Caregiver Role Strain Nursing Diagnosis and Nursing Care Plan

Caregiver Role Strain Nursing Care Plans Diagnosis and Interventions

Caregiver Role Strain NCLEX Review and Nursing Care Plans

5 Nursing Care Plans on Caregiver Role Strain

Caregiver role strain happens when the caregiver feels that he/she can no longer carry out responsibilities adequately. Role strain is often accompanied by feeling overwhelmed, or stressed, and anxiety. A caregiver is a person that gives care to another person such as a spouse, partner, a child, or an aging relative.

Caregiver role strain may affect the benefits of caregiving and may lead to caregiver burnout. Caregiver burnout is defined as a state of physical, mental, and emotional exhaustion of the caregiver. Caregivers are usually busy caring for and helping others which tends to decrease their health which includes emotional, spiritual, and physical health.

The main priority of planning care is to avoid caregiver role strain to meet the physical and emotional needs of the patient.

Signs of Caregiver Role Strain

Experiencing stress while caring for someone’s well-being usually happens to caregivers. Responsibilities and workload can cause feelings of loneliness, anger, and guilt.

If the caregiver is experiencing role strain, they may manifest the following symptoms:

  • Insomnia – a sleep disturbance in which the caregiver have a hard time falling asleep, and cause the caregiver to wake up early and not be capable to get back to sleep. A person may still feel tired when the person wakeup. The common causes of insomnia include stress, sleeping habits are poor, and the disorder of mental health such as anxiety and depression that can affect the physical well-being of a person.
  • Excessive sleep or hypersomnia – occurs when a person often shows feelings of tiredness and sleeps too much than usual. Excessive sleeping is usually caused by depression and other health conditions.
  • Chronic fatigue – characterized by increased fatigue that lasts for time or at least 6 months. Fatigue may worsen the physical and mental activities of a person. Fatigue may also be characterized by difficulty in focusing and concentrating, and dizziness that may be worsened when moving, sitting, standing, and lying down.
  • Irritability – happens when a person feels agitated as a result of stress and mental health condition. When a person is irritable they may feel annoyed and agitated even on small things. The person becomes short-tempered when a person is irritable.
  • Social withdrawal – the caregiver may avoid people that they usually enjoy being with, which can progress to social isolation. Social isolation is avoiding family and friends and just wanting to be alone most of the time. Social withdrawal is one of the symptoms of anxiety and major depression.
  • Diminished self-worth –  affects the person’s self-esteem. Low self-esteem causes a lack of confidence and shows feeling anxious and shy around other people. Low self-worth is caused by unresolved experiences and emotions.
  • Concentration problems – there may be a decrease in the ability to focus on thoughts and things. Tiredness and emotional stress may lead to concentration problems for other people. Signs that the person may experience when having concentration problems may be seen such as making careless mistakes, being unable to make choices, lack of energy, losing things, and unintentionally forgetting things that just happen.
  • Appetite changes -n may affect the person’s ability to do activities. Depression, stress, and anxiety may lead to appetite changes in a person.
  • Weight gain or weight loss – unexplained weight change is an obvious drop or increase in the bodyweight of a person that may be caused by stress or serious illnesses.
  • Reduced sex drive – this is a problem that may affect both males and females. Lower sex drive may be caused by relationship issues, tiredness, or stress and can be a sign of a medical problem such as a decrease in hormone levels.
  • Less interest in hobbies – signs of less interest in hobbies include: social withdrawal, and decreased willingness to express oneself verbally and non-verbally.
  • Frequent crying may indicate depression, sadness, and hopelessness leaving a person to cry frequently. Crying may be normal in some situations, but if crying becomes frequent for no reason it may indicate a serious condition.
  • Frequent headaches and body pain – headaches and body pain may occur at the same time due to anxiety and depression and may also be because of underlying conditions.
  • Unhealthy coping ways of the person such as alcohol or drug abuse – some people think that taking alcohol and drugs will help in forgetting problems and will help a person to manage and avoid particular situations and stress.

Caregiver burnout symptoms include:

  • Mood changes and irritability
  •  Feeling of frustration, anger, depression andanxiety
  • Health condition problems
  • Persistent sleep disturbances
  • Avoidance of friends, family, and loved ones
  • Lack of interest in doing activities the caregiver previously enjoyed

These signs typically occur to caregivers with caregiver role strain and may increase the chance of having depression and may affect the overall health of a person. A person who is experiencing these symptoms should consult a doctor or mental health professional.

Common Causes of Caregiver Role Strain

  1. Financial Burdens. Caregivers have financial responsibilities aside from administering care. Caregiving costs may affect the finances because expenses can increase. The income is not proportionate to the expenses of the caregivers and the caregiver’s family. The caregivers cut spending on leisure activities and hobbies which increases the risk of caregiver role strain.
  2. Added Responsibilities. Many caregivers take on a lot more responsibilities for their families while caring for others full time. Added activities make the duties difficult to manage which may further increase the risk for caregiver role strain and increase burden and stress.
  3. Family or Role Shifts. Changes in the caregiver’s family and roles cause caregiver role strain. Sadness and confusion can happen when a general shift in roles happens to a person the caregiver care for that also cared for the caregiver.
  4. Unrealistic Expectation. When caring for somebody else the caregiver might think that supporting others will affect the other person’s well-being. When unrealistic expectations don’t happen, the person might doubt their abilities which may lead to caregiver role strain.
  5. Inadequate Support. An adequate and strong support system plays an important role to improve the quality of life. Having a support system can help in managing stress. Without support from others, the caregiver may have caregiver role strain.
  6. Insufficient Training. Skills are important in caring for others. Right skills may lower the stress and frustrations and may help in planning, managing, and organizing care. Background of the knowledge may help in reducing caregiver role strain.
  7. Social Withdrawal. Social withdrawal is when the person starts to avoid people and activities that the person usually does and enjoyed. The interpersonal relationship of a person may also be affected if there is not enough support system and if there is not enough time to rest and recharge.
  8. Self-Neglect. Self-neglect is a behavioral condition in which the person lacks self-care and unwillingness to do one’s personal needs. It is important to maintain a person’s well-being and have time for themselves. Personal care may decrease caregiver role strain.

Risk Factors to Caregiver Role Strain

  • Being a woman
  • Living with the care recipients
  • Caring for a spouse and significant others
  • Lack of choice for caregiving
  • Young age of caregiving

Prevention of Caregiver Role Strain

A person cannot avoid experiencing stress while giving care, the following may help reduce the risk of caregiver role strain:

  • Caring for themselves. This is important because when caregivers look after themselves, they will have energy, patience, and focus. After all, caregiving usually demands most of the caregiver time.
  • Exercise. Exercise with the caregiver loved ones is a great way on maintaining bonding. Exercise may promote muscular strength and body balance and maintains the overall health of a person.
  • Practise mindfulness. Being aware of personal feelings is important to avoid losing patience when giving care. When frustrations arise, caregivers should give themselves a break from the situation.
  • Be organized. Making schedules can help make the job easier. A caregiver may take down notes of the tasks to do and arrange them based on the level of urgency or priority to help avoid role strain. Being organized makes a person more productive and saves time.
  • Find support. The support system is very important; someone may be available to assist in giving care. Finding a support system may lessen the risk of social isolation and may heal the caregiver to express their feelings.
  • Encourage realistic expectations. Be mindful of the things the caregiver can and cannot do and remind them not to push themselves too hard as they are already doing the best they can.
  • Communicate with others. Communicate with others about the caregiver’s responsibilities, roles, and feelings. Making time for activities that the patient and caregiver enjoy will strengthen the bond and may benefit caregiving rather than giving burden. Communication is vital to expressing oneself and feelings.
  • Eat healthy meals. Eating healthy meals such as fruits, vegetables and plenty of water is a great way to start. Eating healthy meals helps to boost the mood of a person and may provide more energy.

Caregiver Role Strain Nursing Diagnosis

Caregiver Role Strain Nursing Care Plan 1

Alzheimer’s Disease

Nursing Diagnosis: Caregiver Role Strain secondary to Alzheimer’s disease as evidenced by fatigue, anxiety, stress, social isolation, and withdrawal from the patient in his time of need.

Desired Outcomes:

  • The patient’s caregiver will support the patient’s needs at all times.
  • The patient’s caregiver will express decreased fatigue, anxiety, and stress.
  • The patient’s caregiver and the family will demonstrate proper coping ability skills.
Caregiver Role Strain Nursing InterventionsRationale
1. Ask the patient’s family and caregiver about their knowledge about dementia and assess for possible violent reactions and inappropriate behaviors.Assessing the family’s knowledge about the condition will help in developing strategies and coping skills for the condition. This will also help the nurse to know the family’s perception of the disease.
2. Check for the caregiver’s level of fatigue and reduced social exposure and the caregiver’s feelings towards the role in caring for the patient.The family of the patient may increase the emotional burden because of the long-term needs of the patient. The condition of the patient may affect the caregiver’s physical and psychosocial health which may affect the caregiver’s goals in life. Allow the family to express their feelings and concern about the situation to reduce their anxiety.
3. Ask the caregiver to define the possible problems and explain the techniques that may help in problem-solving.Providing support in solving problems and teaching the caregiver about coping skills will help reduce fatigue and stress.
4. Teach the family and caregiver about energy-conserving techniques that can be used in assisting the patient.Teach the caregiver to sit if they can. Planning activities will help to conserve energy throughout the day. Learning energy-conserving techniques helps to build up strength and minimize fatigue of the muscles, joint stress, and body pain.
5. Train the caregiver on ways to maintain their health and explain the importance of coping skills.Allow the caregiver to take a break and have enough rest and sleep because physical, mental, and emotional strain will reduce one’s ability to provide care.

Caregiver Role Strain Nursing Care Plan 2

Stroke

Nursing Diagnosis: Caregiver Role Strain secondary to stroke as evidenced by fatigue and social isolation.

Desired Outcomes:

  • The caregiver will be healthy emotionally and physically.
  • The caregiver will show reduced stress and anxiety.
  • The caregiver will express feelings about the condition.
Caregiver Role Strain Nursing InterventionsRationale
1. Check for the caregiver’s understanding of the condition and the caregiver’s ability to do patient care.Assessing the caregiver’s understanding will help in setting goals that will reduce the caregiver’s role strain and ways to enhance the caregiver’s knowledge in providing care.
2. Ask the caregiver to describe the caregiver-care recipient relationship.Satisfying relationships between the caregiver and patient promotes therapeutic caregiving practice. If the relationship between the caregiver and the patient is not satisfying the result of care may be ineffective.
3. Check for the family resources and support system.Support of the family may result in ineffective coping. Many factors such as aging parents and distance from family members as well as limited financial means may affect the effectiveness of coping.
4. Evaluate the caregiver’s health such as physical and mental health that may affect caregiving.Physical impairments such as vision problems, muscle weakness, and limited body strength will affect in providing care. The mental health assessment is important to evaluate if the caregiver can think clearly and may lessen the risk of stress and anxiety.
5. Advise the caregiver to plan activities of care to lessen the burden and fatigue during the implementation of care. Instruct the caregiver about the stress-reducing methods.Planning activities will help the caregiver to have enough rest without adding a burden to the patient. The caregivers must have the opportunity to relax throughout the day.
6. Encourage the family to help the caregiver in giving care to the patient.The family is also responsible for giving care to the patient. The family should help the caregiver to avoid role strain and work overload.

Caregiver Role Strain Nursing Care Plan 3

Caring for Elderly Patients/Geriatric Patients

Nursing Diagnosis: Caregiver Role Strain secondary to caring for elderly/geriatric patients as evidenced by insomnia, irritability, and verbalization of worries that own health will suffer because of caregiving.

Desired Outcomes:

  • The caregiver will demonstrate a positive feeling about caregiving.
  • The caregiver will report an adequate support system.
  • The caregiver’s pattern of sleeping will be regular.
  • The caregiver will use resources to overcome stress and verbalize less worry about the caregiver’s health.
Caregiver Role Strain Nursing InterventionsRationale
1. Promote a good relationship between the caregiver and the patient. Check for the presence of dysfunctional relationships between the patient and the caregiver.Promoting relationships will help the nurse to assess the intervention needed. If the relationship between the patient and the caregiver is dysfunctional it may result in a caregiver role strain.
2. Weigh the family’s communication and support system.Open communication will help create a positive and caring environment. The support of the family will help promote positive coping for the patient and caregiver. The nurse should also assess the financial resources of the family because the limited financial resources may affect coping.
3. Encourage the caregiver to express his/her feelings about the condition and assess the caregiver’s level of understanding and willingness to do the care for the patient.Response of an individual especially the caregiver to a certain condition is important. The willingness of the caregiver should be assessed and evaluated.
4. Encourage the caregiver to ask for help from other family members if needed. Encourage the family members to help the caregiver in providing care.The family members should participate with the caregiver in the care of the patient. The caregiver should be given enough rest and sleep to decrease the burden and exhaustion. Having enough rest and sleep will maintain the health of the caregiver and make the caregiving effective.
5. Ask the caregiver about the caregiver’s physical and mental health and if there are the presence of physical impairments and mental problems that will affect the quality of care.Physical impairments and mental problems will reduce the effectiveness of care. If the caregiver is impaired plan of care for the patient will be affected.

Caregiver Role Strain Nursing Care Plan 4

Multiple Sclerosis

Nursing Diagnosis: Caregiver Role Strain secondary to Multiple Sclerosis as evidenced by the caregiver’s self-isolation and bizarre behaviors.

Desired Outcomes:

  • The caregiver will show proper behavior when caring for the patient.
  • The caregiver will positively respond to lifestyle changes.
  • The caregiver will utilize available resources that will help in the process of caring
  • The caregiver will demonstrate satisfaction with the plan of care and support that is available for the caregiver.
Caregiver Role Strain Nursing InterventionsRationale
1. Check for the caregiver’s level of responsibility and commitment to the care of the patient.The nurse may use assessment tools such as a burden interview to determine the abilities of the caregiver. Decreased level of responsibility and commitment will affect the plan of care.
2. Discuss the caregiver’s feelings and view about the situation and ask the caregiver about his/her concerns about the situation.Allowing the caregiver to verbalize his/her feelings will let the nurse know about the concerns and needs of the caregiver.
3. Assist the family and the caregiver to develop a plan of care. Encourage the family to be involved in the activities.When the family helps the caregiver when providing care to the patient, the caregiver’s risk to be overloaded will be decreased.
4. Check for the available adaptive equipment and availability at home and in vehicles.This will help to promote the caregiver and the patients’ safety. Adaptive equipment such as wheelchairs and bath chairs are used to help the caregiver and it is designed to help people with disabilities. 
5. Encourage the caregiver to maintain personal needs, hobbies, social activities, and self-nurturing.The caregivers may experience burnout and be overwhelmed by the situation. The caregiver must continue his/her hobbies and social activities to avoid being burned out. Explain the need for maintaining self-worth and self-nurturing.

Caregiver Role Strain Nursing Care Plan 5

Spinal Cord Injury

Nursing Diagnosis: Caregiver Role Strain secondary to spinal cord injury as evidenced by fatigue, depression, and social withdrawal.

Desired Outcomes:

  • The caregiver will identify the coping skills to prevent fatigue, depression, and social withdrawal.
  • The caregiver will participate in the interventions and planning with the family.
  • The caregiver will maintain social interaction with others and verbalize feelings.
Caregiver Role Strain Nursing InterventionsRationale
1. Instruct the family members to be involved with the care of the patient to decrease the pressure on the caregiver.Family members should be involved in caring for the patient. Instruct the family members about their responsibilities and ask them to help the caregiver in taking care of the patient as necessary, especially when positioning a patient with spinal cord injury because it may be difficult for the caregiver to carry the patient alone.
2. Advise the caregiver to make time for his/her personal needs and advise the caregiver to do things that will help him/her relax.Taking time to relax will help the caregiver to maintain physical and emotional needs.
3. Instruct the caregiver to do stress-reducing methods.Stress-reducing methods such as deep breathing exercises, meditation, relaxation to music, and talking with the family will help reduce stress.
4. Advise the use of relevant instruments or devices that will help the caregiver to improve the patient’s condition while maintaining the health of both the caregiver and the patient.Assistive devices for spinal cord injury are important to help the caregiver move the patient easily. Individuals with spinal cord injury have a chance to continue with independent lives with minimal assistance with the use of assistive devices.
5. Instruct the caregiver about the techniques used to deal with different patients’ behavior.Patients with spinal cord injury may be irritable because of immobility. The caregiver should learn techniques to deal with the behavior and maintain self-control.

Nursing References

Ackley, B. J., Ladwig, G. B., Makic, M. B., Martinez-Kratz, M. R., & Zanotti, M. (2020). Nursing diagnoses handbook: An evidence-based guide to planning care. St. Louis, MO: Elsevier.  Buy on Amazon

Gulanick, M., & Myers, J. L. (2022). Nursing care plans: Diagnoses, interventions, & outcomes. St. Louis, MO: Elsevier. Buy on Amazon

Ignatavicius, D. D., Workman, M. L., Rebar, C. R., & Heimgartner, N. M. (2020). Medical-surgical nursing: Concepts for interprofessional collaborative care. St. Louis, MO: Elsevier.  Buy on Amazon

Silvestri, L. A. (2020). Saunders comprehensive review for the NCLEX-RN examination. St. Louis, MO: Elsevier.  Buy on Amazon

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This information is intended to be nursing education and should not be used as a substitute for professional diagnosis and treatment.

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Anna Curran. RN, BSN, PHN

Anna Curran. RN-BC, BSN, PHN, CMSRN I am a Critical Care ER nurse. I have been in this field for over 30 years. I also began teaching BSN and LVN students and found that by writing additional study guides helped their knowledge base, especially when it was time to take the NCLEX examinations.

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