Caregivers give most of the care to those with Alzheimer’s and many other conditions (eg assistance with daily activities; taking of drugs) and all health professionals need to address the needs of these people as well. About one third of caregivers are spouses and two thirds are female. Caregiving can be a rewarding experience, but meeting the needs of the unwell older person increases stress and morbidity in the caregivers. Mood changes and depressive changes can occur in up to 50% of caregivers – care giving can be a distressing process/activity. Caregiver stress can lead to neglect of the older person.
Huston (1990) considers the following as indications of caregiver stress:
• presenting complaints (fatigue, anxiety, depression, back strain, functional somatic complaints)
• associated features (anger, guilt, resentment, frustration, social isolation, perception of poor health)
• elements to look for in screening for elder abuse (overwhelming daily needs of older person; history of alcohol or drug abuse; history of violence; mention of punishment of older persons; recent life stress for caregiver)
Huston (1990) suggests the following therapeutic approach to caregiver stress:
• emotional support (offer positive feedback to caregiver; discuss feelings of anger and guilt with caregiver)
• education (give information on caring for the elderly; suggest sources of assistance for caregivers)
• advice (encourage caregivers to set limits; recommend that other family members be involved; recommend against taking time off work)
• intervention (refer to support or self help groups; consult with social services if abuse is suspected)
The emotional and psychological stress of caregiving is not necessarily relieved with the death of the spouse. Former caregivers have been shown to not to improve on several measures of psychological well being over a 4 year period . They did show decreases in levels of stress and less negative affect (anger and guilt), but scores of depression, loneliness and positive effect do not rebound to levels of non-caregivers.