Family Caregiver Well-Being is Important to Care Recipient Health

Thoughtful womanIn their roles and activities, family caregivers may have a major influence on care recipient health and well-being. The decline of family caregiver health is one of the major risk factors for institutionalization of a care recipient, and there is evidence that care recipients whose caregivers lack effective coping styles or have problems with depression are at risk for falling, developing preventable secondary complications such as pressure sores and experiencing declines in functional abilities (Elliott & Pezent, 2008). Evidence indicates that cognitive-behavioral interventions to help family caregivers benefit their family members as well: As caregivers experience decreases in depression in response to treatment, so do their care recipients (Berry, Elliott, Grant, Edwards & Fine, 2012).  

Care recipients may also be at risk for encountering abuse from caregivers when the recipients have pronounced need for assistance and when caregivers have pronounced levels of depression, ill health, and distress (Beach et al., 2005; Williamson et al., 2001).

As a result of the above factors, the health and well-being of family caregivers – and the subsequent ability to assist their care recipients – is a public and mental health priority. Healthy People 2010 explicated the need for behavioral and social initiatives to promote the health and quality of life of persons with disabilities and their family caregivers. In addition, two reports from the Institute of Medicine, The Mental Health and Substance Use Workforce for Older Adults: In Whose Hands (2012) and Retooling for an Aging America: Building the Health Care Workforce (2010), encouraged professionals and direct service workers to prepare family caregivers for their role, and to consider family caregivers as members of the health-care workforce

Suzanne's Story

Suzanne has been in psychotherapy for depression for 8 sessions.  Her concerns relate to her family – each of her three adult children is in a challenging life transition (e.g., divorce, financial strain, job loss); her sister is fighting breast cancer; her Dad has become increasingly irascible with her mother. Suzanne describes her life as heavy and exhausting. It has been increasingly clear to Suzanne’s therapist that the practical burdens and emotional challenges of caregiving are significantly exacerbating her depression. He is comfortable helping her look at the emotional issues, but it he is less clear about how to help her with the overarching practical concerns related to her father and sister.

References

Beach, S. R., Schulz, R., Williamson, G. M., Miller, L. S., Weiner, M. F. and Lance, C. E. (2005), Risk Factors for Potentially Harmful Informal Caregiver Behavior. Journal of the American Geriatrics Society, 53, 255–261.

Berry, J. W., Elliott, T., Grant, J., Edwards, G., & Fine, P. R. (2012). Does problem solving training for family caregivers benefit care recipients with severe disabilities? A latent growth model of the Project CLUES randomized clinical trial. Rehabilitation Psychology®, 57, 98-112.

Elliott, T.R. & Pezent (2008). Family caregivers of older persons in rehabilitation. NeuroRehabilitation, 23, 439–446.

Institute on Medicine (2008). Retooling for an Aging America: Building the Health Care Workforce. Retrieved Nov. 2, 2010, from http://www.iom.edu/agingamerica.

Institute on Medicine (2012). The Mental Health and Substance Use Workforce for Older Adults: In Whose Hands. Retrieved from http://www.iom.edu/Reports/2012/The-Mental-Health-and-Substance-Use-Workforce-for-Older-Adults.aspx

Williamson, G. M., Shaffer, D. R., & the Family Relations in Late Life Project, (2001). Relationship quality and potentially harmful behaviors by spousal by spousal caregivers: How we were then, how we are now. Psychology and Aging, 16, 217–226

U.S. Department of Health and Human Services (2010). Healthy People 2010. Retrieved Nov. 2, 2010, from http://www.healthypeople.gov/2010