Do you fear you may be heading for burnout and want to slam the brakes on before it happens?
Burnout is a devastating experience that can make you feel that you are falling deeper and deeper into a black hole with no hope of stopping the descent.
Once the descent begins both you and the person you are caring for begin to suffer. It will interfere with your ability to function, raising the risk of chronic depression and other mental and physical ailments. Carer burnout is a major cause of placements of loved ones in Nursing and Care homes. It is suggested that 85% of caregivers are at risk.
The first step in dealing with the problem is to be aware that it’s happening.
What are the signs?
Answer the statements in the box below. Answer honestly. Don’t put yourself or the person you are caring for at risk by failing to face reality.
I feel overwhelmed, exhausted and drained, even after a rest.
I feel helpless and hopeless.
I no longer want to be around my loved one.
I have angry outbursts that are uncharacteristic
I am increasing irritable and impatient.
I have thoughts of harming myself or my loved one.
I feel increasingly resentful.
I am neglecting my own needs because I don’t care any more
I am eating, drinking or smoking more than normal
I have difficulty relaxing
I am neglecting important responsibilities.
I rarely see or contact friends or family members
I have difficulty sleeping.
I have lost interest in things I used to enjoy.
If you answered yes to any of the statements, a warning light is flashing and you need to take action. More than one puts you and your loved one in increased danger.
If you have been experiencing thoughts of harming yourself or your loved one you need to seek professional help immediately. There is no shame in what you are experiencing, so don’t feel embarrassed. It takes more courage to put your hand up and ask for help than it does to hide away and risk both your own and your loved one’s safety.
Cause of caregiver burnout
This can be a combination of many factors including:
- Providing continual care for someone who is unable to reciprocate their feelings or show gratitude for their care
- Feeling deserted by family, care services, religion or a partner
- Fears about how long you can cope with limited support
- Frustration and disappointment that, despite the efforts put in, your loved one does not make progress or continues to deteriorate. This is a failure to accept that the care you are providing is not the cause of the decline.
- You are reluctant, unable or unwilling to seek out or accept help from others
What to do
The key to avoiding burnout is to take action to regain some balance in your life. The better you are at taking care of your own needs, the more you can be physically, mentally and emotionally available to support the person for whom you are caring. ‘Easy to say’, you reply. True. But the fact is that unless you do regain some balance you won’t be around to look after your loved one. Don’t risk it.
Assessing the situation
The main areas you need to look at to make improvements are:
- Physical – this is getting sufficient rest, eating nutritious food and exercising regularly. Don’t skip visiting the doctor for your own health issues.
- Strengthening your support system – if you have little or no help from family seek out a local support group and assistance professionals can provide. As well as providing emotional understanding, groups and professionals are great sources of information and guidance. Don’t forget many internet groups are available – especially useful if you are unable to leave the house.
- Creating some sense of fulfilment in life – This might mean doing something creative or meaningful for yourself apart from looking after your loved one.
- Looking for ways of getting some appreciation for what you are doing – especially if the person you are caring for is unable to show appreciation.
Suggestions to help
There is no set answer
What works for one person does not suit someone else. The purpose of this blog is to help you examine the causes and plan the right solutions for you. Here are some suggestions others have found useful to help find some balance.
You are already tired and exhausted, why would you exercise? It relieves stress, lifts mood and helps you fight depression as well as boosting energy levels. It will also aid sleep. Aim for at least 30 minutes each day. This might be going for one or two short walks, dancing or exercising to music. The person you are caring for may be happy to exercise with you.
Identify what you can and cannot change
Trying to change things over which you have no control will only increase your frustration. Accept what you can’t change and ask: ‘What do I have control over? How can I change what I do to make life easier?’
Ask for help. Speak up
There is no shame in admitting you can’t do everything yourself. You are not being selfish or inadequate. Be clear and specific about what you want help with. Make a mental list of tasks others could do. This might include errands, taking the person for a walk, sitting with them for an hour or two while you go to the doctors or a relaxation class. Let people choose what they would like to do. Don’t be offended or take it personally if someone turns you down. The same person may be happy to do something else at a later date. Try to avoid asking the same person too often.
Having goals, no matter how small, and working towards them gives you back a sense of control, achievement and progress. Break large goals down into small manageable steps. Typical goals might be:
- Ask my neighbour Janet if she would stay with Mum for an hour while I go to the shops.
- Make an appointment to go to the dentist.
- Spend fifteen minutes each evening listening to music and relaxing.
Keep a journal
Many peoplefind that keeping a notebook in which they write down their thoughts and feelings helpful. It enable you to think through and be objective about what is happening, rather than be overwhelmed by emotion. Alternatively, you can write in a diary all the things you have achieved or that went well each day. Browse through it at the week-end. This enables you see the positives and keep a balanced view rather than focus on the negatives all the time. Try it. It only takes a few minutes.
Be open minded and objective. Sometimes you may think the problem is that you are feeling exhausted all the time when it really is that you think you are the only one who can look after your partner, parent or son. Look at things from a different viewpoint. If you were supporting a friend in your situation what would you be saying to them?
Imagine how your loved one would respond if he/she was able to show their appreciation. Close your eyes and imagine them saying it. Talk to family, a friend or another support group member who will listen to how you feel and acknowledge what you are doing. Also, acknowledge and praise yourself for your own efforts. Celebrate achievements with small treats.
Do something you enjoy
This may mean getting out of the house, reading a book, meeting a friend who makes you laugh for coffee or going for a swim. Whatever it is that takes your mind to another place, do it. If necessary get a friend, a family member or a paid carer to give you a break.
Even relatives who live long distances away can help. They can listen and acknowledge what you are doing. They may be able to contribute money to pay for a respite carer one morning or day a week to give you a break.
Attitude matters. You might think you are being realistic by telling yourself ‘I provide care because no one else will’. There may seem little alternative but this is thinking that will drain both your resilience and drive. It will make you feel resentful over time. Restate this thought with something that will sustain energy and motivation. Examples are:
‘I care for my relative/son/brother/father because I believe it is the right thing to do.’
‘I look after Dad because he always looked after me.’
A change of attitude makes a big difference.
Accept your feelings
Being angry from time to time, feeling frustrated with the care system, support available, relatives or over things which go wrong is normal. You’re human. It doesn’t mean you are a bad person or carer.
Decide what is important and build your life around this.Make conscious decisions about what you can and can’t do. Learn to say ‘No’ to things which are not essential.
List your daily tasks. Could anyone else do some of them? Perhaps your son/daughter could cook dinner some evenings. Could your partner run some errands or take your loved one for a drive? Often people want to help. Don’t beat about the bush – tell them how.
Update and fine-tune your plans regularly
Over a long period of care-giving your situation will change. Conditions and the resources available to you will also alter. There may be changes at work, the people available to help you, the health of your loved one, financial resources and the needs of other family members. You need to be creative and choose from available options as new problems arise.
It is surprising what difference even very small changes can make – don’t try to make too many in one go. If something is not working try something else.
The more aware you are about your own issues with burnout the more capable you are of making the correct adjustments to take care of your own mental, physical and emotional health. And the better you will be able to look after the needs of the person you are supporting.
This article was written for Carewatch by Robin Dynes. Robin also wrote our Activity guides for people with dementia to help carers enrich the lives of those they support.
Robin has worked in the National Health Service, Social Services and Adult Education for over 30 years as a counsellor and trainer. His main role has been to develop innovative services to meet the needs of older people and others who are vulnerable.