Caregiver, Take Care
Mary Lund, PhD, RNC
Becoming a caregiver is a time of transition
that requires a restructuring of one’s goals,
behaviors, and responsibilities. Although
the individual circumstances that bring one
to the caregiver’s role may differ, one thing
is certain—no one comes to the job pre-
pared for the task. No matter how difficult
the role, however, becoming a caregiver can
give birth to new skills, new strengths, and
new friends and contacts. Being able to
cope with the stress of being a caregiver is
part of the art of caregiving. (Geriatr Nurs
2005;26:152-3)
There are four kinds of people in the
world: those who have been caregivers,
those who are currently caregivers, those
who will be caregivers, and those who
will need caregivers.
—Rosalyn Carter
B
ecoming a caregiver has been variously
described as “crossing a threshold”
whose other side is unexplored and
often threatening, “drifting into the role,” the
point at which concern, visiting and “helping
out” become “caregiving,” and an “unexpected
career.”1-5 The caregiver role can be a cloak
that’s thrown on overnight by a catastrophic
event, or it can be a role that comes on gradual-
ly, thread by lonely thread, until it becomes an
engulfing blanket of concern.6
While individual circumstances might differ,
one thread is common—no one comes to this
job prepared. Becoming a caregiver is a transi-
tion that requires moving from a known, cur-
rent reality to an unknown new reality, a
restructuring of goals, behaviors, and responsi-
bilities.7,8
Caregiving itself is not new. As long as there
have been people, there have been caregivers. A
2004 survey on caregiving in the United States
reported that more than 20% of all households
provide care to someone who is 50 years or
older. Caregivers are predominantly women,
152 Geriatric Nursing, Volume 26, Number 3
but this is changing. The study showed that 39%
of caregivers are men. The estimated cost of
care provided by families has reached $196 bil-
lion a year.9 Caregiving is—or will be—a reality
for most Americans. It affects our families, our
workplaces, and our communities. The assis-
tance provided by caregivers has its rewards,
but it can also create great burdens.10 Twenty
years ago, it was suggested that caring for fam-
ily members was becoming so common that it
should be regarded as a “normative” life
event—a milestone as expected as getting mar-
ried, working, or retirement.11
Taking on the role of caregiver means taking
on something new, but it is also about loss—of
what was or what could have been. Caregiving
responsibilities often create conflicts with obli-
gations to work and family. There is the emo-
tional pain of seeing a parent or spouse physical-
ly or cognitively incapacitated. Caregivers
experience the whole range of human emotions:
guilt, anger, frustration, exhaustion, anxiety, fear,
grief, sadness, love, and the not-to-be-underesti-
mated satisfaction of having done a good job.12
Both men and women caregivers face late-in-
life role changes. An older woman may need to
learn to drive, manage money, and make deci-
sions by herself. If married, she may have to
admit that she and her husband are no longer
partners, that she has become more like his
mother or sister. Male caregivers must take on
unfamiliar household chores such as cooking
and laundry, or helping their partner with per-
sonal hygiene, or adjusting to the loss of a part-
ner. Both men and women suffer the loss of
freedom and privacy.13,14 Role reversal puts
stress on the care recipient who may resent see-
ing the spouse or other family member as care-
giver because it acknowledges the care recipi-
ent’s personal loss of independence.15
The bonds of caregiving may be those of vol-
untary love or of obligatory responsibility.
Whatever the case, these bonds are sources of
stress. Trying to manage one’s time and juggling
multiple and constant responsibilities as a care-
giver can lead to feelings of resentment: “I have
to do his job in the family and my own job.
There isn’t enough time.” The caregiver feels
the pressure of the recipient’s increased emo-
tional dependency: “Don’t leave me,” to which
the caregiver may respond, “I’m always on
call!” The stress also results in feelings of anger:
“He didn’t take his medicine for high blood
pressure. Now I have to pick up the pieces.”
Resentment, bitterness, depression, and iso-
lation are common and may be expressed as
thoughts such as, “My life is a mess through no
fault of my own.” “I feel like a bird in a cage.”
“I know it’s not his fault and try not to be
angry with him, but it does get so tiring.” “ I
always feel tired, sometimes angry, some-
times sad.”
Being able to cope with the stress of being a
caregiver is part of the art of caregiving. To stay
healthy so we can continue to be caregivers, it
is essential to recognize our limitations and
learn to care for ourselves. This is the best way
to be an effective caregiver. Today’s Caregiver
Magazine14 lists the top 10 ways to do this:
• Find out all you can about caregiving
• Set practical goals for your loved one and
yourself
• Understand that caregiving is often a
stressful activity
• Stay in touch with your friends as much as
possible; do not give up the activities you
enjoy
• Take advantage of respite services avail-
able to you and your loved one
• Keep a caregiver journal
• Practice daily relaxation methods such as
exercise, reading, walking, humor, medita-
tion, and prayer
• Focus on improving communication with
your loved one, family, and friends
• Join a caregiver support group
• Concentrate on your own physical and
mental health
Caregiver, take care. You are not responsible
for doing everything. Take a pass on guilt. Do
whatever you can to keep yourself well in body
and spirit.
Kairos, the Greek word from which “care”
derives, refers to a unique time in a person’s
life—an opportunity for change, a transition.
Becoming a caregiver can give birth to new skills,
new strengths, and new friends and contacts. J.
Boryshenko, a psychoneuroimmunologist, wrote
Geriatric Nursing, Volume 26, Number 3
that no experiences—even difficult ones—are
worthless.15 They can be spun into gold, giving us
gifts of understanding and compassion that were
unexpected. In A Woman’s Book of Life, Lin
Yutang, a Chinese American scholar, wrote that
hope is like a road in the country: where once
there was never a road but when many people
walk in the same direction, a road comes into
existence.15 There are many of us walking on the
caregiving path. However difficult these experi-
ences may be, they can make us stronger.
References
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14. Barg G (ed). The fearless caregiver. Herndon, VA:
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15. Boryshenko J. A woman’s book of life. East
Rutherford, NJ: Riverhead Books; 1996.
MARY LUND, PhD, RNC, is a gerontological nursing con-
sultant affiliated with the Health Education Network of
Eau Claire, WI and a caregiver.
0197-4572/$ - see front matter
© 2005 Elsevier Inc. All rights reserved.
doi:10.1016/j.gerinurse.2005.03.055
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