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Podcast with Dr. Dan Manshes
Burnout While Caring for an Elderly Parent: Support Is Needed Not Only for the Patient
Arthur Andonis:
Dr. Manshes, thank you for joining us again.
In previous episodes, we talked about memory, anxiety, psychological trauma, and the changes that often occur later in life.
Today, however, I would like to focus on the people standing beside the patient.
The daughter who accompanies her mother to every appointment.
The son who answers phone calls in the middle of a workday.
The spouse who has been caring for a loved one for years.
When we talk about dementia, loss of independence, or chronic illness, most of the attention naturally goes to the patient.
But very often there is another person going through a crisis as well.
The caregiver.
And caregiver burnout is not always visible.
Sometimes it appears as exhaustion.
Sometimes as irritability.
Sometimes as guilt.
And sometimes simply as the feeling that there is nothing left to give.
Today, we will try to answer a few important questions:
- How can burnout be recognized?
- Why is caring for an elderly parent so emotionally difficult?
- What should someone do when guilt or frustration begins to appear?
- And how can people continue supporting a loved one without losing themselves in the process?
Dr. Manshes, let’s start with the basics.
1. How Can Someone Recognize That They Are Beginning to Burn Out While Caring for an Elderly Parent?
Dr. Manshes:
Burnout is a state of prolonged emotional and physical strain.
It often develops when someone spends a long period of time caring for a close family member.
At first, many people believe they can manage.
They tell themselves that the situation is temporary.
That they only need to get through another week, another appointment, another difficult period.
But gradually, caring for a loved one begins to take up more and more space in daily life.
At some point, it becomes difficult to truly rest.
Even when they are not physically with their parent, their thoughts remain focused on them.
- Did they take their medication?
- Have they eaten today?
- Did they fall again?
- Is everything okay while I’m away?
Over time, other signs may begin to appear as well.
- Fatigue that does not improve with rest.
- Irritability.
- Less patience.
- Losing interest in activities that once brought enjoyment.
- Pulling away from friends, family, or personal hobbies.
I often hear people say:
“I honestly can’t remember the last time I did something just for myself.”
Or:
“I feel like I’m constantly on alert.”
Many people assume burnout happens suddenly.
In reality, it usually develops gradually.
Almost unnoticed.
And the most important thing I tell family members is this:
Burnout does not mean you love your parent any less.
It does not mean you are not doing enough.
And it certainly does not mean you have failed.
In many cases, the people who burn out the most are the ones who care the most.
The ones who are the most devoted and the most committed.
2. Why Can Caring for a Parent Be So Emotionally Difficult?
Arthur Andonis:
Dr. Manshes, many people step into the role of caregiver out of love, responsibility, or even a desire to give something back to their parents for everything they have done over the years.
Yet despite that, many family members describe an enormous emotional burden.
Why is caring for an elderly parent often such a difficult experience emotionally?
Dr. Manshes:
Because caring for a parent is about much more than helping.
It is far more complicated than that.
When we care for a parent, we are not caring for a stranger.
We are caring for the person who once cared for us.
The person who represented security, stability, and support throughout much of our lives.
That is why, when we begin noticing changes in our parents, something also changes within us.
One of the most significant processes involved is what we call a reversal of roles.
At some point, the child becomes the one reminding a parent to take medication, scheduling appointments, accompanying them to medical visits, and making important decisions.
Meanwhile, the parent who once appeared strong and independent begins needing help.
Emotionally, this is a very difficult transition.
Because in some ways, we are forced to let go of an image that has been part of our lives for decades.
I often hear people say:
“I know it’s still my mother, but sometimes she doesn’t feel like the same mother I used to know.”
Or:
“It’s hard for me to believe that my father, who used to make every decision for the family, now needs constant support himself.”
These are painful experiences.
But they are also deeply human.
Sometimes a sense of loss begins long before any actual loss has occurred.
The person is still physically present, yet the relationship has already started to change.
That is why the challenge is not only practical.
It is not only about appointments, medications, or organizing care.
It is also about emotions.
Memories.
Family history.
And fears about the future.
When love, concern, sadness, responsibility, fear, and sometimes frustration all exist at the same time, many people begin to feel emotionally overwhelmed.
That does not mean they are doing anything wrong.
It simply means they are facing a very complex human situation.
3. Is It Normal to Feel Angry Toward an Elderly or Ill Parent You Are Caring For?
Dr. Manshes:
This is one of the hardest questions people ask.
Sometimes it is even difficult for them to admit that they are asking it.
Because society expects us to be good children.
Patient.
Compassionate.
Understanding.
Strong.
And when anger appears, many people become frightened by their own emotions.
They begin to think that something is wrong with them.
But the truth is that emotions are a natural part of every human relationship.
Including the relationship between parents and children.
When someone spends a long period caring for an elderly or ill parent, many different emotions can exist side by side.
- Love.
- Concern.
- Compassion.
- But also exhaustion.
- Frustration.
- And sometimes even anger.
This does not mean the person loves their parent any less.
It does not mean the relationship has been damaged.
Often, it is simply a sign that the burden has become too heavy.
Imagine someone trying to manage everything at once for months or even years.
- A career.
- Their own family.
- Household responsibilities.
- And at the same time, caregiving responsibilities.
In that situation, it is almost impossible never to feel frustrated.
The real problem begins when people refuse to acknowledge those emotions.
They tell themselves:
- “I have no right to be angry.”
- “I’m a terrible person.”
- “I should be more patient.”
And then guilt is added on top of exhaustion.
In practice, being able to say:
- “Yes, this is hard.”
- “Yes, I’m tired.”
- “Yes, sometimes I feel angry.”
is often the first step toward a healthier way of coping.
Because once we stop fighting the emotion, we can begin to understand what it is trying to tell us.
Sometimes it tells us we need help.
Sometimes it tells us we need rest.
And sometimes it tells us that we are carrying far more than one person can reasonably carry alone.
4. Why Does One Family Member Often End Up Carrying Most of the Responsibility?
Arthur Andonis:
Dr. Manshes, I often hear the same story from families.
Gradually, one person becomes the coordinator of everything.
They speak with the doctors.
They arrange appointments.
They keep track of medications.
They are the person everyone calls when there is a problem.
And very often, they are the one who is physically present almost every day.
Why does this happen so often?
Dr. Manshes:
This is an extremely common situation.
And interestingly, it almost never begins with a formal family decision.
Usually, nobody sits down and says:
“From now on, you are responsible for Mom.”
Or:
“You are now responsible for Dad.”
It simply happens over time.
Someone starts helping a little more than everyone else.
One more phone call.
One more visit.
One more appointment.
One more task.
And gradually, the entire system begins to rely on that person.
Sometimes it happens because of emotional closeness.
Sometimes because one person is more available.
Sometimes because they naturally feel a stronger sense of responsibility.
And sometimes simply because nobody else stepped into the role.
At first, it may seem completely natural.
But over time, the cost becomes greater.
People start saying things like:
“Everyone asks how Mom is doing, but I’m the only one actually taking care of things.”
Or:
“I have brothers and sisters, but somehow everything ends up on my shoulders.”
5. Do Professional Caregivers Experience Burnout Too? Dr. Manshes:
Absolutely.
And it is something people often forget.
When we talk about burnout, we usually think about family members.
But professional caregivers, live-in care aides, nursing home staff, and even healthcare professionals can also experience significant emotional exhaustion.
At the end of the day, these are people who spend their days caring for someone who depends on them.
Sometimes for years.
They deal with responsibility.
Uncertainty.
Complex medical situations.
Changes in a patient’s behavior.
And emotional demands that are not always visible from the outside.
Sometimes caregivers have very little opportunity for real rest.
Sometimes they are far away from their own families.
And sometimes they effectively live at their workplace.
That is a considerable burden.
I remember one patient whose caregiver became extremely tired and emotionally exhausted during a certain period.
Over time, it became harder for that caregiver to respond attentively to her needs.
There was less patience.
Less emotional presence.
Less energy to give.
The patient herself became increasingly anxious and unsettled.
She felt unheard.
Misunderstood.
As if she was losing even more control over her own life.
And naturally, that only increased her anxiety.
This reminds us of something important.
We often think of caregiving in terms of medications, medical appointments, and treatment plans.
But at its core, caregiving is also about human relationships.
And when the person providing care becomes burned out, the entire system feels it.
That is why it is so important to remember that professional caregivers also need support, rest, understanding, and sometimes professional help.
Because no one can continue giving indefinitely without receiving support themselves.
6. Why Do Conflicts Sometimes Arise Between Family Members and Caregivers?
Arthur Andonis:
Dr. Manshes, I think many families have experienced this.
At the beginning, everyone wants the same thing — the best possible care for an elderly loved one.
But over time, tension and frustration can develop.
Family members may feel that not enough is being done.
Caregivers may feel that their efforts are not appreciated.
And sometimes each side feels that they are carrying most of the burden.
Why does this happen so often?
Dr. Manshes:
Because several people are living under significant pressure at the same time.
On one side, there is the family.
Children worry about their parents.
They fear that something may happen.
They feel responsible.
And sometimes they feel guilty because they cannot always be there.
On the other side is the caregiver.
A person who spends many hours each day with the elderly individual.
A person carrying daily responsibility.
And someone who may also be dealing with fatigue and emotional exhaustion.
When both sides are living under constant stress, conflict becomes much more likely.
Sometimes a family member notices a small detail that was not handled exactly as expected.
At the same time, the caregiver may feel that all of their efforts are simply taken for granted.
I often hear family members say:
“I’m the only one who is truly taking care of my mother.”
And caregivers say:
“No one understands how difficult this job really is.”
Most of the time, both sides are being completely sincere.
The problem begins when people stop seeing one another.
When family members notice only mistakes.
And caregivers hear only criticism.
At that point, the elderly person often begins to feel the tension as well.
Sometimes without a single word being spoken.
Older adults are often very sensitive to the atmosphere around them.
They sense frustration.
They sense tension.
They sense conflict.
And sometimes they begin to see themselves as a burden to others.
That is why it is important to remember that everyone is ultimately on the same side.
The goal is the same for everyone.
To help the patient.
To preserve their dignity.
And to provide a sense of safety and stability.
When people remember that, conversations often become calmer and more productive.
7. Who Takes Care of the People Who Are Taking Care of Everyone Else?
Dr. Manshes:
That is a very important question.
And one that is often overlooked.
People who care for others become accustomed to being the ones who hold everything together.
They organize.
They solve problems.
They coordinate.
They make decisions.
Over time, they become used to being the person who gives support rather than receives it.
But they are still human beings.
They get tired.
They burn out.
They worry.
They become afraid.
And sometimes they feel very alone.
One of the most common mistakes is believing:
“I have to handle this on my own.”
But long-term caregiving is not a sprint.
It is much more like a marathon.
And nobody runs a marathon without rest, recovery, and support.
I meet many family members who tell me:
“I’m fine.”
But after a few more minutes of conversation, it becomes clear that they have not been sleeping well for months.
They are living under constant stress.
They have stopped seeing friends.
And in some cases, they have even stopped taking care of their own health.
And this is where it is important to understand something.
Asking for help is not a sign of weakness.
It is a sign of responsibility.
Because when the person holding everything together becomes completely exhausted, the entire system suffers.
Support can come in many forms.
Sometimes from family.
Sometimes from friends.
Sometimes from professionals.
And sometimes simply from having a conversation with someone who understands the weight of what you are carrying.
The goal is not to stop caring for a parent.
The goal is to make it possible to continue being there for them without becoming completely depleted.
8. How Can You Take Care of Yourself While Caring for an Elderly Parent?
Arthur Andonis:
Dr. Manshes, I think many people listening to us right now will recognize themselves in this situation.
They know they are tired.
They know they are carrying a tremendous burden.
But they do not really know how to stop.
They do not know how to take care of themselves without feeling guilty.
How can someone protect their own well-being when caregiving continues for months or even years?
Dr. Manshes:
I think the first thing to understand is that long-term caregiving is not a short-term event.
Many family members begin this journey thinking:
“I’m just going to help a little.”
Or:
“We only need to get through this period.”
But in many cases, this becomes a long road.
And it needs to be approached differently.
When we run a short race, we can use all of our energy at once.
But when the journey is long, we need to manage our resources wisely.
Many people do not do that.
They place themselves at the very bottom of the list.
After their parent.
After their children.
After work.
After everyone else’s needs.
For a while, that may seem manageable.
But eventually, the cost begins to show.
The exhaustion builds up.
Patience becomes harder to maintain.
Joy gradually disappears.
And life starts revolving entirely around caregiving.
That is why I often tell family members something very simple but very important:
If you want to be there for your parent over the long term, you also need to remain present for yourself.
That is not selfish.
It does not mean you care less.
In fact, it means the opposite.
Because a completely exhausted person cannot continue giving indefinitely.
What does that look like in practice?
Sometimes it means continuing physical activity.
Sometimes it means making time to meet friends.
Sometimes it means holding on to a hobby that was part of your life before caregiving became such a large responsibility.
And sometimes it can be something very small.
An hour each week.
A walk.
A cup of coffee.
A good book.
A few quiet moments.
The specific activity is less important.
What matters is having a space where you are not only a caregiver.
Many people also find that speaking with a professional can be extremely helpful.
Not because they are “failing.”
But because everyone occasionally needs a place where they can speak honestly.
About exhaustion.
About anger.
About guilt.
About fear.
Without feeling that they must always remain strong.
And perhaps most importantly, it is important to remember that nobody is supposed to carry everything alone.
When people ask for help early enough, it often prevents much more serious burnout later on.
Because the goal is not only to care for a parent.
The goal is also to preserve the family.
To preserve relationships.
And to preserve the person providing the care.
Because caring well for another person always begins with the ability to care for yourself.
9. When Should a Family Caregiver Seek Professional Help?
Dr. Manshes:
This is a very important question.
Because many people seek help only after they have become completely exhausted.
I often tell people that they should not wait for a crisis.
They should not wait until getting out of bed in the morning feels impossible.
They should not wait until fatigue, frustration, or hopelessness begin controlling every aspect of life.
Sometimes simply asking yourself:
“I’m no longer sure I can handle this on my own”
is reason enough to stop and seek professional guidance.
There are several signs I encourage people to pay attention to.
For example:
- Ongoing fatigue that never seems to improve.
- Difficulty concentrating.
- Daily anxiety or emotional tension.
- Persistent guilt.
- Growing irritability.
- Pulling away from friends and family.
- Giving up your entire personal life in order to care for someone else.
Many people come to me convinced that the problem belongs only to their parent.
But during our conversation, it becomes clear that they themselves are carrying an enormous emotional burden.
It is important to understand that a psychogeriatric or psychiatric consultation is not only for the older adult.
Sometimes it helps family members better understand what is happening, gain practical coping tools, and find a healthier way to support a loved one.
I have seen many families feel relief after just one consultation.
Not because the problem disappeared.
But because things suddenly became clearer.
There was structure.
There was understanding.
There was a plan.
And there was a sense that they did not have to carry everything alone.
Ultimately, caring for an elderly parent is not a test of strength.
It is a long journey.
And on a long journey, sometimes the most important step is knowing when to stop, ask for help, and continue forward with more support and more strength.
Conclusion
Arthur Andonis:
Dr. Manshes, thank you very much.
I think today’s conversation reminds us of something extremely important.
When we talk about aging, dementia, loss of independence, or chronic illness, our attention naturally focuses on the person facing the condition.
But surrounding that person are often others carrying an enormous responsibility.
Spouses.
Children.
Professional caregivers.
Live-in care aides.
And sometimes they need support as well.
Today we talked about burnout.
About guilt.
About anger.
About responsibility.
And about how difficult it can be to watch someone you love change before your eyes.
But we also talked about something else.
The importance of asking for help.
The importance of sharing responsibility.
And the understanding that caring for a loved one should not come at the expense of your own well-being.
Sometimes simply stopping for a moment, talking about your struggles, and sharing what you are going through can become the first step toward positive change.
Dr. Manshes:
I completely agree.
Many people believe they must stay strong all the time.
But the ability to acknowledge difficulties, ask for help, and take care of yourself is exactly what allows you to remain present for a loved one over the long term.
And when caregivers begin caring for themselves as well, they not only feel better.
They are also able to provide more stable, compassionate, and sustainable support to the people who depend on them.
For a private consultation with Dr. Dan Manshes:
📞 Phone: +972-73-374-6844
📧 Email: [email protected]
💬 WhatsApp: +972-52-337-3108
