Are you having back pain with any of the following?

  • Severe pain, weakness or tingling in your leg(s).
  • Difficulty stopping urination or loss of control of bladder or bowels.
  • Unexplained fever, nausea or vomiting.
  • A history of cancer or unexplained weight loss.

We understand that you are experiencing one or more of the health issues that might be impacting your back pain.

We recommend that you discuss these health issues with your doctor before proceeding with this program.

Once you are cleared by your doctor to do this program, we hope it helps you find relief from your back pain.

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Caregivers

Being a caregiver is a very special role with its own health challenges for the person providing care. We offer tips and strategies so that you can do this important job while protecting your health and well being.

Overview

Being a caregiver to a disabled adult child or an elderly parent is a great service, best performed out of love. Caregiving, willingly accepted, will have its rewards, but it is a very demanding job. If you are someone's full-time caregiver, you will probably have less time to devote to your family, your career, and other pursuits.

The physical, mental, and emotional challenges of caregiving can give rise to many uncomfortable feelings, including:

  • A sense of being overwhelmed with responsibility
  • Anger about having little time for yourself
  • Fear that you will not be able to continue this for much longer
  • Frustration that you cannot do more
  • Urges to physically strike out at the person you are caring for
  • Resentment toward the person you are caring for

Though you should not let feelings such as anger and resentment (much less violent urges) dictate how you act, you should allow yourself to have these feelings without judging yourself for them. All these feelings are natural. Support is available to help you understand your feelings.

Caregiving can be exhausting and all-consuming. Burnout is a real hazard. Therefore, good self-care and coping skills are essential. Your own well-being is extremely important – not only for yourself and your family, but also for the person you are caring for.

Improve Communication

Clear communication between yourself and the person you are caring for will make life easier, more pleasant, and less stressful for both of you.

Even if you have known someone for years, and you have been used to communicating with the person, the fact that you are now the caretaker places new demands on both of you. Therefore, it is important to be deliberate and thoughtful in establishing good communication habits.

Setting the tone

If you're feeling tense, breathe deeply a few times and calm yourself before beginning a conversation. If you are calm and collected, this will have a relaxing effect on the other person, too. Remember to keep breathing deeply as you converse.

Be at eye level with the person, rather than standing above them. If they are sitting, sit next to them. Look them in the eye. Make sure they have their hearing aids and/or glasses on.

When conversing, minimize or eliminate background distractions, such as television noise.

Speaking and listening

When conversing, give the person your full attention. Don't try to wash dishes or fold laundry while you talk. It may also be helpful to speak in short, simple sentences.

Ask questions one at a time. Listen closely to the answers. Allow the person time to think and respond. Allow silences to stretch for some moments. Sometimes, a person receiving care may be hesitant to express their fears and discomforts. Patient, attentive listening can help someone feel safer saying what they're really thinking and feeling.

Speak at a slow pace, but do not talk to your loved one in a condescending way. When addressing a third person in the room, never talk about the person you're caring for as if they're not there or as if they can't hear or understand you (even if you think they really can't).

Nonverbal communication

Pay close attention to the person's body language. Do they look relaxed? Anxious? Listen to their tone of voice, too, for a sense of how they are feeling.

When appropriate, physical touch can help to reassure your loved one. A simple gesture such as touching the person's shoulder or placing your hand on their hand can be more effective than words. Smiling is also helpful.

Avoiding communication problems

Being dependent on someone and constantly requiring their help can cause a person to feel irritable and even resentful. If the person you are caring for acts grouchy and unreasonable, try not let yourself be drawn into an argument.

At times this can be difficult, especially if the person is someone who knows you well, such as a parent. Still, it is up to you, the caretaker, to maintain a civil and respectful tone. Also, keep in mind that beneath their words the person you are caring for is probably frightened and sad about having to be dependent.

Use humor to help relieve tension. Remind your loved one of fond, familiar people and events. Draw attention to sentimental objects and photographs. Put on music to help lighten the mood. If your loved one is upset, try to distract them from what's bothering them by directing their attention elsewhere.

Be creative and flexible and patient with yourself. Do not expect yourself to be perfect and do not blame yourself when communication problems arise. Take guilt-free time for yourself. Enjoy a break from caregiving tasks.

Get Help

As a caregiver, you are inevitably going to need help. You cannot do everything yourself.

Your main sources of help will be other family members and outside services.

Family member help

You can ask other family members and close friends to help out in 3 ways:

  • Delegate specific tasks, such as grocery shopping or certain household chores, to other family members on a regular basis. This way, they each assume some manageable portion of caretaking duties.
  • Ask other family members to be available for occasional "respite" backup. Arrange for them to "cover for you" when you need a break for a day, a weekend, or longer. They should understand that this periodic relief is absolutely necessary in order for you to maintain your role as the primary caretaker.
  • When important decisions need to be made on behalf of the person you are caring for, such as medical or financial decisions, bring other family members into the discussion. Obtaining the necessary legal information and documents when you are a surrogate decision maker is appropriate if your loved one cannot make decisions.
Other services

A range of elder care and respite care services are available in most communities. Talk to your loved one's health care providers and social workers and/or ask friends, family, and colleagues for referrals. Senior centers, too, can help steer you in the right direction, or you can check with your local Agency on Aging or chapter of the American Association of Retired Persons (AARP). There are many options, including the following:

  • Adult daycare programs provide recreational activity, such as singing and games, along with close supervision. Such programs enable you to have a break for hours at a time. Some adult daycare programs are available for a low cost at assisted living facilities. Also, many government-funded adult daycare programs are free or low-cost.
  • Private home care services can allow you to leave the home while an aide provides bathing, toileting, and other personal care services to your loved one.
  • Home-delivered meal services are also an option that can save you meal-preparation labor. Many of these programs are government-funded (for qualified care receivers) and offer a wide variety of menu choices.

In some cases, your loved one's insurance or medical plan may cover all or part of the costs of adult daycare and respite home services. In addition, the National Family Caregiver Support Program and the Older Americans Act help fund respite care and other services for families in need. Some agencies and community groups provide volunteer help as well. Local support groups may also be available.

Avoid Caregiver Burnout

Signs of burnout

As a caregiver, it is easy to lose yourself in the demands of your job and neglect your own needs. But if you fail to care for yourself, the burden of caring for someone else can lead to burnout.

Signs of burnout include:

  • Lack of interest in activities you used to enjoy
  • Difficulty sleeping
  • Social withdrawal/isolation from friends
  • Exhaustion and irritability
  • Feelings of sadness, hopelessness, and helplessness
  • Getting sick often
  • Careless, unhealthy eating and/or increasing use of alcohol 
Preventing burnout

The following steps are all essential for preventing burnout:

  • Take plenty of breaks. Get respite care when you need it from family or professional services. Studies show that caregiving for lengthy periods of time without a break is a risk to your physical and emotional health.
  • Be firm about your limits. Everyone has a point beyond which they can do no more. Be clear about the limits of your time, energy, and stamina and communicate your limits to the other members of your family, as well to health care providers.
  • Take good care of your physical health. Get plenty of exercise. Walk, run, swim, dance, do yoga – whatever works for you. Eat healthy meals every day and limit your intake of junk food and alcohol. Make sure to have your own regular medical checkups, get flu shots, and take your own medication (if any) as prescribed. Meditation or other relaxation activity is also a good way to reduce your stress and strengthen your health.
  • Get a good night's sleep. If you're having trouble sleeping, try reducing or eliminating caffeine. Daily exercise will also help you to fall asleep at night. Many people also find relaxation tapes or soothing music effective for falling asleep.
  • Get plenty of emotional support. Caregiving often brings up difficult emotions, such as sadness, guilt, and resentment. Have someone to talk with about your feelings. If you don't have friends or family members you can confide in on a regular basis, consider joining a caregiver support group or getting professional counseling. Support may also be found in your place of worship or spiritual community.
  • Manage your time wisely. Establish routines. Have grocery lists and lists of tasks to complete. Keep often-used items in designated places. Plan activities for the week. Make sure to schedule "down time," too.
  • Include enjoyable activities in your life every day. You need enjoyment because without it, you will burn out. Every day, do something that gives you pleasure, whether it's reading a book or magazine, watching a favorite TV show, spending time with (or calling) a friend, drinking a cup of hot chocolate, romping with the dog, walking on the beach, treating yourself to a therapeutic massage, gardening, listening to music, going out to a movie, or any other favorite activity. It may even help to make a list of your healthy pleasures, so that you can remember to keep them central in your life.

Stay Emotionally and Mentally Healthy

Maintaining your emotional health is as important as keeping physically healthy. Caregivers are at an increased risk for depression and other emotional problems.

The first step in staying emotionally healthy is to acknowledge negative feelings when they arise and never to judge yourself, even for the "worst" types of feelings, such as rage and resentment.

It is also essential that you have someone to talk with, whether it is a psychotherapist, a grief counselor, or a trusted close friend or family member.

Manage stress

Caring for someone else can be stressful. Consider what has helped you through stressful situations in the past. Create time to take care of yourself and reduce your own stress level by doing the following:

  • Develop healthy habits such as getting enough sleep, eating healthy meals, and exercising regularly.
  • Develop a support system of people you can talk with and lean on.
  • Participate in uplifting free time activities.
  • Manage your time to avoid rushing around and to allow time to relax.
  • Set realistic life goals that do not put too much pressure on your time or your health.
  • Manage chronic illness or chronic pain, if needed.
You may be at risk for depression

Everyone has difficult feelings from time to time. Depression, however, is a serious condition of ongoing emotional pain or numbness.

If you are a caregiver, there may be no other person observing you each day to make sure that you are okay. Therefore, you need to observe yourself. If you are experiencing any of the following symptoms, you may be clinically depressed:

  • Unrelenting feelings of sadness, helplessness, and hopelessness
  • Crying every day or feeling constantly on the verge of tears
  • Suicidal thoughts
  • Appetite changes
  • Lack of interest in people or pleasurable activities
  • Feeling continually exhausted and drained of energy 
If you are depressed, you can take steps to help yourself

Seek professional help

  • It is important to recognize that if you find you cannot combat your depression on your own, you should certainly seek professional help immediately. Different forms of psychotherapy, as well as anti-depressant medication, have proven very effective in treating severe depression. Talk to your health care provider about these options.
  • Do not expect to feel "up" right away. It takes time to recover from a bout of depression. You will begin to feel better gradually if you continually take the right steps.

Develop and maintain healthy lifestyle habits

  • Physical exercise has been shown to help relieve depression. Simply walking briskly outdoors for 30 to 60 minutes is often enough to lift one's spirits and dispel depression. Making time to exercise can be challenging for caregivers, but even if you are not depressed, it is essential to get regular exercise.
  • Getting enough sleep and eating a healthy diet are also important for overcoming depression.
  • Setting reasonable goals for yourself helps, too. Break tasks down into small steps and don't be hard on yourself for not getting things done.
Additional References:

If you have an emergency medical condition, call 911 or go to the nearest hospital. An emergency medical condition is any of the following: (1) a medical condition that manifests itself by acute symptoms of sufficient severity (including severe pain) such that you could reasonably expect the absence of immediate medical attention to result in serious jeopardy to your health or body functions or organs; (2) active labor when there isn't enough time for safe transfer to a Plan hospital (or designated hospital) before delivery, or if transfer poses a threat to your (or your unborn child's) health and safety, or (3) a mental disorder that manifests itself by acute symptoms of sufficient severity such that either you are an immediate danger to yourself or others, or you are not immediately able to provide for, or use, food, shelter, or clothing, due to the mental disorder. This information is not intended to diagnose health problems or to take the place of specific medical advice or care you receive from your physician or other health care professional. If you have persistent health problems, or if you have additional questions, please consult with your doctor. If you have questions or need more information about your medication, please speak to your pharmacist. Kaiser Permanente does not endorse the medications or products mentioned. Any trade names listed are for easy identification only.

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