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

An 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.

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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.