If the long-term care provided by spouses or relatives were to stop today the infrastructure of professional healthcare provision would collapse under the strain. Over 80 percent of long-term care is provided outside of formal healthcare. Quite simply we rely on the legions of friends, relatives, helpful neighbors, volunteers, wives and husbands to provide care for people who are sick or disabled. The system is such that more complex care is meant to be provided by health professionals, whereas more basic needs such as cleaning, washing, cooking and dressing can be done at home. We know it's not as straight forward as this, yet somehow this fragile arrangement seems to work. Informal homecare can appear to be cost free but there's no such thing. Everyone who needs care needs some form of special provision but this Sharepost is about the cost that providing care can have on the caregiver.

I doubt there is anyone reading this, if they've ever worked in health or social services, who hasn't seen a situation where a caregiver looks as ill, or worse than the person they care for. At its best caregiving can be a rewarding and fulfilling experience for those involved. At its worst it can destroy relationships and become an eroding, physically and emotionally damaging experience, from which some people never fully recover.

Not everyone is equipped with the skills or the temperament to provide long-term care. If they recognize this and they are fortunate enough to have the resources to buy in care then the situation is eased. Others, through necessity, love, guilt or duty, become the principal caregiver. At the outset they perhaps find it relatively easy to cope with the needs of the person they care for. Over time things can change. A relative with Alzheimer's, for example, will require increasing care and supervision as the disease progresses. Before they know it the caregiver is working fewer hours or has left work altogether. Social contacts begin to diminish and the provision of care becomes an almost exclusive activity.

So how can all this affect the caregiver? Think of an emotion and you've probably ticked one of the boxes. Yes, some elements of caregiving can be enriching but more negative emotions such as frustration, anger, guilt and depression can affect even the most dedicated caregivers. There is often a physical strain from extra work such as cleaning, lifting and getting up during the night to see to needs. It leads to exhaustion and a great deal of stress.

Stress affects health. There is a wealth of evidence that points to caregivers experiencing higher levels of anxiety, depression and problems of attention, memory and problem-solving. Long-term stress affects the body by flooding it with stress hormones. This affects the immune system and leaves the caregiver prone to infections that take a longer than average time to shake off. Even cuts and grazes take longer to heal. Caregivers are more prone to medical problems such as diabetes, heart disease and cancer. Compared to people who aren't caregivers, they are more likely to ignore their own health, do less exercise, eat more unhealthy foods.