Elder Companion: Lesson 6: Stress Management
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Elder Companion: Lesson 6: Stress Management

   

Elder Companion: Lesson 6: Stress Management1

Elizabeth B. Bolton2

This document is best viewed as a PDF. Click here to access the PDF.

The Elder Companion training program is designed to train persons interested in becoming employed by local service providers as sitter/companions for the elderly. The objective of the program is to help participants develop the necessary skills to provide high-quality care including: assistance with daily living activities, home management services and companionship for the elderly adult.

This training course is preparatory to studying to become a certified nursing assistant (CNA).

For an overview of the training course, see FCS5246/FY586 .

In the Elder Companion training program, the following topics are addressed:

• FCS5247/FY587 : Elder Companion: Lesson 1 Roles and Responsibilities

• FCS5248/FY588 : Elder Companion: Lesson 2 Aging

• FCS5249/FY589 : Elder Companion: Lesson 3 Communication

• FCS5250/FY590 : Elder Companion: Lesson 4 Nutrition

• FCS5251/FY591 : Elder Companion: Lesson 5 Home Maintenance and Safety

• FCS5252/FY592 : Elder Companion: Lesson 6 Stress Management

• FCS5253/FY593 : Elder Companion: Lesson 7 Time Management

• FCS5254/FY594 : Elder Companion: Lesson 8 Leisure Activities

• FCS5255/FY595 : Elder Companion: Lesson 9 Getting a Job

In addition to the nine topics which are taught as Lessons 1 through 9 in a classroom setting, training program participants will be required to make a field observation at an elder care facility. An Agent's guide and observation form are provided in Attachment 1.

Agent's Teaching Guide: Stress Managment

Part 1: Stress... What is Yours?

Part 2: Warning Signs of Stress

Part 3: Job Stress for the Elder Companion

Part 4: Managing Stress

Time: 2 Hours

Equipment/Supplies:

Overhead projector/screen, transparencies created from Handouts B, H, and K

Instructor: County faculty, Psychologist, Mental Health Professional

Handouts:

Part 1

Handout A: Know Your Stressors

Handout B: Ideas to Remember

Handout C: Stress Myths and Facts

Handout D: Stressor Diary

Part 2

Handout E: Check for Body Warning Signs

Handout F: Check for Behavior Warning Signs

Part 3

Handout G: Stressful Job Situations

Handout H: Stress Prevention for an Elder Companion

Part 4

Handout I: Dealing With Stress

Handout J: Relaxation Recipes

Handout K: Six Steps to Managing Stress

Objectives (Expected Outcomes):

After this section, participants will be able to:

Part 1: Stress...What is Yours? Lesson Plan

Introduction:

We all have various stresses in our lives. In fact, life would be quite dull without stress. Where does stress in our lives come from? It comes from within us: the mental (thinking), emotional (feelings), or physical responses to various situations. Those outside events or situations causing us stress are called stressors.

Do we all responds to stressors in the same way? No, stress is very personal and unique to each individual. For example, what might be relaxing for you may be very stressful for me. You have your own combination of stressors that affect you most.

Take a moment to think about what kind of day you have had so far. How many stressors-mild or major-have you encountered today?

DO:

REFLECT:

DO:

REFLECT:

APPLY:

Handout A: Know your Stressors

Identifying Your Everyday Stressors

In the space below, take three minutes to write down quickly as many stressors in your life as you can recall. If you find it helpful, you can list your stressors as they occur in different part of your life. (Feel free to add your own other categories, too.)

Now read through your list and mark those stressors that cause you the most stress.

Handout B: Ideas to Remember

Handout C: Stress Myths and Facts

Do you agree (A) or disagree (D) with the following myths or facts about handling stress in your life:

____ Stress is not a part of my life.

____ Stress affects humans of all ages, including elderly people.

____ Stress is no big deal.

____ The "wear and tear" of stress on your body leads to illness and can reduce your life expectancy.

____ Stress is just a freak condition that occurs when things are really going badly in your life.

____ You experience stress every day in your life. Fighting stress is part of maintaining your whole health.

____ Stress just happens. You can't help the bad things that happens in your life - good and bad.

____ Actually, you set up a great deal of what happens in your life - good and bad. By making good choices you can avoid much stress.

____ Stress is just too powerful when it happens - it's stronger than you can handle.

____ Coping with stress takes practice - but you can learn to handle any stress you experience, no matter how powerful.

____ I'm too busy to worry about stress - I don't have time to practice stress techniques.

____ Effective use of stress-beating techniques will end up saving you time.

____ I've tried techniques before but they didn't work.

____ Your attitude makes a huge difference in how well the techniques work for you.

Handout D: Stressor Diary

Directions:

STRESSOR DIARY

Date: ____________

Time of Day

Stressor

What it Felt Like/What I Did




































Part 2: Warning Signs of Stress: Lesson Plan

Introduction:

One of the many ways we can know that we are experiencing too much stress is by paying attention to our bodies. What are some body signals for stress? (List on chalk board/flip chart.)

Have you ever experienced poor health conditions because you let everyday stresses keep you from taking care of your own body needs? (Have participants share experiences.)

Besides physical ones, what are some other reactions to stress that experience? (List on chalk board/flip chart) These reactions represent behavioral responses. They are often a result of our thoughts (mental perspective of the situation) or our emotions (feelings that result from the situation).

DO:

REFLECT:

APPLY:

Handout E: Check for Body Warning Signs

What you do:

When you feel under a lot of stress and pressure, which of the following responses do you notice?

Place a check before those items which apply and occur frequently or regularly.

Place an X before those that occur only occasionally.

____ Feeling exhausted/fatigued

____ Headaches

____ Dizziness

____ Face feels hot, flushed

____ Hands and/or feet feel cold or sweaty

____ Skin blemishes

____ Dry mouth/throat

____ Grind teeth/jaw pain

____ Neck/shoulders tighten up/ache

____ Heart beats faster

____ Heartburn/indigestion

____ Chest pain

____ Back tightens up/aches

____ Stomach upset/nausea

____ Cramps

____ Increased urination

____ Diarrhea

____ Legs get shaky or tighten up

Now what signs are you going to watch for ?

_______________________________________________________________

_______________________________________________________________

_______________________________________________________________

What will you do when you notice stressful signs?

_______________________________________________________________

_______________________________________________________________

_______________________________________________________________

Handout F: Check for Behaviour Signs

What you do:

When you feel under a lot of stress and pressure, which of the following responses do you notice?

Place a check before those items which apply and occur frequently or regularly.

Place an X before those that occur only occasionally.

____ Crying

____ Depression

____ Restlessness, fidgeting or frantic increase in normal activity level

____ Lack of interest in things that normally interest you

____ Feeling exhausted/ fatigued

____ Withdrawal from friends and normal social activities

____ Aggression: shorter temper/ anger aroused more easily/ lowered tolerance of frustratiom

____ Boredom

____ Lack of concentration

____ Desire to sleep or go to bed to escape

____ Inability to sleep

____ Nightmare

____ Change in appetite...eating more or less than what's normal for you

____ Moodiness, over sensitivity

____ Difficulty making decisions

____ Nail biting

____ Increased smoking

____ Drug/alcohol misuses

____ Dry mouth/throat

____ Grind teeth

____ Tapping fingers/ feet

Now what signs are you going to watch for?

_______________________________________________________________

_______________________________________________________________

_______________________________________________________________

_______________________________________________________________

What will you do when you notice stressful signs?

_______________________________________________________________

_______________________________________________________________

_______________________________________________________________

_______________________________________________________________

Part 3: Job Stress for the Elder Companion Lesson Plan

Introduction:

Job stress for the elder companion occurs on a regular basis. Stress occurs in several areas which we will explore by looking at some possible situations you might encounter. Job Stress can be grouped under the following categories:

- Job Changes Often

- Work Agreements

- Instructions

- Family Space

- Personal Stressors

- Need to Talk/Share

DO:

REFLECT:

APPLY:

Handout G: Stressful Job Situations

A companion may face the following situations on the job. These situations can be stress producing. In small groups review each situation and make suggestions about how to handle.

Situation 1.

Mrs. Jones has been hired by Mrs. North to care for her elderly sister-in-law who is recovering from a stroke. The elderly client is staying in her own home with a daughter who works during the day. She needs daily help with personal care, meals and exercise.

Mrs. Jones was hired to work six hours a day. She comes in at 10 each morning and gets her instructions from Mrs. North. Mrs. North stays with her sister-in-law each morning from 8 to 10 because the daughter's work starts at 8 am. When Mrs. Jones arrives for work the first day, she is instructed by Mrs. North in the daily routine of lunch and exercise. Mrs. Jones carries out the indicated routine for several days. One evening the daughter comes in from work and tells Mrs. Jones that she is upset that the house has not been cleaned.

What do you think Mrs. Jones should do?

Situation 2.

Mrs. Taylor has been sitting from 8 am to noon with Miss Anderson in the hospital. Miss Anderson is an elderly woman who has just had hip surgery and seems to be doing well. Mrs. Taylor was hired to keep Miss Anderson company until she can go home. Mrs. Taylor has had a few hints from the nurse's aides that she should be doing more than just chatting with Miss Anderson. She has been asked at least once by an aide why she has not given Miss Anderson her bed bath.

What do you think Mrs. Taylor should do?

Situation 3.

Mr. Black has been sitting with Mr. Vansky, a cancer patient, for about six months. Although Mr. Vansky is dying, he never talks about death. Lately, he talks all the time about when he is "up and around" again. There is no close family for Mr. Black to discuss his concerns with.

What do you think Mr. Black should do?

Handout H: Stress Prevention for an Elder Companion

Suggestions are provided here to prevent/reduce stress before it starts:

1. Job changes may be often. Can you deal with frequent changes and different clients?

2. Work agreements should be settled before taking a job.

3. Instructions are important.

4. Recognize family space.

5. Consider personal stressors.

6. Need to talk.

Part 4: Managing Stress: Lesson Plan

Introduction:

We have learned that stress is an everyday part of life. The challenge is to learn how to handle the situation in a positive and helpful way.

DO:

Dealing With Stress

REFLECT:

APPLY:

Handout I: Dealing with Stress

Following is a list of some of the ways people attempt to deal with stress. Some show positive, productive attempts as stress reduction while others are negative, non-productive and actually harmful.

Try to be honest as you rate your own reactions to stress. Check the boxes for ways you usually deal with stress. Since this exercise is meant to be seen only by you, you'll only be judging yourself.

When I find myself in a stressful situation or feeling stressed, I may:

Handout J: Relaxation Recipes!

Below are two ways in which you can cope with stress and reduce tension in your live. Choose which one works for you .

ABDOMINAL BREATHING: Take five or ten minutes once or twice a day to practice the abdominal breathing method below until it becomes routine. It can be used to reverse the stress response whenever it is triggered.

For practice purposes, place your hands on your abdomen, right below the navel. The fingertips of each hand should touch one another.

Breathe through your nose. Many people breathe through their mouths, an almost sure sign of stress overload, and not nearly as healthy.

Inhale very slowly. As you do, push the abdomen out as though it were a balloon expanding. Your fingers should separate. As the abdomen expands, your diaphragm will move downward, allowing fresh air to enter the bottom part of the lungs. Keeping your back straight will aid the process of maximizing inhalation. As you continue inhaling, expand your chest. More air should now enter, filling the middle part of the lungs. Slightly contracting the abdomen, raise your shoulders and collarbones. This should fill the upper part of the lungs. At this point, the entire respiratory mechanism has been employed and no portion of the lungs is left unfilled.

Hold your breath for about five seconds.

Exhalation is as important as inhalation. Proper exhalation not only expels all used air, it opens space for fresh, new air to enter. After holding your breath, begin slowly to exhale through the nose. As you do so, draw in the abdomen. This will lift the diaphragm. The expanded rib cage will return to its normal position, and the lungs will empty. Remember, exhale slowly and let all the air empty out. If comfortable, hold it a second or two before beginning the inhalation again.

When you resume, remember to inhale slowly and completely. Repeating the word "calm" or "relax" as you exhale is also helpful.

AUTOGENIC RELAXATION: This activity shows you the effect relaxation has on the body. Word formulas are cue signals sent by the mind to the body, telling that part of the body to relax. Assume a comfortable position. You may lie down; close your eyes; loosen any tight clothing; and be quiet.

Assume a passive attitude. Focus on yourself and on achieving a state of relaxation in specific areas of your body. Tune out all thoughts of other events or happenings.

Repeat the word formulas as follows. Keep the words in sequence and repeat each formula silently.

Allow all your body parts to become heavy, warm and relaxed.

Focus on your state of deep relaxation. Remember, repeating the procedure increases your ability to relax.

Word Formula:

My right arm is heavy.

My right arm is heavy.

My left arm is heavy.

My left arm is heavy.

My arms are heavy and warm.

My arms are heavy and warm.

My arms are heavy and warm, warmth is flowing into my hands.

My arms are heavy and warm, warmth is flowing into my hands.

My legs are heavy.

My legs are heavy.

My legs are heavy and warm.

My legs are heavy and warm.

My breathing is calm and regular.

My breathing is calm and regular.

My breathing is calm and regular, I am at peace.

My breathing is calm and regular, I am at peace.

I am at peace.

I am at peace.

Source: Joe Pergola, IFAS, University of Florida

Handout K: Six Steps to Managing Stress

1. Eat right! Good nutrition can go a long way in giving your body the proper balance to handle stress. Foods high in sugar, fat, salt, and caffeine put chemical stress on an already stressed body. Stop smoking, as the chemicals in a cigarette rev up the body in much the same way as stress. Eliminate these extra stressors.

2. Get enough sleep. Dr. George Sheehan says we are a generation of "sleep cheats."

Because our lives are so busy with job, family, care giving, and voluntary commitments, we tend to cram in more hours of activities to get these jobs done. Being a "sleep cheat" ultimately will backfire. Try to get between 7 to 8 hours of sleep each night. Avoid sleeping pills since these pills negatively alter normal sleep patterns.

3. Actively work off stress and tension. We hear about this every day, yet fewer than 20% of Americans exercise regularly. Too many "couch potatoes" means too little stress eliminated. Just think of the 1988 Olympics. Florence Joyner, the 100 meter gold medalist, was an example of beauty, grace, and physical fitness. Exercise needn't be painful or boring. Too often in the past, physical exercise coaches told their students, "No pain, no gain." This philosophy has been rapidly replaced with the notion that exercise can be a wonderful reward in itself - one that is fun to do.

4. Relax. Bubble baths are wonderful! Long, hot showers work for some. Simply closing your eyes and deep breathing can trigger your body into releasing tension.

5. Make a list. This may sound silly, but it's one of the simplest means to organize what needs to be accomplished. List the things which need to be done first, second, third, and so on. By ranking what needs to be done, the tasks which cannot be put off are taken care of first. Too often, we try to do everything at once with the result that nothing gets done the right way. Guilt over a poorly done job, or guilt at makes it possible to eliminate those things which we may think we need to do, when in reality they may not need to be done at all, or they may be delegated to someone else. A humorous way to look at the list is to label it a "Worry List" - let the list "worry" for you!

6. Learn acceptance. So often, we worry about things which we cannot control. Face that fact! If you cannot control a situation or occurrence, then learn to accept that as a reality. Conserve your energies for the things which you can control. Your focus and your capacity to accomplish those factors within your control will become clearer and easy to do if all of your energies are directed toward that accomplishment instead of being channeled off into a direction over which you have zero control.

Footnotes

1. This document is FCS5252/FY592, one of a series of the Department of Family, Youth and Community Sciences, University of Florida, UF/IFAS, Gainesville 32611. First published: September 1999. Revised: January 2004. Reviewed by: Mary N. Harrison, professor, Consumer Education, Department of Family, Youth and Community Sciences, University of Florida, UF/IFAS; Mary Chernesky, M.S. extension agent IV, Hillsborough County, Seffner; Audrey Norman, courtesy extension agent, Palm Beach County, West Palm Beach; Meredith Taylor, M.S., extension agent IV, Suwannee County, Live Oak. Please visit the EDIS Web site:http://edis.ifas.ufl.edu/

2. Elizabeth B. Bolton, PhD, professor, Community Development, Department of Family, Youth and Community Sciences, Florida Cooperative Extension Service, University of Florida, UF/IFAS, Gainesville, 32611.

The Institute of Food and Agricultural Sciences (IFAS) is an Equal Opportunity Institution authorized to provide research, educational information and other services only to individuals and institutions that function with non-discrimination with respect to race, creed, color, religion, age, disability, sex, sexual orientation, marital status, national origin, political opinions or affiliations. For more information on obtaining other extension publications, contact your county Cooperative Extension service.

U.S. Department of Agriculture, Cooperative Extension Service, University of Florida, IFAS, Florida A. & M. University Cooperative Extension Program, and Boards of County Commissioners Cooperating. Larry Arrington, Dean.


Copyright Information

This document is copyrighted by the University of Florida, Institute of Food and Agricultural Sciences (UF/IFAS) for the people of the State of Florida. UF/IFAS retains all rights under all conventions, but permits free reproduction by all agents and offices of the Cooperative Extension Service and the people of the State of Florida. Permission is granted to others to use these materials in part or in full for educational purposes, provided that full credit is given to the UF/IFAS, citing the publication, its source, and date of publication.