When Burnout Results in Family Caregiver Neglect
When caregiver burnout results in family caregiver neglect everyone suffers. Research confirms that caregivers become sicker than the person for whom they care. Aging parents, spouses, and loved ones who need care rely on and trust the caregiver to make good decisions.
What happens when the husband, wife, son, or daughter becomes exhausted and abusive?
Who will step in to advocate? If you are a caregiving professional you have a mandatory duty to make a report about suspected elder abuse.
You make the report and the police and adult protective services will complete an investigation. Reports can be made on a confidential basis so that your identity is not revealed.
Causes of Caregiver Burnout
Caregiver burnout is caused by emotional and physical factors. The level of stress associated with a caregiving situation affects caregivers differently. Stress can be managed positively by attempting to anticipate problems before problems begin. Being proactive involves having a plan or multiple plans for responses to manage family caregiver neglect if and when it does arise.
Unfortunately, because caregiving represents the unexpected, few caregivers are proactive to anticipate problems and have backup plans in place. The aging adult, who likely did not plan to need care, also fails to do the same.
Ongoing declines in health, weight loss, malnutrition, poor medical care, not taking medications, and changes in conditions from day to day result in caregiver burnout. Many of these conditions result from the caregiver and the aging adult lacking the skills and knowledge about how to manage care.
Help Offered May Be Help Refused
When offered help, caregivers and aging adults refuse because they think they can manage the situation. Caregivers commonly believe that they have to do it all.
There also may be concerns about having others involved in the care situation. These thoughts are the beginning of the downfall of many family caregiver neglect situations.
Distrust of the medical and healthcare community exists among consumers. Because healthcare literacy is low in the United States, caregivers and aging adults fail to understand simple explanations.
They fail to follow up with suggested care. As a result, the health of loved ones continues to decline. Feelings of stress and caregiver burnout continue to increase.
The risks continue to grow. Older adults refuse or are unable to follow orders for taking prescriptions. Others lack the skills to evaluate the pros and cons of medical decisions.
When caregiving stress and feelings of overwhelm exist, decision-making becomes cloudy. Caregivers resist making decisions because they don’t know what to do.
Any effort beyond making it through the day is too stressful. Caregivers may turn to drugs or self-destructive behaviors.
Important information that should be communicated to a primary care physician is passed off as not being important. Family caregivers with few caregiving skills don’t know what information is important to the care of loved ones — and what information is not. Health issues with aging loved ones and low healthcare literacy result in caregiver burnout and stress and neglect of care for the aging parent or spouse.
Abuse and Neglect Happen in the Home
Most cases of family caregiver neglect and abuse happen in home situations. A family caregiver more often commits the abuse. The goal of most aging adults is to stay at home, but they are unable to do this alone and without help.
The idea of staying home and all of the tasks required usually involve help from family members. When parents or aging adults live at home and health declines, isolation often happens. They are less able to get out of the home without some type of assistance.
Isolation happens because friends visit less. The older adult may have lost the ability to drive. In other situations, health declines, memory loss, anxiety, and other behaviors make the aging adult a person that others—besides the caregiver—don’t want to be around. These examples are all risk factors for family caregiver neglect and abuse.
Adult children and spouses are the main culprits causing poor care and neglect. Caregiving stress affects the ability to gain clarity about needed care. Burnout prevents being proactive to make good medical decisions.
Apathy and lack of action become the norm instead of the exception. Caregivers fail to realize how their negative attitudes and actions have an ill effect on the care of aging parents or a spouse.
Frustration and Impatience Lead to Family Caregiver Abuse
Caregivers who experience stress are easily frustrated. They find ways to cope that may prove harmful to the care situation. Some caregivers avoid problems and find ways to escape. These escapes may include alcohol or drug use. Other caregivers may disappear for hours or days without telling anyone.
Unexplained or unplanned caregiver absences can leave to worries of abandonment by the aging parent or spouse. While these activities may provide short-term relief, they are no solution to the longer-term problem that may exist.
As a result of these behaviors, harm may come to loved ones in unexpected ways. Medications may not be set out or organized correctly, resulting in an emergency room visit because health is not being managed well. Weight loss, malnutrition, dehydration, or constipation may be ongoing problems that result in an altered mental status, also called delirium.
The aging adult loses the ability to hold sensible conversations, may slur words, or say things that are out of character. The caregiver becomes frustrated and does nothing to investigate or solve the problem. Health declines become more extreme and irreversible.
Caregivers Can Feel Entitled to Money and Property
Family caregivers feel entitled to money and personal items because they gave up their life—or their job—to be a caregiver for an aging adult. Entitlement is another concerning situation, especially if the caregiver moved into the home.
Caregiving spouses can become overcontrolling and have their own health issues. Longstanding habits or mental disorders become more apparent when a single spouse is a caregiver. Previously both of the aging parents were able to accommodate negative habits or behaviors.
Now that one spouse needs care, accommodating negative behaviors is no longer possible. Adult children are often shocked by behaviors that occurred during a lifetime but were hidden in the marital relationships of their parents by one spouse.
Isolation and Control
Situations where a single child lives with an adult parent quickly become abusive in many ways. Other children and family members may be denied visits.
Phone calls may be monitored. Money in bank accounts may be used for the personal needs of the caregiver without the aging parent knowing what is happening. Family caregiver neglect and abuse happen in many forms.
These types of caregiving situations become overcontrolling and dangerous to the health of the aging parent. The caregiver views the situation as if he or she is doing all for a parent without realizing that harm is the result of these behaviors and beliefs. Similar situations happen when spouses are caregivers.
Family members who have concerns may be kept at arm’s length by the caregiver living in the home. The aging parent may feel as if they cannot complain or express concerns for fear of physical or emotional harm by the family caregiver.
The situation progresses until harm occurs. Whether it be a hospitalization, a fall, or a serious health concern, this event should serve as a wake-up call that concerns about the care being provided exist.
Regret and guilt are experienced by other family members about how harmful the situation had become. There is a realization that someone should have done something—but they did not.
Mandatory Duty to Report Elder Abuse
After an accident or harm occurs and cannot be hidden, hindsight confirms that there were signs of abuse that existed, but no one paid attention. Paid caregivers may have noticed small ongoing injuries like bruises on the hands or the arms that indicated poor transfers or attempts to restrain the aging parent.
Medical issues that continued to be out of control that could have been managed better are noticed. Delays in seeking medical care for fear that the abuse or neglect would be discovered are now well realized.
The desire to hide information by family caregivers committing neglect includes the idea of changing medical doctors to avoid the prior physician questioning significant changes or neglect.
But if you are a physician or healthcare provider your duty is to protect a client or patient. If you’re not sure what steps to take, consult your supervisor.
Abuse and Neglect by Self-Interested Family Members
When family caregivers have a vested interest in living with an aging parent, extreme actions will be taken so that the situation is not interrupted by outside parties. While it may be difficult to prove harm, it is possible with an intervention and a monitoring or safety plan being put into place.
In extreme situations, where no hope exists, family caregivers murder the person needing care. Stories in the news about these occurrences are shocking. Situations of family caregiver neglect and abuse that include murder make it clearer that caregiving should be a life-long discussion.
Family members who may not be involved on a day-to-day basis must remain involved. The oversight that may not be welcomed by a brother or sister will be welcomed by an aging parent or a spouse if abuse is happening.
The life transition of caregiving benefits from caregiver support groups, caregiving courses, and interactions that raise confidence and self-esteem while reducing caregiver stress and burnout. Caregiver burnout should never result in neglect.
Looking for more resources for caregiving families or yourself, check out Pamela’s complimentary online webinar program about caring for elderly loved ones.
© 2019 Pamela D. Wilson, All Rights Reserved.
© 2019 Pamela D. Wilson, All Rights Reserved.