Home Health & Hospice Week

Keep an eye out for these signs that a caregiver's had enough.

A little empathy from a home health nurse can make all the difference in preventing family caregivers from going over the edge and neglecting--or even abusing--their ailing loved ones.

If you think only bad people would do such a thing to a helpless family member, think again. The caregiver may have taken on an almost overwhelming burden of caring for an elderly person--sometimes by default, says Daniel Sheridan, a forensic nurse specialist at Johns Hopkins University School of Nursing in Baltimore.

"You see a lot of stress in middle-aged women, for example, with sole responsibility for an elderly relative or parent at night and weekends," Sheridan notes.

"The person may also be trying to work inside or outside the home for pay and caring for children. And that's a recipe for stress and potential abuse or neglect of the patient," explains Sheridan.

Know When The Caregiver Role Is Taking A Toll

Look for signs of stress in caregivers who may reside with your patients.

Telltale signs: Watch for heightened anxiety where the caregiver may appear more worried about facing the next day or future--or irritability, suggests Peter Reed, director of care services for the Alzheimer's Association.

According to the Alzheimer's Association, other indications the person may be overwhelmed by the caregiving role include:

• symptoms of depression,
• declining physical health,
• social withdrawal,
• insomnia due to worry, and
• anger at the patient or at others who don't understand the caregiver's situation (or because no one has found a cure, etc.).

What you can do: If you see warning signs that a caregiver may be under stress, talk to the person in a private setting, advises Sheridan.

"Acknowledge the stressful situation and ask the person if they are angry or if the care is getting to be too much." he suggests.

Best bet: "Be empathetic, nonjudgmental--and give them permission to say [the situation] is difficult," Sheridan advises.

Know When to Report

What if caregivers confide in you that they have been neglecting or hurting their elderly or disabled charge? Check your state requirements so you'll know what you are required to report, advises Sheridan.

"You have to protect the elderly [or disabled] person," he emphasizes. "Most people with caregiver stress who have crossed the line into abuse or neglect are at their wit's end and just want help," Sheridan adds. "And the situation is out of hand, which is why they may have confided in you that they are hurting or neglecting their family member."