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Caregivers Often Neglect Their Health

National Study Shows High Rates of Fatigue and Depression

Medically Reviewed by Louise Chang, MD on September 26, 2006
From the WebMD Archives

Sept. 26, 2006 -- The stress of caring for a chronically ill loved one isjeopardizing the health of millions of Americans, new research shows.

Because of the responsibilities associated with caregiving, many caregiversare at high risk of exhaustion and depression, pooreating and exercise habits, and increased use of medications and alcohol,researchers say. They may feel so overwhelmed that they skip regular doctor anddentist appointments even though their own health is deteriorating.

"They can become more ill than the person they're caring for," saysSherri Snelling, director of Caregiving Services for Evercare, a health-plancompany that co-sponsored the study with the National Alliance forCaregiving.

They released "The Evercare Study of Caregivers in Decline: A Close-UpLook at the Health Risks of Caring for a Loved One" today.

Building on Previous Research

Evercare was prompted to research the health woes of caregivers after a 2004study by the AARP and the National Alliance for Caregiving showed that anestimated 2.5 million of the nation's 44 million caregivers are in fair or poorhealth.

So the new study surveyed a national sample of 528 caregivers in fair orpoor health, and who reported that their health worsened due to theircaregiving. They designed the study to specifically determine how caregiving isaffecting their health. Nearly 40% of them said they spent more than 40 hours aweek on caregiving while an additional 30% reported 20 hours to 39 hours.

Nearly nine in 10 of the caregivers were women. Their average age was 47.Most of them were not working, and most had an annual household income of lessthan $50,000.

'Alarming' Effects on Health

"What jumped off the page for me was the extraordinarily high prevalenceof depression," says John Mach, MD, Evercare's CEO. The study showed that91% of the caregivers had depression and that 81% of those said caregiving hadmade their depression worse.

Other common complaints included lack of sleep or energy (87%), aches andpains (60%), and physical ailments, such as high bloodpressure, arthritisflare-ups,and heartattack scares.

Although the caregivers were aware of a downward spiral in their healthstatus, nearly three-quarters of them said they weren't seeing their doctor ordentist as often as they should and half of them reporting missing doctor'sappointments. More than one in five of the women said they were gettingmammograms less often and a similar proportion of men said they weren't up todate on prostate exams.

About half of the caregivers reported increased medication use, and one in10 said they were misusing prescription drugs or alcohol to cope with stress.

"This is alarming," Snelling says. "On average, caregivers spendfour and a half years in a caregiving situation. We don't want to see ourselvesin a public health crisis because caregivers are not taking care ofthemselves."

Caregiver Woes Often Unrecognized

"I'm not sure that there's a terribly large amount of new stuff here.But this study certainly shows the overall impact to caregivers and has done anincredibly good job of pulling together the data," Eric J. Hall, CEO of theAlzheimer's Foundation of America tells WebMD.

"Caregivers are truly the heroes of our society," Hall says."They do incredible work day in and day out, sometimes with littlerecognition or gratitude."

Although the study showed that more than half of caregivers forgo doctorvisits because they're placing the care recipient's needs ahead of their own,Hall says it would have been stronger if it had emphasized caregivers' primarymotivation: love.

"They're doing this out of an incredibly large heart," he says."They end up sick because they are so absolutely committed by love to carefor their loved one. It's outrageous that this has a negative effect on theirhealth."

Relieving the Burden

"Now that we know more about caregivers, it's important to provide themwith early interventions and prevention so they don't get to this fair or poorhealth status," Mach says.

"It's important for caregivers to know they aren't alone and that thereare a lot of resources to help them shoulder the burden," Snellingsays.

Evercare offers a "Solutions for Caregivers Program" that isavailable to 400,000 employees nationwide through employer insurance and alsois available to uninsured individuals. Other companies offer similar plans thatprovide nursing and social-worker support to caregivers.

"Long-term care plans are obviously beneficial," says Hall. "ButI suspect that only a rare minority of companies offer them to theiremployees."

For many individuals, he says, purchasing such plans may not be feasible."There's a monthly fee that comes with that. Let's face it, not everyonecan afford to pay for their own long-term care insurance."

Caregiver Burden to Increase

Because most of the patients needing care were functionally impaired, thestudy showed that up to three-quarters of caregivers had to assist with dailytasks such as providing medicine; helping loved ones get in and out of beds andchairs; dressing, feeding, and bathing them; assisting with toileting; anddealing with incontinenceissues.

With the Baby Boomers nearing retirement, the burden on caregivers isexpected to dramatically increase.

"Long-term care is a critical issue," Hall says. "As a nation,we need to be more sensitive to the needs of caregivers and those who havelong-term illnesses. I don't know who will ultimately pay for it, but we needto pay more attention to the care side of things."

Show Sources

SOURCES: "Evercare Study of Caregivers in Decline: A Close-Up Look at the Health Risks of Caring for a Loved One," Sept. 26, 2006. John Mach, MD, Evercare CEO. Sherri Snelling, Evercare Director of Caregiving Services. Eric J. Hall, Alzheimer's Foundation of America CEO.

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