The Impact of Caring on Caregivers' Mental Health: A Review of the Literature

Article excerpt

Abstract

This paper provides a brief overview of the literature on the impact of caring on the mental health of informal caregivers in the areas of aged care, disability and mental health. Factors discussed that may impact on caregivers' mental health include the relationship between the caregiver and care recipient, the nature of the care recipient's disability and the stage of the caregiving process. Several moderators of the impact of caring on mental health are described, including socio-economic factors, social support and coping strategies. This information provides a context within which to examine the type of interventions appropriate to assist caregivers in various situations.

Introduction

Given recent Federal Government announcements on the importance of supporting informal caregivers in their caregiving role (Australian Department of Health and Ageing, 2002), it is timely to consider some of the issues related to this role. This is particularly so given the probability that as the percentage of older Australians increases, many more individuals will find themselves thrust into the role of unpaid caregiver. The impact of caregiving on the mental health of caregivers is well documented and warrants careful assessment when support structures for caregivers are considered and procedures implemented. Efforts to support caregivers in their role should ideally lessen the negative physical and mental effects that caring can have on their health. It is also known that the impact of caring on caregivers' mental health is different for individual caregivers. Some caregivers experience a substantial negative impact while others are less affected by the caring role. This variation in the impact experienced is not simply related to the extent of caregiving provided (Schofield, Bloch, Hcrrman, Murphy, Nankervis & Singh, 1998).

This paper presents a brief overview of the literature on the impact of caring on the mental health of caregivers. It encompasses caregivers of persons of all ages and covers aged care, mental health and disability. A caregiver is defined as a relative, friend or neighbour who provides practical, day-to-day unpaid support for a person unable to complete all of the tasks of daily living. The person who is receiving care is the care recipient, defined as a person who lives with some form of chronic condition that causes difficulties in completing the tasks of daily living. This review provides information that helps address the question of how best to support caregivers, and will inform the development and implementation of interventions to sustain caregivers in their role.

Method

This paper is derived from a larger overview of the literature on sustaining earegiving relationships (Savage, 2002). The published literature was sourced utilising the PsychINFO, CINAHL and Medline databases. Terms searched were 'carer' and 'caregiver' with 'impact', 'support', 'coping' and 'interventions'. Reports and conference proceedings were sourced via internet searches and contacts with workers in the field. More recent literature and Australian research is included where possible, and relevant reviews have been summarised where possible.

The impact of earegiving

The negative impact of earegiving on the mental health of caregivers is substantiated in the literature. For example, the Victorian Carers Program conducted a population-based study in which differences in well-being between caregivers, as a group, and non-caregivers were demonstrated (Schofield et al., 1998). The researchers found less life satisfaction, less positive affect, and more negative affect among caregivers compared with noncaregivers, regardless of age or marital status. In data collected by the Australian Bureau of Statistics (ABS), approximately 30% of caregivers reported that their well-being had been affected by earegiving, and that they were often worried or depressed (ABS, 1998). In a review of 41 studies published between 1990 and 1995 on the effects on caregivers of care recipients with dementia, it was reported that increased levels of psychiatric morbidity were generally found, with elevated levels of depression being a consistent finding (Schultz, O'Brien, Bookwala & Fleissner, 1995). …