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Anger management for caregivers

It is easy to understand why caregivers can become angry or frustrated at times.

It is often a sign that our inner resources for coping with the various stressors involved in caring for someone with Parkinson’s are depleted.

The lockdown due to the coronavirus pandemic can be an added stressor because caregivers have been deprived of opportunities for small breaks from their partner or parent who is living with Parkinson’s.

Exercise classes, physio visits, external carer support and Support Group visits are in many cases no longer available. Being at home all day with your partner – particularly if they are not communicative – can add more pressure and strain on the relationship.

These pressures can lead to feelings of loss of control of your outer circumstances. However, it is important to remember during these times that the one thing we can control, or change is our inner state.

Attention to our inner state is particularly important when we feel anger and frustration brewing over behaviours that we observe in our partners or parents that we think they should know how to manage better.

First steps

First and foremost, if you find your anger consistently rising around your spouse or parent then you may need some respite. Respite care is often a very helpful tool for caregivers who are struggling with stress levels and difficult emotions.

Whether you opt for adult day care, in-home care, or permanent placement, even the smallest break from repetitive issues that come up will help give you some perspective and provide a mental break.

Anger is not right or wrong, meaningful nor pointless, it simply is!

Anger is something we feel. It exists for a reason, and it deserves our respect and attention. It can often be a call for change – that we’ve tolerated something that has been difficult for too long, that we are exhausted, and something needs to change.

As a caregiver of someone living with Parkinson’s there is much to do on a daily
basis:

  • You help to maintain the quality of life of your loved one.
  • You educate yourself about symptoms, treatments, and the progression of the disease.
  • You keep track of appointments with the doctor, allied health support, medication schedules, and exercise.
  • You are often the mediator or go-between for a person living with Parkinson’s who has impaired speech and other family members, friends, and the community.
  • You offer the love and support required to meet the challenges of Parkinson’s.

Warning signs of caregiver fatigue

To address caregiver fatigue, you and the people in your support network must be able to recognise the warning signs:

  • An ongoing tendency to ignore or postpone taking care of your own health needs
  • Growing feelings of isolation, often expressed by: “Nobody knows or understands what is really going on with me”
  • Feelings of anxiety and uncertainty about the future.
  • Outbursts of anger and frustration at the care recipient or situation, often followed by guilt.
  • Feelings of profound tiredness and exhaustion not relieved by sleep.
  • Emotional strain/stress, often manifesting as various physical symptoms.
  • An inability to concentrate or make decisions.
  • Bitterness toward friends or relatives who “…should help more”.
  • Tendency to use alcohol or drugs to try to lessen stress levels.
  • Depression, despair, and feelings of hopelessness.

Notice when your anger flares

This is a signal worth listening to within yourself. Ask yourself what is really going
on?

  • Are you really hurt or grieving underneath?
  • Are there specific needs or wants that you haven’t been adequately addressing for yourself?
  • Has there been a change in your partner’s level of need, a decline in their cognition, or recent falls that have increased our level of stress?
  • Does something feel not right? Where do you feel you need more support? Are you giving more or doing more than you are comfortably able to manage?
  • Is there a part of you that tells yourself you need to take care of your partner on your own? You need to be strong enough to care for them?

How Does Your Anger Show Up?

  • Reactive Anger

Are you on a short fuse?

Does your anger come out in a flash so that you abruptly explode?

This type of anger can be caused by frustrating experiences around Parkinson’s where you feel you’ve explained things over and over. Even though the person you’re caring for seems to understand what you are asking they still don’t get it. They quickly forget and keep doing the same things.

What’s really going on for you? Is it hurt or fear? Worried that your partner isn’t doing something that you see as important for their health? Fear that you are losing the person they were?

Or perhaps a painful reminder that Parkinson’s is progressing? For example, the person for whom you are caring remembering to take their medications on time or to wear their vital call pendant when you go out.

  • Explosive Anger

You feel you’ve kept a lid on things and haven’t spoken up over several frustrating events, then suddenly you explode. Does your anger come out in a flash so that you abruptly explode?

You feel you’ve kept a lid on things and haven’t spoken up over several frustrating events, then suddenly you explode. It has all felt too much and you’ve been overwhelmed with all the little things piling up.

It may be the tiniest thing that then makes you snap. Managing and recognising your anger earlier is helpful. Address the smoke before it becomes a fire.

  • Passive-Aggressive Anger

In this case it may look like you’re okay on the outside, but your tone and sarcasm say something else – that really underneath anger is brewing. This can cause you to hang on to your anger for a very long time, which can create a feeling of helplessness and over time effects mental health.

  • Projecting Anger

Something frustrating may have happened at work, or while you were at the doctor’s office, and you come home and project the anger you felt but didn’t express at work onto your partner or parent. This type of misdirected anger can hurt your relationship and can create a guilt spiral afterwards.

Anger Management Tips for Caregivers

These different aspects of anger often set off a shame cycle where we feel guilt and shame for having had the outburst. Things may quieten down for a while, but gradually and eventually lead to another outburst.

If you identify with one or more of the types of anger described above, then it may be beneficial for you to learn some techniques for breaking your anger/guilt cycle.

Many people find themselves lashing out uncharacteristically once they’ve invited the stresses of caregiving into their lives. Here are some tips on controlling your emotions and expressing anger in a heathier way.

With practice, the following techniques will enable you to better handle your emotions and feel more like your old self.

  • Count to Ten

It may sound like a cliché, but there’s a reason why counting to ten is a commonly recommended anger management strategy. Count slowly with a breath in between each number. It works.

When something upsets you, mentally taking a step back and counting to 10 helps prevent knee-jerk reactions and allows you extra time to decide how to handle the situation. If you haven’t gathered your thoughts after counting to 10, feel free to continue counting as long as you need.

Remember to take slow, deep breaths to help calm your body as well. You can also take this method a step further by removing yourself from the room or building where your anger has been triggered. This tactic is particularly useful for people who are prone to explosive episodes of anger.

  • Be Direct

It’s okay to admit your anger or frustration to others as long as you do so in a relatively calm, direct manner. One of the best ways to express anger is to do so clearly and without too much drama.

This can be difficult for some individuals, especially in the beginning. However, with practice you can develop the mental skills necessary to recognise, control, interpret and communicate your anger in a productive manner.

  • Rewind

To help you practice responding to frustrating situations, try an exercise called ‘rewinding the tape’.

First, envision a time when you got angry in the past. Picture all the details in your mind’s eye. Where did it take place? Who was there? What were people wearing? Treat the scene like a video and let it play out once without trying to change anything. Simply observe how the events unfolded.

Next, think about what you would like to have changed about how the event played out. How might you have responded differently to the situation to make it better? It is important to reflect on your own actions rather than those of others.

Remember that the only person you can ever really control is yourself.
Finally, replay the improved version of this encounter in your mind over and over until you feel as though you could do and say what you are envisioning in real life.

  • Move away and ‘take 5’

The moment you recognise the anger building up in yourself, move away from looking at your partner. Looking at them can be a trigger point in escalating your anger. If possible, go into another room and take five deep breaths. This should take about a minute or two.

Deep breathing requires you to be very conscious about the movement of air into and out of your lungs. The period required to take the deep breaths will allow you to dissociate yourself from negative feelings. It also allows you to observe what these emotions and thoughts are all about.

Your Caregiving Action Plan

1. One small change I can make today that is just for me:

…………………………………………………………………………………………….

…………………………………………………………………………………………….

2. Two steps I will take in the next month to simplify my schedule or add joy to my life:

• …………………………………………………………………………………………

• …………………………………………………………………………………………

3. It may be time to talk to a counsellor and practice some exercises that help calm and self-soothe your nervous system. If not a counsellor, speak to a friend you trust and let them know what you are struggling with.

 

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