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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