Caregiving is no picnic. Do I even need to say that? By definition, the job is stressful and debilitating. A mountain of reports have linked caregiving to heart disease, depression and a shorter lifespan.
So, it comes as a surpise to find a cluster of new studies that seem to conclude caregiving is good for you. That’s right, instead of wearing you down, making you demented or depressed, good for you!
And, the good it does you is more than just the psychological kind. We’re talking benefits in strength, longevity, brainpower and more.
As it turns out, the author of the studies, Lisa Fredman, a professor of epidemiology at Boston University, was just as surprised when the results first started to come in: “It was a shocker,” she says, adding, “My first thought was, ‘This can’t be right!’ Like many before me, I subscribed to the idea that caregiving is bad for your health. But over time I kept finding essentially the same patterns.”
Fredman’s first study, conducted over eight years, showed that caregivers had lower mortality rates than non-caregivers. The next one focused on physical ability, and found that high-intensity caregivers demonstrated better walking pace, grip strength and speed of rising from a chair than lower intensity caregivers or non-caregivers. A third study was on memory and brain function. Once again, the caregivers performed well, demonstrating brain skills equivalent to those of people ten years younger.
Following is a conversation I had with Fredman about her work and its implications:
Q: You’ve said you were surprised by the results of your research. What was your original hypothesis going into this work?
A: My hypothesis was that caregivers were going to have poorer health outcomes then noncaregivers. And that remained my hypothesis for the first three grants that I wrote over eight or nine years. So I was pretty wedded to that.
Q: What changed your mind?
A: My initial results were that caregivers had lower rates of mortality than the noncaregivers. While they were much more stressed than the noncaregivers, they seemed to be doing better physically. The differences were dramatic. Mortality rates were 25 percent lower for caregivers. Functional decline such as walking speed, grip strength and chair-stand speed was lower for caregivers. Caregivers also maintained higher cognitive ability.
Q: What did the caregivers experience that might have contributed to these positive effects?
A: The physical activity probably has salutary effects. And there are psychological benefits as well. A lot of caregivers report they feel a great deal of gratification that they are able to care for their relatives and keep them out of a long term care facility.
Q: So, why do you think other studies have found such different outcomes?
A: Well, there is a key difference. We used an independent measure of stress, which previous studies had neglected to do. And so we are able to separate out the health effects of stress from the health effects of caregiving. We found that it is primarily the stressed caregivers who are experiencing negative health effects. So now I actually really believe in this hypothesis.
Q: What about the question of selection bias? Obviously you weren’t able to assign some individuals to caregiving roles and then assign others to be free of this responsibility and then compare the two groups. You had to pick those who had chosen to be caregivers and compare them to those who had chosen not to. Does that muddle the data at all?
A: I don’t think it’s a question of whether you have a choice. If you are healthy enough to take care of an older relative who needs assistance you become the caregiver. I wouldn’t consider it a selection bias, but there is a selection of healthier older people assuming the caregiving role.
Q: What about the political risk—or repercussion—of studies showing that caregiving may be healthy? To put it bluntly, is there a chance policy-makers will read too much into this and, say use your results to defund agencies that are helping the caregiver?
A: That is always our concern globally. The message here is that caregiving can be very stressful and stress can have very deleterious effect, not just on a person’s emotional well-being but their physical health as well. And what our studies seem to show is that it is really stress—not being a caregiver—which does a person harm. If anything, my studies support the call to fund more research.
Q: Stress is something that you can reduce by intentional effort. Based on your studies, would you tell someone who is a caregiver to more actively pursue stress-relieving activities?
A: I’m very interested in the effects that stress-relieving activities such as yoga have on caregivers and people in general. I’m excited that we now have the ability to look at physiological and brain effects of these stress reduction programs. Caregivers should try to find ways that work for them to reduce stress such as support groups, talking with a friend, yoga, swimming, running, reading etc. But it is not always realistic to simply advise a caregiver to pursue something like this.
Q: Why not?
A: Caregivers often have trouble finding free time. It can be very difficult for people in this role to stop and concentrate on themselves because they are often fully consumed with the wellbeing of the person that they are caring for.
Q: So how can caregivers find personal time to lower their own stress?
A: It really is important for others to offer respite to caregivers by taking on some of their responsibilities. For example, my sister is the main caregiver for my father. When I pitch in, I seem to spend the entire day doing errands—errands that can seem minor and not very helpful. But my sister assures me that it really helps her because it saves her a substantial amount of time. So it’s exactly those kinds of things—things that don’t seem like such a big deal—but really are, because they give the caregiver the gift of some free time.
(Steven Slon is editorial director for The Saturday Evening Post. This column was first published by Beclose.com)