This report is nearly two years old yet “caring for the caregiver” is still a timely and important subject.  How/what does your family do to assist your eldercaregiver?  Please share your ideas and suggestions.

REPORT:

Half of Elder Caregivers Suffer from Depression

Sing Tao Daily, News Report, Fanny Chiang, Posted: Nov 09, 2009

In the last century, the average life expectancy has increased from 47 years to 78 years. “Super seniors,” who are 85 or older, are also the fastest growing group. Enjoying a longer life expectancy means the costs for senior care will continue to increase and the needs for senior caregivers, who usually are the children or the spouses of the senior, are also on the rise. However, statistics show that 50 percent of senior caregivers show signs of depression, reflecting the burden of the increasing lifespan of seniors.

Struggles and Tolerance

Ten years ago, while Mrs. Lam, a 50-year-old Chinese-American woman, was living with her 70-year-old mother, she noticed her well-educated and elegant mother change behaviors. Not only was she forgetting things, she was also putting frying pans into the shoe cabinet, leaving food in pockets, singing and dancing in a shopping mall, even shouting and yelling at strangers. Lam was embarrassed by her mother’s behavior but all she could do was teach her mother how to behave. Lam said her mother was doing everything she once taught her not to do.

Back then, Lam’s husband was working in Shanghai, and her daughter was studying aboard. Lam had to work and take care of her mother all by herself because none of her siblings were willing to share the responsibilities. They even blame her for not doing her job. Lam said bearing all those difficulties, she could only face them with patience and silently cry to herself because whenever she wanted to end a day with a good night’s sleep, her mother would come and knock at the door.

“There were times I refused to go home after work. I even hoped to die in a car crash when I was driving home,” said Lam, who was showing early signs of depression.

Two years later, Lam’s mother was diagnosed with Alzheimer’s disease. Through some Alzheimer’s organizations, Lam’s mother was admitted to a Catholic adult day care center, where she learned drawing, and shuttle buses could be arranged to bring her back and forth from home. Since then, Lam also enrolled in a monthly support group, where caregivers were given opportunities to express their needs and frustrations.

Lam said not until then was she able to take a deep breath and feel relief.

Lack of Support, Building Pressures

However, Lam is not the only one. According to statistics from the federal Centers for Medicare & Medicaid Services, many senior caregivers are also breadwinners and child care providers at their households. Under such tremendous family and financial pressures, half of these caregivers are showing signs of depression. Zhang Pei-Ling, outreach specialist for the Chinese community with the Alzheimer’s Association Northern California and Northern Nevada said 70 percent of Alzheimer’s patients are living at home, often taken care by their spouses or children. Therefore, 80 percent of senior caregivers are experiencing high stress, while 50 percent show signs of depression.

Care givers from On Lok Lifeways, a comprehensive health plan serving Bay Area’s Asian elders largely in San Jose, said Alzheimer’s disease is not only the most common elders disease, it will also creates pressure on the patients’ families. According to statistics from the Alzheimer’s Association, there are about 5.3 million Alzheimer’s patients in the United States. One-eighth of the seniors who are 65 or older have Alzheimer’s, and one out of two seniors who is 85 or older have the same disease.

On the other hand, lots of caregivers share the same experience as Lam. According to the data from Caregiving Coalitions and the Mental Health Department of Santa Clara County, 80 percent of caregivers are relatives of the care-recipients, and the care provided is free of charge. Moreover, 75 percent of the caregivers are females, with one-third of them taking care of their children as well. Only 35 percent of them get support from their workplace in taking care of seniors who are 65 years old or above.

As a result, almost one-third of the caregivers need to adjust their schedules or take time off from work as Lam did while caring for her mother. Although the average length of time providing care is four years, most of the caregivers don’t receive professional nursing training or get enough support from the family or society. A majority of the care-recipients are at least 60 years of age, including those with chronic diseases, disability and terminal diseases.

Taking care of the seniors may be rewarding and good for the family, but without appropriate support, it can be a very stressful responsibility.

Feeling Lonely, Damaging Physical and Mental Health

Spending most of her time taking care of her mother and family, Lam sacrificed her social life. She slowly became isolated and often asked herself, “Why isn’t there anyone to help me?” In fact, caregivers’ health is often at risk because of the workload and lack of support. Many caregivers are already experiencing problems with their health, such as sleeplessness, headaches, anxiety, decreasing immunity, and the increasing possibility of chronic diseases and suffering accidents.
According to 2006 surveys conducted by the organizations cited above, caregivers with the lowest incomes are experiencing the highest level of stress. A lot of them become short-tempered, isolated, pessimistic, unable to concentrate, or they experience physical problems, such as with the immune system. Some of them even become alcoholics, refusing to face the realty by drinking. These physical and mental problems can lead to anger towards the seniors, which in turn can lead to elder abuse.

Chen Minghui, founder and executive director of the Chinese American Coalition of Compassionate Care (CACCC), said end-of-life care is often provided to Chinese seniors by their spouses or family members at home. Since most of the seniors at that stage are unable to take care of themselves, caregivers are facing lots of challenges. They often feel helpless and guilty because of not providing all the care the senior needs, losing their temper.

“Chinese Americans contribute 1.2 percent of America’s 0.3 billion population, but they seldom ask for end-of-life care services,” said Chen, who explained that death remains a taboo in the community, and is a topic rarely discussed. Chen believes there is a need for increasing awareness of end-of-life services in the Chinese community.

Private Nursing Home Costs High

Li Fengli, from the San Francisco Bay Area, recently celebrated his 100th birthday. His son, Li Yalun, from New York, flew in to celebrate with him. Li Yalun said his father was lucky to be able to afford a nursing home so he can live with his friends and be taken care of. Traditionally, generations of Chinese live together in families. However, modernization, the rise of the nuclear family and job migration have forced children to live apart from their parents. Thus, admitting seniors to nursing homes or senior housing becomes a solution.

Chen Lina, a social worker from Self Help for the Elderly, has been assisting seniors with their medical care, housing, benefits and resources, immigration and translation services for the past eight years. She said new Chinese immigrants usually live with their children when they first arrive in the states, but later they will seek senior housing, senior care and nursing homes. To avoid conflicts between generations and remain independent, seniors who are able to live independently choose senior housing where family services are provided by the government. However, slots are limited and the wait is long. Seniors who need some kind of care favor assisted living, but the affordable ones also have a long waiting list, while private ones can charge up to several thousand dollars per month.

Apart from senior care, the problems of elder abuse are also on the rise. Santa Clara Elder Abuse Preventive Program Director Betty Malks said as the society ages, elder abuse cases increase and the Chinese community has witnessed the same thing. However, only one out of 14 senior victims will report elder abuse and that is especially true for Chinese Americans because they do not anybody to know.

Volunteer Help and In-house Services

There are different types of elder abuse, including physical and sexual abuse, negligence, abandon and financial abuse. Forty percent of elder abuse is financial abuse, where elders are targeted for fraud or scams involving their retirement funds.

Social workers and experts recommend that elders participate in social activities, such as meeting new friends and learning new activities, because staying home all the time will only slow down their reaction time. Caregivers should also make use of the resources offered by local nonprofits and the government, such as requesting volunteer and housekeeping services, or participating in lectures and social opportunities offered to caregivers, so they can gain support from others. Caregivers should also be clear and honest about the development of their seniors’ sickness, be patient with them and bring them to treatment once abnormal signs appear. Neighbors should also be told about their’ situation so they can offer certain levels of help. Council on Aging Silicon Valley believes a senior caring plan is as important as one’s retirement plan, and it should be taken care of early enough to prevent further aging problems.

Caregivers should be aware of their own physical condition and watch for warning signs, such as experiencing changes in dieting and sleeping habits, feeling tired, suicidal or irritable. Apart from caring for the seniors, caregivers should also be cautious about their own physical and mental health.