It’s time to start looking past the patient

Helping others can harm caregiver, study shows

According to The Journal of the American Medical Association, there are an estimated 25 million family caregivers in the United States, many of them elderly, who must provide help and support to a spouse or other family member. In some instances, the patient may require assistance with almost every aspect of daily life.

In many circumstances, families are fortunate enough to have the assistance of a home care professional, however, for much of the time they must fend for themselves.

Stress from caregiving takes a toll

The responsibility of looking after a seriously ill family member only adds to the stress of daily life and often with harmful results. The JAMA article, Caregiving as a risk factor for mortality: The Caregiver Health Effects Study, demonstrated the depths to which this stress can impact a caregiver.

Elderly caregivers who experience mental or emotional stress as a result of caring for a disabled spouse are at higher risk of dying than those spouses who are not caring for a disabled spouse. After adjusting for sociodemographic factors and physical health status, the study found "caregivers who provide support to their spouse and report caregiving strain are 63% more likely to die within four years than noncaregivers."1 (The study did not find that spouses who were caring for a disabled spouse but not experiencing related stress had higher mortality rates.)

Spouses are especially at risk

The effects of caring for a seriously ill spouse, the study showed, greatly contributes to the likelihood that the caregiver will experience significantly higher levels of depression and anxiety as well as a greater lack of perceived health.

After examining 392 caregivers and 427 noncaregivers between the ages of 66 and 96 who were living with their spouses, caregivers "are much less likely to get enough rest in general, have time to rest when they are sick, or have time to exercise. All of these factors, and others not assessed in this study, are possible mediators in the association between caregiving and mortality," the study said.

The study went on to suggest that health care professionals such as primary care physicians are in the best position to ascertain caregivers who may be at risk.

Home health professionals, it stands to reason, are in an even better position to determine whether the stress of caring for a disabled spouse is too great a strain on the caregiver — after all, they see firsthand the condition of the patient’s home and family.

As anyone in the business knows, all too often home care providers end up caring for more than just their patients, for their families form an integral part of the patient’s treatment plan and can greatly impact the likelihood of their eventual recovery. For home care providers searching for a way to go the extra mile without doing all the running themselves, JAMA has made available a checklist designed with the at-home caregiver in mind. (See box, at left.)


1. Schultz R, Beach SR. Caregiving as a risk factor for mortality: The Caregiver Health Effects Study. JAMA 1999; 282:2,215-2,219.