How You Handle Stress Is How You'll Handle Caregiving?


How You Handle Stress Is How You'll Handle Caregiving?

library_researchResearchers released the results of a study today which took a closer look at the stress of of caregiving. In essence, the study decided to answer this question: "Does caregiving cause psychological distress?"

The results showed that the associations between caregiving and different types of psychological distress (depression, anxiety, perceived stress and perceived mental health) depend largely on a person's genes and upbringing -- and less so on the difficulty of caregiving.

If an individual has a history of depression before being a caregiver, then "caregiving may be like putting salt on the wound," said Peter Vitaliano, a professor of psychiatry and psychology at the University of Washington (UW).

The press release about the study explains more:
Vitaliano argues that psychiatric states and psychological outcomes are a function of exposure to stressors and vulnerabilities (early family environment, genetic factors, disposition). How one responds to stressors also depends on a person's resources (coping, social supports, income).

Vitaliano said his past research has also shown that caregivers' stress hormone levels are especially high relative to other caregivers if they are high in dispositions, such as neuroticism and disagreeableness. He has also found that caregivers with chronic illnesses such as heart disease or cancer have more physical problems with their illnesses than do noncaregivers with chronic physical illnesses.

In essence, your caregiving stress will be affected by your ability to manage stress as well as the availability of resources to help you manage stress.

I write regularly about my concern that we've over-researched the caregiving experience and instead need to focus on providing support and help to family caregivers. I'm curious about this study, which looked at 1,228 female twins; some were caregivers and some were not. I would like to know more about the specifics of the caregiving situations, including:

  • For whom did they care (spouse, parent, other family member);

  • The length of time in a caregiving situation;

  • The caree's diagnoses and care needs;

  • The number of hospitalizations throughout the caregiving experience;

  • Family dynamics;

  • Age of the family caregiver and caree;

  • Whether or not the family caregiver worked.

Certainly, our stress management skills will affect how we handle difficult times during our life. I see that in my own family. I'm calm--my sisters are, well, not. I saw the difference in how each of us coped with my father's cancer diagnosis. Or, was it just my exposure to caregiving that kept me calm? I now spend much more time with my parents than my siblings do. I'm beginning to help and, I can tell you, it already stresses me out.

What's interesting to me about this study is that the lead researcher wanted to prove his own theory. "Vitaliano said he had long predicted that caregiving doesn't directly cause distress," the press release notes. "Because health care funds are limited, Vitaliano hopes that treatment interventions and policies will be targeted towards caregivers who are at the highest risk."

Certainly, research like this helps shine a light on the caregiving experience. I wonder, though, if it will really help us target those family caregivers with the greatest risks. Wouldn't it just be more helpful to actually research the interventions that help those family caregivers with the greatest risks? Meaning, the researcher already had a theory about those at risk. Why not simply find those family caregivers at risk and then provide them with various interventions to determine which intervention helps most? Or, why not simply ask us here which interventions help us manage our stress?

I agree that we all manage stress differently and that our emotional, mental and physical health will impact our ability to manage another stressful situation, like caregiving.

Just typing that sentence makes me mad.

Of course, this is true. It's frustrating when we again spend more research dollars to research the obvious.

Bottom line: Let's only research what helps family caregivers feel better during their stressful experience of caregiving. Let's design a research study that includes ways to support family caregivers. No more studying the stress. We know we have stressed-out family caregivers. Let's just go out and help them.

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First, I believe a discussion about researching a disease is very different than a conversation about researching the caregiving experience. Research about a disease can directly impact a patient and a patient's family. I read every day how researching a disease's cause, progression and cure impacts a patient and a family unit.\r\n\r\nI can't remember the last time I read or heard a family caregiver say about caregiving research, “Thank goodness for the money spent researching the caregiving experience. My day is so much better because of research spent on what the experience is like for me.” And, I've been working with family caregivers since 1990 and in direct contact with them on a daily basis since 1996. I honestly can't remember the last time a family caregiver gave thanks for research. They give thanks for their therapist, for this website, for their journal, for their faith, for the adult day service. \r\n\r\nMy point is that we are researching what common sense would already tell us. Why not use the research dollars to create innovative and amazing interventions to help at-risk family caregivers because we already know, from common sense, what puts them at risk? Or to support the interventions which already exist like an adult day center, online support groups, journaling classes, sessions with a therapist? We already have organizations that work directly with family caregivers. Why not contact them and say, “Refer your most critical cases to us. We have money to fund interventions to help family caregivers at risk to see the impact of the interventions as well as to ensure we make these interventions available to any and all family caregivers.”\r\n\r\nI support research about the caregiving experience that changes the caregiving experience right now. When I think of a way to help a family caregiver, I simply do it. I don't research it. \r\n\r\nI think of our discussion this way:\r\n\r\nA group of homeless persons sit in a room. A researcher arrives and says, “I've got research dollars. So, I'm going to ask you a series of questions about your experience being homeless. I'm not actually going to help you. I'm simply going to ask you questions about your experience. And, when I'm done asking you questions, I'm going to ask you to leave the building while I go back to my lab and crunch the numbers.”\r\n\r\nWouldn't you instead use research dollars to try to find a warm bed and food for as many as you could? And, as you help, you can ask as many questions as you need to find out which one is neediest and would benefit from additional interventions. \r\n\r\nWe all know which family caregivers are neediest. Think of our CareGifters program which raises money to help a family caregiver in need. Since I launched the program, only the neediest have applied. I've actually encouraged a few family caregivers to apply who have told me, “I'm okay. I know others would benefit more. Help them first.” I had one family caregiver apply for funds because she couldn't sell her parents' home which put them in a severe financial crunch. After I wrote to let her know I approved her for help, she wrote back that the house unexpectedly sold and that they would be okay. I wrote her back to let her know we'd still help her. Nope, she said, we're going to be okay scraping by. (Note: I ran out of money last year so had to put our CareGifters program on hold. I'm working to get it back up and running.)\r\n\r\nWe all make room at the beginning of the line for the neediest. I don't believe we need research to make this happen.\r\n\r\nThe caregiving experience is over-researched and under-funded. The best way to bring attention to the family caregiver experience is by making a difference in their day-to-day lives with services and help.


Hi Peter--So glad you commented!\r\n\r\nTo clarify a statistic about how many men care:\r\n\r\nAccording to Pew Research released last summer, 40% of women aged 18 and over care for a family member while 37% of men care for a family member. The research indicates almost as men as women are family caregivers.\r\n\r\nI appreciate your perspective. I still believe we need to get out of the lab, so to speak, and into the trenches and help family caregivers. We know they need help and we know there's not enough help. Let's change that.