BURNOUT AMONG FAMILY CAREGIVERS
The concept of burnout emerged in the early 1970s. Its heritage is embedded in the ideas of Herbert Freudenberg, Christina Maslach, and Ayala Pines. Since then, the term "burned out" has been used to describe a condition of staff and administrators in positions that have a high degree of people contact. 1 I would like to extend this concept of burnout to family caregivers as well.
Burnout may be a widespread consequence of caregiving. A definition of burnout as a response to chronic emotional stress contains three components: emotional and/or physical exhaustion, lowered job productivity, and depersonalization. There is a general consensus that the symptoms of burnout include attitudinal, emotional, and physical components. 2
Staff who work with people who are mentally retarded and old often need to make decisions on behalf of their clients. (See Chapter 23) One important type of recommendation made by our Interdisciplinary Team had to do with placement out of an institutional residential setting. Sometimes this recommendation resulted in the person with mental retardation being placed either in a foster home or in the care of a family member. Financial assistance, services, and emotional support are needed to provide an alternative to institutional care of people who are old. This sort of residential placement also links the older person with mental retardation to the formal community resources that he needs.
The results of a decision to have a family care for a person with mental retardation who is old are not without possible adverse consequences to the parties involved. One of the major consequences of this care is the family burnout response. The process of burnout is more often the result not of stress per se, but of unmediated stress: being stressed and having no "out," no buffer, and no support system. 3