Caring for the Mental Health of Caregivers

The mental health of caregivers of older people in Latin America and the Caribbean appears to be at risk. A recent IDB survey of more than 27,000 caregivers across the region found a worrisome situation: more than 30% of unpaid caregivers and 19% of paid caregivers reported experiencing symptoms of depression.

In this note we will explore some of the effects that caregiving has on the well-being of caregivers in the region and some opportunities to support them.

Long-Term Care and Its Impact on Mental Health

The circumstances in which people live and work-such as income, employment, education, inequality, gender and ethnicity, among others-are factors that affect mental health. These are called social determinants of mental health.

In the case of caring for the elderly, this is a physically and emotionally demanding task, which confronts us with the vulnerability of people who need support to perform activities of daily living, such as eating, bathing or shopping. It is a task that is generally invisible and socially undervalued, despite its immense contribution to the organization of societies.

In our region, the circumstances in which this care is provided are far from ideal. Paid care is still an incipient, informal sector, characterized by low wages and limited access to social protection benefits. The coverage of these services is still insufficient, and most of the burden of care is assumed by unpaid caregivers, falling mainly on women in the family, who take on this work at great personal cost.

In recent years, the aging of the population has pushed the long-term care agenda to the forefront in our region. Many countries are developing policies to be able to respond to the growing demand for care. However, there are still no clear strategies on how to address the mental health care of caregivers.

The Overburdening of Unpaid Caregivers

Although caring for a loved one can be a rewarding task, it is often detrimental to the mental well-being of caregivers. The heavy physical, emotional and time demands of caring for an elderly dependent person can lead to overload, experienced as intense stress. These consequences are more pronounced in women.

It is common to read that self-care is fundamental for caregivers, but what is more frequently observed is that caregivers postpone their projects and needs in order to assume this role. In the recent IDB survey, almost half of the caregivers reported needing medical care in the past year, but being unable to obtain it because of their caregiving duties. The burden of caregiving negatively impacts multiple aspects of caregivers’ lives, such as the likelihood of participating in the labor market and their financial well-being, increasing the prevalence of depression symptoms, and also affecting family, partner or friendship relationships. Psychological distress appears to be greater as the caregiving dependence increases, as in the case of people with dementia.

Paid Caregivers: A Precarious Sector

The working conditions are associated with mental health, and the paid long-term care sector is characterized by informality, lack of social protection, low wages and low levels of training.

The World Health Organization (WHO) points out some risks to mental health at work, and one of them is insufficient skills to perform daily tasks. In this regard, one in four paid caregivers has some training, and only three out of ten have completed an extensive course.

Another risk highlighted by the WHO is experiencing violence, harassment or bullying, and the IDB study found an alarming situation: 39% of paid caregivers who responded to the survey reported having experienced verbal abuse, while 15% acknowledged having suffered physical abuse.

In addition, it should be noted that people whose work involves frequent emotionally intense interpersonal relationships are more likely to suffer from chronic work stress or burnout due to mental and psychological exhaustion.

Opportunities to Care for the Mental Health of Caregivers

Let’s explore some of the policies that have the potential to significantly improve the well-being of caregivers.

• Respite services, such as day centers , provide care for the needs of elderly people with varying degrees of dependency. Day centers seek to improve the quality of life and well-being of the elderly person and his or her family. In addition to having the potential to diminish or rehabilitate the functional, cognitive and social abilities of users, and thus reduce the burden of care, they allow caregivers to take a break and rest. Personal time is an invaluable resource for caregivers.
• Training: better tools for caregiving. Training is essential for people to feel more confident and perform better in caregiving activities, which also has positive effects on the quality of care provided. Having the necessary tools and skills for caregiving is crucial to be able to adequately manage stress, especially in such a physically and emotionally demanding job. Training has multiple advantages: it is associated with greater job satisfaction, reduced distress and stress, and lower job turnover. It is also associated with higher earnings and lower levels of stress and symptoms of depression.  
• Labor policies that allow for the compatibility of work and care, such as caregiving leave or flexibility in the work schedule. This could help reduce the number of caregivers who leave their jobs.

In a rapidly aging region, taking care of the mental health of caregivers is critical. Do you have an experience you’d like to share? Tell us in the comments! Or, if you are involved in eldercare, share your experience in our survey.