Nancy Langman is a mental health and public health nurse practitioner on Martha’s Vineyard and an Adjunct Clinical Instructor at the University of Massachusetts Amherst. The author has no financial relationships to disclose.
Caregiver stress and SELF-CARE Primary care providers can be instrumental in not only offering referral to services to reduce caregiver stress but also encouraging self-care behaviors for caregivers. They have the opportunity, early on, to anticipate the stresses that caregivers may experience as their loved one’s disease progresses and to provide helpful referral for services (including psychotherapy and support groups), information, and support to preventively address functional ability and self-care behaviors.
The relationship between caregiver stress and self-care behavior has been widely studied. Using the Caregiving Hassles Scale, Kinney and Stephens examined the mediating function of the relationship between caregiving stress and self-care behavior. They found caregiver stress to correlate to self-rated health at a statistically significant level (r = .30, P = .003).13 On a positive note, the investigators also found that the more symptoms family members reported (depression, poor health), the more self-care behaviors they used.
Lu and Wykle also used the Caregiving Hassles Scale in their correlational crossfunctional study. Caregivers (n = 99) were assessed for the mediating function of the relationship between caregiving stress and self-care behavior in response to symptoms.49 Those who reported higher levels of caregiving stress also reported poorer self-rated health, poorer physical function, high levels of depressed mood, and more self-care behaviors at a statistically significant level (r =.30, P = .003, Cronbach’s alpha = .95). The researchers determined that depressed mood was a strong mediator between caregiver stress and response to the symptoms with self-care behaviors.
Unsteady on his feet, Henry became a fall risk. His growing confusion and cognitive decline led to increased depression and agitation, which reduced his socialization and physical activity. Over time, this resulted in a disturbing chain of events, including urinary tract infections, hospitalization, and behavior changes that were upsetting to his wife and children as well as to Henry. Joann was not sleeping well and contracted a cold that turned into pneumonia, leading to a hospitalization. Through all of this, Joann knew that she could call Henry’s NP for advice and support. She found solace in knowing that the caregiver support group she attended regularly would always be there to encourage and inform her and that Henry’s support group would not only give her respite as a caregiver but also provide Henry with cognitive stimulation shown to enhance the well-being of those experiencing memory loss. These groups soon became her lifeline. Without vital early screenings, this family would not have adequately managed the difficulties brought on by Henry’s unexpected diagnosis.
