How do I best deal with how I am feeling about being a caregiver?Caring for a Family Member with Physical or Mental Health Difficulties
20% of Canadians are struggling with mental health difficulties, for a total of 1.5 million children and
4.5 million adults. 13% of Canadian’s (3.8 million) are struggling with physical disabilities,
and among those over the age of 75 the rate is 43%.
The role of caregiver, whether it is of an aging parent, a family member with a physical disability or a child with mental health difficulties, can at times be overwhelming. The time, energy and finances required to care for a loved one, and the emotions associated with being a caregiver, sometimes lead to caregiver burnout, a state of physical, mental and emotional exhaustion. Exhausted caregivers describe feeling stressed, anxious and depressed, and they report symptoms similar to those seen with depression. For example, they report irritability, loss of interest in activities they used to enjoy, social withdrawal, poor appetite, sleep difficulties, and feelings of hopelessness. In a state of burnout, a previously positive and loving caregiver may become negative and uncaring. Caregivers also often experience guilt, anger and self-doubt. Strategies to address the feelings associated with caregiver burnout are detailed below.
We all want the best for our loved ones, and this can result in caregivers setting high standards for the care of their family members. In setting high standards for the care of their loved one, caregivers may set unrealistic expectations of themselves and may assume exclusive responsibility for the care of their loved one. When caregivers do not meet the high standards they set for themselves, it is not surprising that they then become self-critical. For example, a parent of a suicidal teen might tell herself “I should have checked on my daughter more often throughout the night”. A child of an ailing parent might tell himself “I cannot put my mom in a nursing home, I should be able to make it work at home”. Not being able to live up to self-imposed unrealistic expectations, and the resulting belief that they are not doing a good enough job of caregiving, results in feelings of guilt and shame.
In order to reduce feelings of guilt it is important to set realistic goals for yourself, accept your own limitations, and allow others to assume some responsibility for the care of your loved one. When you start to feel guilty, ask yourself whether you are being realistic or idealistic.
Many caregivers become frustrated by a lack of money, resources, and skills to effectively plan, manage, and organize their loved one’s care. They also can become angry that their loved one is suffering. Anger can be directed at their loved one, themselves, other family members, healthcare professionals, and/or a higher power. It is important to understand that anger is a normal human emotion that we experience in response to feeling a lack of control with our situation.
In order to reduce feelings of anger it is important to accept what you cannot change about the current situation, and use the energy associated with anger to change the things you can. Remember that even when you do not have control over the situation or outcomes, you are in control of your own behavior and can choose how you will cope.
Caregivers commonly question whether they are doing the right thing for their loved one, and they may become confused when they are given differing opinions from a variety of sources. Self-doubt can become exacerbated when caregivers judge their caregiving approach based on the response of their loved one, whose symptoms may vary or progressively worsen.
In order to reduce self-doubt, it is important for caregivers to educate themselves about their loved one’s illness and the treatments or care available. Remember that your loved one’s response to your care is based on a multitude of factors, including the illness your loved one is struggling with. Be realistic about your loved ones illness, their symptoms are not a reflection of your caregiving.
The primary strategy to prevent or treat caregiver burnout is self-care. Finding the time for self-care is often a challenge, and even when time is taken, caregivers often feel guilty for not using that time to help their loved one. However, it is important to remember that self-care is necessary to be the best caregiver you are capable of being. Self-care requires making time for breaks, and using that time for fun, socializing and rest. This may require another family member, caregiver or organization providing you with some respite (e.g. in home care, short stays in nursing homes or group homes). Self-care includes eating well, exercising, getting adequate sleep, and taking care of one’s own medical needs. Seeking support from others is also necessary for self-care. Sharing your feelings with those within your support network (e.g. friends, family, religious community), a counsellor, or another caregiver in a similar situation (e.g. support group) can be a great way to release stress and get helpful advice.
Written by Dr. Sherry Van Blyderveen
Clinical & Counselling Psychologist
Dr. Van Blyderveen received her Ph.D. in Clinical Psychology from Simon Fraser University. She is an Assistant Professor (part-time) in the Department of Pediatrics at McMaster University. Her previous experiences include a variety of hospital, community mental health, private practice and correctional settings, including over seven years with the Pediatric Eating Disorders Program at McMaster Children’s Hospital.
She is a Clinical & Counselling Psychologist at New Leaf Psychology Centre in Milton, ON.