When Less is More : Three Strategies for Preventing Caregiver Stress

Preventing Caregiver Stress. Getty

We want to alleviate the emotional and psychological pain of the person for whom we are caring. The mistake many caregivers make is believing “doing more” is the solution. In caregiving, as in writing, sometimes less is more.

He spent his life being attentive to his wife, whether activities involved taking care of the house, finances or arranging social gatherings. For forty years what he did for her was always out of love.

His wife also did many things for her husband.  But with progressive muscular degeneration, her ability to take care of everyday chores decreased.

He now handled everything in their lives requiring mobility from shopping for food to helping his wife with toileting. As her needs increased and with little help available, what was done out of love before she became ill, was done because of necessity. He still loved his wife, but he daily skated on the verge of burnout.

Many strategies can make caregiving easier. The one most often written about is the reduction of stress. The problem with focusing on stress reduction is the strategies are for AFTER events get out of control. For example, one often reads, “Take a break for yourself at least once a day.”

While taking breaks is important for reducing stress, the well-meaning statement doesn’t address what created the stress. Stress is what happens BECAUSE of prior events.

Focusing on the resultant condition is similar to closing the gate of a barn after the animals have left.

Instead of focusing on stress reduction, concentrate on stress prevention. Caregiving is stressful, but we can do various things to reduce its impact. Below are three I and other caregivers found reduce the occurrence of stress.


One of the hardest things caregivers face is prioritizing what’s important. Many people, such as the husband, assume they can best serve their loved one by doing everything they did prior to the illness. While laudable, their efforts often are unrealistic, regardless of the love someone has for the person receiving care.

Equating the pre-caring situation with the caring situation is a formula for disaster. Even if the amount of effort appears identical, you need to factor in the new emotional weight of the activities.

Think about using simple criteria to prioritize needs. For the husband, developing criteria was simple. “Most important” was anything that could affect the physical health of his wife (e.g., creating a barrier-free home environment). Second most important were things that “buoyed her spirits” (e.g. going to the symphony). Least important were “everything else” (e.g., keeping the kitchen spotless).


“Complications” are a part of caregiving. A complication may involve increasing the number of required activities.

At other times, the complication may involve consequences (e.g., scheduled ingestion of medicines moves from important to critical with some conditions).

Simplicity can be introduced into caregiving. The easiest way is to rank order the importance of everything you’re doing, as suggested in the “Prioritize” strategy. But often, even reducing the number of necessary activities doesn’t result in the prevention of stress.

An alternative is to reduce the importance of an outcome. In our example, the husband and wife always took pride in the spotlessness of their house. While a “clean house” was still important, an “immaculately clean” one no longer was. “Acceptably clean” simplified their lives.


Caregiving is always in flux; either because the illness is progressive, or the effects of it continually require attitude adjustments by both the loved one and caregiver. Just when the caregiver and loved one adjust to the change, the situation shifts and a new period of adjustment begins which inevitably will change again.

“Acceptance” becomes the basis for developing future strategies. By planning for continual changes, you reduce the possibility of more disappointment when improvements don’t occur. If there is improvement, that’s icing on the cake.

Many people refuse to accept the permanence or progressiveness of a condition requiring care. They equate “acceptance” with “giving up”.  However, acceptance of reality often leads to creative ways of adapting (e.g. trading in a sports car on a van equipped with a wheelchair ramp). Hope, on the other hand, can prevent adaptation and becomes a delusion leading to continued disappointment.


Will implementing all three strategies make caregiving a joy? Probably not. Caregiving involves making choices. Rarely are they between what’s “great” and what’s “terrible.” Most involve choosing between two or more alternatives, that are “less than great.” Using the three strategies will enable you to adapt to what is presently occurring and minimize the possibility of disabling stress.

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