Caregiver Stress

Every day millions of Americans serve as caregivers, providing unpaid assistance to family members or friends who are in some way incapacitated and need help with the activities of daily life. Caregiving can have many rewards, but it can also be a significant source of stress for the many caregivers who provide care, often at great personal sacrifice to their own physical, emotional, social, and financial well-being.

Caregiver stress has been studied extensively and negative consequences of caregiving have been clearly documented; nevertheless, researchers find significant variability in how caregivers adapt over time to the demands of caregiving. This variability can be attributed to numerous factors. The relationship history between caregivers and care recipients can be grounded in respect and love, or anger and resentment, each resulting in different emotional reactions by the caregiver to the demands of caregiving. Additionally, disability and disease characteristics vary significantly from one care recipient to another, placing unique demands on caregivers. Caring for elders with dementia, for example, is found to be generally more physically, emotionally, and socially stressful than caring for elders who are simply physically frail. Those living with the care recipient often report greater stress than those who don't, and the intensity and duration of care provided also are important determinants of stress. Those who provide care the longest and with the greatest number of responsibilities generally report feeling the most stressed. Finally, the meaning that caregivers assign to the demands of caregiving and their perception of how well they can cope with those demands play a critical role in influencing stress levels. The actual demands of caregiving may be less important than the caregiver's reaction to them and the coping resources, both internal and external, that the caregiver believes he or she has available.

Just as the demands of caregiving are multifaceted, so too are the stress-related consequences of providing care. Many caregivers report that over time, the demands of caregiving take their toll physically, emotionally, socially, and financially.

Physical Consequences of Caregiving

Numerous researchers have found caregivers to be at an increased risk of physical illness and premature death compared to noncaregivers. One study found that elderly spousal caregivers who reported experiencing high levels of stress were 63#x0025; more likely to die earlier than control subjects. Researchers have also established that in general, stress affects one's health by increasing blood pressure, suppressing the immune system, delaying wound healing, increasing cardiovascular risk, increasing levels of stress hormones, and prematurely aging cells.

Specific to caregiver stress, Ohio State University researchers found levels of interleukin-6 (IL-6), a substance that plays a role in immune system regulation, to be four times higher among Alzheimer's caregivers than noncaregivers. Not only were IL-6 levels significantly elevated, but the levels remained elevated for years, even after caregiving responsibilities had ended. These findings are important, because excess IL-6 is related to various health threats, including, for example, increased levels of [Page 150]C-reactive protein (CRP), a risk factor for cardiovascular disease. Additionally, elevated levels of both CRP and IL-6 are related to arthritis, diabetes, congestive heart failure, and osteoporosis, diseases that significantly reduce one's quality of life and can increase the risk of early mortality.

...