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Aug 28, 2013

Counseling Families and Caregivers of Older Adults

Over the summer, I had the opportunity of co-facilitating a program for older adults in the early stages of Alzheimer’s disease or related dementias and their caregivers. In addition, I have been facilitating a support group for just caregivers, and over the course of the summer have learned a great deal about the challenges caregivers of older adults face in regards to mental health and wellness. Furthermore, as my caseload grows as a mental health counselor working with older adults, I have had a growing number of experiences engaging with families and caregivers.

The term caregiver encompasses an individual who is providing care for another individual living with various daily challenges. The caregiver can be of any age and any relation, or none at all, to the person receiving the care. In many cases I have encountered the spouse of the older adult who is facing multiple medical challenges or living with chronic conditions takes on the role of caregiver. However, I believe it is important as a counselor not to overlook the possibility of children, grandchildren, or even distant relatives taking on this role for some individuals. Furthermore, while a spouse may be a primary caregiver, the children, grandchildren, extended family or close friends simultaneously take on the role of caregiver. Therefore a counselor working with older adults can sometimes find themselves building a relationship with a large network of people who provide different domains of care.

One my first thoughts that came up each time I sat with caregivers was that much of their focus during that time revolved around the loved one they were caring for. This makes complete sense when you consider the role of a caregiver involves 24/7 demands. The group discussions centered upon sharing strategies for caring for their loved one and how their loved one was doing. I believe that such discussions served a positive purpose for the caregivers as they were able to provide support for each other through problem solving and releasing the worries they hold for their loved ones’ well being. At the same time, however, I found myself looking for possible ways to guide some of our time to focus on the caregivers themselves-how were THEY feeling? In my observations, since caregiving is such selfless role, and as it becomes a 24/7 job, it seemed very difficult for the caregivers to separate their own feelings from their concerns for their loved one. I believe this is an area where the essence of the word support comes into play. Helping the caregivers to maintain who they are separate from being a caregiver. I found that providing levels of psychoeducation on self care helped me to guide the discussions more towards focusing on the caregivers as separate of their loved one. Through my experiences, allowing time for caregivers to share their concerns for their loved one or strategies for managing various behaviors is very important in helping to ease their life as a caregiver; however in addition, taking time to help caregivers step out of being a caregiver and just be who they were before their loved one needed such extensive care is critical to their own mental health and well being.

The other major theme I have grown to view as essential in working with caregivers is providing an extensive network of support for each caregiver. This network involves professional and personal resources who can act as “go-to’s” for the caregiver. I found that helping the caregiver to develop a list of healthcare providers of all areas, financial professionals, legal professionals, respite help, emergency supports, and reliable friends or family provides a safety net for the caregiver. Encouraging the caregiver to contact individuals from each of these domains to establish a relationship and keep each of these “go-to’s” up to speed on his/her situation. The development and maintenance of a reliable supportive network cannot be stressed enough when it comes to working with caregivers of older adults. Furthermore, as a growing counselor, helping caregivers develop a network of support provides me with a deeper knowledge into the resources in my community, which builds upon my own repertoire as I act as an advocate in connecting caregivers with the resources they need.

I wanted to add a brief note on an aspect of caregiving that I have gained more awareness into, but believe is still either not known of or overlooked at times. Long distance caregiving is becoming more of a reality for many individuals in the United States. At first, it was hard for me to imagine caring for an individual when the caregiver lives in a different state. However, I have growing experiences working with individuals who act as long distance caregivers. In many instances, it is not feasible for an individual to move to where their loved one resides as they age or decline in functioning, as a result many long distance caregivers take on all the responsibilities for that loved one. The long distance caregiver must oversee legal and financial planning, while also setting in place individuals who can physically care for their loved one since they themselves are far away. Simply because an individual is not providing physical care for a loved one, does not mean they are not still acting as the primary caregiver for that person. As the population of older adults continues to increase so rapidly, even counselors who do not work primarily with older adults will most certainly have clients who are caregivers for older adults. Therefore it is a population that will affect all counselors and an area that deserves more attention in exploring the best practices of care and counseling available.

I hope everyone had an amazing summer and as always thank you for your time in reading. Feel free to send ideas, thoughts, or comments to me at

Lee Kehoe is a counselor working with the older adult population. It is her passion to serve the older adult population through counseling, research, and advocacy efforts, with the hope of raising awareness to the growing needs of older adults and their families.

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