Depression Prevalent in Caregivers of Loved Ones with Dementia
When I began caring for my elderly parents (both with early Alzheimer’s not properly diagnosed), I was shocked to read that family caregivers are often more depressed than those they care for. And caregivers who have a chronic illness have a 63% higher death rate than their peers of the same age. A year later, without a day off with my “challenging” elderly father—I was surprised the statistic was that low!
Additionally, caregivers of loved ones suffering with dementia are twice as likely to suffer depression than those providing care for non-dementia patients—and the deeper the dementia, the deeper the depression is likely to be. Since 5.2 million people in the United States are afflicted with Alzheimer’s (just one form of dementia), and 7 out of 10 are cared for at home by family and friends who provide 75-80% of their care—millions of caregivers are suffering from depression or are at great risk of developing it.
Depression often occurs when a caregiver gets overwhelmed trying to manage too many responsibilities. Emotions fluctuate from sadness, loss, grief, isolation, anxiety, exhaustion, anger and frustration—and the resulting guilt for having those feelings. Caregivers tend to sacrifice their own careers, neglect healthy family members, ignore their own physical and emotional needs, and postpone their own medical checkups resulting in undiagnosed and sometimes serious ailments.
DENIAL & DESPERATION
Oftentimes family members don’t even consider themselves “caregivers”, thinking they just need to toughen-up and then they will be able to cope with the heart-wrenching situation. And since they’ve always been able to manage stressful situations and solve problems in the past, the perceived failure damages self-esteem and compounds depression. But who wouldn’t be depressed when day-after-day a devoted family caregiver:
· Watches a loved one suffering and declining.
· Worries about money and finances.
· Spends hours and days at doctor appointments and hospitals.
· Thinks about life and death issues and fears that the end is near.
· Hates the world and everyone in it for what has befallen their loved one.
· Wonders how long their caregiving will last and if they will have a normal life again.
· Feels ashamed for not having enough patience, persistence and strength.
Even though the stigma of seeing a healthcare professional for depression is lessening, many still feel it is a sign of weakness and that they will eventually snap out of it on their own. A National Mental Health Association survey found that many people do not seek treatment for depression simply because they feel ashamed and are embarrassed.
Compounding the problem, oftentimes friends and family who are not directly involved with the caregiving don’t know how to give the support a caregiver needs. They may be emotionally unable to handle the stressful situation and back away, causing the caregiver to feel even more isolated and depressed.
By making a list of those who are willing to help and a list of chores needing to be done, a caregiver can ask friends and family to pick the tasks they feel most comfortable with. If hands-on caregiving is too stressful, there’s always things like: cleaning, organizing, fixing things around the house, organizing the pantry, attic and garage, taking the car in for service and having the tires rotated, grocery shopping, cooking meals for the freezer, tending the garden, having clothes mended, taking the patient to have their hair done, or simply taking the caregiver out to lunch.
ADULT DAY CARE
Enrolling an elderly loved one in Adult Day Care provides several hours of respite for an overwhelmed caregiver and is often the best thing for the patient. Their day gets filled with social interaction and activities lead by healthcare professionals trained to work with them. It takes a couple weeks, but soon they’ll enjoy participating in the singing, dancing, cooking, games, crafts, bingo, movies, current events, lectures, exercise, etc. The caregiver gets a much needed break enabling them to have better coping skills later when their loved one comes home again. Additionally, all the activities tire the patient out, helping them to sleep through the night instead of being a “sundowner” and up all night with an exhausted caregiver.
RISK OF ELDER ABUSE
Caregivers who make sure they take breaks from their responsibilities may be saving themselves from reaching a “breaking point” and committing elder abuse—even though they never dreamed they could ever cross that line. When a cranky nasty loved one becomes unappreciative of the extraordinary efforts being made to care for them, says the most hurtful demeaning things, accuses the caregiver of stealing from them, hits, spits, throws things, and pushes the caregiver to their absolute limit—the elder abuse line can be crossed even in very subtle ways. Instead of gently sitting their loved one down in a chair, the angry caregiver may suddenly be inclined to just let the person “flop” down in the chair in retaliation for a momentary punishment. Of course, the result is guilt which leads to more depression and desperation.
SUPPORT GROUP A MUST
The realization that a once-competent loved one is no longer who they used to be, even though still physically there, can cause profound feelings of sadness and loss. However, when caregivers attend a support group regularly and learn creative solutions and coping strategies during brainstorming sessions with others going through similar experiences—they tend to feel less alone and often report lower levels of depression.
The ideal place to find and attend a support group is at a loved one’s Adult Day Care Center, as the professionals there will be familiar with the specific situation. Support groups educate caregivers on how to manage challenging behaviors and help them develop an emotional shift so hurtful statements no longer cause the pain and devastation they once did. They learn not to argue or use logic or reason, but practice using distraction and redirection instead.
And when a caregiver desperately needs someone to talk to but it is 4:00 am, online support groups can be very helpful. The good news is that it’s daytime somewhere and online caregivers offer help and support from every corner of the world.
SIGNS OF DEPRESSION
· Feeling tired and listless most of the time.
· Change in eating habits resulting in unwanted weight gain or loss.
· Change in sleep patterns, too much or not enough.
· Loss of interest in people and activities that used to be pleasurable.
· Becoming easily agitated, anxious, angered, frustrated, overwhelmed.
· Feeling that nothing is ever good enough.
· Persistent “what’s the use” thinking.
· Thoughts of death or suicide, or attempting suicide.
· Ongoing physical symptoms that don’t respond to treatment such as headaches, digestive disorders and chronic pain.
DEPRESSION IN THE PATIENT
Depression should also be suspected in the one being care for and evaluated by a healthcare professional. Imagine yourself, having to rely on someone to care for you (usually the child you sacrificed and did so much for) and telling you what to do every hour of every day. You’re not allowed to drive, you’ve lost many of your friends and family and been to dozens of funerals, you have constant aches and pains and health problems, your mobility, sight, hearing, and memory are slipping, and you’re facing mortality directly. OK, who wouldn’t be depressed? Be sure to walk a mile with their walker and ask the doctor if an anti-depressant might be tried, which may greatly help the patient as well as the caregiver’s quality of life.
The emotional roller coaster of watching a loved one decline is one of the hardest experiences of life. Therefore, as soon as the caregiving journey begins, caregivers must immediately realize their increased risk for developing depression and/or a serious ailment and respond to the earliest symptoms to lessen the severity and duration of an episode. With regular exercise, a healthy diet, positive self-talk, using Adult Day Care, focusing on a loved one’s present rather than the decline, attending a support group, and seeing a mental health professional and if needed trying an anti-depressant—the level of depression may be greatly reduced.
Learn more about Jacqueline, an international speaker, radio host, and bestselling author at ElderRage.com