The Clinical Guide to Supportive and Palliative Care for HIV/AIDS

A Clinical Guide to Supportive and Palliative Care for HIV/AIDS • Chapter 20: Care for the CaregiverCAREGIVER BURNOUT■ Finding rewards in caregiving does not necessarily make these activities less stressful.A high degree26 picasof involvement, whether positive or negative, can produce stress. The term“burnout” is used to describe the process in which everyday stressors that are not addressedgradually undermine the caregiver’s mental and physical health. 28Psychologists define burnout in terms of three components: emotional exhaustion,depersonalization, and reduced personal accomplishment. 47 Emotional exhaustion representsthe basic stress dimension of burnout. This condition is characterized by feelings of beingemotionally overextended and lacking enough energy to face another day. Depersonalizationrepresents the interpersonal dimension of burnout. Feeling drained and “used up,” the caregiverdevelops an emotional buffer of detached concern and interacts with others in a negative andcallous manner. Reduced personal accomplishment represents the self-evaluation dimension ofburnout. This dimension is characterized by a growing sense of inadequacy and may result in aself-imposed verdict of failure.Factors Contributing to Caregiver BurnoutThe literature on caregiving suggests that both individual and situational factorsincrease the risk of burnout (Table 20-2). Empirical research suggests that situational factorsare more strongly predictive of burnout than individual characteristics. 47, 50, 51 Caregiversexperiencing work overload and interpersonal conflict over an extended period of time areparticularly vulnerable to burnout. 47Table 20-2: Factors Contributing to Caregiver BurnoutIndividual• Age (younger caregivers moresubject to burnout)• High expectations of oneselfand others• High levels of commitment,dedication, and idealism• The need to work hard• The need to prove oneself• Strong goal orientation• Difficulty saying no• Difficulty delegatingresponsibility to others• Propensity toward self-sacrifice• Tendency to be a “giver” ratherthan a “receiver”Situational• Role ambiguity (i.e., lack of clarity aboutwhat the caregiver is supposed to do)• Conflict between role demands• Work overload• Job tension• Interpersonal conflict (with care recipient,family members, colleagues, or supervisors)• Inadequate preparation for caregiving• Insufficient resources to meet the demandsof caregiving• Inadequate social support• Lack of recognition for the caregivingfunctions performed• Workplace-related factors (e.g., unrealisticwork targets, lack of decision-makingautonomy, inadequate referralarrangements)XXSources: References 25, 35, 48, 49. Sources: References 28, 47, 49 – 51.U.S. Department of Health and Human Services • Health Resources and Services Administration • HIV/AIDS Bureau 415