Being sick is undoubtedly a life stressor, but it is also stressful to suddenly find yourself in the caregiver role. Much of this stress is further compounded if the caregiver is older and navigating their own changing health conditions. A wide variety of research has been done on the issue of caregiver stress, and it is becoming an increasingly important area of research as the American population continues to age. Below, we will uncover common caregiver stress statistics and how the need for further intervention is needed.
Even though many older Americans receive care at nursing homes and assisted living facilities, a significant number of those needing care remain at their homes. In other words, they are aging in place. In such situations, families sometimes contract with professional home health care agencies to provide necessary services. However, this is not always the case.
Frequently, the caregiving role falls on friends and family members, many of whom are elderly themselves. The organization Caregiver Action estimates that each year friends and family members provide $375 billion in elder care to loved ones. This figure swamps the number of services offered by professional organizations.
More than 40 million adults are estimated to provide regular caregiving services for a loved one. It is also worth noting that the Family Caregiver Alliance found that 1 in 3 caregivers are struggling with poor health themselves. This influences how long they can provide care and the quality of care they can provide.
Many caregivers are often struggling with multiple responsibilities and rising financial burdens. Middle-aged adults who have a living parent that’s 65 or older and are either raising a child under age 18 or supporting a grown child are a part of the sandwich generation. The financial and career stress of taking care of both parties often leads to relationship strain. In fact, 25% of caretakers for older relatives said they had made sacrifices in their romantic relationships because of it. In addition, the high-stress levels associated with providing for aging parents and younger children cause the following hardships:
Universally, stress has significant impacts on any person’s physical, mental, and emotional health. It has been linked to the following health conditions and challenges:
These stress-related symptoms and illnesses are problematic. They also lead to lost productivity and elevated costs of doctor’s office visits. Interestingly, some experts suggest that nearly 90 percent of doctors appointments are linked either directly or indirectly with stress and complications from stress.
Many of the statistics provided below are for caregivers in general and are not broken down based on the caregiver’s age. This is because there is less research focused on elderly caregivers. However, one can easily conclude that these problems that impact the general population are likely to be even more pronounced when looking at older individuals. In fact, some studies suggest that younger caregivers have the most elevated risk of reporting dramatic declines in their own health as a result of active caregiving.
One of the most consistent research findings has been that caregivers generally suffer from more depression and a sense of helplessness compared with their peers. Depression symptoms negatively impact up to 70 percent of caregivers, and perhaps up to 50 percent could be diagnosed with major depressive conditions.
Depression, mainly if left untreated or undertreated, can have significant consequences on an affected individual, including an elevated risk of death by suicide. However, depression does not impact all caregivers equally. Many studies have noted that depression and feelings of being burdened by the caregiving role are particularly marked in individuals who are caring for adults with dementia. Caregiving is often much more intensive when working with patients with dementia than with other illnesses.
Considering these figures, one would guess that placing the affected individual in a nursing home setting would decrease the feelings of depression and the overall sense of being burdened. But, this is, in fact, often not true. Instead, many caregivers feel guilt when they go through the placement process. As a result, depression may increase in these settings. This is noted to simply say that there are not necessarily easy answers to reducing caregiver stress.
Also, the stress of caregiving may disproportionately affect caregivers of color. Hispanic and Asian caregivers report dramatic declines in self-reported health metrics when they serve as caregivers. Additional research likely needs to be conducted to understand the complex dynamics behind these figures.
The vast majority of research into caregiver stress has focused on depression. However, depression is not the only mental health or emotional concern that may impact caregivers. Caregivers also note increased feelings of anxiety and frustration.
One study noted that more than 1 in 4 caregivers stated that they felt that their caregiving role was emotionally hard on them. Exhaustion is also a real factor for those who are serving in the caregiver role. Upwards of 20 percent of individuals state that they are exhausted almost every night when they go to bed. Exhaustion itself can have real negative impacts on people, such as experiencing their own cognitive decline.
The physical effects of this stress are every bit as real as the emotional impacts for many caregivers. In fact, these effects can be even more marked for female caregivers, as we will explore in more detail below. Perhaps most strikingly, more than 10 percent of caregivers report that their own health had slid downhill once they assumed an active caregiving role. When these same caregivers are asked to self-report their own health on a relative scale, well over half stated that their own health is poor or fair. This self-reported indicator is seen as an important warning signal by many medical providers.
Many of these caregivers report problems, such as GI distress and stress headaches. But, they also suffer from a wide range of other challenges. For example, stress hormones have been shown to interfere with healthy immune system functioning. Stressed caregivers often experience more infections than their peers, and they may also struggle with wound healing.
Often, caregivers are unable to leave their homes without worrying about the safety of their loved ones. As a result of this, they usually have to miss their own doctor’s appointments. Roughly 55 percent of caregivers reported missing their own medical appointments, which is particularly concerning for those with chronic health conditions. Caregivers are also less likely to engage in exercise outside of the home, which may leave them susceptible to obesity and a range of related health problems, such as coronary artery disease and Type 2 diabetes. Fifty-eight percent of caregivers reported that their exercise habits had gone downhill after becoming a caregiver, and other self-care behaviors showed a similar, if less marked, decline.
Stress undoubtedly impacts all caregivers. However, this impact seems to be particularly marked for female caregivers, who make up approximately 70% of caregivers. Female caregivers, even those who are not full-time caregivers, have elevated risks of heart disease. Some studies suggest that this risk may actually be two-fold compared with their peer group.
Serving as a caregiver also results in complicated economic situations for many women. Many female caregivers have to restrict their work hours outside of the home in order to do caregiving. A woman who is a caregiver has a more than two-fold likelihood increase in poverty. Many of these female caregivers also rely on Supplemental Social Security Income to meet their basic needs.
Lastly, women seem to experience more stress related to their caregiving role than men, and their self-care may be significantly negatively impacted. For example, female caregivers may delay necessary early detection of medical care, such as mammograms.
Caregiving often brings with it an elevated risk of death for caregivers, and the risk of patient hospitalization also increases. Not surprisingly, given the risks and behaviors highlighted above, many studies show that being a caregiver is associated with a higher risk of dying. These elevated risks are particularly marked for older caregivers. For example, one study found a more than 60 percent uptick in mortality for elderly caregivers across both genders. There was also an increased risk of death for the caregiver when the loved one they are caring for is hospitalized.
Another study found that high perceived caregiving strain is associated with increased all-cause mortality. It’s suggested that persons reporting significant strain from caregiving may be taking on mortality risk as strong as someone who has a history of cardiac disease. However, in unadjusted analyses, while highly strained caregivers were at an increased risk for mortality compared with caregivers reporting no strain or some strain, they were also the least likely to have diabetes, stroke, or cardiac disease.
These eye-opening statistics underscore why it is essential to look at ways to keep caregivers, especially older ones, mentally, emotionally, and physically safe and protected during the caregiving process.
Some studies show the opposite effect of what was mentioned above. In at least eight population-based studies, caregivers experienced a 16% to 26% lower mortality rate than non-caregivers. The reason for this reduced risk of mortality may result from the following:
Many loved ones step up to the plate and provide essential caregiving services when their older family members experience cognitive or physical declines. Yet, there are very real risks and challenges associated with being a caregiver. One of the primary difficulties noted above is that caregivers experience real stress. This stress leads to spikes in depression and anxiety and may also be associated with a rise in risky and unhealthy behaviors.
Stress can also have real physical impacts, such as migraines and GI distress. There are also the less well-known impacts of stress, such as a rise in infection rates and increased risk of poor wound healing. These impacts can have deadly consequences for caregivers who may put off their own medical care and vital self-care activities to care for others.