Caring for the Caregiver

As the population ages, caregiving from an immediate family member is on the rise. But this informal care can take a detrimental toll on the caregiver's mental, physical, and financial health.

Close-up of a young woman's hand holding the hand of an older man lying on a bed. Caregiving concept

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As the lifespan of the global population increases, cases of dementia are rapidly climbing, with an estimated 57 million people diagnosed worldwide. More than two-thirds of patients are cared for by immediate family or other relatives, so-called “informal” or unpaid caregiving. There are documented benefits to being an informal caregiver, including reduced mortality. However, being a caregiver can have many detrimental effects on one’s physical and mental well-being, as well as a financial burden.

According to the Alzheimer’s Association,  40% of caregivers reported high levels of loneliness and social isolation during the first year of the COVID-19 pandemic. Assisting a loved one with basic necessities, including bathing, feeding, walking, and managing medications, takes a physical toll. Working or living in high-stress environments puts caregivers at increased risk for high blood pressure and heart disease.

A greater percentage of older adults  living in rural areas are cared for by informal caregivers. Most rural informal caregivers have limited access to hospitals, long-term care, or in-home professional caregiving services. Additionally, rural caregivers reported increased physical burden and decreased health status with fewer healthy behaviors than their urban counterparts, resulting from less access to help for family members from professional caregivers.

Researcher Steven Cohen and colleagues used caregiver data from the CDC’s 2018 Behavioral Risk Factor Surveillance System (BRFSS) to determine if any rural-urban differences exist in informal caregivers’ physical or mental well-being. Responses from Georgia, Oregon, and New Jersey were included in their analysis, which focused on questions about the intensity of caregiving, length of time serving as a caregiver, and unmet needs for caregiving services and support.

Rural respondents were more likely than urban caregivers to provide 20+ hours of work per week. Further, rural caregivers had an increased likelihood of having poor health-related quality of life compared to non-caregivers. All informal caregivers, regardless of where they live, were found to be 60% more likely to smoke, and more likely to report poor general health.

These findings highlight the need to recognize and address the health risks for informal caregivers. The researchers recommend policies to provide more professional resources accessible to both rural and urban populations, with particular attention to the former, perhaps via the provision of mobile health interventions that can be delivered remotely. Medical providers should ask patients if they are acting as caregivers and tailor healthcare resources to address the specific health behaviors or mental health needs of this hard-working and unseen population.

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