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PREVIEW
The shift of healthcare to the ambulatory care setting has resulted in a dramatic increase in the burden placed on a patient's family and other loved ones. Despite this fact, caregiver burden and burnout are probably greatly underidentified by primary care physicians. The authors of this article provide information that will help to better identify and manage these trying situations. They also alert physicians to the possibility of their own burnout and the need to maintain a healthy perspective.
Informal or lay caregiving is the act of providing assistance to an individual with whom the caregiver has a personal relationship. Caregiver burden is defined as the strain or load borne by a person who cares for an elderly, chronically ill, or disabled family member or other person.1 (Reference) It is a multidimensional response to physical, psychological, emotional, social, and financial stressors associated with the caregiving experience. The caregiver's perception of the burden, rather than the perception of other family members or healthcare providers, determines the impact on his or her life.
Caregiver burnout is the progression of caregiver burden to the point where the experience is no longer a viable or healthy option for either the caregiver or the person receiving care.
Prevalence
The prevalence of caregiver burden has been described in multiple surveys. Results of a 1992 study by the Carers National Association indicated that one of every two caregivers had financial burdens and that two of every three were in ill health themselves.2 (Reference) Other studies show that (1) a large majority of caregivers have experienced fatigue, frustration, and stress as a result of caregiving, (2) two thirds believe that caregiving has put a strain on their marriage, and (3) one fourth have felt despair as a result of the caregiving experience.2 (Reference)
Effects of caregiving
Home care of chronically ill persons has received considerable attention in recent years. However, difficulties experienced by caregivers often are considered only after the signs of burnout are apparent. Illness frequently has a ripple effect across the entire family group, affecting both the health of other family members and the quality of care they deliver.
Family members and other providers often accept responsibility for the care of those with chronic health needs. Typically, they do...