Who cares for the caregiver?

A confluence of variables in Parkinson's disease results in Parkinson's informal caregivers facing tremendous challenges. Factors include: motor and non-motor symptoms, staging, rate of progression and increased life expectancy of people with Parkinson's (PwP) due to effective drug therapy and surgery. Informal caregivers may have to cope with dispersed family members, and a lack of centralized disease specific healthcare support alongside shrinking healthcare budgets and resources. These variables demonstrate the need to strategically address the unmet needs of the informal caregiver. Expectations placed on caregivers by themselves, the PwP, family members (often absent) and the healthcare system can threaten their physical and mental health, giving rise to the question: Who cares for the caregiver? In answering this question, this article discusses the needs of caregivers, presents various models of caregiving, and considers the nature of caregiver interventions. (C) 2009 Elsevier Ltd. All rights reserved.