Caregiving at What Price? Coping with Drugs and Alcohol While Taking Care of Mom or Dad

Whether you’re providing care for a small child or an elderly parent with dementia, being a caregiver is one of the toughest jobs there is. Diapers need to be changed. Meals need to be prepared, and your loved one needs to be spoon fed. Fits need to be tamed.

But while caring for a small child offers the reward of the boy or girl one day being able to care for themselves, caregivers of elderly parents may not see such a joyful end to their journey.

Watching the physical and cognitive decline of a parent or grandparent, the “slow goodbye,” as Alzheimer’s Disease in particular often is referred to, can be difficult for a caregiver to bear. In fact, studies show that caregivers frequently turn to self-medicating to cope with the situation. Some small studies even suggest that caregivers are more likely to develop suicidal 1 and even homicidal thoughts 2.

Diane Carbo is a registered nurse based in Philadelphia specializing in geriatric care and caregiving. She also operates the website CaregiverRelief.com. She says she most often sees two different scenarios that tend to create the perfect storm for substance abuse among caregivers.

“There is the chemical-dependent person who is taking care of a family member because of, how do I say this–maybe the elderly person may not have been the best person in the world, maybe they already had their history of alcohol or drug abuse and nobody else will care for them,” she said. “And then they have a kid that has a substance abuse problem too, and they are the one who steps up.”

The other scenario she frequently sees are elderly people caring for their spouses and leaning on alcohol to get through the day. “I see scenarios where there are people in their seventies and eighties who have been used to drinking their whole lives,” Carbo said. “They always had cocktail hour and such. Older women— I see women do this in particular—who then become caregivers have a tendency to medicate themselves with alcohol. Many seniors look to alcohol for comfort.”

People who find themselves in either scenario should heed a warning that they may need treatment, Carbo said.

Anxiety, Depression and Isolation: A Dangerous Mix

A 2010 paper published in the journal Addictive Diseases is one of very few studies that have directly examined alcohol use among caregivers 3. The researchers used a mail survey of 998 unpaid caregivers in Chicago who still held other paid jobs.

“Findings suggest that caregivers who experience social and emotional burden related to caregiving are at risk for problematic alcohol use and warrant attention from health and mental health service professionals,” the authors concluded.

Caregivers who felt family relationships had become strained during the caregiving process were at particular risk for alcohol abuse, the authors found. “Those who work with caregivers should be particularly attentive regarding reports of strained family relationships or negative feelings toward their care recipients, as alcohol use puts both the caregiver and the care recipient at risk.”

While the Chicago study focused on caregivers who still are employed outside of unpaid caregiving, the journey of a caregiver usually results in them giving up their jobs. When this occurs, they may become extremely isolated, another factor that can raise the risk of substance abuse.

With 10,000 Baby Boomers turning 65 each day, our nation is in the midst of a potential caregiving crisis. With assisted living costing an average of $4,000 per month, and nursing homes $8,000 per month, many people cannot afford to put their loved one into long-term care. Others dread the idea for fear their loved one will be mistreated. So they push themselves too far and end up needing help themselves. Scarier still, many caregivers now are in the so-called “Sandwich Generation”; mom and/or dad no longer can care for themselves, yet the caregiver still has his or her own children to care for as well.

“Caregivers tend to report worse physical health, including insomnia, headache and weight loss, and are more likely than non-caregivers to put off seeking needed medical care,” the authors of the 2010 study wrote.

“Some well-known correlates of alcohol use in nationally representative adult samples are exhibited by a large proportion of caregivers. For example, depression and anxiety are predictors of increased alcohol use. Social isolation, which is experienced by some caregivers, is also predictive of increased alcohol use.”

The above-mentioned problems – anxiety, depression, isolation – could be signs that it’s time to seek help. Caregivers who have good support networks, such as supportive families and access to community resources, are at much less risk.

When Cocktails, Anxiety and Pain Medication Become Daily Escapes

Carbo said as caregivers become more worn down and isolated, they will often turn to family members for help. Not only will those family members typically ignore pleas for help, but they will respond with disrespect instead of sympathy. “Family members will say, ‘You chose to take care of so-and-so; live with that decision now,’ instead of support the caregiver.”

As the resentment builds, the caregivers often become more and more reliant on substances. They can become resentful of the people they are caring for as well as their disrespectful family members.

“They need a drink to get through the day, or anxiety pills to get through the day, or they want their pain medications increased,” Carbo said. “I think the medical delivery system really drops the ball in terms of helping caregivers in any way, let alone when it comes to substance abuse. This is really something that needs to be explored a lot more, because very little attention is being paid to this situation.”

Carbo said that when people develop drinking problems, they may sleep through a loved one’s fall or not hear them walk out the front door during a wandering episode.

“Alcohol use, particularly alcohol use that meets criteria for abuse or dependency, is a cause for concern among caregivers, as both their health and the health of the care recipient is at risk, particularly if they are responsible for assisting their care recipient with activities of daily living,” the authors of the 2010 paper wrote. “For example, caregiver alcohol use has been linked to elder abuse.”

For some, being a caregiver and realizing that not only is your own health in jeopardy, but also someone else’s, may be an impetus to seek rehabilitation and counseling.

“I think it’s important that caregivers know that there is help out there – inpatient rehab, outpatient rehab, online support as well,” Carbo said. “But they do need to reach out, because they can’t do it alone. It’s something that requires encouragement, support and understanding.”

Bibliography

1. O’Dwyer, Siobhan et al. (2015, July 20). Suicidal ideations in family carers of people with dementia. Aging and Mental Health. Retrieved Dec. 29, 2015, from http://www.tandfonline.com/doi/abs/10.1080/13607863.2015.1063109?src=recsys#.VoLEvhUrKhc
2. O’Dwyer, Siobhan et al. (2015, July 20). Homicidal ideations in family carers of people with dementia. Aging and Mental Health. Retrieved Dec. 29, 2015, from http://www.tandfonline.com/doi/abs/10.1080/13607863.2015.1065793?journalCode=camh20&
3. Rospenda, K. et al. (2010, July). Journal of Addictive Diseases. Retrieved Dec. 29, 2015, from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2906825/

Written by David Heitz

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