Let’s talk about caregiver stress
University of Pittsburgh psychiatry professor Richard Schulz has been one of the nation’s foremost researchers on caregiving stress for decades.
That recognition earned Mr. Schulz, 69, the chairmanship of a prestigious committee that last year produced the report, “Families Caring for an Aging America,” for the National Academies of Sciences, Engineering and Medicine. He is also head of The Caregiver Project at Pitt, a year-old research initiative to examine the status of family caregivers in the region and identify ways to help them.
Mr. Schulz is the first featured speaker for a new Ursuline Support Services series of caregiving-related presentations. Those interested in attending his lecture at 7 p.m. Wednesday at Calvary Episcopal Church in Shadyside may visit www.ursulinesupportservices.org for ticket information.
The following is a condensed version of a web interview with Mr. Schulz that has been published on the Aging Edge section of post-gazette.com.
Aging Edge: What’s so hard about family caregiving, which your research has shown leads to health problems for the caregivers
themselves?
Schulz: The experiences and needs you encounter are relatively unpredictable. Youtypically enter a situation where there’s current demand for support and help for a given individual but little idea of what’s ahead down the road. That air of uncontrollability contributes to a lot of psychological stress.
Aging Edge: How does that compare to physical demands?
Schulz: There’s the true physical challenge of the hours you have to put in, especially for conditions like dementia or stroke where you have to always be vigilant — You’re on edge all the time. There may be out-ofpocket costs as well, and there’s one final kicker, which is caregiving often involves exposure to the suffering of somebody close to you, and seeing that person suffer on a 24/7 basis is an extremely distressing experience for many individuals.
Aging Edge: If there are so many things that build stress about this role then, what are the consequences?
Schulz: The most common consequence reported as a symptom is depression. They don’t get enough sleep, and you get self-neglect in terms of caregivers not caring for themselves, ignoring things like seeing the doctor and getting checkups and doing things to remain healthy. Almost 20 years ago we did a study on increased mortality among spousal caregivers, and there’s some evidence of chronic disease linked to the amountof caregiving.
Aging Edge: What’s notably different about the stresses since then?
Schulz: The complexity and duration of the caregiving has increased dramatically. Nowadays we’re asking caregivers to perform what were traditional nursing tasks, like giving injections, monitoring and treating wounds, and operating complex medical equipment. That means an increase in the magnitude of challenges faced, especially for caregivers of persons with Alzheimer’s disease.
Aging Edge: Are there any positives associated with fulfilling the caregiving role?
Schulz: Most caregivers, especially early in the caregiving trajectory, report feeling good about having a positive impact on another person’s life, making a difference through a contribution to someone else while often learning new skills. It increases their self-esteem. But in later stages when the challenges often become insurmountable, the caregiving becomes more frustrating and distressed in every way. The good you see yourself getting from it just drops out when you see where you’re not making a difference anymore, and you’re really just performing a maintenance function.
Aging Edge: So what are the solutions caregivers can seek to save themselves from whatever hardships they can becaus preserving their own health is supposed to also benefit those they care for?
Schulz: One thing is teaching these individuals about whatever disease they’re dealing with and its trajectory because many don’t understand the condition and have no sense of where it’s going. No. 2 is teaching them about resources that are available to caregivers and recipients. Third is learning how to manage specific activities of daily living. They should also look for help from other family members as well as formal support and try to assist their mental health by carving out time for pleasurable activities — something that getsthem out of the negative.