UVA Nursing Professor Paula Sherwood spent years treating people with brain cancer, and in that role she met many caregivers who were stressed out.
“It’s like you’re walking down the road, and you run into a bear," she explains. "Your fight, flight or freeze system kicks in. Your body starts pumping out adrenaline, and your heart rate goes up and your blood pressure goes up.”
You can run away from the bear, but if your stress is rooted in caring for a loved one, she says, the bear doesn’t go away and neither can you.
“And on top of the circulating hormones wiping out their immune system, family caregivers tend not to go to the doctor," Sherwood says. "They don’t take care of themselves. They put the patient’s needs first.”
Caregivers often say their work gives them a sense of purpose, but it can also cause depression, anxiety and illness.
“Unless they take care of themselves, their physical health may deteriorate to the point where they’re unable to provide care.”
That’s one reason why she and her colleagues at UVA are looking for ways to test caregivers for stress – to convince them that they need to take time off, to exercise, meditate or get therapy. If they can show high levels of certain chemical markers in bodily fluids, that might prove persuasive. One of those markers is a hormone called cortisol.
“It used to be that you could only get cortisol from blood or from urine or from saliva, and you had to take it several times a day, and you can’t ask a family caregiver to do that, because they’ve got too much to do.”
But the bio-molecular lab at UVA has found a way to test for cortisol in hair. Because it grows gradually over time, Sherwood says, measuring cortisol in a strand of hair can show whether someone is adjusting to the role of caregiver.
“Not only at that point in time, but you can measure what it was one month before you cut the hair and then two months before that and three months before that. So you can really see how is the body adjusting to the stress of providing care. There are some people who have a stress response, and then it gets better over time, because they adapt to it.”
Sherwood says this work is especially important as the U.S. population continues to age.
“People are living longer. You have higher incidences of dementia. higher incidences of cancer, and we don’t have as many people to go around. It’s not the days when you had ten children and they could each take a part in providing care.”
And the average caregiver is 51 – supporting a parent or spouse -- subject to many chronic conditions as the years go by.
“A lot of these folks are in their 50’s, 60’s or 70’s, so they have hypertension or they have diabetes or they have COPD or any number of health conditions that need to be monitored.”
Sherwood hopes her research will help to identify the least expensive and easiest way to test for stress – measuring cortisol or some other substance – and to determine what level might signal future health problems for caregivers.
Professor Sherwood will give a free talk on the emotional and physical stress of caregiving on Zoom. Healthcare professionals can secure continuing education credits. Click here for more information.
