by Jason Joyce for Crain's Cleveland
In my role as CEO of the Alcohol, Drug Addiction & Mental Health Services (ADAMHS) Board of Cuyahoga County, I regularly hear from people who are caring for someone they love while also managing the many other responsibilities in their lives. Increasingly, those responsibilities extend in two directions.
Many adults are raising children, supporting teenagers or helping young adults find their footing while also caring for aging parents who may be experiencing declining independence, health challenges or behavioral health concerns.
We call this group the “sandwich generation,” but that phrase does not fully capture the pressures these caregivers face every day.
Much of that pressure is invisible. A caregiver may appear productive and composed at work while privately coordinating medical appointments, responding to a child’s emotional needs and worrying about the next unexpected expense. They may begin the morning helping a child prepare for school, spend their lunch break talking with a parent’s doctor and end the evening wondering whether they have done enough for either one.
Because caregivers are often viewed as the dependable ones in their families, others may not think about asking how they are doing. In many cases, they are quietly carrying responsibilities that others do not fully see.
The guilt is also real. When caregivers are helping an aging parent, they may feel they are taking time away from their children. When they focus on their children, they may worry that a parent is being neglected. When they are at work, they may feel they should be with their family. Even taking a few hours for themselves can create guilt because someone else still needs them.
Over time, that emotional strain can affect a person’s mental health. Caregivers may experience anxiety, depression, irritability, difficulty sleeping or complete burnout.
Too often, people wait until they are completely overwhelmed before seeking help. We must create a culture in which asking for help is viewed as responsible, not selfish. No one should feel that they must carry the needs of everyone on their own.
Caregivers are often the safety net, but safety nets need support too. Employers can help through supportive leave policies and workplace cultures that allow people to discuss caregiving responsibilities without being viewed as less dependable or committed. Even a small amount of flexibility can make the difference between an employee being able to manage a difficult period and feeling forced to leave the workforce.
Behavioral health is about the whole family system. Children may sense the tension in the home. Aging parents may feel guilty that their needs are creating stress. Employers may see increased absences or reduced productivity. Family relationships may become strained when one person assumes a lopsided share of the responsibility.
Families can also take steps before a crisis occurs. Aging adults can be encouraged to discuss their preferences, finances, health care wishes and expectations for future care.
Adult children and other relatives can speak honestly about what each person can realistically contribute. These conversations may be uncomfortable but avoiding them often leaves one person carrying nearly the entire load.
We can honor caregiving without romanticizing burnout. Calling caregivers strong, selfless or heroic may be well intended, but praise alone does not reduce their workload. Caregiving should not require someone to sacrifice their own mental health until they have nothing left to give.
For caregivers in Cuyahoga County who are feeling overwhelmed, help is available before the situation becomes a crisis.
The ADAMHS Board’s website offers a service finder that allows residents to search for mental health, addiction and family support services by provider, location, age group or type of support. Anyone experiencing emotional distress, a mental health or addiction crisis, or needing help finding services can call or text the 988 Suicide & Crisis Lifeline at any time. Trained counselors are available to listen without judgement and help people explore their options.
The most important first step is simply reaching out and letting someone know that support is needed. At the ADAMHS Board, we know caregivers deserve support before there is a crisis. When we care for the caregiver, we strengthen the entire family system and, ultimately, our community.
Jason Joyce is chief executive officer of the Alcohol, Drug Addiction and Mental Health Services (ADAMHS) Board of Cuyahoga County.
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