Caregivers are often an overlooked population in a rehab setting and this oversight can be detrimental to the attainment of the goals, safety, and overall success of the client. How do we know this is an important consideration as providers?
These numbers speak for themselves while bringing to light the need for increased caregiver resources and supports…
- 40-70% of caregivers suffer significant signs of depression
- 31% of caregivers contemplate suicide while on the job
- Almost ⅓ of caregivers provide direct care for more than 20 hours per week
- 2 of 5 caregivers have at least 2 chronic conditions
- ¼ caregivers are 65+ and report caregiving has made their health worse
Caregiver burnout is described as “… a state of physical, emotional, and mental exhaustion.”
Signs and Symptoms of caregiver burnout can vary based on the client they are caring for and can resemble other diagnoses and can even cause the onset of conditions like depression and anxiety. Overwhelming feelings of guilt, stress, and exhaustion are also common characteristics associated with caregiver burnout which is why it is important for caregivers to understand the signs and symptoms of caregiver burnout to reduce risk of negative impacts on their health and well-being. Some signs and symptoms may include:
- Withdrawal from social interactions
- Lack of interest in favorite activities
- Changes in sleep patterns (lack of energy)
- Neglecting own needs
- Emotional exhaustion
- Physical exhaustion
- Irritability
- Feeling blue or helpless
- Wanting to hurt yourself or the people you are caring for
Contributing Factors
- Confusion: This can happen when people assume a caregiving position (especially if it is unexpectedly) and are unsure how to separate their caregiving role from their personal life and other roles they embody. As a result, caregivers tend to take the stress of caregiving with them throughout their day-to-day life and never really get a break from the job itself. The inability to separate themselves from this role can lead to feeling lost, confused, and overwhelmed.
- Unrealistic expectations: It isn’t uncommon for caregivers to feel that their job as a caregiver will give them a sense of fulfillment because they are helping others. However, it can be hard to see a loved one lose their ability to perform basic tasks and the level of assistance required might be unexpected. Spending time with a loved one during their time of need is admirable however, the stress it places on the relationship could be an unforeseen challenge when assuming the role of a caregiver.
- Lack of control: This can be in many forms including lack of caregiver resources and supports, money, and ability to organize or control one’s life.
- Unreasonable demands: In some cases, especially when a family member is a caregiver, the client is comfortable placing demands on their caregiver as they neglect their own responsibility to complete tasks they are capable of doing – or at least attempting. This leads to the caregiver’s role exceeding their initial expectations and as a result having an unsustainable amount of responsibilities.
- Lack of self-care: The responsibilities of a caregiver can become quite overwhelming and persist all hours of the day. For some caregivers, they might not know the signs and symptoms of caregiver burnout, so they are unaware that they are neglecting themselves and their needs.
How can burnout impact client outcomes?
Burnout can impact clients quality of care in so many ways such as: medical errors, strained relationships, decreased compliance in home programs, and decreased social interaction. Exhaustion, lack of energy, stress, and impaired cognitive function of caregivers can result in negative client outcomes.
For example, in the instance of medical errors, these factors can cause caregivers to make mistakes with medication schedules or dosages and can even mix up medications that can cause adverse effects. It is important for both caregivers AND clinicians to understand what caregiver burnout out is and how to address it in order to prevent decreasing client care and promote caregiver well-being.
Strategies for Clinicians to Intervene
We as clinicians cannot forget to address caregivers as they are an INSTRUMENTAL teammate during the rehab process and for successful carryover. But how can we offer support during times of burnout?
Caregiver resources and supports we recommend:
Family Meetings:
Bringing the family together with the entire interdisciplinary team can promote positive outcomes within therapy sessions and the home. The primary goal of this meeting should not necessarily be to mediate between opposing sides of conflicts but instead to hear caregivers’ concerns and feelings towards their role in the rehab process. Using our expertise, we may be able to implement compensatory strategies to decrease the physical, mental, and emotional strain associated with the role of a caregiver.
Prior to the meeting day, it may be beneficial to prepare your client and their family to make them feel comfortable; here is a printable resource to help out!
Education on Respite Care:
When caring for a loved one, there can be a lot of pressure put on caregivers to handle all aspects of the care independently. Helping them understand their options and how to accept help can improve their mental health and provide them with breaks from their role as a caregiver. Respite care can be offered by many different parties including other family and friends, government entities, and healthcare providers.
Use this link to provide necessary caregiver resources and supports on respite care with direct links to associations for specific diagnoses, options to inquire about with your physician, and specific examples for including others in the caregiving process.
Support Groups:
Sometimes there is nothing more beneficial than discussing hardships with other people who have experienced or who are currently experiencing the same thing. Caregivers might not be able to recognize the benefits of joining a support group or might not know how to locate these groups. Assisting with this process falls within the scope of the interdisciplinary team.
Here are some wonderful groups to get this process rolling: Family Alliance on Caregiving & Caring.com Resource Center
Develop & Manage a “Caregiver Plan”:
Organization of the day-to-day can help minimize the stress, anxiety, and exhaustion associated with caregiver burnout. Dedicating a session to helping the caregiver develop a plan will provide a client-centered approach to managing medications, appointments, emergencies, and more. Download this customizable document to assist caregivers with the development of this plan.
At the end of the day, we as clinicians need to recognize caregivers as our clients as well and understand what caregiver burnout looks like, how it can impact your client’s success in the rehab process, and how to support the caregiver and their mental health. Familiarizing yourself with caregiver resources and supports will allow you to successfully intervene substantiate your role as a difference maker in a holistic sense and promote the well-being of all members of the team.
Don’t let your client’s caregiver forget, caregiving starts with you!
Alicia is a doctoral capstone student working with a non-profit agency to discuss mental health advocacy through various online platforms. She is earning her OTD from Gannon University located in Ruskin, FL.
Terrell is a doctoral capstone student working with ARC Seminars to complete a qualitative research study tailored towards benefiting the profession of occupational therapy. He is earning his OTD degree from Gannon University located in Ruskin, FL.
