Caregiver Health

I'm under a great deal of stress from caring for my husband. Do certain types of music help reduce stress more than others? I've always been a rock ‘n' roll girl, but it's not really helping.

"Music has different effects on us: physically, psychologically, even cognitively," says Al Bumanis, director of communication for the American Music Therapy Association, and a board-certified music therapist in Maryland. "That said, you must be aware of what the music is doing. Is it energizing you or relaxing you? Then you have to find the music that has the desired effect."

Bumanis adds that "music is very individualized. If you're looking for a relaxation response, playing hard rock or faster-tempo rock might not do it—but that's not the case with everybody." He suggests going to a music therapist who would "do evaluation and assessment, incorporating cultural background, and see how different music affects you.

"For most music therapists in clinical music therapy," Bumanis adds, "it's [about] creating music, engaging the client, whether drumming together, singing together, or creating music in other ways. Maybe playing an instrument can be relaxing, rather than more passively listening to music. Or you can do a mix of both. The key is to find what works for you."

Why does stress make me so tired?

“Stress and feeling exhausted or tired are subjective phenomena that differ for each of us with respect to frequency, severity and cause,” says Paul J. Rosch, MD, president of the American Institute of Stress.

“In many cases, this is a manifestation of depression that is mild and intermittent and quite different from what is seen in patients suffering from chronic fatigue syndrome. The stress we’re talking about happens several times a day and does not affect your cardiovascular system, but your immune system. Many people who claim to feel tired are really depressed. They don’t want to hear it, but it’s a fact. And caregiving contributes to depression.

“Treatment depends on finding the source of the problem, and therapy also differs since no stress-reduction strategy works for everyone. Meditation, jogging, yoga and more are great for some but prove dull, boring and stressful when arbitrarily imposed on others,” Dr. Rosch explains.

Managing this stress, he notes, “is all about developing a sense of control. You have to list all the things that tick you off—people, situations—and put them into two categories: This is something I can’t control and this is something I can do something about.”

I have arthritis and it’s difficult for me to get out of a chair, though once I’m up I can get around okay. How can I solve this problem?

“Be sure your chair isn’t too low,” says Patience White, MD, chief public health officer for the Arthritis Foundation. “The seat should be higher than your knees so you can lean forward and get enough weight over your knees to get up.” She suggests you might elevate the seat with pillows.

Beyond that, says Dr. White, exercise is vital to joint health. “The majority of people with arthritis don’t like to exercise because it hurts,” she explains. “But it’s a vicious cycle. You hurt, so you don’t exercise and muscles get weaker. You don’t need to get into a gym to gain strength. Much of that can be done in isometric exercises when you’re sitting. And for lower-joint health, walking is very helpful.

The CDC recommends thirty minutes of walking each day, and you can do that in three ten-minute episodes, five days a week.”
If trouble persists, she says, “a lift chair will help. But I recommend one only after you’ve tried to improve the strength and range of motion of your joints.”

Between work and caring for my ill husband, I feel tired a lot even though I sleep through the night. Is there something I should be eating to help keep my energy levels high?

A stressed and busy lifestyle makes it easy to forget some important basics that should help you revive your energy. "My first question would be, how much water are you drinking? One of the first symptoms of dehydration is being lethargic," says Julianne Koritz, RN, LDN, a dietician in private practice in Boca Raton, FL. Koritz suggests drinking "four twenty-ounce bottles through the day. Morning, afternoon, one at three or four-when people mainly get lethargic-and one at dinner."

Coffee or tea isn't necessarily a good substitute; as Koritz points out, "caffeine is dehydrating." Also, she says, "fresh fruits between meals are better than a power bar or granola bar because the sugar in that bar can cause dehydration. Fresh fruit is not just glucose, it's a natural fructose, which you absorb slower to keep energy levels up."

Greens will also do the trick, says Koritz. "Vegetables, raw or cooked, it doesn't matter. Also, add a bit of protein, perhaps tofu or hummus." For a quick, on-the-go boost, she suggests pistachios, pecans or walnuts, noting that nuts, period, are the best pre-packaged snack.

Sleeping during the daytime makes me groggy. How do I get an ideal nap that leaves me refreshed?

According to Sara C. Mednick, PhD, research scientist at the Salk Institute at La Jolla, CA, and author of the book Take a Nap, "our biological rhythm telling us when to sleep and wake changes across the lifespan. In older adults, those signals become weaker, and people develop changes in sleep pattern."

That said, there are some recommended methods for a nap that will leave you refreshed. "Typically, between one and three in the afternoon, you feel a bit of an energy dip," Dr. Mednick, says. "You can, within those hours, get on a schedule with your body. A nap of reasonable length is no longer than an hour and a half. That length of time gets you through a full sleep cycle. Also, you don't want to be sleeping too close to bedtime. Leave at least a three-hour window before beginning nocturnal sleep."

Being guided by moderation is the key to a nap that leaves you more energized than tired. "There's no benefit to napping beyond an hour and a half," Dr. Mednick stresses. "Beyond that, you're relaxing into the next sleep cycle."

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