Self Caring

How Much Stress Is Too Much?

Last updated: Aug 01, 2011

Prince Charming @Santiago's Airport

Even loving caregivers -- who put up with more stress than most mortals -- have a proverbial straw that breaks the camel's back. Would you recognize these "this is too much" warning signs if you saw them? Or would you be like that frog swimming in a pot of water that's getting hotter and hotter, who's boiled alive before he knows it?

A Alzheimer's Stage Groups member's recent story makes this question very real. A longtime caregiver to her husband, who has later-stage dementia, she'd noticed he was getting more agitated in the evenings, more angry. One night, he came into her bedroom -- with a knife. He didn't cut her, just laid it against her skin, but of course it scared her just the same: "I don't know what to do," she wrote in her stage group forum.

Her fellow forum members knew, and quickly weighed in with caring advice. So did senior medical editor Ken Robbins, a geriatric psychiatrist. He suggested that a caregiver in this situation not wait until an upcoming doctor appointment to address the problem, as she'd been considering:

The caregiver should call her husband's doctor immediately, explain the danger, and ask the doctor to re-evaluate the patient's drug regimen (he's on five different meds, and drinks beer daily) and help her arrange an involuntary hospitalization to evaluate him. If she's unable to reach or get help from the doctor, she should call the police to request an involuntary hospitalization, clearly explaining that she feels unsafe and is worried that she's in danger. The purpose of calling the police isn't to "arrest" or punish the patient, but instead to make sure he gets appropriate help.

A knife in the dark warrants help, fast. But so do many other situations, such as:

  • Incontinence that's causing you to lose your temper

  • Inability to physically manage basic care for someone bigger or stronger than you

  • Any kind of behaviors that make you or another family member feel unsafe

  • Threats of suicide

  • Your own feelings of overwhelming helplessness and hopelessness (which could be not just stress but depression, a very real caregiving risk)

"Help" doesn't necessarily mean out-of-home placement (though it can). Help can mean adding in-home caregivers, arranging more respite time, getting medical help to reassess meds and symptoms, and other strategies for managing the situation, and your lives, differently. The woman in this story did get her husband hospitalized before his scheduled appointment, where his drugs and behavior were immediately monitored.

The challenge: Recognizing a crisis point. It's usually easier to see in someone else. Stalwart caregivers tend to write off crises in their own lives as "exceptions" they hope won't happen again. Or to think of even terrible difficulties as "temporary." Or to feel alone or unsure whether anything can be done, and to therefore think, "why bother?"

Please know this, as the story from the forums reminds us all: Help always exists, in some form -- or many forms. Avoid being boiled alive by reaching out to someone when you're the slightest bit concerned or stressed. And that includes strangers in support groups online, often kindred spirits because they're on the same journey.

How about you? Have you ever felt "on the brink", or known someone who reached out in the nick of time?