Information for Family Caregivers

(Elder Abuse Prevention Series, HealthLink BC, March 2005)

Most families are supportive

Eighty per cent of caregiving to older adults is provided by families, usually by the person's spouse or partner or by adult children, quite often a daughter or daughter-in-law.

Families may help an aging parent or spouse with daily activities, finances (such as banking or paying bills) or personal care such as bathing and dressing. They may take on these responsibilities out of love, a sense of personal or family duty, feelings of guilt or because there is no one else available. Every family is different. Some family relationships are very positive and mutually supportive. Others are filled with mixed feelings, conflict and tension.

Sometimes abuse and neglect occurs

In many cases, the person who is abusive is their spouse or partner, a family member or other people they rely on or trust. Abuse and neglect in later life can affect an older adult's health, happiness and safety. It can take many forms, including physical, emotional, financial, sexual, spiritual or social.

Why do some families become abusive and neglectful?

Most people do not intend to become abusive or neglectful. They may not feel comfortable with the changing roles in their family, especially if the older adult now needs to rely on them. Some family members may not know how to provide the care or assistance needed. They may not understand the nature of the disease or condition and how it affects the older adult's abilities or behaviour.

For some spouses in later life, both the person providing care and the person receiving care may have some difficulties with their health, memory or ability to make decisions. This can affect how people relate and react to each other.

In some situations of abuse, people have used physical force or emotional control over the other person throughout the relationship. Some people receiving care may have been abusive or controlling earlier in life. Now that the older person depends on others, the caregiver may feel it is their turn to treat the parent or spouse in a similar way.

Family caregivers often have many competing responsibilities for their children, their spouse or partner, and their job. Trying to juggle these can lead to tensions and conflicts within the family.

Sometimes family caregivers may have significant personal problems, including financial, mental health, substance abuse, or gambling problems. This may mean that hands-on caregiving may be difficult for them to safely offer.

Helping with finances creates special risks

A family member may not realize what their legal responsibilities are when assisting an older adult with finances, particularly through a power of attorney. They may take over the finances because it simply seems easier. Some may incorrectly feel they are entitled to the money or property or assume they will get it anyway when the person dies, so they might as well use it now. This may lead to financial abuse.

Does stress lead to abuse?

Most people giving care to someone else (even someone they care about deeply) can feel very stressed at times. Fortunately, people can learn to recognize the warning signs of stress and plan ways to avoid the situation becoming abusive. To prevent a stressful situation from gradually becoming an abusive situation, pay close attention to your own emotional and physical health.

Some warning signs of stress

• Changes in your feelings (such as becoming anxious or depressed).
• Always feeling exhausted.
• Needing medication to help you sleep or cope.
• Changes in your lifestyle, including the amount that you eat, the amount of tea, coffee or alcohol you drink.
• Visiting your doctor more often, or developing health problems.

Everyone has a limit and each person's limit is different. People's needs and abilities, including your own, can change over time. Be willing and able to accept help, especially when it is offered. Ask for it, when it's not.

Take care of yourself

Taking some regular time for you is an important part of good caregiving. Even little breaks from caregiving, including short walks or a favourite hobby can help refresh you mentally and physically. Set aside part of the day to do these things. Give up some of the responsibilities you used to do. Make use of local caregiver support groups. They can help you find resources or learn useful tips, as well as to share your feelings.

Abuse prevention starts with families

There are many different ways that families can reduce the chance of abuse or neglect happening to others or themselves in later life.

1. Good communication helps

Discussion and support within families, as well as between couples, is very important. Talk about the current situation and plan for future needs. What does the older adult want? What can they do on their own or with some support? This can help to create realistic expectations in families.

Regular contact between family members is very useful. This can help everyone become aware of changes in the health of a parent, spouse or partner. Families may recognize problems earlier and help avoid a crisis from developing.

Couples can often make small changes in housing and support as they grow older. Some health changes can be prevented or slowed down.

2. Work together

Good caregiving means having the time, right temperament and resources to take on this responsibility. Where possible, try to share the caregiving responsibilities. Family members often have different kinds of skills and can be supportive in various ways. Also learn about any available community resources.

3. Strengthen relationships

Even if an older person's health or abilities change, many aspects of the relationship remain very rewarding. Some families strengthen relationships by keeping in touch, sharing old traditions and building new ones.

Helping with finances creates special risks

A family member may not realize what their legal responsibilities are when assisting an older adult with finances, particularly through a power of attorney. They may take over the finances because it simply seems easier. Some may incorrectly feel they are entitled to the money or property or assume they will get it anyway when the person dies, so they might as well use it now. This may lead to financial abuse.