Caregiver role strain occurs when caregivers experience difficulty performing their caregiving role or feel overwhelmed by their caregiving responsibilities. This nursing diagnosis focuses on identifying risk factors, managing caregiver stress, and preventing burnout while ensuring quality care for both caregiver and care recipient.
Causes (Related to)
Caregiver role strain can develop due to various factors affecting the caregiver’s ability to cope with responsibilities:
- Care recipient factors:
- Complex medical conditions
- High dependency level
- Cognitive impairment
- Behavioral issues
- Unpredictable care needs
- Caregiver factors:
- Limited caregiving knowledge/experience
- Multiple roles and responsibilities
- Financial constraints
- Physical health problems
- Emotional attachment to the care recipient
- Environmental factors:
- Inadequate support systems
- Limited resources
- Social isolation
- Poor living conditions
- Limited access to healthcare services
Signs and Symptoms (As evidenced by)
Subjective: (Caregiver reports)
- Feelings of overwhelming responsibility
- Emotional exhaustion
- Sleep disturbances
- Anxiety and depression
- Social withdrawal
- Financial concerns
- Relationship strain
- Guilt about inadequate care
Objective: (Nurse assesses)
- Signs of physical exhaustion
- Poor self-care practices
- Changes in eating habits
- Irritability or emotional lability
- Neglect of personal health needs
- Decreased social interaction
- Changes in work performance
- Signs of depression or anxiety
Expected Outcomes
Successful management of caregiver role strain is indicated by:
- Caregiver demonstrates effective coping strategies
- Caregiver maintains adequate self-care practices
- Caregiver utilizes available support systems
- Caregiver reports reduced stress levels
- Caregiver maintains a balanced lifestyle
- Care recipient receives appropriate care
- Caregiver-care recipient relationship improves
Nursing Assessment
Evaluate Caregiver Status
- Assess physical and emotional health
- Review sleep and rest patterns
- Monitor stress levels
- Evaluate coping mechanisms
- Check support system availability
Assess Care Recipient Needs
- Evaluate care requirements
- Review medical conditions
- Assess dependency level
- Monitor behavioral issues
- Check care complexity
Evaluate Resources
- Review financial resources
- Check community support availability
- Assess healthcare access
- Monitor respite care options
- Evaluate educational needs
Monitor Risk Factors
- Assess burnout potential
- Check for depression signs
- Review relationship dynamics
- Monitor physical health
- Evaluate social support
Nursing Care Plans
Nursing Care Plan 1: Caregiver Burnout
Nursing Diagnosis Statement:
Caregiver Role Strain related to complex care demands and limited support systems as evidenced by verbal expressions of fatigue and overwhelming responsibility.
Related Factors:
- Complex care requirements
- Limited support network
- Multiple responsibilities
- Inadequate rest periods
Nursing Interventions and Rationales:
- Assess caregiver stress levels
Rationale: Identifies early signs of burnout - Teach stress management techniques
Rationale: Promotes effective coping strategies - Connect with support resources
Rationale: Reduces isolation and burden
Desired Outcomes:
- Caregiver will demonstrate reduced stress levels
- Caregiver will utilize support resources effectively
- Caregiver will maintain adequate self-care practices
Nursing Care Plan 2: Knowledge Deficit
Nursing Diagnosis Statement:
Knowledge Deficit related to lack of caregiving experience and complex care requirements as evidenced by verbalized uncertainty about care procedures.
Related Factors:
- Limited caregiving experience
- Complex medical needs
- Inadequate educational resources
- Overwhelming information
Nursing Interventions and Rationales:
- Provide caregiving education
Rationale: Increases confidence and competence - Demonstrate care techniques
Rationale: Ensures proper care delivery - Offer resource materials
Rationale: Supports ongoing learning
Desired Outcomes:
- Caregiver will demonstrate proper care techniques
- Caregiver will verbalize understanding of care requirements
- Caregiver will access educational resources as needed
Nursing Care Plan 3: Social Isolation
Nursing Diagnosis Statement:
Social Isolation related to demanding caregiving responsibilities as evidenced by decreased social interactions and expressed loneliness.
Related Factors:
- Time constraints
- Limited mobility
- Reduced social opportunities
- Caregiver responsibilities
Nursing Interventions and Rationales:
- Facilitate social connections
Rationale: Reduces isolation - Arrange respite care
Rationale: Enables social activities - Connect with support groups
Rationale: Provides peer support
Desired Outcomes:
- Caregiver will maintain social relationships
- Caregiver will participate in support groups
- The caregiver will utilize respite services
Nursing Care Plan 4: Ineffective Coping
Nursing Diagnosis Statement:
Ineffective Coping related to overwhelming caregiving demands as evidenced by emotional exhaustion and maladaptive behaviors.
Related Factors:
- Chronic stress
- Limited coping skills
- Emotional attachment
- Role conflict
Nursing Interventions and Rationales:
- Teach coping strategies
Rationale: Improves stress management - Provide emotional support
Rationale: Reduces emotional burden - Develop self-care plan
Rationale: Promotes healthy coping
Desired Outcomes:
- The caregiver will demonstrate effective coping strategies.
- Caregiver will maintain emotional well-being
- The caregiver will practice regular self-care
Nursing Care Plan 5: Decisional Conflict
Nursing Diagnosis Statement:
Decisional Conflict related to complex care decisions and competing responsibilities as evidenced by expressed uncertainty about care choices.
Related Factors:
- Complex care decisions
- Limited decision-making experience
- Conflicting responsibilities
- Emotional involvement
Nursing Interventions and Rationales:
- Provide decision support
Rationale: Facilitates informed choices - Clarify care options
Rationale: Reduces uncertainty - Offer guidance resources
Rationale: Supports decision-making
Desired Outcomes:
- Caregiver will make informed care decisions
- Caregiver will express confidence in choices
- Caregiver will utilize decision support resources
References
- Gordon JR, Pruchno RA, Wilson-Genderson M, Murphy WM, Rose M. Balancing Caregiving and Work: Role Conflict and Role Strain Dynamics. J Fam Issues. 2012 May;33(5):662-689. doi: 10.1177/0192513×11425322. Epub 2011 Oct 21. PMID: 32123460; PMCID: PMC7050936.
- Jammal M, Kolt GS, Liu KPY, Guagliano JM, Dennaoui N, George ES. A systematic review and meta-analysis of randomized controlled trials to reduce burden, stress, and strain in informal stroke caregivers. Clin Rehabil. 2024 Nov;38(11):1429-1445. doi: 10.1177/02692155241271047. Epub 2024 Aug 28. PMID: 39194341; PMCID: PMC11528954.
- Lindt, N., van Berkel, J. & Mulder, B.C. Determinants of overburdening among informal carers: a systematic review. BMC Geriatr 20, 304 (2020). https://doi.org/10.1186/s12877-020-01708-3
- Longo UG, Matarese M, Arcangeli V, Alciati V, Candela V, Facchinetti G, Marchetti A, De Marinis MG, Denaro V. Family Caregiver Strain and Challenges When Caring for Orthopedic Patients: A Systematic Review. J Clin Med. 2020 May 16;9(5):1497. doi: 10.3390/jcm9051497. PMID: 32429398; PMCID: PMC7290989.
