Caregivers of stroke survivors are at risk for depression and complications from chronic stress

Jul 21 2012

Caregivers of stroke survivors are at risk for developing depression and complications from chronic stress, according to a study published by researchers at the Loyola University Chicago Marcella Niehoff School of Nursing (MNSON) in the latest issue of Biological Research for Nursing.

Stroke is one of the leading causes of long-term disability, according to the Centers for Disease Control and Prevention. The National Family Caregiver Association reports that up to 80 percent of stroke survivors are cared for by family members who help them manage their physical and cognitive dysfunction, which can include paralysis, personality changes, urinary incontinence and speech difficulties.

"Stroke survivors can suffer significant and lasting disabilities that may require lifelong support from family and other caregivers," said Karen Saban, PhD, RN, APRN, CNRN, lead author and associate professor, Loyola University Chicago Marcella Niehoff School of Nursing. "Many families struggle to provide 24-hour care for their loved ones. This burden places the caregivers at risk for depression, anxiety and sleep disturbances, which can harm quality of life and heighten their risk for other health problems.

This study evaluated 45 women who were caring for a family member who had experienced a stroke during the past year. Study participants were recruited from support groups, social networking sites and two outpatient clinics. The median age of the women was 55.8 years and the average hours of care they provided was 50.7 hours per week. The women completed surveys about perceived stress, caregiver burden, social support, quality of sleep and depressive symptoms. They also provided saliva samples to test for the stress-related hormone cortisol four times throughout the day for two days.

Results revealed that women had high levels of perceived stress and caregiver burden and poor quality of sleep. The study also found that the burden of caring for a stroke victim increases the risk of depressive symptoms and stress. This burden can include financial strain, home confinement, changes in the relationship with the care recipient, noncompliance of the stroke survivor, demands of caring for the stroke victim and having little personal time for oneself. Those who had high symptoms of depression also had decreasing levels of cortisol during the day while women with fewer symptoms of depression had higher levels. Authors suggest that lower cortisol levels may contribute to an increased risk of depression.

Another Loyola study published in a recent issue of the Journal of Neuroscience Nursing found that female caregivers of stroke survivors grieve the life that they once shared with the stroke survivor and struggle to cope with multiple family and work demands while trying their best to interact with health-care providers to attain the best possible care for their loved one. The study also found that health-care providers can assist caregivers in identifying their needs and referring them to appropriate resources related to assistance with care, transportation, nutrition and ongoing education.

"This was one of the first studies to look at the unique needs of women caring for stroke survivors," Saban said. "Recognizing the challenges of these caregivers may help health-care professionals better support these women."