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Stress Management & Prevention Program for Alzheimer’s Caregivers

The group I have chosen is Alzheimer's caregivers as it is very close to my heart since

it involves all my family. Caring for a person with Alzheimer's is very challenging and

requires a lot of work and a lot of people. There are many moving parts involved from daily

care, decision making, medications, and doctor visits so there is a lot of stress to go along

with it especially as the disease progresses. In my family, it is my mother who has

Alzheimer's with most of the care falling upon my four sisters who live in the area, and my

father who helps as he can. We are lucky in the fact that there are so many family members in

the area to provide care. However even with that many close by there still can be times that

they feel overwhelmed and stressed since they not only have to care for our mother but also

their own families. Over the past several years my mother has become more like a happy child

who does not realize what is happening so we all do what we can to keep the happy face and

enjoy our time with her.

There are many things that can stress a person out in their own lives however by

adding in the additional responsibility of caring for someone with Alzheimer's stress is now

compounded. The list of things that can stress a caregiver out is very long, so I reached out to

my sisters to ask what stresses them the most about caring for our mother and was sad but not

surprised by their answers. My sister Marcia advised that her biggest stressor is that wanting

to ensure a way of giving my mother the independence she would want so she can do things

on her own but the realization that she cannot (2020). She mentioned an example of getting

her dressed if our mother were left to dress herself it would be the exact same outfit every day

without changing (Sargent, 2020). Her other concern is how easily she could be taken

advantage of since out mother has no real concept of time someone could tell her something
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and she would agree (Sargent, 2020). Next my sister Melinda has the stress of feeling like she

is never doing enough for our mother and not being able to provide her with full-time care

(2020). She struggles with the feeling of failing our mother (Homan, 2020). Her other stress is

that of our father who for years was in denial which only hurt the situation he now is more

willing to accept things however he is not a full participant in her care (Homan, 2020).

Additionally, she stresses over wanting to ensure our mother has things that stimulate her

mind so that we can in some way slow her progression (Homan, 2020). As for my sister

Monica’s thoughts she just feels mentally drained caring for her and dealing with the daily

challenges that arise from her not knowing my sister or my father not helping enough (2020).

An additional concern is not having the whole family on the same page with care and

everyone wanting to do something different (Zeigler, 2020). Being able to manage everything

can be very trying for anyone. Lastly my sister Michele bathing and washing our mother’s

hair can be stressful since she sometimes must convince her that it needs to be done (2020).

Sometimes she needs to distract her to get her to cooperate to be bathed or to even change her

clothes (Gresh, 2020).

In summary of the items that caregivers can stress over would be of the feeding,

bathing, dressing, providing medications but also stimulating their brains, keeping them

active, not feeling like a failure, wanting to keep them safe from being taken advantage of,

and the stress of watching them decline without realizing what is happening as you watch the

whole thing.

According to the Alzheimer's Association, the stress a caregiver feels is frequent and

overwhelming which can lead to harmful health and mental obstacles. Such possible

problems that could arise is that of anxiety, depression, exhaustion, sleeplessness, irritability,
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anger, and a lack of concentration (Alz.org, n.d.). Stress is not only felt mentally but also

there are many physical problems that can be associated with stress. Physical symptoms that

could appear are that of frequent headaches, weight gain or loss, weakened immune system,

digestive issues, and a higher risk of chronic diseases (Caring Bridge, 2020). However, it is

possible for caregivers to manage the stress they feel by giving their mind and body the care it

deserves as well. Once they can understand their own health is just as important, they may be

able to work together to reduce the stress.

There are many things that can be done to manage stress through mindful strategies

and practices. The stress management program created for my family can easily be adapted to

any caregiving group of friends, family, or just those in the same position of having to care for

a family member with Alzheimer’s. The program would include mindful lying yoga,

meditation, journaling, music, or art group therapy, creating personal mantras, and open group

conversations. Seaward has provided some suggestions when it comes to personal stress

management strategies that if followed could make accepting a new program easier to

understand. First is to spend time each day getting to know yourself better through different

activities such as journaling or music therapy (Seaward, 2018). Next would be to understand

your emotions and why you were triggered. When you can notice your emotions and why

something sets you off you can learn to control them and help yourself cop (Seaward, 2018).

Another is something I find very important and that is the practice of unconditional self-love.

This can be one of the most rewarding but most difficult tasks to learn. Self-esteem goes hand

in hand with effective stress management so by thinking positively you can appreciate your

intelligence, emotions, and spiritual self (Seaward, 2018). It is also important for well-being

to take the time needed to balance all aspects of life (Seaward, 2018). Then lastly it is
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suggested to be like a child learn to giggle at the little things, smile more, or just let yourself

cry. Cultivate curiosity, imagination, and creativity while letting go of adult expectations

(Seaward, 2018). Learning and growing through mindful practices can benefit life in so many

ways even if we just start with one change.

To implement the program for my sisters is to do a form of meditation and journaling

daily, mindful lying yoga at least twice a week, and the music/art therapy and group

conversation monthly. As for the personal mantra, they should create one that is specific to

their own thoughts for example: "I love myself", "Breath you can handle anything", or "Smile,

life is beautiful and so are you".

Meditation: To practice proper meditation you first must practice mindful breathing. To

effectively clear your mind first set your focus on each breath as it flows in and out of your

body (Stahl & Goldstein, 2019). If need be practice laying down with your hand on your

stomach so you can feel your breath from the abdomen. During this time close your eyes and

think about what you are grateful for. Should your mind wander allow yourself to

acknowledge these thoughts then refocus on your breathing (Stahl & Goldstein, 2019). We do

not want to ignore the thoughts that arise however we should not focus on them. Allow

yourself to be present at the moment so that throughout the day you can be present in your life

(Stahl & Goldstein, 2019). Meditation practice should be at least 10 to 15 minutes per day

working up to 30 minutes. However, if only 5 minutes can be done that is fine as well the

point is to do daily practice.

Mindful lying Yoga: This form of yoga is a great way to implement mindfulness through

relaxing, stretching movements that can rejuvenate their bodies (Stahl & Goldstein, 2019).

Worksheets will be provided with full details on how to do each of the yoga poses but by
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doing lying yoga instead of the standard it is easier on their bodies. Yoga should be done a

minimum of twice a week for no less than 15 minutes to receive the full benefit.

Journaling: Is a great way to enhance self-awareness and self-reflection between mind and

soul creating a deeper coping mechanism for stress (Seaward, 2018). Each of them should

keep a notebook and spend at least 10 to 15 minutes writing each day about the events that

took place no matter how small, how they are feeling, and all the emotions that were included.

There is no judgment in journaling so they can feel free to say anything without fear.

Music/Art therapy: Each month one day should be set aside for creativity and fun together as

a group with the sisters, mom, and dad as well as any other family member who wants to join.

They can take turns hosting everyone in their homes or find a location that suits their needs. A

specific day should be selected each month so that there is consistency and accountability

among the group. I suggest picking the 2nd or 3rd Sunday of each month so that everyone

knows they will be available. Music and art therapy are powerful agents for stress reduction

and relaxation (Seaward, 2018). The person hosting will select the music preferably

something upbeat and fun. As well as having a creative activity that is easy enough for

everyone to make. For example, making cards for each other, painting pictures, or making

floral arrangements. Anything that gets the mind active and allows for freedom of expression.

Group conversation: This could be the most difficult for my sisters to handle however it is

important that they each find a way to express themselves through personal ideas and feelings

while being open to the other's feelings (Seaward, 2018). This self-disclosure will create

mutual trust and improve their communication skills as a family caregiving group (Seaward,

2018). I recommend that they meet a minimum of once a month at a place of their choosing
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and allowing each of them to take turns speaking freely to each other without judgment or

criticism. Each person has their own unique perspective on how they see things and another's

opinions should not be pushed upon them. Allowing for open discussion can create a stronger

bond and move forward they will be able to come to each other with a stressful situation and

work through things together.

The main obstacles they will face are themselves how to get out of their own way. It is

an unfortunate reality that when there are stress and family involved emotions can run high

leaving people to possibly misunderstand conversations and others left feeling hurt. Other

obstacles could possibly be the location of where to do each activity which is why it is

suggested to take turns hosting each other that way one person does not have to take on the

entire responsibility. A calendar can be created for the group get-togethers as well as a

personal calendar for daily and weekly activities. In addition, they should keep each other

accountable to the group and for themselves. Nevertheless, should they come together

willingly and openly then the obstacles can be reduced and possibly even avoided.

Alzheimer's Association has online and in-person support groups that can be utilized

for support for the family group as well as answer any questions the caregivers have about

what to expect or how to give care. Having someone to talk to who understands what you are

going through is a vital asset for any caregiver no matter the disease or relationship to the

patient. My sisters can join now zoom support meetings or find comments on a current

message board for Alzheimer's (Alz Connected. n.d.). The point is for them to know they are

not alone in any of their feelings and that the feelings they are having are valid and should be

acknowledged. Their other form of support is that of our mother's physician who can listen to

their needs as well as make recommendations for care, nutrition, or even just listen to them.
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In the setting of my sisters, the measurement of success for this program will be on

their own personal levels. A marked reduction of stress will be felt after a few months of

sticking to this program should they follow through will all the recommendations. Should this

get adapted to other groups there can be stress surveys given bi-monthly or every six months

to document the level of stress, tension, and anxiety. After the first six months, new

recommendations can be given, or the program adapted to either increase progression or

should any problems arise.

Caring for a person with Alzheimer's can be incredibly stressful however with the

support of the group things can be easier. The disease does not and should not diminish their

lives however the way things are done may be dictated by the ability of the patient. Through

mindfulness everyone's lives can be improved, health can be improved, and most of all stress

will be reduced. The stronger bond that will be felt is more than worth the effort for the

unfortunate short number of years left. This program is designed to give each a personal

option for relaxation and stress reduction as well as to be a support system for each other. Be

aware of the moment enjoying life and loving each other to give mom and dad the greatest

care possible.
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References

Alzheimer's Association (Alz.org). (n.d.) Caregiver Stress. Alzheimer's Disease and Dementia.

https://www.alz.org/help-support/caregiving/caregiver-health/caregiver-stress.

Alz Connected. (n.d.) Alzheimer's. Retrieved from:

https://www.alzconnected.org/discussion.aspx?g=topics.

Caring Bridge. (2020, April 29). 14 Life-Changing Tips for Managing Caregiver Stress.

CaringBridge. https://www.caringbridge.org/resources/techniques-to-relieve-caregiver-

stress/?gclsrc=aw.ds.

Gresh, M. (2020, August 29). Personal Interview

Homan, M. (2020, August 28). Personal Interview

Sargent, M. (2020, August 28). Personal Interview

Seaward, B. (2018). Managing stress: Principles and strategies for health and well-being (9th

ed.). Jones & Bartlett Learning.

Stahl, B., & Goldstein, E. (2019). A mindfulness-based stress reduction workbook (2nd ed.).

New Harbinger Publications.

Zeigler, M. (2020, August 29). Personal Interview

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