Although everyone’s situation is different, the basic challenges and predominant issues usually are the same. I find that people are better able to cope and are more apt to act when they understand the issues with which they are dealing. Findings from research that I conducted over a three-year period indicated five main reasons family caregivers often find themselves overwhelmed and unprepared. Whether you are preparing for future responsibility or are already a caregiver, I expect you will be able to relate to the findings, and that you may even respond by thinking that makes sense or now I understand.

1. INconsistent: The age at which people begin facing functional limitations can be quite inconsistent. Some people age gracefully and live independently into their 80s and 90s. Others face complications or illness and need assistance in their 40s or 50s. This age inconsistency makes it difficult for families to know when to get more involved in a loved one’s life. Compounding this challenge are health problems that often go undiagnosed because many people have a difficult time distinguishing characteristics of normal aging from age-related disease or illness. As a result, it often takes a crisis situation to occur for family members to take a more active role.
2. INdependent: Family caregivers and care recipients often do not seek outside support because the issues they face tend to be personal and private. Family caregivers also find it difficult to identify, and consequently associate with, others facing similar challenges. Instead, many try to figure everything out on their own. At a time when information and support is so important, the tendency is for family members to try to cope independently instead of reaching out for help and direction.
3. INexperienced: It does not matter what you have done as an adult or parent – nothing will prepare you to deal with age-related health concerns and long-term care. Caregivers and care recipients quickly find they are inexperienced, and they lack knowledge and understanding about the many issues and challenges they are likely to encounter. Likewise, they soon realize the U.S. health care system is fragmented, specialized and difficult to navigate. For example, until people approach the age of 65, most have never given much consideration to anticipating frailty and old age, receiving care, or navigating the Social Security and Medicare system, let alone coping with dying and death.
4. INtrusive: A common response to a family member who expresses concern or a wish to provide support is “I’m fine.” When that occurs, family members find themselves unsure of how to respond, how to help and what to do. Periods of change and adjustment can be extremely hard, especially on people who are aging or ill. Role conflict can be emotionally challenging. People do not want to be a burden and often find it difficult to accept support. Involvement in other people’s personal affairs feels uncomfortable and intrusive. In addition, family members struggle with the principles of honor, obey and respect.
5. INterlocking: Although it may be human nature to focus strictly on what people perceive to be the immediate issue or problem, I find that by doing so people often get blindsided by seemingly unrelated issues. Caregiving is a process of dealing with the unexpected. Failure to look beyond the immediate issue and see the bigger picture often leads to regrets. I find that when caregivers consider the bigger picture (see diagram on next page), the interlocking issues, and how the choices made today affect tomorrow, they are better able to make informed decisions.