Caring without overdoing it, what’s the risk?

matthew mckenzieWelcome back to another blog post on mental health carers and to be honest, sometimes I just post on general mental health to raise awareness. I do not want to give those relying on carers a bad name, but I felt this time I should post on how easy it is for carers to risk burning themselves out while providing care.

However it does depend on the service user situation, not all mental health problems demand a high level of care, but alas for some families and carers, they will have to try and provide care for the long term. If this is the case, what are the issues? What are the risks for carer fatigue, burnout and stress?

If you wish, feel free to view my video on this topic.

Emotional impact on the family.

When mental health problems strike someone in the family or close friend, then the situation is emotional enough already. It is like you are trying to connect to a different person. You begin to wonder if they are the same person, but for some reason they will have a different outlook. Unfortunately the outlook could have such an emotional impact on the family, there will be arguments, accusations, withdrawal and suspicions.

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Such impacts can threaten to split the family and quite often this is usually the case when a family needs to be at its strongest. Unfortunately there will be situations where a lone carer is expected to get on with it, a carer is expect to provide that care regardless if there is family support or not, and quite usually family support tends to be lacking, because lets face it, no one likes conflict. Thus the emotionally strongest person tends to step in and provide that care.

The thing is when mental ill health starts tearing the family apart, how can a carer be in control of their emotions?

Fear, Sadness and Anxiety

Leading on from emotional impact on the family structure, one could ask what type of emotions are we talking about here? Well as the title suggests it is usually the 3 I have mentioned, but there are plenty more that can be added. I suspect most carers will encounter the 3 emotions I have brought up, usually fear is there because carers are in fear of the future, they fear they are not providing enough care. Carers can also fear when their loved one is about to have another relapse and they also worry how bad it would be.

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There is also sadness, because a mental health carer will remember the day when their loved one used to be independent. Carers can also remember how loving that person used to be and how the future looked so different, now its like there is a shell of a person, when a carer looks into their loved one’s eyes, perhaps there is lack of emotion or fear of rage. Maybe with medication side effects, their relative or friend cannot muster the energy to connect with others.

Another common emotion is anxiety, where a carer is anxious about what is going to happen in the future. Carers will sometimes stay awake at night wondering if that person is coping well. Carers worry not only about the mental health of their caree, but also of physical health problems. Depending on how unwell the person is, a carer may have to deal with correspondence and confidentiality. Eventually a mental health carer will have inherited many difficult tasks.
Family conflict

As mentioned earlier on in this blog post, a carer is bound to have differences of opinion when looking after a close relative. Families will clash on care plans and they will also clash on who does what, just if it was not enough to provide care for someone, then the family begins to have conflict, where there is a risk of members of the family moving withdrawing from the situation.

Money

If there is one thing that initiates arguments or conflict then it has got to be money. If mental ill health was not primary concern of money issues then money itself can be the burning issue. The problem is those suffering mental health problems, can but not always have a problem dealing with finances. Still, this does depend how bad the mental health crisis is.

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A carer will usually end up trying to get some means of financial support, but they then worry how this would affect their love ones benefits. If someone is a full time carer, then working for the future is going to be difficult enough, plus getting some financial support means that they have to fight for it. Most carers cannot often work and be at hand to care at the same time, which is why money can be a difficult issue in the carer’s life. Another problem with money is that the person with lived experience may not be as proactive in dealing with their finances and this can lead to debt problems, which the carer is trying to find out.

Who does what

This might be so simple to ask, but when you look closely at the issue, you may find that a carer is sometimes expected to do so many things when it really should be someone else’s role. There are times when carers are expected to coordinate care, or are expected to monitor medication even if their are confidentiality issues. Carers are sometimes meant to be at home especially if the mentally ill person has trouble looking after themselves alone.

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Sometimes this might boil down to family members trying to help out, while others tend to back off and let the solitary carer do all the work. There is no clear guide when a carer needs to do something and quite a lot can be guess work. Carers can sometimes end up being harassed to take on too much, this is never a good thing, but to be honest it does happen.

Stand your ground

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To avoid carer burnout it is so important for carer’s to stand their ground. One of the most common situations a carer can find themselves in is being confused on whether to act or make a decision. If you are a carer or especially a mental health carer, then its always important to ask questions. A carer may often need to be made aware of this if they are in a ward round at the hospital or at their loved ones care plan meeting. As a carer it does little good to sit in silence and let the mental health professional decide the care plan. A good care plan involves not only the person being cared for, but also the carers. If there is something a carer feels is wrong then they should stand their ground if they are not sure of something or need clarification. This does not mean carers should initiate conflict, but at least state their points.

Such a situation can again extend to a family where family members sometimes can demand a carer do more than they are equipped to do. Carers need to stand their ground if they are being taken advantage of. Perhaps this is a human condition, if someone does something for so long, then everyone thinks they are responsible for that role.

A problem shared

If one or all of the above affects you if you are a carer or mental health carer, it is always a good idea to share your problem. As in speaking to others or connect with other carers. The saying goes like this “A problem shared, is usually a problem halved”. It is not always a good idea to be a carer in isolation as there are so many carers out there isolated from society, isolated from their family and isolated from looking after themselves.

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As a carer, one of the best thing is to seek advice, seek connections with other mental health carers. Even reach out to family members for support. It can be so easy to keep it all in, but there always is a risk of being overwhelmed and end up being burnt out.

Self care

Self care usually means keeping an eye on your health, this could be watching what you eat, getting a good nights sleep, de-stressing yourself and basically looking after yourself mentally. I expect this is not going to be an easy task as many carer’s neglect self care because the support mechanisms are not in place to allow a carer to focus on self care.

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Still, this need not have to be the conclusion as there should be times when a carer needs to be assessed on what support that should be available for themselves. This could be done by the services who provide mental health services, or by a carer organisation. Carers can if willing, provide their own self assessment. Carers should try plan ahead and recognise the signs of neglect or burnout. If a carer cannot care for their own health then how can they expect to care for someone else?

Time out

Carers need to recognise the signs or just take time out even before there is any conflict or burnout. Taking time out need not be a selfish thing or be heavily planned. Taking time out could be as small as going for a walk, a relaxing bath or going to see friends. If there is one thing that carer’s suffer from it has to be isolation from society or the community. Carers need to use time out a tool to aid not only in support for their loved one, but also for themselves

Your health is their health

Remember, if you are a carer or know someone who is a carer, part of the family structure is support. A family unit has to try and work together to care for each other. Obviously there will be times when part of the family has to provide care for long term. The same can be said for the community as friend may try to be their for other friends or neighbours. We are all connected to some point, if caring in the family then your health will effect the level of care and support provided.

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