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. Reviewed by the Faculty of Harvard Medical School

Caregivers And Depression: Avoiding The Inevitable

Former First Lady Rosalynn Carter writes that there are only four kinds of people in this world — caregivers, former caregivers, future caregivers and those who will need caregivers. Here are just a few statistics to back up her claim:

  • Fifty-four million Americans — one out of every four — cared for family or friends last year.
  • Almost four out of 10 caregivers looked after someone around the clock.
  • Three out of every 10 caregivers have been caregiving for more than a decade.

With millions needing care, who is caring for the caregivers?

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Think Of Yourself, Too

Various studies report that 24 percent to 60 percent of caregivers are to some degree depressed or anxious. Not surprisingly, the caregivers who report the greatest stress are adult children who tend to parents, children, jobs and housekeeping at the same time.

Of course, caregivers must take care of themselves before they can really care for their loved ones. This is especially difficult for those who must dress, bathe and toilet another.

Indications Of A Problem

If you are having a hard time being a caregiver, take stock of your current situation. You may need to reduce stress by taking care of yourself better, especially if you answer yes to any of the following questions:

  • Do you have difficulty falling asleep or staying asleep?
  • Are you missing your own doctor appointments and letting physical exams and mammograms (if you are a woman) slide until you have more time?
  • Do you feel hurried? Do you find it difficult to concentrate? Are you easily irritated?
  • Do you feel fatigued and lack the energy to do new things?
  • Have you lost interest in activities you used to enjoy? Do you not enjoy yourself, even when away from caregiving duties, because you are thinking about the things you'll have to do when you return?
  • Do your colds linger?
  • Are your interactions with siblings or other loved ones unpleasant?
  • Do feel sad without a reason? Do you believe things will never get better?

The stock prescription for the caregiver is to take some time off, but that's easier said than done, according to Richard Schulz, a psychiatry professor at the University of Pittsburgh who has written extensively about caregiving. He says that using respite care services relieves some pressure, but short-term care introduces new tasks that make the caregiver's life even more challenging — getting the patient dressed and fed, and convincing him or her to trust a stranger.

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Possible Solutions

Even if you have no way to be relieved of your duties, there are many things you can do to improve your caregiving and your life. Here are tips from Ronda C. Talley, director of the Rosalynn Carter Institute, and from the National Family Caregivers Association:

  • If friends or family offer to help, suggest specific things they can do. A friend might be willing to watch over your loved one for an hour once a week. A family member could file the insurance forms or help with house repairs.
  • Encourage the patient to do everything he or she can do independently (for example, bathe, brush teeth). The patient may get some satisfaction from it, and the work will be done.
  • Spend some time bonding with the person you are caring for. Look at old photo albums. Invite old friends in. Watch a comedy that the person loved when he or she was well. Laughter helps.
  • Encourage the person you are caring for to join a support group. Patients often feel better when they meet others who have experienced similar losses.
  • Eat healthy foods. Ask a friend or family member to contribute ready-to-eat veggies and packaged salads regularly so you always have something healthy on hand when you become hungry.
  • Have a family meeting out of earshot of the patient. Request specific and regular help from family members. For example, ask each relative to invite the patient for dinner and a video on a regular schedule.
  • Make exercise a part of your routine. Research shows that people usually feel less depressed and anxious if they’re physically active.
  • If your hopelessness persists, ask a doctor to recommend professional help.

Caring for a loved one gives us the opportunity to give love back to the ones who have loved and cared for us. Unloading some responsibilities may free you up to feel more giving — something you might feel better about.

Ultimately, a medical professional can help answer important questions:

  • Are the patient and the caregiver each doing as well as they can?
  • If not, what services, equipment, medication and environment changes would help?
  • What is a realistic plan for putting services in place — what are the priorities and what time frame is realistic
  • Can time be carved out for the caregiver and patient be separate, to allow better health and caring for both?

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Last updated February 22, 2005


   
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