Caregiver Stress

Caregiving’s Physical and Mental Impact on Family Caregivers

• Elderly spousal caregivers have a 63% higher mortality rate than noncaregivers of the same age(aged 66-96).¹
• 33% of Caregivers are themselves in poor health.^2,3 They experience increased blood pressure, higher insulin levels⁴, impaired immune systems⁵, and are at increased risk for cardiovascular disease.⁶
• 20%-50% experience depression, particularly when providing dementia care.^7,8

The Golden Rule for Family Caregivers: Treat Yourself as You Would Treat Others.

• Take care of yourself physically.
• Take a break. Get assistance from a home care agency, family, or others. Even a few hours of respite care a week can provide great benefits.
• Seek out support organizations for knowledge and moral support.
• Frequently assess your stress level and take steps to manage your stress.

Caregiver Stress

Caregiving can be as difficult to provide as it is rewarding. The struggle to balance caregiving with other responsibilities and the emotional and physical strain of caregiving can easily lead to stress. Caring for a loved one living with Alzheimer’s or another form of dementia may add to stress because the care recipient no longer knows who you are. Caregiving for someone with behavior problems, like hitting, wandering, or yelling, may add to frustrations and increase your stress levels. Other feelings can also lead to stress like anger, feeling guilty, depression, or feeling isolated from friends and social events. Although stress may be a constant part of caregiving, it is important to know how to relieve daily stress to avoid caregiver burnout and health problems.

Know the Signs of Caregiver Stress

• Eating problems (eating too much or not enough)
• Loss of interest in activities you used to enjoy
• Visiting with friends and family less than you used to
• Feeling guilty due to thoughts that you should be a better provider
• Experiencing frequent bodily pain such as headaches, neck and back pain
• Feeling anger or irritation toward the care recipient or others
• Crying unusually often
• Sleeping problems
• Experiencing mood swings
• Unusual weight gain or loss
• Experiencing low energy levels more often
• Experiencing worry or anxiety constantly
• Feeling that you don’t have any time for yourself
• Abusing alcohol or drugs (including prescription drugs)

Understand Caregiver Stress Affects Your Health

• elder spousal caregivers have a 63% higher mortality rate than elder spousal non-caregivers
• have weaker immune systems
• are more likely to have symptoms of anxiety and depression
• have slower wound healing
• have higher levels of obesity
• are more likely to have long‑term medical problems such as heart disease, cancer, diabetes, or arthritis
• may be at higher risk for mental decline, including problems with memory and paying attention

Manage Caregiver Stress

The first step in managing caregiver stress is to not pass it off as “just stress”. You now know that “just stress” can include the risk of health debilitating effects that are too serious to pass off. Reducing your daily stress will also reduce those risks to your health and can even give you the energy boosts you need to successfully get through the day. The following recommendations for managing caregiver stress can have a significant effect on your health and happiness:

Breathe

Believe it or not, the breath controls the way we think and feel. Unfortunately, many of us have forgotten how to breathe correctly as we’ve grown out of childhood. Yes, there is a correct way to breath ‑ slow, deep breaths in and out. Taking slower, deeper breaths will slow your heart rate, reducing blood pressure levels, and slows your thought process down so you can increase concentration levels. Try associating the practice of deep breathing with something repetitive in your life. For example, if you are a clock watcher, stick a post‑it on the face of the clock to remind you to take slow breath in and out. Make it a habit to breath slow and deeply 20 to 40 times a day, and feel your stress melt away.

Exercise

Finding the time to exercise is the first battle, but with some “outside‑the‑box” thinking, you can easily get 30 minutes of exercise in a day. For example, if you go up and down stairs throughout the day, make a few extra trips up and down; if you find yourself in a chair most of the day, learn some chair exercises; go for walks in the community; park in the back of parking lots and walk; turn housekeeping into workout sessions; be active while watching TV: stretch, use hand weights, ride a stationary bike; make exercising a social event: invite friends and family to workout with you and share motivational support. You can find a way to exercise more. Yes, you can.

Eat Right

You’re probably tired of hearing this, especially when you think you don’t have time to eat healthy. But the advise is as true today as it was when it was first suggested. Pack healthy snacks that include fruit and vegetables and nibble on them on the go. Reduce the amount of sugars in your diet to avoid mood swings and energy crashes. Drink more water to cleanse your system of harmful toxins. The Internet provides an abundance of healthy recipe ideas ‑ take the ingredience list to the grocery store to help plan and stock up for your weekly meals. Remember, it is never too late to start eating right!

Don’t Smoke

We all know the reasons why! Chew gum or suck on a straw when you get the familiar oral fixation. Know you’re not alone. Get the support you need to help you fight cravings.

Cut Back on Caffeine

Recent research has found links between stress and caffeine intake. Caffeine is a drug. Just like other drugs, caffeine can interfere with the chemistry of your body, especially your central nervous system which can exacerbates stress responses. Caffeine disrupts sleep patterns, produces moodiness and increases anxiety. People who kick the caffeine habit are more likely to maintain energy levels longer than those who require multiple caffeine drinks through the day. When cutting back be prepared to experience withdrawal symptoms such as headaches, constipation, shakiness, and bouts of hot and cold flashes. These symptoms are a sign of detoxification and are temporary and worth going through to reduce daily stress.

Simplify and Learn to Say “No”

Take a good look at your daily activities and eliminate those that are unnecessary. For example, let the dirty dishes at home pile up tonight so you can enjoy a fun activity with friends; don’t worry, your dishes won’t miss you. Learn your limitations and say “no” when you see that you may be taking on more than you can handle. It is okay and healthy to say”no” in both your professional and personal life.

Express Yourself

Get stress off your chest. Call a friend and share your frustrations. Write in a journal regularly to let off steam and brainstorm constructive ways of dealing with tough situations. Talk to a councilor. Not voicing your feelings can lead to feelings of resentment and hostility toward those around you.

Even the most difficult situations reveal opportunities and lessons. Look for the upside in down times. If your own poor choices contributed to a stressful situation, reflect on them and learn from your mistakes. Thinking positively will keep you from dwelling on the negative and help you overcome fears and frustrations.

Managing stress is all about taking charge: taking charge of your thoughts, your emotions, your schedule, your environment, and the way you deal with problems. The ultimate goal is a balanced life, with time for work, relationships, relaxation, and fun ‑ plus the resilience to hold up under pressure and meet challenges head on.

1. Schulz, R. and S. R. Beach, Caregiving as a Risk Factor for Mortality: The Caregiver Health Effects Study, JAMA 282 (1999): 2215-2219.
2. Health and Human Services. Informal Caregiving: Compassion in Action. Washington, DC: Department of Health and Human Services. Based on data from the National Survey of Families and Households (NSFH), 1998.
3. Navaie-Waliser, M., P.H. Feldman, D.A. Gould, C.L. Levine, A.N. Kuerbis, and K. Donelan. 2002. When the Caregiver Needs Care: The Plight of Vulnerable Caregivers. American Journal of Public Health 92:409-413.
4. Jones, I. Kawachi, G.A. Colditz, L. Berkman and E. Rimm. 2002. Reverberation of Family Illness: A Longitudinal Assessment of Informal Caregiver and Mental Health Status in the Nurses’ Health Study. American Journal of Public Health 92:305-1311.
5. Kiecolt Glaser, Ja., and R. Glaser. Chronic Stress and Age-Related Increases in the Proinflammatory Cytokine IL-6. In proceedings of the National Academy of Sciences, 2003.
6. Lee, S, G.A. Colditz, L. Berkman, and I. Kawachi. 2003. Caregiving and Risk of Coronary Heart Disease in U.S. Women: A Prospective Study. American Journal of Preventive Medicine 24: 113-119.
7. Schulz, R., A.T. O-Brien, J. Bookwals and K. Fleissner. 1995. Psychiatric and Physical Morbidity Effects of Dementia Caregiving: Prevalance, Correlates, and Causes. The Gerontologist 35:771-791.
8. Cohen, D., D. Luchins, C. Eisdorfer, G. Paveza, J. Ashford, P. Gorelick, R. Hirschman, S. Freels, P. Levy, T. Semia and H. Shaw. 1990. Caring for Relatives with Alzheimer’s Disease: The Mental Health Risks to Spouses, Adult Children, and other Family Caregivers, Behavior, Health and Aging 1:171-182.