Caregiving and Health Behaviors

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Contrast the positive and negative aspects of caregiving from the caregiver’s perspective and discuss the issues that tip the balance for any given individual

The positive aspects of caregiving are often linked to the nature of the relationship that the caregiver has with the care recipient. The numerous and burdensome negative aspects of caregiving can cripple a caregiver’s career long term, especially without monetary or other remuneration. On the other hand, the alternative to the sacrifice of caring for a loved one, that of abandoning the dependent person to the care of strangers, can cause worry in the short term and guilt and grief in the long term. Both paths have long term impacts.

Negatives

It consumes time and imposes an opportunity cost¹ It is affecting the caregiver’s future economic security, emotional health, and social status. It can be physically strenuous and even cause back injuries, socially isolate the caregiver, and cause squeamishness or embarrassment. It is like being a nurse or nurse’s aide without the title, the camaraderie of co-workers, insurance, pension, parking space, or paycheck.

Positives

The obvious ones are avoidance of guilt and worry, although some evidence suggests that caregiving confers significant feelings of importance (Boerner, Schulz, & Horowitz, 2004). Providing no care at all can contribute to the premature death of the dependent person, causing guilt. Although helpful, there are guilt-inducing drawbacks associated with the alternative of care in the home with paid home health aides² The more costly option of institutional care bears risks as well³.

Guilt and self-reproach over not having done everything possible for a loved one in the hands can persist for decades. When the dependent person dies, the grieving process is much complicated if the bereaved has not done everything possible to care for the deceased.

The choice between career and caregiving may depend on the nature of the relationship with the dependent person. Although self-importance, inheritance, or pay may help to tip the balance, the major factor seems to the prospect of feeling rotten about having not done everything possible for a loved one.

Health behaviors are primarily under the control of the individual. What can the formal health care delivery system do to encourage healthy lifestyle behaviors?

The formal health care system can probably affect personal health choices but must do so in ways that are not discriminatory or leave patients un-cared for. Here are some ideas:

Make it preventive: Focus funding on primary and preventive services in medical, dental, and mental health services.

Make it easy: Co-locate services so that follow-up on any recommendations becomes a simple and easy matter. Make it simple to navigate the phone systems of major hospitals.

Make it cheap: It should be cheap or free to get guidance and encouragement in quitting smoking, getting gentle exercise, learning to eat healthily, dealing with mental health issues, and getting clean and sober, among other items.

Make it consistent: All health care practitioners, especially primary care professionals, should be inquiring about and following up with education about: ⁴ Health behaviors: substance use, exercise, driving with seat belt, firearm presence in the home, how they deal with feelings of depression, workplace hazards, use of non-prescription drugs, and sexual behavior, among other items.

Conduct your own self-risk appraisal. A number of programs are available on-line that lead you through a risk profile and give a risk score at the end. Please find one and tell us about it. Also, identify your own list of risk factors and state why you are at risk or not. Create a personal plan for minimizing risk factors. For this portion, only share information that you are comfortable sharing with everyone.

My score on the HealthStatus.com self-assessment tool (HealthStatus, 2013) was 95, or fairly low risk. However, some behaviors still needed amendment, including:

Exercise and weight loss: Time spent in front of a computer has inevitable results. My solution should be to allocate time to exercise even when I am working hard on school assignments. I could set a timer to remind me to move around every half hour.

Lower driving speed: I need to plan my time to allow for a safe speed.

Check for cancer symptoms: A family history of cancer demands vigilance in monitoring and testing, even if inconvenient or intrusive. I need to grit my teeth and make appointments for the checkups and tests that are needed.

Reduce fat in the diet: My student diet is less than ideal. I should be watchful of what I eat when I am working hard.

Bibliography

Anderson, R. (2013). Disadvantages of Insititutional Care. Web.

Boerner, K., Schulz, R., & Horowitz, A. (2004). Positive Aspects of Caregiving and Adaptation to Bereavement. Psychology and Aging, 19(4), 668-675. Web.

Cifuentes, M., Fernald, D. H., Green, L. A., Niebauer, L. J., Crabtree, B. F., Stange, K. C., & Hassmiller, S. B. (2005). Prescription for Health: Changing Primary Care Practice to Foster Healthy Behaviors. Annals of Family Medicine, 3(Supplement 2), 54-511. Web.

HealthStatus. (2013). Health Status. Web.

Footnotes

Taking care of a dependent elder, invalid, or disabled person consumes time and imposes an opportunity cost on the caregiver. The time spent in care could otherwise be spent on a job, education, training, or just on oneself. In many cases, caregiving means a complete abdication of a career or of advancement.
Anecdotally, paid home health care can precipitate a nightmare of long waits for home health aides and nurses’ arrival, the risk of negligence, abusive speech or behavior, victimization, or fast turnover. All this can cause worry, guilt, fear, a distraction from work, or one’s own life on the part of the family and friends of the dependent person.
Institutional care, apart from restricting all sorts of personal liberties (Anderson, 2013), can also expose the dependent person to depression, agitation, secondary medical problems, or worsening of existing conditions. Secondary medical problems could include such inconveniences as constipation (due to change to an institutional diet) or the discomfort of a UTI (due to not staying hydrated). The change of setting, especially if the patient is not happy to be there, can lead to less assiduous management of more serious conditions such as elevated blood pressure, depression, or diabetes. The change to an institutional setting may cause disorientation and lead to wandering or resistance to treatment. In some instances, there is outright abuse (sexual, verbal, or physical) or neglect. These problems also impose guilt, worry, anger, distraction, and depression.
Cifuentes et al., 2005.

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