Caregivers Often Neglect Their Health

National Study Shows High Rates of Fatigue and Depression

From the WebMD Archives

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

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

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

They released "The Evercare Study of Caregivers in Decline: A Close-Up Look 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 2004 study by the AARP and the National Alliance for Caregiving showed that an estimated 2.5 million of the nation's 44 million caregivers are in fair or poor health.

So the new study surveyed a national sample of 528 caregivers in fair or poor health, and who reported that their health worsened due to their caregiving. They designed the study to specifically determine how caregiving is affecting their health. Nearly 40% of them said they spent more than 40 hours a week 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 less than $50,000.

'Alarming' Effects on Health

"What jumped off the page for me was the extraordinarily high prevalence of depression," says John Mach, MD, Evercare's CEO. The study showed that 91% of the caregivers had depression and that 81% of those said caregiving had made their depression worse.

Other common complaints included lack of sleep or energy (87%), aches and pains (60%), and physical ailments, such as high blood pressure, arthritisflare-ups, and heart attack scares.


Although the caregivers were aware of a downward spiral in their health status, nearly three-quarters of them said they weren't seeing their doctor or dentist as often as they should and half of them reporting missing doctor's appointments. More than one in five of the women said they were getting mammograms less often and a similar proportion of men said they weren't up to date on prostate exams.

About half of the caregivers reported increased medication use, and one in 10 said they were misusing prescription drugs or alcohol to cope with stress.

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

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 an incredibly good job of pulling together the data," Eric J. Hall, CEO of the Alzheimer'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 little recognition or gratitude."

Although the study showed that more than half of caregivers forgo doctor visits 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' primary motivation: 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 care for their loved one. It's outrageous that this has a negative effect on their health."

Relieving the Burden

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

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


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

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

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 everyone can afford to pay for their own long-term care insurance."

Caregiver Burden to Increase

Because most of the patients needing care were functionally impaired, the study showed that up to three-quarters of caregivers had to assist with daily tasks such as providing medicine; helping loved ones get in and out of beds and chairs; dressing, feeding, and bathing them; assisting with toileting; and dealing with incontinence issues.

With the Baby Boomers nearing retirement, the burden on caregivers is expected 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 have long-term illnesses. I don't know who will ultimately pay for it, but we need to pay more attention to the care side of things."

WebMD Health News Reviewed by Louise Chang, MD on September 26, 2006


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.

© 2006 WebMD, Inc. All rights reserved.