How To Avoid Caregiver Burnout

Last year was "the year without a summer." Sure, most people had warm weather, packed picnic lunches, went swimming, ate watermelon, looked at sunsets -- but not me or my siblings.

In July 2010, my 89-year-old father collapsed in his apartment, where he was found on the floor after 48 hours of unconsciousness. After a stint in the hospital, he was transferred to a rehabilitation center, and from there to assisted living. He had to give up his car, his independence, and a healthy portion of his dignity. For my dad, a former airline pilot, it was a painfully difficult transition. For his kids, it was no less. He was grouchy, needy, frail, confused -- and at least one of us spent a good portion of every day with him, despite heavy workloads and busy personal lives.

By the end of the summer, I felt like a prizefighter after eight rounds in the ring: punchy, exhausted and dying to get back to my "normal" life. Although the intensity eventually eased up, there was no longer a "normal." Rather than making time once a week for my dad, I now needed to go see him for several hours, several times a week.

My sister and I are both single. My brother is married, but his boys are out of the home. We shared the burden equally, but our family seems to be in the minority: Most of my single friends with aging parents seem to do the lion's share of caretaking.

That observation was borne out by a recent University of Massachusetts study, which found that adult unmarried children are more likely to provide assistance to their parents than their married siblings -- especially the single sisters. While 68 percent of married women help with caregiving, 84 percent of the never-married do. And while just 38 percent of married men help out their parents, 67 percent of never-married men do.

You might think, "Of course -- single people have fewer obligations," but that would be incorrect, says registered nurse Angil Tarach-Ritchey, who works with the Visiting Angels senior support organization.

"It is assumed that a single person has less to do when they are not caring for a spouse, which couldn't be further from the truth," she says. "Singles have to run entire households without help, which can lead to serious burnout when you add that to elder care. I often see these caregivers putting their loved one's needs before their own, and feeling guilty when they even think about their own needs.

"Women in general put everyone and everything on the to-do list but themselves. But all caregivers are at risk of burnout if they don't take steps to prevent it."

What form does burnout take? According to a policy brief by the University of California-Los Angeles Center for Health Policy Research, the stress can be emotional, physical, time-related and financial. With the U.S. Census projecting that the population of those 65 and older will more than double in the next 30 years, the burden of largely uncompensated care by family and friends will rapidly increase.

Among the findings: Caregivers report moderate or serious distress levels, with almost one-third reporting that their emotions interfere with their household chores (30 percent) or their social lives (33 percent). The study also found that caregiving is time-intensive, with one-third of respondents spending an average of 36 hours a week on caregiving -- almost as much as a full-time job. It also can hurt financially. Only 7.4 percent of informal caregivers reported being paid for the help they provide. Moreover, nearly 20 percent said they spent $250 or more of their own money on caregiving in the past month. Only 13.5 percent of caregivers report ever using any respite care for themselves.

Falling into the trap of excessive caregiving is easy, says Tarach-Ritchey. "Many aging parents have a way of guilting their adult children into providing for all their needs by refusing outside help and telling the caregiver that they are the only one who can do whatever they're asking for."

So how can an adult child draw the line? What steps can a person take to avoid burnout? After all, in most cases, being a caretaker usually isn't a sprint, but a marathon that can last for years.

Tarach-Ritchey offers 10 pointers for caregivers:

1. To avoid burnout, start by doing a self-assessment. Write down commitments that aren't flexible, such as jobs and tending to children's needs. Next, list all the necessary tasks that need to be completed to run a household, such as shopping, cleaning, paying bills, and home maintenance. Next, it's time to schedule some "me" time. Whether that is an hour a day or four hours a week, there must be time to rejuvenate -- whether reading time, going to lunch with a friend, getting a massage or just resting in peace and quiet. This is critical to avoid burnout.

2. After completing an assessment, see what time is left over to provide care. In the time available, you'll need to list the most important things the loved one needs help with -- and the things you're able to do.

3. Make an additional list of family members or friends you can solicit for help. Most people don't get involved because they haven't been asked. These people can be asked to help shuttle to doctors' appointments, drop off meals or do some chores.

4. Sit down with the person needing assistance and have a truthful conversation. It's preferable to include all the people who will be helping. Discuss what the parent's true needs are, who can help and when. Also discuss your own commitments.

5. Be firm in what you can commit to, and do not back down. If you're not able to meet all their needs, it's time to discuss outside help. Many aging adults do not accept loss of independence and deny the need for help, even when they're running an adult child ragged. They will refuse outside help by saying they don't need help. Be understanding but firm.

6. Don't be afraid to ask parents to contribute to their own care. It's important not to do things for care recipients that they can do for themselves. What they don't use they will lose. Involve parents or ailing relatives in tasks as much as possible. If a parent cannot use the stairs to do laundry in the basement but he can gather and separate dirty clothes or fold items out of the dryer, ask him to do that. Parents need to do whatever they are capable of doing, or they will quickly become more dependent.

7. Let go of guilty feelings. No one can "do it all," despite what we've been led to believe. Guilt is a heavy contributor to burnout.

8. Put safety first. This is especially important for those who have parents with dementia, who often want to continue making all the decisions, even when those decisions are no longer appropriate.

9. Don't take mom's anger personally. It's hard not to be overly concerned when a parent gets angry, but it helps to keep in mind that the anger is generally really not about the caregiver -- it's more about the changes the parent is going through and the inability to accept those changes.

10. More than anything, be as aware of your own needs as you are of your parent's. Your ability to help will decline if you don't attend to your own health and happiness. Don't be afraid to put yourself first sometimes.