Being a caregiver is a challenging and time-consuming job. Caring for someone who is ill or disabled requires energy, time and resources. Often, the caregiver is a family member, a friend or other person that provides care often without compensation.
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Caregiving can have an impact on your physical and mental health. The intensity and longevity of being a caregiver can lead to caregiver burnout.
The Cleveland Clinic defines caregiver burnout as “a state of physical, emotional, and mental exhaustion that may be accompanied by a change in attitude — from positive and caring to negative and unconcerned.”
It is becoming vitally important that we can understand what causes burnout, how to identify symptoms of burn out and ways to treat caregiver burnout.
First, caregivers are persons in someone’s social network that provide physical, emotional and other assistance. Caregiver duties and responsibilities differ, but they often assist with activities of daily living, such as coordinating appointments, providing or scheduling transportation, medication distribution, and numerous other activities.
“Keeping up with your own physical and mental health is essential to preventing caregiver burnout.”
Specific needs and tasks of caregivers
Former First Lady Roselyn Carter summarizes caregiving best “There are only four kinds of people in this world. Those who have been caregivers, those who are caregivers, those who will be caregivers, and those who will need caregivers.” Caregiving is a role that is often unexpected and provides many challenges and barriers.
Between 2015-2016 the Center for Disease Control and Prevention gathered data on caregivers, their tasks completed, and time spent. The data lends an important view into the lives of caregivers that often goes ignored.
The CDC estimates that approximately 1 in 5 people are caregivers in some capacity. Furthermore, 30% of caregivers have provided care for someone at least 20 hours per week. Data also indicates that half of the caregivers surveyed provided care for at least 2 years.
The CDC estimates that 1 in 6 non-caregivers expect to become a caregiver in the next 6 years. However, very few are aware of the mental and physical health concerns that accompany caregiving
What Are the Causes of Caregiver Burnout?
There is no singular cause to burnout, however, there are multiple factors that can contribute to caregiver burnout:
Not Understanding Your Role
The role will often depend on the severity and type of person that you are providing care to. Assuming a caregiver role can be complicated.
The tasks and responsibilities associated with caregiving can be new and different. For example, an adult child may be taking care of an adult parent; or a spouse is more of a caregiver than a partner.
There are many barriers to identifying a specific role including confusing diagnoses, complex treatment plans and lack of resources. Not understanding roles can lead to frustration, increased stress causing burnout.
Expectations
Expectations of caregivers come from many sources including family, medical providers, the person being cared for and, importantly, our own expectations. Setting unrealistic expectations for yourself, or unrealistic expectations given by others can be stressful and lead to burnout.
Control
Caregivers often experience stress by no longer being in control. Many variables come with caregiving creating barriers and hurdles that may create feelings of helplessness or hopelessness and loss of control.
For instance, a caregiver may no longer have control of their schedule, they have no control over the outcome of treatment or what resources are available to them. Feeling out of control can be a contributing factor to burnout.
Time Constraints
Approximately 43.5 million caregivers have provided unpaid care to an adult or child in the last 12 months. [National Alliance for Caregiving and AARP. (2015). Caregiving in the U.S.]
While time and longevity will vary based on illness and ability for the person being cared for, most caregivers spend a significant amount of time providing care. Family caregivers spend an average of 24.4 hours per week providing care.
Nearly 1 in 4 caregivers
What Are Signs and Symptoms of Caregiver Burnout?
Attitude Change
Tasks or interactions that were once easy or routine are now more stressful, angering or intimidating. Caregivers may find themselves “snapping” at supports or the person they are providing care for. They may be dismissive or disengaged where they once weren’t.
Making Mistakes
With so many demanding tasks, balancing caregiving and personal life responsibilities can seem impossible. Signs of burnout may include forgetting appointments or not scheduling follow-ups, missing medications, or forgetting about other responsibilities.
Changes in Other Interpersonal Relationships
The caregiver and the person being cared for are not the only ones affected by caregiver burnout.
For example, caregivers may neglect other relationships, skip important events, isolate themselves, or lose interest or motivation in maintaining healthy relationships. Often, this is a result of duties and responsibilities rather than an overt attempt to change other relationships.
Resentment, Anger, Frustration
These emotions can be common amongst caregivers that are overextending themselves. Resentment may develop for the person being cared for as the caregiver may place blame on them for changes occurring in their life.
Anger and frustration can come from expectations that the person being cared for will improve or will be able to be more self-sufficient.
Poor Physical Health
The demands of caregiving can cause caregivers to neglect their own needs. Poor diet, reduction in exercise and lack of sleep are all signs that caregivers can be burnout or lead to burnout.
Remember, each person and situation is different. If you feel there is a chance you could be suffering from burnout, seek professional assistance.
Reducing the Likelihood of Caregiver Burnout
The good news is, caregiver burnout can be prevented or reduced. Now that we are aware of the signs and causes, what can be done to reverse or prevent it?
Become Informed
Seek out information on the disability or illness of the person you are providing care to. By developing a greater understanding of treatments, symptoms
Misinformation, lack of understanding and even conflicting information can cause burnout and stress. Seek information from professionals that specialize in the disability and illness. It can also be helpful to become informed about being a healthcare power of attorney, living wills and other tasks that come with providing care.
Set Realistic Expectations
On average, caregivers perform 1.7 of 6 activities of daily living, most commonly getting in and out of beds and chairs (43%). [National Alliance for Caregiving and AARP. (2015). Caregiving in the U.S.].
Expecting to be able to care for someone full time, work, maintain a meaningful social life and take care of one’s own needs can be unrealistic at times. Having unrealistic expectations of self and the person being cared for foster feelings of disappointment, resentment
Understanding the capacity in which a person with a disability or illness can reasonably be expected to perform is vital. Remember, that caregivers are often not trained/paid professionals.
57% of caregivers report that they do not have a choice about performing clinical tasks and that this lack of choice is self-imposed. [National Alliance for Caregiving and AARP. (2015). Caregiving in the U.S.].Seek further education and resources for tasks that are beyond your capability.
Monitor Self Talk
Corinna Loeckenhoff, Associate Professor of Human Development at Cornell, studied caregiver personality traits that yielded positive correlations between caregiver self-efficacy and better overall health.
Researchers postulate that caregiver personality traits influence caregivers’ perceptions of their abilities to successfully navigate daily challenges of caregiving. Understand your strengths and weaknesses as a caregiver. Seek out resources and supports in areas that may be weaker, such as organization.
Focusing on caregiver strengths, such as compassion and extroversion, that will increase self-efficacy in caregivers. Focusing on areas of improvement can lead to negative beliefs about ability. Where as focusing on strengths and recognizing areas where support is needed can lead to greater physical and mental health.
Set Boundaries
Caregivers are not able to perform all tasks, all the time. Family, friends and other professionals may get used to you being able to complete most tasks.
Setting boundaries are important to maintain your physical and mental health. Saying no to certain tasks, setting schedules and organizing caregiver unavailability can be essential in reducing caregiver burnout.
Self-Care
Poor physical and mental health can be an outcome of being a caregiver. Self-care is a conscious effort to choose behaviors that balance the effects of emotional and physical stressors (Mickinnie,2010).
Caregivers may feel guilty or ashamed or selfish in taking time for themselves. Remember, self-talk and realistic expectations of self are essential to preventing caregiver burnout. Self-care is not selfish, but rather an intentional effort to recharge and address stressors can contribute to caregiver burnout.
Maintain Physical and Mental Health
Keeping up with your own physical and mental health is essential to preventing burnout. Continue with routine physical health care and seek further assistance if you are noticing changes in mood, appetite, sleep or attention.
According to the Anxiety and Depression Association of America, between 40-70% of caregivers report symptoms of anxiety and depression. Approximately 25-50% of those caregivers meet criteria for Major Depressive Disorder. Therapy can be an effective tool to increase self-efficacy and caregiver effectiveness.
Caregiver Support Groups
Remember, you are not alone. There are over 40 million Americans who are caregivers. There are many organizations that provide support groups for caregivers. Interacting with others going through the same or similar circumstances can normalize feelings, struggles
Ignoring the signs of burnout, choosing not to seek help when needed can lead to or exacerbate poor mental and physical health. By understanding and addressing signs of caregiver burnout, caregivers can increase the quality of the care they give while simultaneously improving their quality of life.
Resources
References
Caregiving: Recognizing Burnout. (n.d.). Retrieved January 15, 2019, from https://my.clevelandclinic.org/health/diseases/9225-caregiving-recognizing-burnout
Caregiver Statistics: Demographics. (n.d.). Retrieved from https://www.caregiver.org/caregiver-statistics-demographics.
Caregiver Mental Health. (n.d.). Retrieved from https://adaa.org/resources/caregivers
Loeckenhoff, C., Duberstein, P., Friedman, B., & Costa, P., JR. (2011). Five-factor personality traits and subjective health among caregivers: The role of caregiver strain and self-efficacy. Psychology and Aging, 26(3), 592-604. Retrieved January 16, 2109.
Mickinnie, C. (2010, June 05). Self-care in a toxic world. Retrieved January 16, 2019, from https://www.psychologytoday.com/us/blog/everybody-marries-the-wrong-person/201006/self-care-in-toxic-world
Ian, Good Evening, it’s been a Long time! Glad you are doing well & so involved in your field of study!
You are spot on with everything you wrote about. Your mom shared your article & we are all so proud of you. Congratulations, we have all 4 parents alive! 98,90,86,86. Guess we might live long too.
Jan Murray