Chapter 3: Caring For You The Caregiver


Stress is a big issue for caregivers. You feel a lot of emotional and physical stress when you are taking care of a loved one.

Our bodies have a response that helps us cope with stress called the fight or flight response. It causes your body to change physically and comes in three stages:

Stage 1 - Moving energy - during this stage, your body makes adrenaline, your heartbeat goes up and you breathe faster.

Stage 2 - Using energy stores - if you stay in the first stage of stress for a long time, your body starts to release stored sugars and fats. This makes you feel tense, pressured and tired. Some people drink more coffee, smoke more or drink more alcohol to deal with these feelings. You may also feel anxious, have a lowered immune system (and may have more chance of getting sick), think more negatively or have some memory loss.

Stage 3 - Draining energy stores - when the body stays stressed for even more time without a break, your body will need more energy than you can make. At this stage, you might not be able to sleep, make poor choices and your personality can change. You may also develop a serious illness. Most people who have constant stress will experience poor health, such as anxiety, depression and/or cardiovascular illness.1,2

We all react differently to stress. The key to understanding stress and controlling your reaction is to know what situations or events give you stress.

What is caregiver burnout?

Being a caregiver usually makes you feel some stress. However, some things can make it even more likely you will have a burnout.

Burnout means that you cannot keep giving the best care to your loved one because you are worn out emotionally or physically.

Here are some questions to help you see if you are at risk for caregiver burnout:

  • did you answer yes to a lot of the questions about depression
  • do you feel you like you are being pulled in different directions
  • do you feel like you are trapped in your role as a caregiver
  • is there a problem between you and the people you are close to, between you and your loved one, between the people you are close to and your loved one
  • do you feel that you are not getting help from other people
  • is your loved one demanding and expecting too much from you
  • do you feel like you cannot do everything that your loved one wants and expects
  • do you have a hard time talking to others around you
  • is your health or the health of your loved one getting worse
  • do you feel like there is too much to do3,4,5

If you said yes to a lot of the questions above, you may be at risk of caregiver burnout.

It is important to start taking care of yourself. This means making changes and getting some support.

Managing your stress

Here are things you can do to cope with stress:

List what makes you stressed

List the main things (stressors) in your life that give you stress, and then start doing something about them. It will take time for you to recognize and point to the exact sources of stress in your life.

You might not be able to remove all your stressors, but you are in control of how you react to them.

Do not try to control the things that you cannot control (your loved one's condition, the doctor's bedside manner).

You do not have to be perfect: be kind to yourself and others around you, and remind yourself that no one is perfect. Do your best.

Ask for and accept help: recognize when you need help and let yourself accept it. Feeling exhausted and stressed is bad for your physical and mental health. This does not help you or your loved one. You need to know when you are at your limit and where to go for help. Often, people will not offer help because they do not know what type of help you need or if you need help at all.

Be specific and positive when asking for help; tell people what you need.

Take some time for you!

A way to help lower your stress and anxiety is to take care of your physical health. Exercise regularly, eat a balanced diet and get enough sleep!

Watch the Home Care - Caregivers' Experiences  from the Health Council of Canada. It will show you how other caregivers feel and shows different views of life as a caregiver.

The views expressed in the video are those of the participants, and not necessarily those of Ottawa Public Health.

Taking care of yourself

Here are things you can start doing now to help you take care of yourself.

Eat Well

You have to eat to get the energy you need to cope with stress. Your body will not have the energy it needs if you are not eating healthy foods. It is important to eat the recommended daily servings of vegetables and fruits, meat and dairy, as well as avoid foods like sweets, caffeine and alcohol.


Worrying at night can interrupt your sleep and if you do not sleep well, you will feel tired and not be able to handle your day-to-day stress.


  • avoid caffeine, cigarettes and alcohol near bedtime and try to cut down your use during the day.
  • wake up at the same time every day, even on weekends.
  • do not eat large meals or heavy foods before bedtime.
  • exercise during the late afternoon but before supper. Hard exercise three to four hours before bedtime can make it hard to sleep.
  • have fewer distractions in your bedroom.
  • if you cannot sleep, get up out of bed. Lie on the couch or sit in a comfortable chair. Even if you do not actually sleep, at least you will be relaxed.

Be Active

Your heart, lungs and bones are all healthier if you enjoy regular physical activity. Exercise also makes your mind happy. Exercise makes the body release hormones called endorphins that improve your mood and make you feel good. Start off slowly...Exercising 30 minutes a day, like doing yard work or going for a walk can make a difference in how your body and mind feel.


There are many different forms of yoga, but most western practitioners focus on physical postures, breathing exercises and meditation. Check for yoga classes in your communitylocal recreation centres and telephone directories.

Deep breathing

Simple deep breathing is an easy but important technique that can help you relax. Breathe in slowly through your nose to fill chest with air; then breathe out slowly through your mouth. Make your breath out twice as long as your breath in. Do this every day and use it whenever you feel stressed.


Meditation allows you to be in control of your thoughts. It lets you calm your mind and help you think more clearly. Meditate every day to feel the benefits. Check your local telephone and community resources directories for classes on meditation.


Visualization is using your mind to move yourself from a stressful place to one that allows you to feel peace. You can do it anywhere and at any time. Sit in a quiet place, close your eyes, and picture yourself in a place that makes you feel peaceful and calm. This space will be your own - you might picture yourself in a field full of spring flowers, lying on a sunny beach or watching the waves of the ocean. Pay careful attention to the sights, sounds and smells in your vision. How do they make you feel? Hold the vision for as long as you need to.


Science has proven that touch reduces stress and anxiety. A massage through touch or other techniques helps the body relieve stress, tension and pain. It is important to remember massage is a therapy and there are many different types of massage. Massage therapists have a lot of training. Check to make sure your massage therapist is a registered massage therapist (R.M.T.) registered with the proper governing body.

Take time for yourself

It is important to take time for yourself during times of extreme stress and anxiety.

Ali, a caregiver to his adult son with Down's syndrome says:

"I take advantage of the regularly scheduled times where I can have some respite care. During this time I do things that I enjoy, things that make me feel good."

It might be something as simple as reading a book, visiting an art gallery, taking a walk, playing your favourite sport or taking up that new hobby you have always wanted to try. Whatever the activity, the point is to remember to stay involved in your life. Express yourself and do something you enjoy!

Visit your local public library and take advantage of the many books, audio books, and programs. Ottawa Public Library

Humour and laughter

Humour and laughter are the body's natural way to prevent stress. Use them to help improve the function of your mind, body and spirit. Research shows that being able to laugh at a situation gives you a feeling of power and perspective. Laughter and humour help you to feel positive and hopeful.

Ideas to laugh and relieve stress:

  • watch your favourite funny movie or TV show
  • read the comics in the daily newspaper; cut them out and keep them handy when you need a smile
  • tell at least one bad joke every day
  • read a funny book
  • wear clothes that make you feel happy
  • listen to music that makes you feel happy
  • call up a friend who always makes you laugh and smile
  • surround yourself with things that make you laugh such as a funny photograph, favourite toy or picture

Take care of yourself! The more time and energy you put into taking care of yourself, the more you will be able to care for those around you who need your time and assistance.

Regular medicals

It is important that you keep regular contact with your family health care provider. Regular checkups and physicals help to keep your mind and body healthy.

Give us your feedback

Please share your comments or concerns on this section of the Guide. Your comments are important to us. We appreciate and thank you for taking the time to complete this short Feedback Survey. If at any time, you wish to speak with a nurse at Ottawa Public Health please call 613-580-6744 TTY/ATS: 613-580-9656 or email us at


  1. Health Canada. [Internet]. Mental Health - Coping With Stress. 2007. [cited July 12, 2013]. Available from
  2. Canadian Mental Health Association. [Internet]. Stress. [cited July 12, 2013]. Available from
  3. Treasure J. Review: exploration of psychological and physical health differences between caregivers and non-caregivers. Evidence-Based Mental Health. 2004. Vol 7(1). Pp: 28.
  4. Onega L. Helping those who help others: The Modified Caregiver Strain Index. American Journal of Nursing. 2008. Vol 108(9). Pp:62-69
  5. Parrish M & Adams S. Caregiver Comorbidity and the Ability to Manage Stress. Journal of Gerontological Social Work. 2004. Vol 42(1) Pp: 41 - 58.

Recognizing When You Need Help

Physical limitations

You may have some health problems that make it harder to be a caregiver. For example, if you have heart disease, you might not be able to lift or move your loved one. The stress of caregiving can also affect your health. The physical part of caregiving can make a breathing problem worse, and if you have any trouble with your bones and joints, you might not be able to care for another at all.

If you cannot hear or see very well, you may also need help with caregiving. There could be a risk of danger to your loved one if you miss hearing a health care provider's instructions, or if you cannot hear the person call out for your help. When you cannot see well, you may be more likely to make mistakes with medications.

Talk to a health care provider about your health. Ask them how it can affect you being able to take the best care of your loved one.

Signs you may need help

  • pain that seems to have no cause, including chest pain
  • headaches
  • stomach problems
  • cannot sleep
  • teeth grinding
  • tense muscles
  • alcohol or drug problem
  • no interest or not aware of  the world and people around you
  • strong emotions and mood swings
  • forgetting things
  • more accidents
  • cannot relax
  • changes in eating habits
  • no energy
  • cannot concentrate
  • existing health problems getting worse
  • no sex drive
  • feeling depressed

The stress of your added responsibilities as a caregiver and the feelings that go along with it can be very hard for you. You are more likely to get sick if you don't take care of your body and emotional well-being; and you are less able to provide good care. This does not mean that you are a bad caregiver; it just means that you have reached your limits.

Here are some reasons why caregivers do not ask for help:

  • feelings of guilt and shame
  • not knowing that others are in the same situation
  • lack of knowledge about available options
  • not able to pay for formal caregiving services
  • not enough time to find help
  • cultural issues that discourage help from outside the family
  • lack of services to meet your needs
  • feelings of depression, which can reduce the motivation needed to find help
  • not being able to talk about feelings

Think about which reasons might be stopping you from getting help. If you notice a big change in your mental or physical health, find help as soon as you can.

You should feel proud of what you are able to do and realize that you have a right to continue to make a meaningful life for yourself.

You need to know that it is okay to ask for help. It is part of providing the best care possible. Many caregivers share this advice: Do not be afraid to ask for the help you need!

A final check

  • you may want to ask yourself what you would be doing if you were not a caregiver. Would you spend more time with your children and spouse?
  • would you take part in an activity you enjoy
  • how important are these activities to you
  • if you cannot use your time, as you would like, how do you think this will change your life
  • can you accept those changes

What type of help do you need?

Figure out what type of help you or your loved one need. Get family and friends together to support your decision. People who are not directly involved in a person's care might not think you need help because they are not with you and your loved one every day and don`t know about the situation. Give them regular updates and try to include them in any decisions you want to make.

What do you need help with? For example:

  • you are not strong enough to lift and move a person
  • your loved one cannot manage his or her money, and you do not know how to help him or her
  • you need a break from caregiving
  • you are not comfortable with helping your loved one go the toilet or take a bath

Think about what you can and cannot do. Then think about how often you need help. Is it every day, once a week or in the evenings? During the day when you are at work?

Now you will have to think about how to pay for support services. Government funded programs may cover some types of assistance, and other types of assistance may be covered by private insurance. However, you or your loved one will have to pay for services that are not covered.

Family, friends and neighbours:

The people closest to you and your situation are a possible source of help that will not cost money. Ask for help and be specific. When many people are helping, any one person might only need to offer a small amount of time.

Mika, along with a network of other friends and neighbours, offered support to a woman with breast cancer and her husband. Everyone took turns taking care of the couple's children so that they could have some time alone together.

Even though meetings and discussions with family and friends are helpful, make sure to respect everyone's opinions and limits. Even family or friends who live far away from your loved one can help. People can help by:

  • walking the dog
  • preparing meals in advance
  • running errands
  • helping you take care of your own household and family

A neighbour may be able to help with shovelling snow or can be on standby for your loved one in case of an emergency. Think about the skills everyone has and take advantage of their strengths.

Support groups:

People who are dealing with similar problems can join a support group. Members of a support group share their feelings. They also talk about what they are going through in a safe and accepting environment. You can find out about community resources, get tips on caregiving and just feel better about your situation by being with people who understand what you are going through. There are support groups for caregivers or ones that focus on a specific illness.

Make sure the support group is right for you by asking yourself:

  • does it make you feel welcome and safe
  • is everything you share private
  • is the environment respectful
  • are meeting times and places good for you? (an online or web support group might be an option)
  • are experienced health care providers involved
  • does the group invite experts to speak

Your faith community might have a support network you can join. You can also get help from a professional counsellor to manage conflict, stress, grief, anger and other feelings.

To find out about groups in your area, talk to your health care provider. You can contact groups focused on particular illnesses and conditions.

You can also look in local community listings and general phone books like the Yellow Pages to find other sources of support (try looking under headings such as Home Health Care Services, Supplies, Charitable, and Not-for-Profit Organizations).

Your province or territory may have an association for caregivers and caregiver support. Try searching for links on your Ministry of Health's website, on Health Canada website. You can also call your local community health centre or the Ottawa Public Health information line at 613-580-6744.

See Resources and Support Services list at the end of this section for more information about these organizations

Medical help:

Sometimes no matter what you do, you still feel stressed or sad. If you continue to feel this way, it is important that you speak to a health care provider.

You can start with your primary care team such as your family doctor or contact a service such as the Canadian Mental Health Association who can help you find some support. Click here to find your local CMHA. Click here for the Ottawa CMHA.


  • learn to recognize when you need to ask for help.
  • do not feel guilty or useless if you need to ask for help.
  • work with other family members to decide on the best solution and do not forget to include your loved one.
  • congratulate yourself regularly for all you have been able to do.

Give us your feedback

Please share your comments or concerns on this section of the Guide. Your comments are important to us. We appreciate and thank you for taking the time to complete this short Feedback Survey. If at any time, you wish to speak with a nurse at Ottawa Public Health please call 613-580-6744 TTY/ATS: 613-580-9656 or email us at

Taking Care of Yourself

Taking care of someone else can be rewarding and stressful. You learn new skills and build stronger relationships as a caregiver. But the stress you might feel can affect your health.

It is normal to feel many different emotions as a caregiver1. Research has shown that caregivers have higher levels of depression and anxiety than other people do.2

This section talks about how to take care of you as the caregiver. Often caregivers do not think of themselves.

You might not use all the information in this guide, but it is still helpful to read it. Research tells us that caregivers' risk 'burnout' from too many demands and too little time to take care of themselves.3

The most important thing to remember as a caregiver is to take care of you.

Caregivers tend to take more medications and have higher levels of stress than others. They also may not take proper care of themselves such as not going to the doctor, not being physically active, etc.3


  • caregiving might take up a lot of your time and energy; but it also can be an opportunity to build a new and deeper relationship with your loved one.
  • it is okay to say no!
  • ask for help. Family and friends may want to help but do not know how. Community organizations can also help you.
  • take time to take care of yourself daily. You need to sleep and stay healthy.4
  • know your limits. Learn how to recognize when you feel stressed; learn ways to cope with stress.
  • talk to others who have been through what you are going through. See the Resources and Support Services list at the end of this section.
  • the stress and negative feelings that you might experience can affect relationships between family members. Take steps early to talk about what you are feeling.
  • if you are a caregiver who works outside the home and would like to know more about work-life balance please ask your employer to consider one of Ottawa Public Health's(OPH) FREE interactive educational sessions, such as Balancing Work and Home, Personal Stress Management, Caring for an Older Adult, etc.

Caregiver's Bill of Rights

Often, the feelings and demands of the caregiver role mean you might not have time for yourself. Use these rights to remind you to take care of yourself. Read them daily.

I have the right to:

  • take care of myself. This is not selfish. It will give me the energy to take better care of my loved one.
  • get help from others even if my loved one does not want me to. I know my limits, what I can do.
  • keep parts of my own life that does not include the person I care for, just as I would if he or she were healthy.  I have the right to do some things just for myself.
  • get angry, be depressed, and talk about other difficult feelings sometimes.
  • not let my loved one control me by using guilt, anger or depression.
  • get consideration, affection, forgiveness, and acceptance for what I do for my loved one, as long as I offer the same in return.
  • take pride in what I am doing. To be proud of the courage it has taken to meet the needs of my loved one.
  • make a life for myself that will help me in the time when my loved one no longer needs my help.
  • expect and demand improvements in resources to help and support caregivers.
  • add my own statements of rights to this list.5

Feelings about Caregiving

As a caregiver, you may be in sensitive situations that cause both positive and negative feelings - this is normal.

Feel your own emotions even if they are negative feelings. Be aware of and accept the feelings you have and you will then be able to deal with them.

Long-term caregiver Maureen shares her thoughts:

"I think what I would have benefited from early on is knowing that it is okay to get angry about additional responsibilities. It is not necessarily okay to display your anger in certain ways. And it is okay to say no."

Read some of the common emotions that caregivers feel. Do you have these feelings?

Positive feelings

Caring for a person can be a wonderful and positive experience. It can be full of laughter and close moments. You may get a lot of satisfaction from being able to help your loved one when they need you most.

The positive feelings you have about being a caregiver depend on your own situation.

Personal growth

You may feel like you have grown personally because you learned to be more patient to give the best care.

Greater appreciation for health and well-being

Caring for someone who is very ill can change the way you look at life and death. This may lead to a new understanding or meaning of life, change what you see as important or change your personal goals.

Strengthened relationships

Often the caregiving role allows you to become much closer, physically and emotionally, to the person you are caring for and this will make you feel appreciated.4,6

Negative feelings about caregiving

Caregivers face difficult situations and you might have negative feelings. You might try to ignore them by not admitting or working through them. You may tell yourself that you should not feel a certain way or ignore your feelings.

For example, to feel worthy and useful, it might be important for you to take care of your parents when they need help. If you are unable to do this, you might feel unworthy and this can lead to guilt or anger. Try to identify the real cause of your feelings to be able to learn how to deal with these feelings.

Here are some negative feelings caregivers can feel:


Feeling unsure about the future can cause you to feel anxious. It can happen when you worry that something bad will happen. For example, you may feel anxious because you do not have enough resources to cope with your current situation. You may feel the situation will not get better and might actually get worse.


You experience fear when you feel threatened. The responsibilities of caregiving or doing something wrong might scare you. Learn more about your loved one's illness or disability; visit the different sections in this guide to get tips on how to care for your loved one. You can also ask a health care provider for advice.


You may be in situations that will cause you to feel guilt. You may feel guilty because:

  • you think that you are not doing enough
  • you think that you do not have the energy to deal with one more day
  • you are not able to keep promises you made to your loved one
  • you have your own life outside the home while the person you are caring for might not

Frustration, resentment and anger

These feelings often go together. You may be frustrated because you cannot find enough time for yourself; this may lead to resentment and then to anger.

Hurt feelings and isolation

There may be days when you feel that no one appreciates what you are doing. Your loved one may actually be angry with you. It may be hard not to feel hurt by these moments, or to feel like you are alone.

The responsibilities of caregiving may mean you are not able to do things you like as often; this can lead to feelings of isolation. There are services that can help you to take time for yourself. You deserve a break.


Grieving is the process of adjusting to a loss. This can be coping with death or loss of health from a disability or illness. Grief can make you feel many things you may not understand. For example, you might feel sad, angry, lonely, anxious and frustrated all at the same time. As a caregiver, you may feel grief at different times during the caregiving process.


Depression is common among caregivers. It is three times higher than in other people. This could be due to the stress of taking care of someone else, and the isolation, fatigue and frustration.4 Depression causes you to stop getting pleasure from your life or the activities you used to enjoy. When you are depressed, you may feel sad, anxious, empty, guilty, hopeless and worthless.

 If you say yes to any of the signs and symptoms of depression below, talk to your doctor.

  • do you have many headaches
  • do you have new health problems (example: high blood pressure, ulcers, or other stomach and digestive problems)
  • do you find it hard to concentrate or to remember things
  • do you have feelings of despair, are you overwhelmed, depressed, or anxious
  • are you crying for no reason7

Speak to your health care provider about what is happening or see Recognizing when you need help found later in this section.

Give us your feedback

Please share your comments or concerns on this section of the Guide. Your comments are important to us. We appreciate and thank you for taking the time to complete this short Feedback Survey. If at any time, you wish to speak with a nurse at Ottawa Public Health please call 613-580-6744 TTY/ATS: 613-580-9656 or email us at


  1. Treasure J. Review: exploration of psychological and physical health differences between caregivers and non-caregivers. Evidence-Based Mental Health. 2004. Vol 7(1). Pp: 28.
  2. Cochrane JJ, Goering PN, and Rogers JM. The mental health of informal caregivers in Ontario: an epidemiological survey. American Journal of Public Health. 2009. Vol 87(12). Pp: 2002-2007
  3. Onega L. Helping those who help others: The Modified Caregiver Strain Index. American Journal of Nursing. 2008. Vol 108(9). Pp:62-69
  4. Schumacher, K., Beck, C., & Marren, J. Family caregivers: caring for older adults, working with their families. American Journal of Nursing, 106(8), 40.
  5. Horne, Jo. Caregiving: Helping an aging loved one. 2006. Toronto: AARP Books, 1985. Retrieved from Family Services Toronto,
  6. Corry M & White A. The needs of carers of people with multiple sclerosis: a literature review. Scand J Caring Sci; 2009; 23; 569-588
  7. Health Canada. [Internet]. Mental Health - Depression. 2009 [cited July 12, 2013]. Available from

Give us your feedback

Please share your comments or concerns on this section of the Guide. Your comments are important to us. We appreciate and thank you for taking the time to complete this short survey Feedback Survey. If at any time, you wish to speak with a nurse at Ottawa Public Health please call 613-580-6744 TTY/ATS: 613-580-9656 or email us at

Chapter 3 survey

Resources and Support Services


The Dementia Society of Ottawa and Renfrew County: Individual and group support by trained dementia coaches for people living with dementia, and for their caregivers, families and the general public. FREE brain health and dementia education, social and recreational activities. Visit or call 613.523.4004

Champlain Community Care Access Centre: an in-home service and placement services including respite care. 613-745-5525
4200 Labelle St. Suite 100, Ottawa, ON, K1J 1J8

Ottawa Public Health: Caregiver Supportfree "Caring for a Senior?" Resource Guide, phone and email support to caregivers from nurses.
613-580-6744 or 1-888-426-8885,;

Ottawa Public Library

The Regional Geriatric Program of Eastern Ontario:  a network of specialized geriatric services, from hospital to home. 613-761-4458
The Ottawa Hospital

Western Ottawa Community Resource Centre: general caregiver support groups and support groups for caregivers of individuals with dementia related disorders. 613-591-3686

Short stays and overnight respite care

Ottawa West Community Support: 613-728-6016
1137 Wellington St., Ottawa, K1Y 2Y8

Perley Rideau: 613-526-7170, extension 8808
1750 Russell Rd., Ottawa

St. Patrick's Home: 613-731-4660
2865 Riverside Dr., Ottawa

The Guest House: A Home Away from Home: 613-247-1664
1750 Russell Road, Ottawa, K1G 5Z6


Care-Ring Voice Network: a free, bilingual and confidential web program that connects caregivers and families to information and support with teleconferencing. 514-488-3673, extension 1556

Family Caregivers' Support Network: a peer support telephone line for caregivers of older adults, which operates Tuesday, Wednesday and Thursday from 1 pm to 4 pm: 1-888-283-8806

Seniors' day programs: For a list of adult day programs, please see Adult Day program association

Saint Elizabeth: Caring for Family: information, support and community resources on being a family caregiver - and caring for yourself.


The Dementia Society of Ottawa and Renfrew County: Individual and group support by trained dementia coaches for people living with dementia, and for their caregivers, families and the general public. FREE brain health and dementia education, social and recreational activities. Visit or call 613.523.4004

Canada Cares: is a not-for-profit organization whose vision is to create a sense of community for family and professional caregivers by increasing awareness, providing encouragement and showing appreciation.

Canadian Caregiver Coalition: a national body representing and promoting the voice, needs and interests of family caregivers with all levels of government, and the community through: advocacy, leadership, research, education, information, communication and resource development.

Canadian Mental Health Association: promotes the mental health of all and supports the resilience and recovery of people experiencing mental illness, through advocacy, education, research and service.

Canadian Mental Health Association - Coping with Stress

Caring for Caregivers Resource Centre: search for caregiver support and support programs by province or territory

Health Canada - Provincial/Territorial Ministries of Health

Health Council of Canada - Seniors in need, caregivers in distress: What are homecare priorities for seniors in Canada?

By Us for Us Guides: created by a group of talented and passionate persons with dementia and/or partners in care.

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