Invisible Care in a Low-Income Setting: Reflecting on Family Caregiver Fatigue in Dementia Care

Dementia care is largely provided by family members, particularly in low-income settings where formal support systems are limited or absent. As a result, family caregivers face sustained emotional, physical, and psychological demands that place them at high risk of caregiver fatigue. Although caregiver burden in dementia care is well documented, less attention has been given to how caregiver fatigue is experienced, normalized, and rendered invisible within everyday life and health systems. This reflective paper draws on personal experience as a family caregiver for a relative with dementia in Ethiopia, supported by relevant literature, to explore the lived dimensions of caregiver fatigue in the absence of formal support structures. Reflection revealed that caregiver exhaustion was not solely task-related, but a predictable response to structural absence, moral expectations, and limited institutional recognition. Through reflective engagement, caregiver fatigue was reinterpreted from an individual limitation to an ethical and systemic concern. The paper discusses implications for nursing practice, education, advocacy, and policy, highlighting the need for collective responsibility and meaningful support for family caregivers.