Moving Us Closer To Osler
A Miller Coulson Academy of Clinical Excellence Initiative

How to Mitigate Caregiver Burnout

Encourage caregivers to get support.


Caring for a loved one can be emotionally exhausting. Remind caregivers to prioritize self-care and encourage them to seek support from others.

Mrs. X, an 83-year-old woman with advanced dementia whose primary caregiver was her daughter, was my last home visit of the day. As I was wrapping up the visit, I turned to the daughter and asked, “How are you doing?”


“I’m so sorry to be crying,” she said, “You’re the first doctor to ever ask about me, and I’m not doing well. I feel like I’m never doing enough for my mom.”


Over the next half our, I listened as the daughter shared the physical and emotional exhaustion that was taking a toll on both her marriage and her relationships with her own children. “I do everything I can to help my mom and be present for my husband and children,” she said. “But I feel like it’s never enough.”


Recent estimates show that at least 20 percent of adult children are caring for an older parent, and 75 precent report that caregiving is stressful. As physicians, we’re taught to care for the whole person, and it’s therefore important to acknowledge that giving holistic care also involves supporting your patient’s caregiver, in particular watching for the signs of caregiver burnout.


Here are 4 of the root causes of burnout:


1. Caregivers may have conflicting demands and workload.

In addition to their role as caregiver, they also have to take care of themselves and may also be working full-time.


2. Caregivers may have unrealistic expectations of themselves.

Many view caregiving as their exclusive responsibility and are reluctant to ask for help.


3.  Caregivers may feel the societal pressure that they’re not doing enough.


4. Caregivers may struggle with uncertainty.

Many aren’t trained to give medical care, and therefore experience uncertainty about their skills to effectively manage their loved one’s care.



7 signs of caregiver burnout to watch for: 


1. Emotional and physical exhaustion

This can manifest as frustration, fatigue, difficulty concentrating, and withdrawal.


2. Insomnia


3. Changes in appetite/weight


4. Skipping their own medical and mental healthcare appointments.


5. Substance abuse


6. Elder abuse


7. Suicidal and/or homicidal ideation



3 strategies for mitigating caregiver burnout:


1. Education

Educate caregivers about their loved one’s disease and the expected trajectory.


2. Emphasize self-care

Remind caregivers that, “You can’t pour from an empty cup.” Encourage them to take care of their physical, mental, and emotional health.


3. Encourage them to get more support.

Advise caregivers to recruit family members and/or to hire an aide if possible. Connect them with available resources available in their community.



It’s also important to regularly commend the caregiver for the care they’re giving and to accept their limitations as part of being human. 


After we explored the concept of caregiver burnout and ways in which the daughter could get more help with her mother’s care, I took her hand and said, “You’re doing your best. Your efforts are enough.”




This piece expresses the views solely of the author. It does not represent the views of any organization, including Johns Hopkins Medicine.