Study suggests that 2 in 5 caregivers suffer from depression

When thinking about caring and home health care, naturally we most often focus on the needs of the client: Are they receiving the medical and social support that they need? Is their health and well-being being managed effectively? Are they able to live the kind of life they want?

These are all important questions which deserve serious consideration. But there is one aspect of caring that can sometimes be overlooked, and that is the psychological pressures placed on caregivers. Caring is a demanding job, not only in terms of the long hours which it can require, but also in terms of the psychological burden of managing another person's health and well-being. This is especially true when the client is a family member or close friend, and the caregiver must deal with the declining health of a person who is dear to them in addition to the stresses of the job.

Today we're going to talk about the mental health of caregivers and some of the psychological issues that they can face.

Depression and anxiety among caregivers

One of the biggest mental health issues affecting caregivers is depression. Research has found varying levels of depression among caregivers depending on how it is assessed, but most studies have shown higher levels of depression among caregivers than in the general population. For example, a study from 2004 of caregivers for people with dementia found that over 2 in 5 caregivers were depressed (43%)1, while another study found that this problem was particularly prevalent among young caregivers2.

Some of the reasons given for this high level of depression include caregivers not having anyone that they can confide it about their problems, practical difficulties that arise from living with someone with dementia, and being exposed to depression in the person with dementia.

When a caregiver feels isolated and like they have no one to turn to for advice or support, they are more likely to be affected by depression – especially if the person that they are caring for is also depressed. Levels of depression are also higher among female caregivers than male caregivers3, possibly due to the lack of acknowledgment that women receive for their caring duties. When the attitude in society is that women are naturally nurturing and therefore it is their duty to care for children or the elderly, the work that they do and the difficulties this work creates for them is undermined and they are more likely to feel undervalued and unappreciated4.

Another common mental health issue among caregivers is anxiety, which affects about a quarter of caregivers for people with dementia5. This tends to arise from feelings of worry and fear that caregivers have both for the client they are caring for and for themselves. It is also true that depression and anxiety are linked, so people who are depressed are more likely to be anxious as well. Higher levels of anxiety were found in caregivers who had physical health issues themselves, who lived with their clients, and who had a worse relationship with their client5. When a caregiver feels that they have a difficult or combative relationship with the person they are caring for, they are more likely to be anxious.

How to support caregivers

As mental health problems can develop in caregivers due to a lack of social support, one way to help is to give them the opportunity to confide about their problems. This could come in the form of support groups for caregivers, or simply from giving them the chance to get to know other caregivers who are experiencing similar problems. Even just letting caregivers know that they are not alone if they are having difficulties can help, which is one of the aims of this article.

Also, there is a strong relationship between the behaviors of a client and how likely a caregiver is to be depressed. For example, caregivers of clients who exhibit problem behaviors such as being aggressive or uncooperative have a higher level of depression6, likely due to the psychological strain of dealing with these problem behaviors. Between this and the fact that a depressed client is more likely to have a depressed caregiver, you can see that one way to alleviate depression among caregivers is to focus on the non-cognitive symptoms of the client.

This means that a client should not only be assessed in terms of how well their memory is functioning, or how aware they are of their environment - they should also be assessed in terms of how they are feeling and how they express those feelings. Prioritizing the psychological experiences of clients will help lessen the psychological burden on caregivers, which in turn will help alleviate experiences of depression and anxiety.

Practical issues

As well as the stresses of a caring job, caregivers often face serious life stresses in addition to their work. This means everyday worries like having enough money to pay for rent and bills, the challenges of raising children, or managing relationships with family and friends, all of which exacerbate the stresses from their caring work. This is notable because a disproportionately large portion of caregivers tend to be women, people of color, and people from other economically disadvantaged groups7. These people already have more life stresses in addition to caring, and are therefore more vulnerable to mental health issues.

This is why it is important for caregivers to be paid a reasonable wage, so that they are not forced to work a full time job on top of caring duties, which can lead to stress and burnout.8 Paying caregivers benefits society in two ways: firstly, it makes it easier for family members and friends of a client to care for them at home, lessening the need for expensive hospital stays, and secondly, means that the caregivers themselves will be less stressed and less likely to quit9, which would leave the client in need of a professional caregiver provided by the state.

Here at Burd Home Health, we help caregivers to get the pay that they deserve from public Medicaid funding. Find out more at https://www.burdhomehealth.com/

References

1 https://onlinelibrary.wiley.com/doi/full/10.1002/gps.1136

2 https://onlinelibrary.wiley.com/doi/full/10.1046/j.1365-2206.2003.00292.x

3 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2349840/pdf/bmj00525-0025.pdf

4 https://www.theguardian.com/global-development/2013/oct/07/woman-job-unpaid-caregivers

5 https://www.researchgate.net/profile/Gill_Livingston/publication/6789680_A_systemic_review_of_the_prevalence_and_associates_of_anxiety_in_caregivers_of_people_with_dementia/links/0912f50f862df34ead000000.pdf

6 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2350802/pdf/bmj00537-0031.pdf

7 https://www.apa.org/pi/about/publications/caregivers/faq/cultural-diversity.aspx

8 https://www.oecd.org/els/health-systems/47884865.pdf

9 https://www.express.co.uk/comment/expresscomment/792419/social-care-workers-quit-jobs-why-pay-travel

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