"Respite Care is a Must for Caregivers
(Take a Break from Caregiving and Do It Often)"

By Lisa M. Petsche

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If you are providing care to a chronically ill family member, you may be aware of the importance of taking a break from caregiving duties and have arrangements in place that allow for this. If not, this article is for you.

Although caregiving can be very rewarding, it can also be quite stressful over time, owing to the physical toll of hands-on helping and the emotional strain of dealing with the illness of a loved one, especially if he or she poses behavioral challenges. That's why it's important for caregivers to have respite, ideally on a regular basis.

Health care professionals encourage caregivers to take breaks in order to attend to things on their "to-do" list they've been putting off, but especially to take care of their personal needs and maintain their individuality.

This break time can involve a wide variety of activities, from performing necessary household management tasks, to running errands, to engaging in self-care (catching up on sleep, getting a haircut, attending a support group), to enjoying some recreation and leisure time (pursuing a hobby, visiting friends, attending a cultural event, taking a vacation).

Benefits

The goal of respite is to refresh caregivers physically, mentally and spiritually, the change of pace--and often environment--renewing their energy and restoring their perspective. When practiced regularly, respite helps keep the stresses of caregiving manageable, preventing burnout—a common phenomenon among caregivers that's manifested by physical health problems or such emotional symptoms as frequent irritation by small annoyances and feeling overwhelmed.

The benefits of respite extend to care recipients as well: they receive a fresh approach to care and perhaps more individualized attention from the alternate caregiver. If respite takes place in the community, it provides a stimulating change of environment and a chance to socialize as well as participate in new or previously enjoyed activities.

In addition, regular breaks can serve to reduce any tension that might exist between caregiver and care recipient because of constant togetherness and, in some cases, personality differences. Respite also expands each person's world, opening them up to new relationships and opportunities and providing interesting topics for conversation when they're together. This serves to enrich the relationship between caregiver and care recipient.

Care options

In-home respite may be provided by a health care aide employed by a government agency or hired directly by the caregiver through a home health care agency; an individual with or without formal training, hired under a private arrangement (most often located via word of mouth or newspaper classified advertising); a trained volunteer (for example, from the Alzheimer's Association); or a relative or friend.

Community-based respite options include caregiver support groups that offer concurrent care; adult day care centers that provide social and recreational programming and often include a mid-day meal; and residential care facilities that have a short-stay program.

Selection factors

Some caregivers are fortunate to have friends or relatives nearby who are able and willing to provide regular or periodic respite. Some of these people may offer to help, while others might need to be asked but are glad to be of assistance. Other caregivers, however, may not have any local relatives, or none who are in a position to help (due to their own health problems or other obligations, for example), and must rely on formal help instead.

The following factors need to be considered when choosing a respite service:

• Type of assistance needed - companionship, supervision, housekeeping, personal care, or medical monitoring and intervention. This will determine the type of caregiver qualifications required.
• Special medical or behavioral needs, communication challenges, or eccentricities of the care recipient.
• Time involved - length and frequency of desired breaks.
• Setting - consider transportation issues as well as the care recipient's energy level, personality (for example, shy versus outgoing) and any preferences he or she might have.
• Cost, including whether a subsidy is available, or if any insurance will cover it. Be aware that many agencies charge a three-hour minimum per visit for homemaking, personal support and companion services.

If you decide to seek private in-home help, arrange to meet with the potential helper in your home after performing a telephone screening. Prepare a list of questions in advance, to help you determine his/her qualifications and suitability, and provide a comprehensive description of your relative's needs and your own expectations. Pay close attention to how the candidate interacts with your relative. Ask for and check references (both educational and employment-related), and do a police check on anyone you decide to hire.

If you wish to pursue care in an adult day care center or residential care facility, take some tours and talk with staff and clients. Involve your relative in this process as well, if feasible. Otherwise, bring along a family member or friend for a second opinion.

Lisa M. Petsche is a medical social worker and a freelance writer specializing in health and elder care issues.