you don't need to do the full hour at one time; you can break it up into shorter sessions throughout the day.
  • Make a commitment to having your annual checkups, screenings, and flu shots. This may mean changing doctors in order to use the same office your family member goes to, but will go a long way in ensuring that your basic medical needs are met.
  • Get a good night's sleep. If nighttime responsibilities are interfering, explore paying for occasional help or sharing nighttime duties with another family member.
  • Take your vitamins and your prescription medications, and make sure you refill them on schedule. If you find it difficult to get to the pharmacy, look into on-line companies or specialty pharmacies that will deliver to your home. Again, this may help you manage your family member's medications better as well.
  • Consider a respite program, which would allow you to safely leave your family member with someone else for a few hours, a full day, or even overnight. While these programs are still rare (the VNS CHOICE managed long-term care program has a built-in respite component for members), they do exist. For example, the Older Americans Act of 2000 started a national Family Care Support Program which offers funding for information, referral and respite programs throughout the country to qualified individuals. There are 15 program sites in New York City, including one at the Mount Sinai CAPP Caregiver Resource Center and one at the New York Foundation for Senior Citizens.
  • Finally, if you're feeling overburdened or stressed, try relaxation techniques. Do breathing exercises, say a prayer, meditate before bed, or try aromatherapy in the form of a long bubble bath. This kind of attention can often give you that extra energy you need.

Many caregivers struggle to find the time and energy needed to attend to their own health, but it's important to remember--you can't take care of anyone else effectively if your own health is suffering.

*Family Caregiver Alliance, Fact Sheet: Caregiver Health,