"Why haven't you visited me?" asked Heather's* mother, who lives in a nursing home. "I haven't heard from you or seen you in over a week."
"Mom, I am so sorry, I will be there on Thursday, I promise," Heather said. "Work has been extra busy this week."
After hanging up the phone, Heather felt paralyzed and overwhelmed with her responsibilities. Besides caring for her mother, she was also raising two teenage daughters and managing a business. Her mother often complained that Heather didn't visit more or do enough. Heather feared being disowned if she let her mother down. As a result, she often felt guilty and never said no to her mother (or anyone who needed her). She felt burned-out and directed her stress and irritability toward her husband, Jeremiah.
Caregiver burnout can happen in many situations. Perhaps you are your grandson's sole caregiver because your daughter cannot adequately care for him. Maybe you're the parent of a child with a disability who requires constant care. Or possibly, like Heather, you're the adult child and primary caregiver of an elderly parent whose health is failing. Whatever the circumstances, taking care of a family member without taking care of yourself can harm your emotional, physical and relational health. Here are some tips to help you develop self-care strategies:
Discover caregiver self-care
Self-care includes relaxing and recharging, setting boundaries, asking for help, joining a support group and having self-compassion. When a flight attendant explains safety procedures, he tells parents to put their oxygen masks on before putting a mask on a child. If you place the mask on your child first, you may become too disoriented to help yourself. The same is true of caregivers. If you don't make time to care for yourself, you will eventually burn out and help no one, including your spouse. That's what happened to Meredith and her family.
Fifty-four-year-old Meredith loved her mother who was starting to show signs of dementia. She spent a great deal of time at her mother's house, helping, organizing and cleaning. She inadvertently started to neglect her husband, David, and their children. Sadly, Meredith and David did not communicate well before Meredith's mother got ill. They did not prioritize their marriage and often lived separate lives in the same house.
Because they did not discuss their priorities, feelings, thoughts, schedules and concerns on a regular basis, Meredith ended up stressed and overwhelmed but did not realize it. Feeling frazzled became her baseline. She was often snapping at her immediate family members because she was running on empty. If Meredith and her husband had had better communication before she took on caring for her mother, they may have avoided caregiver burnout.
Meredith's story is just one example of how caregiver burnout happens. Many marriages suffer as a result. Caregivers must take care of themselves to maintain connection and healthy communication with their spouses, even during trying times. That includes taking time to relax and recharge.
Relax and recharge
Every individual relaxes and recharges in his or her own way. Reading books, going out with friends, soaking in the bath, exercising, meditating or listening to an encouraging podcast are just a few examples.
Not surprisingly, some caregivers only recharge when they feel overwhelmed, but that's not often enough to prevent burnout. You need to re-energize when things are going well, too. For example, many of my clients find exercising three to four days a week benefits their well-being.
In a marriage, sharing what you need and making a plan with your spouse produce a win-win situation. Don't make assumptions about logistical matters such as who will watch the children, how long an activity will take or how you can provide reciprocal time for your spouse. Instead, discuss and make plans openly with your spouse for personal rejuvenation time.
The Lord Jesus himself took the time He needed to recharge after ministering to the multitudes. The Gospels mention Jesus going by himself to pray to the Father (Matthew 14:23; Mark 1:35; 6:46; Luke 5:16; 6:12; 9:18). As Christians, we are to follow this example and spend time in relationship with the Father. This allows us to share our concerns with Him (1 Peter 5:7), and to receive His peace that "surpasses all understanding" (Philippians 4:6-7).
Caregivers burn out for lack of healthy boundaries. They usually feel guilty for not meeting a need that they view as their responsibility. Just because you feel guilty doesn't mean you are. Learn to identify false guilt.
When you feel guilty for saying no, ask yourself if there's something wrong with your response. For example, if a friend said no in the same situation, would you think it was wrong? If not, you are likely experiencing false guilt. If you struggle with guilt for saying no, try suggesting a later date or time to accommodate the request.
Process your thoughts and feelings with your spouse to gain insight and perspective when you have to make difficult decisions. Your spouse may be able to identify when you're taking on too much because he will be picking up the slack at home. He may even be feeling neglected, a sign that you are overextending your loved one's care at the expense of your marriage.
Your time and energy are both valuable and limited commodities. Do you help your loved one out of guilt or manipulation? Do you think you're responsible for making everyone happy? Identify your motives for doing what you do. Reflect on why you do it to the extent that you do. Practice saying no and setting boundaries.
Realize that if you aren't setting relational boundaries, you aren't loving yourself. We're told in Matthew 19:19 to love our neighbors as ourselves, which suggests we can't truly love others until we love ourselves. When you care for yourself with good boundaries, you are able to keep yourself from being depleted of energy, and then you'll be able to give to others in a healthy way.
Prepare for conflict
If you set boundaries and stick to them, people will most likely become upset and angry, especially if you've always played the caregiver role. Your family members or friends may call you selfish. The person you care for may try to manipulate you into letting go of your boundaries and being available at all times.
Be prepared to respectfully disagree, explain yourself and stick to your boundaries. If she continues to disregard your boundaries, accept that she doesn't understand your position. Do not explain yourself again and do what makes you comfortable to continue helping your loved one without compromising your emotional and physical well-being. Assert yourself, maintain healthy boundaries and accept what you can and cannot change. You will feel empowered, grounded and healthy. Don't help your loved one out of guilt or manipulation; instead make a clear, intentional decision about when and for how long you will be available.
Pray for loved ones with whom you come into conflict. The Word of God says our problems aren't with other people, but with the spiritual forces of darkness (Ephesians 6:12), and that our prayers are powerful and effective (James 5:16).
Reach out for help and support
Asking for help and not taking on the entire load alone can help reduce caregiver burnout. Identify people around you who can step in or take turns. Recruit extended family such as mature teens or other adult children. This can help the person in need deepen his or her connection with other family members and help teenagers grow in empathy and gratitude.
Search online for support groups in your area and see what help is available. Check with local churches or nongovernmental organizations and connect with people who are going through similar issues.
According to psychology professor Kristin Neff, self-compassion is talking to yourself as you would a good friend. The benefits of practicing self-compassion include greater emotional resilience and more accurate self-concepts. Emotional resilience prevents caregiver burnout, and an accurate self-concept helps you recognize when you're doing too much so you can set healthy boundaries.
Caregivers who do too much often believe they don't do enough or that there's more they can do. Ask yourself whether the same logic applies to your spouse or kids. In other words, if your spouse overextended himself in a similar manner, would you think he needed to do more? Or would you encourage him to set better boundaries and engage in more self-care? Use your answers to guide you toward practicing self-compassion.
Honor your family by taking care of yourself
Eventually, Heather's husband, Jeremiah, expressed his concern about her well-being. He shared how her frequent trips to the nursing home, along with her work and her family obligations, were harming their marriage. He recognized she needed time to rest and recharge.
She didn't become defensive. They worked together on a plan to set better boundaries, make time for each other and make sure Heather took care of herself. Her mother didn't like it, but she didn't disown her daughter, as Heather had feared.
Be there for your family members, honor your mother and father, and take care of your children. But do not do so to the detriment of your own well-being. Without proper self-care, nobody ends up getting help and often a spouse ends up suffering. By avoiding caregiver burnout, you and your spouse can enjoy a stronger marriage as you support each other during this season of caregiving.Pascual Chen, Psy.D., is a licensed clinical psychologist in Wexford, Pennsylvania.
*Names have been changed.
A variety of marital issues can lead to challenges or even hopelessness for one or both spouses in a marriage. Gaining a sense of hope and direction often requires understanding the underlying issues and relationship patterns which may have led to the crisis. Reach out to well-trained helpers even if you are the only person in the marriage willing to take action at this time. We can guide you as you seek a referral and take your first steps toward recovery. You can contact us Monday through Friday from 6 a.m. to 8 p.m. (Mountain time) at: 855-771-HELP (4357) or