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Reducing Fatigue/Increasing Endurance

During time of life changing events, such as stroke, caregivers often need to improve their endurance. However, more commonly you are in need of relieving feelings of fatigue. Fatigue, both physical and mental exhaustion, may be experienced by you and your loved one.   This exhaustion is a normal result of life changes that have happened in both you and your loved one’s life and have created an uncertain future.

Changes in Your Life:

Changes in Loved One’s Life:

Poor sleep pattern

Physical Dependence

Nervous about role changes

Decreased ability to communicate

New financial burden

Role changes

Pain of loved one’s lost ability

Decreased quality of life

Lower quality of life

Poor sleep pattern

Dependence on friends and family

Unclear about the future

More physical work

Limited time for self

Learning of new skills

Grief over loss of ability

Feeling overcome

Biological change

Unclear about future life

Body image changes

Little time for self

Changes in activity level
  Poor diet

What’s Next?

You and your loved one may be grappling with and possibly faced with anxiety, substance abuse, grief and loss, denial, and fear of dependency, but by knowing what to expect, you may be able to minimize the future fatigue.

 What Can fatigueYou Do?

DEALING WITH ANXIETY

Anxiety can be minimized by verbalizing how you are feeling; this can be done by talking with fellow caregivers, by journaling to yourself, or by attending support groups with other caregivers. Dealing with your loved one’s anxiety may be done in the same way. Your loved ones can talk with nurses, and doctors to voice their concerns, or attend support groups with other stroke survivors where they may learn from others’ successes.

PREVENTION OF SUBSTANCE ABUSE

As a caregiver of a stroke survivor you may find yourself newly overwhelmed. You may feel less healthy, have trouble sleeping, have lost weight and may put off seeking needed medical care. You could also be feeling more anxious or depressed. In the past, you might have been able to make a change and the problem was fixed. However many caregivers find themselves without the coping skills, resources or support they feel that they need.In these hard times many find it easy to use alcohol or other substances as an escape from the painful reality that they are living with. It may start with drinking in order to sleep at night, or the use of medications in times of panic. However overuse can lead to serious problems. Often when overuse has become a problem, life does not seem to work without the use of that drug or alcohol. Although some may think there is no problem others may notice these changes:

  • neglecting your responsibilities at home and in caring
  • causing problems in your relationships such as fights with your partner or family members or loss of old friends and the abandoning of activities you used to enjoy
  • using alcohol or drugs under dangerous conditions or taking risks while under the influence
  • getting into legal trouble, such as driving under the influence.

Recognizing that a problem may be starting or already exists is the first step on the road to recovery, one that takes tremendous courage and strength. Facing this type of problem without minimizing the seriousness of it or making excuses can feel frightening and overwhelming, but recovery is within reach.

Finding help for drug abuse: Call 1-800-662-HELP to reach a free referral helpline from the Substance Abuse and Mental Health Services Administration.

DEALING WITH GRIEF AND LOSS

Grief is a normal reaction to a major loss and is often unhappy and painful. Also, there is no normal time frame for grieving. People may grieve at different paces and in different ways. In the case of caregivers of stroke survivors, you may be grieving the loss of quality of life you once had, relationships which are strained or fear of lost ability to achieve future goals. It may be common for you as a caregiver to feel anger and your loved one may be angry as well. You and your loved one must deal with frustration, vulnerability, and sadness to reach a level of comfort with the new life style. After you have moved beyond grief you can find happiness and balance in your new lifestyle.

Here are some effective and healthy ways to deal with grief:

  • Seek counseling
  • Talk with clergy
  • Try prayer
  • Keep a journal
  • Pursue reflection and
  • Use your support systems.

When you grieve, it is more helpful to surround yourself with support instead of isolating yourself. For connection with support groups or counseling see the list of helpful Resources listed below.  

resting on a couchMANAGING DENIAL

Denial is a common response to a life changing event such as a stroke. Denial is when you are not being realistic about a change happening in your life. You or your loved one may be experiencing denial about the disability the stroke has caused. It’s OK to say, "I just can't think about all of this right now." You might need time to work through what has happened and adapt to new circumstances. It is important to realize that denial ought to only be temporary. Overcome denial honestly, ask yourself what do you fear?

What can you do? Think about the consequences of not dealing with you or your loved one’s feelings. How could that negatively change your lives?

  • Do allow yourself to express your emotions.
  • Identify, with help, where you may be thinking unrealistically about changes that have or will happen, or what your future will be.
  • Encourage your loved one to do the same and allow the same opportunities for him/her.

DEALING WITH FEAR OF DEPENDENCY

Your loved one may be unwilling to accept help. Your loved one might refuse treatment and/or medical advice and may feel embarrassed. What can you do?

  • Express your fears and encourage your loved one to express their fears.
  • Allow your loved one to complete their own care at their own pace and help when needed.
    • Important: MAKE TIME FOR YOURSELF; ALLOW YOUR LOVED ONE THE SAME OPPORTUNITY.
  • If you need help with caring, ask family, friends, clergy, and healthcare providers for advice.

How Can We Eliminate Fatigue and Improve Endurance?

  • How Can Sleep Pattern and Nutrition be Improved?

water aerobicsIt is important to get a good night’s sleep (6-8 hours each night), and take naps when tired. However, try not to nap in the late afternoon or evening. A routine sleep schedule is a good start, such as a standard bedtime of 11pm and just relax after a bath starting at 10pm, and stick to it.

Also, watch your diet, foods high in sugar or drinks with a lot of caffeine can leave you feeling tired. As for your loved one’s nutrition, check out Tips on Nutrition and Dysphagia to help ensure adequate intake of needed foods.

Information on diet and energy can be found at the following link:

http://www.fitness-nutrition-weightloss.com/eat-these-7-energy-foods-increase-energy-levels.html

  • Is Fatigue Associated with a Physical Problem?

Especially in the case of your loved one, could the cause of fatigue be a medication? Is your loved one not sleeping because of pain? Could your loved one be dehydrated/not drinking enough water or beverages? Might your loved one need treatment for depression? If these could be the source of the problem visit your practitioner to help eliminate these.

-      Identify needed and not needed tasks

Could you get help from family and friends or even outside assistance to help with caregiving? You might be afraid or shameful to seek assistance, but you’ll be glad you did. Having help in the house or waiting to perform certain tasks until able might improve your energy level and the relationships that may have suffered from your new caregiver roles. Make lists and reminders if fatigue is causing memory loss, this can improve endurance by reducing stress

-      With the OK of a practitioner get physical therapy for your loved one or start an exercise program together.

Exercising can reduce fatigue and improve strength and endurance for you both, also it may provide your loved one with more ability, and improve their self-esteem. Another helpful tip is thinking of ways to conserve energy, like placing things conveniently, or sitting when showering.

Additional Information:

The following are some web sites to provide you with more information on endurance. (Please click to view the web sites.)

Increase Your Endurance

http://www.stroke.org/site/PageServer?pagename=SS_MAG_sp2011_rehab

Support for Caregivers of Older Adults - Physical Activity

http://www.caregivercollege.org/scoa/?PhysicalActivity.html

Substance Abuse Information

http://helpguide.org/mental/drug_substance_abuse_addiction_signs_effects_treatment.htm

 Support Groups for Persons with Stroke

http://www.stroke.org/site/PageServer?pagename=support_groups

http://www.strokeassociation.org/idc/groups/stroke-public/@wcm/@hcm/@sta/documents/downloadable/ucm_309688.pdf

Counseling Resources

http://www.goodtherapy.org/find-therapist.html?gclid=CLaR7JaCuq8CFQTrKgodigH4hg

http://www.thefamilycaregiver.org/improving_caregiving/protect_your_health.cfm?gclid=CL6hvtGBuq8CFSgTNAoddyeDhg


References:

Ackley, B., & Ladwig, G. (2006). Nursing diagnosis handbook: A guide to planning care (7 ed.). St. Louis, Missouri: Saunders, Elsevier.

McCance, K., & Huether, S. (2010) Pathophysiology: The biologic basis for disease in adults and children (pp. 606, 1149, 1193). Maryland Heights, MO: Mosby, Elsevier.

Rospenda, K. M., Minich, L. M., Milner, L. A., & Richman, J. A. (2010). Caregiver burden and alcohol use in a community sample. Journal of Addictive Disease, 29(3), 314-324

Varcarolis, E., & Halter, M. (2010). Foundations of psychiatric mental health nursing (6 ed.). St. Louis, Missouri: Saunders, Elsevier.

Developed in 2012 by Mathew Dixon, BSPS, at the University of Toledo for Caring~Web©.

 

 

 

 

Last Updated: 6/17/14