Caregiver Burden – Part of the Assessment, Goals and Recommendations

Care Managers are always focused on their clients’ needs and wellbeing. Caregiver stress should always be included as part of the assessment of the client. Caregiver stress can lead to burnout and is linked to a higher chance of abuse. In 2020, 41.8 million Americans, nearly 17% of the U.S. adult population provides unpaid care to an adult over the age of 50. More than 75% of these caregivers are women. (Samuels, 2023).

The first step in addressing caregiver burnout is part of the assessment process. A great tool given to caregivers to complete is the “Caregiver Burden Scale”.  This is a 22 question tool that asks questions such as “Do you feel angry when you are around your relative”. And “Do you feel stressed between caring for your relative and trying to meet other responsibilities for your family or work”? Each question is rated on a scale from 0 = Never to 4 = Nearly Always. After completing the survey, the numbers are tallied to show if the caregiver has little to no burden, mild to moderate burden, moderate to severe burden, or severe burden. I personally used to give this questionnaire to all the family caregivers that were present during the assessment and allowed them to privately fill it out and give it to me while I continued speaking with the client. Another way is to email each caregiver the survey to complete and send back privately. The surveys are not shared across multiple caregivers as it is a personal thing to be addressed with each caregiver individually.

The goal for caregivers is to minimize stress and burnout, so they can care for their loved ones as they wish and minimize disruption to their own health and well-being. The care manager can help provide recommendations to both prevent caregiver burnout as well as minimize the current burnout a caregiver may be experiencing.

Recommendations will be customized to the caregiver and family in need depending on their unique situation. Bringing in outside help for caregiver duties for at least a portion of the day, or a minimum of a few hours a few times a week could help immensely if the family is open to this and have the means. If this is not feasible, discuss asking for and accepting help from other support systems such as neighbors or friends. A day program can be recommended for caregivers who need support during the day and can watch their loved ones in the evening and night. This can be a good balance between accepting help, but not placing the individual full time in a nursing home, which they may not be ready to do quite yet. Support groups are a great resource to recommend to families. For caregivers dealing with dementia, the Alzheimer’s Association typically have local support groups to connect families. Respite care, which can be placement in a facility for a couple or few weeks a couple times a year, may provide some much needed relief. The caregiver typically comes back refreshed and is a good reset. Technology to support the caregiver, such as cameras, personal emergency alert system, remote caregivers, medication administration machines, pill packs delivered to the home, and door alarms are just a few technologies that can lessen the burden of caregiving. 

Addressing caregiver’s needs should always be included in the assessment, goals, and recommendations. Discussing the caregivers needs and health and how this benefits the client can help lessen caregiver guilt over feelings of overwhelm and stress. Self-care is always important for caregivers, so getting enough rest, eating well, taking frequent breaks and making time for exercise are all ways caregivers can care for themselves. Having an open conversation with all involved promotes collaboration and problem solving for best outcomes for everyone involved.

Reference:

Samuels, C. (2023). Caregiver Statistics: A Data Portrait of Family Caregiving in 2023. Retreived from https://www.aplaceformom.com/senior-living-data/articles/caregiver-statistics

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