Introduction
Effects
of Family Caregiving
Symptoms of Caregiver
Burnout
Strategies
to Cope with Caregiver Burnout
Summary
Introduction
As medicine and technology continue to improve, and baby
boomers continue to grow older, it is evident that life expectancy will
continue to rise. Today, there are 33 million Americans who are over 65
years of age. By the year 2030, that number will double. How does this
affect us? Finding quality and affordable care for our loved ones will
continue to become a crisis for family members. Eldercare has become a
multi-million dollar industry, and although there is a growing number of
living and caring alternatives, still the responsibility of day-to-day
care often falls to a family member.
Caring for an aging parent or loved one requires time,
patience, and energy, and almost always results in frustration and exhaustion.
Caregivers strive to meet the needs of the person they are caring for at
the expense of their own needs. Caregivers often experience higher stress,
illness, and burnout than non-caregivers. The reality is at one point or
another we will all be faced with what is often referred to as the impossible
profession: caregiving. There are ways to minimize the burnout we may incur
while caring for a loved one.
Becoming a family caregiver is a responsibility or job
no one looks forward to. In fact, it often comes about suddenly as a result
of a medical crisis. In my practice I often hear, “My father just fell
and broke his hip” or “my grandmother was just diagnosed with a terminal
illness and needs care.” No one wants to think about or prepare for these
life-altering, devastating events. No one prepares to be a caregiver. According
to the American Association of Retired Persons, the definition of a caregiver
as “someone who provides unpaid assistance to a second person aged 50 or
over." The assistance consists of help with at least one activity of daily
living (ADL) such as:
And at least two instrumental activities of daily living
(IADL) such as:
-
Grocery shopping
-
Cooking
-
Cleaning
-
Transportation
-
Managing finances
-
Administering medicine
Today, more than seven million households contain caregivers.
Most often it is a child caring for an aging parent. The caregiver is typically
female although there has been an increased number of male caregivers in
recent years. The median age of the caregiver is 46 years old, who are
often caring for young children too. This is considered the Sandwich Generation
caring for both child and parent simultaneously. Most caregivers are employed,
however caring for an aging loved one is definitely more than a nine to
five job.
Effects
of Family Caregiving
The effects of family caregiving can place a tremendous
emotional, physical, and financial toll on all involved. Although the caregiver
is preoccupied and overly concerned with the changes taking place with
their ailing relative, there are changes that affect the caregiver that
often are overlooked.
Emotional changes
Role reversal: The
parent being cared for becomes the child, and the child who is the caregiver
becomes the parent.
Role overload: Typically,
the caregiver does two to three times the normal workload of a non-caregiver.
Changes in the family system:
The
entire family is affected by the caregiver’s new role. For example, young
children and the caregiver's spouse may feel neglected and by the caregiver.
In turn, this causes friction and conflict for the family.
Normal routine of living is interrupted
on a temporary to permanent basis: The recipient of care may
need to live with the caregiver, which can restrict the caregiver's social
life and infringe on privacy.
Negative or positive feeling
retrogressed: There may be negative or positive feelings from
the recipient of care and the caregiver. For example, if it was a difficult
relationship before you become a caregiver, very often, issues or family
dynamics often resurface while caregiving. For instance, if you are caring
for your father who is fiercely independent, he may feel now that he is
a charity case, and having to ask for assistance makes him resistant and
resentful of becoming dependent.
Physical changes
Changes in home environment:
Your
aging loved one may have to live with you. You may need to install medical
equipment or make your home environment accessible for your family member
to get around.
More frequent travel: You
may need to travel long distances to care for a loved one or even relocate
to another city. In my private practice I have worked with caregivers who
commute daily from Boston to New York in order to sustain employment and
meet their family members' needs.
Financial changes
Lost wages, benefits and insurance:
Elder care is costly. Many caregivers have to miss hours of
work or pass up promotions to care for a family member.
Symptoms
of Caregiver Burnout
Over time, these emotional, physical, and financial changes
begin to affect the caregiver. Caregivers feel overwhelmed, exhausted,
frustrated, resentful, and guilty. Do not ignore the following signs of
burnout if you are a caregiver:
Physical Symptoms
Headaches
Digestive problems
Sleep deprivation
Heartburn
Chronic back pain
Other muscle tensions
Loss of appetite
Weight gain
Emotional Symptoms
Depression
Increased anger
Emotional exhaustion
Fatigue
Increased anxiety
Preoccupation with death and dying
Low self-esteem
Apathy
Increased use of nicotine/alcohol/drugs
Isolation
Withdrawal
Memory loss
Strategies
to Cope with Caregiver Burnout
Caregiving for a loved one will undoubtedly bring upon
some of the above-mentioned symptoms of caregiver burnout. The good news
is that there are strategies to manage the increased stress and help you
cope with this tumultuous period in your life. Caregiver burnout can be
controlled. Here are some suggestions to combat the caregiver burnout you
may be experiencing:
Set your own goals: You
should decide what you can and cannot do. Do not let doctors or other family
members decide for you what you should be doing. Be realistic. For example,
it may be impossible for you to leave your job every day to prepare lunch
for your family member that requires care, but it is realistic to go home
to fix lunch once a week.
Evaluate the situation:
Ask yourself realistically how much time I can designate to caregiving.
Understand that it is acceptable
to have mixed feelings: Your emotions should be mixed. For example,
allow yourself to feel angry that your family member is not appreciating
the care you are providing and, at the same time, may be feeling guilty
that you’re angry when your loved one is physically or mentally ill.
Understand that you cannot create
or cure illness: As much as we all would like to be capable
of controlling our loved ones pain, it is beyond our control. As a caregiver,
we can only make it more comfortable for our family member.
Talk about it: Do
not keep your emotions inside—develop a support system. Friends, relatives,
or support groups can be a tremendous benefit to you and your well-being.
Due to the increase in caregivers and the growth spurt of the aging population,
there are now caregiver support groups in most communities. Contact your
local Department of Aging for more information.
Be proactive: Plan
ahead, although it may be difficult to do so, it is important to be proactive
rather than reactive. Begin to discuss topics with your family that are
directly related with the care of a family member. For example, living
wills, healthcare proxies, and end-of-life decisions need to be figured
out.
Share the care: You
do not have to do everything on your own. It is okay to ask for help. There
are many caregiver services available to assist your family member in need.
For example, respite care provides temporary relief to caregivers on either
an hourly or daily basis. There are services that deliver nutritious meals
to your loved ones. There are home health aides available to assist with
the instrumental activities of daily living such as cooking or grocery
shopping. Contact you local Department of Aging for more information on
the resources available in your area.
Summary
There is no doubt about it—caregiving for a family member
is difficult and often impossible. The stress of taking care of loved one
can take a toll on you quickly. Each elder-care situation and circumstance
is unique. Most caregivers, however, experience similar symptoms of caregiver
burnout. It is important to take care of yourself during this time period.
Caregiver burnout can be minimized. If you are susceptible to high levels
of caregiver burnout, you will ultimately not be able to care for yourself
or your loved one.
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