Care for Caregivers: How do we help those that help others?

Being the primary caregiver for an individual with mental or physical health needs is a full time job. In 2015, approximately 43.5 million caregivers have provided unpaid care to an adult or child in one year. At an estimated, $470 billion in unpaid, at home caregiving. [National Alliance for Caregiving and AARP. (2015). Caregiving in the U.S.] In rural areas specifically, this number is expected to grow. With constant care taking both an emotional and physical tool, in an area that is already underserved by mental health professionals, what options are available to caregivers?

Excerpt from the JOURNAL OF CLINICAL PSYCHOLOGY: IN SESSION, Vol. 66(5), 479--489 (2010)

Rural Mental Health and Psychological Treatment: A Review for Practitioners

“This trend re-emphasizes the need for therapeutic interventions in rural areas because giving constant care to a family member is taxing. For instance, research suggests that family caregivers often spend at least six hours a day addressing the physical and emotional needs of their patient, often foregoing their own personal activities or work. Additionally, caregivers are likely to experience psychological distress in the forms of anxiety and depression, especially when they feel that they have little control over the situation or have low self-efficacy in their nursing abilities. Unfortunately, such stress reduces the well-being of both the caregiver and patient. Stressed caregivers are not only more likely to develop mental disorders, but they are also more likely to abuse their patient. Family caregivers in rural areas seem to be particularly at risk for experiencing the adverse effects of stress, as they often have less access to coping resources than caregivers in urban areas. Adult daycare facilities and senior centers tend not to be available in rural areas, removing another potential source of support for caregivers. Because of the difficulty in receiving services in general in rural areas, telehealth has been proposed as an effective way to administer such therapy to caregivers in rural populations. The overall outlook of telehealth programs for rural family caregivers is promising; in preliminary studies, rural family caregivers showed significant benefits by receiving CBT-based telehealth, noting that it was convenient, easy to use, and informational.”

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With the advent of tele-mental health reaching even the more remote areas of the United States, there are more promising tools available to family members who are caregivers. Telehealth interventions have successfully reduced caregiver burden, decreased symptoms of depression, improved self-efficacy, improved decision making confidence, increased sense of security, improved quality of life, decreased anxiety, increased feelings of support, and improved knowledge and skill in caregiving tasks. (PMC) As a group, caregivers have little time to devote to helping themselves, and telehealth offers a connection that is based on their own timeline and limitations. In addition to creating a space that creates resources and peace, by introducing tele-mental health into the home, caregivers are also eliminating any stigma around receiving care.

“The most common barrier to treatment […] The belief that “I should not need help.” Other commonly cited barriers: not knowing where to go, distance, mistrust of counselors or therapists, “not wanting to talk with a stranger about private matters” and stigma. Stigma — the sense that something is shameful — may be felt more acutely in small rural towns because of the relative lack of anonymity there. (Next Avenue)” As many caregivers in rural areas are family members, it can be hard to vocalize the burdens associated with taking care of a loved one. Telehealth options allow for needed resources while providing the security of care within the home.

There is still more work to be done, but telehealth is paving a path in providing care to those who provide care to others.