How Does Caregiver Counseling Usually Work?


Certified Care Manager, Aging Life Care Professional, and National Master Guardian Emeritus

The stress and strain of caregiving for a loved one can leave many people feeling overwhelmed and unable to manage the added responsibilities of their own lives. Feelings of depression and anxiety are common with caregivers. There are estimates that between 40-70% of caregivers have symptoms of depression. It can feel difficult or shameful to talk about these feelings and seek help.

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You may feel you are giving up your life to care for an aging parent, and feel as though you have no time or nowhere to turn with all these responsibilities on your shoulders. Remember that you are not alone. Support is available from many different sources. As a society, we are starting to recognize the mental health and financial toll that family caregiving takes on people of all ages. Asking for help is a healthy and positive thing to do.

Depending on your situation, you may only need some short-term advice. But you might also benefit from longer-term therapy to help you cope.

What Is Caregiver Counseling?

You might be asking yourself, “what is the difference between caregiver counseling and therapy?” Caregiver counseling is usually condensed into a shorter period of time than psychotherapy because caregiving can create unique and specific issues. Counseling for caregivers in particular focuses on problem-solving and skill-building to cope. Caregiver counselors can be case managers, care managers, or social workers.

Psychotherapy, by contrast, usually deals with long-standing issues. The principle behind psychotherapy is that a person's thinking and behavior affect their relationships. The goal is to help people feel better able to manage stresses, understand patterns in their behavior that may interfere with reaching goals, have healthier relationships, and better manage their thinking and emotional responses to stressful situations.

There are similarities between the two, but the primary focus of caregiver counseling is to give caregivers the opportunity to voice their frustrations and to find healthier ways to cope with the stress of work. It is possible that during the course of caregiver counseling, other issues may emerge that lead to the need for longer-term psychotherapy. 

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Why Do People Seek Out Caregiver Counseling?

There is no doubt that caregiving is stressful and is becoming even more so. Two trends in the caregiving world are impacting family caregivers in particular. One, people are getting older and living longer. So for example, we may see millennials taking care of grandparents and women quitting their jobs to care for an aging parent while still having children at home.

The other trend is that caregiver duties are becoming more intense by adding increasingly complex medical tasks. Most people say they want to age at home, which translates into the need for more and more care. Assisted living costs are rising, placing even more pressure on families to provide as much care as they can at home. 

You may notice that there is some symptom overlap with depression and anxiety when feeling more despondent in relationship to caregiving. People seek caregiving counseling for many reasons, but these may be the most common:

  • Feeling sad and hopeless. It is normal to occasionally have these feelings due to caregiving’s stress, but not continuously. 
  • Feeling that nothing you do is good enough. You may think or feel that your efforts have no impact. It’s as if the more you do, the less positive you feel—additionally, you might have concurrent thoughts of guilt and shame.
  • Becoming easily irritated and agitated. Chances are your irritability and agitation may be increasing to the point where you are unable to control your emotions. These emotions can spill over into your private life and adversely affect your relationships.
  • Grief is overwhelming. Sometimes grief is in response to watching someone with dementia slip away from you. As dementia progresses, people often don’t recognize family members and become paranoid and agitated. Other times you may be caring for a loved one who has declined to the point where they may not have much longer to live.
  • Increasing isolation. Staying away from friends and other family members due to a negative work-life balance can lead to feelings of loneliness.
  • Your favorite things no longer bring you joy. Difficulty engaging in pleasurable activities that used to bring you joy
  • Developing unhealthy habits. You may be neglecting physical and mental health as a result of poor eating, inadequate sleep, and substance use.

What Happens During Caregiver Counseling?

Every counselor may have their own approach to caregiving counseling, as they will tailor their advice and help based on the specific needs you have. The two of you can set goals and decide on priorities.

You might have several issues or just one or two that you need help coping with. That being said, counseling sessions do share some commonalities. Counselors are like coaches — they offer encouragement, focus on your strengths, and help you solve problems.

Acknowledging your feelings

Caregivers often feel alone in their plight. Part of what happens in caregiver counseling is giving you the space to air out your feelings and letting you know that they are real, legitimate, and very common. When someone else normalizes and acknowledges what you are going through, it can be a relief. 

Focus on self-care

Self-care is the foundation of wellness, whether you are a caregiver or not. During the stress of caregiving, it is not unusual for self-care to slowly decline. After all, you are focusing on the person you are caring for, not yourself.

Shoring up that foundation will be a focus of counseling. They may start with identifying the areas of your life that have changed for the worse. Your counselor may set goals with you related to eating, exercising, and sleep hygiene.

Stress management

Managing stress is a critical component of coping with emotions. A counselor may advise you on time management, stress relaxation techniques, and ways to bring enjoyment back into your life.

Family conflict

Family conflict can arise for several reasons. As the primary caregiver, you might be under pressure from other family members to do things a certain way or get lots of advice but little help.

A counselor will help you resolve those conflicts by offering suggestions on better ways to communicate and negotiate with family.

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Reaching out to friends and family

Sometimes it is hard to see the light at the end of a tunnel when you are in it. A counselor can help you see that light, and recognize that your most effective support systems are your friends and family.

Sometimes all it takes is a nudge to reach out to friends and family who will be happy to give you emotional support.

Caregiver resources

Caregiver resources can be an immense support to stressed-out caregivers. Resources can include online participation in caregiver support groups and other supportive services like home care, home health, and respite care. A caregiver counselor will direct you to the best resources.

Asking for help

Asking for help can be one of the hardest steps a caregiver can take. It is normal after a while to feel like you are the one who does things best, and besides, everyone is busy with their own lives.

A counselor can coach you on asking for help, either from family members or through other community resources.

Tips for Finding Caregiver Counseling or Other Forms of Support

For better or worse, paying for counseling through a qualified and licensed professional will be dictated by insurance. Don’t rule out the possibility that some counselors offer a sliding fee scale based on your income and ability to pay. 

Take full advantage of the caregiver counseling offered by the social worker at home health, hospice, or even a hospital and rehab setting. Geriatric care managers can also be a big help in evaluating your caregiving situation and offering advice on how to manage more effectively. Geriatric care managers are typically private pay, but a one-time consultation may very well be worth it.

1. Call your insurance company

You might be able to get counseling through your health insurance. If you are concerned about your mental health, there is no downside to reaching out to a licensed psychotherapist. Your insurance company will have a list of providers.

2. Contact your employer’s Employee Assistance Program (EAP)

More and more companies are offering caregiver coaching to their employees. These companies realize that their employees’ health and productivity are compromised if they are suffering from caregiver burnout or have to take time off work. Call the human resources department to find out if your employer offers this benefit.

3. Psychology Today

Psychology Today is not only a magazine as it also provides a national database of therapists. The site allows you to put in your zip code to find a therapist nearby. The site gives you access to profiles, specialty areas, and insurance coverage.

4. Look at Eldercare Locator for resources

Eldercare Locator is an excellent place to find resources in your area. Just put in your zip code to be directed to your local area agency on aging or other caregiver resources.

5. National Caregiver Associations

National caregiver associations can be a great resource for support, information, and education. These organizations understand the complexities of caregiving and the emotional toll it takes. A few of the more well-known ones are:

6. Consider caregiver support groups

Start with the national caregiver associations listed above to find groups. Some of these groups will have a group coordinator and others won’t.

Some of these groups will be very organized, and others will be in a forum format where people can ask for advice and offer one another support.

Considering Caregiver Counseling

It takes courage to take up caregiver counseling. Even with the big step you are taking, it is important to recognize that there is no shame in asking for help. Quite the opposite in fact. When you decide to consider caregiver counseling, you are making a renewed commitment to yourself and your loved one.

After all, helping yourself can make you a better person all around and spread to all other parts of your life, including caregiving.

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