Stress can be a daily dose of one of the not so pleasant parts of life, caregiver stress doubly so. Stress is a feeling that’s created when we react to certain events. It’s our body’s way of rising to obstacles and preparing to deal with strenuous activities. As caregivers, we must learn to cope with stress and understand how it affects us on a day-to-day basis. Many times we struggle to balance our responsibilities as a caregiver with our non-caregiver responsibilities such as work, family life and social lives. Half the battle of dealing with stress is in knowing the signs and symptoms. Here are some of the signs that caregivers should know to look out for:

• Depression
• Exhaustion
• Guilt
• Anxiety
• Irritability
• Weight Loss
• Anger
• Lack of Concentration

If you are a caregiver who has noticed that you are experiencing one or more of these symptoms, we encourage you to talk with your doctor or seek out community support. If you feel that your loved one may need more care than you can provide please do not hesitate to reach out to Hospice Care of South Carolina. We are a passionate team of support and would be honored to help you and your family through this journey. Our social workers, clergy and highly trained staff are here to listen to you, help and support you. If you know of someone giving care that is dealing with stress, talk with them about it, they might not even notice that they are experiencing caregiver stress or are simply waiting for someone to talk with about it.

An easy way to lower stress levels before they get too high is to take a small break from caregiving and tend to your own needs. Asking a friend or family member for help is a great way to find a bit of spare time to go for a walk or take a quick nap. Remember, it’s ok to ask for help and it’s also ok to take some time to yourself, especially when it can increase your own health and well being. Taking breaks from caregiving is a part of maintaining a healthy lifestyle that lends itself to balance and mental alertness.

You’re doing an amazing service by caring for a loved one or friend, but no one expects you do to it alone, and the risks associated with caregiver stress are not worth it. So continue to be a caregiver, but remember that you need to care for yourself as well.

As caregivers, we find ourselves fully immersed in the day to day hardships and rewards that come with having a loved one who needs round the clock attention. Whether the journey lasts months or years, as caregivers, we take on new identities and life paths. Schedules get more chaotic, hobbies may change drastically and social circles wane. We become so involved in caring for our loved ones that we tend to lose ourselves in the name of servitude. Our entire lives seem put on hold in the pursuit of giving our loved ones the care and attention they need and deserve. Just as we may have not been mentally prepared for our loved one’s dying process, chances are that we may not be mentally ready for the after-death process.
It is not easy to move on after a loved one’s death. After the caregiving ends, you may feel at a loss. Suddenly there is so much time in a day. You may find yourself wondering what you did before being your loved one’s caregiver. It’s important to remember that there is not going to be a return to “normal” that you may have imagined prior to your loss. Instead, the goal should be finding a new “normal”. Though all the extra time may be overwhelming, it can be a great way to focus on reconnecting with your passions in life. Reconnect with friends, discover rewarding hobbies, learn a new skill, or volunteer in your local community. Volunteering in a caregiving role can be a great way to transition into your new normal, as it is reminiscent of the past yet serves as a springboard for your future.
There may be days that seem to never end, thoughts of regret that paralyze and strip motivation from its core. But do not lose hope; time really does heal all wounds. Finding the beauty that remains and surrounds us on a daily basis can be a consistent reminder that things will get better. Finally, one of the best things you can do is to share the memories of your loved one with your family and freinds, and pass along insights that being a caregiver has given you. And remember the impact your compassion and care had on the one you cared for. In this way you can connect the past with the present to make a new normal for the future.

Spring is here, love is in the air, birds have returned to their perches and the sun is beginning to warm things up again. As spring progresses into summer, it’s important that we are prepared for the heat. Items such as suntan lotion, UV sunglasses and proper clothing can be essential gear for coping with those hot summer days, but one of the most necessary items, water, may be easily overlooked. It makes up nearly 70% of the average adult’s body and is a key ingredient to life itself. Water is extra important, and we need to be sure that our loved ones are getting enough of it at all times.
Although dehydration may seem like more of a discomfort issue, it can have serious health risks for seniors and those with advanced illnesses. If left untreated, dehydration may lead to strokes, seizures and even death. With these serious health risks in mind, as a caregiver, you can take the steps necessary to ensure that your loved one remains safe and hydrated throughout the summer.
Knowing the most common symptoms of dehydration can help you to evaluate your loved one’s needs and hydrate them accordingly.
Fatigue/ Excessive Tiredness – Our bodies are complex systems that operate under specific conditions. The fluctuation of even half a degree of our body temperature can make us feel uneasy. The same is true for water intake. If water levels are even a bit under normal, we begin to feel tired or lethargic. When these levels get severely below normal, your loved one may exhibit extreme fatigue for no apparent reason.
Dry Mouth – A common and easily observable symptom of dehydration, dry mouth can be a sign that your loved one is not getting enough water. You may notice that their saliva is white and foamy or that they are having trouble swallowing.
Headaches – Water plays a vital role in allowing your loved one to release heat and regulate their body temperature. Headaches will result from the stress of the high temperature that the body is trying to manage.
Cramps and Joint Pain – Water supplies the nutrients that muscles need to function properly. It also helps with joint lubrication; if your loved one complains about aching joints or muscle cramps, water is the first solution that you should try.
Making sure that your loved one gets enough water each day is one of the best things you can do to ensure that they remain as healthy as possible, especially as these hot summer months approach. Dehydration can be treated simply by replacing lost fluids (through water and even some foods), but make sure that you know the signs and symptoms in order to take control of the situation. Have fun and enjoy the warm weather with your loved one, just be sure to compliment the fun with a nice tall glass of water.

When a Loved One has Cancer

Caring for a loved one with a terminal illness can be challenging. Giving care to someone with cancer presents special challenges and heartaches that you may not know how to handle. Luckily, there are a number of tips that can be used to make sure that you have the ability to provide your loved one with the care that they deserve.

• When the days are numbered, remember that each day is a gift and make it special. Being mindful of this idea can help you to appreciate the present instead of clouding your mind with the uncertain future. Cherish the small things that you may have overlooked in the past. When an unfavorable circumstance arises, consider how you have dealt with similar situations in the past and try to adopt a different attitude.

• Set up a list of activities that your loved one would like to do. It’s ok if they list things that aren’t possible, because even if you manage to accomplish one thing that day, you have still been successful. Don’t forget that seemingly impossible goals can be achieved with a little ingenuity and adaptation. The internet can be an amazing resource for accomplishing these goals and offers an opportunity to be creative with your goals.

• When possible, let your loved one take care of you. It may not seem like much, but the simple act of letting them help you with ordinary tasks may go a long way to increase their feelings of self-worth and outlook on life. Small acts such as helping you decide which meals to make or letting them plan your next activity can boost their confidence and in turn increase their mood and health.

• Another strategy that can be an amazing source of strength is to rely on your friends and family members. Simply talking with them about your experiences and letting them listen will help you to express your feelings. Let them know that you are not expecting them to have all the answers, or any of the answers for that matter. Tell them that just listening to you would be a great help. Your friends and loved ones can also pitch in to help you with little things that may be time consuming which will allow you to tackle the bigger obstacles of the day.

The situation you are dealing with might not be anything close to ideal, but making the best of each day will help you to establish a “new normal.” Caring for a loved one with cancer can be one of the most difficult challenges you’ve ever faced, but it’s important to remember that you have loved ones around you and resources available to help you through this journey.

Planning a trip to visit a loved one is a great way to relax and reconnect with family. It’s the best time to just be you and not worry about school, projects, business meetings or keeping up with the Joneses. Though many of us get to see relatives on a fairly regular basis, many are not as fortunate. A year or more may lapse before everyone’s schedule syncs up long enough for a visit and it’s important to make the most of it when you do get the opportunity.

While you might have everything planned to a T, it may come as a surprise your relatives have gone through some unsuspected changes. Little Timmy is now big Tim, your brother in law gained some weight, lost a bit of hair, and Grandma doesn’t seem as “alert” as she was the year before. While growing up or growing out may be a source of laughter at the dinner table, mental decline is not something to take lightly.

The Alzheimer’s Association notes that one in eight people aged 65 and older suffered from Alzheimer’s disease in 2011. When factoring in seniors aged 85 and over, the number jumps to nearly one in two. With these disturbing odds, it’s possible that you’ll be coming into contact with a loved one suffering from Alzheimer’s or another dementia during your next family visit.

So whether or not your loved one is a parent, grandparent, or a friend, you may be unsure of what to expect during your visit in light of learning about their mental decline. While you can’t change their situation, there are some simple steps to prepare and ensure that things go as smoothly as possible.

- Be honest with yourself about your new feelings. Though we’re expected to be happy during family visits, it’s healthy to accept and affirm other feelings related to our loved ones. By accepting unpleasant feelings instead of disregarding them, you may find that you are more relaxed and better able to assess the situation as it unfolds.
- Realistic expectations. Your family has changed and assuming that you can force-fit your activities as they did in years past will bring about more headaches and heartaches than necessary. Try to adapt desired family activities to fit into your families “new normal”.
- Be understanding of your loved one’s condition as well as their caregiver. If your brother is the primary caregiver, consider that they might be under more stress and therefore more irritable. This may mean you have to cede an argument or pitch in on more chores.
- Prepare Mentally. Read up on your loved one’s disease. By preparing, you give yourself the tools to manage new challenges that may arise during your visit. You can also help other family members cope with the illness by providing some understanding.

By following these simple steps you can ensure that your visit is rewarding and peaceful in light of this disease.

The other day I was at Walgreens picking up a prescription, when I wandered over to the card section. This is my favorite way to waste time at a drugstore…funny, but true! There is just something about all the funny and sentimental ways you can share how you feel about someone and reading the stacks of cards in those aisles always uplifts my soul and fills me with birthday cheer, gratitude, and well wishes. Typically, I enjoy the feelings these words offer me and leave the cards on the shelves and my money in my pocket. However, to my surprise I had collected an impressive stack of Valentine’s cards, twelve to be exact. This was odd for two reasons: First, I typically would only buy a Valentine’s card for my husband, who is the love of my life, but for some reason I had a stack of cards all of which in their own unique way expressed the way I loved many people in my life from my husband (who, have I mentioned is the love of my life??) my daughter, my dad, my brother, my grandfather, my aunt, my cousins, friends, and so on. Second, (for anyone that knows me will chuckle a bit), Valentine’s was still over a month away and, despite being an organized person, I am not one to plan to far in advance.
Well, I tucked this smidge of odd behavior into the back pocket of my jeans and got in line straightway. Surely one splurge doesn’t amount to much of anything at all. However, over the next couple days, I found myself picking up things in stores that I thought the people in my life would enjoy. As these gifts began to gather around and about my house, I couldn’t help but notice the trend. Despite their obvious presence, for the life of me I didn’t yet know how it was that they had found their way into my home. Sure, each item brought to mind someone who I dearly love, but why wasn’t I pausing, smiling warm familiar thoughts, and then leaving the items safely tucked inside the store – like I usually do?!
I didn’t know why –until I sat down to write a message on the inside of the card I had purchased for my brother.
Brandon-
Now that mom is gone, I am finding myself wishing I had more of her life hanging around the house. So this year, I’ve purposed to leave bits and pieces of me in the bookshelves, closets, and even junk drawers of people I love. Maybe I hope to be better missed when it’s my turn to die. Or maybe I just figure people should know a little more of how I feel, and think, about them. But, one thing is certain; I never want you to wonder what you mean to me. You are my little brother and I love you, will still protect you (even if you are bigger than I am now) and I will always be here for you!!!
Love Always, 
Sissy (Something my brother has always called me…I sometimes wondered if he actually thought this was my name).
Well, there you have it. Turns out, I am collecting goodies to give to people I love because I want a piece of me to linger in their lives. Wow. I guess it’s kind of a grief thing, if you want to look at it that way.
But I don’t think it’s a bad thing, I think, it’s a good thing. I mean, I don’t care if my friends and family toss the cards in junk drawers or put the gifts on the top shelves of their closets or bottom shelf of their book cases. What matters is that they know without a doubt, even when I’m gone, that they were truly important to me. Every time they see those little things I gave them, they will remember that I loved them, and thought of them often.
Keeping this story in mind, I would like to say, that maybe Valentine’s Day could be turned into a good grief day. A day to celebrate the love you feel for those people that are still alive and a part of your life. Use it to cherish the memories of those that have passed on, but also use it to create new memories for people in your life….ones that they can cherish when you have passed on. Spread a little bit of you and your life around and let those dearest to you know what they mean to you.

The Holding Cross

There has always been something about crosses that soothes my soul. I have many pictures of them and a dear friend built one for me out of the wood taken from the home in which he was born. It’s beautiful and I look at it each morning. I had never had a cross that I could hold in my hands.
Tera Barnwell, one of the Nurses from my office, found a website that sold small crosses. The idea for the “holding cross” came from a Hospice Nurse in Texas. Her husband happened to be a carpenter. She gave them as gifts to her patients. The crosses were designed to fit perfectly in any hand. Tera bought one for each employee at the Cherokee County office. The day I got mine, I was on my way to make a visit with a patient. Jimmy was diagnosed with Lou Gehrig’s disease only a few months after he retired. He was a Christian man but God’s timing for his life had shaken his faith to its core. He dreamed of retiring and spending summer days at the lake fishing with his grandson. Instead, he had lost the use of both legs. As time passed, he started to slowly lose the use of his hands. His wife told me with tears in her eyes that he had stopped reading his Bible.
I sat in my car with my present from Tera in my hand, touching the smoothness of the wood, examining the way the wood looked, knowing that no two would ever be alike. And I prayed and thanked Jesus for what that small cross symbolized. And again, I felt warm, loved and special. I remembered what Jesus had done for ME.
I wondered if this cross would give Jimmy the same comfort that it gave me. I took it in and gave it to him. He looked at it and then put it on a table beside his bed where it sat for weeks. My cherished cross slowly gathered dust.
Jimmy’s condition worsened and as his body failed him over and over, his wife prayed for a miracle. We all did. I believe we received a miracle but not in the way we expected.
I came to visit one day and Jimmy was asleep. Just below his hand was his
“holding cross.” It looked as if it had slid out of his hand as he slept. Trying not to cry, I started to put the cross back in his hand. When I turned his hand over I saw something so beautiful. The imprint of the cross was on his hand. He must have been holding it so tightly. His wife and I stood in silence, knowing that he had found comfort.
Jimmy never regained consciousness. He had his cross in his hand when he passed away.
I woke up one morning not long ago and my second “holding cross” was on the floor. It had slipped from my hand as I slept. When I looked at my hand, there was the imprint of my cross. I thought of Jimmy and smiled.
I thank God for what the cross means, for how it calms and reassures me when life isn’t going the way I expected. Everything is done in God’s timing, not ours. Who better to hold our tomorrows than the one who loves us the most and first believed in us?

-Lisa Jolly

Every day we learn from those we care for, we somehow change because of these experiences. Our patients are more than just people we provide services to. They become our friends, our teachers, and our heroes. From time to time we hope to share their stories and honor their memory to show how they made us better caregivers.

Mr. Valentine

I have been sitting at my computer staring at a blank screen trying to find the words to share a story with you. It usually comes easily. I just open my heart and it pours out. Not this time.

It has been over a year since Nathaniel passed away. I can still hear him saying “nobody will miss me when I’m gone.” He was so wrong. Nathaniel Valentine. I loved saying his name. He hated it. He said I could call him “Nate,” I asked if I could call him Nathaniel. With a smile on his face, he said “whatever.” If you go only by first impressions, Nathaniel didn’t make a very good one. He knew it but he didn’t seem to care. He could be rude, angry, and at times demanding. He pushed me to see if I’d come back. I had Nathaniel figured out in about ten minutes. What he didn’t know was that I liked a challenge.

He said I needed to visit him before lunch each day. No particular reason that he could give me, he just said it and thought it would be done. I explained to him that it would be after lunch. Just as I thought, he didn’t care. He just smiled and said “whatever.”
Nathaniel was a very handsome young man with dark brown skin, deep soulful eyes and a soft, calming voice.

And Nathaniel had cancer throughout his body.

During his first week on Hospice, I climbed the 25 steps to his apartment in 100 degree heat only to have him yell through the door, “I’ve already had a bath.” I let him get by with that for two days. On day three, I asked him if I could just come in and rest. I knew there was a gentleman inside him somewhere when he opened the door and let me in. Nathaniel’s apartment was sparsely furnished but very neat and clean. He was watching Westerns on television. He asked if I’d ever met a black man who liked Westerns. I told him “rarely.” He seemed to like that. It made him different. We had wonderful conversations about “everything.” He couldn’t swim, loved seafood, could re-build a car engine and loved the Clemson Tigers. He told me that he’d been saved as a young boy and baptized in a river. We laughed about that because he was so afraid of water. He said the Preacher dropped him and he almost drowned in ankle deep water. I never found out if that was true but I doubt it. I would later find out that Nathaniel’s biggest fear wasn’t death. His biggest fear was being forgotten.

Nathaniel’s health was declining rapidly. He became much more at ease talking to me and letting me help him. The majority of his family lived out of town. He had a brother in town that helped out when he could. Nathaniel’s condition worsened as fast as I’d ever witnessed. It was still a shock when the Nurse called and said that she needed help with crisis care. When I got there at midnight, Nathaniel’s brother was there and his sister had just gotten there from Columbia. Nathaniel was un-responsive. As I sat there that night and watched Nathaniel, I noticed again how young he looked. He was only a few years older than me. Hour after hour, there was no change.

I could still here him saying “nobody will miss me when I’m gone.” He was so wrong. I missed him already. Just before the sun started to rise, Nathaniel’s sister sat beside his bed and started to read the Bible to him. At first, there was no response. As she continued to read, Nathaniel raised his eyebrows. Seeing this, his sister looked at me to see if I had seen it. As she read, she would stop to say “you will have to take that last step by yourself baby brother, God will meet you.” And then, something happened I’d never seen. After hours of his body barely moving,
Nathaniel’s feet moved. I got up and went to his bed and touched his hand. Nathaniel’s feet moved once more. It looked as if he was walking. Nathaniel took two final steps, took one more breath and walked straight into Heaven. It’s safe to say, I will never forget him.

f you have a story about how your life has been shaped by someone you cared for, tell us about it. We would love to share in the memory of someone dear to your heart.

Losing someone close to you is a very painful experience. With the holidays almost upon us the special days ahead can intensify that pain. Planning a remembrance or ritual to celebrate your loved one’s life can ease the sorrow of these challenging times and help preserve memories of the affection you shared.

Though the holidays can be particularly difficult for those left behind, it may also offer a unique opportunity to honor your loved one. Placing a special ornament on the tree, setting out a cherished decoration or serving a favorite holiday meal can evoke fond memories. Friends and family may wish to share notes of remembrance, placed in a stocking put up for your loved one. A candle might be lit in their memory, or perhaps a toast or prayer can be offered in tribute before a meal. Money that would have been spent on a gift could be donated in your loved one’s name to their favorite charity, homeless or animal shelter, or a needy family.

Though your loved one’s presence will be missed and the holidays will not feel the same, the holidays can be a great time to remember them. Friends and family may come together to share stories and cherished memories, such as the way they laughed or their favorite quotes. Sharing these recollections with younger friends and family members is a wonderful way to honor your loved one, who may have passed before the children were old enough to know them. By gathering old photos, you can make a mosaic or a memory album of the times you spent together. Create a calendar from pictures or drawings with poems written to or about them, or simply write a letter to express your feelings.

Crafts offer many unique opportunities to remember those close to you who have passed. You might make a quilt from their favorite clothes, inscribe their name on a piece of jewelry, or compile treasured possessions and photos into a scrapbook that will be cherished for years to come. A wonderful way to remember a loved one who enjoyed cooking might be to create a memory cookbook. These favorite recipes can recapture loving memories of family dinners, picnics and holiday meals, especially if you include photos and captions with them.

A living memorial can serve as a permanent, life-affirming remembrance in honor of your loved one. Planting a tree or creating a garden of their favorite flowers provides a loving reminder with each spring’s blossoms, and you could offer seed packets to mourners at the memorial service to plant in their honor.

Celebrating and honoring the memory of your loved one is an important part of coming to terms with your own grief and healing from your loss. As you make plans for these remembrances, be aware that we all respond to grief in our own way and have our own methods of coping. Talk with your family and friends about how you want to remember and honor your loved one. During your grieving process, understand that you may continue to feel sad, angry or lonely for a long time, but you will also gradually experience increased periods of joy and happiness as you begin to heal. These are all normal emotions, and feeling happy doesn’t disrespect your loved one’s memory, it simply reflects your progression from mourning to a celebration of the life you shared.

Our Center of Compassionate Care is here to offer a path to healing. We can help you through your grieving process in a way that is best for you so that through acceptance you can regain hope and continue along your journey of life. We’ll help you find a way to reconnect to life during the holidays or at anytime you may need us.

As a caregiver, you may have experienced several emotions throughout your journey. Sadness, frustration, resentment, anger, you may feel as though you are prepared to handle all of them, but you may have overlooked guilt. Guilt is a common emotion, though it may come up suddenly and unexpectedly for many caregivers.

Caregiver’s guilt may stem from the fact that you have this ideal standard about the level of care that you should be providing. When the juggling act of family life competes with your loved one’s need for care, you may have to make “either or” decisions. In your rational mind, you understand that you cannot be in two places at once, but in your ideal mind, you should have been in both places. The mismatch between your rational and irrational mind can cause feelings of guilt for many caregivers.

Caregiver’s may also notice that guilt can stem from past actions. Though hindsight is 20/20, it’s important to realize that we aren’t perfect and past mistakes or missteps should not be something to beat oneself up about. We all say things we regret to those we love, we all wished we’d spent more time with others, and when caring for someone we wish we were super human. But realize all the things you’ve done right and all the love, care and time you have given.

When those feelings of guilt do occur, here are some steps that may help:

• Identify any feelings that may be causing guilt. Often there are underlying feelings that are buried beneath guilt. Once you assess them and reflect upon them you may find that you have a new perspective with which to view your feelings.

• Do not neglect yourself. When you realize that you are just as important as your loved one, consider that your ability to care is directly connected to your own well-being. If you are tired, stressed or pushing yourself too hard, how can you expect to deliver the standard of care that you wish to?

• Prioritize your needs and wants. If you need to go for a walk instead of sitting with your loved one while they watch TV, it’s time to go for a walk. When you organize and make choices about which things come first, it’s easier to think objectively and manage guilt that may accompany tough choices.

• Look to your friends and loved ones for support. Call a family meeting and see if you can delegate a few responsibilities. This way the whole family is involved and can be leaned on for assistance. If you don’t feel comfortable having a friend care for your loved one, simply ask them to cook a meal or drop the kids off at school.

• Realize that perfection and the ideal situation do not exist. Things are not going to go your way all the time and you won’t be able to save the day every day. Part of being the best that you can be requires an understanding of your own imperfection and the fact that life is an unpredictable journey.

By keeping these tips in mind, hopefully you will begin to notice that grief is a natural and manageable emotion that accompanies caregiving. By paying attention to, and caring for yourself, you increase and improve your ability to care for others. Remember that caring for someone is an incredible act of love and compassion, so be proud of the role you are playing.