Betty hasn't been to the doctor for a mammogram or pap smear for five years -- since before her husband Frank developed Alzheimer's disease. As a caregiver, she lives in a state of chronic stress. She's tired all the time, doesn't sleep well and eats far too much. Her diet, which consists mainly of comfort foods these days, has become devoid of fruits and vegetables. She doesn't exercise at all anymore. She can't remember the last time she actually felt well.
The Family Caregiver Alliance estimates that 44 million Americans are caregivers. And the Alzheimer's Association, in its latest Facts and Figures report, states that 15.5 million of those are caring for a loved one with Alzheimer's disease.
What many of these caregivers don't realize is that carrying out their duties may be creating chronic stress, which, according to the Family Caregiver Alliance, can lead to a steady and significant decline in physical and mental health. What's more, the Alliance says that caregivers' health status worsens as the patient's condition declines.
Women tend to experience worse health effects than men, who report fewer health effects than expected. And according to a report entitled Alzheimer's Caregiving in the US, "spouses who are serving as caregivers are among the least likely to rate their health highly. Only 24 percent rate their health as excellent or very good."
The Family Caregiver Alliance report gives some insight into the possible reasons for caregivers' declining health. It says that for one thing, they fail to pay attention to their own health.They are slightly more likely to smoke and consume more saturated fat. They may fail to fill prescriptions, they state they have not gone to the doctor as often as they should. They also report that their eating and exercising habits are worse than before they became caregivers.
The National Alliance for Caregiving says that caregivers have "an increased number of emergency room visits and use of all types of health services." Furthermore, "caregivers have an increase ($4,766 per year) in healthcare costs associated with their caregiving."
Not surprisingly, an article published in the American Journal of Nursing states that caring for someone with dementia is particularly challenging, causing "more severe negative health effects than other types of caregiving."
Mental Health Effects of Caregiving
According to the American Psychological Association (APA) caregiving has [the following] significant consequences on mental health:
"When compared to their non-caregiving counterparts, family caregivers report highler levels of stress/distress, depression, emotional problems, and cognitive problems. Estimates suggest that between 40 - 70 percent of caregivers have clinically significant symptoms of depression, with approximately one-fourth to one-half of these caregivers meeting the diagnostic criteria for major depression."
This depression is not only significant in itself, it can lead to physical problems as well. (Alzheimer's Association.)
Physical Health Effects of Caregiving
The APA report lists physical ailments common to caregivers, including "chronic pain such as headaches and backaches, and weakened immune systems."
The Family Caregiver Alliance lists health problems such as "chronic conditions (including heart attack/heart disease, cancer, diabeter and arthritis)," which it says occur at nearly twice the rate of noncaregivers. Other health problems mentioned include:
"Increased rates of physical ailments (including acid reflux, headaches, and pain/aching), increased tendency to develop serious illness, and high levels of obesity and bodily pain." Another physical ailment cited is a "diminished immune response, which leads to frequent infection and increased risk of cancers."
One might logically conclude that negative health consequences related to caregiving decrease when the care recipient is admitted to a facility. However, Alzheimer's Caregiving in the US found that even when their loved one is in assisted living or a nursing home, the emotional stress of supporting them can still be prevalent."
Finally, the APA says that "strained caregivers have a 63 percent greater chance of death within four years as compared to non-caregivers." This includes deaths from suicide, which, according to the Family Caregiver Alliance, is one of the consequences of the depression common in caregivers.
Next week's article will focus on what caregivers can do to protect their physical and mental health from all of these illnesses.
Marie Marley is the award-winning author of the uplifting book, Come Back Early Today: A Memoir of Love, Alzheimer's and Joy. Her website contains a wealth of information for Alzheimer's caregivers.