Many people with disabilities and/or older adults rely on a caregiver, which according to the National Caregiver Alliance, is defined as someone over age 18 who assists with activities of daily living and/or medical-related tasks.  As the U.S. population has aged, the health status and disparities experienced by caregivers have become an urgent public health issue.

Demographics of Caregivers
In 2015, the National Alliance for Caregiving and the AARP found that 43.5 million adults provided unpaid care to an adult or child in the past year.  In 2010, nearly 40 million adults over the age of 18 provided care to an adult with a developmental disability, who collectively represented 16.6% of the population.  Again in 2015, nearly 16 million adult family caregivers provided care for someone with Alzheimer’s disease or Dementia. 

Effects on Mental and Emotional Health
Surveillance and studies have consistently shown that caregivers are more prone to experiencing symptoms of mental health disorders, especially depression and anxiety.  Often, as the level of function of the individual receiving care declines, depressive symptoms can remain or even get worse, particularly if the individual is placed in a nursing home or other long-term care setting.  Caregivers also report higher levels of stress and fatigue, often with an accompanying loss of self-identity and self-esteem.  These feelings can often lead to higher rates of substance abuse, and if an individual is caring for their spouse, may lead to harmful behavior toward him or her.

Effects on Physical Health
Caregivers report higher rates of chronic pain and other minor ailments such as headaches and acid reflux.  Caregivers have been shown to have a diminished immune response, exhibiting a reduced level of antibody response and a higher response level of stress hormones, which can make an individual more prone to illness.  Caregivers also report higher levels of other chronic conditions such as heart disease or hypertension and exercise less than their non-caregiver peers, making obesity more common.  Those providing 36 or more hours of care per week reported higher rates of smoking as well. 

Exacerbating all of these health conditions, caregivers are less likely to engage in self-care.  A 2006 study showed that nearly ¾ of caregivers do not go to the doctor as often as they should, and this is further complicated for those living in rural areas where primary care is more difficult to find.  Ultimately, caregivers have a higher mortality rate than their non-caregiving peers. 

Tips and Resources

Caregivers Living a Healthy Lifestyle
While there are external factors that can affect caregiver health and ability to care for both their loved one and themselves, many factors are under an individual’s control. 

• Managing stress which can be influenced by an individual’s coping skills, relationship with the person receiving care, and level of support available, is paramount in managing your caregiving responsibilities.  
• Setting personal goals for taking care of yourself will help you focus on your own health needs.
• Taking action based on your goals is of course key to improving your own health and ability to care for a loved one.  Regularly taking some free time for yourself is a step towards a goal of reducing your overall stress level and improving your mental health.
• Communicating constructively will help you get the support you need.
• Understanding the importance of asking for and accepting help.  Caregivers can even identify ways in which they need support.
• Incorporating exercise into the daily routine as much as possible is often more critical for caregivers to ward off health problems.
• Caregivers should recognize and learn how to cope when negative emotions take over one’s ability to enjoy activities outside of caregiving.
• Developing a partnership, or at the very least clear communication, with the health care provider is important so you understand the loved one’s health conditions, but it’s also an opportunity for the caregiver to mention any health concerns of their own and have them addressed.

“Taking Care of YOU: Self-Care for Family Caregivers” from the Family Caregiver Alliance provides more details about actions a caregiver can take to address each of the steps above.

Resources

ARCH National Respite Network and Resource Center
This online resource will connect you to a wide variety of technical assistance and information related to respite care, as well as an online search tool containing information about respite care programs and funding nationwide.

National Caregiver Alliance and National Center on Caregiving Family Care Navigator
This online database provides State-by-State listing of a variety of resources for caregivers of older adults and/or individuals with disabilities.  Topics include legal assistance, sources of respite care, government assistance programs, private organizations and general information.

A starting point on the way to a healthier lifestyle as a caregiver could be to completing the “Caregiver Self-assessment Questionnaire” on the next two pages.  This checklist is found on the web site for the National Alliance for Caregiving and was developed by the American Medical Association.