Caregiver Issues / Stress

Caregiver with old woman in wheelchair

Caregiver issues can affect both professional caregivers, who are paid to provide care to individuals in their homes or in a health care setting, and unpaid individuals who provide care to a loved one, friend, or family member. These issues may include stress and isolation, among others. Those who become stressed or anxious or experience other mental health issues as a result of providing long-term care may find the services of a mental health professional to be helpful.

Caregiver Stresses and Issues

Caregivers can be divided into two groups. One group is made up of people caring for a loved one or friend who is ill, disabled, or experiencing symptoms of aging. This may be as temporary as caring for a spouse who has had surgery, or the long-term care provided a child born with physical or emotional disabilities. Sometimes the caregiver is middle-aged who not only has children at home but also is caring for an aging parent. This group is often referred to as the “Sandwich Generation.” Taking care of a loved one can take place in their home, the caregiver’s home, an assisted living/long term care facility, or even long distance. The second group consists of caregivers who are paid to provide care in the homes of their patients or in long term care settings. They can be professionally trained and hired through an agency or can be an acquaintance employed by family members to take care of their loved one. They often take care of one patient at a time and can become very attached to their patient.

Caregivers, whether they are paid or unpaid or are related to a patient or are professionals, may encounter many stresses and pressures in their caregivng work. Stresses and issues caregivers may experience include:

Becoming Isolated as a Caregiver

Caregivers may become isolated from others when a patient requires extensive, ongoing care. This typically causes stress, which may lead to mental and/or physical health problems. Whether the caregiver is providing care during a temporary time of crisis or the care is ongoing, helping people who cannot care for themselves can be one of the most exhausting, challenging, difficult, yet loving things anyone will ever do. Unfortunately, many caregivers find little time for self-care. What they often forget is one must take care of oneself in order to take care of another.

Self-Care for Caregivers

The following methods may assist caregivers in taking care of themselves:

  • Attend classes and training courses to learn new skills. These are often taught through a hospital or at a local chapter of the American Red Cross.
  • Avoid isolation. Associate and interact with other people, especially other caregivers.
  • Find organizations and associations who specialize in helping caregivers.
  • Seek support from friends and family. Consider getting the support of a professional therapist or doctor if needed to help cope with the pressures or side effects of caregiving.

Psychotherapy for Caregivers

Psychotherapy can be beneficial for caregivers who have become isolated, overwhelmed, anxious, depressed, or are lacking support from others. Though the work of caregiving requires strength and resilience, without taking care of oneself over time, a caregiver can wear down and become susceptible to mental and emotional distress. Psychotherapy--either individually or in a support group--may provide the help and motivation for caregivers to continue their work and take proper care of themselves.

Physical Health Concerns for Caregivers

Physical health can be greatly affected as a caregiver. Many caregivers develop health problems and end up unable to care for their patient. Without proper treatment and care of self, some physical ailments that may affect caregivers include, but are not limited to:

  • Exacerbation or returning of previous or preexisting illness(es)
  • Hypertension
  • Insomnia or fatigue
  • Frequent headaches
  • Lowered Immune System
  • Substance abuse (drugs and/or alcohol)
  • Injury caused by improper lifting or transferring of a loved one or patient

Taking time for basic personal needs such as proper diet, adequate sleep time, exercise, and time with friends or alone can help reduce the risk of developing physical health problems.

Case Examples

  • Elderly wife experiences difficulty caring for aging husband: Marcia never thought she would ever be visiting a therapist, but she did not know where else to turn. Marcia, age 65 and recently retired, has been married for 40 years to Frank, age 75. They had looked forward to Marcia’s retirement with plans to travel around the country in their RV. Within months of Marcia’s retirement, Frank suffered a stroke that left him paralyzed on one side, unable to express himself verbally, and with some cognitive impairment. After many months of rehabilitative therapy, Frank is able to walk with a cane and to speak but his speech is often garbled. Frank, who was usually happy-go-lucky before his stroke, is now quite moody and frustrated with his disabilities. Marcia and Frank have no children and no relatives close-by. Her caregiving has left Marcia feeling quite isolated. She feels very lonely since her relationship with Frank has gone from being equal partners and best friends to one where she feels like his parent. They both take their frustrations out on each other and their once harmonious home seems like a battleground. Marcia feels guilty about not having patience with Frank. She has put on 25 pounds since his stroke, stopped her regular walks, and doesn’t have energy for much besides keeping up with housework and laundry. In therapy, Marcia was able to come to acknowledge and work through her grief over the “loss” of the man who was her husband and the future she had anticipated. She was also able to learn stress management strategies to help with her frustration and anxiety. With encouragement from her therapist, she was able to incorporate a regular exercise plan which not only helped her lose weight but also energized her to begin focusing on the things she could do with, and without Frank, to make her future look less bleak and lonely.
  • Woman overwhelmed by multiple caregiving positions in middle age :Sally, age 52, sought the help of a therapist when she found herself constantly yelling at her kids, bickering with her husband, and not wanting to answer the phone when she saw that her mother was calling. Her father had been diagnosed with dementia and her mom needed extra advice, help, and support from Sally, her only child. Her parents lived in another state so any help Sally could give was long distance. She felt torn between her family’s needs and those of her parents’ and more often than not, felt frustrated and angry. The therapist was able to help Sally see that anyone in her position would feel stressed and have little patience. She taught Sally anger management strategies and stress reduction techniques. She advised her on how to find local support for her mother and father through the Alzheimer’s Association chapter in their area. Sally invited her two teenage daughters and her husband into one of her sessions with her therapist With the therapist’s help, they were able to talk about the stressors at home and devise a plan to have more “quality” time together as a family.


Last updated: 07-13-2015

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