Caregiving Population & Stressors

The caregiving population is a growing population. This is due to an increasing older population and people with disabilities living longer. (CDC, n.d.) Caregiving responsibilities are always subject to change and can increase immediately due to the recipient's needs. An unpaid family member typically does caregiving although that is slowly changing. Many times, unpaid caregivers are the backbone of their homes providing significant care for the family member that is in need. According to the CDC, ninety-four percent of65 adults are caregivers ages 45- 65 years. Eighteen percent are above 65 years old. That means over 40 percent of adults are caregivers to someone in their family.

 I picked this population to develop a health program for because I watched my paternal aunt and my mother be caregivers to each of my grandmothers. This selfless act was so stressful that my aunt gained a massive amount of weight (she has since lost it) and my mother had a stroke caring for her mother. I also think about what it will look like for me as my parents age in the next 20 years by grace. I want to be in the best physical, mental, and spiritual position to help them and myself. I also want to be able to help my clients and those in my sphere of influence go through this challenging time. Several stressors come with taking care of the aging population or a loved one with a disability. These stressors should be considered before undertaking the task of being a part-time or full-time caregiver.

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Explained Stressors

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Isolation is one of the biggest stressors that a caregiver can have. Preoccupation with caring for a loved one can make an individual withdraw from activities in which they would normally participate. (Besch, 2020) They may feel like taking time away from their family member will be failing that family member in some way. They may also feel that they do not have the support that they need to step away and make time for themselves. This makes them particularly vulnerable if they do not have an outlet for all the stress that comes with the responsibility. Another stressor is getting enough rest for your own body. In one survey thirty-six percent of caregivers reported not getting enough sleep. (CDC, n.d.) This can lead to other chronic illnesses such as diabetes, a heart condition, and even a stroke, as my mother had. At the time my mother was getting three to four hours of sleep. Once she went down, I was the next man up to care for my grandmother. This was particularly hard for my grandmother who was suffering from the beginning stages of dementia. She was used to a routine, and that included my mother’s around-the-clock care.

When a caregiver gets sick that leads to another stressor, the recovery of their health. My mother was placed in a facility after her stroke so that she could learn to walk again and talk again. She stressed so much about the process of getting well. She wanted to make sure that my grandmother had the best care in her absence. This created a lot of anxiety for her until I convinced her with my actions that I would fully support my grandmother while she focused on getting back to 100 percent.

Another stressor that a caregiver may face is financial. Expenses can add up depending on the needs of the one receiving care. Food and shelter must be provided. They also may need prescriptions filled. They may need aftercare for surgeries and procedures. Or need personal incontinence items for their daily care. All those things add up. Mostly those costs come out of the pocket of the caregiver. Some programs provide aid, but they also have their limitations. The fiscal responsibility that comes with caretaking can be an additional stressor. (National Hospice and Palliative Care, n.d.)

Many caregivers are still working because they must support their family members and themselves. So, working a job/career in addition to being a caregiver can be another stressor. Sometimes you must take unexpected time off, and if you do not have a family-friendly career the stress of holding on to that job position can be overwhelming. While caring for my grandmother in her final stages, one job I had said if I left for the day they would give me an infraction. I stayed for the rest of the day, and it was the same day that my grandmother died. From that day I promised that I would never let any job scare or threaten me into not putting my family first. So, a job/career can be an additional stressor.

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Physically being a caregiver can be demanding. Depending on the level of service that you give to your loved one, physical pain can start to manifest after a while. In a 2015 study, researchers found that most of the caregivers were classified as “high burden” caregivers. They reported elevated levels of physical strain and musculoskeletal discomfort. (Darragh et al, 2015) Some even reported sustaining injuries while helping a loved one move from one place to another or while bathing them. (Darragh et al, 2015) Any injury can be a stressor, but it is particularly a stressor for caregivers because if they are injured it may be hard to find someone that would be willing to complete the daily tasks that they must complete.

Caregiving can also be an emotional stressor. One study examined the difference in emotional health between caregivers who had a choice and those who felt that they did not have a choice in picking up caregiving duties. Although both groups experienced emotional strain, caregivers who had no choice reported a more negative impact on their overall well-being. (Shin et al, 2023) In this research, more than half of the 1,642 caregivers (54.4%) believed that they had no choice in becoming a caregiver. Having no choice was associated with higher levels of physical strain and emotional stress and a greater negative impact on the caregiver’s overall health. (Shin et al, 2023)

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Transportation needs can also be a stressor. Many times, you must take a loved one to appointments. Sometimes transportation can be offered as a part of a medical or an insurance plan and sometimes it is not. It is up to the caregiver to make sure that the recipient is arriving at appointments so that they can continue to get the maintenance care that they need. Sometimes that is a doctor’s follow-up visit. Sometimes it may be for a major surgery or a minor procedure, either way, it can be stressful to get a loved one from place to place. Once you factor in traffic that adds another element of stress. The caregiver must consider the timeframe of the appointment and be prepared to leave early, if necessary, to combat congestion. My grandmother had lots of appointments before she passed, and when my dad fell ill this year, I found out firsthand that transportation programs are quick to say, “not qualified” (for discounted or free services) That leaves the burden of transportation on the caregiver.

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Another stressor is balancing family. The chances are as a caregiver life does not stop. You may still have other children, a spouse, and other household responsibilities that can cause additional stress. Taking care of one family member and pouring your time into that individual can even lead to feelings of guilt. (CDC, n.d.) If you take one moment away from them to maybe go to a family football game or support one of your children that can lead to feeling guilty. At the same time missing those events can also cause a caregiver to be riddled with guilt. So, finding a balance between them is also a stressor.

The last stressor, but there are plenty more, is keeping an accurate schedule and records. No one explains that becoming a caregiver means you instantly become a manager, a secretary, and a historian. You need to keep accurate records of your loved one’s history and maybe even your family history as well. You must make sure that all their appointments are scheduled. You must make tons of follow-up calls. The caregiver becomes the advocate and part of advocating effectively is keeping accurate records. That means the caregiver must be organized and have some sort of system to stay abreast. Systematically organizing post-hospital medical records can help caregivers keep their loved ones’ medical information orderly, up-to-date, and easily accessible when needed. (Caregiving.com, 2023)

Stressor Importance

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All these stressors are important because they can lead to more serious health problems. If the stressors are left unmanaged it could lead to chronic stress. Chronic stress can lead to diseases such as hypertension, stroke, and even death. These stressors can also lead to caregiver burnout. Caregiver burnout can show up in diverse ways. This can manifest in irritability, lack of control, and even putting off one’s important healthcare appointments. (Cleveland Clinic, n.d.) Further, if stressors are left unmanaged, they can also lead to emotional distress, which includes depression and anxiety. This can reduce the caregiver's quality of life and overall well-being. (Cleveland Clinic, n.d.)

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Program Descriptions/Recommendations

When you have a client that is a caregiver all programs must be considerate of their time. For that reason, I recommend guided mindfulness meditation, massage therapy, and journaling. I picked guided mindfulness meditation because there are numerous ways to practice this. One can be early in the morning when the home is quiet. Or one can take a walk listening to a guided walking mindfulness meditation. This can be done in as little as 5 minutes up to 30 minutes. For a beginner, I would recommend 5 to 15 minutes. Mindfulness is known to reduce stress and combat chronic diseases. (Stahl& Goldstein, 2019) I chose massage therapy because caregivers are accustomed to doing things for others and not for themselves. I recommend a scheduled massage twice a month even if it is for 30 minutes. This should be a standing appointment. Massage Therapy is now an acceptable form of healing therapy. (Seaward, 2018) The recent focus of massage therapy has been on the use of warm stones (stone therapy) to heat muscle tissue to relieve soreness, stiffness, and pain. Any use of touch has been shown to relieve stress. (Seaward, 2018) Lastly, I chose journaling because that is a form of stress relief that can be done right before sleeping. The caregiver has an outlet to release pinned-up emotions and to de-stress. Journaling, in its way, is a vehicle for meditation. It is a technique to clear the mind of thoughts, it can also have a calming effect as thoughts and feelings are transferred from the mind onto a page. (Seaward, 2018)

 

Program Implementation

This should be implemented right away. The walking or sitting meditation is recommended to be done in the early morning hours when it is relatively quiet. Preferably before everyone is awake. I recommend 10 to 15 minutes either by using an app such as Calm or finding different mindfulness meditations on YouTube. The caregiver can walk around the house or sit in a quiet place and focus on the moment. This should be done daily as much as possible. A massage should be worked into the schedule at least twice a month. I recommend either a Saturday or Sunday while asking a trusted family member to take your place for about an hour. They will need to pay for the massage sessions which cost $50 to $120, home visits may be more. (Seaward, 2018) As a caregiver, one must practice self-care as it will be easy to burn out. Lastly, at the end of each night, I recommend journaling for at least 10 minutes. Set the alarm clock and just write. I would remind the client to date and time the entry. This can be useful when looking back. It can also add more gratitude once you have seen how well you have served your loved one.

Program Obstacles

Program obstacles include making time. The caregiver must be intentional about carving out self-care time and focusing on where they are in the present. There may be an urge to abandon the program because a caregiver is used to serving others and pushing their need to the back. However, if the caregiver is not healthy, they are not an immense help to the person receiving care. I have seen those receiving care outlive their caregivers and receive professional caregiving services for the remainder of their lives. So being well is especially important. You must stick to your wellness routine. And if you can add additional physical activities such as mindfulness walking, it will benefit the health of the mind and the body. Whenever my client feels like quitting, I would remind them of their why. They must be healthy so that the loved one can get the best version of them.

Health Professionals

I recommend a caregiver have a close relationship with their primary care provider. They need to monitor their health constantly also. This can either be done with a traditional primary care provider or one who practices naturopathic medicine, either way, the relationship must stay current. Second, I would make sure that the massage therapist is a certified massage therapist. Massage therapy is also considered an acceptable form of healing. (Seaward, 2018)

Program Measurements

To know if this implementation is successful caregivers should be followed for 24 months. That way their health numbers can be monitored, and we can see if the prescribed program is working. Those who participate will share how their lives have improved or not and if they were able to consistently stick to the plan. The need for caregivers is expected to continue to grow with increases in the US older adult population. Currently, there are seven potential family caregivers per older adult. By 2030, it is estimated there will be only four potential family caregivers per older adult. (CDC, n.d.) The need for caregiving is not expected to go away as the aging population increases, but the number of family members who can render these services is projected to decrease. That means less help within the family. This makes it even more important to stay mentally, spiritually, and physically healthy.

Summary

Caregiving is not an easy task. Though it may be honorable to take care of and serve the one you love, it can be taxing on the body. Since caregiving is a trend that is expected to increase, there must be programs in place to reduce stress. Chronic stress from caregiving can have long-term effects. It can lead to chronic diseases and if left untreated can lead to death. It is important to know that there are several stress management programs that individuals can participate in, from yoga to just walking consistently. These actions can be done to maintain health. I recommended guided meditation, journaling, and massage. All of these are relatively easy to start. But sticking to the program is key. Caregivers need to know that there is a way to care for their loved ones successfully. And that starts with the caregivers taking care of themselves.