The late First Lady Rosalynn Carter had a famous quote: “There are only four kinds of people in the world — those that have been caregivers, those that are caregivers, those who will be caregivers, and those who will need caregivers.” Given that this affects so many of us, I asked a psychologist friend of mine, Barbara Shaffer, to provide some of her expertise on staying healthy as a caregiver for a family member. This is part one of three articles on the topic that she so graciously provided.
Because of the vicissitudes of health insurance, personal finances and other variables, in-home, unpaid caregiving poses major challenges to millions of people. 75% of caregivers for an adult over the age of 50 are women. With an average age of 65, they can spend almost as many hours a week providing care as in a full-time job. Many younger caregivers are also employed and raising their children. Both men and women provide an equal amount of care if they are age 75 and above and caring for a spouse. The average age of care recipients is around 70, and they too struggle with many challenges.
The Caregiver Role Has A Lot Of Responsibility
Responsibilities that fall on the shoulders of the caregiver range from grocery shopping and laundry to being an advocate with providers, government agencies, community services and insurance companies; from feeding, bathing, dressing, and giving toileting assistance to the care recipient to performing medical and nursing tasks while feeling decidedly untrained and inadequate; from providing emotional support to engaging in prolonged, frustrating telephone calls about billing, benefits, and payment issues – or waiting on hold forever.
Caregiving Can Be Exhausting – Physically and Mentally
Clearly, not everyone is by nature and/or experience able to carry out such diverse tasks with ease and accuracy. Given the many responsibilities and the always-on-call nature that can be part of caregiving, it’s no surprise that exhaustion, a weakened immune system, frustration, depression and/or anxiety can develop. Around 70% of caregivers show signs of clinical depression, and many are taking medication for depression and anxiety.
Factors that tend to be related to the degree of impact on the caregiver are the caregiver’s age, health status, and gender; the duration of the caregiving; the degree of stress; the presence of positive social relationships. Good health and positive social relationships seem to be the most important mediating variables.
Family Caregivers Also Deal With Emotional Connections
In addition to the burden of responsibilities, there is the weight of losses and regrets felt by the caregiver. Losses can include freedom and privacy if the caregiver and recipient need to live together. Self-confidence can be dealt a stunning blow with criticism and untrue accusations of theft and immorality. Other losses are personal control, a full sense of self, income, and perhaps a dream. Of course, one of the most profound losses can be the death of the recipient of the care. Additionally, regrets tend to haunt and to keep alive incidents of impatience, unkind words, exhaustion.
Around 30% of caregivers die before the person they are caring for. Nonfatal illnesses like depression and autoimmune diseases are pervasive. Moreover, elderly caregivers have a 63% higher risk of dying than non-caregivers in the same age group.
Ways To Recharge The Caregiver
Obviously, such an emotional and physical toll will bankrupt the caregiver unless efforts are made to replenish resources. Resources can be restored and preserved through several kinds of self-care. Self-care is not selfish, not a luxury; it’s a necessity! A familiar parallel from commercial flying would be the necessity of putting on one’s oxygen mask first in an emergency in order to be able to assist others.
In order to replenish resources, the following suggestions are offered:
- Be sure to keep all annual physical and dental appointments and have a thorough physical. Stress depletes serotonin, which can lead to depression. Antidepressants restore serotonin and can treat anxiety as well.
- Eat healthily and keep hydrated. (not with alcohol!)
- Take time outside daily, even 10 minutes in the morning and 10 in the afternoon. Research has shown that time spent in nature is an antidote to stress and lowers blood pressure and stress hormone levels, reduces anxiety, and improves mood. Focus on your surroundings. And stay off your phone!
- Journaling helps to put feelings into words so they don’t just swirl around in your mind. Consult with a therapist; telehealth makes that easier now.
- Keep a gratitude journal and record three things each day that you can be grateful for. Research has shown that gratitude increases happiness.
- Restore parts of your life: resurrect an old hobby, read your favorite genre, listen to your favorite music, watch reruns of your favorite shows.
- Develop and use respite care options: adult daycare; in-home care; short term nursing home care. For yourself, ask to use someone’s beach house or house while they’re away. That’s budget friendly!
- Meditate/pray. Seek the help and support of a faith community and/or clergy.
- Pursue humor and laughter. Jeanne Robertson’s YouTube channel hilariously demonstrates how to find humor in everyday events.
- Keep in touch with positive family and friends. Technology can facilitate that.
While caregiving can be rewarding, it can also take a heavy emotional toll and affect the mind, body and spirit in harmful ways. Selfcare is a powerful frontline antidote.
Barbara W. Shaffer, PhD, is a licensed psychologist in private practice in Pennsylvania. She has more than 40 years of experience and has helped many many people manage stress in their lives, including many caregivers.
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