Caregiver Stress Overview

FACTS

  • Stress is helpful and important. In the short term, it can alert a person that something is potentially threatening which prompts a reaction to prevent a negative outcome.
  • Chronic, long-term stress can be emotionally draining and have negative health effects.
  • Caregiver stress is very common.
  • It is imperative that caregivers acknowledge and learn to manage the stress that comes with helping someone diagnosed with a memory or mood disorder.

REASONS TO ADDRESS CAREGIVER STRESS

Physical and mental health

  • Research shows that up to 75% of caregivers report that they do not go to the doctor as often as they should.
  • The risk of depression, anxiety, and chronic conditions in caregivers (including heart disease, cancer, diabetes, and arthritis) is nearly twice the rate seen in people without caregiving responsibilities.
  • Caregivers have 23% higher levels of stress hormones and 15% lower level of antibody response, which has been shown to lead to slower wound healing and a weakened immune system.
  • Elderly spousal caregivers (aged 66-96) have a 63% higher mortality rate than people without caregiving responsibilities.

Developing a deeper sense of connection with others

  • This journey can allow for beautiful and meaningful interactions and moments of joy despite the hardships and challenges that can occur. When caregivers are highly stressed or burned out, these special moments go unnoticed because of physical and emotional exhaustion.

Improving life at home

  • It is easy for the stress from the day to affect the atmosphere in the home. The person with a memory disorder senses the tension which may result in increased anxiety or agitation.
  • Being aware of the potential to unintentionally increase stress at home provides an opportunity to evaluate stressors encountered outside the home and develop strategies to reduce them.

STRESS ASSESSMENT

  • Identify caregiver stress, burnout, and compassion fatigue by checking off symptoms from the lists below. The more items that are selected, the greater the stress.

Stress

    • Overwhelmed or constantly worried
    • Tired most of the time
    • Feeling sad
    • Sleeping too much or too little
    • Gaining or losing weight
    • Easily irritated or angered
    • Frequent headaches, body pain, or other physical symptoms
    • Overusing or abusing alcohol or medications

Burnout

    • Withdrawal from friends and family
    • Feeling despair, hopeless, or helpless
    • Emotional and physical exhaustion
    • Getting sick more often
    • Feelings of wanting to hurt self or another person

Compassion fatigue

  • This results from caregiving work being performed on a regular basis and can be seen in health care professionals in the military or emergency room setting, or in long-term caregivers.
    • Inability to understand or share the feelings of someone else
    • Excessive blaming
    • Bottled up emotions
    • Substance abuse
    • Compulsive behaviors such as overspending, overeating, gambling, or sexual addiction
    • Lack of self-care, including poor hygiene or inattention to appearance
    • Recurring nightmares or flashbacks to traumatic events
    • Difficulty concentrating
    • Denial

SOURCES OF STRESS

Dynamics of relationships

  • Role changes occur over time when a person has a memory or movement disorder.
  • Because of the disease, the person does not function at the previous level or engage with others in the same way.
  • Past experiences affect a person’s readiness to accept the diagnosis and take on the role of caregiver.

Anticipatory grief

  • This commonly experienced grief response stems from feeling that the caregiver is losing someone while the person is still alive.
  • The “golden years” may no longer look like what was envisioned.
  • The loss of easily accomplishing errands and tasks, traveling, and socializing with family and friends may bring feelings of anger, sadness, and loneliness.
  • Grief may occur without the person realizing it and surfaces as physical and emotional symptoms. Five stages of grief that may be experienced at any time and in any order are denial, anger, bargaining, depression, and finally, acceptance.
  • Dealing with anticipatory grief, often with the help of a therapist or counselor, can help someone reach a level of acceptance with reduced stress while meeting new challenges.

Day-to-day tasks

  • Everyday responsibilities can become overwhelming.
  • Physical and cognitive limitations create the need for the caregiver to learn or take over dayto-day tasks such as paying taxes, yardwork, or managing finances.
  • Many caregivers are older and may have health issues that add to the challenges of managing day-to-day responsibilities.
  • Repetitive questions or difficulty communicating can add to frustration and exhaustion when trying to accomplish tasks.

Expectations

  • There is an intersection where the expectations of someone’s abilities are different from reality. The larger this difference, the higher the stress.
  • Realigning expectations with reality can lead to reduced stress and improved relationships.

Strategies