Dr. William Haley 0:00
It's widely found that people with high perceived stress don't live as long. And people who are highly depressed don't live as long, right? So we looked at that in both caregivers and non-caregivers spend this huge study. So we got over 3000 in both groups, and among non-caregivers, that finding holds up. If you're highly depressed at the baseline, and you have high perceived stress, you don't live as long. But for caregivers, there's no relationship between their self rated stress at the baseline and their depression at the baseline and how long they live. So something about caregiving seems like it might actually physically strengthen us and give us resilience.

About the Psychology of Aging Podcast

Dr. Regina Koepp 0:44
I'm Dr. Regina Koepp. I'm a board certified clinical psychologist and I specialize with older adults and families. I created the psychology of aging podcast to answer some of the most common questions I get about aging, questions about mental health and wellness, changes in the brain like with dementia, relationships, and sex, caregiving, and even end of life. Like I say in my therapy group, no topic is off topic. We just have to have a healthy way of talking about it. So if you're an older adult, or caring for one, you're in the right place. Let's get started.

Dr. Regina Koepp 1:25
We have a narrative in society that says that caregivers have more depression and stress, spend their caregiving years suffering, only to lead to premature death. Our guest today shares a more balanced and factual narrative about caregivers. Yes, many caregivers do indeed have increased rates of stress and depression. Yet research shows that they are remarkably resilient and actually don't have a reduced lifespan as a result of caregiving.

About Today's Guest

Dr. Regina Koepp 2:01
Our guest today is Dr. William Haley, a professor in the School of Aging Studies at the University of South Florida. His research is focused on stress and coping and family caregivers of older adults with Alzheimer's disease, stroke, cancer and terminal illness. He has a special interest in caregiving and diversity, resilience to stress and developing and evaluating interventions for caregivers. He's published over 170 peer reviewed research articles and serves on the editorial boards of several prominent journals in the field of aging. In addition to sharing how caregiving actually affects you, the caregiver, Dr. Haley also shares several resilience strategies you can use starting today, to bolster your resilience and lower your stress. Listen until the end for all the great tips and strategies. I don't want you to miss a thing. If you are just getting started with caring for an older loved one, or have been caring for an older loved one for some time, download my free caring for aging parents checklist. I'll link to it in the show notes. All right, let's jump into the interview.

Dr. Regina Koepp 3:12
Dr. Bill Haley, thank you so much for joining us on the psychology of aging Podcast. I am thrilled that you're here to talk about caregivers and the side of caregiving that we often don't get to hear a lot about, which is how resilient caregivers actually are. We so often focused on the stress and depression and burnout. And that's only part of the story. And I'm delighted that you're here to actually give us the whole picture so that we're not just stuck in the suffering, but we have some resilience factors that caregivers are demonstrating as well. So thank you so much for being here. Oh, it's fun to be here in Regina, I love your podcast, and your blog and such. And so it's really great to be a part of this. Thank you so much. Can you start by just sharing a bit about who you are and what you do? What's your story?

Dr. William Haley 4:02
So I was raised in a suburb of St. Louis, my dad was a cop, and my mom managed a fabric store. Neither of us had completed college, but they really valued education. My dad, he didn't own a house until he was about 60 years of age. But he moved us into a school district that was excellent. So I was a good student. I got to take AP courses and such. And I won a full scholarship to Southern Illinois University. And after that, I went to grad school at UMass Amherst. I was there for four years and never paid a nickel of tuition in my life because I was on full scholarship. And they used to have NIMH fellowships for people in graduate school. So I got to live in different parts of the country. Then got accepted at the clinical internship at University of Washington Seattle.

Dr. William Haley 4:58
And we were chatting about this earlier, but I'll tell the viewers here. So I applied for 22 academic jobs and didn't get one. And so I had had no background in aging, but there was a postdoc in Jura psychology. I took it and then it changed my life. And I'll tell you about how I got into caregiving. But the other thing I mentioned, I met, I had my first girlfriend and my senior year, Susan, who actually we ended up marrying three years later after I finished undergrad. And we've been married 44 years. So I've had this incredible adventure with her. Where we've moved all over the country. We're in Birmingham for a while now down here in Florida. So I've had a really fun life and had a lot of great things kind of fall into my lap, I guess I'd say, Oh, wonderful. Okay, so tell us how did you get into caregiving or studying Yeah, giving. So I started my first day on my postdoc in neuro Psychology at the University of Washington, and I had one of the first memory disorders clinics in the United States, this 1981. So there's no, there's an Alzheimer's Association, but nobody's heard of it. We're still saying people have seen out dementia, there's no self help books about caregiving, there's no webpages or no support groups, there's nothing.

Dr. William Haley 6:18
So I went in, and my job as a psychologist was mainly to do psych testing. That was how it was put in those days, you know, to ascertain whether people had dementia or normal aging or depression, nobody even had thought about mild cognitive impairment at that point, and I found out was just much more interested by the caregivers and their stories and their problems than I was by the testing. You know, these people were putting up with these crazy behavioral problems of people saying it wasn't their home and take them home to their mother who had been dead for 20 years, or seeing ghosts in the house. And there's no medical treatment for those things. And there was nobody to give them advice. And I just I'd love to they're just regular folks trapped in this, you know, wild thing they were unprepared for. And I found that as a psychologist, I could help them really readily with some straightforward information, behavior management techniques, ways to communicate. And not only did they benefit, they were really grateful. So it was just a very, it just hooked me immediately, I could see it was gonna grow. And so anyway, then I was able to, after I postdoc, I got a job as a assistant professor at University of Alabama at Birmingham. And I was able to work a day a week in the VA hospital. And I can tell you more about that if you're interested. But we started one of the first Alzheimer's disease centers in the United States at UAB. And I was head of the education Corps. So I had a fun time, like getting all that established. But it also helped me to learn more about caregiving, and to recruit people for studies and such.

Dr. Regina Koepp 8:01
So you were really an early pioneer...

Dr. William Haley 8:05
I tell my students, you want to find what's going to be hot in 10 years. You know, that's a hard thing to do. But I kinda was able to do that you could see it, you know, anybody working with these families and seeing the figures could tell this was going to be a big thing. Dementia Care and caregiving?

Dr. William Haley 8:23
Yeah, right around this time, 1984, I read a book by Lazarus and Folkman about stress appraisal and coping. And it just slapped me on the side of the head, that this stress process model was a way to think about caregiving. Will you jump into what is the stress processing theory. So you know, the most commonly cited one today is purlins theory. And that adds a lot of elements to it. But this Lazarus and Folkman theory, it's real simple. It's that basically we have stressors that are coming at us from the outside world. And we subjectively appraise how upsetting those things are, and also how much of a threat they pose to us. And so that element of how people subjectively appraise things, that's the crux of stress. Because, you know, a everyday example, right? If I had to bathe my mother, and I'd never had any experience with that, and you know, it's, it's very out of my range, that's really stressful. But if I've been a nurse for 20 years, and I based people, and I'm very skilled at it, right, then that same stressor is not as upsetting to me. And this theory basically says, again, it's really common sense. It's that we have internal and external resources that help us to cope and the more internal and external resources we have, the less stressful things are. So internal resources are things like having had experience or being a good problem solver, or having had other adversity that kind of toughens you and teaches you how to hold up to things.

Dr. William Haley 10:03
For some people, it's spiritual beliefs, they have education, like learning about the condition you're caring for. So those are internal resources. And external resources are things like having money, having family to help you have in a church group that helps you having services. And so I view it that the job for caregivers is to build their internal and external resources. And the job for psychologists or counselors is to find those internal and external resources building on what people have. And that string. And that model is not only sort of common, sense oriented, but it really works in terms of intervention. And we can demonstrate that changing those resources actually makes people cope a lot better.

Dr. Regina Koepp 10:53
Yeah, and some are free.

Dr. William Haley 10:56
Yes, exactly. You know, so learning information or learning skills from other people, you know, you can pay to do that. But there's also a lot of free information out there. Now, that wasn't always right. Right, or even relying on your church family. Yeah. Now, one of the one of the tough things about that is it's there. But a lot of caregivers are hesitant to ask for it. So we've got to work to help people use the external resources they have, you know, if you've got a lot, if you're employed, or you got young kids, so you've got other, you've got a person with really tough behavioral problems. There are some caregivers that sort of are objectively much harder to manage. Yes. And some people have a temperament that seems to say sweet when they're demented, and some become troublemakers. And we can try to move that a little bit. But some of it is objective. But so much of it is this perception of, you're not going to give up that you have options you've been trained. So you know, some options, etc.

Dr. Regina Koepp 12:07
Yeah, well, I appreciate your saying that. Because yes, I have also worked with families with really challenging behaviors that are just really like waking in the middle of the night and urinating on the coffee table, pacing and rummaging all night, so nobody's able to sleep. And then you have to work the next day.

Dr. William Haley 12:24
I mean, there's a lot, you know, I want to recommend a book, I don't know if you've heard of it. It's, "Your Name is Hughes Hannibal Shanks". It's written by an African American woman who was a caregiver of her husband with dementia. And it portrays a lot of these details, I'm talking about black culture, where basically Sure, they'd been through hardships that had discrimination, and it toughened her, but she literally, like took up weight training, so she could lift her husband, he was urinating over the heater openings on the floor. She just did it, she figured out if she'd covered that he wouldn't do it. So many examples of really creative problem solving. And there's just no formula for that. But you know, it's a really inspiring book, another thing she mentions, that's really,I think, so important. She emphasizes the humanity, but there's still a person,you know, there's can be a tendency for us to say, well, the brain has taken over them, they're no longer themselves, you know, and in some ways they're not. But she mentioned seeing the little things in him, that were him the way he jumped over a puddle, the things that would make him smile, right. So in her mind, seeing his humanity, not blaming him for the problems, but seeing the part of him that was still there.

Dr. Regina Koepp 13:47
Yes. I love that message, too. Yes, that's so important. Thank you for sharing that. So will you send me the link to that book? in the show notes? Oh, thank you, good, Bill. So often we focus on the hardships with caregiving, and indeed it can be really hard. And we know that caregivers do experience higher rates of stress and depression. And then somehow, even though that is a pretty universal, potentially a universal experience among caregivers, in some of your research, I noticed or I saw it didn't impact longevity that caregivers could still live as long or longer than people who are not caregivers.

Dr. William Haley 14:33
Yeah. So I think you can think of resilience both as psychological and physical and the two affect each other in terms of psychological resilience, you know, just surviving this thing of being a caregiver. And you know, it's gonna make you sad at times, but not becoming as sad still having things in your life that are important and meaningful to you. For some caregivers, keeping a person at home is something that they value. And we found black families were slower to place their relatives in nursing homes because of this resilience. But I was also part of a clinical trial, the New York University caregiver study that Mary middlemen LED. And we showed that caregivers who got counseling, delayed placing their relative in a nursing home by a year and a half compared to controls, and they were less depressed for a three year period. So counseling can help build resilience. So it's partly it's psychological, it seems to have to do with things like finding benefits in caregiving that are there, feeling proud of what you're doing and such.

Dr. William Haley 15:44
And I have a PhD student Victoria Marino who's written a really interesting paper, she has gone back to the idea from Aristotle that there's two kinds of well being, there's he donek, which is how happy you are. And then there's something called eudaimonic, which is like, feeling like your life has meaning and that you have mastery in your life. And you have things to look forward to. And her work in her hypothesis, she's doing a dissertation on this is a caregiving sort of hurts your hedonic well being, but it builds your eudaimonic well being and she's doing a dissertation to see whether that holds up over time. So that's one way I think of it psychologically, physically. We were very surprised, I was part of a David Roth has been a longtime collaborator, we were at the University of Alabama at Birmingham together, and now he leads the aging Center at Johns Hopkins. But we had access to a big longitudinal data set. And there was a 1999 paper by Richard Schultz and Scott beach to great scholars, published in the journal American Medical Association wide, widely cited, and caregivers who reported stress had 63%, higher mortality over a four year follow up than did people who had a healthy relative who were a comparison group, that study really, you know, slap people in the face, it's gotten a lot of attention. But we did our analyses, and we didn't expect to see this. But in fact, the people who were caregivers live longer, somewhere around 18%, longer than the people who were non caregivers after doing really extensive covariate adjustment for their health, for their educational status, for, you know, various demographics and health factors, whether they smoked, etc. And then we looked at this literature, there are already several other papers that had found this identical thing. There's now somewhere in the range of a dozen papers that show that caregivers, if they're matched on these factors live longer, somewhere in the range of 15 to 20%, longer. And we think that that's probably there's probably due to the idea that you find meaning in your life and purpose, you have a reason you've got to keep yourself going. It may also keep you physically active, it may also make you watch your health a bit more. But we so there's no real great research to tell us the mechanisms. But it's a very dependable effect.

Dr. William Haley 18:18
And another David was lead author on a paper we published, it's widely found that people with high perceived stress don't live as long. And people who are highly depressed don't live as long, right? So we looked at that in both caregivers and non caregivers spend this huge study. So we got over 3000 in both groups, and among non caregivers, that finding holds up. If you're highly depressed at the baseline, and you have high perceived stress, you don't live as long. But for caregivers, there's no relationship between their self rated stress at the baseline and their depression at the baseline and how long they live. So something about caregiving seems like it might actually physically strengthen us and give us resilience.

Dr. William Haley 19:05
And this is way beyond my expertise, but they're biology, biologically oriented researchers who basically believe that, you know, caring for others is part of our evolutionary heritage. And we can find this examples in animal species as well. And they've hypothesized there's a whole biochemical thing that happens when we see somebody suffering who we care about, that harms us. But if we can do something to help them, it sets off a cascade of hormones that protect us physically. So that's out of my paygrade to explain it. But there's there's certainly something there. And along these lines, there's been the long standing belief from from some good science that caregivers have like terribly compromised immune systems. An early study found slower wound healing higher rates of infectious illness. So we've been able to look at this both in a meta analysis where we looked at all the studies that had been done. And in our own study, and we pretty much found caregivers might have a slightly higher level of inflammation. But it's a really small effect, it accounts for maybe 12% of the variance as a statistician, but it's a it's not enough to have caused caregivers to drop dead from stress and and from from infectious illness.

Dr. William Haley 20:30
So I think David wrote a paper that he's lead author on in 2015, where we called for a new narrative about caregiving. And the idea is sure people are depressed, they're stressed, they need help. But let's also not scare people away from caregiving, that it's as dangerous as cigarette smoking, you know, and that it's making you die early. So let's, let's understand a balanced narrative, and also how we can get people to find ways to cope successfully. How can we work on that? And how can we provide resources for that?

Dr. Regina Koepp 21:07
Yes, yes. I think in that same study, there was a concept of meaning based coping. Do you know much about that?

Dr. William Haley 21:14
Yeah, I'm really interested in well, Susan Folkman actually wrote a reformulated stress and coping model that included that that has been really impactful on the field of caregiving. And yeah, so caregivers who find greater meaning, and who look for benefits in caregiving. It's not just a rose colored glasses, they actually do better. And I've got a buddy in Hong Kong, Tach Chang, I don't know if you know, Tach. But he has done some randomized trials where he adds benefit finding to a standard, psycho educational caregiver intervention, where you give people information and skills. And he finds that adding that benefit finding, and finding meaning component makes the counseling more effective.

Dr. William Haley 22:03
I think that is just awesome, because we're showing that this is not just it's not due to just your personality trait of optimism. It's not just sort of the way you're built. It's not just the stressor situation, we can actually teach people to begin to notice, you know, the joys in their life. And you know, people talking about mindfulness. Now, I think there's similar philosophy there. So there's some things that I think we can move forward on that to help develop this balanced narrative. But I have to say, I think we've got a real mess, though, at the public level. Because, you know, when I go to hear public talks about caregiving, or I look at webpages, this high caregiver mortality story is still being told the idea that caregivers are dying before their relatives, which is false. There's also research showing that's false. Is pervades the talks that people give, partly, you know, I think advocates think that it might help them raise concerns. And it might help them get legislation passed to get resources for people, or it might help them raise money to find a cure for Alzheimer's and such. But we're doing a disservice by setting up this really negative. The standard story of caregiving is just that it's a tragic thing. It'll beat you into the ground. Right? And we can do better than that.

Dr. Regina Koepp 23:26
Because what is the fallout then if we only use that narrative, what do you see is the downside?

Dr. William Haley 23:33
Well, I mean, we're facing a period where we're going to have fewer people available as caregivers, right? People are having smaller families. And with blended families and stuff, you may have multiple parents and step parents. And so you know, a narrative that it's basically a killer stress and that you're in it on your own, won't help us manage that. And so we've not only got to help not sell a false image, but sell a reasonable narrative about caregiving, but also get the people real help. You know, workplaces have to find ways. workplaces have daycares for kids, right. And they have workers who help people find resources for mental health or substance abuse. We need every workforce to be caregiver friendly. And to find ways to get people resources at a federal level. We can't count on states to do it. You know, the VA does some great things like this where they pay caregivers, we need to give people real help. So it's not just a matter, like buck it up and smile and you can get through it. We got to give people resources. If you're a caregiver and you're not working, you're losing your Social Security benefits. So we need to do a million policy things to allow this. You know, I got to go to Wu Han China actually, you can believe it the November before COVID hit. And they invited me I got to do a talk. I just loved it. But China's an example of a country that's in deep trouble. Because they have a really small birthrate. They don't allow any immigration really like we do. Immigration is helping us there. But they have really bleak prospects of how to care for this mushrooming older adult population. So we've got better than many countries, Italy's another one in this problem, but we've got to plan ahead.I know that Joe Biden actually is that caregiving is something he cares about. So we need some policy supports for caregivers as well.

Dr. Regina Koepp 25:35
Yeah, there was a recent podcast with Brene Brown and Melinda Gates talking about something very similar. And using a sort of family systems framework for thinking about I'm a family systems therapist. But using us a family systems framework for understanding caregiving and how to create scaffolding in businesses like with family medical leave, or even elder care. And if we're offering child care supports, how are we also offering elder care support? Disproportionately falls on women, both, Still.

Dr. William Haley 26:08
And so I've also been really impressed a couple of scholars. I'm going to mention Karen fingerman at University of Texas at Austin. And Sara Qualls is at University of Colorado, Colorado Springs. They're looking at this through a lifespan perspective. And, you know, we mainly think about older people as, Oh, they're this tsunami, and they're going to take all this help and care. But older people do a lot to help younger generations. So Sarah has written a beautiful paper about this, that basically, caregiving is a new normal. It's a thing that we but we need to look that older people are giving a lot to their children to their grandchildren, they're helping them throughout life, it's a reciprocity. And Karen does studies that were she thought studies, mutual exchange across across generations, at a sort of micro level, like day to day, how does it make you feel when you do this? And what are the kind of things so I think we've also got to build in that it's not just an isolated, you know, older adult thing. You know, we've got to look out for families across the lifespan. As an example, you know, my wife's brother had a spinal cord injury when he was 18 or 19 years old. And he required caregiving for his entire adult life. So there are circumstances like our people, I've had a student do a study.People have a child with an intellectual disability, that's a lifelong caregiving prospect. And so we've got to help people, not just the older people are not just kids what our constituency is, we've got to take a life courseapproach to this thing.

Dr. Regina Koepp 27:47
That speaks to me for 10 years, I also lead a spinal cord injury group in Atlanta VA, and it was mostly men. It was veterans. And so mostly men between the ages of 27 and 80. Living with spinal cord injuries. And this could have been from gunshot wounds during Vietnam, or could have been through a car accident or a motorcycle or all sorts of changing a light bulb and landing. Yeah, wrong. I mean, all sorts of unusual or typical.

Dr. William Haley 28:19
And you know, we talk a lot about dementia, caregiving, I've been fortunate to do research on stroke, caregiving, and cancer, caregiving. They all have different elements due to the nature of the disease, but these common underlying issues of like, you got to build internal and external resources and how people you know, have time to go out and do things and such, they're common across all these illnesses, and caregiving is even important and things like transplantation. So we can't think of an area healthcare or live life that, you know, isn't linked with caregiving. It's the nature of human beings to care about each other and the nature of families to do that.

Dr. Regina Koepp 29:01
And we are mere mortals we're vulnerable. Yeah. And we are resilient. And so finding that I like the David Roth concept of a balanced narrative. Yes. Yeah. Because we are vulnerable. And we are also resilient. Even people living with spinal cord injuries who require care are resilient.

Dr. William Haley 29:19
Well, and it struck me anyone who's worked with people with spinal cord injury, it's portrayed in movies like it's a death sentence. They have a horrible life. Oh, they can't walk. Well, my wife's brother, he had a million things he enjoyed. He had a ton of friends. He had a beautiful life. And so we've it's also a matter of just appreciating that people can have different kinds of great lives with the right support.

Dr. Regina Koepp 29:47
Yes, well, and so now we're talking also, we've hit ageism. Yeah. Yeah. We're also talking about ableism because there is also a lot of discrimination toward folks who are living with acquired disabilities, physical disabilities, disabilities that you're born with, if you have an intellectual disability, or developmental disability, I mean, and there are so many barriers, I will say, yeah, and for folks living with disabilities and back to the resources, so are there protections in place from a policy level to support caregivers for folks living with disabilities? Are there protections in place if you use a wheelchair? So, yeah, so if you go to New Orleans, you can actually go up on the curb because it's all cobblestones. You know, you can easily use a wheelchair and New Orleans. No. And so but so how are we helping folks? Or and it's, you know, live life with a disability or if you're deaf, and you're, I have a friend MJ Grant whose mom is deaf and has dementia. And so MJ is hearing is a sign language interpreter and has these beautiful videos talking with her mom with dementia, using sign language. And, and she talks about the challenges of for her mom and for her with caregiving, because so very few caregivers sign of course, professional caregivers, and so she always has to be available to help her mom because otherwise her mom can't communicate.

Dr. William Haley 31:17
You know, and I think one thing we don't recognize is actually things are getting better for caregivers. I don't know if you've seen Jennifer Wolf who's at Johns Hopkins. She wrote a paper published in a gerontologist a couple of years ago, and my colleague, David Roth was an author. But she's looking at data back to 1999 that looks at how burdened caregivers feel from different national data sets. And there's actually a decline in caregiver burden over that time. There's an increased use of respite sources. Wonderful. So you know, so it's not like, there's been some magic fix, you know, we still have big problems. But you know, now most people have heard about dementia, they've heard about caregiving, we have things that weren't at all the case in 1999. So I do feel like we've got to make it a priority, though. And it's good. It's not just good to make people feel better. It's good for the economy. It's good for health. Care. Yeah, you can't deliver health care to people without considering their caregivers. So

Dr. Regina Koepp 32:23
and what is that Rosalyn Carter quote? Yeah, that there are four types of people in the world those who need care those who provide care those who will need care, though you have needed care something

Dr. William Haley 32:35
Yeah, you know, a lot of us haven't become caregivers. And will you know, so yeah, nobody's really good to escape this. It's good for everybody. It's not just good for a little niche of people.

Dr. Regina Koepp 32:47
Now, Bill, we've we've gone broad and, and far, and I'm so delighted with this conversation, I could talk to you all day. So just for the caregivers listening or people who are supporting caregivers, what can caregivers do to bolster their resilience?

Dr. William Haley 33:03
Well, the general things is they need to build internal and external resources. But in a practical way, that means you can get yourself educated about the condition that you're caring for someone about, you can get yourself learning about what resources are available for your family member in the community. You can learn how to problem solve, and there's some great work. It's a problem solving rubric that you can use you identify, brainstorm, you evaluate the options, you try things and evaluate them. So some people do that all the time. But it's a great general coping technique that works for a lot of problems. And there's that some called problem solving therapy that's even tried to do that. But I think the key thing is that know that what you're doing is important. This is your you're helping your family member, they would be in an institution without you. And they wouldn't have as good of a quality of life. And so try to notice the ways that what you're doing is making a difference. Try to notice the things that give you pleasure, or satisfaction, maybe even think about in 10 years, you're probably going to be really happy that you did this instead of not doing this you may or going through some Distress right now. And find a way to in terms of external resources, find a way to connect with the people you know and love. I know so many people who are caregivers, they're givers.

Dr. William Haley 34:38
There's some there's a term we've used serial caregivers, right? That caregiver, one person after another, yes, but they're never used to asking for help for themselves. And you know what makes other people feel good, if they can help you. So don't hesitate to ask people but as a psychologist, I have to work with them to how to asked for something specific. That's plausible. So for example, could you come by for three hours, one day a week? And watch mom, so I can go out and do X, Y and Z? Right? Right, something practical and small like that. Or, you know, through a church group could, could you help them to learn more about this condition? And maybe an old friend from there, help you? So we've got to find, can you modify your home, so that it's safer for the person so you're so build finding ways to find meaning in what you're doing? Getting counseling, we know actually, really helps build people's internal resources. It does. And it actually something I teach from, it actually can change your personality, and build resilience that helps not only with the task you're being counseled about. So caregivers auto do not feel like it's an embarrassment. It's not meaning that you're mentally disordered, it's mean that you could use some help and some coaching handling stress. So there are some really good practice under some great self help books. I know, the 36 hour day is a book that I really like a lot. There's newer ones. This night, this book your name is use Hannibal Shanks is one that isn't very widely known. But everybody who reads it is just astonished and inspired. So, yeah, caregivers, you may feel kind of buried in stress. But there are ways that you can try to work to help yourself cope better, find time for yourself, that means getting somebody maybe to help you relative, using Adult Day services or other respite services. You can make your life better, and you're going to be very proud of yourself and years ahead, that you've done it.

Dr. Regina Koepp 36:53
Well, Bill Haley, thank you so much for joining me today. Thank you, you shared so many helpful resources and tips for caregivers and for older adults.

Dr. William Haley 37:02
Well, I've enjoyed getting to know you a bit better. And I really the people who are caregivers, you know, they're they're sort of heroes that aren't recognized, indeed. And so we do have to do more, and we have to do better to help them. And I really think we all we should honor that. Like we honor first responders, you know, these are people who are giving their all to keep a loved one at home and give them the best life that they could have. No, I have a very deep respect for that.

Dr. Regina Koepp 37:32
Wasn't that a great episode, so many excellent tips that we can all use. But especially you if you're caregiving, I would love to hear which resilient strategy you have been using and which resilience strategy you plan to start using. And to Dr. Haley's last point, I couldn't agree with him more. You know, those signs that people have on their front yards since COVID started that say, "Thank you healthcare heroes". Well, I want to make a yard sign just for you that says "thank you, caregiving heroes."

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Dr. Regina Koepp 38:13
If you'd like more resources and providing care and taking care of yourself, download my free caring for aging parents checklist. It gives lots of resources and information. I'll link to it in my show notes. That's all for today. Now, it's your turn. Join the movement to include older adults in conversations, mental health and wellness. It's simple. All you have to do is subscribe, leave a review and share this episode with others so that they can be part of the conversation, too. One last thing, a special thanks to Jhazzmyn Joiner, our psychology of aging podcast intern, for all you do. Lots of love to you and your family. Bye for now.