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July 6, 2022 31 mins

Whether noticing signs of anger or feeling overwhelmed with no help, understanding caregiver burnout is vital to combating its effects. That is why therapist and social worker, Lindsey Pace, became focused on helping those feeling caregiver burnout after working closely with folks caring for terminal family members. She counsels caregivers on how to recognize the signs of burnout, defuse the related stress with movement or mindfulness, and employ self-care tactics to find the joy in caregiving. Adjusting to major life changes can be difficult, but through strength and resilience, the  opportunities for growth and bonding with a loved one are never-ending.

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Episode Transcript

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Speaker 1 (00:00):
Hi everyone. I'm Holly Robinson, pete actor, author, advocate, do
it all mom, and I'm also a caregiver. And this
is care Walks, a podcast from I Heart Radio and
Volteran Arthritis Pain Gel. It's a show for family caregivers
who give everything to everyone and need to make time

(00:22):
for themselves through movement. Every episode is designed for you
to walk as you listen, so just think of me
and my guests as you're weekly walking buddies. We'll hear
stories from caregivers and gain tips and insights from health
experts and advocates who know how important it is to
take care of yourself and manage joint pain due to
arthritis that often accompanies being a caregiver. Will discover community

(00:47):
ourselves and maybe even alleviate some joint pain due to
arthritis in the process as we walk together and connect
to the best parts of being a caregiver. I can't
believe it. We have arrived at our final episode for
this first season of care Walks. Thank you so much

(01:08):
for joining me on this journey. Over the course of
this season, we've reflected on how caregiving has changed our
lives and how we can better care for our own
bodies and minds while becoming conscientious caregivers for our loved ones.
Just a reminder right now, you're listening to the full
version of this episode, but if you don't have time
for a full walk today, then go check out our

(01:30):
bridged version of the same episode. It's like cliff notes
for podcasts. Setting out on this journey, I was really
excited to hear from other caregivers and honestly curious to
know how their experience was similar or different to mine.
But even beyond that, exploring the many approaches to self care,
from scheduling weekly time to yourself to making movement a

(01:53):
daily practice. Throughout this season, I've learned so much from
our guests, and I'm so grateful to be part of
this movement to recognize the needs and well being of
family caregivers. For this last episode, I want to talk
about caregiver burnout. According to the website Aging in Place,
a free online resource for aging at home, about of

(02:17):
family caregivers in the US do not receive any respite care.
Burnout isn't something we typically are preparing ourselves for. Oftentimes
we don't realize we are burnout until it's already taken
a big toll on us. So today we're also going
to dig into how we can keep burnout at Bay.
Later in this episode, you'll hear from Lindsay Pace, a

(02:39):
license therapist and advocate for those adjusting to major life
changes like becoming a caregiver. Lindsay helps caregivers build resiliency
and take the steps towards a full and prosperous life. Together,
Lindsay and I will talk about the signs of burnout
and how caregivers can continue to use self care as
a means of heal link from over extension. But before

(03:02):
we get to my conversation with Lindsay, let's get walking.
Begin to let go of any negative feelings you're holding
onto and find a sense of release. Let go of
any stress and any anxiety that you may be feeling

(03:25):
or resonating in your body. Allow this time to be
about you. For you. Take a deep breath in through
your nose and now exhale out your mouth. Let's do

(03:51):
this again, and as you exhale, I want you to
release a sigh in through your nose. Then release that
sigh as you exhale through your mouth. Great job. Now

(04:13):
last one inhale deeply and exhale with a sigh. We
want to remember to be mindful of our energy. We
cannot operate on an empty tank, and time spent filling

(04:33):
your tank makes for better and brighter you as you
find your stride. Join me as I explore how we
can combat caregiver burnout with Lindsay Pace. Lindsay Pace is
a licensed therapist in Virginia who counsels folks who are

(04:55):
adjusting to stressful life changes, helping individuals who are stuck
in neg the patterns and burnout by the demands of
caring for those around them. She's going to help us
recognize the signs of burnout, better cope with that added stress,
and reinforce our self care strategies to combat caregiver burnout.
Thank you so much for joining us today, Lindsay, Hi, Holly,

(05:18):
thank you so much for having me. I'm excited to
be here with you. I'm excited to talk to you.
Can you tell me what inspired your work as a
therapist and what what led you to focus on helping
those who care for others. Yeah. So, I'm a licensed
clinical social worker and I've been in the field about
sixteen years, and my first ten years were in hospice,

(05:42):
and so I worked in the hospice field where I'm
going into people's homes, working with patients who have a
terminal illness and working with the families and the caregivers
to help them process, feel supported, um navigate eight what's
to come. And it was through those years that I

(06:04):
recognized how much we ask of caregivers and how much
is is on them to do and the lack of,
you know, unfortunately resources that they need to adequately care
for themselves while they're caring for somebody else. And it
was through that time that I really wanted to focus

(06:26):
in on anxiety. Anxiety disorders is my area of specialty
now that I'm in private practice, because what we would
often see is is people become very anxious in the
caregiving role. People experience a lot of depression in the
caregiving role, and of course a lot of overlap with
burnout as well. So that's what brought me to the

(06:48):
field of working with caregivers. That is fascinating work. I
I have always wondered about hospice care and about emotion
that you go through when you're trying to walk someone
through that really difficult time, and I think It's fascinating
to me that from that you you really looked at

(07:10):
the caregiver aspect of this and how hard it is
to go through all of that emotionally, physically, you know,
when you take care of someone for so long and
then it gets to that point. I'm sure there are
a lot of people that don't even take the time
to acknowledge that they're feeling burnout, acknowledge that they're really
struggling emotionally and and psychologically and with their mental health,

(07:32):
because we always put ourselves at the back of the
line right when it comes to caregiving. So from your work,
how do you see the role of caregiver um and
pushing our care for ourselves to the back burner? How
do you how do you see that? And what are
ways that we can speak to caregivers about that? Well,
I think that the individuals who find themselves becoming the

(07:56):
primary caregiver usually are natural inclined to be feelers and
attuned to the needs of others, have more of a
willingness to put themselves on the back burner. It definitely
attracts a certain kind of person to do the work,
not always, but most of the time. And so when

(08:17):
you're in this role of primary caregiver and you have
a person who is increasingly dependent on you, you just
continue to step up to the plate. Whatever the next
need is, Okay, how can I meet it? What can
I do? And it can be very easy to be
very tunnel visioned on the individual that you're caring for

(08:38):
um and task oriented Okay, I've got a problem, let's
solve it, and not having time because issues come up frequently,
changes are required regularly with caregiving to examine what am
I needing, how am I doing? And so people don't
recognize that they've kind of crossed a line in their

(09:00):
self care until they are really burned out or experiencing
depression or having other health issues that unfortunately have to
be a wake up call. I would say the biggest
contributing factor to burnout is feeling like you have the
way of this person's life on your shoulders and your
shoulders only. Maybe you think that nobody can do it

(09:23):
like me, therefore I'm not going to ask for help,
or maybe the person does not have anyone they can
ask for help, and that would be a real contributor
to the burnout happening. For are there ways to ask
that are effective that you found. I think being specific

(09:45):
is the best way to ask for help instead of
just saying, hey, I need help and expecting them to
identify something that they can do. Get very specific. I
need help on Tuesdays from one to three so that
I can do whatever it might be. Yeah, so just
take the generality out right, So being very specific, I

(10:06):
need you to take my dog to the vet for
me today, or I need you know, very specific. The
more specific you are that, I think that kind of
limits the person that you're asking. They really understand what
specifically is needed from them, and it's not like it's
not gray, it's not a gray area. That's a great,

(10:26):
great tip. What other signs would you say that you
you might see as well of caregiver burnout? How their
physical signs that you can see or what else do
we look for? Yeah, I think when we're looking for burnout,
if if a person is in a caregiving situation and
they're kind of asking themselves, am I burned out? I

(10:48):
would look at whether or not you are experiencing more
cynicism you know about the role of being a caregiver. Oh,
that's interesting. How much sentment are you carrying. Are you
feeling increasingly tired and exhausted and experiencing that sense of

(11:08):
isolation and helplessness? So that would be what I'm looking for.
When I walked into a home with hospice patients and families,
when I noticed those symptoms, I was, you know, thinking, yes,
we are, We've reached a limit, and we had to
be very sensitive about how we would work with the

(11:29):
caregiver because the last thing you want to do to
someone who's burned out is say, hey, you're burned out
and you need to do X, Y and Z. Right,
that doesn't seem like it would be helpful. No, No,
how do you think we can manage our expectations that
we have for ourselves as caregivers? I know, as a
caregiver for my dad when he was diagnosed with Parkinson's,

(11:51):
I was very young and I didn't even think about, well,
you know, nineteen and think about, you know, managing any
of my expectations because I was so young. But I think, well,
you have so many more resources now and something like
care walks where we can talk about these things. So
how how can we as caregivers just manage these expectations

(12:14):
we have for ourselves. Yeah, over extent, over commit all
of those things. Well, you know, everyone comes to the
caregiving position by different means. Some people march boldly into it,
you know, volunteering here, am I let's do this right,
and they're eager and excited. Other people kind of just

(12:35):
find themselves. Oh, there's nobody else. I guess I have
to do this. You know that there will be a
variety of expectations a person would have going into being
a caregiver. I would say the first thing that we
need to recognize is that caregiving is costly. It is costly,
you know, financially, it is costly, physically, emotionally, mentally, on relationships.

(12:59):
You understanding that there is a cost to making this
decision and recognizing that there's also the potential for a
great reward. But I have to hold those at the
same level that there is going to be a cost,
there will be consequences, and there's also a reward opportunity here,
and holding those to the same degree versus just okay,

(13:19):
I'm gonna do this, but um, recognizing that there are
consequences as far as adjusting expectations, you know, I would
walk into homes that were pristine you know where they know,
vacuum every day, and they have all of these routine
household activities that they maintain while caring for somebody who

(13:42):
is you know, bed bound and total care and needs
help with feeding and every every activity of daily living.
And yet they're still trying to maintain this rigorous and
rigid schedule of household responsibilities. And so I would encourage people,
is there just one thing, one thing that you can

(14:04):
let go of for a season. I always like to
say for a season, because caregiving does not last forever.
And so putting down one thing for a season that
you can pick up again later so that you can
lower the amount of pressure and responsibility you have on

(14:25):
yourself for now, that's another good takeaway. Another good takeaway, lindsay,
because it just minimizes some of the overwhelming confusion you
have when you have so many things coming at you
at once for a season writing that down. Um, And
So to tell me more about the reward opportunity with

(14:49):
being a caregiver, how do you define what that is
and what that even looks or feels like? Mm hmmm.
I think that of course this will very person to person.
But the rewards that I often heard from people were
that they got to spend time with their loved one

(15:09):
that they would not have had had they not been
in the caregiving role. They got to see sides of
their loved one that they didn't know existed, that they
really enjoyed and could really share stories about. And for
some relationships it's a chance of reconnection and redemption. Sometimes,

(15:30):
you know, maybe the relationship was not what it could
have been, you know, when things were well, and unfortunately,
being in the caregiving situation, we know that someone is
not well. But it could be a chance for reconciliation
for people. And I've seen that, yes, And you know,
the other half of the battle is, you know, remedying

(15:52):
our exhaustion. You know, how how do we go about
recovering when we recognize that we're burned out. What are
some of the things that we can do. Obviously you
said you take some things off your plate, or there
other things. Yes, certainly there are other things that we
can do for the level of exhaustion. That is simply
we're looking at energy conservation. How can we conserve energy

(16:15):
right now while resources are low? Again, you know, putting
that for a season behind it, it will not always
be this way. So for now, what can we do
to conserve this energy? Do we need to hire someone
to clean the home? Do we need to utilize medication
from the doctor that will help our loved ones sleep

(16:38):
so that we can sleep, or from the doctor that
will help us sleep. Relief can come from all sorts
of sources, including having someone to your grocery shopping. I
personally loved using shipped for my groceries, and that is
time that's saved for me. And yes, I might pay
a little extra, but it saves me that time and

(16:59):
that energy that I would rather give to my family.
Those kinds of things can be really helpful in conserving
energy when energy is already low. Yes, and you mentioned
earlier we were talking about the the journey of how
to get to becoming a caregiver, and we all get
there in different ways. But yeah, when you're sort of

(17:22):
I don't want to say the word forced into it,
but when it's sort of you're the only option, and
then that does sometimes build some feelings of resentment, feelings
of not feeling appreciated. What would you say to someone
who like that, who's burnout but they're also a little resentful?
Mm hmmm. Well, it's a hard place to be because

(17:42):
sometimes when you're in that resentful place, you think I
shouldn't have to ask. I shouldn't have to you know, X, Y,
and Z. We can get stuck in our resentment simply
by I call them should statements. Right, should statements is
a criticism. UM doesn't produce any kind of progress forward.

(18:04):
It's just I shouldn't have to I they should know
what I want? Right, So recognizing if okay, check in
with yourself right now? Am I feeling resentful? What does
that feel like? What am I doing about it? Okay?
Have I asked anybody for help? So the first thing
would be to make your needs known. Let them be known,

(18:26):
Let people know that you are frustrated that you are
feeling some resentment. I can't guarantee what their response is
going to be. Yeah, that that's a very important part
of it. Yes, but I do think that UM, you
can be wise and recognizing who might be a person
you can share this with that can respond in a

(18:46):
way that is helpful if you truly have no one
like that. This is where caregiver support groups are an
excellent resource where you can talk with other caregivers who
find themselves in the same situation, also going to therapy
it can be very traumatic the reason that you are

(19:06):
a caregiver, and so working maybe with a therapist to
help you process this huge transition and the road ahead
of you. And thankfully with COVID, most therapists offer telehealth,
so you don't even have to leave the home and
find someone to sit with your loved one. We'll be

(19:31):
right back with more from Lindsay Pace, and now back
to my conversation with Lindsay Pace. The physical toll of
caregiving can is it's can really be difficult on the

(19:54):
body and in your experience, what what things stand out
about the physical demands in the caregiving journey. Often in
the caregiving situation, they're having to help somebody move who
someone maybe who is immobile, maybe someone who is bed bound,
so doing a lot of lifting and pulling and turning physically.

(20:17):
Aside from the exhaustion, there are occupational hazards that caregivers
have to be aware of, Yes, there are. So what
are some of your favorite self care practices that help
you prioritize movement or find stress relief, either physically or emotionally. Well.

(20:37):
I used to be better at this than I am now. Um.
In fact, I have a goal to get back outside
and walk daily. But if I'm not able to do that,
it might be that I'm turning on music dance video
on YouTube and just dancing like a crazy person with
my kids, and it gives us an opportunity to move

(21:00):
and connect and laugh, and those things are vital to
disrupting the stress or the exhaustion that might be going on. Yeah,
I have a son who has autism and he is
favorite thing to relieve his stress is jumping on a
trampoline and so we get's been We are a jumping family.

(21:22):
Like all of us were out there and get on
this trampoline. If you can imagine all six of us
out there, even the dog gets on the trampoline and jumps.
But just the stress relief and just the laughter or
even laughing about the dog getting on and you know,
at all the things that we do. So just that movement,
that little movement can really create a release that you

(21:46):
otherwise wouldn't have just stagnantly sitting. So it's just about
getting up and doing it right, just just making that
first step, yes, and it can it can totally change
the tone of the situation. So if you know tice
that you're just sitting there and you're overwhelmed by something,
simply changing posture and position can help break you out

(22:08):
of that. So it doesn't take a lot to accomplish that.
If you can move your body in any way, UM,
do it, UM, dedicate a little bit of time each
day to that. I love that this podcast encourages caregivers
to walk while they listen. That's just a wonderful motivation
and it gives people, Okay, it's my podcast time. I'm

(22:29):
going to go and do this walk now. Because simply
being outside moving your body can help relieve some of
the stress and pressure that you're carrying. When you're a caregiver,
you end up in a very hyper vigilant, hyper aware
this checking always going on in your mind of what
do I need to do next. That's a stress response

(22:50):
system that's been activated, and to work that out is
to release some of that energy. So going for a walk,
doing something that creates a little bit of an increased
heart rate can be very helpful and working out that
increased energy. Have you noticed that in your experience? Have
you noticed that taking time to connect with others can

(23:12):
help combat burnout for caregivers, Yes, absolutely, because then you
can recognize, oh, it's not just me, there's other people
who are experiencing this. Because sometimes we think that because
it's hard, we must be doing something wrong, or maybe
there's a better way to do this, and really it's

(23:34):
just hard. There is not one great way to be
a caregiver that's going to assure that you have no
resentment and no guilt and no frustration. And so connecting
with other people can be very healing, very validating, and
perhaps give you hope to move forward through the caregiving journey. So, lindsay,

(23:57):
when you're starting to recognize the symptoms of and out,
how can caregivers work through these negative feelings and avoid
taking it out on those around them? Great question, and
I would like to say that there is no way
we can avoid these negative feelings. The goal, especially when
I'm working with clients and private practice, we're not trying

(24:21):
to get rid of or eliminate any of these negative
thoughts or feelings. We're trying to choose a new way
to respond to them and interact with them. So, if
you are noticing that you are bombarded with negative thoughts
about your family, who's not helping, and you get into

(24:42):
this automatic thought loop about they should do more. They
you know, they this, they that, noticing the thought process
that you're stuck in, noticing the negative feelings that come
up with that, and a lot of times when we
notice we're doing something that we know isn't helpful, we
then start to be hard on ourselves. So instead of

(25:03):
being critical or judgmental, I should be grateful, Why am
I feeling like this? Something's wrong with me? Acknowledging those
negative feelings with acceptance, with compassion, and without judgment. And
when we can allow ourselves to have these negative feelings
and negative thoughts without trying to get rid of them

(25:25):
and push them away or let them take over, we
can be with ourselves when we're uncomfortable and not engage
in unhealthy or unhelpful behaviors. Great advice. And I think
the thing that really jumps out at me that is
so different from the way I approach caregiving at nineteen

(25:49):
with my dad with Parkinston's or even later on with
my son with autism, was that I never acknowledged my feelings.
You know, I never there was no mindful this about
oh I'm feeling this way it was always suppress it,
suppress it. This kid needs me right now. I don't
have time to feel this way. My dad needs me
right now. And that is I think so important that

(26:12):
people allow themselves to really acknowledge that it's okay to
feel that, Embrace it, and then it's how you react
to that and how what you do with those feelings. Right.
Sometimes we interpret our negative feelings as problematic, that I
shouldn't have these, they shouldn't be here, what is wrong?
But negative feelings are just a part of life. They

(26:34):
come and go like every other emotion. And when we
focus in on trying to get rid of them or
avoid them, we're giving them more energy than if we
had just let them show up and let them leave
when they were done. I have an exercise if you'd
like to hear about it. It's called dropping the anchor. Oh,

(26:54):
come on right. Yes, this is not my my creation.
This is from Acceptance and Commitment Therapy. Russ Harris is
the developer and it's a very simple technique based on
a metaphor of a boat going out to sea. When

(27:16):
the boat's going out to sea and it notices that
a storm is coming up, it's um got a couple options.
It can return to the shore, but likely the storm's
going to catch up to it. It can continue on
its course, but then it's definitely going to meet the storm.
Or it will drop its anchor, and usually the boat's

(27:36):
going to drop its anchor because the anchor will study
the boat through the storm. It doesn't make the storm stop,
it doesn't make the storm go any faster, but it
does study the boat while the storm passes, and once
the storm is passed, it pulls up the anchor and
it carries on its way. Now the boat will still

(27:57):
rock right, the waves are still going to hit the boat,
but it's not going to be as detrimental as if
it had race back to shore or just sped on
through the storm. So we often, whether we're a caregiver
or not, can find ourselves in emotional storms where we
are overwhelmed with our thoughts and our feelings and worries

(28:19):
about the future. And we can get really caught up
in those and make some poor decisions or say things
we don't mean, and then of course that causes more
of an emotional storm, or we can drop our anchor.
Instead of getting swept away by that storm, we might
still have some of the storm remnants going on, but

(28:42):
we have a little bit more space to be able
to act in a way that aligns with our values
and keeps us from causing more harm. That's awesome the engagement.
I love the engagement and an opportunity to just drop
that anchor, drop that anchor. I love that, so lindsay,
it has been awesome speaking with you. Thank you so much.

(29:04):
I know how important this topic is to so many
um in the caregiving journey, just understanding what burnout looks like,
understanding what you might be able to do to avoid it,
to prevent it, to to make it less painful. And
I just I'm so glad that we were able to
have this conversation and just thank you so much for

(29:24):
the work that you do. People like you I call
angels on the path, your people that really help in
situations that seems so impossible, and you will understand what
it is we need to hear at certain times that
can be very very high stress situations. So thank you
for your work in this this field, and thank you

(29:45):
for talking to us on care walks. Thank you so
much for having me. I'm so grateful to be here
and to share my experience, and hopefully any caregivers that
are listening have some good practical takeaways to help them
on their journey. Thanks again to Lindsay Pace for joining
me for our last episode of care Walks. Our conversation today,

(30:09):
and certainly all of our time together has taught me
so much about prioritizing self care. Burnout is so real,
and when we learn to recognize the signs and make
healthier choices as caregivers, we honor our role and we
honor the ones we love too. Hearing about Lindsay's work
with diverse caregivers reminded me how we all walk different

(30:32):
paths on this journey, and ultimately we can all benefit
from building our caregiver community. We are stronger together and
when we acknowledge our needs, remember that showing up for
ourselves enables us to better show up for others. I'm
sad to say goodbye for now as we close out
this first season of care Walks, but I want to

(30:55):
thank everyone who is listening for letting us join you
every week on your walk. I hope you continue to
use this resource throughout your caregiving. Keep walking, You're doing great,
and until next time, don't forget to always take care
of yourself too. Care Walks is produced by I Heart

(31:19):
Radio in partnership with al teren Ar Threat as pain
Gael and hosted by me Holly Robinson Pete. Our executive
producer is Molly Sosha. Our head engineer is Matt Stillo.
This episode was written and produced by Sierra Kaiser, with
special thanks to our partners at g s K Platform, GSK, Weber,
Shandwick and Edelman
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