Caregiver Burden & Stress

Instructor: Karin Gonzalez

Karin has taught middle and high school Health and has a master's degree in social work.

In this lesson, you will learn the definition of caregiver burden and stress and the prevalence of this in the sandwich generation. You will learn the reasons for caregiver burden and stress, symptoms, effects, and ways to cope with it. Following the lesson will be a brief quiz to test your knowledge.

Caregiver Burden & Stress

The sandwich generation is growing more and more as older people live longer with the help of medical intervention. The sandwich generation are middle-aged adults who care for their aging and fragile parents and their still dependent children. A report from the American Association for Retired Persons (AARP) found that 44% of adults ranging from 45 to 55 years old were housing both an elderly parent and a dependent child under the age of 21 in their home.

Although caring for an elderly parent can strengthen the bond, it can also be burdensome, stressful and exhausting.
Caring for elder parents

Caregiver burden and stress entails negative psychological, behavioral, and physiological effects due to the chronic stress and burden of caring for family members. The cost of medical care in a facility or hospital is expensive, and family members can do informal care in their homes at a fraction of the cost. Moreover, in the past, parents would pass away earlier, and children got married sooner. The new responsibility to care for both the older and younger generation longer is causing significant stress.

Reasons for Stress

There are several factors associated with heightened levels of caregiver burden and stress. We'll look at Trisha and Ben, parents of two teenage sons, and caregivers to Trisha's aging mother who lives in their home.

Multiple Parallel Stressors

Caregivers are often faced with a myriad of stressors that are typical for everyone, some of these are separate from the stressor of caring for family members. For example, Ben's employer has not been doing well and is firing employees. Ben worries he could be next.

Caregiver burden and stress can be exacerbated if one is also experiencing stress in other areas of life, such as work.
Stress at work

No Hope

Caring for a family member with a progressive disease, like Alzheimer's or terminal cancer, can be quite draining and depressing. Trisha's mother has Alzheimer's disease, an illness that progressively strips away memory and clear cognition. Her mother is starting to not recognize or appreciate Trisha's dedication, attentiveness, and care, which makes the job even harder and makes Trisha feel unappreciated.

Financial Strain

Trisha and Ben are saving for college education for their sons and their approaching retirement. They pay a monthly mortgage, house repair expenses, and Trisha's mother's mortgage. These financial obligations, on top of the cost of medication, food, medical equipment, time away from work, and activities for Trisha's mother, are overwhelming and burdensome.

Managing Personal Health

Ben's doctor told him that he is pre-diabetic and needs to watch his sugar intake. Trisha's mammogram results were concerning; she'll need to visit her doctor for further evaluation. With the added stress of their own medical concerns, Ben and Trisha can feel overwhelmed.


Many caregivers of family members are silent angels. They may not outwardly complain or whine about their responsibilities to care for so many individuals, including themselves. There are several symptoms that can indicate caregiver burden and stress including:

  • Depression and anxiety
  • Difficulty concentrating
  • Irritability
  • Exhaustion
  • Easy annoyance
  • Sleep disturbances
  • Health problems
  • Substance abuse
  • Lack of interest in social or fun activities
  • Withdrawal from responsibilities or obligations

Caregiver Burnout

Trisha and Ben are experiencing caregiver burnout. Caregiver burnout is when the stress and burden of being a caregiver is chronic and has escalated to the point of physical and mental exhaustion. It involves many of the above symptoms of caregiver burden and stress, on a deeper and more intense level.

Trisha and Ben are exhausted and are always getting sick. Trisha's life revolves around the care of her mother, and Ben's life revolves around mustering up the finances to support his own nuclear family and mother-in-law. Ben and Trisha's marriage is now focused on being caregivers, and the stress, anger, resentment, and depression that comes with that responsibility. Trisha is neglecting her own needs, like getting a haircut or seeing a mental health therapist. Ben is resentful and irritable with his mother-in-law. He feels like his marriage and life are now in a rut due to this immense responsibility.

Effects of Burnout

One of the ways that the body responds to stress is by releasing the steroid hormone, cortisol. This hormone suppresses the digestive, reproductive, and immune systems, leading to a heightened risk of getting sick. Stress can also lead to depression, anxiety, and heart disease, as well. Heightened stress has been linked to decreased longevity and early death.

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