General advice for caregivers

Caregivers are those who take care of someone with a chronic illness or disease such as a parent, spouse, sibling, or child. Caregivers often provide emotional as well as physical support to the chronically ill and the job can be very taxing. Caregiver stress levels can run very high and there is a real danger of the caregiver becoming ill themselves if they do not take care of themselves The tips below may help caregivers to balance their critically important role with their own health and well being.

Take care of your own health

It is critical to remember to take care of your own health as well as the health of the person you are caring for. Caregivers are at greater risk for contracting infectious disease than the general public. This is probably due both to the stress that being a caregiver entails, which can reduce the effectiveness of the immune system, and to a lack of time in a busy caregiver’s life to devote to one’s own health.

If someone is dependent on you for regular care, when you get sick both of you will suffer. Keeping up with your vaccinations and continuing to have yearly physical examinations and other appropriate medical surveillance (e.g. mammograms, prostate exams) are two things you can do to keep yourself healthy.

Depression is twice as common among caregivers as non-caregivers. While it is normal to feel down sometimes when taking care of a sick relative, it is important to pay special attention to your mood and seek out medical advice if you start to have symptoms of clinical depression. For example, if you find you are losing interest in the things you normally enjoy the most, or getting angry for no reason, or if you are avoiding friends and loved ones, you may want to see a doctor to be screened for depression.

Take time for yourself

Caregivers are often employed in addition to spending large amounts of time taking care of their patients. You should try to take some time for yourself every day. That doesn’t mean you need to watch a three hour movie; sometimes a hot bath is enough, as long as you have some respite from the day where the only person you are focused on is you. This can do wonders for your emotional well-being.

Get some exercise

Physical activity often gets neglected when caregiving. Finding time to exercise, even for twenty minutes a day can help you maintain your physical health.

Eat healthy

When people are busy they tend to eat more fast food and junk food, or to skip meals entirely. However, even a little effort can improve your eating habits dramatically. Buy breakfast foods that you can eat on the go. Get fruits and vegetables to eat as snacks - they are affordable and portable. Try to make dinner at home. If you don’t have time to make dinner, get takeout or delivery from a restaurant that has a healthy menu option.

Learn how to manage stress

Learning how to manage stress can be difficult, but it can make all the difference for your own health. Stay in touch with your friends and family members. If you need to, ask them for help giving care. Asking for help doesn’t make you a failure; it just means you know your own limits.

Find caregiver resources in your area

Finding support is critical to sustaining yourself as a caregiver. Sharing your experiences with others in a similar situation, or hearing how other people deal with the same challenges that you face can help you gain perspective. See “Core Resources” for links to some caregiver organizations.

Allergy specific issues for caregivers

Taking care of someone with allergies requires vigilance. Many allergy caregivers have a young child who is allergic to several things and just making sure they steer clear of these triggers can seem like a full-time job. Below are some tips on how best to manage the task.

Allergen avoidance

If you know the allergens that provoke a reaction in your allergy sufferer, the best thing you can do for them is help them avoid exposure.

For adults and children with food allergies, this means helping them avoid exposure to foods that contain the allergen. Sometimes this is an easy task, e.g. don’t give a handful of peanuts to someone with a peanut allergy. Unfortunately, some foods contain ingredients that you might not expect to find in them and so reading food labels is critical. You should examine the ingredients list of any food the allergy sufferer is to consume and make sure no food allergens are present. Even if the food in the package does not list a particular allergen as an ingredient, if it is processed in a facility that also processes food allergens, trace amounts may be present in the package. Many food companies have started printing warnings on the food label near the ingredients list stating that the food may contains trace amounts of allergens such as wheat or peanuts.

For children with food allergies, it is important to teach them how to recognize the symptoms of an allergic reaction as soon as they are able. That way, when symptoms occur unexpectedly, they can let an adult know right away. You can also help them learn the look, smell, and taste of the foods they are allergic to so they can avoid them as much as possible. Keeping all traces of those foods that contain the allergy sufferer’s allergens out of the house is the best way to prevent accidental exposure; even trace amounts of food allergens on your hands can cause a skin reaction in a sensitive child.

For adults and children with drug allergies, it may be a good idea to get them a Medic Alert bracelet that lists any known drug allergies in the case that they are hospitalized unexpectedly. It may also help the allergy sufferer to remember to mention their allergies in medical situations. If they are taking a new drug for the first time, stay with them after they have ingested it and watch them carefully for signs of a reaction with a dose of auto-injector epinephrine at the ready. A doctor can tell you more about the potential of specific medicines to cause allergic reactions.

For adults and children with airborne allergies, avoiding or reducing their exposure to allergens is very helpful. This can include things like removing down comforters and pillows from the allergy sufferer’s room, vacuuming and dusting their living space frequently, and keeping windows closed during sensitive months of the year. If the allergy sufferer has a pet allergy, not only should they avoid pets in their home, but if you come into contact with a pet somewhere else, you should make sure to wash your hands and change your clothes before entering the allergy sufferer’s living space.

Controlled exposure to allergens

If a loved one is newly diagnosed with allergies, you may not know all of the things to which they are allergic. A doctor can provide you with a list of things that may cause serious allergic reactions. He or she may recommend avoiding those things entirely or, especially in the case of food allergies, controlling the allergy sufferer’s exposure to new foods. This means providing them with very small amounts of foods containing allergens and then watching them carefully to see if there is a reaction. DO NOT attempt this method unless you have been fully instructed by a doctor on how to carry it out. The doctor could also recommend detailed allergy testing with an allergist to determine the list of allergens. However, since allergies are always subject to change and new ones may appear at any time, it is important to be careful and observant when exposing an allergy sufferer to any new foods, drugs, or other chemicals.

Medication management

Several medications can help prevent the symptoms of allergies and most need to be taken daily. As a caregiver, you should have a system to make sure that the allergy sufferer takes the medications when and how they are supposed to be taken. You can use alarms or timers to remind the allergy sufferer when to take each pill and weekly pill dispensers to make sure they only take the dose that is prescribed. You may want to keep a medicine calendar and note every time the allergy sufferer takes a dose, or have them do it themselves. You will also want to refill prescriptions before the allergy sufferer runs out, so keep tabs on the supply of each medicine.

Side effects

The side effects of allergy medications can be dangerous and as a caregiver, you should monitor the allergy sufferer and be on the lookout for signs of trouble. Some antihistamine medications cause drowsiness and so should not be taken before driving. Steroids, which are found in some nasal sprays, have many possible side effects including nosebleeds, cough, weight gain, and elevated blood pressure. Rarely, long term use of nasal steroids can reduce the body’s ability to fight off or recover from infections of the nose and mouth. Use of decongestant nasal sprays for longer than the recommended three days can cause rebound congestion, commonly referred to as becoming “addicted” to nasal spray. Make sure the allergy sufferer follows the guidelines for all of their medications and note any changes in behavior.

Emotional support

Perhaps the most important role of a caregiver is providing emotional support. Simply being there to listen to the allergy sufferer’s concerns and to provide encouragement can keep them on the path toward health. Especially when you are taking care of a child, letting the allergy sufferer know that you are there for them and making them feel safe despite their infirmity can help them deal with the disease. Providing them with suggestions about how to explain their condition to their friends can help them deal with the social stigma.

Know about the symptoms of severe allergic reactions and anaphylaxis

If you are a caregiver for someone with allergies, especially to food, drugs, or bee stings, you need to be on the lookout for a severe allergic reaction that could lead to anaphylactic shock. This condition, if not treated properly, can result in death in less than one hour. The symptoms of anaphylaxis include:

• swelling of the face and tongue (angioedema),
• trouble with talking
• low blood pressure (hypotension)
• flushed appearance
• hives
• itching of the mouth and throat
• nausea and vomiting
• abdominal pain
• trouble breathing
• difficulty swallowing
• fainting
• unconsciousness

If these symptoms occur CALL 911 IMMEDIATELY and administer injectable epinephrine (EpiPen). Epinephrine will help restore the allergy sufferer’s ability to breathe, but a trip to the hospital is still necessary to stabilize the patient.

Have a plan of action

While it is critical for you as a caregiver to be able to recognize the symptoms of anaphylaxis, it may be even more important to teach the allergy sufferer to be able to recognize the symptoms on their own. Symptoms can develop in minutes and the sooner the allergy sufferer realizes what is happening, the sooner they can ask for help. It is also important to teach them how to self-administer injectable epinephrine and to remind them to carry it with them at all times. Even if they are able to call for help or recruit someone else to do so, the allergy sufferer may still need to administer epinephrine to avoid losing consciousness while waiting for help to arrive. Wearing a Medic Alert bracelet that describes their allergies can help bystanders or paramedics recognize the problem more quickly and allow them to provide help more quickly.