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Mature Focus: Aug. 8

Preventing caregiver burnout

Preventing “caregiver burnout” is very important for those caring for an aging loved one at home.

According to statistics from the National Alliance for Caregiving and AARP, close to 40 million Americans have served as unpaid caregivers for an adult age 50 or older in the last 12 months. Nearly 16 million family caregivers care for someone who has Alzheimer’s disease or other types of dementia. 

Although providing daily care for an aging parent or other loved one is both a necessary and rewarding job, it is indeed a job – often a difficult and demanding one. “Caregiver burnout” is defined as a state of physical, emotional, and mental exhaustion that can shift a caregiver’s outlook from positive and helpful to negative and withdrawn. Burnout can occur when caregivers don’t get the help they need, or when they try to do more than they are physically or financially able. Many caregivers also feel guilty for taking time away to care for their own needs, so they may rarely take a break.

Caregivers who are burned out may experience fatigue, stress, anxiety and depression. Often, they don’t recognize these signs as burnout and eventually get to the point where they cannot function effectively, or even become ill themselves.

To make caregiving a positive experience, those who provide care to others must also make their own well-being a priority. The Mayo Clinic provides the following tips for preventing caregiver burnout:

• Ask for specific help. Make a list of ways that family members and others can help, and let each helper choose what he or she would like to do. For instance, different people may be able to run an errand, pick up groceries or medicines, or cook a meal.

• Set realistic goals. Make lists, and break large tasks into smaller steps that you can do one at a time. Say no to requests that are draining, such as hosting holiday meals. Understand that no one is the perfect caregiver and accept that you are doing the best you can for your loved one.

• Get connected. Find out about caregiving assistance resources in the community, including services such as transportation, meal delivery or housekeeping. 

• Join a support group. A caregiving support group can provide encouragement and friendship as well as problem-solving strategies for difficult situations. Visit caregiver.org for a list of groups in your area.

• Maintain your own health. Establish a good sleep routine, find time to exercise on most days of the week, eat a healthy diet and drink plenty of water. See your doctor for regular health screenings.

• Get respite care when needed. Taking regular breaks can be one of the best things you can do, both for yourself and the person for whom you’re caring. Seek out resources near you that provide in-home respite care or adult day care services for daily needs [websites like Eldercare.gov and care.com may be a good place to start]. When it’s time for a longer break or a vacation, many area nursing homes and senior living communities welcome people needing short-term care for several days while caregivers are away. 

Shingles vaccine recommendation

Shingles, a painful reactivation of the chicken pox virus decades after the initial illness, is all too common in adults over 50.  One in three people will develop shingles in their lives, and the risk increases with age. 

A painful rash that typically develops in a stripe pattern on one side of the face or body, shingles is often preceded by tingling, pain or itching in the area where the rash soon develops. The rash consists of blisters that usually scab over in seven to 10 days, and clears up completely within a month. However, some people continue to experience nerve pain, called post-herpetic neuralgia, for months after the shingles rash is gone. In others, shingles can develop in the eye, causing intense pain and loss of vision.

An initial vaccine to prevent shingles, called Zostavax, became available in 2006. It was approved for use in people over 50, but health experts didn’t recommend getting Zostavax until age 60, due to its effectiveness level [it is 64 percent effective at preventing shingles in people ages 60-69] and the fact that its protection lessens significantly over time.

In late 2017, a new vaccine called Shingrix was approved by the FDA. Shortly afterward, the U.S. Advisory Committee on Immunization Practices [ACIP] officially recommended Shingrix for adults over age 50. The committee also recommended that those who have already received Zostavax be revaccinated with Shingrix. 

Earlier this year, the U.S. Centers for Disease Control and Prevention [CDC] also gave its final recommendation to Shingrix over Zostavax to prevent shingles. The CDC recommends that healthy adults 50 years and older get two doses of Shingrix separated by two to six months. 

Shingrix has been shown to be more than 90 percent effective against both shingles and post-herpetic neuralgia, and protection remains at a level above 85 percent for at least four years following vaccination. 

According to the CDC, Zostavax may still be used to prevent shingles in healthy adults age 60 and over, in cases where an individual may be allergic to the Shingrix vaccine or needs immediate vaccination and Shingrix is not available. There is no upper age limit for receiving either vaccine.

Surgery and the aging brain

Seniors who have general anesthesia during surgery may experience a small but lasting decline in memory and thinking skills, recent Mayo Clinic research found.

In adults over age 70, undergoing surgery with general anesthesia may be related to a subtle yet lasting decline in memory and thinking skills, according to new research. Although the decline in brain function found in the study was small, it could be significant for seniors with pre-existing or undiagnosed mild cognitive impairment who are considering surgery.

The researchers used data from the Mayo Clinic Study of Aging, a long-term study designed to provide information about cognitive changes related to getting older. The participants included 1,819 seniors, who were between the ages of 70 and 89 when they enrolled in the study. Researchers analyzed whether surgery with general anesthesia during the period 20 years before enrollment was associated with cognitive decline, as well as whether having anesthesia after study enrollment as an older adult was associated with a cognitive change. 

While older adults often experience cognitive decline as part of the normal aging process, that level of decline following exposure to anesthesia and surgery was found to be slightly accelerated beyond that associated with typical aging.

“We need to be sure that patients considering surgery, and their families, are properly informed that the risk of cognitive dysfunction is possible,” said Juraj Sprung, M.D., Ph.D., a Mayo Clinic anesthesiologist and the study’s senior author. “In addition, alternative strategies should be discussed with patients before surgery is undertaken for those deemed to be at high risk.”

On the calendar

St. Peters Senior Center is looking for people who love to play bridge. Games take place on Monday and Thursday mornings from 9 a.m.-noon. Anyone interested in playing can sign up by calling Mary Ann at (636) 397-0866.

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St. Louis OASIS offers a Better Choices, Better Health free diabetes workshop on Tuesdays, Aug. 14-Oct. 2, from 1:30-4 p.m. at the Middendorf-Kredell Branch Library, 2750 Hwy. K in O’Fallon, in Room A. Living with diabetes can present many challenges; this workshop, developed at Stanford University, can help you manage these concerns. Light refreshments are included; the session is free. Advance registration is required by visiting bjcstcharlescounty.org/Events.

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