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caregiver stress - Mediation Line

caregiver stress

Post image for Keeping Aging Couples Together: mediating your family’s eldercare options

As the elderly population grows, one segment of that group is bigger than ever before: married seniors. 45% of men over the age of 85 still live at home with their spouse. Another 10% of senior men are married, but are living apart from their spouse (who is most likely in a nursing home). As senior couples and their concerned family members confront caregiving decisions, the couples’ desire to continue to live together is a huge challenge. There are a number of living arrangements to consider and holding a family meeting to consider them may be the best way to sort out the pros and cons.

Most senior couples prefer to continue to live together at home. But when one spouse is in need of extra help, it places the healthier spouse in a care-giving role. Remaining at home may be the goal for many, many couples, but doing so without the right support can mean injury for the healthier spouse. When families are faced with the important question of how elderly loved ones can enjoy their time together without compromising the health and safety of each partner, it makes sense to hold a family meeting – sometimes with the aid of a mediator – to weigh the options. Here are a few to consider:

Aging in place at home may seem like the best option for elderly couples. They have the chance to stay together in a familiar environment and if they can manage to hire an in-home care professional, the couple will get the care and support they need. On the other hand, families must keep in mind that constant contact with caregivers can lead the healthier spouse to feel intruded upon, and round the clock in-home care can be pricey.

Moving together to an assisted living facility is a also a popular option, but rarely do both spouses stay at the same activity and health level. One spouse is likely to fall into a caregiving role in this situation as well, when the facility does not have the services the weakening spouse needs. Moving together to a facility that provides the higher level of care the less healthy spouse requires ensures that health needs are met, but can result in the healthier spouse feeling trapped in a place that doesn’t offer the opportunities he or she needs to remain active, and can result in the healthy spouse deteriorating.

Living separately at different facilities (assisted living and a nursing home) or one spouse remaining at home while the other moves into residential care are options, but is usually distressing for both spouses and can negatively impact their health.

Continuing Care Retirement Communities (CCRCs) have been stepping up to the plate lately to fill the void. These residential centers offer a wide array of services and care which can be customized to each spouse’s needs. This may be the perfect solution for a couple that can’t remain at home together, however it can be cost-prohibitive. Most CCRCs require a buy-in fee and then monthly payments (which can be comparable to live-at-home costs). And the sliding levels of care may only be offered in specific buildings on the grounds, meaning one spouse might need to move to receive a higher level of care.

Clearly, there are a number of options available to aging couples – some of which have not even been touched upon here. There are no perfect solutions, but understanding a couple’s need to remain together is the first step in the process of making long-term care decisions. Holding a family meeting, either with or without the help of a mediator, is a great way to put everyone’s needs and concerns on the table so they can devise the best possible strategy.


According to the National Family Caregivers Association, in any given year, more than 45 million Americans are caring for an aging parent, close family member or friend.  While more often than not, women tend to shoulder more of this burden, increasingly men are just as likely to face the challenge.

For those of you who have wrestled with caregiving responsibilities, you know that it can often place a tremendous strain on one’s health, personal finances, job responsibilities, and relationships.  Day after day, you’re making tremendous personal sacrifices caring for loved ones, but who’s taking care of you?

Ask yourself these 10 questions to see whether you’re heading for Caregiver Burnout.

1. Are you constantly feeling tired and exhausted?  Don’t have the same energy for performing routine activities that you used to?

2. Do you find that you sleep poorly at night and either have trouble falling asleep, or sleep restlessly throughout the night?

3. Are you constantly wondering if you are making right decisions for your loved one? Do you question your decisions because of  the stress you may be under in dealing with other family member’s conflicting ideas of how to care for your loved one?

4. Do you find yourself becoming increasingly impatient and irritable with others for no good reason?

5. Do you find yourself being resentful toward your loved one or at other family members for the burden that’s being placed on you?

6. Do you feel increasingly joyless, depressed, or apathetic and find that you derive less and less pleasure in either taking care of your loved one, or in other activities that used to give you pleasure?

7. Have you found yourself wanting to withdraw socially?

8. Has your appetite changed noticeably – either you are eating considerably more due to stress, or you have lost interest in food?

9. Have you developed an increased dependence on substances such as cigarettes, alcohol or drugs?  Or do you find yourself escaping into other “unhealthy” activities such as overshopping, excessive use of the internet and other escapist activities?

10. Do you feel a sense of guilt that you aren’t doing quite enough for your loved one?

Of course, even non-caregivers can experience some of these symptoms now and then in response to stress at some points in their lives.  But if you answered “yes” to more than 3 of these questions, and experience these symptoms on a pretty consistent basis, then you could be heading down the path to Caregiver Burn-out.

What Now?

Here’s one of my favorite resources that I want to share.  The Family Caregiver Alliance, National Center on Caregiving produces a wealth of resources – manuals, provider lists, research studies, you name it – for care givers.  I particularly like their “Long Distance Caregiver Handbook”, which stresses that caregivers who may be facing burn-out reach out and get help, ask for professional support, and call a family meeting to delegate some of the caregiving repsonsibilities.  

It’s thorough and concise and it offers some wonderful tips, links and strategies for caregivers.  I love the section that advises caregivers to hold a family meeting! That’s great advice.  For many people, though, the idea of sitting down with other family members and sorting through complex emotions and devising an appropriate caregiving strategy can be daunting.  However, with the assistance of a third party neutral, such as an eldercare mediator, to facilitate the discussion that conversation can become much more manageable. Food for thought.