CAREGIVING AS A RISK FACTOR FOR MORTALITY

It is estimated that over 15 million adults currently provide health care for relatives, with the majority of caregivers being middle-aged adult children or older spouses caring for a parent or spouse with functional limitations. Although family caregivers perform an important service for society and themselves, there is a strong consensus that caring for an elderly individual with disability is burdensome and stressful to many family members, and contributes to psychiatric morbidities such as increased depression. The prolonged distress and physical demands of caregiving may also contribute to chronic stress and decreased physiological functioning, as shown through decreased immunity and slower wound healing.

In a recent, large study of caregivers versus non-caregivers over four years, (51 % women, 49% men with ages ranging from 66 to 96), about 81% were providing care and 56% reported caregiver strain. Even taking into consideration stressful life events and physical health status, participants who were providing care and experiencing caregiver strain had mortality risks 63% higher over the four years of the study than those participants whose spouses did not require care. Participants who did not have a disabled spouse or who did not experience strain in caring for their spouse did not show significantly higher mortality rates than non-caregivers. Strained caregivers; also showed higher levels of depression, anxiety, and lower levels of perceived health.

Although this study only focused on a subset of the caregiving population (elderly caregiving spouses who are living with the disabled patient), it suggests that physicians who care for older adult couples should work to identify caregivers at risk. If caregiving demands are high or caregiver health is compromised, opportunities for interventions to reduce demands such as respite services may be needed.

More information may be obtained by reading:

Schulz, R Ph.D. and Beach, S Ph.D. "Caregiving as a Risk Factor for Mortality: the Caregiver Health Effects Study". JAMA: Vol. 282 No. 23. pp 2215-2219

Abstract by Lisa P. Hu, M.D.