Care in the IE: California’s Caregivers – Coping with the Mental Health Strain

Overview: Caregivers play a vital role in helping aging or injured loved ones and community members, managing everything from personal care to medical tasks, all while balancing work and other responsibilities. However, the emotional and physical strain on caregivers often goes unnoticed, leaving their own needs unmet. As more Californians take on caregiving duties, addressing the mental health impacts and expanding support systems has become critical to sustaining their longevity in the role.

Mariah Brown 

Janice McDermott, a 62-year-old caregiver from San Bernardino County, recently brought her daughter and grandchildren to visit her client for her birthday. They captured the moment on video as the client opened her gifts, a gesture of love and support. For McDermott, these moments are special, as they allow the pressures of caregiving to fade into the background, reminding her why she appreciates her job.

Caregivers play a vital role in helping aging or injured loved ones and community members, managing everything from personal care to medical tasks, all while balancing work and other responsibilities. Amid their many demands, they still find time to offer emotional support through quality time with their clients. However, the emotional and physical strain on caregivers often goes unnoticed, leaving their own needs unmet. As more Californians take on caregiving duties, addressing the mental health impacts and expanding support systems has become critical to sustaining their longevity in the role.

In the caregiving community, social support often fills the gap where mental health resources are lacking. The constant demands of caregiving, coupled with burnout and financial strain, make it difficult for many caregivers to seek professional help or envision healthier ways of coping.

McDermott says caregivers mostly rely on each other for mental support. “We check in on each other from time to time to make sure we’re okay because we know how stressful the job can be,” McDermott said.

These challenges highlight the growing pressures caregivers face, as they navigate the emotional toll of their work while often lacking the support needed to manage their own well-being.

The Caregivers’ Experience: Constant Pressure

Caregivers are often financially strained and undercompensated for the work they do, leading to stress. Many have to search for additional clients to make ends meet. 

McDermott has been caring for her 63-year-old client for the past three years. The client has medical problems, cannot walk, falls frequently, and can’t be left alone for long periods of time. McDermott ‘s caregiving responsibilities include cooking, laundry, errands, and other day-to-day activities.

Although McDermott lives just seven minutes from her current client, she spends a lot of time with her, often working extra hours to help with cooking and other tasks. After 23 years as a caregiver, McDermott emphasizes the importance of self-care amid her many responsibilities, saying, “I take care of myself first because if I don’t, I won’t be able to take care of them.” 

She notes that some of her caregiver friends have heavier loads because often caring for one client is not enough to make ends meet. She herself is looking to take on another client. She said feelings of isolation, frustration, and guilt are common among caregivers. Many feel they must be strong and selfless, even as the work exhausts them mentally and physically. 

Experts warn that this mentality can lead to “caregiver burnout.” The antidote is self-care, but it doesn’t have to be elaborate. “Family caregivers are often advised to prioritize self-care,” says Saige Downs, a Licensed Clinical Social Worker (LCSW)  and Clinical Director at Inland Caregiver Resource Center. “Most caregivers think of self-care as something big, like taking a vacation or getting their hair done, but it can be much simpler.”

Expert Advice: Avoiding Caregiver Burnout

Downs emphasized that self-care is essential to prevent burnout. Burnout—marked by chronic fatigue, emotional exhaustion, and helplessness—can arise when caregivers fail to take breaks or set boundaries. These symptoms tend to creep up without notice because they’re normalized amid the caregiver grind. 

“Self care can make a big impact for the smaller day-to-day things such as taking a 10 minute nap, having your favorite snack, cuddling with a pet or enjoying a good cup of coffee,” Downs said. 

To help combat burnout, Downs recommends caregivers seek support, such as joining caregiver support groups and taking advantage of resources at their disposal and not to get overwhelmed if they’re not ideal. Access to caregiver mental health services such as therapy, can be challenging to access due to limited long-term resources and professionals specializing in their area of expertise, Downs said. 

For caregivers who are able to access social or mental health services, referrals are often made by the caregiver’s or care receiver’s doctor to provide additional support. However, one of the primary challenges Inland Caregiver Resource Center’s (ICRC) Family Consultants hear from caregivers is that they can’t leave their loved one alone and don’t have alternative care to participate in activities they enjoy. “Many of our clients are more likely to use available resources when they receive a respite grant,” Downs said.  “Another barrier is simply not having the time or energy to pursue those resources.”

Seeking Mental Health Support: A Mixed Response

Despite the intense emotional strain of caregiving, many caregivers hesitate to seek professional mental health support, as packed schedules and financial constraints make it difficult to prioritize their well-being, even though research indicates they are at a higher risk of developing anxiety and depression—around 40-70 percent report symptoms of depression, and roughly a quarter suffer from clinical depression, according to the Family Caregiver Alliance.

Support Systems for Caregivers

Organizations like the California Caregiver Resource Centers (CRC), Alzheimer’s Association, AARP, and Parkinson’s Association offer support groups, classes, case management programs, counseling and  other services. 

These counseling sessions address stress, depression, and grief related to caregiving. Additionally, free support groups provide caregivers a space to share experiences and concerns, which can ease their burdens and improve decision-making skills, according to Susan DeMarois, Director of the California Department of Aging

“These resources are essential in helping caregivers navigate their challenges while providing the best care for their loved ones,”DeMarois said. 

However, specialized mental health resources remain limited. Long-term therapy options are scarce, and finding qualified professionals can be challenging. While programs like ICRC’s short-term counseling and Riverside County’s Prevention and Early Intervention initiatives—such as PEARLS and Thrive—provide some relief, many caregivers struggle with barriers like leaving their loved ones unattended or lacking the time and energy to seek help. In rural areas, the distance to resource centers and lack of transportation pose additional challenges.

When accessing support through Medi-Cal, particularly regarding supplemental income to alleviate financial pressures, caregivers face significant obstacles. Many are unaware that supplemental income is available for those who qualify. ICRC has noted caregivers’ frustrations about their loved ones qualifying for Medi-Cal, especially when financial resources are already stretched. “Consulting with legal teams can be costly and time-consuming,” Downs said. 

Affordable or Free Mental Health Services

Mental health services can be costly, but there are options available to caregivers at low or no cost. Nonprofits like the National Alliance on Mental Illness (NAMI) offer free support groups and counseling for caregivers and their loved ones. Sliding-scale therapy services, based on income, are available at some community health centers, making mental health care more affordable.

Online platforms such as BetterHelp and Talkspace also offer reduced-fee options for caregivers facing financial challenges. Employee Assistance Programs (EAPs), for those who work, provide short-term counseling services at no charge.

Supporting California’s Caregivers 

While caregivers in institutions or hospitals earn more than those in private homes, McDermott remains dedicated to her work, underscoring the vital role family caregivers play in California’s long-term care system, which saves the state billions annually, she said.  

Recognizing the emotional toll on caregivers is important, and enhancing financial and emotional support systems could help caregivers like McDermott continue their important work without sacrificing their mental health, according to experts. 

“Everybody wants love. Everybody wants to be loved. I don’t care who they are,” McDermott said.

This article is part of the 2024 Black Voice News reporting series on Caregiving in the IE supported in part by the United Domestic Workers of America representing home care and family child care providers across the state of California.