- Story Highlights
- Stress of full-time caregiving increasingly referred
to as "caregiver syndrome"
- Symptoms: Depression, anxiety, anger, declining
health
- Many don't realize they have a recognizable condition,
don't seek help
BOSTON, Massachusetts (CNN) -- Do you take care of someone
in your family with a chronic medical illness or dementia?
Have you felt depression, anger or guilt? Has your health
deteriorated since taking on the responsibility of caregiving?
If your answer is yes to any one of these, you may be
suffering from caregiver stress.
This condition is increasingly being
referred to as "caregiver syndrome" by the medical
community because of its numerous consistent signs and
symptoms. In the pamphlet, "Caring for Persons with
Dementia," Dr. Jean Posner, a neuropsychiatrist in
Baltimore, Maryland, referred to caregiver syndrome as,
"a debilitating condition brought on by unrelieved,
constant caring for a person with a chronic illness or
dementia."
An increasing number of Americans are
finding themselves taking care of someone who's aging
or ill or both. According to the American Academy of Geriatric
Psychiatrists, one out of every four American families
cares for someone over the age of 50. As America's population
ages, that number is expected to skyrocket. In 2000, the
Census Bureau reported, just under 35 million Americans
were 65 or over; by 2030, the number is projected to more
than double, to more than 71 million.
Many exhausted, ill caregivers today
don't seek help because they don't realize that they have
a recognizable condition. According to a report from the
National Consensus Development Conference on Caregiving,
the most common psychological symptoms of caregiver syndrome
are depression, anxiety and anger. Peter Vitaliano, a
professor of geriatric psychiatry at the University of
Washington and an expert on caregiving, said that the
chronic stress of caring for someone can lead to high
blood pressure, diabetes and a compromised immune system.
In severe cases, caregivers can take on the symptoms of
the person that they care for, he said. For example, a
person caring for someone with dementia may develop progressive
memory loss. Worse still, this syndrome can lead to death.
Elderly caregivers are at a 63 percent higher risk of
mortality than noncaregivers in the same age group, according
to a study by University of Pittsburgh researchers Richard
Schulz and Scott Beach reported in the Journal of the
American Medical Association in December 1999.
Vitaliano suggests that the physical
symptoms are a result of a prolonged and elevated level
of stress hormones circulating in the body. He likened
exhausted caregivers' stress hormone levels to those suffering
from post traumatic stress disorder.
Caregivers are usually so immersed in
their role that they neglect their own care, said Vitaliano.
The stress is not only related to the daunting work of
caregiving, but also the grief associated with the decline
in the health of their loved ones. The majority of caregivers
go through a period of shock followed by a major adjustment
in their roles. Such emotions are reflected in online
discussions among caregivers such as one at the Alzheimer's
Association Online Community. A number of spouses described
their role slowly evolving from partnership into a nurse-patient
relationship. The caregivers described the difficulty
of the change and talked about feeling anger, resentment
and guilt. They also suggested that in such an emotional
state, it's difficult to provide high-quality care to
their loved ones.
Physicians, too, are not always certain
how to approach the issues raised by long-term caregiving.
Although the term "caregiver syndrome" is widely
used among allied health professionals such as hospice
workers and nursing home assistants, the syndrome is not
yet recognized in American medical literature. Without
that official validation, it's not surprising that this
problem is not addressed more by physicians. A survey
in the American Academy of Family Physicians found that
fewer than half of caregivers were asked by their doctors
whether they had caregiver stress. Vitaliano believes
that more research should be done to help spread awareness.
But Vitaliano isn't sure giving caregiver
syndrome the status of an official diagnosis would be
a good thing. He argues that if "caregiver syndrome"
were listed in the Diagnostic and Statistical Manual of
Mental Disorders (a text published by the American Psychiatric
Association that defines all mental health disorders)
it could stigmatize those that have it. "Caregiver
stress is directly related to the way our society views
the elderly and the people who care for them,"Vitaliano
says. Today, caregiving is viewed largely as a burden
in this county. If it were viewed as more of a societal
expectation and people were willing to offer more support,
fewer caregivers would suffer in isolation, he says.
Others think giving caregiver syndrome
an official name would be helpful. Kathryn Anderson, a
researcher in families and chronic illness at Florida
International University, argues that caregiver stress
should be named a syndrome because it would help caregivers
seek the help and resources they need. Naming it a syndrome
would encourage health professionals to develop better
treatment strategies and require health insurers to pay
for treatment, she believes.
For now, the American Academy of Family
Physicians and the National Center on Caregiving call
for every caregiver to be screened for stress and depression.
Caregivers who show signs of hostility, anxiety and a
loss of interest in activities they used to enjoy are
urged to talk to their doctors.
Experts agree that expanding the caregiver
support system, finding sources of help for caregiver
tasks and educating caregivers can significantly decrease
the occurrence of this syndrome.
Andree LeRoy, M.D., a 2006 graduate
of the University of Illinois at Chicago College of Medicine,
was an intern with CNN Medical News this summer. She is
now in residency at Spaulding Rehabilitation Hospital,
in Boston, Massachusetts.
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