Daughters caring for a parent recovering from stroke more prone to depression than sons

Caring for a parent who has experienced a stroke results in a dramatic shift from the usual parent-child relationship. "Stroke can be particularly challenging for families," says Bastawrous, a masters candidate at the University of Toronto. "Taking care of elderly parents can bring out family strengths and family weaknesses."

The adult child-to-parent bond can result in excellent care when a senior has a stroke. But not always, she says.

The study found that close and secure relationships with parents predicted better mental health and greater satisfaction in adult child caregivers.

"But strained relationships before or following the stroke increases depression in daughters," she says. "If the relationship between a parent and adult daughter is already strained, a stroke can make things even worse."

The quality of relationships both before and after the stroke had an equally important influence on wellbeing.

The study found that adult daughters placed greater importance on family relationships than sons and, in turn, were more negatively impacted by poor relationships with their parent.

"When a parent has a stroke, adult children often become their primary caregivers," says Heart and Stroke Foundation spokesperson Dr. Michael Hill. "It's important that as part of the recovery process we examine their experiences because they are obviously vital to the ongoing care of the stroke patient."

Sandwich generation spread too thin

Study co-author Dr. Jill Cameron says adult children providing stroke care for their parents need help and they need it now.

"Adult children are stroke care's forgotten generation," she says. "We can't afford to leave them behind."

Sixty two percent of stroke caregivers are adult children. Yet stroke care interventions are overwhelmingly designed for spouses.

This imbalance must be addressed, says Dr. Cameron. "We need to make better use of financial resources to enhance the support provided to this growing population of caregivers."

She notes that adult children caregivers need to balance the challenges of professional life, family life, and the added responsibility of taking on the care of somebody post-stroke. "Caregivers need more support," she says. "They aren't trained but their role is essential."

To remove some of the strain − financial and emotional − innovative thinking is required.

"Our healthcare system is not sustainable in the face of rising costs," says Dr. Cameron. "We need to plan."

Here's what Dr. Cameron envisions as part of this plan:

• Create work environments that support family members caring for stroke survivors (e.g., caregiving leave).
• Recognizing that family members perform many caregiving duties after the stroke survivor returns home but receive little if any training; hospitals must train family members for their caregiving role.
• To ensure post-hospital care plans incorporate the unique circumstances of the family, caregivers should be recognized as members of the care team. "Family caregivers are critical to stroke recovery and typically assume major care roles that are frequently costly to their financial, social, and emotional well-being," says Dr. Antoine Hakim, spokesperson for the Canadian Stroke Network. "Innovative new ideas to support their balance and quality of life is essential."