How To Avoid Carer Burnout (Without Dropping Care)
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How To Avoid Carer Burnout
Sometimes in life we find ourselves in a caregiving role.
Maybe we chose it. For example, by becoming a professional carer, or even just by being a parent.
Oftentimes we didn’t. Sometimes because our own parents now need care from us, or because a partner becomes disabled.
Philosophical note: an argument could be made for that latter also having been a pre-emptive choice; we probably at some point said words to the effect of “in sickness and in health”, hopefully with free will, and hopefully meant it. And of course, sometimes we enter into a relationship with someone who is already disabled.
But, we are not a philosophy publication, and will henceforth keep to the practicalities.
First: are you the right person?
Sometimes, a caregiving role might fall upon you unasked-for, and it’s worth considering whether you are really up for it. Are you in a position to be that caregiver? Do you want to be that caregiver?
It may be that you do, and would actively fight off anyone or anything that tried to stop you. If so, great, now you only need to make sure that you are actually in a position to provide the care in question.
It may be that you do want to, but your circumstances don’t allow you to do as good a job of it as you’d like, or it means you have to drop other responsibilities, or you need extra help. We’ll cover these things later.
It may be that you don’t want to, but you feel obliged, or “have to”. If that’s the case, it will be better for everyone if you acknowledge that, and find someone else to do it. Nobody wants to feel a burden, and nobody wants someone providing care to be resentful of that. The result of such is two people being miserable; that’s not good for anyone. Better to give the job to someone who actually wants to (a professional, if necessary).
So, be honest (first with yourself, then with whoever may be necessary) about your own preferences and situation, and take steps to ensure you’re only in a caregiving role that you have the means and the will to provide.
Second: are you out of your depth?
Some people have had a life that’s prepared them for being a carer. Maybe they worked in the caring profession, maybe they have always been the family caregiver for one reason or another.
Yet, even if that describes you… Sometimes someone’s care needs may be beyond your abilities. After all, not all care needs are equal, and someone’s condition can (and more often than not, will) deteriorate.
So, learn. Learn about the person’s condition(s), medications, medical equipment, etc. If you can, take courses and such. The more you invest in your own development in this regard, the more easily you will handle the care, and the less it will take out of you.
And, don’t be afraid to ask for help. Maybe the person knows their condition better than you, and certainly there’s a good chance they know their care needs best. And certainly, there are always professionals that can be contacted to ask for advice.
Sometimes, a team effort may be required, and there’s no shame in that either. Whether it means enlisting help from family/friends or professionals, sometimes “many hands make light work”.
Check out: Caregiver Action Network: Organizations Near Me
A very good resource-hub for help, advice, & community
Third: put your own oxygen mask on first
Like the advice to put on one’s own oxygen mask first before helping others (in the event of a cabin depressurization in an airplane), the rationale is the same here. You can’t help others if you are running on empty yourself.
As a carer, sometimes you may have to put someone else’s needs above yours, both in general and in the moment. But, you do have needs too, and cannot neglect them (for long).
One sleepless night looking after someone else is… a small sacrifice for a loved one, perhaps. But several in a row starts to become unsustainable.
Sometimes it will be necessary to do the best you can, and accept that you cannot do everything all the time.
There’s a saying amongst engineers that applies here too: “if you don’t schedule time for maintenance, your equipment will schedule it for you”.
In other words: if you don’t give your body rest, your body will break down and oblige you to rest. Please be aware this goes for mental effort too; your brain is just another organ.
So, plan ahead, schedule breaks, find someone to take over, set up your cared-for-person with the resources to care for themself as well as possible (do this anyway, of course—independence is generally good so far as it’s possible), and make the time/effort to get you what you need for you. Sleep, distraction, a change of scenery, whatever it may be.
Lastly: what if it’s you?
If you’re reading this and you’re the person who has the higher care needs, then firstly:all strength to you. You have the hardest job here; let’s not forget that.
About that independence: well-intentioned people may forget that, so don’t be afraid to remind them when “I would prefer to do that myself”. Maintaining independence is generally good for the health, even if sometimes it is more work for all concerned than someone else doing it for you. The goal, after all, is your wellbeing, so this shouldn’t be cast aside lightly.
On the flipside: you don’t have to be strong all the time; nobody should.
Being disabled can also be quite isolating (this is probably not a revelation to you), so if you can find community with other people with the same or similar condition(s), even if it’s just online, that can go a very, very long way to making things easier. Both practically, in terms of sharing tips, and psychologically, in terms of just not feeling alone.
See also: How To Beat Loneliness & Isolation
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Reclaiming Body Trust – by Hilary Kinavey & Dana Sturtevant
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Authored by a therapist and a dietician, this book draws from both of their extensive professional clinical experiences, to explore how we can (often early in our lives) be led into disordered thinking when it comes to food and our bodies, and how we can “take back that which has been stolen from us”.
More prosaically: the presented goal here is for us to each figure out where we are with our own body, and how we might build our relationship with same going forwards, in the way that will work the best for us.
The style is relaxed and conversational, while taking care to cover topics that are often tricky with no less seriousness. Chapter headings such as “Your coping is rooted in wisdom”, “What does grief have to do with it?” and “Allowing for pleasure and satisfaction” give an idea of the flavors at hand here.
Bottom line: if you think your relationship with food and your body could be better, not only are you probably right, but also, this book can help.
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Eggs: Nutritional Powerhouse or Heart-Health Timebomb?
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Eggs: All Things In Moderation?
We asked you for your (health-related) opinion on eggs. We specified that, for the sake of simplicity, let’s say that they are from happy healthy backyard hens who enjoy a good diet.
Apparently this one wasn’t as controversial as it might have been! We (for myth-busting purposes) try to pick something polarizing and sometimes even contentious for our Friday editions, and pick apart what science lies underneath public perceptions.
However, more than half (in fact, 60%) of the subscribers who voted in the poll voted for “Eggs are nutritionally beneficial as part of a balanced diet”, which very moderate statement is indeed pretty much the global scientific consensus.
Still, we’ve a main feature to write, so let’s look at the science, and what the other 40% had in mind:
Eggs are ruinous to health, especially cardiometabolic health: True or False?
False, per best current science, anyway!
Scientific consensus has changed over the years. We learned about cholesterol, then we learned about different types of cholesterol, and now we’ve even learned about in some instances even elevated levels of “bad” cholesterol aren’t necessarily a cause of cardiometabolic disorders so much as a symptom—especially in women.
Not to derail this main feature about eggs (rather than just cholesterol), but for those who missed it, this is actually really interesting: basically, research (pertaining to the use of statins) has found that in women, higher LDL levels aren’t anywhere near the same kind of risk factor as they are for men, and thus may mean that statins (whose main job is reducing LDL) may be much less helpful for women than for men, and more likely to cause unwanted serious side effects in women.
Check out our previous main feature about this: Statins: His & Hers?
But, for back on topic, several large studies (totalling 177,000 people in long-term studies in 50 countries) found:
❝Results from the three cohorts and from the updated meta-analysis show that moderate egg consumption (up to one egg per day) is not associated with cardiovascular disease risk overall, and is associated with potentially lower cardiovascular disease risk in Asian populations.❞
Egg whites are healthy (protein); egg yolks are not (cholesterol): True or False?
True and False, respectively. That is to say, egg whites are healthy (protein), and egg yolks are also healthy (many nutrients).
We talked a bit already about cholesterol, so we’ll not rehash that here. As to the rest:
Eggs are one of the most nutritionally dense foods around. After all, they have everything required to allow a cluster of cells to become a whole baby chick. That’s a lot of body-building!
They’re even more nutritionally heavy-hitters if you get omega-3 enriched eggs, which means the hens were fed extra omega-3, usually in the form of flax seeds.
Also, free-range is better healthwise than others. Do bear in mind that unless they really are from your backyard, or a neighbor’s, chances are that the reality is not what the advertising depicts, though. There are industry minimum standards to be able to advertise as “free-range”, and those standards are a) quite low b) often ignored, because an occasional fine is cheaper than maintaining good conditions.
So if you can look after your own hens, or get them from somewhere that you can see for yourself how they are looked after, so much the better!
Check out the differences side-by-side, though:
Pastured vs Omega-3 vs “Conventional” Eggs: What’s the Difference?
Stallone-style 12-egg smoothies are healthy: True or False?
False, at least if taken with any regularity. One can indeed have too much of a good thing.
So, what’s the “right amount” to eat?
It may vary depending on individual factors (including age and ethnicity), but a good average, according to science, is to keep it to 3 eggs or fewer per day. There are a lot of studies, but we only have so much room here, so we’ll pick one. Its findings are representative of (and in keeping with) the many other studies we looked at, so this seems uncontroversial scientifically:
❝Intake of 1 egg/d was sufficient to increase HDL function and large-LDL particle concentration; however, intake of 2-3 eggs/d supported greater improvements in HDL function as well as increased plasma carotenoids. Overall, intake of ≤3 eggs/d favored a less atherogenic LDL particle profile, improved HDL function, and increased plasma antioxidants in young, healthy adults.❞
Enjoy!
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Ageless Aging – by Maddy Dychtwald
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Maddy Dychtwald, herself 73, has spent her career working in the field of aging. She’s not a gerontologist or even a doctor, but she’s nevertheless been up-to-the-ears in the industry for decades, mostly as an organizer, strategist, facilitator, and so forth. As such, she’s had her finger on the pulse of the healthy longevity movement for a long time.
This book was written to address a problem, and the problem is: lifespan is increasing (especially for women), but healthspan has not been keeping up the pace.
In other words: people (especially women) are living longer, but often with more health problems along the way than before.
And mostly, it’s for lack of information (or sometimes: too much competing incorrect information).
Fortunately, information is something that a woman in Dychtwald’s position has an abundance of, because she has researchers and academics in many fields on speed-dial and happy to answer her questions (we get a lot of input from such experts throughout the book—which is why this book is so science-based, despite the author not being a scientist).
The book answers a lot of important questions beyond the obvious “what diet/exercise/sleep/supplements/etc are best for healthy aging” (spoiler: it’s quite consistent with the things we recommend here, because guess what, science is science), questions like how best to prepare for this that or the other, how to get a head start on preventative healthcare for some things, how to avoid being a burden to our families (one can argue that families are supposed to look after each other, but still, it’s a legitimate worry for many, and understandably so), and even how to balance the sometimes conflicting worlds of health and finances.
Unlike many authors, she also talks about the different kinds of aging, and tackles each of them separately and together. We love to see it!
Bottom line: this book is a very good one-stop-shop for all things healthy aging. It’s aimed squarely at women, but most advice goes for men the same too, aside from the section on hormones and such.
Click here to check out Ageless Aging, and plan your future!
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From immunotherapy to mRNA vaccines – the latest science on melanoma treatment explained
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More than 16,000 Australians will be diagnosed with melanoma each year. Most of these will be caught early, and can be cured by surgery.
However, for patients with advanced or metastatic melanoma, which has spread from the skin to other organs, the outlook was bleak until the advent of targeted therapies (that attack specific cancer traits) and immune therapies (that leverage the immune system). Over the past decade, these treatments have seen a significant climb in the number of advanced melanoma patients surviving for at least five years after diagnosis, from less than 10% in 2011 to around 50% in 2021.
While this is great news, there are still many melanoma patients who cannot be treated effectively with current therapies. Researchers have developed two exciting new therapies that are being evaluated in clinical trials for advanced melanoma patients. Both involve the use of immunotherapy at different times and in different ways.
The first results from these trials are now being shared publicly, offering insight into the future of melanoma treatment.
Svitlana Hulko/Shutterstock Immunotherapy before surgery
Immunotherapy works by boosting the power of a patient’s immune system to help kill cancer cells. One type of immunotherapy uses something called “immune checkpoint inhibitors”.
Immune cells carry “immune checkpoint” proteins, which control their activity. Cancer cells can interact with these checkpoints to turn off immune cells and hide from the immune system. Immune checkpoint inhibitors block this interaction and help keep the immune system activated to fight the cancer.
Results from an ongoing phase 3 trial using immune checkpoint inhibitors were recently published in the New England Journal of Medicine.
This trial used two types of immune checkpoint inhibitors: nivolumab, which blocks an immune checkpoint called PD-1, and ipilimumab, which blocks CTLA-4.
More than 16,000 Australians are diagnosed with melanoma each year. Delovely Pics/Shutterstock Some 423 patients (including many from Australia) were enrolled in the trial, and participants were randomly assigned to one of two groups.
The first group had surgery to remove their melanoma, and were then given immunotherapy (nivolumab) to help kill any remaining cancer cells. Giving a systemic (whole body) therapy such as immunotherapy after surgery is a standard way of treating melanoma. The second group received immunotherapy first (nivolumab plus ipilimumab) and then underwent surgery. This is a new approach to treating these cancers.
Based on previous observations, the researchers had predicted that giving patients immunotherapy while the whole tumour was still present would activate the tumour-fighting abilities of the patient’s immune system much better than giving it once the tumour had been removed.
Sure enough, 12 months after starting therapy, 83.7% of patients who received immunotherapy before surgery remained cancer-free, compared to 57.2% in the control group who received immunotherapy after surgery.
Based on these results, Australian of the year Georgina Long – who co-led the trial with Christian Blank from The Netherlands Cancer Institute – has suggested this method of immunotherapy before surgery should be considered a new standard of treatment for higher risk stage 3 melanoma. She also said a similar strategy should be evaluated for other cancers.
The promising results of this phase 3 trial suggest we might see this combination treatment being used in Australian hospitals within the next few years.
mRNA vaccines
Another emerging form of melanoma therapy is the post-surgery combination of a different checkpoint inhibitor (pembrolizumab, which blocks PD-1), with a messenger RNA vaccine (mRNA-4157).
While checkpoint inhibitors like pembrolizumab have been around for more than a decade, mRNA vaccines like mRNA-4157 are a newer phenomenon. You might be familiar with mRNA vaccines though, as the biotechnology companies Pfizer-BioNTech and Moderna released COVID vaccines based on mRNA technology.
mRNA-4157 works basically the same way – the mRNA is injected into the patient and produces antigens, which are small proteins that train the body’s immune system to attack a disease (in this case, cancer, and for COVID, the virus).
However, mRNA-4157 is unique – literally. It’s a type of personalised medicine, where the mRNA is created specifically to match a patient’s cancer. First, the patient’s tumour is genetically sequenced to figure out what antigens will best help the immune system to recognise their cancer. Then a patient-specific version of mRNA-4157 is created that produces those antigens.
The latest results of a three-year, phase 2 clinical trial which combined pembrolizumab and mRNA-4157 were announced this past week. Overall, 2.5 years after starting the trial, 74.8% of patients treated with immunotherapy combined with mRNA-4157 post-surgery remained cancer-free, compared to 55.6% of those treated with immunotherapy alone. These were patients who were suffering from high-risk, late-stage forms of melanoma, who generally have poor outcomes.
It’s worth noting these results have not yet been published in peer-reviewed journals. They’re available as company announcements, and were also presented at some cancer conferences in the United States.
Based on the results of this trial, the combination of pembrolizumab and the vaccine progressed to a phase 3 trial in 2023, with the first patients being enrolled in Australia. But the final results of this trial are not expected until 2029.
It is hoped this mRNA-based anti-cancer vaccine will blaze a trail for vaccines targeting other types of cancer, not just melanoma, particularly in combination with checkpoint inhibitors to help stimulate the immune system.
Despite these ongoing advances in melanoma treatment, the best way to fight cancer is still prevention which, in the case of melanoma, means protecting yourself from UV exposure wherever possible.
Sarah Diepstraten, Senior Research Officer, Blood Cells and Blood Cancer Division, WEHI (Walter and Eliza Hall Institute of Medical Research) and John (Eddie) La Marca, Senior Research Officer, Blood Cells and Blood Cancer, WEHI (Walter and Eliza Hall Institute of Medical Research)
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Simple Wall Pilates for Seniors – by Grace Clark
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While the cover illustration makes this look a little too simple, in fact there’s a lot of value in this book, with exercises ranging from things like that on the cover, to the “wall downward dog”. But the actual exercises (of which there are 29) themselves are only a part of the book (taking about 70 pages of it with clear illustrations).
There’s also a lot about important Pilates principles to apply, such as breathing, correct body alignment (if you don’t already do Pilates, you will not have this, as Pilates alignment is quite specific), flexibility, balance, stability, coordination, range of motion, isometric exercise considerations, endurance, and more.
Unlike a lot of “…for seniors” books, this is not a watered down barely-does-anything version of the “real” exercises, but rather, would present most the same challenges to a 20-year-old reader; it’s just that the focus here is more on matters that tend to concern an older rather than younger demographic. That 20-something may be busy building their butt, for instance, while the 80-year-old is building their bones. No reason both shouldn’t do both, of course, but the focus is age-specific.
The author guides us through working up from easy things to hard, breaking stuff down so that we can progress at our own pace, such that even the most cautious or enthusiastic reader can start at an appropriate point and proceed accordingly.
She also talks us through a 28-day program (as promised by the subtitle), and advice on how to keep it going without plateauing, how to set realistic goals, how to tailor it to our abilities as we go, track our progress, and so forth.
The style is clear and instructional, and one thing that sets this apart from a lot of Pilates books is that the education comes from an angle not of “trust me”, but rather from well-sourced claims with bibliography whose list spans 5 pages at the end.
Bottom line: if you’d like to progressively increase your strength, stability, and more—with no gym equipment, just a wall—then this book will have you see improvements in the 28 days it promises, and thereafter.
Click here to check out Simple Wall Pilates For Seniors, and experience the difference!
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No, taking drugs like Ozempic isn’t ‘cheating’ at weight loss or the ‘easy way out’
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Hundreds of thousands of people worldwide are taking drugs like Ozempic to lose weight. But what do we actually know about them? This month, The Conversation’s experts explore their rise, impact and potential consequences.
Obesity medication that is effective has been a long time coming. Enter semaglutide (sold as Ozempic and Wegovy), which is helping people improve weight-related health, including lowering the risk of a having a heart attack or stroke, while also silencing “food noise”.
As demand for semaglutide increases, so are claims that taking it is “cheating” at weight loss or the “easy way out”.
We don’t tell people who need statin medication to treat high cholesterol or drugs to manage high blood pressure they’re cheating or taking the easy way out.
Nor should we shame people taking semaglutide. It’s a drug used to treat diabetes and obesity which needs to be taken long term and comes with risks and side effects, as well as benefits. When prescribed for obesity, it’s given alongside advice about diet and exercise.
How does it work?
Semaglutide is a glucagon-like peptide-1 receptor agonist (GLP-1RA). This means it makes your body’s own glucagon-like peptide-1 hormone, called GLP-1 for short, work better.
GLP-1 gets secreted by cells in your gut when it detects increased nutrient levels after eating. This stimulates insulin production, which lowers blood sugars.
GLP-1 also slows gastric emptying, which makes you feel full, and reduces hunger and feelings of reward after eating.
GLP-1 receptor agonist (GLP-1RA) medications like Ozempic help the body’s own GLP-1 work better by mimicking and extending its action.
Some studies have found less GLP-1 gets released after meals in adults with obesity or type 2 diabetes mellitus compared to adults with normal glucose tolerance. So having less GLP-1 circulating in your blood means you don’t feel as full after eating and get hungry again sooner compared to people who produce more.
GLP-1 has a very short half-life of about two minutes. So GLP-1RA medications were designed to have a very long half-life of about seven days. That’s why semaglutide is given as a weekly injection.
What can users expect? What does the research say?
Higher doses of semaglutide are prescribed to treat obesity compared to type 2 diabetes management (up to 2.4mg versus 2.0mg weekly).
A large group of randomised controlled trials, called STEP trials, all tested weekly 2.4mg semaglutide injections versus different interventions or placebo drugs.
Trials lasting 1.3–2 years consistently found weekly 2.4 mg semaglutide injections led to 6–12% greater weight loss compared to placebo or alternative interventions. The average weight change depended on how long medication treatment lasted and length of follow-up.
Higher doses of semaglutide are prescribed for obesity than for type 2 diabetes. fcm82/Shutterstock Weight reduction due to semaglutide also leads to a reduction in systolic and diastolic blood pressure of about 4.8 mmHg and 2.5 mmHg respectively, a reduction in triglyceride levels (a type of blood fat) and improved physical function.
Another recent trial in adults with pre-existing heart disease and obesity, but without type 2 diabetes, found adults receiving weekly 2.4mg semaglutide injections had a 20% lower risk of specific cardiovascular events, including having a non-fatal heart attack, a stroke or dying from cardiovascular disease, after three years follow-up.
Who is eligible for semaglutide?
Australia’s regulator, the Therapeutic Goods Administration (TGA), has approved semaglutide, sold as Ozempic, for treating type 2 diabetes.
However, due to shortages, the TGA had advised doctors not to start new Ozempic prescriptions for “off-label use” such as obesity treatment and the Pharmaceutical Benefits Scheme doesn’t currently subsidise off-label use.
The TGA has approved Wegovy to treat obesity but it’s not currently available in Australia.
When it’s available, doctors will be able to prescribe semaglutide to treat obesity in conjunction with lifestyle interventions (including diet, physical activity and psychological support) in adults with obesity (a BMI of 30 or above) or those with a BMI of 27 or above who also have weight-related medical complications.
What else do you need to do during Ozempic treatment?
Checking details of the STEP trial intervention components, it’s clear participants invested a lot of time and effort. In addition to taking medication, people had brief lifestyle counselling sessions with dietitians or other health professionals every four weeks as a minimum in most trials.
Support sessions were designed to help people stick with consuming 2,000 kilojoules (500 calories) less daily compared to their energy needs, and performing 150 minutes of moderate-to-vigorous physical activity, like brisk walking, dancing and gardening each week.
STEP trials varied in other components, with follow-up time periods varying from 68 to 104 weeks. The aim of these trials was to show the effect of adding the medication on top of other lifestyle counselling.
Trial participants also exercised for 150 minutes a week. Elena Nichizhenova/Shutterstock A review of obesity medication trials found people reported they needed less cognitive behaviour training to help them stick with the reduced energy intake. This is one aspect where drug treatment may make adherence a little easier. Not feeling as hungry and having environmental food cues “switched off” may mean less support is required for goal-setting, self-monitoring food intake and avoiding things that trigger eating.
But what are the side effects?
Semaglutide’s side-effects include nausea, diarrhoea, vomiting, constipation, indigestion and abdominal pain.
In one study these led to discontinuation of medication in 6% of people, but interestingly also in 3% of people taking placebos.
More severe side-effects included gallbladder disease, acute pancreatitis, hypoglycaemia, acute kidney disease and injection site reactions.
To reduce risk or severity of side-effects, medication doses are increased very slowly over months. Once the full dose and response are achieved, research indicates you need to take it long term.
Given this long-term commitment, and associated high out-of-pocket cost of medication, when it comes to taking semaglutide to treat obesity, there is no way it can be considered “cheating”.
Read the other articles in The Conversation’s Ozempic series here.
Clare Collins, Laureate Professor in Nutrition and Dietetics, University of Newcastle
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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