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“It’s a Sunday morning. A daughter gets up, well rested, she sits down with a cup of tea, opens her laptop, and begins planning the day she has been postponing for weeks. However, as she is sitting down to work, her father calls her in his room. He isn’t in pain; he is simply lonely today and wants someone to sit with him for a while. The entire day gets lost in catering to his needs and before she knew it, it was already night time and all the pending work remains pending”.
For countless families, this is not an unusual Sunday – it is everyday life. This is the reality of innumerable people around us; caring for people who cannot take care of themselves. Whether its mothers taking care of their neurodivergent children, some family member caring for a cancer patient or a person with longstanding physical illness, a person looking after a psychologically compromised family member or, as the story suggested, the everyday care of an ageing parent, the common thread is caregiving responsibilities.
Caregiving responsibilities, when they continue for prolonged periods without adequate support, can insidiously lead to a phenomenon that psychologists refer to as caregiving burden – a term used to describe physical, emotional, social and/or financial strain that slowly accumulates in caregivers. Being gradual in nature, it becomes difficult to recognise the signs before the impact on the caregiver is substantial. A very important point to remember here is that experiencing caregiving burden is not a reflection of the caregiver’s feelings or connection with their loved ones. It is rather a natural response to continued demands of caregiving. Understanding this is important because acknowledging that they feel tired leads to unnecessary guilt in caregivers. The guilt amounts to avoidance of voicing their fatigue, leading to compromised self-care. This, in turn, reduces the sustainability of compassionate and empathic caregiving to the person needing them, ultimately compromising the quality of care received by their loved one. Recognising caregiver burden is not about questioning a caregiver’s love or commitment – it is about acknowledging that even the strongest individuals need support to continue caring for others.
In Pakistani context, understanding the realities of caregiving burden is particularly important. Being a collectivistic society, with strong cultural and religious roots, caring for ageing parents, chronically ailing spouse or family member, or children with special needs is considered to be a duty rather than a choice. Additionally, a strong sense of obligation towards family commitment makes the conversations around caregiving difficulties more of a taboo. Compounding this, urbanisation, migration and choice of nuclear family systems over joint families have made fewer family members available to share the caregiving responsibilities. Additionally, culturally, women are expected to shoulder the responsibility of caregiving more than men. Our culture celebrates caring for loved ones, and this is one of the biggest strengths of our society that no one is left behind or alone in majority of cases. However, when conversations become hesitant, when choices become non-negotiable duties, and when support becomes scarce, the comfort of one person quietly becomes the burden of another. The next step, therefore, is to understand how to recognise if caregiving burden is present, and to have a plan of strategies and support for those who care for others.
Caregiving burden rarely appears overnight. Due to its subtle nature, it usually goes unnoticed until its effects become significant. A once very patient and understanding person finds themselves to be slowly turning into an irritable, emotionally withdrawn and constantly fatigued individual. What starts as cognitive signs of difficulty in concentration, minor memory lapses and mental exhaustion progresses to emotional signs of feelings of anger and guilt, having frequent crying spells and eventually emotional numbness. This, in turn, materialises as physical symptoms of frequent headaches, constant fatigue, body aches and becoming more susceptible to illnesses. Over time, these changes begin to affect not only the caregiver’s own well-being but also the quality of care they are able to provide to the person who depends on them. Many caregivers mistake these changes for indicators of personal weakness or poor coping, while in reality, they are the mind and body’s way of signaling that support is needed.
Moving on towards the practical strategies that can be adopted to deal with caregiving burden, an important point of consideration is that while families, communities and healthcare systems have an important role in supporting the caregivers and sharing their responsibilities, caregivers themselves have a responsibility towards their own care as well. At social and community level, it is imperative to understand that supporting caregivers does not require grand gestures. A small, but intentional step can create a meaningful positive difference in alleviating their mental health and caregiving burden. For families, understanding that caregiving is a shared responsibility rather than a burden to be shouldered by only one individual can serve as the first step towards relief. When caregivers know that they have family support, it reduces the guilt associated with self-care, frequently misperceived as being selfish.
At the individual level, the caregiver needs to take short periods of rest, look after their own physical health, and remain connected with people who provide emotional support. All these acts are not self-indulgence but rather an investment towards their ability to continue compassionate care. Seeking professional support, where required, is also a sign of self-awareness and strength rather than a sign of failure. A caregiver who feels emotionally supported is better equipped to continue providing compassionate, empathic and sustainable support to their dependents – a caregiver who pauses to care for themselves is not stepping away from responsibility; rather, they are ensuring they can return to it tomorrow.
Collectively, caring for the caregivers as well can help us continue being a society where support is celebrated and help is available to all when required. Perhaps next Sunday, that daughter will once again choose to close her laptop and sit beside her father. She will do it with love, as she has always been doing. But perhaps this time, the rest of us will remember to ask her a simple question we so rarely ask caregivers: “And how are you doing today?”
