Caregiver burnout often leads to depression.

Caregiver Burnout

Caregiver Burnout is a National Health Crisis

Research shows Caregivers at Risk for Burnout

       Research by organizations such as the Centers for Medical Services (CMS), Centers for Disease Control (CDC), National Alliance for Caregiving (NAC), and the American Association of Retired People (AARP) shows the significant and long-term impact of caregiving. Based on their research, caregivers who provided continuous care for long periods of time are at risk for developing caregiver burnout (among other ailments).  

    Caregiving is a physically and emotionally draining job.  After performing caregiving duties daily for an extended time, the impact of that strain begins to take a toll on your physical and mental health.

40-70% of Caregivers Show Signs of Significant Depression 

Statistics from the Caregiver Action Network show the following impact of caregiving on the health of the caregiver:

  • 40-70% of family caregivers show clinical signs of significant depression, with 25% of those meeting the criteria of major depression (some considering ending their lives)
  • 20% of employed female caregivers over age 50 report symptoms of depression
  • 23% report their health is fair or poor because of caring for a family member
  • 72% report not going to the doctor as they should instead of caring for someone else
  • 1:10 (11%) of family caregivers report that caregiving caused their health to get worse
  • A caregiver wife’s hospitalization increases her husband’s risk of dying to 35% within one month of that hospitalization. If the husband is the hospitalized caregiver, the risk for his wife’s death is 44% within the month of his admission.
  • The extreme stress of family caregiving causes premature aging and takes approximately ten years off caregivers’ life expectancy.

Chronic Conditions Develop  

   Often caregivers develop chronic health conditions that become disabling due to failure to take care of their own health needs. High blood pressure, diabetes, high cholesterol levels all come about due to poor eating habits, high stress, and lack of sleep. Family members who spend nine or more hours per day in caregiving activities double their heart disease risk. As the family caregiver ages, so increases the risk of early mortality.

As more and more of the healthcare burden is shifting to care at home, the impact on family caregivers is becoming a healthcare crisis.

Difficulty sleeping is a common symptom of caregiver burnout since caregivers often anticipate calls for help.
Difficulty sleeping is a common symptom of caregiver burnout since caregivers often anticipate calls for help.

How Can you Reduce Your Risk of Caregiver Fatigue and Burnout?

Recognize the signs of caregiver burnout, and when you do, ask for help from those around you.

     The support you need is a chance to get away from caregiving as the “Lone Ranger” for a while.  Therefore, try to get away for a day or two or at least to share your caregiver burden with someone else.

If you find that you feel resentment, seek someone to meet with for counseling.

     Professional counseling may be useful but may not be essential. Sometimes all you need is a trusted friend with whom you can share your feeling without fear of judgment.  Often, making peace with your situation goes a long way in resolving the stress and burnout symptoms that plague your mental health.

Get some fresh air and exercise.

     I’m not talking about an exercise program unless you want to do one because many of us don’t have the time to commit to anything formal but instead break the exercise down into 5-10-minute segments that you enjoy.  Turn the radio up while doing the dishes and dance around, “pump-iron” with your clothes as you fold them, buy an electronic peddler to use periodically while you sit at your desk, and feed your special needs child.  Be creative and develop an activity you like to do, and turn it into an exercise routine. Take it outside, and you get to add Vit. D, and Vit. C to the mix.

Monitor your own health needs.

     Keep up with your annual health and dental appointments, eat a well-balanced diet, and drink plenty of water. Try to get enough sleep that you feel refreshed in the morning, but if you can’t, try to nap during the day.  Even brief naps of 20-30 minutes are restorative.

Learn to accept help.

     I had a tough time accepting offers of help, but I came to realize that when I denied people the opportunity to help, I was taking away their joy. People feel good when they help. When I deny them the ability to help me, I’m taking away their opportunity to feel good. Once I realized my mistake, it was a little easier to say yes to their offers.

Focus on what you can control.

     Do you know the Serenity Prayer? “God grant me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference.” Remember, you can’t control everything. Pray for the wisdom to know the difference and to let go of what you can’t change.

     If you can put these practices into action daily, you’ll find it much easier to avoid burnout.

Caregivers often experience feelings of depression, being overwhelmed and loneliness.
Caregiver overwhelmed by the daily pressures of caregiving.

Has Compassion Fatigue Progressed to Burnout?

Compassion Fatigue or Caregiver Burnout

     Caregivers suffer from two syndromes that indicate they need some personal attention.  One is called “Compassion Fatigue” and the other “Caregiver Burnout.”

Running at Full Throttle     

     I like word pictures, so here’s one for you. Think of a boat.  You have a caregiver running full throttle hitting waves head-on, staying the course for hours on end without taking time to protect his shoreline.  In his mind, if his boat stops, the enemy will breach his coastline and enter his home; therefore, he cannot quit.  He runs out of gas, but he must defend his coast! (caregiver fatigue)

Runs Out of Gas

     Consequently, he picks up the oars and paddles harder and faster until more gas arrives. More gas comes, and he gets to rest, but only a short while, and it happens again. The need to defend his shoreline repeatedly happens over a series of months and years. (caregiver burnout)

Compassion Fatigue 

     The pattern of rest and pushing ahead creates more significant stress leading to Compassion Fatigue. The caregiver begins to be less tolerant of others, feels disconnected, becomes annoyed more easily, has increased low self-esteem, and less compassion. Unless he takes a break and recognizes he is overwhelmed and needs to get away for a while, his emotional state will progress to Caregiver Burnout.

Caregiver Burnout

     If he ignores the warning signs and keeps peddling or he drops his oars and loses them in the water, he then reaches the point of Caregiver Burnout, where he begins to attempt to protect his shoreline by peddling the water with his arms alone.  He is so exhausted, he has little left to give, but he keeps giving anyway. Common signs of caregiver stress associated with compassion fatigue include:

  • Anxiety, depression, irritability
  • Feeling tired and run down.
  • Difficulty sleeping
  • Overreacting to a minor nuisance
  • New or worsening health problems
  • Trouble concentrating
  • Feeling increasingly resentful
  • Drinking, smoking, or eating more
  • Neglecting responsibilities
  • Cutting back on leisure activities
 Caregiver Burnout Occurs if Fatigue Is Not Addressed

Compassion Fatigue symptoms progress to the following if they are not addressed and corrected. 

  • Having much less energy than before
  • Catch every virus that comes along
  • Feeling exhausted even after sleeping all night or taking a break.
  • Neglecting your own needs because you’re too busy or don’t care anymore
  • Your life revolves entirely around the person needing care by you; however, you receive no satisfaction from providing the care.
  • Have trouble relaxing even if help is available
  • Become increasing impatient and irritable with the person for whom you’re caring
  • Feel hopeless and helpless

Having help and support of someone who cares can reduce the effect of caregiver burnout.
Having help and support of someone who cares can reduce the effect of caregiver burnout.

My Own Experience

By Donna Steigleder  

     I’m going to be brutally honest with you as I tell my story. I went from a nice person everyone liked to someone I didn’t even like due to burnout. Pay Attention, so it doesn’t happen to YOU. 

I Love My Husband, but I’m Tired

     I love my husband, but caregiving wears me out. I tried for years to do it on my own.  I worked full-time and was a full-time caregiver using friends to cover for me when I went into work for many years.  I did all my husband’s physical care before I left for work or after I came home. My friends only had to feed him and help him with his typing during the day (he’s an author).

Catheters Allowed Anyone to Stay with Him

     I inserted an indwelling catheter before I left for work daily and removed it when I returned home. Therefore, his bathroom needs only involved them emptying the urine bag while I was away. By limiting the amount of time he had the continuous catheter, the risk of bladder and kidney infections was reduced. During the five years we managed this way, he had only one urinary tract infection.

Did I Mention I Was Tired?   

      I worked outside the home for 10 hours.  Once home, I took over caregiving duties and house responsibilities, leaving only 5 hours to sleep at most.  Many nights I got up at least once to catheterize Lynn and do other care activities. I was always tired and sleepy. When I was awake, I barely managed to put one foot in front of the other to keep going.

The Guilt 

   I felt guilty about everything–that I couldn’t give enough time to Lynn, to my job, to my children, or my elderly parents. I knew in my head I was doing my best but not in my heart. When I looked back at what I had accomplished at the end of each day, I never felt I had accomplished enough and would fall into an exhausted sleep, dissatisfied with what I had achieved.

I Cried Often   

 In the shower, I cried, often going home anywhere I could be alone because I didn’t want Lynn to know how I felt. He couldn’t help the situation though he often tried to “fix” it. His attempts to “fix” me just made me angry and frustrated, creating a rift between us at times. There was nothing he could do; I would try to explain, but he kept pushing until he finally gave up.  

Money Was Tight    

   We were not eligible for Medicaid because my income was too high, but we wouldn’t have enough money to pay our bills if we hired someone to help. I thought about quitting my job, but if I did that, then I would not have health insurance (this was before the Affordable Care Act), so I keep going it alone. I felt like I carried a heavyweight around all the time.

 Developed Depression

     I used to look happy and smiled a lot but started looking sad and withdrawn.  No one talked to me about it other than to say, “Are you okay?” Some did suggest that I see someone, but I honestly could not figure out how I could find an opportunity to get away to an appointment regularly.  I didn’t have anyone to stay with Lynn while I went. I didn’t want to go on work time because I already had a modified work schedule and feared how additional time off might affect my job.

Afraid of Failure

     I was scared of letting people down all the time. I felt paralyzed and unable to make decisions regarding my own needs. I realize now that I needed someone to take the lead for me to help me get care. So, I did nothing. 

Wanted to be Alone    

 Instead, I alienated everyone. I was short-tempered and frustrated.  I was self-isolated because I didn’t want to be around anyone else.  I told myself that I couldn’t spend time with anyone else with so much to do, so I only spent time working or caregiving and never allowed time for myself. I pushed everyone away—my friends, my coworkers, my colleagues, my family.

Self-Imposed Isolation

     By the time I retired, I doubt that many realized I had left. I no longer had close contacts. Once I was well known, now even many in my own department didn’t know me, and I had acquired a reputation as being terse and not a willing team player. My failure to participate in group gatherings and my direct responses led to a controlling and inflexible reputation.