Caregiver Guilt: Understanding, Managing & Overcoming Self-Blame

Caregiver guilt is a common challenge many family caregivers face when caring for an aging loved one. It’s important to understand how it surfaces and ways to manage it. When caregivers overcome guilt, they can move from self-blame to self-care, which improves their own health and the health outcomes of those they care for.      

Key takeaways

• Caregiver guilt is common: 70% of family caregivers report feelings of guilt. 
• Signs of caregiver guilt include feeling inadequate, resentment, social isolation, physical exhaustion, and anxiety and depression. 
• Strategies to overcome guilt include: validating emotions, self-compassion, setting healthy expectations and boundaries, and seeking caregiver support services and professional help.

What is caregiver guilt?

Caregiver guilt is a persistent feeling that you are not doing enough for a person in your care. No matter how much effort you put into caring for someone, you may feel as though you’re not doing enough. You might even become resentful and angry at yourself and the person you care for, and you’re not alone in feeling this way.

Senior caregiver guilt is increasing in frequency. With the world’s population of people 60 and over estimated to double by 2050, the need for senior care is growing. And the demands of this care primarily falls on family members. The number of family caregivers has climbed to 63 million Americans, and almost half face high-stress situations that take a physical and mental toll on the caregiver’s health.  

In addition to increases in caregiver stress, there is a significant demand on their time. On average, caregivers spend over 23 hours per week caring for others, and 1 in 4 spend more than 40 hours a week providing care. More people than ever are spending more time and energy caring for loved ones, yet, 70% of family caregivers report feelings of guilt. 

If it always seems like there is more to do, and you’re not satisfied with the amount of care you’re providing, there’s a good chance you could be experiencing caregiver guilt.  

Signs of caregiver guilt include:

• The time you dedicate to your loved one never feels like enough
• Asking for help feels impossible, and it seems like everything falls on you
• You worry that you are failing your loved one
• Taking breaks or time to yourself brings feelings of guilt
• You feel resentful, angry, depressed, and/or burnt out

If you relate to these statements, know that there are resources available to help you release the guilt associated with caregiving so you can balance caring for yourself and those you love.

Common triggers of caregiver guilt

Common triggers of guilt when caring for older adults include:

• Feeling like you should be doing more
• Unrealistic expectations
• Impatience
• Facing important decisions like long-term care options

A common theme underlying each of these triggers is perfectionism.

If you’re dedicating the majority of your time and energy towards caregiving, and keep raising the bar on what you expect of yourself, there’s a good chance perfectionism is at the root. 

Many senior caregivers set unrealistic and sometimes impossible standards for themselves, believing they must provide 24/7 care without any support. A common belief is that you are the only one who can provide the care and attention the person needs. Taking breaks or time for yourself can trigger immense feelings of guilt.

Perfectionism also surfaces as high expectations for the results of your care. You may experience feelings of impatience and frustration when you’re not seeing the progress of your effort. An example is thinking that a medication or treatment “should be working by now.”

Major decisions involving life transitions and care options are other instances that can also make you feel guilty. It’s important to be aware of perfectionist tendencies that can surface in senior caregivers. Examples include the following:

• One-sided thinking, like “This is the only way” 
• “Shoulds” such as “I should have all the answers” 
• Needing to find the “ideal” option

This type of thinking fuels more guilt, making difficult decisions even more stressful.

It can be hard to let go of high standards, but you can’t take on all of the care alone. Identifying the lead-ins to caregiver guilt and learning ways to overcome them can help you remember that you deserve the same level of care you are striving to provide to others.

Who is most at risk?

Those facing the most burnout and guilt are women, long-term, and dementia caregivers. 

Women 

More than 75% of family caregivers are women, giving them the highest risk of developing caregiver guilt. Women also face the heaviest mental load, taking on the vast majority of daily, repetitive household responsibilities. These roles already create high levels of stress and burnout and can impact careers and income. The added responsibility of caring for an aging adult increases the risk of feeling guilty.

Long-term caregiving

Long-term caregivers face additional challenges that put them at high risk of experiencing the effects of caregiver guilt. At age 65, the chance of needing long-term care reaches 70%. Long-term care provides support to seniors with illness and disability, and can include assistance with daily activities, meal prep, transportation, and housekeeping. Because care can take place in-home or in a long-term facility, people who provide unpaid care can face challenges in the amount of care needed, the duration of care, and cost. These factors can contribute to increased feelings of guilt.

Dementia

Dementia affects more than 6 million people in the U.S., and the number is growing. Approximately one quarter of dementia caregivers are responsible for taking care of an aging parent and at least one child under 18. Those caring for someone with dementia are more likely to provide help with daily activities like bathing, dressing, and feeding. 

The recurring need for care could be one reason ​​dementia caregivers face higher work productivity loss than other caregivers. Those caring for someone with dementia can face caregiver guilt, as well as guilt associated with their work and home responsibilities. 

Signs and symptoms of guilt

Guilt can surface in two main ways: emotional and behavioral. Emotional signs of guilt consist of what you are feeling, while behavioral signs are shown through what you are doing.

Emotional signs of guilt:

• Anxiety: Uneasiness and worry about the future. 
• Depression: Persistent sadness and feelings that things will not get better.
• Irritability: Finding yourself angry and upset over things that normally wouldn’t bother you.
• Obsessive thoughts: You find it hard to dismiss persistent negative thoughts. 

Behavioral signs of guilt:

• Burnout: Persistent feelings of exhaustion and overwhelm, even after resting.
• Social isolation: Not going out as much or having conversations with friends like you used to.
• Self-neglect: Putting your own needs last. 
• Refusing help: Turning down offers for help, feeling as though you have to do everything alone.
• Health changes: Changes in sleep, appetite, physical pain, and illness.

As you care for someone longer, you can lose sight of how much time you spend caregiving and the toll it’s taking on you and your relationships. Oftentimes, it can help to speak with trusted loved ones who can offer their observations. 

How to manage and let go of guilt

If you relate to the signs of caregiver guilt, know that you aren’t alone and that there are strategies and support that can help you improve your wellbeing.

Acknowledge and validate your feelings

Acknowledging means naming what you’re feeling. You might say, “I notice I’m feeling a lot of guilt.” Validation is a way to show yourself compassion and understanding: You can say, “This is hard to feel.” 

Another part of validating your feelings is reminding yourself you’re not alone and that you are capable: “Lots of other people feel this way, and I can get support.” This process not only helps you let go of guilt, but it also helps you build resilience so you can better respond to future stress.

Practice self-compassion

Having compassion for yourself is not the same as feeling pity for yourself. True self-compassion is holding space to acknowledge that you are suffering and gently reminding yourself that you can take action. Compassion means taking responsibility for your feelings and actions without blame or shame. When you notice feelings of guilt, compassion calls you to practice self-forgiveness and find a healthier pathway forward. Exercises to practice compassion and forgiveness include journaling, meditation, expressing gratitude, and speaking to yourself kindly. 

Set realistic expectations and boundaries

Unrealistic or unmet expectations are associated with increased anger and resentment. When it comes to relationships between a caregiver and the one needing care, both people are negatively affected by resentment. It’s important to set healthy expectations and boundaries to preserve your relationship. 

You can tackle this by:

• Handling the simplest problems first
• Breaking more complicated tasks into smaller chunks
• Seeking help where you can 
• Setting aside time for self-care
• Creating limits around the duration and type of care you can provide 

Use respite and support services 

There are many services available to help provide care for your loved one and support caregivers. Respite care offers temporary relief for caregivers by providing short-term care for older adults or individuals with disabilities. 

Options for support services and groups span from in-person to online. Caregiver support groups offer a place to connect with other caregivers and receive emotional support. You can search for groups in your area through organizations like National Alliance for Caregiving, Family Caregiver Alliance, and National Institute on Aging. Other support groups can be specific to a disease state so you can learn strategies for coping with the particular challenges you face. You can also join caregiver courses to learn more about different types of care and how to balance self-care with caring for others. 

Expanding your caregiver circle through respite or other services provides both you and your loved one with additional support. And as you branch out into a bigger caregiver community, you’ll learn how common it is to feel guilt and have additional resources to help combat it.  

Seek professional help

More than 60% of caregivers experience burnout, and half report increases in emotional stress due to caregiving. Talking with a mental health professional can help if you are feeling overburdened by the care you’re providing. It is common to feel guilt, depression, and anger from time to time. However, if you feel overtaken by these emotions for extended periods, it’s an indication to seek help. 

Overwhelming guilt takes a toll on both your physical and mental health. If you notice changes in your overall well-being or are worried about your physical and mental health, a professional can guide you. 

Guilt vs. other caregiver emotions

Caregiver guilt is often accompanied by other emotions, including sadness, anger, and anxiety. Excessive guilt can also be a symptom of depression, and is typically experienced as persistent feelings of worthlessness and sadness. To distinguish guilt from other emotions, it can be helpful to understand guilt on a basic level. 

Guilt is a self-perceived state that surfaces when you believe that you are behaving outside of your values and beliefs. You can get to the root of guilt by exploring your beliefs and determining whether you’re actually out of alignment or if an adjustment to your beliefs is needed. 

For example, if you believe you should provide 24/7 care to your loved one, you will likely feel guilty until you can revise this belief into a more attainable goal. The anger, anxiety, and sadness that can surface along with guilt are important to notice and manage. Working with a professional can help you through these feelings.

Special considerations for long-term illness and facility placement

Other situations where caregiver guilt is prevalent include long-term disease and the decisions and timing concerning facility placement. Caregivers often feel anticipatory grief when faced with these life-changing decisions, which can induce deeper feelings of guilt. Anticipatory grief happens before a loss and is usually experienced when someone has a long-term illness like cancer or dementia. 

Half of caregivers experience guilt when determining the timing of placement. Factors such as understanding the needs of your loved one in a different setting and maintaining visitation schedules can add additional guilt and stress. Enlisting the help of a healthcare provider when making these decisions can help you and your loved ones navigate this especially difficult time.  

Practical tools & resources

Below is a list of support that can help you identify and manage caregiver guilt. As you branch out for support, sometimes the options can feel overwhelming. It can be helpful to make a list of your own needs and the needs of the person you care for. Identify which items can be outsourced and begin searching for support. 

Caregiver resources and links: 

• ARCH National Respite Network provides a  Respite Locator Service to find qualified respite care providers in your area.
• Visit your local Area Agency on Aging for information on respite care and caregiver support programs.
• The NADSA directory provides adult day service centers that offer supervised care and social activities nationwide.
• The National Alliance for Caregiving and the National Institute on Aging offer resources and connections for caregivers and loved ones.
• The Family Caregiver Alliance provides ongoing support and services.
• Caregiver Action Network offers resources and connects caregivers to help. 
• National Alliance on Mental Illness (NAMI): Offers support for those caring for someone with a mental health condition.
• Transamerica Institute provides resources and information that can support those who need and provide care. 

When to seek therapy at Sailor Health

Today, 34% of caregivers are age 65 or older. If you’re experiencing caregiver guilt, Sailor Health can help. Our therapists specialize in helping older adults and have a deep understanding of the challenges you face when caring for a loved one. 

Plus, we offer affordable virtual therapy sessions that fit in with your schedule. Most Medicare patients have a $0 copay. Contact us to get started today. 

FAQs about caregiver guilt

Is caregiver guilt the same as caregiver burden?

Caregiver guilt is an intense symptom of caregiver burden. Caregiver burden is defined as stress and strain experienced by a caregiver. It consists of objective burden, which is caused by the physical and observable tasks of caregiving. Subjective burden includes the emotional, personal feelings, and distress affecting the caregiver. 

How do I stop being resentful as a caregiver?

Ways to deal with anger and resentment that surface when caring for someone you love include managing stress and taking care of yourself. Talk with a medical provider if you are feeling intense anger and resentment toward yourself or a loved one. Here are some other tips:

• Don’t do it alone; ask for help. 
• Set realistic expectations for the level of care you can provide. 
• Seek community support.
• Consider professional support for yourself and your loved one.
• Prioritizing self-care.
• Take care of your own physical health.

What are 5 symptoms of caregiver stress?

There are a variety of symptoms that can indicate caregiver stress that are also related to caregiver guilt. They include:

• Feeling overwhelmed
• Constant worry
• Feeling tired and fatigued often
• Sleep disturbances
• Changes in weight
• Becoming more easily irritated or angry
• Losing interest in activities you used to enjoy
• Feeling sad
• Frequent pain, headaches, or other health issues

Can you get PTSD from being a caregiver?

Yes. Prolonged stress or traumatic events involving emergencies and a decline in health of people you care for can trigger PTSD-like symptoms in caregivers. Some common indications are experiencing intrusive memories, avoidance, and hypervigilance. Seek professional help if you or someone you know might have these symptoms.

References

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