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Caregiver Health Issues

February 9, 2015

Caregivers are a critical national health care resource. Families often are a primary source of home care and support for older relatives, contributing services that would cost hundreds of billions of dollars annually if they had to be purchased. Nurses’ role in home health care has expanded from being primary caregivers to teaching and assisting family members to provide care. Similarly, social workers now play a critical role in providing advice and support to caregivers.

Although relatively few studies have focused on the association between caregiving and health habits, researchers have found evidence of impaired health behaviors, such as neglecting their own health care appointments and eating a poor-quality diet, among caregivers who provide assistance with basic activities of daily living (ADLs) like toileting and eating.

According to the National Institutes of Health (NIH), evidence on the health effects of caregiving gathered over the last two decades has helped convince policymakers that caregiving is a major public health issue. Professional advocacy group, including nurses and social workers, have been instrumental in raising awareness about this issue. In fact, caregiving has all the features of a chronic stress experience: It creates physical and psychological strain over extended periods of time, is accompanied by high levels of unpredictability and uncontrollability, has the capacity to create secondary stress in multiple life domains such as work and family relationships, and frequently requires high levels of vigilance. Caregiving fits the formula for chronic stress so well that it is used as a model for studying the health effects of chronic stress.

It appears that certain aspects of particular caregiving are more detrimental to the caregiver than others. For example, greater degrees of depression and stress and low ratings of subjective well-being in caregivers are consistently associated with the care recipient’s behavior problems, cognitive impairment, functional disabilities, duration and amount of care provided, the caregiver’s age, with older caregivers being more affected, the relationship between caregiver and care recipient, with a spousal relationship having a greater effect and the caregiver’s gender, with females being more affected. As is the case with physical health effects, caregiving for someone with dementia is associated with higher levels of distress and depression than caring for someone who doesn’t have dementia.

Research clearly shows that the intensity of caregiving, whether it is measured by the type or the quantity of assistance provided, is associated with the magnitude of health effects. We also need a better understanding of the different types of caregiving experiences and their effects on health. Providing help that fails to enhance the quality of the patients life may lead to frustration, resignation, and negative health effects for the caregiver. It is important that the caregiver is aware of the potential health hazards and can get support before serious health concerns arise.

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