For 26 years, Keith Wolfard worked as a firefighter for the Clackamas County Fire District in Oregon. He was used to dealing with plenty of on-the-job stress. But nothing could have prepared him for the stress and challenges he ran into as a full-time caregiver to his beloved wife, Daphne.

Keith was Daphne's companion and caregiver from the time she was diagnosed with Alzheimer's disease in 2001 until late 2008. Then, her condition worsened to the point that Wolfard had to face the painful decision of placing his wife in a care facility. Today, he remains her devoted companion.

"When my work was rescuing people from death, I could protect myself with emotional detachment," explains Wolfard. "Caring for Daphne—and watching her slowly deteriorate before my eyes—was emotionally draining because you don't emotionally detach from an intimate, loving relationship."

Finding support

In 2007, Wolfard knew that he needed help in order to take care of his own mental, emotional and physical health. He found a program called Powerful Tools for Caregivers (PTC), a nonprofit organization originally developed by Legacy Caregiver Services in Portland, Oregon. The program helped Keith grow and use the self-help skills he needed to take care of himself so that he could continue caring for Daphne.

"Because of the multifaceted role that family and informal caregivers play, they require a range of support services to improve their caregiving skills, reduce stress and remain healthy," says Kathy Shannon, manager of Legacy Caregiver Services.

"Our six-week educational program provides family caregivers with tools to increase their self-care and confidence," Shannon adds. "Caregivers learn how to use community resources, better manage stress, communicate effectively with friends, family and health care providers, and deal with unruly emotions." Everyone who goes through the program gets a copy of the course guide, "The Caregiver Helpbook." (You can order this handbook from Powerful Tools for Caregivers.)

In addition to taking the PTC course, Wolfard joined a men's caregiver support group in 2008. "It's a great place where we guys can get together and talk about our trials and tribulations," says Wolfard. "We talk about our feelings, our finances, our fears—and group members know that it's OK to cry in here."

Managing stress

The PTC program and other caregiver classes and organizations teach people about how important it is to manage stress. The PTC program and others help people who are caring for loved ones experiencing any type of major ongoing disease or condition.

According to Shannon, caregivers need to know that one of the most important things you can do for yourself and the person you care for is to take care of yourself. "We want people to thrive, not just survive," says Shannon. "And an important tool for thriving is being able to recognize and manage stress."

According to the PTC program, the first steps to managing stress are:

  1. Seeing the warning signs early. (It takes longer to recover from stress if you're overwhelmed.)
  2. Figuring out what causes you stress.
  3. Recognizing what you can and cannot change.
  4. Taking action to reduce stress, which will give you a sense of control.

The program advises people that stress can be physical, emotional or mental. If you ignore the warning signs of stress, problems develop.

Warning signs may include:

  • Irritability
  • Illness
  • Headaches
  • Lack of concentration
  • Muscle tension
  • High blood pressure
  • Resentment

Neglecting stress causes increased health problems, disrupted relationships, burnout and depression. Your loved one also gets worse care.

Stress reduction techniques

It's important to find things to do that help you relax, make you feel good and that you can continue to do on a regular basis. Even doing something briefly every day can do wonders. Find whatever works for you.

Stress-reduction activities include:

  • Exercise: Walking, yoga, swimming, dancing, biking
  • Hobbies: Gardening, knitting, reading, playing an instrument
  • Socializing: Visiting with family and friends, attending plays or concerts
  • Relaxation: Meditating, taking a bubble bath, deep breathing, getting a massage
  • Taking charge: Just saying "no," delegating responsibilities

"We ask caregivers to come up with a weekly action plan that focuses on doing something for themselves to help reduce stress," explains Shannon. "It's a way to have people be more accountable for taking care of themselves."

Wolfard used the action plans from his PTC class. "[Making an action plan] was very helpful because I needed to do some things for myself to alleviate stress, and this tool helped me stay on track," he says.

It's hard for many caregivers to take time out for themselves. They feel guilty that they're not attending to their loved ones. "But," says Shannon, "evidence shows that caregivers who get support and find balance in their lives can be better caregivers, which allows their loved ones to remain at home longer."


Published on Sept. 15, 2009; updated on May 16, 2014.