Going the distance

Caretaker stress: You need to take care of yourself too

By Edward T. Creagan, M.D. February 25, 2009

Each of us at MayoClinic.com has been profoundly touched by the struggles of case managers, patients and families trying to navigate through the bewildering minefield of the healthcare delivery "system." We each know that this is a non-system with fragmented care; crushing bureaucracy; and poor communication between many healthcare providers. So what can we do for ourselves, our families and our patients?

Colleagues often ask me what has been the biggest change I've seen in my 32-year career. Without question, it is the disintegration of the American family and the isolation of many patients, especially the elderly. Decades ago, the patient was admitted to the hospital for an acute event, managed as well possible and then typically returned home to the support of family and community. Today, that simply does not happen.

The family support network is a thing of the past, as divorces, blended families, step-families and professional responsibilities take their toll. As a result, the elderly patient typically leaves the hospital for an empty house or a nursing home. Those who do well in this environment have an advocate — a friend, a confidant, a social worker or a member of the clergy who acts on the patient's behalf. But here comes the challenge.

If the advocate is worn down, frazzled and distracted, the patient rarely will do well. For myself I know that the times when I was the most frustrated — with the system or our technidigital world, for instance — are the times when I was sleep-deprived. As simple as it sounds, a good night's sleep empowers and energizes us to tame the demons threatening our wellbeing and that of our patients and families.

I am not proposing that a good night's sleep is the panacea for life's miseries. But from my own experience and that of friends and colleagues, I've learned that compromising on sleep can compromise our thought processes and our judgment. And it has a ripple effect on our patients. We caretakers simply must take care of ourselves, and a big part of that is making sure we are rested and rejuvenated for the work we do.

Am I completely off base? Or can others relate to the clarity and the peace that a good night's sleep can bring? What else helps you keep going? Please speak up. As some poet said, "No person is an island." We are here to learn from each other.


Edward T. Creagan, M.D.

Follow on Twitter: @EdwardCreagan

Join the discussion at #Stress.

Feb. 25, 2009