Domain 7. Role relationship
Class 1. Caregiving roles
Diagnostic Code: 00061
Nanda label: Caregiver role strain
Diagnostic focus: Role strain
Caregiver role strain is a condition that affects those providing care for loved ones, especially within the elderly population. It occurs when an individual and/or family member suffers from physical, emotional, or financial stress due to their caregiving responsibilities. This strain can be especially difficult to handle due to the impact it has on both an individual’s personal and professional life.
NANDA Nursing Diagnosis Definition
The Nursing Diagnosis of Caregiver Role Strain is defined as “the perception of excessive stress related to caring for a dependent person” and is associated with the International Classification of Diseases (ICD-10) code Z73.3. The diagnosis is typically found in elderly populations who may experience roles strain as they juggle the demands of caring for another individual while also tending to their own needs and desires.
Subjective indications of caregiver role strain are often revealed through an individual’s self-reported emotions, attitudes, and behaviors. Some of the subjective characteristics of the diagnosis include:
- A sense of sadness, guilt, or resentment over their caregiving duties.
- Impatience or irritability when interacting with the person being cared for.
- Sleep deprivation, anxiety, and/or depression.
- Feelings of being overwhelmed by the sheer amount of responsibility.
- Social withdrawal from friends and family.
- Lack of time for self-care.
Objective characteristics of caregiver role strain can be noticed in an individual’s physical demeanor, such as:
- Excessive fatigue.
- Weight loss or gain.
- Changes in appetite.
- Difficulties concentrating.
- Inability to make important decisions.
- An increase in illness due to a weakened immune system.
There are several factors that can contribute to caregiver role strain. These may include:
- The intensity of care required – More intense care can often lead to heightened levels of stress, particularly if there is limited assistance available which can cause an individual to feel overwhelmed.
- Lack of formal training – When someone does not have the appropriate training or education to fulfill their caregiving duties, it can lead to feelings of confusion or inadequacy.
- Having to work outside of their home – Having to manage a job, childcare, or other external obligations alongside the caregiving responsibilities can create immense strain.
- Financial burden – If a caregiver is unable to meet the financial requirements of their caregiving responsibilities, it can increase their stress levels.
- Absence of recognition – If caregivers’ contributions go unrecognized, it can lead to decreased morale and increased tension.
At Risk Populations
Certain populations are more prone to developing caregiver role strain than others. Those at an increased risk of being affected by the condition include:
- Older adults with an extensive caregiving history.
- Parents with disabled or chronically ill children.
- Family members caring for elderly relatives.
- Grandparents raising grandchildren.
- Unmarried partners providing care for a significant other.
- Connected individuals caring for those with mental, emotional, or behavioral health needs.
The onset of caregiver role strain can be a major trigger for other psychological conditions in caregiving individuals. Commonly experienced mental health issues include:
- Emotional exhaustion
- Substance abuse
- Social isolation
Suggestions for Use
Nursing practitioners should take note when assessing patients for potential caregiver role strain. Identifying any warning signs or symptoms of the condition is key in order to provide suitable management methods. Suggested interventions may involve formulating a practical plan for caregiving, educating patients about available resources, providing advice about preparation and problem-solving strategies, and encouraging self-care practices. For more severe cases of caregiver role strain, speaking with a mental health professional is highly recommended.
Suggested Alternative NANDA Nursing Diagnoses
Alternative diagnoses related to caregiver role strain may include:
- Risk for Injury
- Ineffective Coping
- Impaired Social Interaction
- Activity Intolerance
- Impaired Home Maintenance
- Disturbed Sleep Pattern
When assisting individuals in their pursuit of managing caregiver role strain, it is important to remember the following:
- Encourage respectful communication between all parties involved.
- Provide accurate information and resources.
- Listen to and validate feelings.
- Promote self-care.
- Acknowledge strengths.
- Respect family dynamics.
The following are some of the patient outcomes that determine the effectiveness of the diagnosis:
- Roles/Responsibilities Coping – The ability to adapt to changes in responsibility.
- Family Processes – The ability to effectively use interpersonal interaction and problem-solving skills to maintain supportive family relationships.
- Caregiver Emotional Health – The capacity to express feelings, cope with emotions, and work through caregiver-related issues in a healthy way.
- Social Interactions – The capability to interact with others in an appropriate manner.
- Coping – The ability to handle stress in a healthy way.
Evaluation Objectives and Criteria
The success of caregiver role strain diagnosis can be measured by evaluating progress towards stated objectives. Such objectives may include:
- Increased expression of positive emotions associated with caregiving.
- Enhanced ability to manage stress and emotional intensity.
- Improved ability to recognize the needs of both the caregiver and the person being cared for.
- Increased understanding of available resources.
- Improved problem-solving skills.
- Increased functioning in daily activities.
- Greater resilience in face of difficult circumstances.
The care plan for those suffering from caregiver role strain will mainly include the implementation of nursing interventions. Suggested interventions may include:
- Provide emotional support to the care recipient and caregiver.
- Develop coping strategies via education.
- Teach problem-solving skills.
- Encourage the caregiver to get rest and engage in leisure activities.
- Assess the need for extra assistance and provide referrals.
- Provide information about legal and financial resources.
- Encourage caregivers to practice self-care.
- Create a plan for respite care.
Nursing practitioners should strive to provide quality care to individuals dealing with caregiver role strain. Nursing activities should focus on:
- Assessing and validating the patient’s feelings.
- Conducting assessments to determine the patient’s role strain score.
- Developing a care plan focusing on personal and family needs.
- Educating caregivers about available community resources, managing stress, and practicing self-care.
- Revisiting topics discussed to ensure all expectations are being met.
- Offering encouragement and support throughout the caregiving journey.
Providing care for a family member or loved one can be a difficult endeavor. Caregiver role strain is a condition that often affects those put in this position and can cause significant strain both physically and mentally. By recognizing the warning signs of caretaker strain and taking steps to reduce its disruption in daily life, individuals can find relief and successfully manage the negative emotions associated with the diagnosis.
- What is Caregiver Role Strain?
Caregiver role strain is a condition that is characterized by feelings of excessive stress resulting from the act of providing care for a dependent person. It is often associated with physical, emotional, and financial strain for the caregiver.
- What are the signs of Caregiver Role Strain?
Some signs of caregiver role strain may include a sense of sadness, guilt, or resentment; sleep deprivation, anxiety, and/or depression; fatigue; weight loss or gain; changes in appetite; difficulties concentrating; inability to make important decisions; and/or an increase in illness.
- How is Caregiver Role Strain diagnosed?
The diagnosis of caregiver role strain is typically made based on an individual’s self-reported emotions, attitudes, and behaviors. Nurses can also assess patients for physical signs such as fatigue, weight loss or gain, changes in appetite, and difficulty concentrating.
- Who is at risk of Caregiver Role Strain?
Those at an increased risk of being affected by the condition include older adults with an extensive caregiving history, parents with disabled or chronically ill children, family members caring for elderly relatives, grandparents raising grandchildren, unmarried partners providing care for a significant other, and connected individuals caring for individuals with mental, emotional, or behavioral health needs.
- What are examples of Nursing Interventions for Caregiver Role Strain?
Nursing interventions for caregiver role strain may include providing emotional support, developing coping strategies via education, teaching problem-solving skills, encouraging the caregiver to get rest, assessing the need for extra assistance, providing information about financial and legal resources, encouraging caregivers to practice self-care, and creating a plan for respite care.