Stress and the Family Caregiver
Marla’s elderly parents lived in a condominium within 20 minutes of her house. This living arrangement worked well until her father was diagnosed with Alzheimer’s disease. During the course of the ensuing six years, his condition gradually deteriorated, resulting in severe strain on Marla’s mother, who suffered from Type 2 diabetes. A year ago, Marla’s mother died of cardiovascular disease. Having no living siblings, the responsibility of caring for her father fell solely on Marla’s shoulders. Because she had an extra room in her ground-level apartment, Marla moved her father in with her to provide day-to-day care. As his dementia worsened, Marla became anxious and depressed. Her physical health worsened, as well, particularly when she repeatedly failed to take the medication her doctor had prescribed for high blood pressure.
Although caring for an elderly loved one who is frail and dependent has positive outcomes, the “costs” involved can be more than financial. As illustrated in the vignette above, caregiving can also affect mental and physical health in various and significant ways.
One four-year study reported that women who care for an ill or disabled spouse were six times more likely to report feeling depressed or anxious when compared to those who had no caregiving responsibilities. But it is not only spousal care that can have this impact. The same study found that women who care for elderly parents were twice as likely as non-caregivers to experience depression and anxiety.
Studies of the impact of caregiving on mental health report that the amount of weekly care given is a key predictor of mental health. One study, for example, found that women who provided 36 or more hours of care per week to a spouse had a higher risk of experiencing depression.
While common, depression is not the only symptom of challenges to mental health of caregivers, particularly female caregivers. When compared to non-caregivers, female caregivers also experience more hostility, higher levels of stress, lower levels of personal mastery, less self-acceptance, and less happiness.
Often accompanying challenges to mental health are physical ailments, such as elevated blood pressure. Although not necessarily a result of caregiving per se, one study found that more than 33 percent of caregivers provide continuing care to others (mostly family members) while suffering themselves from poor health. When asked directly about the impact of caregiving on health, one study reported that 25 percent of the caregivers surveyed reported that caregiving activities and responsibilities have adversely affected their physical health.
Key findings from several studies regarding caregiving and physical health include the following. Compared to non-caregivers, those who care for an elderly loved one:
Are twice as likely NOT to seek and receive needed medical care.
Are at increased risk of hypertension.
Have poorer immune functioning.
Do not take advantage of preventative health services (often due to lack of information and high out-of-pocket expenses).
Have twice the risk of experiencing coronary heart disease (CHD).
Are twice as likely not to fill a prescription.
Gallant, M. P., & Connell, C. M. (1998). “The stress process among dementia spouse caregivers: Are caregivers at risk for negative health behavior change?” Research on Aging, 20(3), 267–297.
Lee, S. L., Colditz, G. A., Berkman, L. F., & Kawachi, I. (2003). “Caregiving and risk of coronary heart disease in U.S. women: A prospective study.” American Journal of Preventive Medicine, 24(2), 113–119.
Marks, N. Lambert, J. D., & Choi, H. (2002). “Transitions to caregiving, gender, and psychological well-being: A prospective U.S. national study.” Journal of Marriage and Family, 64, 657–667.
Older Women’s League. “Women and long-term care.” Retrieved October 13, 2009 from www.owl-national.org/Policy_Issues.html
Press Release (2002, August). “Reverberations of family illness: A longitudinal assessment of informal caregiving and mental health status in the nurses’ health study.” American Journal of Public Health.
U.S. Administration on Aging. (2000). “Older Women” (Fact Sheet). Retrieved October 13, 2009 from www.aoa.gov/naic/may2000/factsheets/olderwomen.html
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