Stressed Out

Overwhelmed spouse caregivers take control of stress.

Like dropping a stone into a pond, a cancer diagnosis sends a ripple effect throughout a family. Spouse caregivers, like the patients, can be physically and emotionally affected by the diagnosis and experience.

Spouse caregivers face unique challenges and stressors, which can lead to fatigue, sleep difficulties, irritability, and depression. Since stress may negatively impact the caregiver and the patient, experts recommend cancer care also focus on the caregiver to address stress-related symptoms for the betterment of both.

Recently retired from her job as an English teacher at the Washtenaw Community College, Edith Croake, 67, has taken on caregiving full time for her husband Dick, 70, who was diagnosed with metastatic prostate cancer in June 2007.

“Here’s your best friend, your spouse, who is becoming weaker. And at the beginning, he was in incredible pain. That is just hugely stressful,” Croake says. “You want to help, but you can’t. This is a Herculean task. There’s not a lot you control, but what you do is very important.”

One study published in the Journal of Clinical Oncology in 2005 found that 13 percent of caregivers of advanced cancer patients met the criteria for a psychiatric disorder, including major depression, panic disorder, or post-traumatic stress disorder.

“It’s really tough and intense, and I don’t expect it to be ­otherwise,” Croake says, adding that when a family member is ­diagnosed, “your life is out of control in a way that it hasn’t been before. It’s a highly stressful, anxious, and frightening situation.”

Laurel Northouse, RN, PhD, professor of nursing and co-­director of the Socio-Behavior Program at the University of Michigan Comprehensive Cancer Center, says caregiver stress may be influenced by many factors, including age, gender, stage of the patient’s disease, caregiving responsibilities, and the quality of the couple’s relationship and communication style following the diagnosis.

Croake says her stress level is influenced by a variety of situations: navigating the medical system, scheduling appointments and visits, doing household chores, taking care of herself, and finding enough time in the day for new, and old, responsibilities.

“You suddenly become a secretary receiving many calls—requests for scheduling appointments, requests for scheduling visits,” she says. “There is more in that whole area of scheduling and communication with others than you are used to.”

Youngmee Kim, PhD, director of family studies at the American Cancer Society’s Behavioral Research Center in Atlanta, says caregivers can avoid becoming too overwhelmed by having open discussions about their concerns or stress level, and recognizing that it is OK to ask for and accept help. To help alleviate frustration and feeling overwhelmed, Croake hired a friend to help with chores around the house once a week and says she also looks forward to the social aspect of the visit.

Maintaining social relationships can help reduce stress, as can exercising regularly, eating a healthy diet, communicating openly with the patient, participating in a support group, and possibly seeing a counselor or medical professional.

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