Are You a Caregiver? WAM’s Lucille Carriere, PhD, Has the Advice You Need to Help You Care for Yourself, Too

As anyone who’s ever stepped into the role of caregiver knows, it can be one of the most rewarding and demanding roles a person can take on. Caregiving is an act of love and sacrifice, and it’s a job that too often comes with little recognition—or rest. 

For National Caregiver’s Day, The Sunday Paper wants to shine a light on the unsung heroes who show up for the people they love in this crucial role of caregiver. That’s why we sat down with Lucille Carriere, PhD, the Behavioral Health Director and Angie Ruvo Endowed Caregiving Chair at The Cleveland Clinic. Whether it’s managing burnout and setting boundaries or finding ways to take a break and sneak in more joy, Dr. Carriere is on a mission to make sure caregivers know that their wellbeing matters, too. Here’s what she wants all of us to know.

A CONVERSATION WITH LUCILLE CARRIERE, PHD

Can you speak to the health impacts of being a caregiver, and the importance of caregivers finding ways to take care of themselves? 

We know that caregivers play such an instrumental role in helping loved ones who need assistance. It is family members who often step into this role, often driven by a sense of commitment, love, and devotion. Unfortunately, it’s well established that family caregivers are particularly vulnerable to negative health outcomes given the demands that are placed on family caregivers when they step into that role.

What we know is that caregiving can increase vulnerability to negative health outcomes when it comes to both physical and emotional health. We see higher rates of chronic disease and inflammatory markers, for example, as well as higher rates of depression, anxiety and insomnia in caregivers.

For readers who are feeling the very real impacts of caregiving, what is your advice?

I think a big part of it is putting words to what you’re feeling—even just recognizing the challenges you’re facing as a result of your job as a caregiver is important. 

Caregivers are so involved and entrenched in their role, and their focus and attention is on the needs of their loved one. It can be easy to dismiss changes in mood, sleep, appetite and energy, and when we look at this over the long term, that’s when we see the negative impacts on their health start to show. It’s not uncommon for caregivers to say, “You know, I’m really dealing with a lot more chronic pain,” or “My blood pressure is higher than ever.” It’s almost insidious the way caregiving can create an environment of chronic stress. 

So, when I’m sitting with a caregiver, we recognize that stress. We label it. And we try to answer this question: What are the demands being placed on you that you feel as though you don’t have the resources to properly address? We start there so that we can develop an individualized plan.  

A lot of caregivers experience intense emotions, like guilt, resentment, and anger. Any advice for how to navigate those tricky feelings?

These emotions have the potential to overwhelm us and can negatively affect you if you don’t develop a plan for how to manage them. Maybe that plan includes seeking informal support, such as building a community of other caregivers who can provide validation and even help you come up with solutions for some of the day-to-day challenges of caregiving. There may be other instances where it’s helpful to seek professional help, especially if those emotions are becoming so intense that they’re getting in the way of your everyday life or even affecting the care relationship.

For many caregivers, the job can feel unrelenting and all-consuming. What are some of the ways you’ve seen people successfully navigate this demanding job?

I think one of the keys as you progress through the journey of being a caregiver is to build a tool kit that helps you navigate the day-to-day challenges and your own emotional journey. One thread I see amongst caregivers who navigate this role well is that they’re able to recognize their value as caregivers. They understand that being a caregiver is one part of their identity among many.

With this, caregivers can give themselves permission to step away from the caregiver role for brief periods of time. Taking a respite and focusing on self-care can be incredibly difficult for caregivers, especially women. Yet giving yourself permission to take time away—and to see that it’s not self-indulgent, but rather critical for your overall health and your ability to manage your caregiver role—is important.

I also think caregivers who successfully navigate this role are comfortable being uncomfortable. So often, caregivers will feel a little bit of angst or discomfort those first couple times that they’re away from their care recipient, whether it’s taking a walk, reading a book, or stepping out of the home. And it’s important to learn to be okay with that discomfort. Those emotions and worries start to settle, and it becomes more comfortable over time.

We know that the majority of caregivers are women. Do you have any advice specific to women to help them navigate the work of caregiving?

As women, we’re subject to the influence of traditional gender roles and norms—and I think that helps us understand why the vast majority of family caregivers are women. There’s added responsibility and pressure to be in that nurturing role, which can lead us to form unrealistic expectations for ourselves as caregivers. 

Oftentimes, we see this in I should comments. I should be more present. I should be doing more. As a result, we may be particularly susceptible to feeling guilt—and that guilt can take over, adding all of this additional burden on us emotionally. This eats away at that confidence that we’re trying to build with skills and support to create an ideal caregiving situation.

This is why it’s important to recognize if and where you are struggling as a caregiver. Do you find yourself struggling emotionally? Or is it more the practical day to day aspects of not having enough time and support? When you know where you need assistance and support, you’re in a better position to brainstorm solutions for your unique situation. 

I think the other aspect of this—and I can’t underscore this enough—is finding a community to feel connection with other caregivers. This can be especially powerful for women! We’re social beings. Connecting with others who are on a similar path can go a long way toward helping you feel a sense of validation.

For those who are reading this who aren’t caregivers but have someone in their life who is, what are some ways we can support the caregivers in our lives?

I think it’s oftentimes so validating for caregivers to hear from others who say to them, “I see you. I see what you do.” 

It’s an acknowledgement that their role is incredible, and their strength and courage to persevere under challenging circumstances really does mean a lot. 

When it comes to more practical means of outreach, try to recognize where you can use your strengths to help. Perhaps you’re a really great cook. Maybe you say to a caregiver in your life, “Let me prep a few meals for you.” Maybe you’re great at organization. You might ask a caregiver, “Can I make a few doctor’s appointments for you, or take your loved one to their appointment next week?” We can get into the trap of asking when or how we can help, but that can tricky for caregivers to answer. 

If you have a caregiver in your life and could use some ideas on how to give them a much-needed break, WAM’s Caregiver Gift Guide is filled with practical tips and advice.

Lucille Carriere, PhD is the Behavioral Health Director and Angie Ruvo Endowed Caregiving Chair at Cleveland Clinic. She has worked in geriatric primary care and provided psychotherapy for individuals and caregivers living with neurodegenerative disorders and complex medical conditions, and she is interested in outcomes research related to caregivers. To hear more from Dr. Carriere on the emotional and physical realities of caregiving, click here.