Department of Psychiatry
Penn Behavioral Health

PAH Outpatient Behavioral Health Clinic

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Newsletter: September 2011

Caretakers: Don’t hesitate to reach out for help

Hallie Kushner, PhD

According to the National Alliance for Caregiving, 65.7 million adults, or about 30% of the adult population of the United States, are caring for family members. Approximately 10 million of these caregivers are over the age of 50. During a time when saving for retirement, and in some cases, surviving day-to-day, has become difficult for many, millions of adults have answered the duty of familial care. These caretakers, who are deserving of respect and support, may find both in short supply.

The word “caretaker” has historically referred to a paid position. The fact that “caretaker” now most often conveys one family member looking after another underscores how important this work is in the economy of health care, whether the work is paid or not. At the bottom of this article, I provide a website from which financial and practical resources may be found. The hope is that after reading this, caretakers who may have hesitated to ask for help, for any reason, will not wait any longer. Below are common barriers that might prevent someone from seeking the help they need.

“There already aren’t enough hours in the day”

The time it takes to look for financial resources. The time it takes to coordinate volunteers. The time it takes to spend an hour or two on oneself. All of these things take time, the very commodity that might be in shortest supply. Yet each of these activities is an investment that will probably repay itself in emotional relief and the ability to keep doing what needs to be done.

Sometimes the things that get in the way of caretakers are similar to problems they have had in other areas of their lives. For instance, that familiar pattern at work where one has the option to train a co-worker to take up some of the slack, but doesn’t, because it seems like it’s just as much time and trouble to train someone else as to do it oneself. No surprise, then, that one might have the same hesitation in marshalling support from friends, family members, or even a community resource. This leads into the next potential barrier…

“I’m the only one who can do it”

Sometimes people become caretakers because it truly seems like there is no other choice. But others seek the duty gladly. People who choose to become caretakers are likely to be people who are confident in their own abilities. They may also pride themselves on being nurturing. They may feel very strongly that their loved one deserves the very best care possible, and that only they can provide it. And often, the people being cared for agree. An elderly mother might not want a stranger in her house. A husband might not want a home health aide tending to his personal bodily functions. Caretakers’ cooking or house-cleaning might be valued too much to allow anybody else to take their place. Conditions may conspire to make a caretaker believe he or she is the only one who can do the job.

This is almost never true. Most people can adjust to circumstances that do not seem immediately ideal. In some cases, the changes brought about by additional people, be they professionals or other family members whose caretaking skills are not as valued, end up being positive changes. The primary caretaker gains the benefit of being able to tend more directly to his or her own needs. The family members being cared for will discover that they are part of a wider community and can be helped by many. Further, a professional caretaker may encourage a greater level of independence, leading to additional benefits.

“I’m tough enough to handle it”

This belief may be the hardest barrier to overcome, because “strength” is a quality that is highly valued within many families and throughout American culture. What defines strength varies based on personal, familial, and cultural assumptions. It is all too common for caretakers to believe that feeling overwhelmed, resenting the person requiring care, or asking other family members to take on some of their caretaking duties, are signs of weakness. And yet somehow, this superhuman expectation for oneself is not extended to anyone else.

Caretakers who are struggling with the expectation that they, and they alone, are expected to be beacons of strength and competence for themselves and others, might ask themselves if there are hidden benefits in believing this about themselves. There may be reasons to sustain this conception of strength that go beyond the immediate, here and now necessity of caring for a family member.

Caretaking within the family is difficult. Not only because the work itself is often difficult, but because there are emotional difficulties, also. Someone you love is in a state of frailty or pain, which may make your troubles appear small in comparison. It is time-consuming. It is generally unrewarded by the working world, so that there may be social costs in using the time off to which you are legally entitled. And it can become very expensive, particularly if outside resources are not sought or maintained. In even the best of scenarios, all of these things could be true. Why make a hard situation even harder?

For more information and resources, please consult The National Alliance for Caregiving at