How to Recognize Caregiving Stress

Over fifty million Americans are family caregivers—ordinary people with no special training who find themselves called upon to care for an aging or disabled parent, spouse, or family member at home. If you’re one of these individuals, you may be experiencing levels of stress you’ve never felt before.

Caregiving introduces an entirely new level of stress into your life. When caring for a loved one, you know that at any moment, you may have to abruptly stop what you’re doing to address your loved one’s immediate need. Sometimes these interruptions are momentary inconveniences, while other times they can completely derail your day or your week.

The frequency and severity of these interruptions are driven by your loved one’s health conditions. Your loved one’s exigencies can make it difficult for you to plan for things like out-of-town trips, daylong excursions, or even a night at the movies. It can become hard to plan for anything in the future, because your loved one needs you here and now.

The stress induced by caregiving includes a nagging sense of never doing enough, despite doing all you can do. It’s a worrisome anxiety that may cause you to feel emotionally spent, tired, and depressed. It’s accompanied by the knowledge that whenever you leave, wherever you go, your loved one is left vulnerable. It’s no wonder that studies have repeatedly demonstrated that family caregivers are more prone to stress-related illnesses than people without caring responsibilities.

Caregiving Stress Leads to Burnout

The unending pressure associated with caregiving demands can become overwhelming and lead to burnout. The telltale signs of caregiver burnout include a wide range of indications of stress, including exhaustion, fatigue, irritability, compulsive behaviors, emotional distress, and depression.

When a caregiver gets worn out, it is referenced in the social sciences as compassion fatigue. This is a very real outgrowth of devoting your hands, heart, and soul to the care of someone else.

The Compassion Fatigue Awareness Project offers an expansive website with information and resources to help caregivers (https://compassionfatigue.org/). The website includes a list of symptoms and signs that a caregiver is worn out. These include:

• Bottled-up emotions
• Isolation from others
• Substance abuse used to mask feelings
• Compulsive behaviors such as overspending, overeating, gambling, sexual addictions
• Poor self-care (related to hygiene or appearance, for example)
• Legal problems, indebtedness
• Recurring nightmares and flashbacks about a traumatic event
• Chronic physical ailments such as gastrointestinal problems and recurrent colds
• Apathy, sadness, a feeling that activities are no longer pleasurable
• Difficulty concentrating
• Mental and physical fatigue

None of these conditions is healthy or desirable, but each one is relatively common among family caregivers. It’s important for caregivers to practice self-care in order to avoid burnout and continue helping those who depend on them.

Differentiating the Stressors of Caregiving

As a family caregiver who’s feeling stressed, it’s vital for you to differentiate your stressors. There are care-related stressors that you cannot control, and there are care-related stressors that you can control.

Let me explain by telling you about a friend who refers to herself as a “clean freak.” Susan’s house is always spotless. When traveling, she wipes down her hotel rooms and airplane seats. Everyone in her family knows that she’s a certified germaphobe.

Years ago, Susan’s mother began to experience health problems and required assistance with activities of daily living, including housecleaning. Despite having five available children, she wanted only Susan to clean her house, and she wanted it cleaned on a weekly basis. Susan lost one full day every week to cleaning her mother’s home. Years of cleaning her mother’s house without any help from the rest of the family caused Susan to feel increasingly—and unnecessarily—stressed.

Acknowledging what you’re experiencing and doing something about it is important if you’re a family caregiver.

After her mother passed away, Susan confessed, with some regret, that she knows she didn’t have to be the only one cleaning her mother’s house. If she had intermittently shared that responsibility with others, her mother would have adjusted, and the stress in Susan’s life would have been significantly reduced.

By contrast, her mother’s recurring hospitalizations couldn’t be rearranged. Whenever her mom was in the hospital, Susan experienced the stress that comes with watching a loved one struggle through an episode of acute care, sometimes without the assurance of survival.

The care-related stress of housecleaning is quite different from the care-related stress of hospitalization. You will benefit from recognizing the caregiving stressors that can be managed more effectively and those that you can’t do anything about. You’ll do better over the long trajectory of caregiving if you take steps to mitigate your unnecessary stressors.

Stress-Reduction Tips for Caregivers

If you’re feeling stressed out, you owe it to yourself to do something about it so that you can be healthy. Here are ten tips you may want to consider in order to reduce caregiving-induced stress:

• Seek help from a counselor.
• Exercise.
• Arrange for respite care by another caregiver.
• See your physician.
• Engage with a local caregiver support group.
• Connect with online caregiver communities.
• Set realistic expectations for yourself about what you can and cannot do.
• Go outdoors.
• Spend time doing something you enjoy.
• Start keeping a journal. As part of your journaling, consider writing regularly about things you’re grateful for—including simple pleasures like a warm bowl of soup or a refreshing moment with your care receiver.

All of the suggestions listed above have been shown to help with stress relief. You may decide to try a few of these at a time. Through your consistent effort, you should be able to alleviate some of the stress you’re feeling, which will make you more comfortable with your caregiving responsibilities—a benefit to both you and your loved one.

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This is an excerpt from Dr. Aaron Blight's new book, When Caregiving Calls: Guidance as You Care for a Parent, Spouse, or Aging Relative. Dr. Blight is an international speaker and consultant on caregiving, aging, and healthcare. He is the Founder of Caregiving Kinetics,  a consulting firm dedicated to those who care for the aging population. He has served as a family caregiver, home care company owner, caregiving scholar, and leader at the Centers for Medicare & Medicaid Services.