Burden and Depression in Family Caregivers

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Caring for an aging family member is an onerous and overwhelming responsibility. It is not surprising that family care-givers frequently experience feelings of depression and burden. When their loved one moves into a residential facility the transition may relieves the physical tasks of care giving, but unfortunately, the emotional distress of care-giving continues.

For the care-giver placement in a facility brings about new sources of stress. Many caretakers suffer a profound sense of loss and loneliness after their loved one moves out. For elderly care-givers arranging transportation to and from the facility can become a daunting ordeal. And for most family care-givers, the burden of financial management of their loved one falls on their shoulders.

Placing a loved one in a facility requires the family care-giver to shift their role from direct care-giver to a care manager. This is an especially difficult transition as family care-givers have often invested a great deal of their identity in the role of care-giver. Emotionally, care-givers may develop a sense that they have failed their loved one because they can longer provide in-home care. Care-givers may also experience feelings of anger and inadequacy, which often leads to displacing their negative feelings on to the facility staff in the form of hostility and disapproval. The challenge for aging spouses acting as care-givers is even greater. They can become depressed, lonely, confused, and distressed.

Symptoms such as failing memory and inappropriate or destructive behaviors often result in distress visits for the family care-giver. Upset over their loved one’s state of mind or deteriorating physical health, family care-givers report greater feelings of depression.

Conflict among family members about placement issues also increases family care-giver depression. And, should the family care-giver feel dissatisfied with the facility’s staff or engage in conflicts with the staff caregiver burden also stress rises dramatically.

Research has shown that when family care-givers participate in family care-giver support groups, their feelings of burden decrease. Additionally, the research points out that social support plays a key role in the psychological well-being of care-givers. Thus, care-giver depression can be reduced when care-givers utilize support from family and friends. When depression and burden begin to interfere with the care-giver’s ability to function, formal support in the form of medical intervention, psychotherapy, and groups must be sought.

For some family care-givers, depression and distress can be further reduced when family care-givers participate with staff in limited direct care activities. However, the care-giving activities must be appropriate to the physical and psychological abilities of the care-giver, and the staff must be aware that direct care activities increase the risk for care-giver burden.

Most importantly, facility staff can ease family care-giver stress by responding promptly to concerns and provide reassurance about the safety and comfort of the care-giver’s loved one. Staff should actively be supportive and encourage family care-givers to seek out social support and make time for social activities.