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Intensive Caring: Can Caregivers Give Too Much?

By Cheryl Deep
Institute of Gerontology
Wayne State University

REVERSING RESEARCH ATTITUDES

Considerable research has been done to determine the effects of caregiving on caregivers. Unfortunately, most of it has centered on the negative. Caregivers feel stress. Caregivers suffer health consequences. Caregivers battle depression. Yes, caregiving can increase stress levels, which impede physical and emotional health, but this is not the full story.

Caregiving has a bright side that researchers have largely ignored. Caring for a person you love validates the relationship and nurtures both the caregiver and the receiver. It is satisfying and joyful when the person you are helping responds to your voice and touch or when you both connect with laughter and purpose. This side of caregiving – with its many dynamics -- has received little research attention. The Institute of Gerontology at Wayne State wants to reverse the negative perceptions of caregiving and encourage research investigations that analyze and elucidate the role’s positive effects. Until then, we dig deeply into several recent research studies in an attempt to unearth the good news.

WHAT’S GOOD ABOUT CAREGIVING?

A few current research studies have noted the importance of the caregiver’s attitude in determining his or her overall feelings toward the caregiving process, noting that other factors also play a role. The initial physical health of the caregiver, other responsibilities in the caregiver’s life, social connections and personality type all contribute to or detract from the caregiver’s well-being. By evaluating caregivers prior to or at the onset of their new role, research suggests that it is possible to provide tailored interventions and supports to encourage a positive, healthier caregiving experience.

STRESS AND HEALTH CONCERNS

A recent study by the American Society on Aging found that the average age of caregivers in this country was 57. One quarter of these caregivers are older than 57. The majority are adults caring for parents, with the remainder primarily being spouses. This is a population vulnerable to health concerns themselves and many prominent studies have examined the impact of this role.

As would be expected, stress levels were measured at consistently higher levels in caregivers than in non-caregivers. In one very specific study, the levels of the stress hormone cortisol were 23% higher than average, and antibody response was 15% lower, making caregivers vulnerable to an array of health issues and illness. What researchers found relevant, however, in determining the long-term health effects on caregivers, was the initial health of the caregiver. Caregivers who began the process in good health maintained that good health (age-adjusted) over the 5-year period studied.

For those with initial health problems, male caregivers experienced the most extreme health decline. Men generally resist preventive medical care and ignore symptoms leading researchers to conclude that it was primarily self-neglect that made male caregivers more prone to health problems. Female caregivers with health problems are more likely to seek prompt medical care, so they showed a less exaggerated decline. Multiple studies concluded that preventive care and prompt medical attention for caregivers would diminish or eliminate the negative health effects caregivers suffer.

ATTITUDE IS EVERYTHING

Emotional health is also vulnerable in caregivers but these problems may also be preventable. One study showed depression levels to be 200% higher in caregivers than in the non-caregivers. Emotional health encompasses several variables, however, including physical health, initial emotional health and, most importantly, how the caregiving is perceived (burden vs. joy, duty vs. choice, etc.). Caregivers who perceive their role as positive and necessary enjoy good emotional health unless their care receiver is moved into an institution and out of their personal care. Then depression increases. This inverse relationship is the basis for the conclusion that a positive attitude toward caregiving prevents an increase in depression or the onset of poor emotional health.

The caregiver’s personality and social support are closely associated with their physical and emotional health. Optimistic caregivers tend to be in better health and to have greater social support networks than those with a negative view of the world. Social support networks are key to maintaining one’s role as caregiver. Caregivers with strong social support networks report lower levels of stress and lower levels of depression – both contributors to physical health problems. Researchers in one study concluded that, by engaging caregivers in therapies and activities that encourage optimism, and by connecting caregivers to social support networks, they are likely to fare far better in their role.

THE BALANCING ACT

One of the primary challenges for caregivers is balancing other roles and responsibilities with the added obligations of their new role. The U.S. Census Bureau reports that 15% of all women age 15 to 64 assume the roles of mother, wife, employee and caregiver simultaneously. This number will increase as baby boomers age and the age of the population becomes more stratified. Consistent with other stress level studies, when stress levels are perceived as high in other roles, the role of caregiver is also perceived as stressful. The opposite is true as well. Feeling highly rewarded (independent of income) in the role of mother or wife will diminish the stress levels of caregiving, increase overall emotional and physical health and raise the level of self-reported life satisfaction. It is not always possible to provide support for caregivers in each of their roles, but fostering a positive attitude in any one role will impact the others.

For additional resources about caregiving and other aging issues, please visit the Institute of Gerontology’s website at: iog.wayne.edu.

Of Special Interest:   HAP's Health Track   Healthy Living   iStrive for better health
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