Caregivers of stroke survivors who show signs of depression have a higher risk of suffering their own health challenges as they age.
The findings, presented at the European Society of Cardiology Congress 2019, highlight the importance of attending to the mental health of caregivers, according to researchers.
“Caregiving is becoming more common and more demanding,” said study first author Professor Misook L. Chung of the University of Kentucky College of Nursing. “More attention needs to be paid, especially early on, to managing depressive symptoms in caregivers. They must realize that self-care is not selfish.”
Stroke is a leading cause of long-term disability around the world and often exerts a heavy toll on caregivers. Providing assistance to patients, including helping with eating, dressing, going to the bathroom and showering, not to mention taking care of meals, organizing a home and supervising medical care, can become a full-time job with a deep emotional component, researchers note.
For the new study, researchers recruited 102 caregivers with a mean age of 58. Two-thirds were female and about 70 percent were spouses. The rest consisted of other family members, although two or three were family friends, said study senior author, Rosemarie King, a retired research professor at Northwestern University School of Medicine in Chicago.
Caregivers answered questionnaires at two points in time: Six to 10 weeks after the patient was discharged from the hospital and again one year later.
The overall proportion of individuals reporting symptoms of depression, such as poor appetite or trouble focusing, declined slightly over the course of the study — 32.4 percent versus 30.4 percent, according to the study’s findings.
More than half the participants (57.8 percent) said they had no issues of mental distress at all, but 20.6 percent, or one in five, suffered persistent depressive symptoms in the first year of caregiving, researchers reported.
The mental health of people with chronic signs of depression was closely associated with their physical health. One-third of caregivers in the study reported their physical health as fair or poor after one year, while 43 percent said they felt their health had deteriorated.
Compared to caregivers who did not have signs of depression, those with ongoing challenges were seven times more likely to report problems with their health after one year of caregiving for stroke survivors, the study found.
Individuals with persistent symptoms of depression during the first year of caregiving reported heavier caregiving duties, poor family functioning, and low interpersonal support.
One limitation of the study is that the researchers did not track primary health outcomes, such as diagnoses of physical illness. Instead, they relied on self-reports of caregivers’ health status and changes in health status. There was also a high attrition rate, with a third of study participants dropping out. Longer-term studies, with objective measures of caregiver health status, are required, the researchers said.
Nevertheless, the study’s findings suggest the need for earlier interventions and long-term follow-up with caregivers.
“We haven’t paid enough attention to caregivers’ health,” said Chung. “Self-care intervention programs should include depressive symptom management for caregivers.”
A pilot study conducted by Chung found benefits by incorporating stress management and self-care management for caregivers.