Aging Advocate: How Caregivers Can Avoid Burnout
By Madhavi Vemireddy, MD, and Jeffrey Jacques, MD
Social Work Today
Vol. 21 No. 4 P. 8

Even though being a primary caregiver for a family member has rewards that go above and beyond financial compensation—most are unpaid—the responsibility can prove to be exhausting and even stressful. Many caregivers take on an improvised role of being the primary decision-maker and protector of the care recipient, who are oftentimes children on the spectrum or elderly family members. The reality is that most unpaid family caregivers are very likely to experience caregiver burnout at some point during their caregiving journey.

According to the National Alliance for Caregiving, more than 53 million Americans are caregivers. This article provides insights on how those generous individuals can minimize and even avoid burnout.

Warning Signs
Caregiver burnout is a state of mental, physical, and emotional exhaustion. Some caregivers may experience these symptoms accompanied by negative or indifferent thoughts toward the loved one for whom they are providing care. Other common signs of burnout include anxiety, depression, and fatigue.

While the mental strain can be easier to pinpoint, burnout impacts more than cognitive functional abilities. Because of the chronic stress of caregiving, caregivers are twice as likely to develop hypertension, pulmonary disease, and diabetes. There is a physical aspect, with warning signs such as reduced energy, frequent illness from an impacted immune system, and constant exhaustion juxtaposing oversleeping with insomnia. This can lead to neglected responsibilities; indulging in vices such as drinking, smoking, or overeating; and even cutting back on leisure activities that usually help reduce stress.

Burnout can appear in caregivers when they are not receiving the support they need or when they are trying to complete tasks that are beyond their financial or physical capabilities. Often, caregivers will rely on family or friends for stability but will usually find themselves in positions that leave them with little support from outside experts. This can leave caregivers in an impossible situation, neglecting their own needs with little satisfaction from taking care of loved ones while feeling increasingly resentful, helpless, and, ultimately, hopeless.

What Causes Caregiver Burnout?
When caregivers fail to practice and maintain consistent self-care habits or are unable to take a break from their professional work or their caregiving responsibilities, burnout is likely to result. Caregiver burnout is a common side effect of being exposed to a high-stress environment. While it is best to maintain preventive measures when it comes to caregiver burnout, proactive action is not always possible due to factors such as the following:

• Lack of resources. A common myth is that caregivers will never need outside assistance. Finding a trusted friend, colleague, or even a health care professional to talk to about both work stresses and caregiving duties can make all the difference in preventing burnout. Most therapists and social workers are adequately trained to offer unbiased counseling, coping mechanisms, and resources to caregivers who may be struggling.

• Lack of boundaries. While most family caregivers prioritize the needs of the family member receiving care, it is imperative that caregivers set appropriate boundaries to protect their own physical, financial, and mental well-being. Caregivers must check in with themselves regularly to gauge their workload and whether it is necessary to seek outside assistance. Establishing proper privacy or autonomy boundaries may also motivate caregivers to set aside time to participate in stress-reducing activities outside of their caregiving duties. Caregivers should clarify these boundaries with all other parties involved in the caregiving process to work out a proper balance between caregiving and maintaining their personal lives.

• Lack of self-care routine. Many caregivers may find themselves in an established routine primarily built around the schedule or needs of the person receiving care. While this is undoubtedly important and beneficial to both caregivers and care recipients, it is also essential for caregivers to have their own separate daily routines. A morning routine can help caregivers set intentions for their busy week and energize or motivate themselves. A nighttime routine can help caregivers by acting as a mental reset or a wind-down period after a stressful week.

How to Prevent Burnout
The best way to prevent feelings of caregiver burnout is to be proactive. However, at the first symptoms of extreme burnout, especially anxiety or depression, caregivers should seek medical attention as soon as possible. In minor cases, caregivers can begin taking small steps to reduce feelings of burnout, such as free meditation, breathing, and yoga videos to help manage stressful moments. The following are some thoughts as to how they can make their health a priority:

• Put their health first. Caregivers spend a lot of time thinking about the well-being of their loved ones. But they may be so focused on caregiving that they don't stop to check in on themselves. As previously stated, chronic high stress levels can harm health. Daily midday check-ins, followed by course-correcting if their needs aren’t being met, can significantly improve caregivers’ overall mood and reduce stress.

• Maintain a physical exercise routine. Whether taking a quick walk outside or practicing resistance training for 30 minutes per day, all caregivers should maintain a physical exercise routine outside of work. Studies have shown that 30 to 150 minutes of physical activity per day can dramatically increase serotonin and dopamine levels in the brain.

• Maintain a balanced diet. Caregivers should be sure to eat well by getting plenty of fruit, vegetables, lean protein, whole grains, and water, and eating three balanced, nutrient-packed meals daily. It can be challenging to squeeze in time to snack, but making sure they consistently fuel their bodies with tasty nutrients will keep caregivers energized and satiated during the day.

• Take breaks. A break doesn’t have to be very long to make a difference. Caregivers should set aside a few minutes every day for a brief pause—whether that’s taking a walk, chatting with a friend, or meditating. A quick nap also counts. Some caregivers may also be eligible for local respite services. Getting enough sleep (at least eight hours nightly) will help them reset to be refreshed for tomorrow.

• Stay proactive. And, most importantly, caregivers should visit a health care provider for preventive checkups, shots, and screenings—even if it’s a virtual visit.

Additional Considerations
Although there are some essential steps to maintaining physical, mental, and emotional health as a caregiver, it can also seem like an added burden or responsibility to think about when overarching solutions are needed. Even the suggestions mentioned earlier aren’t one-size-fits-all and might not produce instant results.

Other options that may help caregivers get back on track include the following:

• Outside assistance. For some caregivers, it is important to be realistic and set healthy expectations based on the care recipient’s condition and needs. Home health services, private care aides, or even assisted living facilities can be great resources for additional assistance.

• Caregiver support groups. Participating in a local caregiver support group is a great way to meet other caregivers going through similar experiences and let off steam or pent-up stress that often results from caregiving. Support groups may also offer a variety of outside resources and additional information that traditional therapists or social workers may not provide.

• Ask for help: When all else fails, asking for help never hurts. Online resources can provide access to licensed clinical social workers, as well as other resources to aid family caregivers. For example, a digital platform can provide personalized support to caregivers at each stage of their caregiving journey, as well as access to relevant health care benefits and community resources for both caregivers and care recipients.

Caregiving is a physically, mentally, and emotionally demanding job, especially when caregivers live with the care recipient and are unable to set aside personal time and healthy boundaries. A caregiver is entrusted to make critical decisions that will affect the care recipient’s well-being and to assist them with completing day-to-day tasks. While being an unpaid caregiver for a family member comes naturally to many people, it is a responsibility that can prove to be stressful and even exhausting at times.

When caregiving duties become overwhelming, caregivers are likely to experience burnout. It is crucial for caregivers to be equipped with the right tools and resources to protect their well-being while caring for their at-risk loved ones.

— Madhavi Vemireddy, MD, is chief operations officer and cofounder of CareTribe, an expert-based family caregiving support platform. She is a seasoned physician executive leader in digital health with more than 20 years of experience in developing population health programs and evidence-based clinical analytics that served more than 23 million Americans across health plans, large employers, and care delivery systems. 

— Jeffrey Jacques, MD, is the CEO and cofounder of CareTribe, an expert-based family caregiver support platform. He has spent the last 20 years building digital health products and services that help individuals better manage their health and take care of their loved ones.