When a loved one is seriously ill or disabled and you take on the task of providing his/her care, it's natural to focus your energies on meeting that person's needs. The financial and physical demands you face may quickly become evident, yet the emotional impact often goes unrecognized-even though it may be the most challenging element of all. Evidence…

  • In a study in Archives of Internal Medicine, 14% of end-of-life caregivers reported significant financial strain...18% reported significant physical strain...and 30% reported significant emotional strain.
  • Emotional stress leaves caregivers vulnerable to depression—sometimes even more vulnerable than the person to whom they tend.
  • In another study, caregiving spouses who reported emotional strain were 63% more likely to die within four years of the studied period than caregivers who did not feel such strain.

If you're a caregiver, you need to protect yourself as well as your loved one.

Helpful: Knowing what to expect as you move through the various emotional stages of becoming a caregiver. and developing specific strategies for coping.

Getting Over The Shock

When a loved one suffers a sudden medical crisis, such as a serious injury, a woman can be thrust into the role of caregiver with no preparation. She may assume optimistically-and often unrealistically—that things will soon return to normal as the patient recovers.

In other cases, caregiving duties grow gradually as a parent or spouse ages or develops a progressive illness, such as Parkinson's disease or Alzheimer's disease. The caregiver may not be able to admit to herself how much the loved one's condition is deteriorating.

Either way, the caregiver's instinctive reaction to the shock is denial. Initially, this tendency to minimize the impact of the illness can help give the caregiver the strength to do what needs to be done. But persistent denial can compromise a caregiver's ability to make sound decisions.

Example: If your mother can no longer walk without risking a fall, but you cannot recognize the need to insist that she use a walker or wheelchair, it jeopardizes her safety.

Support strategies: It is best to face reality. To see your loved one as she is now rather than as she used to be, keep a log of her symptoms and abilities—recording other family members observations as well as your own. Learn enough about her medical condition so that you can understand the treatment options and prognosis. This way, you and her doctors can agree on a medical objective, such as prolonging life or, later, simply making the patient as comfortable as possible.

Living With Negative Feelings

Many caregivers are heartened to experience positive emotions, such as pride in their ability to help and a deepened sense of devotion. But there are bound to be negative emotions, too such as resentment and dread. You may feel resentful about being burdened...then guilty over the resentment...then angry for having been made to feel guilty.

You also may experience conflicting emotions toward the loved one himself as you struggle with the changes in the nature of your relationship.

Example: Suppose that, after your husband's stroke, you need to feed and bathe him as you would a child—and this clashes with your longtime image of him as a partner, peer and lover.

Support strategies: Remember that negative feelings about caregiving are normal and predictable—they do not invalidate your love. To overcome resentment and restore mutual respect, it helps to promote a patient's capabilities as much as his comfort-perhaps by being as dedicated to his physical therapy exercises as you are to his personal needs.

Strongly negative feelings also can be a helpful signal, alerting you to a need to adjust your plans. For example, taking care of an ill brother does not necessarily mean that he must live in your home forever, so stay open to all the options.

Achieving Balance

Some caregivers worry that they're not doing enough, so they disproportionately expend time and energy on the loved one. This can be detrimental to their other relationships.

Example: If you devote yourself to taking care of an adult child with a progressive illness, you may neglect your spouse, other children, extended family and friends.

Losing ties with other people deprives you of support. The more isolated you become, the more susceptible you may be to depression and other health problems. This risk increases if you come to define yourself solely as a caregiver, losing your sense of personal identity

Support strategies: Chronic medical conditions unfold over years, so they need to be handled much like a marathon-by pacing yourself. Talk to your doctor or a mental health professional if you show signs of burnout, such as constant fatigue, insomnia, irritability, cynicism or feelings of helplessness. Be committed to staying connected to others. Carving out time to go to dinner with your husband, play bridge with friends or attend a function at your house of worship will help replenish your spirit.

Help for Caregivers

Family caregivers can get information, support and/or referrals to professional counselors through these organizations…

  • Family Caregiver Alliance, 800-4458106, www.caregiver.org.
  • National Alliance for Caregiving, 301718-8444, www.caregiving.org
  • National Family Caregivers Association, 800-896-3650, www.thefamilycaregiver.org.
  • Strength for Caring, 866-466-3458, www. strengthforcaring.com
  • Well Spouse Association, 800-838-0879, www.wellspouse.org.

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