What does a caregiver do on an off day? Take a day off.
How does a caregiver caring for a person with dementia reset their levels of stress? Anyone? Anyone? Bueller? Taking a day off – or even just the perspective of one – can return caregivers’ stress to normal levels, according to a study published recently in the journal The Gerontologist. Much has been said about the positive effect that respite care can have, but this was the first time that the levels of the stress hormone cortisol have been measured shortly before and during a group of caregivers’ days off. And the best part is that they didn’t even have to go on an escapade through the landmarks of downtown Chicago.
Previous research has suggested that getting time off can significantly relieve the stress caregivers feel – the levels of which can reach stratospheric heights, as has been very well documented too. That was the starting point for study author Laura Cousino Klein from Pennsylvania State University, who monitored 158 people caring for a relative with dementia for eight days, including at least two days in which the care receiver went to an adult day center. The participants reported stressful events and their moods by phone once a day, and collected their own samples of saliva five times per day to be measured for cortisol.
This hormone plays a role in the ‘fight or flight response. Levels of cortisol are at their highest approximately one hour after waking and level off over the course of the day. During stressful times, however, cortisol levels can go through the roof or flatten out, a classic sign of caregiver burnout. Abnormal levels of cortisol have been associated with depression, cognitive issues, and suppressed immune response, among other complications. The study found that the subjects had fewer care-related stressors and more positive experiences on the days their relatives with dementia were at a an adult daycare center, and that cortisone level patterns improved during those days, starting in the morning even before the patient left. “Caregivers may look forward to adult daycare service days and begin the days with a greater focus on getting through their morning routine,” the authors wrote.
Letting off some steam benefits both the carer and the dementia patient. “If the caregiver is comfortable, at ease, calm, in good spirits, that’s going to carry over to the person who’s receiving the care, and conversely if the caregiver is upset, that person with dementia is going to be affected by that,” director of the Division of Geriatric Psychiatry at Montefiore Medical Center in New York Dr. Gary Kennedy, who was not involved in the study, told Reuters. “This study reinforces the notion that caregivers need support and sometimes that support means sharing the care.”
Even if “interventions such as adult daycare services that provide partial relief from daily stressors may help caregivers provide care longer while reducing their risk of illness,” as Cousino wrote, Kennedy warns that the results may not apply to all caregivers because the study centered on a group of people who had already felt the urge to provide care for their loved one with dementia in the form of some sort of adult daycare setting. “It’s important to realize that there are lots of dementia caregivers who don’t need any assistance - they manage remarkably well,” Kennedy said. “Some families just get this and they have multiple individuals who provide support so it just works without any outside support.”
In any case, if you happen to be a caregiver and feel guilty at the mere thought of taking a day off, just remember: “Life moves pretty fast. If you don't stop and look around once in a while, you could miss it.”