Devoting your life to caring for another person will take a toll on your mental health. We address how to combat caregiver burnout.
The American population is aging, and by 2040 the number of citizens over age 65 will have more than doubled compared to 2020. That means an increasing number of elderly people who need round-the-clock care, a job that often falls to a spouse or adult child. Of course, not everyone who needs constant care is elderly — there are children, spouses, or people with chronic illnesses who may also require caregivers. No matter how much you love the person you’re caring for, providing constant supervision and assistance for someone is draining, especially when it involves watching the person you love lose their memory and/or mobility. If you’re a caregiver and have found yourself feeling constantly resentful, depressed, or hopeless, you may be experiencing caregiver burnout.
What is caregiver burnout?
According to Johns Hopkins, caregiver burnout is when self-care falls to the wayside while caring for someone else. “Failing to practice self-care habits contributes to the stress caregivers feel and the problems they may experience with their own physical, mental and emotional health. The likely outcome or consequence for a caregiver who is not taking care of him- or herself is burnout.”
Not sure if you’re burned out just yet? General burnout is “a state of emotional exhaustion that results from failing, wearing out, or feeling totally used up due to too many demands on one’s energy, strength, or resources,” according to Johns Hopkins.
Signs of caregiver burnout
Elizabeth Landsverk, MD, founder of ElderConsult Geriatric Medicine and author of Living in the Moment: A Guide to Overcoming Challenges and Finding Moments of Joy in Alzheimer’s Disease and Other Dementias, tells KCM you should watch for red flags that indicate you’re burned out. Some of them, she explains, involve your mood and outlook: “If you’re constantly irritated with or resentful of the person in their care. If you are exhausted all the time. If doing simple things for the elder feels miserable. If you feel hopeless about the future, feel a constant sense of guilt, or don’t find joy in things you used to love. If you are so overwhelmed by the burden of caregiving that you sometimes wish the elder would pass away.”
Other red flags are behavioral. Examples Dr. Landsverk cites are if a caregiver isn’t prioritizing their own health, if they’re not sleeping, if they’re eating too little or too much, if they’ve stopped leaving the house, or if they’ve started self-medicating with pills or alcohol.
How can you avoid caregiver burnout?
Have the difficult conversations early
Some people may be thrust into a caregiver role, but if you’re able to have a conversation with the person before they need constant care it can make things much easier down the road. Dr. Landsverk explains, “When the person in need of care can still speak for themselves, have a family meeting and ask them what they want.” This includes hospice or end-of-life care, their thoughts on being placed into a care facility, and who they want to entrust with their financial and medical decisions.
Dr. Landsverk says she’s also noticed that the burden of care frequently falls on one family member. “I often find that one person who is either very caring or in the closest proximity to the person in need ends up taking on the sole responsibility of caregiving, and they might feel guilty about others’ reluctance to take on that burden,” she says. “You need to find a balance between caring for yourself and caring about what your family expects from you.” If you have siblings or other family members, she says, “have the conversation about how to divide care early on, so nobody is left caring for the elder or loved one on their own.”
“You need to find a balance between caring for yourself and caring about what your family expects from you.”
If you do end up being the sole caregiver among siblings, Dr. Landsverk notes the importance of addressing the financial impact as soon as possible. “When one person in a family takes on the majority of caregiving responsibilities, that person should be able to use the ill or elderly’s assets to help with care, or even be paid for their time.” She adds, “If that person is giving up their life for years to take care of an aging parent, for example, and there’s an estate left when the elder dies, you might want to make sure that the caregiver’s contributions are considered when dividing up the estate.”
Take time for yourself
According to Dr. Landsverk, “the worst thing that can happen is if the caregiver is constantly trapped at home alone with the person they’re caring for — that’s almost always going to lead to burnout.” Taking time for yourself outside of the caregiving environment is crucial to maintaining your mental health.
Easier said than down, we know. But there are resources that help caregivers take time for self-care. If you’re caring for an elderly person who is financially unable to hire someone to assist with in-home care, Dr. Landsverk recommends trying to find a day program for seniors in your area. “There are really great day programs out there that function almost like dementia communities,” she explains. “Look for programs that have high engagement — somewhere that offers music programs, or arts and crafts, or even just encourages the seniors to talk with each other.” Dr. Landsverk notes that depending on the elder’s behavior, you may have to adjust your search: “If you’re taking care of an elder who can get agitated or violent, you’ll need to find a team that knows how to work with that type of behavior.”
“The worst thing that can happen is if the caregiver is constantly trapped at home alone with the person they’re caring for — that’s almost always going to lead to burnout.”
Another option Dr. Landsverk suggests is teaming up with other caregivers in your community to help ease the burden (we outline options for connecting with other caregivers below). “If you know a caregiver in your area providing for a person with similar issues, try to band together and make a schedule where one person watches both for an afternoon so the other person can take some time for themselves.” If the loved one isn’t too distressed by a change of environment, this option has the added benefit of allowing everyone involved to socialize.
Consider long-term care
Placing your loved one in a long-term care facility can be heartbreaking, but sometimes it’s necessary. “It’s probably going to be rough for the first couple of months,” Dr. Landsverk explains, “but dementia can cause delusions and paranoia and people can be violent and very difficult to take care of. Those people might not be safe at home.”
When it comes to finding long-term care, there are a few options. “If you’ve got the money, hiring a care manager can be great because they can help you figure out what facility is going to be best for your loved one.” Dr. Landsverk stresses the importance of doing due diligence before choosing a care manager: “These managers get paid by long-term care facilities for each placement. Most of them do a really nice job, but sometimes they’ll suggest the place that will give them the highest commission.”
If you’re looking for a facility on your own, it’s important to check out multiple places in-person before committing. “If you walk into a facility and everyone seems to be dozing off, everyone is just watching TV, or the residents aren’t cleaned up or dressed properly, that’s a bad sign,” she explains. There needs to be supervision — some places just keep residents medicated and even leave them alone in bedrooms with cameras just in case someone falls. “You want to look for a place that will keep your loved one engaged and active. residents should look like they’re having fun.”
If you’re financially unable to afford to place your family member in an assisted living facility or nursing home and they are on Medicaid, Dr. Landsverk suggests looking into getting the elder into a skilled nursing facility.
Reach out for resources
Support groups can be incredibly helpful for caregivers. Family Caregiver Alliance can connect caregivers for support and provides resources and information for caregivers. The Alzheimer’s Association also has virtual support groups and an engaged online community.
Dr. Landsverk also suggests looking locally. “Local places of worship like churches, synagogues, or mosques may offer support for caregivers,” she says. “Some cities also have a village network in which local citizens work together to provide programs, services, and even transportation for seniors. Check your county’s division on aging, which also may have low-cost day programs.”
Find new ways to connect
When you’re caring for someone at home, it can be easy to get stuck in a rut. Changing up your routine can make more of an impact than you might think.
One of Dr. Landsverk’s favorite programs for seniors and caregivers coping with dementia is called Connected Horse. “It’s a wonderful program where you can spend a novel and fun afternoon with your loved one taking care of, interacting with, and grooming horses. It can be very healing.”
Getting out of the house and doing something as simple as taking a walk together can also be a great way to reset and reconnect. Dr. Landsverk also suggests bringing out photos from the person’s past to get them excited and talking about something important to them.
“I worked with a group of elderly veterans who were living at a nursing home and generally pretty un-engaged,” Dr. Landsverk recalls. “We brought in pictures of old advertisements and cars from the 1940s, and they all just lit up — they started talking to us, and to each other. It was great.”
Caregiver burnout impacts everyone
As much as caregiver burnout can be a result of too much time with the person in need and not with yourself, burnout ultimately is going to have a negative impact on both of you. As they say on airplanes, you’ve got to put your own oxygen mask on before helping others. If you feel yourself edging toward burnout, ask for help. Trying to power through it could potentially put both yourself and your loved one in danger, and that’s not worth the risk. Giving yourself regular intervals of rest where you’re able to focus on your own needs without being preoccupied with your loved one will ultimately benefit both of you.
