Caregiving for the Elderly

More than ever before, families are providing long-term care to older adults with limitations in the ability to perform tasks necessary for independent living.  Nearly 25% of American households are providing care to people age 50 years and over.  Families are the foundation of the stressed healthcare system.  Hospital stays are shorter than ever and family caregivers are often expected to do what health care professionals once did, and do so without training.  Family members often: monitor symptoms; administer complex medication regimens; assists with personal care; perform housekeeping tasks; provide emotional support; manage difficult behaviors such as wandering, aggression, and hallucinations; deal with health care providers and insurance companies; manage finances; coordinate care; and deal with uninvolved or unhelpful family members.

If you or someone you know is arranged or providing care for someone experiencing illness-related losses or frailty, there are some important facts you should know.

What are the effects of caregiving?

Caregiving is what professionals called the unpaid work of family members that make it possible for spouses and parents to live at home longer.  Most family members think of it as doing what comes natural when you’re a wife, husband, daughter, son, or other family member.  While many caregivers find much meaning in being able to help a loved one, there are health risks associated with long-term caregiving. 

• 80% of caregivers say they feel a great deal of stress.
• 50% have clinically significant depression.
• Anxiety is higher in caregivers than non-caregivers.
• Caregivers have more physical health problems.
• Strained caregiver spouses are at increased risk of dying.
• Caregivers have poorer immune system function and slower healing of wounds.
• Caregivers experience more colds and other viral illnesses.

In addition to help risks, caregivers can experience financial strain associated with illness expenses, passing up promotions, and reducing work commitments in order to continue giving care to a loved one.

Affects on the Family

Spousal caregivers.  People providing care to a husband or wife often experience significant changes in marital relationships.  Responsibilities that were once handled by the ill spouse may have to be taken over by the caregiver.  This may involve learning new skills at a time when there is less energy for new things.  Many times, the spouse feels that rolls have been reversed and this can be overwhelming and frustrating.  There are also losses.  Activities that once provided pleasure and deepened a sense of connection may no longer be possible.  Caregiving spouses can begin to feel very isolated from their friends and feel tremendous guilt about their own unmet needs.

Adult children providing care.  Caregivers often are raising family’s at the same time they’re helping an older family member.  Caregiving can affect the siblings, spouses, children and grandchildren of the caregivers.  Sometimes it seems as if everything in the family revolves around the health concerns of one person.  This can lead many people in the family to feel like health problems have taken over family life.  When this happens, needs for tension go unmet and relationships that we’re doing well before may become stressed.  Often, family members who were not providing direct care to Elders feel guilty for expressing their own needs in the face of family struggles.  When needs go unmet for a long time, unexpected problems may occur.  Husbands and wives may feel more distant and intimacy suffers.  Conflicts that were tolerated before can become more heated, as people are more tired and frustrated.  Children can develop academic or behavior problems that require more energy at a time when less is available. 

How Can You Tell is Caregiving is Becoming Risky?

People who have a lot of unmet needs an anxiety about how things are going tend to let positive health habits drop in engage in activities which feel immediately rewarding, bought are ultimately bad for health.  Often, caregivers report: 

• Missing physician appointments
• Ignoring their own health problems
• Not eating a healthy diet for lack of time
• Over using tobacco and alcohol when they are stressed
• Giving up exercise habits for lack of time
• Losing sleep
• Losing connections with friends for lack of time to socialize
• Holding in feelings of anger and frustration and then being surprised by outbursts directed at the care recipient, other family members, co-workers and strangers

Other signs to look for include: 

• Feeling sad, down, depressed or hopeless
• Loss of energy
• Lack interest in things that used to give you pleasure
• Feeling resentful toward the older adult in your care
• Feeling that people ask more of you than they should
• Feeling like caregiving has affected family relationships in a negative way
• Feeling annoyed by other family members who don’t help and criticize your care
• Feeling upset by arguments with others about your situation

Seeking Help

If you or someone you know is experiencing the signs and symptoms listed above, consider talking with a qualified family therapists who can help you evaluate your situation.  Family therapists are aware of the latest research that demonstrates that strong and satisfying relationships with others can: 

• Reduce caregiver stress and depression
• Reduce health risks of caregiving
• Increase satisfaction with caregiving

Family therapists will work to tailor treatment to the unique concerns of the family and their skillful in helping families become more knowledgeable about the effects of chronic illness on the family.  Family therapists are comfortable working with large groups and know how to manage conflict in improve communication among family members.  They can skillfully a address painful issues from the past; increase family involvement in caregiving; link family’s to community and resources; help family’s deal with grief, and find meaning in dealing well with loss.

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