Having an attentive ear

01 April 2022

Having an attentive ear

Relief, an organization whose mission is to help people deal with anxiety, depression or bipolarity, has recently added support groups for caregivers to its range of services. We spoke with Angéline Roy-Hébert, a mental health worker, about this new service.

Des groupes de soutien pour proches aidants en santé mentale

Discussion à bâtons rompus autour de cette nouveauté avec Angéline Roy-Hébert, intervenante en santé mentale.

If I say, “caregiver,” what and who does that make you think of?

A variety of people! Whenever we see someone at Relief, the topic that always comes up in the interview is the circle of support … or the lack of it. I have been a caregiver myself, in many ways and at varying degrees, since I was 12 years old. My mother had just been diagnosed with a serious illness. In 2020, my sister, who had been increasingly present over the years, took over completely, since I was at the bedside of our youngest son, hospitalized at Sainte-Justine. My mother passed away in 2021. It’s a very complex role. When I welcome a person, I always keep in mind that, when we help someone, the whole system around that person is helped.

Can you tell me about your first intervention with a caregiver? What struck you?

I don’t remember, because I have been doing this type of work for a long time! The great dedication that caregivers demonstrate always strikes me. They say to me, “How can I improve their functioning and quality of life? Tell me what I should do!” I teach them to accompany, to take the person being cared for by the hand rather than carrying them on their shoulders.

Accompagner un proche atteint d'un trouble mental

You are a “counsellor.” How is counselling different when it comes to caregivers of people with mental health problems?

The process is always a two-step process. First, the caregiver asks how to get the person they are caring for to do this or that. We then suggest resources and give them suggestions. Second, we ask, “How are you personally doing right now?” Not all caregivers are comfortable with this stage of the process, although most of the time the initial reaction to this question is positive. It is often the first time they have been asked this question. People are moved, very touched. At the same time, this question also connects people with a sense of heaviness, with their difficulties and their needs. Most of them open up. Rare are the people who do not want to talk about this aspect. When they feel an openness, when they know that they will not be judged, the process goes well.

So it’s all about listening?

I would say that it is a welcoming quality. When you’re a caregiver, you often think you have to meet all the needs of the person you are caring for. This is a myth, of course. As a counsellor, I listen to who you are, what you are going through, all your emotions, pleasant or not. In fact, it goes beyond listening. If it remains at the listening stage, it is possible that the caregiver remains overwhelmed by certain elements and does not feel that they have moved forward in dealing with their situation. This is why at Relief, we provide information, either on the role of the caregiver or on mental disorders, so that the person has a more accurate perception of what the difficulties experienced by the other person are. After this phase, which we call the “psychoeducation phase,” comes the “rehabilitation” phase. It provides concrete tools and strategies for daily functioning and stress relief.

Why did you choose this profession? How did you get there?

My background is a bit unusual. When I did my undergraduate degree in psychology, I was already a caregiver. When I was 18, my grandfather and grandmother died one after the other. My sister and I had no one left. That’s when we both took on the role of caregiver for my mother. I know a lot about helping people! I did my undergraduate degree at McGill University and then a certificate in gerontology which I loved. I started a PhD program, but I was so busy! I had to take care of my mother, who lived with us, and our first son, who had to be hospitalized several times. I burned out and never finished my PhD. I learned a tremendous amount from being a caregiver. It’s something that can never be lost. This role is part of me, even though my mother is no longer here.

What do you gain from being around caregivers?

The ability to help others challenges me: you help one person, another is affected, and this has repercussions, like waves on the ocean. Our support groups and workshops put the person at the centre of their life choices, their knowledge and their actions. Each person becomes a role model who can inspire others. For many, being a caregiver is not necessarily a conscious decision. It is the life circumstances that lead them to take on this role and to transcend themselves. Being around caregivers is extremely inspiring. I have a lot of respect and admiration for them. I find it to be an exceptional form of self-giving.

Why support groups dedicated to caregivers?

Caregivers have been part of Relief’s (formerly Revivre) mandate for a long time. Long before I arrived, there were already support groups for caregivers. Then, individual intervention was favoured. We came back to the support groups when we saw the number of caregivers with needs. Of course, the context of the pandemic has brought their role even more to the forefront. Intervention through support groups makes it possible to address broader themes that are relevant to more people, to express realities and to find ways to “navigate the network” together, to identify the resources and personalized tools that are most appropriate.

Perhaps you played a role in this return of the support groups, with your personal history?

I really don’t know! I have never made a secret of my background. Our Executive Director is a caregiver himself. He is very sensitive to this issue. At Relief, we have a very keen eye for caregivers. The support groups allow for the sharing of experiences, in a space where caregivers can express themselves without judgment. Others understand and are supportive. This helps combat guilt and isolation. Everyone sits together, all caregivers, and nothing is scripted in advance.

Do some mental disorders require more help from caregivers than others?

I would think more in terms of the severity of the symptoms. When the person is less and less able to function on a daily basis, that’s when the caregiver role becomes apparent, and it increases more and more rapidly. There is no choice. The person affected is going to fall, they have to be held back. It is often at these moments that the caregivers call Relief, in panic, asking for help with a sense of urgency and helplessness.

Many people live with, say, a depressed spouse without understanding that they are caregivers…

Absolutely. I have often told people that they are caregivers and that was news to them! A word about a reality that has been around for years… Caregiving is a concept that should be made much more widely known among the general population. When we talk about mental health in the news, we mostly hear about anxiety. However, a caregiver who accompanies a person having an anxiety attack is not to be trivialized! Mental health urgently needs to be better understood and caregiving needs to be better recognized in our society. When all this becomes part of our daily lives, we need validation and recognition.

The person being cared for can have ups and downs … and we can have them too. How, in these conditions, can we maintain a good “balance”?

That’s a good question. If someone I am caring for is bipolar, for example, it can mean living in stability for years before a new episode suddenly appears. Support groups are a way to learn how to navigate this reality. The goal is not necessarily to eliminate the ups and downs, but rather to attenuate it to something that is more comfortable on a daily basis. A good tip is to plan strategies that work with the person you are caring for, so that you are prepared in case of an acute phase. If someone I am caring for breaks a limb, I go to the hospital because I don’t know how to make a cast! It’s the same thing with mental health.

Plan ahead: a 10-tip strategy plan, suggested by Angéline

  • Learn about the problems experienced by the person being helped;
  • Protect yourself and the person you are caring for. By taking the lead, sometimes even overdoing it, we create a relationship that can be harmful to the person being cared for as well as to ourselves;
  • Stand strong, that is to say, do as much as possible while maintaining your balance and autonomy;
  • Look together at the direction we want to go in and move forward;
  • Knowing what helps us to maintain our balance. What is necessary for our balance as a person? Health, sleep, social life, physical health?
  • Take the time to look at what suits us and test it;
  • Identify our fatigue and make a list of what we are still able to do, the pleasures we have, the moments we spend with our care recipient outside of our role as caregivers;
  • Be alert by learning to spot the warning signs. This means observing ourselves in our daily activities to detect the signals that indicate a change in our balance and our sense of well-being. When “things are running smoothly” and we can no longer keep the machine running, we should be alarmed. The goal is to spot the warning signs before the situation becomes too serious!
  • Change the way you look at yourself. The more you work on it, the less likely you are to fall. This reminds me of a certain caregiver who, in a support group, was told that she was at the centre of everything and that if she broke down, the whole system around her care recipient would collapse. She found this so overwhelming to hear!
  • Write down scenarios, in collaboration with the person you are caring for, defining precisely what to do in a given situation, according to our role and our limits. For example, if something happens, we go for a walk. If something else happens, I contact your psychiatrist and accompany you to the hospital. If you have symptoms at night, I tell you in advance that I’m going to hand you over to an emergency service, because that’s when I need backup help.

Interview by Karine Cloutier, Communications Project Manager at L’Appui pour les proches aidants. Many thanks to Angéline Roy-Hébert for this dialogue and for her encouraging comments in the new Mental Health section of our site.

Trained in clinical psychology, Angéline Roy-Hébert has been working for the past twenty years in the counselling field.

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