Many of us find ourselves in situations where our loved ones need care. Often the loved one in need of care is elderly, but that is not always the case. We may also have a loved one who has recently had surgery, or a spouse who is having a challenging pregnancy, making it difficult for our loved ones to carry out the usual activities of daily living. Our first response, in many cases, is to take on the job of the caregiver ourselves. However, not only does taking on this role often fundamentally change the relationships we once had, but studies have shown that the physical and mental health of the caregiver can be significantly compromised, and a large strain is often placed on the finances of the caregiver.
A 2013 study using data from the US National Wealth and Wellness Survey (NHWS) determined that eight million workers were also family caregivers. The NHWS survey determined that these family caregivers had a significant burden on various aspects of their lives. From a health standpoint, the impacts were widespread. Some form of depression was reported by 53% of caregivers, as compared to 32% of non-caregivers. Moderately severe and severe depression was reported by greater than 16% of the caregiver group as compared to less than 6% of the non-caregiver group. The caregiver group reported insomnia much more frequently (46% vs. 37%) and had a significantly higher percentage of smokers in the group (26% vs. 19%).
Evidence suggests that negative psychological health effects vary across subgroups of caregivers, placing some caregivers at higher risk for negative effects than others. For example, women providing many hours of care weekly to a care recipient with challenging behavioral symptoms may be at particularly high risk. In an analysis of data from the prospective Nurses’ Health Study, women who provided 36+ hours of care per week to a disabled spouse were nearly 6 times more likely than non-caregivers to experience depressive or anxious symptoms.
The strain of caregiving has also been shown to have an impact on the careers and financial well-being of caregivers. In the same NHWS study, caregivers reported missing work twice as often as non-caregivers and also reported having a significantly higher productivity impairment (24% of caregivers vs. 14% of non-caregivers). Nearly 30% of caregivers reported that caring for a loved one has put them under financial strain. According to the 2015 American Time Use Survey, the opportunity cost of family caregiving may be as high as $522 billion annually.
The strain of family caregiving can also increase with time. A 2009 study by Jamila Bookwala found in a sample of adult caregiving daughters and sons that longer-term caregivers were significantly less happy in their marriages than those who recently assumed the caregiving role, suggesting that it takes time for negative impacts to manifest themselves. Further evidence of the long-term effects of caregiving were demonstrated in the Health and Retirement Study (HRS), a large representative sample of U.S. adults, which found that being a spousal caregiver independently predicted incident cardiovascular disease, with the impact being particularly dramatic for longer-term caregivers, who had twice the risk of short-term caregivers.
Caregiving has become more complex. Whereas families traditionally have provided emotional support and assisted their older members with household and self-care tasks, family caregivers now are expected to provide health and medical care at home, navigate complicated and fragmented health care issues, and serve in a surrogacy role. Family caregivers may not be properly prepared for this increased complexity. In the 2015 National Alliance for Caregiving and AARP Public Policy Institute survey, over half of caregivers of older adults age 50 and older with Alzheimer’s disease or dementia reported that they provide medical/nursing tasks without prior preparation.
Family caregivers need to do whatever possible to maintain their own health. This includes getting enough rest, maintaining a healthy diet, getting enough exercise, taking breaks, seeking preventive health care, joining a support group, and locating respite care when needed.
Lastly, family caregivers can consider seeking help from a home care agency, which can provide care for a loved one with a trained professional, while allowing family members to regain and strengthen their relationships.
