Caring for an older person at home and looking after yourself

Many older people are looked after at home by a family member or friend. This work can be rewarding, but it can also be tiring and lonely. This article explains what caregiving involves and how to protect your own health, using information from MedlinePlus, the US Centers for Disease Control and Prevention (CDC) and the NHS.

1. Introduction

MedlinePlus describes a caregiver as someone who helps a person who cannot fully care for themselves because of an injury, a disability or a long-term illness such as Alzheimer's disease or cancer. Caregivers may be informal, usually family or friends, or paid professionals ^[1].

The CDC reports that family members or friends usually provide care for adults with Alzheimer's disease and related dementias, and that about 80% of these adults receive care at home. It describes caregiving as demanding and notes that it can make it hard for caregivers to take care of themselves ^[3]. MedlinePlus adds that when caregivers feel better, it is easier to focus on the rewards of caregiving ^[2].

2. What caregiving involves

MedlinePlus lists these typical tasks ^[1]:

• Daily care such as bathing, eating and taking medicines.
• Housework and cooking.
• Errands such as shopping for food and clothing.
• Driving to appointments.
• Companionship and emotional support.
• Arranging activities and medical care.
• Helping to make health and financial decisions.

Many caregivers feel "on call" around the clock, and some also work outside the home or raise children ^[1]. The CDC adds that dementia caregivers face a greater risk of anxiety, depression and poorer quality of life than other caregivers ^[3].

3. Signs of caregiver stress

MedlinePlus describes caregiver stress as the emotional and physical strain of caregiving. Common signs include ^[2]:

• Feeling overwhelmed, or isolated and abandoned by others.
• Sleeping too much or too little.
• Large weight gain or loss.
• Constant tiredness.
• Losing interest in activities you once enjoyed.
• Irritability or anger.
• Frequent worry or sadness.
• Frequent headaches or body aches.
• Turning to unhealthy habits such as smoking or heavy drinking.

Long-term stress may contribute to depression and anxiety, a weakened immune system (the body's defence against infection), excess weight and chronic conditions such as heart disease, diabetes and arthritis. It can also cause trouble with short-term memory or attention ^[2].

4. Ways to ease the load

MedlinePlus suggests these steps ^[2]:

• Learn caregiving skills. Hospitals often offer classes on caring for someone with an illness or injury.
• Accept help. Make a list of specific tasks others could do, such as sitting with your relative during an errand or picking up groceries.
• Join a caregiver support group to share experiences and tips.
• Get organised with to-do lists and a daily routine.
• Stay connected with family and friends.
• Look after your own health: be active on most days, eat well, sleep enough and keep up regular check-ups and screenings.
• Look into community adult day care or respite services for a break.
• Ask your employer about leave options if you need time to care. In the United States, eligible employees can take up to 12 weeks of unpaid leave a year to care for relatives, and your human resources office can explain the details.

Breaks and paid help

The NHS explains that respite care gives carers a break while someone else looks after the person they care for, helping to avoid exhaustion. Options range from a few hours with a volunteer to a short stay in a care home. They include day care centres with social activities, paid home care visits, friends or family stepping in, and sitting services where trained volunteers keep the person company ^[4]. Volunteer visits usually last a few hours and are often free or low cost. Day centres often provide transport, but there may be a charge. Short care home stays can sometimes be booked in advance, and live-in care is available if someone needs 24-hour supervision ^[4].

The NHS also describes paid home care, where a carer visits the home to help with daily living: getting up and dressed, washing, using the toilet, preparing meals, reminders to take medicines, and outings and errands. Some agencies also offer specialist care such as dementia care. If you hire a carer, the NHS suggests asking about charges, training, scheduling and contracts, checking that agency carers carry identification and announce their arrival before coming into the home, and whether the carer will tell you if they are running late ^[5].

Plan for emergencies

The NHS advises identifying a backup person, such as a relative, friend or neighbour, who can step in at short notice. They should have access to the home and know the care needs. Keep written notes on medicines and daily care in an easy-to-find place ^[4].

5. When to see a doctor

See a doctor for yourself if the signs of stress above last for a long time or begin to affect your daily life. The CDC says it is crucial to look after your own health ^[3], and long-term stress can raise the risk of other health problems ^[2]. MedlinePlus advises contacting a health care provider with any questions about your health ^{[1, 2]}.

If you ever think about harming yourself, get help at once. In India, call Tele-MANAS on 14416. In the United States, call or text 988.

In an emergency, call your local emergency number (112 in India, 911 in the United States).

6. Conclusion

Caregiving can be rewarding, but it can also strain the body and mind. Caregivers who feel better are better able to care for the other person. Learning skills, accepting help, using respite and home care services, staying connected and keeping up your own health care are the most useful steps, and a doctor can help if the strain becomes too much.