Caregiver Stress Has Many Faces

Who Are The Caregivers?

At present, approximately 18% of the U.S. adult population or 43.5 million people will spend an average of 20 hours a week being a caregiver (National Alliance for Caregiving and AARP Public Policy Institute, 2015). A caregiver is defined as someone who provides unpaid care to an adult or child with a chronic illness or disability.  Caregivers are diverse: they come from every age, gender, socioeconomic, and racial/ethnic group.

Adult children often attend to their elderly parents with health problems or age-related disabilities while raising their own children. According to AARP (2001), 44% of adult child caregivers aged 45-55 are “sandwiched.” Sandwich caregivers are squeezed between two exhausting caregiving situations. In addition, many grandparents assume the role of “parent” or primary caregiver for their grandchildren due to circumstances related to the biological parents.

No Choices, No Preparation, Lots of Stress

Most caregivers are ill prepared to manage the overwhelming responsibilities and have very little experience or training. Many have no choice in taking on this role and the strain and compromised health is often minimized and/or overlooked by the care recipient, family members and health care professionals. The caregiving role is often regarded as an unrelenting chronic stressor and over time, may lead to diminished immune function, poor physical health, symptoms of depression and anxiety and a diminished quality of life. Caregiving takes time away from usual support sources resulting in caregivers feeling isolated.

Caregivers Have Needs, Too

The day-to-day responsibilities of a caregiver can take an emotional, physical, financial and intellectual toll and the cumulative burden of caregiving can be emotionally and physically exhausting. Caregiving often elicits various emotional reactions. The most common emotions experienced are guilt, anger and ambivalence. Anger can be experienced when the caregiver feels displeasure about undertaking the caregiver role and the responsibilities that go with it. Guilt has two components; it can be experienced as a relief that the caregiver does not have the diagnosed illness and/or it can be experienced when the caregiver feels resentful about the caregiving role. Feelings of ambivalence can surface when the relationship between the caregiver and care recipient are strained; for example, feeling obligated to provide care because of the relationship commitment but feeling resentful due to difficulties in the relationship.

Helpful Interventions

There are various effective interventions for caregivers to enhance knowledge, coping, and physical health, as well as to reduce caregiver burden, distress, anxiety and depression. Caregivers appear to benefit most from an intervention that either frees up their time or provides them with emotional support. Support services may include information, assistance, respite care, home modifications or assistive devices, caregiver and family counseling, and support groups. While many services are available through local government agencies, service organizations, or faith-based organizations, mental health providers can also play a pivotal role in alleviating the negative impact of the caregiver role.

Mary Rzeszut, LCSW, has an MSW from Fordham University. She is a nephrology social worker working in the department of kidney diseases at North Shore/LIJ where she provides support and counseling to those diagnosed with advanced stage kidney disease.  Ms. Rzeszut is a trained bereavement counselor and a social work faculty field liaison for Adelphi University. Her work has been published in the Journal of Nephrology Social Work.
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