By R. R. Fletcher, Contributing Writer
REGION – Nicknamed the “sandwich generation,” many older adults over 50 care for both aging parents and children. Caregivers are typically female – some 75 percent. And 17 percent of all adults over 65 help someone, according to the American Association of Retired Persons (AARP).
And with 40 percent of caregivers juggling full-time work and families – stress is constant – leading to sleep deprivation.
It is no wonder that most caregivers lack sleep. The Centers for Disease Control (CDC) says 37 percent of all caregivers report insufficient sleep. But caregiver sleep loss goes beyond missing a few hours to binge-watch a favorite show. It is a constant decline in sleep quantity and quality. And sleep deprivation causes serious health issues.
Sleep quantity and quality
For adults, six to nine hours of sleep is preferred. After 65, six to eight hours nightly is optimal. But more than just quantity, sleep quality is essential. To be restorative, a person needs to rest long enough to dream and reach deep sleep.
Unfortunately, staying asleep is difficult for caregivers. Sleep-wake cycles are often interrupted — up to several times nightly — when caring for people with chronic pain, infection, or dementia.
Risks of sleep deprivation
Lack of sleep can cause daytime dysfunction, accidents, and mistakes. Known as “sleep debt,” sleep deprivation is cumulative. And many caregivers quickly reach the point where a “good night’s sleep” cannot restore health.
The CDC found that 53 percent of caregivers over 45 report multiple chronic health conditions, including coronary heart disease (angina, myocardial infarction), stroke, asthma, cancer, COPD, arthritis, kidney disease, and diabetes.
Sleep deprivation causes a variety of other problems, including sleep disorders, cognitive dysfunction leading to forgetfulness, inability to think or speak, and mood disorders, including depression, anxiety, and irritability, and imbalances, which the National Sleep Foundation (NSF) says contributes to sweet and salty food cravings.
Severe sleep loss symptoms include Post Caregiver Stress Disorder (PCSD) similar to PTSD. Symptoms include audio and visual hallucinations, significant weight change — more than five percent within six months, and organ failure.
Many caregivers are bombarded with advice from family and friends — urging them to use respite care or take time for themselves. But it is never that simple. Financial or insurance constraints, distrust of strangers, or misplaced guilt often prevents caregivers from seeking assistance.
Massachusetts caregiver resources
The United States Bureau of Labor Statistics reported 40.4 million caregivers providing uncompensated care valued at over $449 billion in 2015. Furthermore, current respite assistance programs vary by state — often with extensive restrictions.
But with an estimated 844,000 caregivers in the Commonwealth, Massachusetts has numerous resources. Mass Care Link pays caregivers through the state adult foster care program. Additional resources can be found at mass.gov, including the Family Caregiver Support Program (EOEA) and the Massachusetts Caregiver Coalition. And a Lexington non-profit, Family Voices, specializes in caregiver networks.
Solutions for caregivers
Coping with stress is complicated, with or without help. Common suggestions to reduce stress and maximize sleep include meditation or limiting caffeine and alcohol. These tips may work for some. But caretakers also need to prioritize themselves – and give “permission” for self-care. And that is not always easy. Caregivers should be present in their care. An easy way to create health awareness is to keep a log. Wearable trackers record food intake, sleep, and regular exercise — which can be as simple as moving or stretching. Exercise produces serotonin, affecting sleep, cycles, and mood.
Remote monitoring technology has advanced. Use it to ease fears and minimize the hourly vigil of checking on an individual, especially during the night. Depending on the illness and situation, baby monitors work, as do voice-activated home systems. Remember that caregiving is a marathon, not a sprint. The key to caring for caregivers is to begin early in the process and integrate a family caregiver’s needs into the patient’s home health plan.