Left Unchecked, Caregiver Burnout Can Lead to Abuse and Violence


Caregiver burnout can lead to feelings of anxiety and depression, but when it goes unrecognized and untreated, the results can be tragic.

An AgingCare.com reader recently shared the strain of caring for her aging mother on the Caregiver Forum: “I truly feel that the only thing that keeps me from taking my own life is that there will be no one to take care of my mother.”

Sadly, thoughts of suicide and even causing harm to their care recipients are not rare for stressed caregivers. Research cited by the National Center for Elder Abuse shows that 20 percent of caregivers “live in fear that they will become violent.” This fear is even more prevalent in caregivers who have been on the receiving end of violence from the person they care for and caregivers who live with their care recipients.

Even though these feelings are fairly common in overburdened caregivers, they are still a dangerous red flag. It is important to realize that, although abuse isn’t always deadly, it is physically and/or emotionally harmful on a daily basis. Multiple studies have found that an estimated one-third of caregivers have verbally abused a family member. Acknowledging negative thoughts and taking steps to ensure they do not become destructive actions is crucial.

There Are Many Types of Elder Abuse

Unlike physical abuse, which is clear-cut and more easily identifiable, neglect is a more insidious form of abuse. The Centers for Disease Control (CDC) define neglect as “failure by a caregiver or other responsible person to protect an elder from harm, or the failure to meet needs for essential medical care, nutrition, hydration, hygiene, clothing, basic activities of daily living or shelter, which results in a serious risk of compromised health and safety.”

Dr. Diana Denholm, a board-certified psychotherapist and author of The Caregiving Wife's Handbook: Caring for Your Seriously Ill Husband, Caring for Yourself, shares this example of neglect and why it may occur: If a distressed caregiver feels that the person they’re caring for isn't happy with the food they serve, they may think, “He isn't eating the food I prepare, so I'm not going to give him anything.” The caregiver’s deprivation of food results in starving the patient.

An exasperated caregiver’s reactions to their situation or their loved one’s attitudes and behaviors can quickly spiral out of control. If you're having thoughts of self-harm or harming others, or you’re feeling that you're being pushed to the edge, there are ways to reduce your stress levels and find help for your loved one and yourself.

Ways to Minimize Caregiver Burnout

  1. Establish Expectations
    Sometimes our expectations and those of others can be our undoing. Talk to your care receiver and determine which tasks you will do for them and which tasks they want to do for themselves. If you stop enabling a co-dependent relationship, your anger level is likely to drop because you won't be taking on every task yourself, Denholm says.
    For example, your dad may want to dress himself. If this is a safe activity of daily living for him to accomplish on his own, then check it off your list. “If he dresses himself and puts on a polka dot shirt and plaid pants, you must leave it alone,” Denholm notes. It isn’t worth the stress of redoing the entire task.
    If you have a micro-managing personality, letting go of some roles can be a challenge. However, you must learn to slightly lower your expectations. Learning to share control in a healthy manner and creating realistic expectations will make caregiving easier on both you and your care recipient.
  2. Ease Family Tensions
    When another family member who isn’t involved in providing daily care thinks they have all the answers, it can be very irritating for the primary caregiver, Denholm says. Even simple questions, such as “Why is Mom wearing that?” and “Shouldn't she have a more comfortable bed?” can spark arguments and even violence.
    The Mayo Clinic recommends holding a family meeting to discuss roles and responsibilities as well as disagreements about care decisions.
    The financial aspect of providing care is an especially common source of familial tension. Invite a counselor, social worker or clergy member to join you and help mediate the discussion. Periodic meetings or conference calls are an excellent idea for keeping everyone involved and discussing changes in responsibilities and new care decisions.
  1. Seek Peace at Home
    “There will be times where you must agree to disagree,” Denholm advises. If your parent wants to eat a certain food or handle their condition in a particular way, don’t push the point to get your way. If something is annoying you, take a deep breath and remember to choose your battles. This will allow you to focus on only the most important issues and help you remember why you love this person and want to care for them.
  1. Avoid Giving in to Guilt
    It is crucial to realize that you're doing the best you can and that no caregiver is perfect. Learn to stop being so critical of yourself and give yourself credit for all of the things you do well.
  2. Be Honest with Yourself
    If you are struggling with your duties as a caregiver, it’s okay to ask for help. Support groups and professional therapy sessions can help you work though difficult feelings, resentment and depression. Regular respite care will stave off burnout and ensure your loved one receives the quality care they deserve and you receive the breaks you deserve.
    Read: Where to Find Respite: Resources for Caregivers
    If you have reached the end of your rope or discovered that providing care just isn’t for you, then you must let another qualified entity take on your role. This could be another family member, a professional in-home caregiver or a senior living facility.
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Most of us just kill ourselves by dealing with all of it internally. The Mayo clinic suggests "holding a family meeting to discuss roles, responsibilities, disagreements, decisions etc."! YEAH RIGHT! Maybe that happens in the "Cleaver" home, but not in my family. My siblings are a malicious bunch who I fear might kill ME, and I've been dad's live-in caregiver for 5 years with zero, and I mean zero help from either of them. They admittedly "hate" me, and claim to "always have". Why; your guess. They "hate" many people, and things in life. I do not know the word "hate". Being alone, living with, and caregiving for a seriously ill parent for 5 years with no one helping you is maddening. I can easily imagine how someone who has either no support, vicious family members or who are all alone could snap. All these "Dr.'s", and "experts" have a LOT of advice. I wonder how many would run right over and deal with what we have to? What we caregivers need is serious hands on organization just for US! We need a hotline we can call when things get crazy, and know that someone will come out to us and help. Ha . . . Yeah right; maybe in the next life. All I can say is thank God most of us are able to keep it together. All we do is hurt ourselves, a crime no one will punish us for except ourselves.

Dear Redhead,

        Despite all I've done for my dad, literally jumping through hoops for him he still gets angry and even vicious with me at times. He has no dementia either which makes it worse! It just hurts like hell, and I just don't understand it. He has blamed me for these past years for the terrible relationships I have with my sisters. He refuses to believe that it has been they who have created these underhanded malicious wars. I tried to reach out to both of them several times to try to get them to come to therapy with me so we might heal what's going on. My therapist has also called each of them four times each, and both of us have been met with resounding "NO'S". I actually took dad to one of my therapy sessions in the hopes that mr. Dr. could help him understand what was really going on. Dad seemed to start to believe it, but after two weeks was right back believing them. My dr. even asked him to ask my sisters himself if they'd go . . . They both told him "It would be too toxic for them."!  They have made my life a living hell here, and despite my deep love for Their resentment of me goes way way back, and my dads illness is triggering huge anger and guilt. They have now actually masterfully coerced my dad into believing I have done something to break up everybody including him!!!!!!  They were actually trying to persuade him to make me leave our home!!!!!! Here we are . . . At the end of his life, and he's angry, cold and mean to his eldest daughter who gave up her own personal life to care for him. Initially I was so angry, disappointed and hurt by him. After feeling sick inside for a couple of weeks I called elderly affairs. They were so kind, and expressed that i have no need to prove anything. They advised me to simply continue to be the good person i am but to tell them i would no longer be doing any chores, cooking or shopping. They said if my sisters after 5 yrs. now want me out of my house, let them take over . . . But do not leave. Despite dads anger he did assure me that he never asked me to leave. It is all due to bullies pulling the wool over my dad and his elderly sister. I can do no more to convince him of anything. I finally realized how ludicrous it's been of me to repeatedly try to prove my "innocence". His thoughts are for HIM to own . . . NOT ME. I'm a person who knows these things, but when a loved parent is involved I sometimes forget to remember spiritual truths I have worked to understand. Family can bring out the best, and the worst in us. They are able to dig into our soul's in a way no one else ever could. I have come to understand just how much I've loved him due to the viciousness I've tolerated from my sisters. That is a HUGE sacrifice; one I would never do for anyone else. I do love my sisters, and always will but I have made sure to keep my distance from them for many years. I avoid negative people, and strangely have never known two more vicious toxic people in my entire life than my own sisters. I used to feel so sad about it, but have recently had an epiphany. They were given to me by the Universe to learn a very serious lesson. They are here to teach me forgiveness . . . True forgiveness.

I recently was online digging around for a different definition of forgiveness. Amongst all the cliche rhetoric we all here all the time, I found the missing piece. The very first ancient Aramaic definition of "forgive" literally means to "untie"!! That gave me the comfort I needed. All I can do now is to keep loving dad despite his feelings or beliefs in me, and continue to be the kind person I am despite how nasty they all behave. I hope this gives comfort to some. You are doing the jobs of angels. Go earn those wings, and forgive yourselves when you have bad thoughts here and there!!!!!!!!!!!  You are just human.

I found a spectacular quote recently written by Mother Teresa. It goes like this:

‎"People are often unreasonable, illogical, and self-centered; Forgive them anyway.
If you are kind, People may accuse you of selfish, ulterior motives; Be kind anyway. 
If you are successful, you will win some false friends and some true enemies; Succeed anyway.
If you are honest and frank, People may cheat you; Be honest and frank anyway.
What you spend years building, someone could destroy overnight; Build anyway. If you find serenity and happiness, They may be jealous; Be happy anyway. 
The good you do today, people will often forget tomorrow; Do good anyway. 
Give the world the best you have, and it may never be enough; Give the world the best you've got anyway. 
You see, in the final analysis, it is between you and God; It was never between you and them anyway."

~ Mother Teresa
In Light and Love,

It is only going to get worse in the years ahead as more people are living to be older.
Pills and procedures can keep some people alive long past when THEY want to be alive or past when they can enjoy life.

There are now people in their 70s trying to care for parents in their 90s and above.

I wish everyone a healthy, happy life but I do not fault the man in his 80s who made the decision that his life and his alz wife life were over. If a husband and wife have made a life decision for the future I don't think the gov or anyone can fault them for deciding when their time came.

endofmyrope is right... most people ruin their 50s-70s with stress over teenagers and NOW parents living into their 90s.