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What is Caregiver Syndrome? Caregiver syndrome or caregiver stress is a condition of exhaustion, anger, rage, or guilt that results from unrelieved caring for a chronically ill dependent. The risk of getting this syndrome is highest when caring for an individual with behavioural difficulties, such as: faecal incontinence, memory issues, sleep problems, wandering, and aggressive behaviour by the person receiving care.

What is the cause of this condition? Caregiver syndrome is caused by the overwhelming duty of caring for a disabled or chronically ill person. The stress on the caretaker is caused by an increased stress hormone level for an extended period of time. This results in increased blood pressure, heart rate and lack of sleep eventually resulting in generalized fatigue and in some cases, depression. Caregivers also suffer the grief of a declining loved one which contributes to the development of a depressive exhaustive state and a deteriorating emotional and mental health. "Double-duty caregivers" are those already working in the healthcare field who feel obligated to also care for their loved ones at home. This over-exhaustion and constant caregiving role can cause an increase in physical and mental health deterioration. It is actually being thought that a part of the stress of being a caregiver is from how they feel about the job. In other words if a caregiver does not like or want to be a caregiver, they will inflict more stress on themselves by accepting the role.

Why is this important? Every day, hundreds of older Bahamians, 65 years of age or older, manage basic health and functioning needs with the help of family caregivers. Increasingly, however,an increasing number of younger Bahamians are requiring this level of assistance as a result of trauma and strokes. This is becoming increasingly common in our community and the level of care given to elders varies across the socioeconomic spectrum that subsequently impacts on the quality of life in the end stage of life.

In the absence of the financial capacity to employ the necessary caregivers, the care for a loved one has to be assumed by family members.In our society however, this commonly results in one relative assuming this role with little if any assistance being rendered by other relatives. These family caregivers, typically are close family members,partners, friends, or neighbours who tend to provide help because of a personal relationship rather than financial compensation. This oftentimes leads to loss of income and social isolation by primary family caregivers. They may arrange and attend medical appointments, participate in routine and high-stakes treatment decisions, coordinate care and services,help with daily tasks such as dressing and bathing, manage medicines, obtain and oversee the use of medical equipment such as oxygen tanks, handle bills and banking. Older caregivers are not the only ones who put their health and well being at risk. If you are a baby boomer who has assumed a caregiver role for your parents while simultaneously juggling work and raising adolescent children, you face an increased risk for depression, chronic illness and a possible decline in quality of life.

Challenges are exacerbated when caregivers are in poor health themselves, don’t have a choice about assuming the caregiving role because no one else is available and willing. Additionally, the half of family caregivers who are employed and work in low-wage jobs with limited flexibility in their work schedules.

This is as a results unhealthy lifestyles such as sleep deprivation, poor eating habits,failure to exercise, failure to stay in bed when ill and postponement of or failure to make medical appointments for themselves What can we expect in the future? As our rates of cancer, strokes, heart disease, high blood pressure dementia and diabetes continue to escalate we can expect that many persons currently in their sixties can expect to have substantial care needs which are defined as having dementia or needing assistance with two or more self-care activities (eating, bathing,dressing, toileting, or getting in or out of bed). Nursing home residents are excluded. Greater rates of childlessness, smaller and more geographically dispersed families, income levels and increasing participation of older women in the labour force pose threats to the availability of family caregivers to meet the needs of the growing number of older Bahamians. Advances in medicine that have extended life expectancy have increased the duration,complexity, and technical difficulty of care required by older adults and delivered by family caregivers. However, health care professionals also do not typically assess family caregivers’ knowledge, understanding, or proficiency in the tasks they are expected to perform at home. Family caregivers describe learning how to provide care by trial and error — and being fearful of making a mistake that will cause harm. Challenges are exacerbated when caregivers are in poor health themselves, don’t have a choice about assuming the caregiving role because no one else is available and willing. Additionally, the half of family caregivers who are employed and work in low-wage jobs with limited flexibility in their work schedules. SOME TIPS TO MINIMIZE CAREGIVER STRESS Take Time for You It's easy to get burned out when you're caring for a loved one, whether it's a special-needs child, a spouse with a chronic illness, or a frail older person. Taking time for yourself every day -- even just a few minutes if you can get relief is one way to help you recharge. Slip out for a 20-minute walk, go to the movies, or pursue any hobby you love. Reducing your stress will make you a better caregiver. Know Your Limits You can't provide good care if you feel overwhelmed and stressed out. Make a list of all the tasks you need to do in a week, including dressing and bathing a loved one, rides, cooking, and household chores. Brainstorm which ones someone else might be able to do. Learn when to say no, and set boundaries so you can take care of your family and yourself. Stick to a Routine A daily routine can be a lifesaver. It can help you feel in control rather than stressed. It lets your loved one know what to expect.That's good for people with dementia. It provides a sense of security and helps them maintain their abilities. Ask for Help Even a few hours "off duty" can help you recharge. Make a list of family, friends, or neighbours to call when you need a break. If finances allow, hire a home health aide. Get Enough Sleep

Most caregivers who say their own health has gotten worse blame loss of sleep. If your loved one sleeps during the day but is awake much of the night, try to take naps during the day. You might need to hire someone or ask a friend or relative to stay with your relative overnight so you can get a good night's sleep.

Cope With Sundowning

People with dementia can become confused or agitated in the evening.Planning for it can help them and lower your stress. Set up activities early in the day, and serve an early dinner. Turn the lights up in the evening. Check with a doctor about any physical or sleep problems that may be making the problem worse.

Make It a Team Effort

Hold regular "family meetings" to discuss the latest medical news, daily caregiving tasks, financial concerns,and your need for support.Include everyone who cares for your loved one, including paid helpers. Connect distant family members through a speaker phone or online video chat. Follow up with a written agreement and a calendar of tasks.

Dr. Patrick Whitfield Family Medicine Specialist.

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