Struck by a van while walking in a Medford parking lot, Valerie Austermann suffered head injuries that led to permanent brain damage.
After Austermann's release from hospital and nursing-home care, her husband, Kurt Austermann, was stricken with "instant caregiver syndrome."
Work options: Working caregivers should discuss needs with their employers. Telecommuting, flex-time, job sharing or rearranging schedules can help minimize stress. Increasingly, companies offer resource materials, counseling and training programs to help caregivers.
Involve older children: Older children living at home may be able to assist caregivers and/or loved ones. Pitching in can help young people become more empathic, responsible and self-confident while giving the primary caregiver needed support.
Ask others to help: Other family members should share responsibilities of caregiving. A family conference can help sort out everyone's tasks and schedules. Friends and neighbors also may be willing to provide transportation, respite care and help with shopping, household chores or repairs.
Create lists of things that need to be done: This includes grocery shopping, laundry, errands, lawn care, house cleaning or spending time with the loved one or friend. Put it on the refrigerator or near the front door, and if someone says, "Let me know if there is anything I can do to help," point to the list.
Take a break from caregiving: Even if it is only 15 or 20 minutes a day, do something just for you.
Exercise: Whether it is a 20-minute walk outside or taking a yoga class, exercising is a great way to take a break, decrease stress and enhance energy.
Eat well: Caregivers' health and nutrition are just as important as loved ones'. Take time to eat a proper diet. If that's difficult, ask for help and get others to fix meals.
Attend a support group for caregivers: Check with your doctor, hospice or local Area Agency on Aging for information.
Seek professional help: Many caregivers at times feel lonely, anxious, guilty, angry, scared, frustrated, confused, lost and tired. If these feelings are overwhelming, call your doctor, hospice or another community resource for help.
— Source: Caring Connections (www.caringinfo.org), a program of the National Hospice and Palliative Care Organization
Shouldering nearly all the duties of his wife's daily care, Austermann found himself among the 29 percent of Americans who do the same for chronically ill, disabled or elderly family members or friends. Studies show family caregivers are at greater risk than the general population for health problems, premature aging and even life spans shortened by as much as a decade. For 66-year-old Austermann, caregiving spelled the end of a serene retirement before it really started.
"The whole damn thing has been disastrous," says Austermann, now 74, of what he and his wife have endured since her June 19, 2003, trauma caused by a 92-year-old driver. "At first, of course, I was devastated."
But as his wife's life-threatening wounds healed and her physical and mental function improved with physical therapy, Austermann had every reason to hope she could return to normal. The high point of Valerie Austermann's recovery was skiing at Mount Bachelor about six months after the Volkswagen almost took her life.
"She was game," says Kurt Austermann. "Her balance seemed to be good."
Skiing without a single fall seemed proof of Valerie Austermann's resilience. In reality, says her husband, "that was about as good as it was going to get."
Shortly after the ski trip, Austermann's behavior turned worrisome. Her husband fretted about leaving her alone at their east Medford home in case she forgot to turn off a faucet or got lost while walking around the neighborhood. He dreaded the ensuing scene when she swiped restaurant food off other customers' plates or merchandise from a store. Paid, in-home caregivers complained Austermann was too much to handle.
"We were just burning up caregivers one after the other," says Kurt Austermann.
The stress robbed Austermann of sleep, time for exercise, a social life and the ability to travel. With his infrequent breaks from caregiving never long enough and his frustration at unprecedented levels, Austermann realized he should relinquish responsibility for his wife's daily care.
"The exasperation was just taxing my strength," he says. "The best caregiving I could do would be to get her in professional and capable hands."
About five years into caring for his wife at home, Austermann made perhaps the most difficult decision facing a family caregiver: moving her into an adult foster-care home and ultimately Skylark Memory Care in Ashland. Coverage by long-term care insurance purchased several years before the accident largely finances Valerie Austermann's accommodations.
At Skylark, Austermann, 73, spends most of her time knitting and reading. Visiting once a week, Kurt Austermann brings her skeins of yarn and potted plants. Although his wife asks periodically if they can go out to lunch, Austermann says he hasn't taken her on an outing alone since she lost her balance getting into the car and fell; he was unable to get her upright again without assistance.
"This is a nice place to live," says Valerie Austermann during one of the couple's visits.
"I needed to hear that," remarks her husband. "That helps."
Unburdened of his wife's care for the past two years, Austermann still struggles with anxiety and depression. Since mourning the loss of companionship, he says the biggest challenge of living a largely solitary life has been emerging from the "cave" he'd "crawled into."
"I have a life left," says Austermann, adding that he's only recently started pursuing it.
After meeting basic needs for food and sleep, reclaiming one's personal life is the most important step for long-term caregivers. If family or friends don't fill in for caregivers, local respite programs furnish clients with time to replenish their energy and indulge their own interests.
"It's a very affordable way for people to be able to get a break," says Ardis Faith Fraser, site coordinator for Lifespan Respite at Skylark.
For $6 per hour per participant, Lifespan hosts four-hour sessions three times a week: Tuesday and Thursday afternoons at Barnett Woods in Medford, Wednesday afternoons at Skylark. A program of The Arc of Jackson County, Lifespan is a nonprofit group that operates on about $60,000 annually, says program coordinator Pam Swisher. Unique in Oregon, says Swisher, Jackson County's arm of Lifespan operates on a cooperative model, allowing clients to volunteer hours in exchange for respite hours.
"You can't even say how much it's worth," says Sheila Stedman, a paid respite caregiver who accompanies clients at Lifespan's program.
Calling its group the Social Club, Lifespan organizes games, crafts, live music and other activities for participants who range in age from 43 to 93 with memory loss and developmental disabilities. Newcomers often are wary, but they usually become happier and more communicative while trying pastimes they ordinarily wouldn't, says Fraser.
"They're not just being baby-sat," she says. "A lot of them are recognizing that they're giving their loved ones a break."
Marilyn Dias, 84, doesn't recognize her daughter-in-law, Duretta Anderson, but she lights up in the company of other Lifespan participants. Alzheimer's disease didn't claim Dias' appreciation for music, which prompts her to sing and clap with astonishing rhythm, says Anderson.
Lifespan's program, in addition to eight hours per week of paid, in-home respite, allows Anderson to shop, hike, teach Bible-study classes and operate a business distributing nutritional supplements. It took Anderson two years of caregiving for Dias and an attitude-altering class at Medford's Hearthstone Nursing and Rehabilitation Center to put some effort back into herself.
"My adrenals were bankrupt," she says. "I was just wiped out."
Anderson swears by staying active, eating a balanced diet of "energizing foods" and getting lots of "really good, quality sleep." She schedules an hour for herself in the evening after Dias has gone to bed and a couple hours in the morning before she gets up, as well as regular chiropractic appointments.
The prescription, she says, will allow her to care for Dias in her Ruch home until the end of her life. Promising her mother-in-law years ago that she'd never put her in a nursing home, Anderson intends to live by her word.
"My soul is well-fed," she says. "I have an easy job."
Call Lifespan Respite at 541-821-8764.