Constrained endurance in long-term family caregiving: Rethinking resilience through nursing ethics

Abstract

Resilience is an established concept in family-caregiver research, where it is used to describe how caregivers maintain functioning and adapt to sustained adversity. In long-term family care for older adults with disabilities, however, resilience is ethically ambiguous. Continued care may reflect adaptive capacity, relational commitment and caregiving competence, but it may also be shaped by dependency, moral obligation, cultural expectations and limited alternatives. This article critically examines the ethical implications of caregiver resilience and develops the concept of constrained endurance to rethink resilience in long-term family caregiving. The article advances an ethical critique of resilience discourse by showing how resilience, when uncritically celebrated, may psychologise caregiver distress, individualise structural problems and attach moral value to endurance. Fatigue, ambivalence, complaint and the wish for relief may then be interpreted as signs of inadequate coping, insufficient responsibility or failure of care, rather than as signals that care arrangements have exceeded what can be sustainably borne. Rethinking resilience through the concept of constrained endurance shifts the ethical focus from asking how caregivers can endure more to examining the conditions under which continued caregiving becomes necessary, costly or unsustainable. For nursing ethics, resilience should function not as a moral standard but as an ethical signal: a prompt to recognise caregivers' limits, acknowledge ambivalence, make hidden costs visible and develop forms of support that make care sustainable rather than merely endurable.