The Female Caregiver: The Health Risks of Being the "Good Daughter"

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It started when she was in her early 40s. Shirley was recently divorced and raising her teenage son while also helping her older parents with doing light housekeeping, navigating insurance claims, filling prescriptions at the pharmacy, cooking the occasional meal, and acting as a taxi service so her parents could attend church services (her mother never learned to drive and her dad had recently given up the keys due to macular degeneration). Although her brother lived in the same community, he was "too busy" with work and his wife and kids to offer help to his parents or to Shirley.

Her caregiving carousel began simply and slowly, but as the years progressed and her parents' health began to deteriorate, Shirley found herself overwhelmed and on a ride that kept whirling faster -- and that she felt she couldn't get off.

Shirley is one of the nation's 24 million "sandwich generation" caregivers -- those squeezed between caring for children while also caring for older parents. She was also part of a certain segment of caregivers -- those caring for multiple loved ones at the same time, which in Shirley's case lasted for more than 25 years. And while a Pew Research study found there has been an increase in men as caregivers -- 45 percent now, up from 34 percent just a few years ago -- women are still perceived as the natural nurturers. Women become the default caregivers more often even though shifting family dynamics and economic realities are closing the gender gap.

We've identified common characteristics of the female caregiver and simple tips to help you cope.

SEE ALSO: Find In-Home Care Help Near You

You don't ask for help when you need it.

"We tend to think women would naturally ask for help as caregivers. After all, they seek help with childcare -- for everything from carpooling to play dates. But the opposite is actually true when it comes to caring for our parents," says Carol Abaya, a nationally recognized expert in elder/parent care and aging issues who writes and publishes the Sandwich Generation magazine. "Maybe it is because they don't want to admit their parents are becoming 'needy' and don't want to admit times are tough."

Tip: Arrange breaks from caregiving. You can find respite care help in several ways. Professional respite is where a companion can sit with your parent to give you a break to run errands or take care of yourself. You can also create your own private online volunteer community, giving family and friends who offer help a chance to sign up for a task through free services such as or

You have a hard time saying no.

Caregivers like Shirley have a hard time saying no or setting boundaries, since their role in the family has been the "good daughter." But the slippery slope for caregivers, especially women, is the health risks associated from taking care of everyone except themselves.

Tip: Join a support group. Support groups are great "boot camps" where caregivers learn to find their voice. A survey found 41 percent of caregivers join social networks or online discussion groups or forums -- the most used source of support for caregivers. The survey also found 57 percent of those caring for an older parent report feeling guilty. Being able to talk to others about the emotional side of caregiving can not only help alleviate stress but also feelings of guilt and depression when you learn you aren't alone in your feelings. At the encouragement of her now 39-year-old son, Shirley finally reached out and joined an online support group for caregivers of Alzheimer's patients when her mother was diagnosed with the disease. It became her lifeline, and her new online friends encouraged Shirley to find time for herself -- to get her hair done or just go for a walk.

SEE ALSO: Find In-Home Care Help Near You

Your own health has taken a toll.

A Commonwealth Study found that caregivers are twice as likely as the general population to develop chronic illness earlier in life due to the stress of caregiving. For women, the risk is heightened, as illustrated in a study conducted by researchers at Bowling Green State University. Observing both men and women who were caring for an older parent, researchers found men take a "block and tackle" approach to caregiving. Researchers found women overanalyze their caregiving performance all day long, adding to their stress levels.

Tip: Learn to "block and tackle." While women are more natural nurturers, they are also worriers. Men are more likely to check off daily responsibilities and move on. Learn to let things go -- tell yourself it is enough that you are providing the care and try not to dwell on your caregiving performance. What can help is to keep a checklist of all the things you have accomplished during the week -- it gives you a sense of fulfillment for what you have done for your parent and helps you go from "guilty" to "grateful."

You're stressed out by all your responsibilities.

The National Alliance for Caregiving reports caregivers who provide care for five years or more report higher stress levels than those who care for less time. For those caring for a loved one with Alzheimer's, stress is reported by 60 percent of caregivers as "high" or "very high," and one-third report also suffering from depression.

In the book So Stressed, by Stephanie McClellan M.D. and Beth Hamilton, studies show the evolution of women's biology over the last 100 years has not caught up with the expanded roles that women play in today's world, including motherhood, careers, and caregiving. In addition, the authors found advances in communication technology negatively impacted female bodies' defenses to protect and heal. Constant disturbance of peace with chiming texts, e-mail notifications, or ringing cell phones puts caregivers on high alert at all times and actually creates isolation rather than connection.

Tip: Learn how to relax. Learn to "unplug" -- turn off the cell phone, TV, and computer for 15 minutes every day and sit quietly, or take 10 deep breaths to clear your mind. Yoga and meditation are also great "healers," helping the body relax. A UCLA study found that 12 minutes of yoga or meditation daily for 8 weeks helped strengthen the immune systems of caregivers of dementia sufferers by reducing their response to harmful inflammation and lowering their blood pressure.

Sherri Snelling

Sherri Snelling, CEO and founder of the Caregiving Club and author of A Cast of Caregivers "“ Celebrity Stories to Help You Prepare to Care (Balboa Press, Feb, 2013) is a nationally recognized expert on America's 65 million family caregivers with special emphasis on how to help caregivers balance self-care while caring for a loved one. See full bio

almost 4 years, said...

Learning how to relax. I am able to relax when I am away from the stressful caregiving, but when I return, the stress starts all over again as if I did not get a needed break. I just want to have some sort of normal life of, family, friends and fun without having so much responsibility of someone else's well being.

almost 4 years, said...

Well, now. I suffered abuse growing up in a dysfunctional family. Now one brother is severely mentally ill. The other brother long ago escaped, left home early, and made a wonderful life for himself. There is only ME left here to deal with the poor,sweet old thing, what a darling! Living in her old falling down house, still! She has dementia (Lewy Body). She thinks people are living in her house. The Kardashians, my brothers, my father. There is NO ONE. NO ONE TO help me out. Everyone is gone, dead or moved away. There is ME.. Well-off bro 2000 miles away full of concern and advice. Not only do I have a severely ill head case to deal with, I have poor sweet old lady....Well, we are using here pension and SS to pay for 'companions', i.e, sitters. Four hours a day, $800 a week. I am NOT going to change the old bag's diapers. I can't not ignore her, I do what I can, but she can sit there in her diaper in her precious house 18 hours a day alone. (There is, seriously, no one left. No one to visit, no one to help out. There is just me. I will help out up to a point. I hope she deteriorates so I can put her on Medicaid and fling her into a nursing home.)

almost 4 years, said...

I can relate to this article as I too was the "Good Daughter" when my father and mother were terminally ill. My love for them and wanting to help them while going through a terminal illness and eventually death took a huge toll on my own health and well being. My siblings weren't there to help, only to grab what they could while they were still alive and also after death. I am a registered nurse and was skilled in caring for them, but was taken advantage of by my siblings. While I sat holding my parents hand and administering medications, my brother and his wife went on a beach vacation and secretly had my mother sign a general POA and a medical POA. My father worked hard to pay off our childhood home. When he passed, my mother moved into my brothers basement which was cold and damp and took her social security check for the privilege. I lived out of state and was not aware until it was too late. My brother literally robbed my mother and the rest of her children's right to any inheritance of over $260,000. My sister came in the day before my mother died as I was sitting with my daughter and holding her hand....and took out a bag of my mothers things. They couldn't even wait till she was gone. My mother has been gone for 6 years now. Be warned....if you think you know your siblings....think again....when someone is frail or ill...the vultures will circle. Not all family is like this, but you would be surprised how many are. Protect your parents rights while they are alive. Hire an attorney if you can. Prosecute for elder abuse if you see it happening. Had I not been in so much emotional pain watching my father and mother die, I would have done these things to protect them as being a nurse, I am a mandated reporter. I waited too long and now have to live with the emotional pain of not only losing them, but of seeing them robbed by their own children.

almost 4 years, said...

My sister became the caregiver for our mother, and I tried to help but she kept me away because she had her eye on the inheritance. Every time I tried to go over and help, I was met with hostility. Our mother used her money as a weapon to tear the family apart. My nieces and nephews were given money by Mom and told not to tell me they got it. I finally went away and left the job to my sister. Sometimes you can't win in families, no matter what you do.

over 4 years, said...

I hear ya! I have been sole caregiver of my mom for 8 years now. I have 2 sisters who have numerous children and none of them help with mom. Sad thing is mom used to babysit the grandkids! I have lived the resentment and hard feelings, the sideline coaching and the utter disregard for all that my husband and I do. I have fretted over the additional financial as well as emotional stress. I can no longer confront my sisters, it just causes to much headache for me. I have a great group of friends who are always there to help me if needed. I am so lucky that way. And they really love my mom. Mom is mid to late stage ALZ., and its so sad her grandkids and daughters are missing out on this still very funny, loving woman. Whats also sad is I use to be so close to my sisters, I cannot muster fake emotions anymore, kinda drained! As moms needs increase so does my stress - I will be able to hold my head up and know I have done the best for my mom - the best I can do. Who knows if my sisters and I will ever be able to repair the damage - they can worry about that! Wonder who will be taking care of dad when he needs it?!! One guess to that!!! (Hope step mom hangs in there!)

over 4 years, said...

I agree to everything above. I was caring for my father for over 7 years, alone.... my sisters wanted nothing to do with it and would not help in any way not even with phone calls. Then out of nowhere, when my father was in recovery for a fall, one sister showed up at the center without my knowledge and tried to get my sick and not lucid father to sign over POA to her, and the other sister then proceeded to show up and kidnap my father and had him sign over all his money to her. I am now left trying to make money to afford a lawyer to fight her, to get my father back. It was only about the money for both sisters and I was stupid enough to call them and let them know that my dad fell and was in a recovery center. I was being the "good daughter" and hoping that they would finally be there for him. Look what happened. Be careful. After 7 years, I had no idea that they would do this. I was blindsided. I lost my life... my health to caring for my father, and this is the thanks I get? wow!

over 4 years, said...

If you are a care giver of a person with Alzheimer's you don't *have* "15 minutes to unplug." During that 15 minutes the Alzheimer's patient could be wondering and lost, washing their hands with bug spray, standing in a chair, coming to ask you what you are doing---any number of things. Fifteen minutes a day is a major luxury that most people don't have. A lot of the articles on this website are helpful, but it really annoys me when I see one that is very unrealistic.

over 4 years, said...

Hello, Thank you for posting your comment. Here is a link that may help you in addressing the issue of your siblings not participating in caregiving: Hope you find this information helpful.

over 4 years, said...

I was looking for the part that addressed the anger over able siblings not participating in the caregiving.