Being a caregiver comes with a complex set of emotions that changes from moment to moment, including guilt.1 Guilt occurs frequently because caregivers self expectations are unrealistic and usually cannot be successfully met. It is important for caregivers to recognize when they feel guilt as it can impact their own health and the care they provide.
A caregiver is anyone who assists another person who is unable to be independent in taking care of themselves. This is often a spouse, parent or disabled child, but could be an extended relative, close friend or even a stranger that hires help. Based on changes to our culture, more and more people are taking on the caregiver role.
If you are a caregiver, determining how to accurately reassess your abilities and create a healthy balance in your life can alleviate the emotional pain guilt creates. Many caregivers find talking with a therapist can help with this process and manage the emotions of caregiving.
Causes of Caregiver Guilt
Guilt emerges when there is a belief that you are falling short in any or all roles and relationships are suffering. Caregivers are frequently trying to juggle multiple tasks and roles simultaneously. In addition to being a caregiver you may be a spouse or partner, a parent, an employee, a student, and a friend. Nobody can effectively juggle all of these roles all the time.
Perhaps the person you are taking care of is not improving. Caregivers can blame themselves falsely believing if they did something else a loved one’s medical condition would improve. When a loved one’s health deteriorates, caregivers mistakenly believe they should be doing more to enhance the quality of life of the one they are caring for. Feelings of guilt, anger, and helplessness occur with this way of thinking.
People can also unknowingly bring their past relationships into their role as a caregiver. Past unresolved conflicts with family members can influence the caregiver relationship. Social Worker Malika Brown describes it this way, “there are issues stemming from childhood or arguments in the past that hinder the caregiving process. Many caregivers feel guilty about this.”2
A research study created a caregiver guilt questionnaire and identified 5 major factors resulting in caregiver guilt. “Guilt about doing wrong by the care recipient, guilt about not rising to the occasion as caregivers, guilt about self care, guilt about neglecting other relatives, and guilt about having negative feelings towards other people.”3
Signs & Symptoms of Caregiver Guilt
There are a number of emotional and behavioral issues that caregivers can experience especially if the stress that comes up isn’t addressed. Guilt can result in “reactive cycles” that create other emotions and symptoms that become cyclical.4
The common signs and symptoms of caregiver guilt include:
- Ambivalence: The feeling of wanting to be doing what you are doing but also not wanting to do it.5
- Resentment: feeling unappreciated for the care you are giving or wanting more help and not getting it.
- Irritability: If you do not feel gratitude for what you are doing or you are repeatedly criticized it might result in irritability.
- Anxiety: Fear that you are doing something wrong or won’t be there when something bad happens.
- Helplessness: Regardless of what you do it never feels it is right or enough.
- Depression and sadness: As a caregiver you can be repeatedly confronted with loss and grief as the person you are caring for changes and gets worse and you can’t do anything to make it stop or go away.
8 Ways to Cope With Caregiver Guilt
Caregivers are often pretty bad about taking care of themselves. By nature, they focus their attention and compassion on others. They can be reluctant to consider what could be done differently help take care of themselves. The reality is to be a good caregiver you also need to take care of yourself. That means recognizing and acknowledging that you sometimes have negative feelings related to your role as a caregiver.
Here are eight ways caregivers can take more control and learn to cope with caregiver guilt:
1. Identify When Guilt Occurs
If guilt is denied it can become more debilitating. Give yourself permission to feel guilt and do not judge yourself harshly for feeling this way.
2. Re-evaluate Self Expectations
Try to realistically evaluate your expectations of yourself and ask yourself if they are reasonable to do on a regular, ongoing basis. Would you ask someone else to respond in the same way you expect yourself to?
3. Feel Your Feelings
There are moments when you don’t want to be a caregiver that will cause a flood of emotions. Avoiding these moments or denying them will only make you feel worse. You may feel angry and irritable or overwhelmed. Consulting a therapist can help you understand and work through your thoughts and feelings in healthy ways.
4. Connect With Others
Find a trusted friend, family member, or someone else you feel comfortable with that you can candidly talk to about the good and challenging moments about being a caregiver.
5. Make Time for Yourself
You must do things to recharge and nourish your soul and spirit. Give yourself permission to do things you enjoy guilt free.
6. Go to Group Therapy
Being with other peers who are also caregivers in group therapy can help you feel less alone. It can normalize your feelings. They can offer insights and tips that you can integrate in your role as a caregiver. Some caregiver groups have a professional leader and some are peer led. Both are good options to help you cope with guilt.
7. Be Kind to Yourself
Show yourself the same compassion you would extend to others who are coping with a crisis. Don’t wait until you are experiencing caregiver burnout. Be proactive on your own behalf. Give yourself permission to act in a guilt free manner.
8. Be Confident in Your Decisions
Social Worker Malika Brown recommends, “Know that you are making the best decision for you and your loved one at that time-This can be hard to accept.” She goes on to say, “A change in that situation may force you to break that promise, realize that promise was made under different circumstances.”6
When to Get Professional Help for Caregiver Guilt
Caregiver burnout is a very common phenomena and guilt plays a major part in burnout. The powerful emotional mixture of guilt, anxiety, resentment, and grief, create a dangerous emotional cycle for caregivers. Caregivers who experience these feelings must acknowledge them and deal with them immediately. If these emotions are not addressed they can evolve into isolation, irritability, anger, depression, and other negative emotions that can be emotionally and physically harmful to caregivers.
It is critical for a caregiver’s emotional and physical well being to have a person they can speak to honestly vent their feelings and not feel judged for having them. Mental Health professionals add an additional layer of support by helping caregivers to understand and process these emotions. In addition they can offer caregivers insights about how to set realistic boundaries, self expectations, and add balance in their lives. They also can teach coping and problem solving skills that will prove to be invaluable tools for caregivers.
Who Should I Consult for Help in Overcoming Caregiver Guilt?
There are many counseling opportunities available for caregivers when they choose to seek support. Individual counseling is a good place to start for guidance, support, and to offer the skill sets discussed above. When looking for a therapist ask about their prior experience working with family caregivers. It is also a good idea to inquire about their knowledge regarding the stressors that caregivers face. Check with your insurance company to see if the provider you want is covered under your plan and what out of pocket costs you might have to pay.
Group counseling is also a good option for caregiver support. It can be affirming and helpful to share caregiving victories and challenges with other caregivers. If you believe you are really struggling you may want to choose a caregiver group being led by a healthcare professional. Their training and experience can offer additional guidance and professional insights that many caregivers can benefit from.
There are also on line chat groups available where you can communicate with other caregivers. Social Worker Lois Esobar describes the benefit of caregiver support groups. She explains “Support groups are a place to give and receive support.” She goes on to say being in a caregiver support group “allows the caregiver to focus on their needs, not only the needs of the care receiver.”7
How to Find a Therapist
There are several things to know about finding the right therapist. This article gives great information on how to choose a therapist, what questions and information to get, and how to assess if they are a good fit for you. It also shares information on how you determine if your therapy is working. You can find a local therapist here.
There are additional places to go to look for mental health professionals with expertise that will be valuable for caregivers. Area Agencies on Aging also has local resource information to find counseling.
Check your insurance coverage to learn about your specific coverage. The cost for therapy will vary depending on the licensure and credentials of the person you are seeing. Generally speaking, people with Master’s level degrees charge between $75-$125 per session. Psychologists fees can range from $125-$200 per session and a psychiatrist can charge between $200-$300.
Cognitive Behavioral Therapy and Emotion Focused therapy are often used as treatment methods with caregivers. This therapy is more short term ranging from 5 to 12 sessions depending on what you and your therapist agree on as treatment goals.
How to Support a Loved One Who Has Expressed Caregiver Guilt
One way to help a loved one who has expressed guilt is to make time for them and really listen to what they have to say without judgement. The goal is to be supportive. Isolation is common for caregivers. This is especially true for long term caregivers. If possible, encourage them to get someone to cover for them (called “respite care”) so they can have time off from their caregiving responsibilities. Try to ask what you can do to help during the course of this conversation.
Time and energy can be a luxury for a caregiver. Especially caregivers who feel overwhelmed and are focusing all their attention on the person they are taking care of. If you sense that a loved one is struggling with their caregiving role, gather information on resources and programs that may be helpful to them and offer them some support and respite. Let them know that you are concerned about them and that you have information that they may need now or in the future.
Guilt is an emotion that is hard to let go of. If you see a loved one struggling with caregiver guilt you can address it in a supportive manner. Donna Schempp, LCSW, recommends helping a caregiver change the message they are giving themselves. She offers these examples; “Consider changing guilt into regret. I’m in a difficult situation and I have to make difficult decisions sometimes. I regret that I am human and get impatient sometimes. I am doing the best I can even though things go wrong from time to time and I regret that I am not perfect.”8
Resources for People Dealing With Caregiver Guilt
- 11 Private Support Groups for Caregivers on Facebook – DailyCaring: This is a site containing a list of 11 private support groups for Caregivers on Facebook. Contact the site administrator and ask to join the group. This ensures your privacy as well as other members in the group.
- Family Caregiver Alliance National Center on Caregiving: This site connects caregivers, offers resources, education, and support for caregivers.
- Caregiver Support Groups: This website also is linked with the Family Caregiver Alliance Center. It has information on support groups serving a number of different specialty communities
- Alzheimer’s Association | Alzheimer’s Disease & Dementia Help: This website offers education, resources, community support, and information on research for patients with Alzheimer’s Disease and dementia and their family members.
