The Clinical Guide to Supportive and Palliative Care for HIV/AIDS

A Clinical Guide to Supportive and Palliative Care for HIV/AIDS • Chapter 20: Care for the Caregiver4. Strive for Good Health.Healthful lifestyles play an important role in burnout prevention. By eating three balancedmeals26eachpicasday, engaging in regular physical activity, and sleeping 7 to 9 hours each night,caregivers can increase their capacity to manage stress. In addition to promotingcardiovascular fitness and building muscular strength, exercise programs increase energyand provide a needed outlet for pent-up emotions. These programs may involve vigorousworkouts, but significant health benefits also can be gained from just walking 20 to 30 minuteseach day. One study of informal caregivers of HIV-positive minority women suggeststhat maintaining a regular exercise regimen, along with a spiritual focus, can be an effectivecoping strategy. 67Some caregivers react to stress by engaging in unhealthful behaviors such as smoking, drinking,and drug misuse. While these chemicals may provide a “quick fix,” their long-term use islikely to increase anxiety and health problems – particularly among caregivers who are noteating or sleeping properly. Caregivers should be informed of the harmful effects of thesebehaviors and encouraged to participate in counseling and/or treatment programs. Alternativeand complementary therapies, such as acupuncture, aromatherapy, acupressure, and massage,also may help to relieve stress.5. Maintain a Life outside the Caregiving Role.Caregivers often respond to stress by becoming over-involved with caregiving duties. 28 Theconstant demands of the job may cause caregivers to neglect friends, interests, and activitiesthat once gave them pleasure. Health professionals should encourage caregivers to takeregular breaks and to keep up with their interests and hobbies as best they can. 62 For somecaregivers, outside employment may provide relief from everyday tensions. Others may simplyneed to get away for a few hours. Health professionals can help caregivers “jump-start” theself-renewal process by linking them with social support resources.6. Build a Support Network.Although U.S. cultural norms emphasize self-sufficiency, 68 empirical studies suggestthat caregivers with higher levels of social support are less likely to experience negativeoutcomes. 69 Social resources can provide emotional comfort and practical support; reducesocial isolation; and offer humor, recognition, and encouragement. 47 They also can be a valuablesource of new information and insights. 59Social support resources should be explored if the caregiver’s answers to screening questionssuggest a need for outside assistance. Formal sources of social support include:• AIDS service organizations (provide supportive services such as buddy/companionprograms, case management, emergency financial support, food banks, housingassistance, nutritional counseling, and transportation assistance)• Home health agencies (provide skilled nursing care, homemaker and personal careservices, and rehabilitation services)• Home-delivered meal programs• Hospice programs (provide in-home or residential palliative and supportive care servicesfor patients in the terminal stages of illness)• Respite care programs (provide short-term, temporary nonmedical care for people withdisabilities and chronic or terminal illnesses)420U.S. Department of Health and Human Services • Health Resources and Services Administration • HIV/AIDS Bureau