What is caregiver stress?
Caregiver stress is the emotional and physical strain of caring for someone who needs ongoing help. The Office on Women's Health at the U.S. Department of Health and Human Services says caregivers report much higher levels of stress than people who are not caregivers, and that many are providing help or are on call almost all day. It notes that long-term caregiver stress can contribute to depression and anxiety, a weaker immune system and other health problems.
Much of that stress is worry. Will she fall while I am at work? Did I give the right dose? What happens when the money runs out? What happens to him if something happens to me? That kind of worry does not clock out at the end of the day, which is part of what makes it so tiring.
Signs that caregiving is taking a toll
The National Institute on Aging and the Office on Women's Health describe warning signs worth watching for in yourself:
- Feeling overwhelmed, constantly worried or on edge.
- Feeling sad or hopeless, or losing interest in things you used to enjoy.
- Irritability, swinging from frustration to helplessness.
- Sleeping poorly, or feeling tired no matter how much you rest.
- Skipping your own checkups, meals, exercise or personal care.
- Drinking more, or misusing alcohol, drugs or prescription medicines, to cope.
Guilt, and the small-town version of it
Many caregivers feel guilty for being tired, for wanting a break, or for not doing more. NIA notes that long-distance caregivers can feel guilty about not being closer, and those nearby can feel resentful about doing the most. In a small community there is an extra layer: everyone at church knows your mother, and asking for help can feel like admitting failure in public. It is not. It is what keeps caregivers going.
Who is most affected?
Anyone can develop caregiver stress. The Office on Women's Health says most family caregivers are women, that women caregivers report more stress and health problems than men, and that the risk is higher for people caring for a spouse or for someone with dementia who needs constant supervision. WHO notes that many older adults care for a spouse with a chronic condition such as dementia, which can be overwhelming and affect their own mental health.
Polk County has a large population of retirees, so caregiving here is often one older spouse caring for another, or adult children balancing a parent's needs with jobs in Spartanburg, Hendersonville or Asheville. Our page on anxiety in retirement covers some of the same ground.
What helps caregivers
NIA and the Office on Women's Health offer practical suggestions. None of them is easy when you are exhausted, which is a reason to start small:
- Accept help, and make a list of specific tasks people can choose from, such as sitting with your loved one, picking up groceries or driving to an appointment.
- Ask for small things at first, and use a text or email if asking face to face is hard.
- Tell your own doctor that you are a caregiver, and keep your own appointments.
- Join a caregiver support group, in person or online.
- Look into respite care or adult day services so you get regular breaks.
- Protect sleep, food and some physical activity, even in small amounts.
Local caregiver support in Polk County
Polk County is served by the Foothills Regional Commission, which acts as the Area Agency on Aging for Cleveland, McDowell, Polk and Rutherford counties. Its Family Caregiver Support Program offers information about services, help accessing them, counseling, support groups, caregiver education, respite and supplemental services. The NC Department of Health and Human Services describes who qualifies statewide, including unpaid adult caregivers of people 60 and older and of people of any age with Alzheimer's disease or a related disorder.
The Meeting Place senior center in Columbus is another local point of contact for older adults and their families. For people on the South Carolina side, ask your county's aging services office about caregiver programs.
When to talk to a counselor
NIA advises caregivers who are feeling anxious, frustrated or depressed to ask a doctor for a referral to a counselor, and to check what their insurance covers. Counseling gives you an hour that is about you, a place to say what you cannot say at home, and help with the guilt, grief and worry that caregiving brings. Our pages on how counseling helps anxiety and faith, anxiety and asking for help may also be useful.
Laura Bass is a psychotherapist who works with adults, and anxiety is among the concerns she sees. She has a part-time office at The Healing Cottage in Columbus; call 704-706-3264 or use the contact page, and ask which days she is there.
If caregiving ever brings you to a breaking point, or you have thoughts of harming yourself or the person you care for, call or text 988, or call Vaya Health at 1-800-849-6127. If anyone is in immediate danger, call 911.
Common questions
Is it normal to feel resentful as a caregiver?
Yes. Caregivers commonly describe swinging between love, frustration, guilt and resentment, sometimes within the same hour. The Office on Women's Health notes that caregiver stress can show up as feeling frustrated and angry one minute and helpless the next. Those feelings do not make you a bad caregiver. They are a sign that you need support and rest too.
What is respite care?
Respite care is short-term care for your loved one so that you can take a break, whether for a few hours, a day or longer. It can be provided at home, at an adult day program or in a care facility. In Polk County, the Foothills Regional Commission's Family Caregiver Support Program lists respite among the services it helps caregivers access.
How can I find time for counseling while caregiving?
It can be hard. Some caregivers arrange a regular sitter, a family member or a respite service for the hour of their appointment. Others start by asking the counselor about scheduling that fits around care. It may help to think of counseling as part of the care plan, since a worn-out caregiver cannot keep going indefinitely.
Do I need my loved one's permission to talk about them in counseling?
No. Your counseling is about you, and you can talk about the person you care for, your relationship and your feelings without their permission. What you say is confidential, within the legal limits a counselor will explain at the start, such as a serious risk of harm or suspected abuse of a vulnerable adult.