The varying health costs of caring

Submitted by tonyplant on December 15, 2005 - 17:54.

A study suggests that the type of assistance that Carers provide is linked to the amount of stress that they experience. Interestingly, the authors report that Carers who are coping with matters such as financial management or medication scheduling on behalf of others report more stress than those who are meeting physical needs.

To watch someone, particularly a parent, lose cognitive abilities so that they cannot do the 'thinking' tasks that they used to, is very hard on the caregiver emotionally—and often is actually more stressful than assisting with the more physically demanding tasks such as bathing or cleaning.

Unsurprisingly, many Caregivers feel increased sadness, irritability, fatigue and guilt. Feelings that are typically regarded as features of chronic unhappiness and precursors of chronic depression. The authors surveyed Caregivers and asked what they thought would help them. Carers stressed the need for practical, real-world assistance that would help them to manage their situation. The least favoured options were psychological counselling, group therapy and support groups.

Hmm-from my family experience, it can depend on the support group. I know that the Alzheimer’s Society runs an excellent network of Carers' groups that can be a one-stop shop for advice on local resources, how to apply for Carers’ Allowance and how to navigate someone through the health care system. My local branch offers a drop-in service on several days a week where Carers and the Care-Recipients can go and meet others, laugh and share stories. Similarly, my local Stroke Association offers a variety of services and different flavours of support.

In a clunky re-write of “I say tomato, you say tomato”, I suppose it depends whether you pronounce “special interest groups” like the above as “support groups” or not. Nonetheless, a study offers evidence that counselling and support in coping with the symptoms of depression can make a significant difference to the quality of life for Carers of people with Alzheimer’s.

The study indicates that after one year, 29.8 percent of Caregivers in the group that had received the extra psychological support had symptoms of clinical depression, compared with 45.1 percent of those who received the usual care. Three years later, Carers who received support still showed fewer symptoms of depression on average than those in the control group. This was true even for Caregivers whose spouses had been sent to a nursing home, known to be a highly stressful event for Carers, or who had died.

One of the researchers, Dr. Mittelman, makes an observation that sheds some interesting light on why Carers might underestimate the value of psychological support. She remarks that the particular value of this study is that it tracks the progress of Caregivers well beyond their intensive counselling period. “Many of the effects of these therapeutic interventions are not felt immediately”, she says. “In fact, the two groups of Caregivers began to show significant differences in their depression symptoms only after a year had gone by since they enrolled in the study.”

It seems as if the benefits of psychological support for Carers can take some time to unfold. And the effect is cumulative and subtle rather than rapid and dramatic. When I deliver Happystance workshops I combine laughter work with exercises for managing stress and building resilience. Participants enjoy the light-heartedness of the sessions. And my intention for the rest of it is that Carers are reminded of simple, small steps that can increase their happiness and reduce their stress levels.

Copyright 2005, Tony Plant Happystance Project

stroke | depression | carer | caregiver | alzheimer's disease