Prevent Caregiver Burnout with Boundaries

“Compassionate people ask for what they need. They say no when they need to, and when they say yes, they mean it. They’re compassionate because their boundaries keep them out of resentment.”

Brené Brown

The Boundaries Burnout Connection

Setting, modifying, and reinforcing boundaries can prevent caregiver burnout. You may be wondering, what are boundaries, what is burnout, and what does this have to do with caring for my family member? Boundaries are the limits that protect our emotional, and physical well-being. Boundaries offer the opportunity for us to be more in control of our time and how we spend it. Without boundaries, the overwhelm of caregiving can feel like being in the middle of a whirlpool of emotions. We may feel like we are drowning, can’t get our breath, and question how we will survive. Our boundaries help us create a calm space around us and help us preserve our energy. Setting boundaries is how we respect and protect ourselves. When you choose when to give, you save enough of you so that you can give when you choose.

Let’s take a closer look at burnout. Caregiver burnout occurs when we have given too much of ourselves without attention to our well-being. When we are beyond our limits, the consistent stress from caregiving results in more pressure because our coping mechanisms are no longer effective at restoring our energy. In this state, we are exhausted, more easily overwhelmed, and more quickly irritated. We often have trouble sleeping, which adds to the negative cycle. You can see burnout as a spectrum, a slippery slope that leads to the flames of burnout. 

Why Setting Boundaries is Important

One reason that boundaries are essential to prevent burnout is that caregiving changes our relationships. Suppose our care recipient is our parent. Our relationship shifts from parent/adult child to care receiver/caregiver. It may be a gradual shift over several years or a sudden shift in the case of a hospitalization or a disease diagnosis. Regardless of the pace of progression, responsibilities change over time, and these changing responsibilities require that we reassess our boundaries.

When we begin helping our family member, we interact and engage with a whole new set of people and even learn a new language that includes acronyms and medical terms. Healthcare professionals become members of our care team. As the leader of the care team, you are charged with communicating information, delegating tasks, and determining and balancing priorities. It is a lot of work and responsibility that would be challenging enough without the added worry about your care recipient that seeps into every decision and every interaction.

Boundaries reduce resentment

Suppose you haven’t given much thought to boundaries before now. In that case, this is the time to reevaluate roles, relationships, and limits so that you and those traveling with you on your caregiving journey feel respected and supported. When we identify what behaviors we can accept and aren’t acceptable, setting and sharing our expectations can reduce resentment and frustration, yours, and the feelings of the folks helping you care for your family member. In the same way, boundaries help us define what we believe to be our responsibilities and what responsibilities we can’t accept.

Because boundaries protect us from burnout, the best time to set boundaries is when you are first wading into caregiving. You may have started helping with finances or running errands. Without limits, tasks that are at first occasional can grow so much that it becomes easy to place our well-being last. When we continually prioritize the needs of others over our well-being, our emotional state and our coping abilities are diminished, leading to feelings of overwhelm and a state of being that is not sustainable. Another indication that we need to set boundaries is when we feel we are being taken advantage of. Anger, resentment, and frustration can signal that we need to communicate our needs and limits.

Boundaries keep us connected to our life

In addition to relationships changing with our care recipient and care professionals, relationships change with other family members and friends. Boundaries can help determine who is on your care team and who is only adding drama to the experience. Boundaries help us stay connected to what makes us feel whole. We can start by helping our family member a few days a week. Unknowingly, two days a week can turn into assisting with daily activities. Bit by bit, we can give up our hobbies and interests until we are entrenched without a clear way out from under the tasks. What starts as fulfilling work becomes oppressive and frustrating when we don’t keep our life. 

Prioritizing our well-being helps us keep our life, which means protecting our other relationships and protecting ourselves from burnout so that we don’t exhaust our abilities to cope with caregiving challenges. Setting boundaries is essential self-care. These boundaries will enable you to prioritize your well-being while you care for your family member. Healthy boundaries help us maintain healthy relationships. Because caregiver burnout occurs when we have given too much of ourselves, establishing boundaries is how we communicate our needs so that we have more control over how our time and energy are spent.

Why Setting Boundaries is Difficult

Setting boundaries with those who are close to us is hard. It is understandable if you are skilled at setting boundaries at work but are less confident setting boundaries with family and friends. This is where emotions complicate the process. We may feel it is risky to set boundaries with family, friends, and people who are accustomed to our open limits. How will they react? Anger? Judgment? You will remove the established expectations that your relationship had been built on. You aren’t giving as much of yourself anymore. Let’s say we are not in the habit of setting boundaries. We may struggle with people-pleasing. We say yes to everything, and when we hear a no from someone, we may think, how dare they!

Boundary lines shift

On the other hand, when we begin setting boundaries, we are more likely to accept and even expect our friends’ boundaries. We become comfortable saying “no” and receiving a “no” from others. We grow to understand and respect healthy boundaries. Yet, to make things more complicated, boundary lines shift as circumstances change. Setting and maintaining boundaries in a new setting takes awareness and practice. With practice, we can determine when boundaries are too rigid, too flexible, or just right. For example, there are varying degrees of “opening up” to people and sharing personal information. The extreme ends of sharing are “rarely opening up” vs. “oversharing.” Another example of being too rigid vs. too flexible is never asking for help vs. never saying no to a request for help. Somewhere in the middle is where healthy boundaries are formed.

Communicating boundaries can feel awkward

Setting boundaries is also challenging because communicating boundaries is not often a one-and-done conversation. Our boundaries will be tested, and reinforcement requires recommunicating the boundary and the consequences. Or, a boundary may change, and you will want to communicate the new parameters. In addition, as mentioned earlier, you will find yourself in the new role of communicating and coordinating care for your family member, which can initially feel awkward and intimidating. Boundaries will help you manage professional interactions with people helping with an intimate situation.

Barriers to Setting Boundaries

Several barriers can make setting boundaries uncomfortable. It is helpful to understand the barriers to setting boundaries so that when we encounter them, we recognize them and are more prepared to overcome the hurdles. A common barrier to establishing limits is that we haven’t been taught how to set boundaries and therefore don’t always recognize the need. Another barrier occurs when we realize a boundary is necessary but feel guilty about setting the limit. Or, we set a boundary, and it is rejected or resisted. We may be interacting with someone who does not set their own boundaries or respect those set by others. In this case, consistent reinforcement may be challenging due to uncomfortable confrontations that might cause us to ignore a crossed boundary.

It’s important to remember that while setting boundaries can feel selfish, the opposite is true. Well-maintained boundaries are a gift to you and those in your caregiving circle. When you feel guilty about setting the boundary, remind yourself that setting boundaries is not selfish but an essential part of self-care as a caregiver. Boundaries will protect your compassion reserves, your capacity for compassion, so that interactions with the care team are respectful and in line with your values. 

Who to Include when Setting Boundaries

So, who do we include when setting boundaries? Boundaries can be established with our care recipient, those helping us care for our care recipient or anyone who impacts our care for our family member. Setting boundaries with ourselves, self-imposed boundaries may be the most valuable of the boundaries we set. Setting these limits allows us to sustain ourselves as we provide care. As we said, as caregiving tasks increase, it is essential to reevaluate limits so that you are not giving so much of yourself that your well-being suffers. 

Setting Boundaries with Ourselves

How much is too much? How much time, headspace, and energy are too much to devote to all that goes into taking care of a family member? This is for you to decide, and the answer may change frequently based on your situation and circumstances.

Set boundaries around physical limits

Defining a limit around care responsibilities is one of the most critical boundaries we can set. This requires that we accept that we cannot do it all… not without consequences. When we accept help, we gain time for ourselves so that we can use that time to focus on our well-being. Another limit may be necessary when care responsibilities involve physical risk or become too intimate for comfort. For example, you may decide that you will not be able to help your family member with showering or toileting and can develop a plan when that level of care is required.

Set boundaries around emotional limits

We can set a boundary around worry. When we realize our anxiety is not productive, it may be time to move to acceptance or devise a plan to address the worry. We can set the boundary around how much time we will spend on a worrisome subject in conversation and our thoughts.

Set boundaries around self-care

Boundaries help us prioritize and protect self-care time. When we schedule self-care activities and communicate that we are engaged in an activity that supports our well-being, we can reinforce self-care boundaries as needed. 

Anger signals a crossed boundary

There is a signal that helps us identify when a boundary has been crossed. Let’s say we have set a boundary. We have shared that we are taking a break for self-care, and we are interrupted. We may feel a touch of anger. Anger can signal that a boundary has been crossed. Awareness that we cultivate through mindfulness helps us pause, be curious, and identify that the source of the anger is a crossed boundary. The pause allows us to act rather than react and thoughtfully reinforce the boundary with compassion.

Setting boundaries with family members

Boundaries with family members can help us maintain relationships. Limits can be set around when to have conversations regarding your loved one’s care. Suppose a family member frequently drops by and offers suggestions and advice. In that case, it may feel like criticism when you are exhausted and overwhelmed by the responsibilities of day-to-day care.

It may help to establish guidelines around communication concerning care. With mindfulness and compassion, you can let them know that they are important to you and that the topic is important but that, in the moment, you cannot give it the attention deserved. An informal meeting once a week could be more productive. Another time when setting boundaries is important but can feel uncomfortable is when your care recipient is transitioning. Well-meaning family members may insist that you take a break, but maybe you don’t want to or would rather take a short break. This is for you to decide.

Setting boundaries with paid caregivers

Setting boundaries with paid caregivers and aides is essential. Limits can be set around sharing personal information. The folks who help you care for your family member can become like part of the family. If this relationship becomes too familiar, it can be uncomfortable to communicate when there is a concern about how tasks are accomplished or if personal conversation interferes with responsibilities. Limits can be set around tasks. For example, if you share space with your care recipient, you may appreciate that the aide helps keep your family member’s living spaces clean but prefer to manage other areas yourself. Clear communication can avoid hurt feelings when a kind gesture from your aide feels like overstepping. Generally, when more rigid boundaries are established early, it is easier to move to more flexible ones. However, it is not easy to start with flexible boundaries and shift to more rigid ones.

Setting boundaries with friends and neighbors

Boundaries with friends and neighbors become important as caregiving intensifies. Friends of your care recipient may drop in unannounced, and it might disrupt the schedule. The disruption might start a stress snowball. Social interaction is essential. Communication and coordination with folks will show respect for the relationship and demonstrate that you value the friendship. Establishing boundaries around visits and communication can help preserve relationships and allow mutually beneficial interactions.

Setting boundaries with our care receiver

When we think about setting limits with our care receiver, the boundaries are for us rather than them. Challenges may arise from living in the same space. Relationship dynamics may be exposed that would otherwise have been kept private. For example, your care recipient may be privy to uncomfortable conversations between you and your young children or between you and your spouse. Boundaries can help us share appropriate personal information without oversharing relationship details or receiving unwarranted opinions. Shared space also keeps us in a heightened state of awareness regarding our care recipient’s mood. We can’t be responsible for someone else’s happiness or contentment. If we find that our care recipient’s mood dictates our mood, it is a signal to revisit boundaries.

In the same way, we may encourage our family member to eat well or exercise. When we find ourselves insisting, we can acknowledge that the resulting conflict harms our well-being and may even be crossing our family member’s boundaries. We can limit how much energy we invest in insisting. Consequences are crucial to proper boundary settings, and this can be complicated when dealing with an aging adult with cognitive decline or a dementia diagnosis. If your care recipient cannot remember that a boundary was set, then the rules must be self-enforced. For example, if you requested that a parent not enter your personal space without knocking, but this continues to occur because your care recipient forgets, you will need to lock the door.

How to Set Boundaries

Since communication is vital in setting and reinforcing boundaries, let’s cover some conversation tips. You will want to be clear on your intention to be clear in your communication. Respectfully and with as few words as possible, communicate your boundary. Word the request in terms of what you need and why you need it rather than use the word “you.” You might say, “I don’t have the bandwidth for that right now.” Maybe you say, “I need some space…” rather than, “You need to stop….”

Share the consequence if the boundary is crossed and be firm and unapologetic. Because we set our boundaries for ourselves, if they are not working, we must reinforce or adjust them as needed. For example, if we set a boundary around when we communicate with our sibling about our parent’s care, and they call us at 11 pm with a suggestion, a “great idea,” they may have crossed a boundary around appropriate times to discuss care details. We can gently reinforce it by reminding them of our scheduled time to talk. You need sleep to be at your best, and a late-night conversation interferes with a good night’s sleep. As you prepare for the discussion, you still might be unsure if setting this boundary will work. One thing you do know is that the current situation is not working, so set and communicate the boundary. The situation will improve.

In summary, our boundaries help us consistently prioritize our well-being which is how we prevent burnout. Boundaries are not fixed. They must widen and narrow and adapt to the circumstances. Setting, modifying, and reinforcing boundaries involves a lot of communication. Because the conversations around boundaries are rarely one-and-done, you will likely have a chance to revisit the details.

Get started 

Reflect

To get started working with boundaries, you might explore how the relationship between you and your care recipient has changed and how boundaries have changed to reflect the new relationship. Think about the last time you felt anger. What boundary may have been crossed? What is not working that setting a boundary might fix? The answers to these questions can lead you to recognize where limits are needed.

Journal

For your journal, if you are not keeping a journal, this is a great time to start! You could consider it your caregiving journey travel diary. Like with any travel, you will experience growth, and your journal can be a wonderful document of where you have been and how far you have come. Use your journal to explore how boundaries could help you prioritize your well-being. You might start by listing the people who are a regular part of your care team. What opportunities exist to establish, adjust, or reinforce a boundary? Describe the conversation that would allow you to set or reinforce the boundary with compassion.

Another idea is to use quotes as journal prompts, and a quote that fits well here is, “You cannot adjust the wind, but you can adjust your sails” (the quote is credited to Cora Hatch). When we find ourselves in the role of caregiver, whether we arrive suddenly or gradually, we need to adjust our sails. A big part of that includes setting boundaries. Journal your thoughts on how to adjust your sails using boundaries.

Practice

To practice using this new information about boundaries, be mindful of feelings of anger because anger is often a clue that a boundary has been crossed. After journaling the communication around a boundary, you want to set, begin the conversation. Keep in mind that it may take more than one. It will likely take more than one conversation.

For more information on boundaries, check out Navigating the Caregiver River: A Journey to Sustainable Caregiving and the Self-Caregiving Strategies Podcast.

Schedule Theresa Wilbanks to speak on caregiving and empower the caregivers in your workplace or community with the 12 Sustainable Caregiving Strategies.

Advice offered is for general information only; please contact your healthcare team, legal or financial advisors to guide your particular situation.