People who – perhaps partly unconsciously – take on the task of caring for a needy family member run the risk of falling into one of the major pitfalls of informal care: they become overloaded. How does such overburdening arise for informal caregivers and how do we recognize the symptoms?
Causes of overload among informal caregivers
Caring for a family member or partner in need of help in the context of informal care always entails a risk of overload. After all, the relationship between the informal caregiver and the person in need of care changes as the dependency on the person in need of care increases. This has an impact on the relationship and it is usually not positive. The increasing dependency means that the relationship is no longer a relationship of two equal people, but rather a relationship of care provider and care recipient.
Moreover, illness is usually a process in which the care recipient requires more and more care . It is not a predetermined process and the care demands can suddenly double, meaning that the capacity cannot be systematically built up. When the disease process is sudden and accompanied by crises, providing care is very difficult and can lead to overload.
Then there is also the uncertainty about the course of the disease, which can lead to a reduction in carrying capacity. Not knowing what is coming is difficult for the informal caregiver because he cannot respond to the needs of the care recipient. As long as the diagnosis is not clearly made, the informal caregiver cannot really organize themselves.
Finally, there is the subjective burden that becomes heavier as the care needs become more frequent and the duration of care becomes longer. The informal caregiver is therefore burdened both physically and emotionally and has the feeling that informal care is no longer a choice. The impact on the personal life of the informal caregiver is therefore so great that the carrying capacity is exceeded.
Symptoms of caregiver overload
There are three types of symptoms that make it clear that the informal caregiver’s capacity has been exceeded.
- The first symptoms are usually stress reactions such as loss of appetite, weight loss, insomnia, tension or nervousness. These reactions are often dealt with by the caregiver by consuming alcohol, smoking more or taking tranquilizers and/or sleeping tablets. Usually the informal caregiver does not see any problem with these symptoms and therefore does not consult a doctor. He assumes that the care recipient has priority over his own complaints.
- Another type of complaints that clearly indicate overload are physical complaints. Due to the increasing need for care, the influence on the informal caregiver will cause physical complaints such as back and shoulder complaints. Another common complaint is a lack of sleep. After all, sleep is often interrupted because the care recipient sleeps very restlessly or because he has to go to the toilet several times a night. This interrupted night’s sleep can also cause other physical complaints such as concentration problems, chronic fatigue or lethargy. These complaints are minimized by the care provider compared to the complaints that the care recipient has. This is a task for the professional care provider.
- Finally, there are burnout symptoms in which a burnout can occur due to the complete burden on the informal caregiver. There are three possible stages of burnout. In the first stage, there are mainly signs of physical and emotional exhaustion such as persistent headaches, insomnia and/or feelings of depression. In a second stage we notice that the informal caregiver adopts a very cynical attitude towards the situation in which he finds himself. He will also very quickly become angry with the care recipient or the environment. We often see an increase in alcohol or medication use. The final stage brings the patient into a phase of complete aversion to his own situation, sometimes resulting in relationship problems or suicide attempts.
How informal care can become derailed care
As mentioned above, it may happen that in a situation of informal care the dependency between care recipient and care provider changes. This dependency can affect the relationship and turn a good relationship into a tense relationship in which all kinds of stress factors come into play. This not only has consequences for the care provider but also for the care recipient. The growing burden on the informal caregiver can lead to overload on the latter and this has consequences not only for the informal caregiver but also for the person in need of care.
After all, the care that is needed is no longer provided as it is needed and forms of neglect and mistreatment arise (this is not about self-neglect where the patient no longer takes care of himself, no longer maintains his home and no longer enters into social relationships). . Very often, derailed care is immediately linked to elder abuse. This is certainly a form of derailed care, but in the context of informal care it is a term that we must interpret more broadly. Derailed care can also apply to minors in need of care, a disabled or chronically ill person in their fifties, etc.
When we look at derailed care from the situation of an informal caregiver and a person in need of care, it is important to outline that in many cases it is a result of overload of the caregiver goes. A derailed care situation cannot de facto be equated with intentional neglect of the care provider. It is therefore more appropriate here to speak of a cry for help that is the result of powerlessness within a situation that has grown out of control. Of course, this does not alter the fact that attention should be paid to it and that derailed care should certainly be discussed with the informal caregiver.
It goes without saying that malicious intent cannot be completely ruled out. In some cases, the informal caregiver’s intentions are not sincere from the start. This is usually the result of a family feud, a family history in which violence is an everyday reality or a failed relationship where there were conflicts around money. In the latter cases we speak of intentional abuse.