Almost all seniors will become dependent on others at some point as they transition to end-of-life.  Due to their high needs, most attention is paid to the senior.  The primary caregiver goes largely unnoticed, yet they are the ones who give up much of their lives to ensure the senior gets the care they need. 

Caregiving is a difficult and thankless task.  It usually falls to a wife, daughter, or sister, though with globalization, friends and neighbours are becoming more common.  Becoming a caregiver can be a slow process that occurs over time, which is often seen with Alzheimer’s patients.  Or it can be sudden; a person has a stroke, and now they can no longer take care of themselves.  Either way, there are similar stages that a person will go through when they shoulder the burden of caring for a dependent senior.   Each stage comes with unique consequences (see Figure 1 below).

Taking on the Role

New caregivers are generally unprepared for the responsibility.  Usually, the job begins after a hospital visit.  The senior leaves no longer able to care for themselves. The return home is harder than expected and the initial response is shock.  Suddenly lives are turned upside down.

Unfortunately, it is almost always the case where a caregiver must set much of their own life aside to provide the necessary care for their dependent senior.   As they settle into the role, it is not uncommon for daily activities to be multiplied, particularly as other people within the senior’s life also turn to the caregiver, who must then juggle communication and coordination together with caregiving.

Beginning to Realize

The impact is large.  Many areas in the caregiver’s life are altered.  This leads to stress and anxiety, lack of sleep, fatigue and exhaustion, loss of privacy leading to conflicts with loved ones as well as difficulties managing time.  Several caregivers end up leaving their paid work to dedicate themselves to caretaking.  Many burnout.

The upside is that most who go through this find a sense of personal growth.  Many change how they value the day-to-day aspects of living.

As they settle into their new role, caregivers realize they need information, time, help support, and instruction for care.  They do not feel sufficiently prepared, and there is a paucity of support and direction.  Finding actionable information that is relevant to their unique situation is difficult, as is finding help. Financial resources are often strained since care needs of a dependent senior are so high.

Implementing Strategies

To overcome this, caregivers develop strategies.  They seek both formal and family help and read the information available as they can on.  They reorder their family and social relationships and develop the senior’s community of care.  Roles and responsibilities can become shared across several people.  This requires good communication and coordination across the community.

To increase their mood and the general positivity and decrease stress, several caregivers adopt strategies such as letting go, speaking with others, intentional humour, and encouraging their dependent senior to maintain spiritual support.  Finding meaning in the bigger picture is helpful.

This article is a summary of the following research article, which looked at data from 393 family caregivers.

Moral-Fernández, L., Frías-Osuna, A., Moreno-Cámara, S. et al. The start of caring for an elderly dependent family member: a qualitative metasynthesis. BMC Geriatr 18, 228 (2018). https://doi.org/10.1186/s12877-018-0922-0