In a presentation to the National Press Club in 1997, former First Lady Roslyn Carter, said, "There are only four kinds of people in the world: those who have been caregivers, those who are currently caregivers, those who will be caregivers, and those who will need caregivers."
Perhaps we need to add a fifth kind of person to that list: Those who are caregivers but don't realize they are. There are a lot more of them than you might think, explains Benjamin Rose's Director of In-Home Services Sylvia Pla-Raith. "This is because they don't see what they are doing-helping mom balance the checkbook, phoning dad every morning to make sure he takes his cholesterol-lowering, diabetes, and arthritis medications, running errands for a disabled neighbor-as caregiving. They see it as an extension of their role as spouse or daughter or friend."
And, she adds, by the time many of them realize they are caregivers ("for many, it's years before they see a caregiver in the mirror when they get up in the morning"), they are suffering from symptoms of caregiver fatigue or, worse yet, caregiver burnout.
Symptoms of both usually include: feelings of guilt and inadequacy because they can't do enough for the person needing care; resentment, anger, impatience, and/or irritability at family members and/or the care recipient; social isolation due to caregiving responsibilities that eat up not only time, but money, too; and physical and mental exhaustion. "Neglecting themselves isn't good for them," says Nurse Dwayne Askerneese, Care Coordinator for the Western Reserve Area Agency on Aging's Family Caregivers Support Program, "and it's not good for the person they are caring for, either."
If you are in your late 50s or early 60s, expect to take on the role of caregiver soon as parents or elderly loved ones enter their late-70s and 80s, says Pla-Raith. "It can be earlier," she adds, "if they have chronic health conditions."
By taking the following proactive steps now, however, you can make the transition to caregiver easier for you and the person you will be caring for:
• Talk to your aging loved ones about their finances, long term care insurance, where important documents are stored, and their need for a durable power of attorney for health care and a living will.
• Talk to them, and their health care provider, about their health status-present and future. If they have a medical condition, such as osteoarthritis or Alzheimer's Disease, that will worsen over time, now is the time to learn as much as possible about it and find out about support groups on the condition. "[Support groups] are all about sharing-information, resources, insights, tips," says Pla-Raith. "Hearing this kind of information from people who have been there is very therapeutic."
• Talk to them about the kind of housing they want as they become less able to care for themselves. If they decide they want to remain in their home as they age-and most people do-investigate the relatively inexpensive equipment, devices, and home modifications that will enable them to do so.
• Talk with family members, the elderly person's physician and friends, and representatives from local community service agencies about the activities, organizations and services (senior exercise programs, Meals on Wheels, home chore agencies, adult day services, transportation services, etc.) available in your community. The best sources for this information are usually your community's Office on Aging.
• And finally, make plans to take care of your physical and emotional needs by lining up substitute caregivers-home companions, adult day centers, even skilled nursing facilities-before you need them. "When someone else takes over the caregiving responsibilities, even for just a day, you can step back into your role as daughter or spouse, and recharge your [emotional] well, too," says Pla-Raith.
These articles were produced the Benjamin Rose Institute on Aging, a leading organization that has been assisting older adults and families since 1908 (www.benrose.org), in collaboration with Eileen Beal, a health writer specializing in issues related to aging and caregiving.