Family Caregiving: Tips for Reducing Stress for Family Caregivers (FS688, Revised Oct. 2019)

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Caregiving provided to aging family members or others in need often is associated with stress and burnout. Although providing direct care to a family member or someone else can result in significant stress, remember that this experience can have positive benefits as well. Consider the rewards and challenges of the caregiving experience honestly.

Sean Brotherson, Ph.D., Extension Family Science Specialist

Jane Strommen, Ph.D., Extension Gerontology Specialist; Philip Estepp, M.S., Extension Associate

Family Caregiving: Tips and Tools for You and Your Loved Ones

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Suggested Benefits to Caregiving

Discussing how the caregiving experience has provided benefits to the caregiver and the care recipient can be helpful. This focus on the positive aspects of the experience can help give perspective and needed hope when stress increases. According to research, many who pass through this experience report specific benefits associated with caregiving.

Benefits to Caregivers

Closer relationships with the person they care for and having sufficient time to be together
Increased understanding of a parent or family member and the ability to forgive or heal past difficulties
Greater patience with individuals and life challenges
Personal growth as an individual due to being challenged and stretched in emotional and other ways

Benefits to Care Recipients

Opportunity to receive assistance in a setting that is caring and personal
Greater individualized care and attention than is available in other circumstances
Opportunity to share life experiences and develop close relationships with people who are close to them and who they appreciate

Areas of Stress Impact Related to Family Caregiving

The caregiving experience does impose demands on family members and, at times, they may need to deal with significant levels of stress. Also, caregiving expectations can vary significantly by the age of the person, and gender or cultural background. Identifying specific areas of stress in caregiving allows for intervention to reduce or alleviate stress as it continues.

Physical demands – direct care, lifting, bathing, feeding, etc.
Financial demands – medical costs, equipment, hired help, lost income
Emotional burdens – feeling isolated, alone, without time for oneself
Relationship challenges – sibling conflict, conflict with dependent adult, etc.

Caregiving involves providing direct physical and emotional support to a family member or other individual who has become dependent and needs some care and assistance. The level of caregiving can vary from occasional monitoring of how a person is doing to full-time, round-the-clock care for a bed-bound or home-bound individual.

Caregiving can be a healthy and fulfilling experience. However, at times, it can bring burdens that lead to stress, exhaustion, anger and even abuse. Awareness of the stresses that may accompany caregiving and tips for dealing with such stresses can be helpful to caregivers and family members.

1. Physical Demands and Direct Care as a Source of Stress

Caregiving often involves basic, practical aspects of care, such as helping someone bathe or dress or move from a bed to a wheelchair. When caregivers perform these tasks for a dependent adult, the resulting demands and labor can be challenging and stressful to a caregiver. Stress sources of physical demands and suggested coping tips are provided below.

Stress Sources of Physical Demands	Suggested Coping Tips
Creating a safe physical environment, preventing falls Providing first aid and medical assistance as possible Bathing a care recipient Assisting with oral hygiene Dressing a care recipient Assisting with toileting needs Feeding or assistance with eating, nutrition needs Meal planning and preparation Lifting, turning or transferring a care recipient Routine housework Management of behavior for care recipients who have cognitive impairment Other physical challenges	Learn how to care for your family member properly. Get training so you know how to perform needed skills, which will make your work easier and safer. Practice healthful habits, including eating a balanced diet, getting regular exercise and sufficient sleep, and visiting the doctor. Get help with physical tasks when needed from other care providers, neighbors or sources of help. Work to keep your care recipient as independent as possible. This reduces your stress and maintains dignity. Utilize adaptive or assistive equipment with specific needs.

2. Financial Demands and Management as a Source of Stress

Caregiving often takes a financial toll on caregivers and families. Financial demands that caregivers experience may include costs of medical care or payment for hired help. Also, at times, caregiving can require a person to become directly involved in the management of a person’s financial affairs with banking, savings or other issues. Stress sources of financial demands and suggested coping tips are provided below.

Stress Sources of Financial Demands	Suggested Coping Tips
Costs of medical care and treatment Costs of adaptive or assistive equipment that is needed Costs of hired help Lost income Reduced work hours Loss of employee benefits Management of financial concerns for care recipients Planning for long-term care financial needs	Evaluate and utilize programs that assist with medical and treatment costs related to family caregiving. Learn about and use programs that provide assistive technology at reduced fees or on loan. Discuss financial needs and impacts with other family members. Plan ahead for projected medical costs or treatment needs by using health savings accounts or getting long-term care insurance. Work with financial planning specialists as needed.

3. Emotional Burdens as a Source of Stress

Caregiving can be a tiresome experience that feels emotionally challenging, especially if it continues for an extended period. Emotional demands are the hidden cost of caregiving and may be the most severe in their stress impact. Stress sources of emotional demands and suggested coping tips are provided below.

Stress Sources of Emotional Demands	Suggested Coping Tips
Feeling alone and unaided A sense of isolation and frustration Insufficient time for oneself and personal activities Fatigue and emotional irritability Anger or frustration at perceived unfairness of a situation Discouragement or personal depression Loss of opportunities Feeling overburdened with demands from care recipient or others Lack of control over circumstances	Find someone you trust and talk about your feelings or frustrations. Be realistic about the demands of caregiving and turn to others for help. Set aside time for self-care and personal renewal. Take advantage of respite care services and get a break for a few hours or a couple of days. Join a caregiver support group so you can share feelings, learn about resources and reduce stress. Get assistance from others in handling specific tasks that are challenging.

4. Relationship Challenges as a Source of Stress

Caregiving changes the normal patterns of family life and sometimes can result in relationship challenges that make life more stressful. For example, adult siblings may disagree about a care plan, or an adult child and dependent parent might have conflict about the level of care or monitoring required. Stress sources of relationship challenges and suggested coping tips are provided below.

Stress Sources of Relationship Challenges	Suggested Coping Tips
Feeling overburdened by care responsibilities so you become resentful of the care recipient Conflict with care recipient about care demands or plans Disagreement with family members about care responsibilities or plans Insufficient time and energy for other family relationships Difficulties with spouse due to care demands Criticism or lack of help from other family members related to caregiving Limited communication about needs Disagreements with medical staff, home health providers or others on caregiving needs or approaches	Focus on positive experiences with the care recipient, such as sharing memories or doing a life story. Involve the care recipient as much as possible in discussions of guidelines for care. Express needs and issues related to caregiving responsibilities clearly to other family members. Take time for other family relationships. Participate in a support network for caregivers and get respite care. Have each family member participate in caregiving and express appreciation for each other. Discuss care concerns or differences about care needs with medical or other caregiving supports.

Tips on Caring for Yourself

Plan ahead for those times when you will be stressed as a caregiver. It happens to everyone. If you have a plan of action, you will be better prepared to deal with stress so that it does not interfere in your life or the care you are providing. No one will be helped if you become sick or overly frustrated from too much stress. A few tips include:

Take a walk or ride a bike.
Take a bubble bath.
Engage in a favorite activity.
Allow for some quiet personal time.
Read a favorite book.
Talk with a friend.
Listen to soothing music.
Watch the sunset.
Share favorite memories with a friend.
Watch a favorite movie.

List at least three ideas that you will plan to do if you feel overly stressed:

1) _________________________________________________

2) _________________________________________________

3) _________________________________________________

Conclusion

Providing care directly to a family member or adult who has specific health or personal needs and challenges has a big impact on one’s life. Caregiving provides opportunities to develop appreciation and give support and feel more closeness. Caregiving also creates challenges that may come due to increased stress, individual fatigue or financial hardships. Caregivers have new things to learn as well.

Recommended Resources on Caregiving

North Dakota

Selected resources are listed here for North Dakota. Search out the resources available in your state or region.

North Dakota – Aging and Disability Resource LINK (ADRL): 1-855-462-5465

The North Dakota Aging and Disability Resource LINK (ADRL) is a toll-free number that provides all North Dakota residents and their family members with free information, counseling and links to services and supports available in your community. The CareChoice website, which is part of the North Dakota Aging and Disability Resource-LINK, can be accessed at https://carechoice.nd.assistguide.net.

North Dakota – Family Caregiver Support Program: 1-855-462-5465

The Family Caregiver Support Program: 1) helps eligible caregivers address challenges related to providing 24-hour care and 2) provides services including respite care, information about services and supports, training to assist caregivers to improve skills, individual or family counseling, and other services to complement the care provided by caregivers. Information on this program can be accessed at www.nd.gov/dhs/services/adultsaging/caregiver.html.

Regional Aging Services Program Administrator (RASPA): 1-855-462-5465

A RASPA is a professional in your area employed by the Aging Services Division who is familiar with local supports and services for older adults and people with physical disability. The RASPA can make home visits, meet you at a convenient location or talk by phone to connect you to available services. Call the ADRL at 1-855-462-5465 to connect with a RASPA to schedule an options counseling visit. Access the North Dakota Department of Human Services website to identify the RASPA for your region at www.nd.gov/dhs/locations/regionalhsc/index.html.

Other Resources

Book and Resource Website – Share the Care: How to Organize a Group to Care for Someone Who is Seriously Ill. (2004). New York: Simon and Schuster – This resource, by C. Caposella and S. Warnock, outlines helpful strategies to provide care and share support when a person is ill, disabled or in need. The book is accompanied by a resource website: www.sharethecare.org
Book – How to Care for Aging Parents, 3rd ed. (2014). New York: Workman Publishing – This excellent, comprehensive resource by V. Morris provides a guide to help with medical, financial, housing, emotional and other issues in caring for an aging parent.
Educational Program – Powerful Tools for Caregivers – This educational program focuses on giving you the knowledge and skills to take care of yourself while caring for someone else. Topics include self-care behaviors, emotion management and community resources. Available in North Dakota and across the U.S.

• www.powerfultoolsforcaregivers.org

• www.ag.ndsu.edu/aging/family-caregivers (North Dakota)

Online Resource – Caring.com – Caring.com is on an online resource site that provides practical advice from caregiving experts and seasoned caregivers for a wide range of topics, from senior hygiene to medication management, meal preparation, transportation and more. The site offers articles, tools, a supportive community and a directory of caregiving services. Learn more at:

• www.caring.com

Online Resource – Videocaregiving.org – Videocaregiving.org is on an online resource site supported by Terra Nova Films that provides visual educational materials to family caregivers. The site focuses particularly on delivering short, simple and practical videos on a wide range of family caregiving circumstances and challenges. Topics addressed in videos include a range of caregiving issues and many specifically on Alzheimer’s disease and care. Learn more at:

• www.videocaregiving.org

Organization – Family Caregiver Alliance (National Center on Caregiving) – The Family Caregiver Alliance is a nonprofit organization addressing the needs of families and friends providing long-term care for loved ones at home. The services, education programs and resources FCA provides are designed with caregivers’ needs in mind and offer support, tailored information and tools to manage the complex demands of caregiving. Resources include online support groups, caregiver education and fact sheets. Learn more at:

• www.caregiver.org

References

Brotherson, S.E. (2004). Family caregiving: Managing stress and accessing resources. Family and Communication Education Club lesson module. Fargo, N.D.: NDSU Extension.

Caposella, C., and Warnock, S. (2004). Share the Care: How to organize a group to care for someone who is seriously ill. New York: Simon and Schuster.

Gitlin, L.N., and Schulz, R. (2012). Family caregiving of older adults. In Prohaska, T R., Anderson, L A., and Binstock, R.H. (Eds.), Public health for an aging society (pp. 181-204). Baltimore, Md..: The Johns Hopkins University Press.

Morris, V. (2014). How to care for aging parents (3rd ed.). New York: Workman Publishing.

Schulz, R., and Sherwood, P.R. (2008). Physical and mental health effects of family caregiving. Journal of Social Work Education, 44(3), 105-113.

Filed under: family-adult-development, human-health-mental, family, family-relationships

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