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From Aging Wiki 16
 Group #16
- 1. Chelsea Mercier
- 2. Kristin Prentice
- 3. Molly Ziraldo
With a large proportion of the population quickly aging, caring for elderly relatives is become more common. Caring for an elderly relative comes with negative effects, such as increased stress levels, the burden of having to care for the elderly as well as their children, and an increased costs of living. This should be enough negative effects to have people not care for their elderly relatives, but caring for elderly also has positive outcomes. Some common positive outcomes are the improvement of the relationship with the elderly relative, the improvement of life satisfaction due to the feeling of fulfilling, and finally it creates another purpose in life. In addition, there are also physical and social benefits for the caregiver. Due to the present of both negative and positive aspects, much research has been done in order to decrease the negative effects and increase the positive. Research has looked for solutions, such as leisure activities which can act as a catalyst towards enhancing an individual's quality of life.
 Negative Impact on the Caregivers
A large portion of North America’s population and other countries around the world are aging quickly. With age, comes the need for assistance as this expanding population becomes frail and ill.  Society offers formal care, but due to personal choice, financial issues, and lack of beds, informal care has become more popular.  Informal caring is when a family member or friend cares for an elderly person without recieving payment.  Due to the increasing need for informal care, more relatives, especially daughters are caring for their parents. Research has found that, in general, caring for relatives has a negative effect on the caregivers themselves. These include physiological problems, psychological problems, and financial issues. 
 Physiological Disadvantages
Caregivers report several physical issues that arise when caring for an elderly relative. To some, this may not come as a surprise because when caring for others, sometimes the caregivers neglect their own needs.  For example, when caring for an elderly relative, the caregiver may cook a meal for them and no longer have the time to cook for themselves. Instead, they turn to fast food. Women, who are more likely to be primary caregivers, report more health issues than men. However, men demonstrate increased stress hormones and increased blood pressure in stressful situations, including the stress brought by caring for their elderly relatives.  Caregivers who are caring for an elderly person with an illness like dementia view the situation as more stressful and more of a burden. Hence, they experience physiological changes that lead to future health issues. Compared to non-caregivers, caregivers caring for people with dementia demonstrate significantly higher hormone levels.  This influences the risk of the caregivers developing hypertension and diabetes later on in life.  Due to these physiological changes, caregiving in stressful situations can lead to increased mortality. 
 Psychological Disadvantages
In addition to physiological problems, caregiving can also lead to psychological issues. Women tend to report more psychological problems than men because they are usually the primary caregivers and are more likely to become emotionally involved.  Women report that they feel like they are part of the “Sandwhich Generation”, because they are taking on the role of caregiver for both the elderly and their young children. Therefore, they view caring for the elderly as an added burden.  Women also report that they feel more stressed and depressed when they are caring for males, due to their specific needs. This generally leads to depression and a feeling of “burn out." 
 Financial Issues
In addition to the physiological and psychological effects that accompany caregiving, there are also financial issues that arise as well. The financial issues affect not only the caregivers but also their immediate family members.
Informal caregiving saves the healthcare system a significant amount of money. Unfortunately, it costs the caregivers a great deal of money.  Caring for an extra person requires more money for basic living essentials like food, clothing and shelter. Moreover, those who take on the role of caregiver often have to sacrifice their careers. Women are more affected because they feel obligated to care for their parents, but this only has a significant effect if they are working for more than 10 hours a week.  After 10 hours a week, few people, especially women, can care for their elderly parent and work full time. Of course, they are not being paid for their assistance. Hence, the elderly can put a significant strain on family income. This seems to not effect men as much because for the most part men are much more attached to their careers and will not chose to care for their elderly relative. 
The North American population is aging rapidly. Due to the lack of hospital beds and healthcare funding in general, informal caring is becoming more common and popular. Research shows that there are physiological problems, psychological problems, and financial issues associated with caring for the elderly. More research is being done in order to further understand this issue. Several resolutions are have been proposed, such as occasional formal caring to help relieve stress and eliminate the thought of caring as a burden, as being a caregiver has adapted the stereotype of a depressed woman.  The following video demonstrates several possible solutions.
 Positive effects for caring for An Aging Relative
What are the positive effects of caregiving? Until recently, the positive view on caregiving was not given much attention. However, it is receiving greater consideration, as a better understanding of the caregiver experience is needed in order to assit these individuals throughout this time in their lives. Caring for an aging relative can bring many positive experiences into one's life, which can help compensate for the stress that can also be felt. There is also new research showing positive cognitive effects pertaining to caregiver well-being . These new findings on positive physiological outcomes are helping shed new light on the role of caregiving.
 Psychological Benefits
Many adult children feel the need to give back to their parents and feel that caregiving is their duty. Actively choosing to take on the caregiver role is one of the most powerful determinants of positive outcomes. Being able to care for a relative who has provided for the family in the past, is something most caregivers take pride in and feel good about. Caregiving is often a time in which the caregiver discovers more about him or herself; helping foster new insights into the self and others. This can positively influence and strengthen relationships within the caregiver’s social networks. Furthermore, because the individual is challenged in new ways, it allows him or herself to learn about him or herself, in ways that would not otherwise be explored. This improvement in self-knowledge can lead to an increased ability to handle and cope with stressors more effectively in other domains of one's life. 
Intimacy is also increased through caregiving. There is a level of intimacy and closeness that is often unattainable without taking on such a role. This level of intimacy is often the result of selfless devotion to another. This type of relationship can be very rewarding for a spouse and especially for adult children, as it allows them a chance to get to know their parents better than ever before. An example of this is provided in the video below. .
Most caregivers claim that above all, caring for a loved one gives their life meaning and purpose. This sense of purpose is often considered the most beneficial effect of caregving, as it can compensate for negative stressors and make the experience worthwhile. Most caregivers also state that caregiving helps them to appreciate life more.. When one sees an ill relative nearing the end of life or slowly losing mobility, it can spark great feelings of gratitude for their current health. This feeling of awareness can potentially lead to greater positive effects by encouraging an individual to take their own health more seriously. In one study on satisfaction attained through caregiving, Cohen and colleagues found that 73% of those surveyed claimed they found atleast one positive aspect of caregiving. This study found that there are specific areas that provide the most caregiver satisfaction. Among these areas, the most satisfying element was companionship followed by the feeling of fulfillment. As individuals grow older, loneliness can become a prevalent concern, and caregiving can help alleviate the onset of such feelings. Caregiving is also known to give meaning to ones' life. The process of making a difference can be very rewarding, and in turn, this feeling of fulfillment can give way to an increase in motivation. Caregivers also reported that enjoyment and satisfaction through caregiving was attained through a renewed sense of responsibility. Having a duty and obligation tend to make one feel a sense of importance. Knowing that someone else relies on them can make one feel needed and worthy. Lastly, caregivers experience satisfaction from the feeling of being appreciated and valued.The reciprocation of gratitude can have powerful positive effects.
 Cognitive Functioning Benefits
Beyond emotional aspects, there are positive effects happening on the cognitive and physiological level. A recent study on elderly women consisted of 375 caregiver and 694 noncaregiver partipcants showed an increase in memory and lower mortality rates in the caregiving group. This is in direct relation to caregiving as it is a physically demanding job and requires constant mental stimulation. The caregiver is often getting physical and mental exercise without knowing it. Results showed improved strength and cardiovascular performance in caregivers versus noncaregivers,which helped contribute to lower mortality rates. Furthermore, the caregivers had higher scores on memory tests, compared to noncaregivers. These opitimistic findings may help caregivers know that their hardwork is paying off in more ways than one.
There is more research to be done regarding the aspects of caregiving, but it is clear that the positive effects are just as important to understand as the negative ones.
 Leisure as a Solution to Caregiver Burden
The role of a caregiver involves both positive and negative aspects. Helping a loved one who is elderly every day is rewarding, but can also be a challenge. Research has identified the main stressors of a caregiving and the impacts that the stressors can have on an individual. There are not many studies that have revealed solutions to caregiver burden. This section will discuss leisure as a potential solution to the challenges faced by caregivers of the elderly. Additionally, it will indicate how leisure that is incorporated into a caregiver’s life can assist in relieving the individual of potential caregiver burden.
 Challenges of Caregiving
Caregivers face challenges when caring for their loved ones. These challenges can be physical or psychological, and can cause the caregiver stress. These stressors can have negative effects on the caregiver, such as depression, feelings of social isolation, risk of detriment to their quality of life and decreased health status . However, researchers implemented leisure interventions for caregivers to discover if leisure would assist in decreasing the negative aspects of caregiving. Several studies have conducted interventions to assist caregivers in burden relief. One type of intervention was a leisure education program.  Leisure education is a way in which individuals can learn more about savouring pleasant moments with each other. Furthermore, leisure education assists in caregiver support. Another intervention involved Cognitive Behavioural Therapy (CBT) techniques. The CBT strategies tested clients’ behaviour and attitudes. The test is used to help individuals to become more involved in enjoyable and constructive activities. Additionally, CBT helps individuals to reconnect with aspects of their lives that make them feel truly happy. 
 Benefits of Physical Leisure on Health
When caregivers are spending the majority of their time looking after their loved one, their own personal time becomes lower on their list of priorities. Older adult caregivers have reduced opportunities to exercise and participate in leisure activities because of their caregiving responsibilities.  Research has shown that caregivers of persons with dementia have a greater prevalence for hypertension, high mortality rate and reduced lymphocyte sensitivity.  The study by Hirano et al. also noted that psychological distress is associated with lower levels of physical activity.  Studies have been conducted involving the importance of physical exercise and the positive impacts it has on the body. Physical exercise has been found to decrease the risk of early mortality, and prevent the risk of cardiovascular disease. Byberg et al. (2009) as cited in Hirano et al. (2011), described how leisure activities reduced the rate of mortality. Furthermore, the study revealed how leisure activities and increasing physical activities can aid the caregiver in decreasing their care burden . In essence, general leisure activities that are physical in nature assist in the decline of caregiver stress. The article did not specify which leisure pursuits assist caregivers in relievig burden but rather discussed leisure activities as an overall strategy to reduce care burden. 
 Benefits of Leisure on Caregiver-Care Relationship
In addition to care receivers feeling powerless and dependent on others, caregivers also feel powerless and less independent. The article conducted by Carbonneau, Caron, and Desrosiers (2011) suggests that support for both the caregiver and receiver are important.  Several studies have researched support care receivers, but little time and focus has been used to assist the caregiver in strengthening their caregiving role.  Leisure can assist in strengthening the bond between the caregiver and care receiver. Voelk (1998), as cited in Carbonneau, Caron, and Desrosiers (2011) , suggests that leisure promotes positive events in the relationship between the caregiver and the care receiver daily. By participating in leisure with the care receiver, the caregiver is spending quality time with their loved one, and is experiencing positive emotions. The positive emotions experienced help strengthen the bond between the caregiver and care receiver. The time spent with each other is more meaningful and memorable, thus the relationship between the two is stronger. Leisure activities such as scrapbooking or photography can be used as memory-maintaining leisure activity, which can evoke positive emotion. The experience of positive emotions may not only improve the quality of life of the care receiver, but may also assist in enhancing the quality of life of the caregiver as well.
 Benefits of Leisure on Quality of Life in General
The quality of life is an essential component of an individual’s life. The quality of life can be described as the perception of an individual’s life and their culture, values and beliefs' role in creating their goals, and expectations.  Although the caregiver realizes that they have a responsibility to care for their loved ones, they should know that maintaining their positive quality of life and well-being is crucial to life satisfaction. In order to achieve life satisfaction, the caregiver must participate in leisure. According to Bedini et al. (2011), research has shown that both passive and active forms of leisure have been used to improve an individual’s quality of life. Passive leisure would include activities such as watching television or reading a book. Active leisure, in contrast includes activities such as riding a bike or hiking. Thus it is important for caregivers to make time for leisure. Research has suggested implementing programs for caregivers to help improve their quality of life. Losada et al. (2010) describe the importance of leisure when considering the needs of the caregiver when creating caregiver services. In order to successfully assist an individual, it is essential that their needs are met. In these circumstances, leisure time is the key to enhancing the individual’s well-being and quality of life.
 Notes and References
- ↑ Yin, T., Zhou, Q. & Bashford, C. (2002). Burden on family members. Caring for a frail elderly: A meta-analysis of interventions. Nursing Research, 51, 199-208.
- ↑ 2.0 2.1 2.2 2.3 2.4 2.5 2.6 2.7 Vitaliano, P.P., Zhang, J. & Scanlan, J.M. (2003). Is caregiving hazardous to one's physical health? A meta-analysis. Psychological Bulletin, 129, 946-972.
- ↑ 3.0 3.1 Lyons, K.S., Zarit, S.H., Sayer, A.G. & Whitlatch, C.J. (2002). Caregiving as a dyadic process: Perspectives from caregiver and receiver. Journal of Gerontology: Psychological Sciences, 57, 195-204.
- ↑ 4.0 4.1 4.2 Kesselring, A., Krulik., T., Bichsel, M., Minder, C., Beck, J.C. & Stuck, A. (2000). Emotional and physical demands on caregivers in home care to the elderly in Switzerland and their relationship to nursing home admission. European Journal of Public Health, 71, 267-273.
- ↑ Nolen-Hoeksema (2001). Gender differences in depression. American Psychological Society, 10, 173-176.
- ↑ Schulz, R. & Beach, S.R. (1999). Caregiving as a risk factor for mortality. The caregiver health effects study. American Medical Association, 282, 2215-2219.
- ↑ 7.0 7.1 7.2 Charmichael, F. & Charles, S. (2003). The opportunity costs of informal care: does gender matter? Journal of Health Economics, 22, 781-803.
- ↑ Breach, Jackson, Schulz & Yee 2000,(15)2 259-271
- ↑ 9.0 9.1 Tarlow B., Wisniski S., Belle S., Rubert M., Ory M., Gallagher-Thompson (2004). Positive aspects of caregving. Research on Aging 26(4)81-94.
- ↑ 10.0 10.1 Lopez , Lopez, & Crespo 2005, (41)1, 81-94.
- ↑ 11.0 11.1 11.2 Connell C., Janevic M., Gallant M.,(2001).The cost have caring: impact of dementia on family caregivers. Journal of Geriatric Psychiatry and Neurology 14,178-187.
- ↑ 12.0 12.1 12.2 Cohen A., Colantanio A. & Vernich L. (2002). Positive aspects of caregiving: rounding out the caregiver experience. Int J Geriatric Psychiatry, 17, 184-188.
- ↑ Span,Paula.(2011,October.12). Caregiving’s Hidden Benefits. New York Times. Retrieved from http://newoldage.blogs.nytimes.com/2011/10/12/caregivings-hidden-benefits/
- ↑ 14.0 14.1 Fredman L., Cauley J., Hochberg M., Ensrud K.E., & Doros G. (2010)Mortality associated with caregiving, general stress, and caregiving-related stress in elderly women: results of caregiver-study of osteoporotic fractures, Journal of the American Geriatrics Society , (58)5 937–943.
- ↑ 15.0 15.1 15.2 Bedini, L. A., Gladwell, N. J., Dudley, W. N., & Clancy, E. J. (2011). Mediation analysis of leisure, perceived stress, and quality of life in informal caregivers. Journal of Leisure Research, 43(2), 153-175.
- ↑ 16.0 16.1 16.2 16.3 16.4 16.5 16.6 Carbonneau, H., Caron, C. D., & Desrosiers, J. (2011). Effects of an adapted leisure education program as a means of support for caregivers of people with dementia. Archives of Gerontology and Geriatrics, 53, 31-39.
- ↑ 17.0 17.1 17.2 Losada, A., Márquez-González, M., & Romero-Moreno, R. (2010). Mechanisms of action of a psychological intervention for dementia caregivers: effects of behavioural activation and modification of dysfunctional thoughts. International Journal of Geriatric Psychiatry, 26, 1119-1127.
- ↑ 18.0 18.1 18.2 18.3 18.4 18.5 Hirano, A., Suzuki, Y., Kuzuya, M., Onishi, J., Hasegawa, J., Ban N., & Umegaki, H. (2011). Association between the caregiver’s burden and physical activity in community dwelling caregivers of dementia patients. Archives of Gerontology and Geriatrics, 52, 295-298.
- ↑ Losada, A., Pérez-Peñaranda, A., Rodriguez-Sanchez, E., Gomez-Marcos, M. A., Ballesteros-Rios, C., Ramos-Carrera, I. R., Campo-de la Torre, A.(2010). Leisure and distress in caregivers for elderly patients. Archives of Gerontology and Geriatrics, 50, 347-350.