November has been designated as National Family Caregivers month. As America’s population is becoming increasingly older, many of us are or will be called upon to provide care for a loved one. The American Association of Retired Persons (AARP) estimates that over 29% of the U.S. adult population is providing care to someone who is ill, disabled, or aged. Family caregiving is now considered a normative family process in the family lifecycle stages. (National Alliance for Caregiving in collaboration with AARP. November 2009.)
The responsibilities of a Caregiver range from visiting the individual, assisting with medications, andaccompanying the individual to doctor’s appointments; to providing day-to-day care for a bed-ridden individual. The complexity and diversity of the Caregiver’s tasks and responsibilities increase as the individual ages and/or their health condition worsens.
Those of us who have been a Caregiver recognize that assisting a loved one as a Caregiver can be overwhelming, but it can also be very rewarding. Our family and close relationships provide mutuality and a sense of meaning. Being bound to our loved ones brings a sense of commitment, loyalty, and respect to honor one another in our times of need. We can begin to see these individuals in a new light and can develop a deeper connection with them. By providing emotional support, active listening, and responding in a non-reactive way, we can connect heart to heart. Communication can become more open about feelings and experiences in the past. Fluctuating emotions including anger are common with both Caregiver and our loved one. Our loved one may be angry at being ill, may have increased pain, decreased energy, and decreased frustration tolerance. As the Caregiver, we begin to experience anger, frustration, grief, loss, and uncertainty as we observe our loved one’s struggle. Tears can be cleansing for both Caregiver and patient. Incorporating humor can assist in decreasing the intensity of the situation and shifting the focus to a more positive emphasis.
Being a caregiver puts a strain on one’s physical health, emotional health, finances, and other relationships. Caregivers find themselves struggling to balance work and family responsibilities. According to the National Alliance for Caregiving and the AARP, up to 70% of the caregivers who are employed experience work-related difficulties. Work schedules may need to be rearranged, up to 4% chose early retirement, up to 5% turn down a promotion, and up to 6% gave up work entirely. Wages, health insurance, and other job benefits may be sacrificed. Employers report an increase in absenteeism and a decrease in productivity among workers who are in the dual role of Caregivers. (National Alliance for Caregiving in collaboration with AARP. November 2009.)
Marriage and Family Therapists are a valuable resource to assist in the adjustment for the aging individual, the family, and the impact the Caregiving role has on the family system. As we are included in the decision making process, we can assist families in sorting out the next steps to be taken. We can provide broadening support to assist in networking and providing practical information. Accessing abilities and emphasizing strengths facilitates resiliency. The MFT can facilitate the redefining of roles and the adjustment around the elderly individual’s self-concept. We assist in the recognition of the connection of the personal and relational functioning to the level of physiological decline. Working collaboratively with the Caregiver, we can assist the Caregivers to create an environment that enables the older individual to enjoy these later years as much as possible. As the individual ages and declines in health, the MFT can assist in processing the symbolic or actual death of the loved one. As we assist in the acknowledgement of the death and loss, we give the families the space to express and process the range of emotions experienced. Our role includes assisting the family with the reorganization of the family system and reinvestment into future life direction without the loved one.
In facing the task of caring for a loved one, it is important for Caregivers to remember that they are not alone. Nationwide there are more than one million Caregivers providing care. Make Caregiving a family affair and involve others in the caring process. Also, remember that there are many services available to assist you in caring for your loved one. Below are a few resources and tips to assist the Caregiver:
Helpful tips and resources for Caregivers:
- Develop good communication with care providers.
- Day-to-day assistance including Home Health Aides available and paid for by some insurance plans;
- Consider Respite care.
- Alternate transportation options may be available including van and shuttle services; contact your area agency on aging.
- Seek food services including Meals on Wheels to assist with meals.
- Take advantage of counseling services, support groups, and online support groups.
- Take care of your own health.
- Find an Marriage and Family Therapist to assist you at: www.therapistlocator.net/
- Contact a Caregiving Hotline: AARP 1-877-333-5885 Monday to Friday 9:00 to 5:00
Assistance to offer to a Caregiver:
- Call or stop by to offer support and reassure the Caregiver that it is OK to ask for help.
- Be a good listener for the Caregiver, and ask how they are taking care of themselves.
- Offer to bring the Caregiver a meal.
- Assist in providing Respite care or connecting Caregiver to Respite Care resources.
- Help the Caregiver connect with other Caregivers and resources.
Administration on Aging (AOA) National Family Caregivers Support Program: http://www.aoa.gov/AoA_programs/HCLTC/Caregiver/index.aspx
Caregiver Action.org: http://www.caregiveraction.org
Easter Seals: http://www.easterseals.com
Family Caregiver Alliance: 800-445-8106; http://www.caregiver.org;
Family Caregiver Resource Center; 1420 Spring Street; Silver Spring, MD 20910; 301-588-8700; http://www.gwbr.easterseals.com
Holy Cross Caregiver Resource Center: 9805 Dameron Drive; Silver Spring, MD 20902; 301-754-7152; www.holycrosshealth.org/svc_senior_caregivercenter.htm
Maryland Health Care Commission: Consumer Guide to Long Term Care http://mhcc.maryland.gov/consumerinfo/longtermcare/GeneralResources.aspx
National Alliance for Caregiving: 4720 Montgomery Lane, 2nd Floor; Bethesda, MD 20814; 301-718-8444; http://www.caregiving.org
National Council on Aging: http://ncoa.org.org
National Family Caregivers Association: 10400 Connecticut Avenue, Suite 500; Kensington, MD 20895; 301-942-6430; http://www.nfcacares.org
Respite Services of Montgomery County; 11621 Nebel Street; Rockville, MD 20852; 301-816-9647
The National Alliance for Caregiving and AARP (2009), Caregiving in the U.S. National Alliance for Caregiving. Washington, DC)—Updated: November 2012
Susan Blair, LCMFT, CCDP