There are also a number of additional factors that increase the likelihood of burnout. Situational factors can include sharing a residence with the care recipient that is not suitably adapted for mobility, long commuting distances, living in an area with few resources and medical providers, and juggling heavy work and family responsibilities with caregiving. Other obstacles can include limited financial resources, and limited familiarity with navigating complex medical, insurance, legal and financial issues.
Interpersonal and familial factors include inadequate support from friends or other family members, isolation from social networks due to caregiving responsibilities, and unresolved family rifts or conflicts resulting in factions, estrangements, or hostility that interfere with caregiving. There can also be an uneven distribution of caregiving responsibilities within a family, or family members who abuse medications or financial resources intended for the patient.
Additionally, nearly half of caregivers feel that they have no choice about their caregiving role and responsibility. Added psychological pressure can come from the hope that caregiving will create the opportunity for healing or closeness of a formerly unsatisfying relationship with the care recipient. Alternatively, there can be a reactivation of traumatic memories and emotions resulting from caring for someone who has been abusive or neglectful in the past (and who may still continue to be). And some caregivers find themselves seeking validation, approval and fulfillment through self-sacrifice and service to others.