Stress Resilience for Family Caregivers

Brain Injury Blog

Stress Resilience for Family Caregivers 

by Janet Cromer, RN, MA, LMHC

The Caregiver’s Journey

Caring for a loved one who has a brain injury leads you on a journey full of challenges, losses, rewards, and adjustments. You might be a caregiver for a short time but, more often, the survivor will require assistance, direct care, or ongoing rehabilitation for years. Preparing for your journey involves packing a suitcase full of skills and attitudes that will help you be healthy, whole, and resilient.

The ability to reduce and manage stress is the foundation for all the other skills you need to create a life of hope and reinvention.

What is stress?

We talk about stress all the time, but what do we really mean? Stress is a normal psychological and physical reaction to positive or negative situations in your life, such as a new job or the illness of a loved one. Stress itself isn’t abnormal or bad. What’s important is how you perceive and deal with stress.

Stress Basics 101

  • The right amount of stress can give you energy and purpose.
  • Too much stress can be harmful to your health, your mood, and your relationships.
  • Stress affects the body, mind, and behavior.
  • Research has shown that being a family caregiver can be an extremely stressful job. Caregivers report more chronic diseases than non-caregivers.
  • Protect yourself by making stress resilience skills part of your daily routine.
  • Our perceptions and self-talk determine what we find stressful. Even if we can’t take away the stressor, we can change what we tell ourselves about it and reduce the stress level.

The Stress Response

Your body has a built-in system to protect against danger and serious threats. When you perceive that you’re in an emergency situation, an alarm system in the brain signals the body to get ready to fight or get out of the situation. You might feel your heart beat faster, your muscles tighten, and your stomach rumble.

A surge of hormones, including cortisol and adrenalin, make your blood pressure rise and blood sugar increase to give you extra energy and help make decisions. Many other reactions take place in your body and mind at the same time. The stress response system works well in a true emergency.

That same stress response can cause problems if the stressors become chronic, or you feel stressed for a long time without relief. When the stress response persists, adrenalin can lead to high blood pressure (hypertension). Cortisol can interfere with the immune system, making you vulnerable to infections and inflammatory diseases. You might also have problems with digestion, sleep, muscle aches, skin conditions, depression, and obesity.

What is stress resilience?

Al Siebert, Ph.D, defines resiliency as the ability to cope well with high levels of ongoing, disruptive change. Resiliency allows us to bounce back from setbacks, and sustain good health under pressure. It also helps us change to a new way of living or working when the old way is no longer possible. Caring for a loved one with a brain injury often requires us to adapt to changes and learn new ways of moving ahead in life.

Stress resilience means that you can deliberately direct your body to shift from a stress response to a more relaxed and focused state. Once you’ve made that shift, you can be open to new ways of thinking, feeling, understanding, and responding. This can be a life-enhancing skill for caregivers.

Several techniques and strategies have been proven to boost resilience. In this post I’ll share some foundation skills that will be helpful all along your journey.  

Foundation Skills

  • Believe that you have a right to prioritize time for your mind, body, and spirit every day.
  • Believe that you are giving the best care you can, and that your love and efforts are contributing to your survivor’s healing in an important way.
  • Recognize your stress signals and intervene often. Does your jaw clench or shoulder’s tighten? Thoughts race or irritability kick in? Does your head or back ache? Scan your body, focus on the tense spot. Inhale into that area, pause, then exhale worry and pain. Repeat the body scan several times a day.
  • Learn a technique to calm your body and mind. Meditation, the relaxation response, mindfulness practices, prayer, yoga, and tai chi are all great.
  • Stay connected to your supports.
  • Express emotions constructively. Write in a journal, talk to a confidant or counselor, or join a support group.
  • Acknowledge losses openly. Grieving helps you move on.
  • Sleep well, eat well, and exercise regularly
  • Train your thoughts to boost coping.
  • Use humor to boost your mood. Make time to play. Spend time with people and activities that lighten your spirit and connect you to life’s goodness.
  • Cultivate positive emotions such as happiness and gratitude.

Where do we go from here?

At each stage or season of the caregiver’s journey—from the crisis period to long-term caregiving— you might experience emotions common to that stage. You will have specific tasks or challenges to deal with. And, here’s the good news—you can learn skills to reduce stress and increase resiliency. If you would like more detailed information, please see the Tip Card “Stress Resilience for Family Caregivers” which I recently wrote.

And remember… your health and well-being are priceless. And you deserve to feel better.


Siebert, A. (2005). The Resiliency Advantage. San Francisco: Berrett-Koehler Publishers, Inc.

March 7, 2012

2 responses to “Stress Resilience for Family Caregivers”

  1. Janet Cromer says:

    Dear Pam,
    Thank you for writing. I’m so sorry that you and your son have been through so much. When I cared for my husband Alan after his severe anoxic brain injury I realized that my stress meter only registered in the red zone, and I thought that was normal. We become so accustomed to living with crisis and pain that the typical” stressors that overwhelm others don’t even register with us until we get sick. Not good for our mental or physical health. I tried to commit to integrating one good stress reduction strategy at a time. That’s plenty. Compassion fatigue is epidemic among family caregivers. I speak nationally on the subject, and hear many stories of caregiver trauma and exhaustion. Next week I’ll write a short post about compassion fatigue for the Lash blog, so please check back.
    My best,

  2. Pam Bryan says:


    This is so true. I have been a caregiver for my son for the past 16 years. He was injured in a car crash at the age of 13. He sustained a severe brain injury, spinal cord injury (paralysis), and severe abdominal injuries. He has been a Type I diabetic for 19 years.
    This past year, he has been hospitalized numerous times for surgeries and illness which included trips to the Emergency room and ICU stays. I work as the Executive Director for the Brain Injury Association of TN and during this past year, I have been working from home, hospital room or office when I could. It has been very stressful. I have developed a caregivers program for families of brain injury survivors in TN. Unfortunately, I have not always practiced what I tell other caregivers in the importance of taking care of yourself. I also have diabetes and in just the last week, I have been having mild chest pains and fatigue (fatigue for some time now) for the past week, but I have been preparing for our statewide conference and my son’s latest ICU stay was just two weeks ago. I contribute this to the stress. I fear that I am experiencing not only caregiver burnout, but compassion fatigue as well.
    Thank you so much for the Foundation Skills to help someone learn to manage stress. Even a longterm experienced hands on caregiver needs this advice. I plan to order some of the tip cards that you wrote.
    Pam Bryan

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