- 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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