If caring for your spouse keeps pushing back your own doctor's appointment, make the appointment you have been putting off and keep it. When you go, tell the doctor that you are a caregiver, since doctors may be able to suggest resources online or in your community.
Whether putting off your own appointments is a warning sign
Putting off your own appointments fits a pattern common among caregivers, though it is not itself one of the stress signs listed below. Caregivers are less likely than others to get preventive health services, like annual checkups, and to practice regular self-care, and as a result they tend to have a higher risk of physical and mental health problems, sleep problems and chronic conditions such as high blood pressure. Caregivers also often neglect their own health needs, which raises their risk of having multiple chronic conditions, and nearly 2 in 5 have at least two chronic diseases of their own. These describe caregivers as a group and predict nothing about you.
You may be on call for 24 hours a day, and working outside the home or looking after children as well, so make sure your own physical and mental health are not being ignored.
Whether this is a busy year or something more is easier to judge against the signs of caregiver stress to watch for:
- feeling exhausted, overwhelmed or anxious
- becoming easily angered or impatient
- feeling lonely or disconnected from others
- having trouble sleeping or not getting enough sleep
- feeling sad or hopeless, or losing interest in activities you used to enjoy
- having frequent headaches, pain or other physical problems
- not having enough time to exercise or prepare healthy food for yourself
- skipping showers or other personal care tasks such as brushing your teeth
- misusing alcohol or drugs, including prescription medications
Two of the nine are about time rather than feeling, so you can check them against the last few weeks: whether there has been time to exercise or prepare healthy food for yourself, and whether showers or other personal care have been skipped. Learn which signs are your own warning signs, and take steps to cut down the sources of stress where you can, before you are completely overwhelmed. If trouble sleeping or losing interest in things you enjoy is severe or distressing and has lasted 2 weeks or more, see your primary care provider; the last section gives more such symptoms, and where to turn in a crisis.
Who else can take something on
Beyond family and friends, others who may be able to help include:
- your doctor, who can give you advice about your own physical and mental health and may know about support groups and other resources in your community, including respite care, where someone else looks after your spouse for a while so you get a break
- a counselor or other mental health professional, if you are feeling anxious, frustrated or depressed; ask your doctor for a referral, and ask your health insurance provider what your plan covers
- your local senior center, state office on aging, social services office or Area Agency on Aging, which will be familiar with the resources in your community and may have tips for getting them; to find a senior center near you, search the Eldercare Locator, whose number is 800-677-1116
- your faith community, where larger congregations may host support groups for caregivers, and where you can ask a pastor, rabbi or other religious leader for guidance
These suggestions are written mostly for people caring for an older adult, so ask each office whether it serves your situation. The tips below on asking for help do not depend on age.
For more information on caregiver health, you can reach the Well Spouse Association at 800-838-0879.
Relatives who live far away can still take part of the load. Long-distance caregivers can help by providing emotional support to the primary caregiver and coordinating certain aspects of care from afar, and someone who is good with numbers could take charge of tasks such as paying bills, keeping track of bank statements and reviewing insurance policies.
Respite care can last anywhere from a few hours to several weeks at a time, long enough to cover an appointment, and it can take place at home, in a health care facility or at an adult day care center. Family, friends or volunteers can sometimes provide it, and there are professionals who offer it. You can search for respite resources in your area, including state-sponsored programs, adult day care centers and services for veterans, with the ARCH National Respite Locator Service on archrespite.org, and the ARCH National Respite Network and Resource Center is at 703-256-2084.
Who provides the respite care changes what it may cost:
| Who provides it | How to find it | What it may cost |
|---|---|---|
| a friend, relative or volunteer | ask them to step in for the hours you need | may come at no cost |
| a professional service | the ARCH National Respite Locator Service, on archrespite.org | charged by the hour or by the number of days or weeks; most private health insurance plans do not cover it, some long-term care insurance plans may, and Medicaid may help pay |
How to ask for help without organizing it all yourself
Ask for small things at first, if that makes it easier for you, and keep a list of what needs doing so the person who offers can choose from it. Many large jobs can be broken down into simpler tasks, and a ready-made list of caregiving activities you could divide up with others is the Coordinating Caregiving Responsibilities worksheet from the National Institute on Aging.
If asking is hard for you, these tips may help:
- If you are not comfortable asking face to face, send a text or email with your request.
- Think about a person's skills and interests when working out how they could help.
- When someone offers, practice saying, "Thanks for asking. Here's what you can do."
- Be honest about what you need and what you don't need, since not every offer is going to be helpful.
- Be ready for some people to say no, and try not to take it personally.
A request can be as small as one of the tasks caregivers do, such as running an errand, doing housework or cooking, or driving your spouse to an appointment. A main caregiver, especially a spouse or partner, may be hesitant to ask for help or a break. Yet many caregivers later say they did too much on their own and wished they had asked family and friends for more support. Many people want to help, and it makes them feel good to contribute.
If keeping track is the part you dread, there are smartphone apps for dividing up caregiving duties, keeping an appointment calendar and sharing updates with others.
When to see a doctor about how you feel
Once severe or distressing symptoms have lasted 2 weeks or more, see your primary care provider about how you feel. Examples include:
- difficulty sleeping
- changes in appetite or unplanned weight changes
- difficulty getting out of bed in the morning because of mood
- difficulty concentrating
- loss of interest in things you usually find enjoyable
- inability to complete usual tasks and activities
- feelings of irritability, frustration or restlessness
Your primary care provider can also send you on to a psychologist, a psychiatrist or a clinical social worker, qualified mental health professionals who can help you work out the next steps (see Flat and tired for weeks while eating less? Book a doctor's visit). If the appointment you keep moving is with your primary care provider, it can cover this as well, and that gives you a second reason to keep it.
If you are struggling or thinking about suicide, reach the 988 Suicide & Crisis Lifeline by calling or texting 988, or by chat at 988lifeline.org; it is confidential and free, and available at any hour of any day. If anyone's life is at risk, call 911.
If you already have a NicoCares account, the care team reaches you through the Spruce app; write to them there that you are caring for your spouse, and let them know promptly about changes in your health, symptoms like those above included. Take those symptoms to your primary care provider too. A message can wait for its answer and a crisis cannot, so a crisis goes to 988 or 911, never to Spruce.
