The Experience of Family Caregivers Who Have Mental Health Problems

Background and Purpose: Abundant literature documents the stresses and burden experienced by family members providing care to older relatives, especially when the caregiving is long-term. Such caregivers often compromise their health, social lives, and financial security as a consequence of their caregiving. The implicit assumption when considering familial caregiving is that the caregiver is robust and in good physical and mental health. Little has been reported about caregiving dynamics when the caregiver experiences challenges such as mental health problems. Authors present findings from the second Family Relationships in Late Life (FRILL2) longitudinal study, comparing the experiences of family caregivers reporting mental health problems (MHPs) to those who do not report mental health problems. We hypothesized that caregivers with MHP would report higher levels of Perceived Stress and Life Events, physical health problems, resentment about caregiving, and Potentially Harmful Behavior (PHB) toward their care recipients. We further hypothesized that the change between Time 1 and Time 2 in PHB would be significant for the CGs with MHP and not for the comparison group.

METHODS: Using various sampling methods, including Random Digit Dialing, 444 co-residing caregiver(CG)-care recipient (CR) dyads in which the CR was over 60 years of age were recruited from three areas of the U.S. Project staff independently interviewed each CG and CR in separate rooms within the participants' home, administering 18 standardized measures related to the caregiving experience. Eighteen percent of the CGs reported having psychological or psychiatric problems and in five percent of the dyads, both the CG and CR experienced psychiatric problems. This paper presents findings about the CGs from Time 1 and Time 2 data (collected 18 months after Time 1).

RESULTS: At Time 1, CGs with MHPs reported higher levels of resentment concerning caregiving activities and more frequent angry responses to caregiving situations than the comparison group. At Time 2, CGs with MHPs reported significantly poorer physical health than the comparison group, more Life Events, Perceived Stress, Activity Restriction, and higher levels of PHB. Repeated measures analyses indicated that both groups' scores for PHB decreased significantly during this time, but the groups were not significantly different from each other on this measure.

IMPLICATIONS: The experience of persons with MHP who provide care to older family members is complex. These problems may affect family members' ability to provide adequate care, exacerbate their feelings of resentment concerning caregiving tasks, and compromise their health. However, their caregiving responsibilities may also have positive impacts for the CRs and indeed their own health and wellbeing. Further examination of this phenomenon, and the development of programs to assist caregivers with their own challenges, may avert negative outcomes for both the caregiver and the care recipient.