Elderly Caregiving: Choices, Challenges, and Resources for the Family

Home / / ( Published on 2014-08-14 )

By many estimates, the group of American citizens 65 years and older will quadruple in the next three decades. With this expected population growth many of us in the upcoming years will be faced with primary or secondary caregiving for a loved one.

Numerous gerontological research studies report that family members provide nearly 82 percent of the necessary care for an elderly family member. Oftentimes there is one primary caregiver. This person is most frequently the elder’s child/children or spouse. There may also be a secondary group of individuals offering support to the elder and the primary caregiver. They could be extended family members, as well as friends.

The Caregivers
The caregivers must often provide care under complex circumstances, often balancing the concerns of their own immediate families, their careers, and their responsibility for elderly caregiving. In fact, caregiving can often be defined as providing unpaid assistance for the physical and emotional needs of another person, ranging from partial assistance to round-the-clock 24-hour care. Caregivers can also be considered primary and secondary. Several studies report the primary is most often a daughter or spouse. The secondary caregivers are most often other family and close friends, as well as those who are not relatives. Secondary caregivers tend to be less frequently involved in the personal care, although they help with support of the elder and respite of the primary caregiver.

Feelings and Experience of the Caregiver
Often as the illness or disability progresses in aging, the amount of caregiving increases rapidly with little warning. Along this journey of caring also comes a wide range of emotions and circumstances that may be confusing or appear conflictual by the caregiver. For example:

  • Chronic emotional and physical fatigue.
  • Internalized guilt.
  • Issues of death, dying, and other end of life concerns.
  • Not fully understanding the course or prognosis of the illness.
  • Anger towards self, the elder, and other caregivers.
  • Social isolation.
  • Sadness and grief.
  • Unexpected and increasing financial burdens.
  • Complex legal issues.
  • Stress on one’s own immediate family and relationships.
  • Denial and lack of preparation for the possibility of a difficult   course of illness.

Care for the Caregiver
All things considered, one can imagine the incredible importance of the caregivers being attuned to caring for themselves. Many studies report that when there is a strong bond between the caregivers and the elderly that the caregivers feel less stress. However, this may not necessarily be the case at particular points in providing care; therefore, taking care of oneself is important to the entire process. All too frequently caregivers are unwilling, perhaps ashamed to ask for help because they perceive this to be a sign of inadequacy, perhaps even failure. The caregivers cannot be expected to do it all and it is imperative to set limits. To provide effective care, one needs to maintain one’s own health. In fact, neglecting your own care may have long-term consequences, not only for you, but also for the person who needs your care. The following items are often neglected by caregivers:

  • Getting adequate sleep.
  • Periodic exercise and nutritious meals.
  • Taking regular short and longer-term breaks from providing care.
  • Allowing others and/or agencies to take over for you (or collaborate   with a co-partner).
  • A good awareness of knowing and acting upon when you need to rest.

Possible Resources for the Elderly

There are numerous private, community, and government sponsored resources for the elderly and their caregivers. Home delivered meals (often called “Meals on Wheels”), adult day care centers, group living facilities, multicultural centers, religious programs, geriatric social workers, and home health care agencies are examples. The American Association of Retired Persons (AARP), the National Council on Aging (NCOA), and the local community senior and cultural centers are also fine examples of resources. At UCSF there is also the Goldman Institute on Aging at the Mount Zion Medical Center, and the UCSF Auxiliary Services that offers elder care consultation and referral services.

Ten Tips for Family Caregivers

  • Caregiving is a job and respite is your earned right. Reward yourself with respite breaks often.
  • Watch out for signs of depression, and don’t delay in getting professional help when you need it.
  • When people offer to help, accept the offer, and suggest specific things that they can do.
  • Educate yourself about your loved one’s condition and how to communicate effectively with doctors.
  • There’s a difference between caring and doing. Be open to technologies and ideas that promote your loved one’s independence.
  • Trust your instincts. Most of the time they’ll lead you in the right direction.
  • Grieve for your losses, and then allow yourself to dream new dreams.
  • Stand up for your rights as a caregiver and a citizen.
  • Seek support from other caregivers. There is great strength in knowing you are not alone.
  • Caregivers often do a lot of lifting pushing and pulling. Be good to your back.

As our elderly population increases more rapidly than ever before, and the large numbers of us become caregivers at some point in our life, potentially stressful experiences may await us. However, caring for an elderly individual can be highly rewarding. It may strengthen relationships among family members with numerous opportunities to work together. It is an opportunity to express love and appreciation for the support the elder has given you. Take good care of the elderly, as well as take great pride in yourselves, family, and friends.

The Faculty and Staff Assistance Program (FSAP) at UCSF provides confidential assessment, counseling, referrals, and consultation services that support the wellbeing of both the individual and the organization. For an appointment or more information contact us at 415/476-8279 or visit the FSAP website.