Running Head: CAREGIVER BURDEN 1

Caregiver Burden

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Introduction

Majority of the patients have family members that are offering some degree of

care as well as support when it comes to individuals of different ages suffering from chronic

illness or some sort of disabilities. This care which can be seen as informal to some extent can be

considered in scope, duration as well as intensity. According to Abdollahpour et al (2014),

caregiving in the family raises safety concerns in two ways that are supposed to be a concern for

the nurses no matter the setting. To begin with, caregivers are every now and then referred to as

‘secondary patients', who deserve as well as need guidance and protection. The study that

supports caregivers-as-client view protecting put more weight on protecting family caregivers

health as well as safety, due to the fact that there demands caregiving put them at a higher risk

for injuries together with unfavourable events. Secondly, the family caregivers are usually

voluntary providers who usually need more support to enable them to become more proficient, a

safe volunteer worker with the focus on protecting their family from harm in a better way.

Description of the clinical analysis of caregiver burden

As a community nurse I came across a caregiver who was taking care of patient

with a series of conditions. The caregiver herself opened up to me on the series of

responsibilities that she has, first was to maintain to the residence. Surviving on a limited

financial budget as well as managing a series of the health condition of her own. Falling short of

physical presence required for a support system, she had to bear the entire burden of her husband

short but extreme outpatient care which entailed: driving, preparation of meals, cleaning,

organizing the medicine and oxygen as well as other related activities by herself lacking. With all
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this, she is still hoping the transplant turns out to be successful while being faced with multiple

uncertainties the major one being the one on her husband survival. While asked she slightly

complained but her face showed severe emotional distress, considerable fatigue, sleep deficiency

as well as challenges in maintaining her focus and energy in the entire process of transplant.

I noticed the caregiver had failed to follow the dosage of drugs as prescribed

citing the pressure that the task entails. This had a negative effect on the health of patient as

though there was improvement but it was noted to be extremely gradual. Psychologically the

caregiver was vulnerable with a high likelihood of causing harm to the patient. Her level of

aggressiveness was a concern together with the way she was easily irritable.

Step 3 - Relevance of Topic/ Situation to You Personally and Professionally

This topic highlights the plight that the caregivers go through, to the caregivers

the common assumptions is that though it's a hard task one get used to it. But this topic has

highlighted and given insights on how entailing the role of caregiver is and it also highlights the

challenges they are likely to face or the ones that they should anticipate in future.

The paper also provides the better side of the healthcare workers as they tend to

offer support to the caregivers and reduce the level of stress that they might be going through.

Most of the issues that caregivers face are psychological, therefore the topic tries to link the

psychological issues as part of the burden that caregivers take as the topic goes hand in hand.
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Identification, Discussion, and Analysis of 3 Issues of the Concept Within the

Clinical Situation 
The threat of elder abuse

The existence of cognitive behavioural problems and dementia put the recipient

of care at danger for abusive behaviours towards the caregiver. Abandonment may also take

place, including urinary incontinence, nutritional neglect together with access to food, falls, and

unmanaged pain. Neglect of the caregiver may also occur due to the fact that the dementia

patient is not able to converse and the caregiver is also not capable of comprehending or know

how to handle nutritional intake as well as pain management (Reinhard, n.d). Chappell, Dujela,

and Smith (2015) discovered that counseling, as well as support for caregivers that face

disrupting behaviour from their family members due to illness, will decrease the degree of stress

over their multiyear caregiving responsibility.

Caregiver spends considerable time engaging with the recipient of care, and at

the same time offering care in a vast range of activities. The interaction of the healthcare

professional with the patient is usually limited while caregiving can last from the shortest period

of time, mostly after the hospitalization of the patient to more than forty years of constant care to

a patient with a chronic illness. The devotion needed to deal with a recipient who has a chronic

illness can be taunting to the mind. This has got serious psychological effects to both the

caregiver and the recipient of care which might end up damaging both of them psychologically.

Medication errors

Regarding the skills together with the familiarity of the caregiver, an essential

case in point of the probable to hurt patient is the administration of medications by the
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caregivers. A considerable number of community-based elders rarely recollect receiving any

directives on how they are supposed to use their medications. They usually depend on the

members of their families for help in taking the drugs (Reinhard, n.d).

According to the study conducted by Travis and colleagues, it was discovered

that caregivers only manage amid one to 14 medication daily have the complexity of keeping

track of many prescription and due to the nature of their tight schedule they are prone to miss

doses (Chappell, Dujela, & Smith, 2015). Their roles of monitoring for the toxic or severe effects

within the members of the families who are incapable of reporting like diarrhoea, vomiting,

dehydration and any situations they see an emergency. Caregivers need to have significant

knowledge to be able to identify both atypical and classical severe effects of the drugs they may

see as the condition of their family members' changes and also help in creating critical thinking

abilities that would enhance them to administer possible problems (Reinhard, n.d).

Having the required skills to manage the condition of the patient will also

minimize the emergency situations as the skilled caregiver will be able to identify when the

condition gets worse and when to give the emergency drugs to the patient when need be. The

problem comes when the illness is prolonged as fatigue and normalization of condition may

make the caregiver to miss essential aspects or assume some of the required symptoms for proper

diagnosis. Proper training about the condition and also being able to keenly follow up on the

patient progress would tackle this concern as the caregiver would easily identify an emergency

situation and offer the patient with the drugs as adviced.

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The prospective of harm

The family members of the caregivers can be exposed into two categories of

risk; situational and preventable risks, to begin with, in spite of the fact that they usually have

good intentions in addition to hard work, if caregivers lack essential skills as well as knowledge

to execute their work, they may end up harming their loved ones unintentionally. Such injuries

are normally related directly to shortage or deficiency of skills as well as competence which can

be enhanced by providing the caregiver with necessary education together with the support. For

instance, according to the recent study which established that patients had numerous

unfavourable outcomes when they are managed by untrained caregivers whom they depend on in

terms of enteral nutrition or tube feeding the challenges that they experience include the

displacement of tube, the clogging of the tube, dehydration as well as an infection. Which lead to

a strainful caregiving situation as well as the readmission in the hospital.

The second fear is that the fact that the work of a caregiver is extremely

demanding, this can put them at risk of engaging in the behaviours which may be harmful

towards the receiver of the care, especially among the individuals with cognitive impairment.

Caregivers who are depressed have a higher probability of harming their spouses, caregivers who

are more likely to be depressed in the course of caring for their spouses with physical impairment

or considerable cognitive are more probable to engage in abusive or neglect behaviours like

yelling and screaming, use of physical force or threatening to abandon, withholding meals, or

even handling the patient roughly.

In an overview, family members may be defied to find the ability or capacity to

provide care, nonetheless, Fulmer discovered those caregivers with poor health or whose

incomes are a loan or the ones with the dysfunctional situation are the ones more likely to have
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limited ability to offer the needed care. They might also not be able to understand the standard

for quality and might not offer the level of care that is required

Review the literature

According to Allred (2013), healthcare professional lack of unambiguous

concentration to caregivers is a huge gap in the healthcare and it’s even more embarrassing

considering it’s been more than two decades with documented potential risks of family

caregiving. As it currently stands caregivers happen o be secreted patient themselves, due to the

adverse mental and physical health consequences from the nature of their work is both

emotionally and physically demanding as most of them tend to pay little attention to their own

health and healthcare at large (Hsiao & Tsai, 2015).

Declines in both physical health as well as premature death amongst the

caregivers in totality have been reported. Reinhard (n.d) discovered that family caregivers face a

considerable negative physical cost as the illness of the patient progresses, the caregiver who was

elderly particularly the elderly spouses with the experience of caregiving which is stressful have

a higher mortality rate at 63% in comparison to the non-caregiver who are at the same age group.

The most current, study, indicated that elderly husbands, as well as wives who take care of their

spouses, have ended up being hospitalized for severe illness and they end up having increased

chances of them dying ahead of time.

The deteriorations in caregivers’ health can be specifically linked with

caregivers who see themselves as ladened. Caregiver burden, as well as caregiver strain, can be

easily connected to caregiver's individual poor health status, amplified health-risk behaviors (for
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instance smoking), and a elevated abuse of drugs which have been prescribed to them (Reinhard

(n.d), Many scholars have highlighted the fact that caregivers are often at risk of fatigue as well

as sleep interruptions, reduced immune functioning, increased in the level of insulin and

pressure, modified influenza shots, altered lipid profile, wound taking time to heal as well as a

higher risk for cardiovascular disease.

Burton and Colleagues investigated the relationship between the provision of

care by members of the family and their health maintenance and behaviour. These scholars

discovered the fact that, with an increased height of caregiving activities, and the likelihood of

caregiver neither having rest, nor have enough time for exercise, and in fact not recovering from

illness were also so high (Reinhard, n.d),. Furthermore, caregivers had a higher probability of

forgetting their prescription for their individual chronic conditions. Offering care creates a

danger to the general health of the caregivers, which can interfere with their capability to

maintain to be caregivers. If it’s inevitable for caregivers to continue providing care, a reprieve

from the distress as well as the burden of maintaining the necessary care ought to be measured.

Both exceedingly negative and positive outcome of offering care may be present

concurrently. It is reasonable that the positive consequences, like rewards together with approval,

may caution the pessimistic effects of caregiving. The positive facets of caregiving are vital

some scholars are now using a caregiver rewards scale to better have a comprehensive insight

into the experiences of caregivers. On the other hand, other scholars are surveying the aspects of

care which are positive as the affinity between the patient and caregiver grows. Whitmore,

Crooks, & Snyder (2017), established that preparedness and mutuality did not minimize some of

the tension on the caregiver. Picot and colleagues worked basically with the caregivers who were
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of African American descent and discovered that rewards seen professed by caregivers were

more vital than coping.

A caregiver who tries to strike a balance between caregiving and other

activities, for instance, family, work and relaxation, may find it cumbersome to keep the

attention on the positive portion of caregiving and usually experience more negative responses,

like an amplified sense of burden (Roper et al, 2014). In spite of the amount of care offered,

caregivers maybe happen to be progressively more distressed if they are not able to contribute to

more valued interests as well as activities. More than half of adult children that offer parent care

are underemployment. Hence caregiving functions can have a negative effect on work functions

as caregivers acclimatize the obligation of employment to manage as well as meet the demands

of care. Employed caregivers record missed days, as well as interruptions at work, which has an

overall negative effect on their productivity at work. They have a problem when it comes to

maintaining work functions and at the same time providing support to family members (Ruiz &

Ortega, 2019).

According to Reinhard (n.d), Low household and personal incomes, as well as

restricted financial resources, can have an increased chance of a caregiver risk for negative

results, specifically if there are considerable out-of-pocket costs for care recipient desires. The

unemployed caregivers or the ones with low income ay face more distress due to the fact that

they have limited resources to meet the demands for care. According to Allred (2013), generally,

financial concerns predominantly distress for caregivers during the treatment periods which

appear to belong and the limited resources become washed-out as those with restricted resources.
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Caregiver burden, as well as symptoms depressive, is the major common

negative results of offering care for the elderly as well as chronically ill. Caregiver burden can be

described as a negative response to the impact of offering care on the caregiver's occupational,

social as well as personal roles and attempt to be a predecessor to depressive symptoms

(Reinhard, n.d). Whether a negative outcome is developed by the caregiver appears to be directly

linked to the care recipient's incapacity to execute ADLs, either because of the physical

limitation or cognitive status. If the recipient of the care wanders (linked with Alzheimer disease)

or portrays the behaviour which is considered to be unsafe, the caregiver has to be at attention

and on call for supervision in 24 hours every day. The regular concern for managing disruptive

behaviours (including walking in the street, abusing pills by taking it in excess, cursing and

yelling and many more) also negatively influences the caregivers (Juntunen et al, 2018).

Care recipients cognitive, functional and emotional status envisages caregiver

burden as well as depression. This may be apparent in feelings of isolation as well as loneliness,

fearfulness as well as being simply worried, as the demands of caregiving restrict their individual

time. Care recipient behaviour like yelling, screaming and swearing are connected with

augmented caregiver clinical depression. The depression of caregiver may also have a somatic

module, like fatigue, insomnia, anorexia and exhaustion (Thompson, 2015).

According to Thompson (2015), Caregivers could suffer serious vacillation in

sleep patterns over time, which may impact depression and aggravate symptoms of chronic

illness. Management of pain is an obstinate problem for caregivers that result in considerable

caregiver distress, as caregivers help with both pharmacologic and nonpharmacologic pain

management policies.
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Caregivers are approximated to be around 15 million people and they offer

around $202 billion of free care to the older adults who suffer from cognitive impairment

because of the neurodegenerative diseases, progressive chronic conditions that can lead to

disturbance in behaviour, memory and orientation. Approximately 80 per cent of the caretakers

is family members (Allred, 2013). These caregivers are usually overwhelmed caring for older

people who are suffering from several chronic conditions that happen to be complicated by

cognitive impairment. Older adults with cognitive impairment that originated from dementia

have higher occasions of hospitalization as compared to older adults without a dementia

diagnosis.

The efficiency of managing the symptoms linked to cognitive impairment has

been linked to the lower caregiver burden. According to Abdollahpour et al, (2014), the

healthcare professionals have been of hand in getting involved to ensure smooth transition of

patient to the subsequent setting of care and could use self-efficacy evaluation tool together with

other clinical assessment to further focus on offering post-hospitalization transformation or

transition plan to the patient needs as well as the caregivers.

Caregivers are also linked to the existence of delirium amongst patients with

cognitive impairment during hospitalization period after alteration for multiple other vital

clinical factors. Nevertheless, the use of pharmacological as well as the non-pharmacological

interventions in the course of hospitalization has been discovered to reduce delirium, particularly

amongst the high-risk patients like the ones with cognitive impairment.
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Discussion/ Analysis of How Your Future Practice Maybe influenced

Considering the majority of the study on caregiving remains to be expressive,

there still exist numerous gaps that are evidence-based research to endorse patient quality care

and safety as secondary as well as caregivers as providers to susceptible policies for future study

By virtue of caregiving being a day in day out a function that varies as the needs

of the care receiver change, it is not well comprehended through cross-sectional research

designs. It is important to note that longitudinal and descriptive designs are employed to follow

the necessary care requirements over the line of illness course. The longitudinal study currently

has matched intervals between observations like 3, 6, 9 or 12 months, devoid of concerns for the

protocol of treatment or phase of disease or the demands of care. Future research should take

notice of to the time points that may be better portray the trajectory of the disease like a time of

original diagnosis, protocols alterations, as well as points of disease exacerbation or in other

words, decline. An extraordinary focus on safety, the risk for negative results as well as severe

effects for both the care recipient and caregiver should be acknowledged.

The key variable that needs to be included in future include the type and the

phase of the disease as well as the treatments due to the fact that they will relate to the kinds of

continuing therapy. This range of therapies will be linked to the requirements of the patients as

well as the assistance with self-care in addition to the ability of the patient to execute other usual

daily activities. Are the demands bestowed upon the caregiver too much in a way that it could

put at risk his or her health?

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The study that uses cautiously selected beginning associates is required so that

disparity in care demands can be well comprehended. It will put as in a far better position to

depict how the course of the disease and linked treatment as well as happenings through care that

is palliative in nature. Undesirable patient care, as well as caregiver situations like medication

errors, subsequent hospitalization and falls, can be noticed over a given time

Conclusion or Summary

Caregivers in the family are signs with significant partners in the plan of care

for patients mostly the ones suffering from chronic illness. Healthcare personnel should b

worried with various issues that affect patients quality of care as well as safety as a family have

over-relied on caregivers. progress can be attained through communication as well as caregiver

support to fortify the competence of the caregiver in addition to teaching them new skills that

will improve the safety of the patient. Preceding interventions and research have indicated the

fact that the outcome of caregiver is more improved when the healthcare practitioners are

involved though more research is needed to be conducted on the area. Nurses play a core role in

relation to helping family caregivers to be more confident as well as competent as they enter the

route of the healthcare process.

Introduction
This paper gives deep insight on caregivers burden with the bias on the clinical

aspects of it. the paper has looked into various literature and the most outstanding point about

caregivers burden is that it can be reduced when they receive support both from the healthcare

professionals as well as their families. Majority of the burden that caregivers face are often
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psychological as it is cumbersome for them to strike a balance between their roles as caregivers

and also their position in the family and at the workplace.

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