1. Baldwin, Kathleen M. PhD, RN, ACNS, ANP, GNP, CEN

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It's inevitable-the American population is aging. And as baby boomers enter the older age groups, the need for caregiving will increase.


On February 7, 2011, U.S. News and World Report released a list of the best long-term-care facilities in the United States, based on national survey data from the Centers for Medicare and Medicaid Services. Three major elements were rated: health inspections, nurse staffing, and quality of care. Out of over 16,000 U.S. long-term-care facilities, only 18 of them made the 2011 honor roll, receiving perfect scores for each of the previous four consecutive quarters in 2010.1


Published results like these cause both older adults and their family members to be conflicted about long-term-care facility placement, resulting in more families choosing to care for their aging family members at home. More than 69,000,000 people spend an average of 20 hours per week engaged in family caregiving.2 Many caregivers are members of the sandwich generation-middle-aged people who care for an elderly family member while caring for their own children.


Research has shown that family caregiving can be stressful for both the person being cared for and the caregiver. Caregiver burnout may occur if nurses miss the warning signs. That's why we need to routinely look for signs that point to caregiver role strain. If caregiver role strain is present, intervention is essential to prevent burnout.


Signs of caregiver burnout include substance abuse, changes in appetite, depression, thoughts of death, neglect or abuse of the person receiving care, insomnia, and difficulty concentrating.3 There are many self-help groups available-both community-based and online-to help caregivers cope with the strain of caregiving. Caregivers experiencing role strain or burnout should be referred to one or more of them. Assure caregivers that they aren't alone in their feelings and that discussing those feelings with others who understand is important.


Respite care is essential to allow caregivers regular, short-term breaks in caregiving. At least 1 week off every 3 months will decrease caregiver role strain and burnout. There are respite care agencies that provide in-home care or care within their facilities. Family members may also provide respite care for caregivers.


Elder care will become a major issue in the future as the average lifespan increases and larger numbers of older adults require care. Family caregivers are now and will remain an essential part of the healthcare system. Become an advocate for family caregivers to ensure that caregiver role strain and burnout are treated. The caregiving experience can be a positive one for both the caregiver and the aging family member receiving care.

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1. Comarow A. Best nursing homes: behind the rankings.


2. National Family Caregivers Association. Caregiving statistics.


3. American Heart Association. Signs of caregiver burnout?