Being the sole or primary caregiver of an ailing loved one can be rewarding, but it can also be extremely stressful. The tasks and challenges involved—from bathing, toileting, and feeding to managing medications and coping with difficult behaviors—are frequently overwhelming.
Caregivers also often sacrifice their own physical and emotional needs to provide the best possible care for their loved ones. The resulting anger, anxiety, sadness, isolation, and exhaustion—as well as guilt for having such feelings—exact a heavy toll that can lead to depression.
Nearly 44 million Americans are caregivers for a family member, with about 34 million of them looking after someone who is 75 or older, according to a report by the National Alliance for Caregiving and AARP. Caregivers are usually looking after a close relative who needs assistance with daily activities because of a long-term physical or mental condition. Half of these caregivers say they did not have a choice in taking on their caregiving role, and 2 out of 5 report high levels of emotional stress.
Not surprisingly, the stress and strain of caregiving can be draining—both physically and emotionally. Many caregivers are so busy caring for others that they often neglect their own emotional and physical health. Studies have indicated that caregivers may be at a greater risk for depression and chronic illness than non-caregivers.
Following are strategies for taking care of yourself while you’re caring for someone else.
Don’t go it alone. Being the only person in charge of someone’s care is overwhelming no matter how devoted you are, and it’s unrealistic to believe you can handle everything yourself. Sharing the responsibility is essential to living a balanced life, which will ultimately benefit your loved one, too.
Start by thinking about what kind of help would be useful to you. Is it someone who can clean the home and shop for groceries on a weekly basis or watch your loved one once a week so you can have a day to yourself? Or do you require assistance with specific tasks such as bathing, feeding, or coordinating medical care? Once you’ve figured out what would be most helpful, ask other family members when and how they can pitch in.
If family and friends can’t cover all the bases, consider hiring a professional caregiver for one or more days per week, if you can afford to do so. Respite care programs can send a health care professional to your home to look after your loved one. For additional information and help finding respite care, visit the websites of Aging Care or Access to Respite Care and Help.
Adult day care is another option, and it may be less expensive than in-home help. Some facilities offer organized activities for adults and have medical staff on-site. However, complaints about neglect, theft, and mental and physical abuse have been reported, so research a facility carefully before you commit to it. Check with the Better Business Bureau, and ask the center you’re considering for a list of references. If you can, talk to families you meet in the parking lot during a visit to the facility, and stop by at different times of day to watch how staff members interact with those under their care.
If managing your relative’s health care is too burdensome, consider hiring a professional care manager, a specialist who acts as a guide and advocate for families that are caring for older or disabled adults. The Aging Life Care Association has an online database of such specialists. (Click on “Find an aging life care expert” at the top of the page.) For questions about caring for a loved one, AARP has a toll-free caregiving support line at 877-333-5885, available Monday through Friday from 7:00 a.m. to 11:00 p.m. Eastern time. You don’t need to be an AARP member to call.
Some 40 states have passed laws to support caregivers. Hospitals in those states are required to provide caregivers with basic training or instructions about medical tasks that will need to be performed for the patient at home. For more information about this, click on your state on this AARP web page. For other resources available to help caregivers, see the AARP website's Family Caregiving section.
Don’t forget about emotional support. Social isolation is common among caregivers and can lead to depression. Research has shown that caregivers who have emotional outlets or support from family and friends struggle less with the physical and mental challenges of caregiving than those who don’t.
In-person or online support groups designed specifically for caregivers allow you to express concerns, feelings, and frustrations and help you make difficult decisions about your loved one’s care. One resource offering online support groups is the Family Caregiver Alliance.
Other avenues for emotional support include religious organizations or individual psychotherapy. Simply socializing with friends on a regular basis can also relieve stress, improve mood, and provide distraction and perspective.
Get enough exercise. Studies have repeatedly shown that exercising prevents and combats depression in many ways: It increases the flow of oxygen throughout the body, stimulates the nervous system, and affects levels of brain chemicals such as serotonin, all of which relieve tension, induce calm, and make it easier to handle anxiety and stress.
Plus, taking care of your body bolsters self-confidence and imparts a sense of self-control, which is crucial for well-being. Arranging for respite care or help from family or friends will allow you to carve out time for exercise.
Get enough sleep. It can be hard to get the rest you need, especially if the person you’re caring for doesn’t sleep well or needs attention during the night. Disrupted or inadequate sleep can lead to increased tension and irritability.
And while insomnia can result from depression, a growing body of evidence suggests that poor sleep may contribute to mood and anxiety disorders. If you can’t sleep well when you’re on duty as a caregiver, arrange to get the sleep you need by hiring a respite worker or asking a friend or relative to relieve you overnight once in a while.
See your doctor regularly. It’s easy to get so caught up in meeting your loved one’s health care needs that you forget about your own. But physical and mental health go hand in hand. Keep on top of your own doctor appointments and medications just as stringently as you monitor your loved one’s care.
If you continue to feel overwhelmed or find that you just can’t seem to shake the sadness, tell your doctor. He or she can thoroughly evaluate your symptoms and decide on the best course of treatment, which may involve antidepressant medication, psychotherapy, or both.
Signs of caregiver burnout
Once you become emotionally drained, you may shortchange your own needs, which can lead to burnout. One component of true burnout is emotional exhaustion—a feeling of being overextended and depleted because you’ve given so much and received so little in return. If you’re experiencing any of the following signs, consider getting professional help. However, if you have thoughts of suicide, seek help immediately.
- Excessive use of alcohol, medications, or sleeping pills.
- Appetite changes.
- Depression, feelings of hopelessness and alienation.
- Trouble falling or staying asleep.
- Difficulty concentrating.
- Frustration and anger at the person you’re caring for, resulting in neglect or rough treatment.
Taking advantage of the whole range of help and community support available can significantly lighten your emotional load. Caregivers whose own health needs are met and who get the support they need do a better job for themselves and the people they care for.
Despite the challenges of caregiving, some research finds that between one-third and one-half of caregivers are doing well emotionally. In addition, many caregivers report that they are rewarded by the whole process. They also readily admit that they feel they have been given the opportunity to “give something back” to a loved one, and they believe they’re fulfilling an important familial duty.
Also see Is Your Doctor Burned Out?
This article first appeared in the UC Berkeley 2019 Depression and Anxiety White Paper.