Measuring Family Caregiver Strain – Knowing is Key to Burnout Prevention

Family caregivers do so much each and every day but are often left feeling they have not done enough.

There are so many needs that must be met, including their own.

As a family caregiver, how do you handle it all? Are you tired at the end of the day? Is your brain worn out? Is your body physically hurt and you are in pain?

Have you stopped during the day to eat, rest, do personal hygiene or care for your personal business?

Many family caregivers don’t get all that done, let along having a chance to read that new bestseller or see the latest movie at a theater!!

Caregivers know this about other caregivers – we don’t always take the time to care for ourselves and we can really impair our ability to continue being caregivers which is the one thing you want to be able to keep doing as long as you are needed. Am I right?

Caregiver Strain Index

Recently I came across this assessment from the Hartford Institute for Geriatric Nursing, New York University College of Nursing called the Modified Caregiver Strain Index (MCSI). It was updated in 2003 from a version called The Caregiver Strain Index of 1983.

It seems to hit all the buttons for caregivers and may help us to realize that we all have our tipping point and should be aware of how caregiving affects us physically and mentally so that we can recognize and plan for burnout.

This assessment is a 13-question tool that measures strain related to the care we provide. It covers a wide range of subjects, including financial, physical, psychological, social, and personal concerns common to family caregivers. Each question is scored with 2 points for each ‘yes’, 1 point for each ‘sometimes’, and 0 for ‘no’ responses.

The higher your score, the higher the level of caregiver strain you are experiencing.

The index is self-performed; in other words, you can complete it yourself. Because the higher the score the more strain is felt, it is important that caregivers take action when they have a high score. Interventions should be put in place to ease the burden felt by caregivers who report high levels of strain. Some things to consider, according to the authors of the assessment, are family conflict, conflict between employment and caregiver, financial strain, cognitive status of the senior adult, caregiving training and caregiver social support.

Another variable to consider is whether the family caregiver also works outside the home or is also responsible for their own family. Being part of the sandwich generation – caring for children, aging family members, household, careers and yourself – can add high levels of strain and stress to even the strongest person.

Burnout Prevention is Important

There are many consequences to caregivers and our senior loved ones when caregiving becomes stressful or feels under constant strain.

  • Caregiver strain or burnout is one of the leading causes of our senior loved ones being admitted to long term care facilities. When we overwork and overstrain ourselves as caregivers, we can no longer provide the care at home that our seniors need to be safe and healthy. This failure to have a caregiver present who is capable of meeting their needs leads to their loss of independence and aging in place dreams. They would much rather you stop and take a break, get help and even have planned respite so that they can stay home with you as long as possible.
  • When caregivers don’t care for themselves properly it can lead to physical injuries and even disability for the caregiver. Being exhausted can result in safety risks to yourself and your senior.
  • It is important to get your own health check-ups, see the doctor when needed, get immunizations and learn safe techniques for caregiving in order to stay well.
  • A 2003 study on caregivers found that stress ‘really can kill you.’ It found that there was a significant deterioration in the health of caregivers when compared to non-caregivers but also found the caregivers had a 63% higher death rate than the control group. That is pretty amazing.
  • Emotional burdens can also plague caregivers who are doing too much and not seeing to their own health. Emotions such as resentment, anger, frustration and even embarrassment can impact our physical health too.
  • Depression is not uncommon for many family caregivers due to the isolation often coming along with caring for senior loved ones, especially those with mobility issues that keep them at home. It seems to be even greater in those who are caring for a person with dementia. Oftentimes caregivers are too busy to keep their friends close and interacting as they once did. There isn’t time to talk on the phone, go out for lunch or spend the day shopping with our best friends anymore therefore we tend to lose touch with ourselves which can lead to depression. Worrying about our senior loved one takes its toll on caregivers. It has been shown that depression does not always lift when the senior moves to a facility or even after their passing. Seeking coping strategies and treatment for caregiver depression is important as it can lead to other health compromises.
  • Caregivers with chronic stress may be at greater risk for cognitive decline including loss in short-term memory, attention and verbal IQ, according to a Psychology and Aging report.
  • Constantly feeling as though we are under stress can lead to immune system problems. Our body reacts to the increased stress we perceive and sends signals to our brains which then begin bodily changes such as increased heart rate and over activity of the immune response. These changes have long term effects for our health as busy caregivers. Impaired immune systems can mean that caregivers get more infections and are susceptible to other diseases. Being ill could mean your inability to care for your senior loved one over the long run.
  • Lack of health insurance coverage for caregivers can be a real problem to overcome in order to access the healthcare that is needed not only for prevention but for injury and managing chronic health conditions. Caregivers who have to leave their jobs to care for their senior loved ones find themselves without health insurance which keeps them from properly caring for themselves.

Family Caregiver Health Issues

According to the Family Caregiver Alliance, “evidence shows that most caregivers are ill-prepared for their role and provide care with little or no support yet more than one-third of caregivers continue to provide intense care to others while suffering from poor health themselves.”

There are things you can do to overcome some of these health consequences that begin with recognizing there could be or already may be burnout.

There is definitely stress associated with family caregiving.

You should start by taking time to care for yourself and your needs. Schedule time for it on your calendar if that’s what it takes.

Get help from others, seek out respite care and get support from in person or online groups. Cultivate a strong network who can support you physically with day to day tasks and emotionally with a shoulder to lean on and kind voice with which to regularly discuss your issues.

Take a class about caregiving and learn coping strategies and techniques that will help you be a more balanced caregiver providing safer care to your loved one.

You are worth the time and effort it takes to keep you healthy!