Ask the Expert: Caring for the Caregiver
It was a late Friday afternoon when my team was asked to do a consult on one of the patients on the geriatric medical unit. The patient’s wife was visiting her husband at the time of our arrival, and we were privileged to witness a beautiful, yet painful encounter of profound sadness and deep love.
Her gray hair, slim frame, and fragile countenance, revealed the many years of being undernourished, sleepless, and constantly anxious and preoccupied about her husband’s health. The years of sacrifice, devotion, commitment, and a promise she had made to her husband – “till death do us part” – appeared to keep her steadfast in the only purpose she had in her life, which was to ensure the safety, comfort, and well-being of her beloved husband who could no longer take care for himself.
Fifty-nine years of marriage had seemed to have flown by. She tearfully and squarely looked into the empty eyes of her husband, softly held his hand, and whispered, “Do you know who I am? Where did you go? Where are you? Are you thinking of anything in particular right now? Is it possible that you don’t know me or our children?”
These frequent heartbreaking questions are not uncommon among caregivers who care for a spouse with dementia and/or other neurological and psychiatric conditions. These affect-laden questions are typically asked by other caretakers, such as mothers with physically, emotionally, and/or mentally challenged children, or caregivers of cancer patients, or people who care for those with severe mental illness.
In fact, these questions are not very different in the extent of the angst and despair, as they convey feelings of impotence, helplessness, and intermittent hopelessness that caregivers experience on a daily basis. Yet, on average, no matter how difficult it gets, caregivers of compromised adults and children continue their quest to fight, protect, and meticulously care for their loved ones.
So, are there any consequences of being the primary caregiver of someone who is medically and/or psychiatrically infirm?
Ironically, caregivers often neglect themselves in the process of ensuring for the care and safety of their loved ones. Research has clearly demonstrated that caregivers tend to be much more vulnerable to both physical and psychological deterioration due to prolonged periods of stress, poor nutrition, and sleepless nights.
There is also clear documentation of the impact of chronic stress on the central nervous system as well as the immune system due to the dysregulation of neurotransmitter and neurohormonal functioning. Regardless of the type of illness or disability that caregivers manage with their loved ones, there is clearly a very high risk for developing anxiety, depression, sleep difficulties, irrational guilt, and general health problems.
At the Jackson Behavioral Health Hospital, we are very aware of the risks involved in being a primary caregiver for family members and partners who suffer from a wide variety of medical and psychiatric disorders.
Our outpatient clinics are specialized in not only treating the patients themselves, but also attending to the needs of the primary caregivers of our patients. We are acutely aware of the challenges that the caregivers of our patients face and endure. We attempt to convey to the caregivers of our patients that they must also attend to their needs in order to stay emotionally and physically healthy and strong enough to be able to continue the caregiving process.
For additional information about our programs in the adult and child clinics and the Center for Behavioral Medicine, contact us at 305-324-HELP (4357).
Efrain A. Gonzalez, Psy.D., MS ClinPharm, ABPP, is the director of medical psychology and a volunteer associate professor at Jackson Behavioral Health Hospital.