Informal caregiving occurs when a loved one provides unpaid, ongoing assistance with activities of daily living for a person with chronic illness or disability (del-Pino-Casado et al., 2021). According to the American Geriatrics Society (AGS, 2020), 14% of American adults serve as caregiver for someone age 50 years or older. Care may be provided full or part time, with 74% of caregivers providing care at least once per week and about 25% of caregivers serving in their role for 5 or more years (AGS, 2020). Although most caregivers only care for one adult, 18% provide care for two or more adults. About 1 in 5 caregivers is financially strained, and some caregivers also have their own health challenges. Unfortunately, over time, the demands of caregiving can have a negative effect on the caregiver's physical and emotional health-a condition known as caregiver stress (or burden).

Signs of caregiver stress include feelings of burnout, self-neglect, excessive use of drugs or alcohol, depression and anxiety, exhaustion, insomnia, and neglect, abuse, or premature placement of a dementia patient in a facility (AGS, 2020). Caregivers who care for patients with dementia or for patient with other intense needs are at high risk for caregiver burnout. Caregivers who have health issues themselves should also be monitored carefully for signs of burnout.

The more the patient can do independently, the less the risk of caregiver burden. Ensuring the patient has the appropriate disciplines (such as nursing, home health aide, therapy, social work, and spiritual care) on the plan of care can aid in patient independence. Other measures that promote patient independence include making sure the patient has grab bars if needed, moving items so they are in reach, providing fall prevention and safety measures, helping develop a routine, and making sure the medications are correct and appropriate for the patient. The caregiver should be encouraged to accept help from family and friends, and should eat well, exercise, and find ways to relax and enjoy themselves. A support group may also be a beneficial resource to allow caregivers to talk about their experiences and feelings to lessen the burden. Additionally, remind the caregiver that if a patient with dementia or other mental/emotional problems says hurtful things or gets angry, it is not a personal attack. It is the illness causing the angry or hurtful words. Seeking help from professional services/agencies/organizations in the area may also help reduce the burden on a caregiver. Some of these professional services may provide help with financial assistance, transportation, meal delivery, respite care services, home aides, and adult day cares.

Clearly, caregiver burden is a significant concern for those caring for loved ones. The longer care is needed and the more assistance the patient requires, the greater the risk for caregiver burden. Home health clinician can provide strategies and resources to help deter or lessen caregiver stress, which is of benefit to both the patient and caregiver.

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