Caring for the Caregiver

In recent years, advances in public health and medical science have contributed to the graying of the population. More seniors are alive today than at any other time in history and those numbers are growing. But the increased elder population has also put pressure on the nation’s acute and long-term care system. In the past three decades, there has been a shift from institutional care to more community based and home health care. And while at-home care is the preference of many people, there is little infrastructure to support it.

According to statistics, approximately 44 million people – typically adult children or spouses who may also be older and frail – provide unpaid assistance and support for their relatives and friends. Those who provide this unpaid assistance are generally referred to as “informal” or family caregivers and they now serve as the backbone of the American system of long-term care for the elder population and those with disabilities.

As the demand for this type of informal care increases, there will also be a rising need among caregivers for information, education, guidance and emotional support and more public and private providers to deliver these services.

Signs of Stress

Caregiving can be an overwhelming role and it’s often heaped upon people already struggling with work, family and personal duties. New roles and responsibilities are acquired – often unexpectedly – with no job descriptions and little preparation. This can carry a substantial cost, such as adverse physical, emotional and social effects.

In fact, research has revealed that caregivers experience excess morbidity and mortality. They develop stress-related illnesses and their social networks shrink. Studies of caregivers of individuals with dementia, for example, indicate that about 35 percent suffer from depression. And there are consequences in the workplace – time lost, opportunities missed for advancement and economic losses in terms of earnings, benefits and pensions. These economic impacts could have repercussions on the caregiver’s own elder years.

So what are some of the signs of caregiver overload?

  • Sleep Disorder. Depression, overexertion, and nighttime caregiving may prevent caregivers from getting adequate sleep.
  • Marital problems. Marriages can be strained because of caregiving responsibilities.
  • Reduced employment. Caregiving demands may force family members to curtail their hours or quit a job, adding financial stress.
  • Social withdrawal. Family caregivers may become lonely, lamenting diminished contacts with friends and fewer social activities.
  • Depression. Caring for a physically or cognitively impaired individual may leave the caregiver feeling helpless and hopeless.
  • Guilt. Caregivers may begin to wish the care recipient was the way he or she used to be or that someone else would take some of the responsibility. They may then feel guilty about having these thoughts.
  • Anxiety. Family caregivers may begin to feel edgy or nervous. Regardless of their efforts, they may have a sense of falling behind.
  • Physical problems. Increased physical and emotional stress may decrease the caregiver’s resistance to sickness. Family caregivers may complain about frequent colds, headaches or backaches.
  • Fatigue. Caregiving can be physically and emotionally overwhelming and may lead to exhaustion.

In addition to the impact on their own health, untrained, unsupported and emotionally stressed family caregivers may become neglectful or even abusive to their recipients. Research has indicated that when caregivers are overburdened, depression increases in the older care recipients plus the care giver reports poorer physical health.

Helping the Overwhelmed Caregiver

Caregiving is an intense job and, with some elders, a thankless task. The nature and scope of the position often changes in sync with the recipient’s condition. But regardless of the aging family member’s health, caregivers still need encouragement and emotional support to help prevent burnout or feelings of anger and resentment. Solutions could range from the sharing of responsibilities, time off, pursuit of enjoyable interests to exercise and use of relaxation techniques. Some situations might even require the introduction of paid caregivers or placing loved ones in an institution.

Caregiver assessment can help to determine the most appropriate family care plan. This includes surveying the caregiver’s strengths and weaknesses, identifying personality traits, whether there is a history of mental illness or substance abuse, financial stability and the knowledge (or lack thereof) of the elder’s health condition. Some caregivers may need mental health interventions such as counseling, support groups, individual therapy, group therapy and psychoactive medication. Either way, families should maintain dialogue in order to share information, identify needed interventions and develop a plan that might include care by both informal and paid care providers.

Caregiving is a major health and public policy issue affecting elders, families and the nation’s rapidly aging society. Although informal caregivers are the backbone of the long-term care system, they are an at-risk population in need of help and support themselves to continue in this essential role.

About the Author: Cathy Jo Cress is a member of the National Association of Professional Geriatric Care Managers (NAPGCM) and author of books including the Handbook of Geriatric Care Management and Care Managers; Working with the Aging Family.

Advocare understands the demands a caregiver role can pose.   We can provide answers and solutions for your senior loved ones. Advocare is an organization that advocates for you. We will help you to effectively manage your role as a caregiver. We make things easier and give you the resources that you need to deal with your situation.

Reprinted from with permission