Being a caregiver for a loved one suffering from Lewy Body Dementia (LBD) is a challenge. Caregivers expect a lot from themselves. (They often have no choice.) They are often hyper-focused on their loved one and are frequently tough on themselves. Perhaps one way to ease that self judgment is to realize that there is actual scientific evidence why we sometimes aren’t working at our optimal level. It’s called Decision Fatigue.

The Journal of Health Psychology describes Decision Fatigue as what happens when “the limited reserve of stamina for decision making becomes drained.” The quote in this article’s title strangely enough comes from a magazine that focuses on people who work in the computer/IT world. In fact, in my research about Decision Fatigue. I found references to emergency workers, flight crews, physicians and nurses, etc. but no mention of at-home family caregivers. Decision Fatigue is real, and it can affect anyone. According to the National Institutes of Health, a typical American makes up to 35,000 decisions a day…yes really! Add to that the myriad of caregiving decisions that must be made every day. Accumulated decision-making leads to mental exhaustion similar to muscle exhaustion when we are overworked physically. The result can lead to diminished ability to cognitively, psychologically, and behaviorally function well.

Think of all the decisions you must make every day as you care for your loved one with LBD: what to make for breakfast…oops…now it’s time for lunch. Should I test him for a urinary tract infection (UTI)? Is it too cold to take her out for a walk? Is it time for me to consider getting help in the home and, if so, where do I look? If I go out for a walk by myself, am I being neglectful? Should I call the doctor and discuss his medications? Does he need a laxative, and if so, which one? Do I need to talk to someone about our finances, etc., etc.? And this is not to mention the additional burden of perhaps now making all the decisions that the person with Lewy used to make for the family.

Signs of Decision Fatigue

1. Difficulty with focusing and clarity of thought
2. Procrastinating often and then doing things impulsively
3. Avoiding decision-making or over-thinking decisions
4. Quick tempered and irritability
5. Feeling a sense of hopelessness and overwhelmed
6. Inadequate sleep, fatigue, headaches, other physical ailments

These are also symptoms of depression and stress. But realizing that some of it may be caused by all of the hundreds of caregiving decisions and life decisions you must make all day—every day—may shed some light on how to help yourself.

Follow a set routine for each day. Yes, this involves decisions, but once they are made, it can eliminate many of the routine decisions such as when to get up, what to eat, when to take your loved one for a walk, etc. Think about what tasks you could put on automatic. For example, have a menu schedule for each day of the week. Once it’s set, then you know what groceries to buy, and what you’ll make for your loved one to eat each day. You could at least keep that same seven-day menu for a few weeks at a time. That would also mean you could keep the same grocery list for a few weeks (and if you order from an online grocery service you can just hit “re-order”). Go through the day in your mind and discover what other tasks could be made “automatic” so a decision need not be involved.

Make your most important decisions early in the day. This may involve making a short list at the beginning of the week of the BIG decisions you are facing and only addressing them in the morning. Research has shown that in all walks of life, the later in the day, the more likely a person will make a less than optimal decision and will be more likely to procrastinate or make an impulsive decision.

Plan your week in advance…less exhausting than winging it. Sit down with a cup of tea and a calendar and plan your week. Then put it out of your mind. Or at least make a plan for tomorrow, write it down, then let it go.

Take regular breaks for yourself throughout the day—even if it’s a few moments to sit and do some deep breathing. Research shows that stopping three times a day and taking three very slow deep breaths (making the exhale longer than the inhale) reduces the stress hormone, cortisol.

Observe when your mind is running ahead. If you’re facing big decisions, just make the most urgent and drop the others for now. Basically, that means stop running ahead in your mind about what will come next. It really is a matter of one day at a time with strategic future planning thrown in.

Emotions affect decision making. Neuroscience imaging studies suggest that during periods of intense emotional regulation, (i.e., containing your sadness, grief, impatience, annoyance, etc.) parts of the brain involved in reasoning and decision-making are less active. Be kind to yourself when upset, and don’t try to make decisions.

Caring for someone with LBD is stressful in many ways and for many reasons. Reducing the need for some decisions might add just a smidgen of relief. If you’ve found ways to decrease your Decision Fatigue, please tell us about it in the comments section below. And if you are feeling overwhelmed or need to discuss some important decisions relating to LBD, call our Helpline. We are available seven days a week from 8:00 am to 8:00 pm Eastern time at 516-218-2026 or 833-LBD-LINE. You can also email us at [email protected] and/or visit our website for much information at: www.lewybodyresourcecenter.org