As discussed in Chapter 4, estrangement is a primary phenomenon among families dealing with neurocompromise. Another common occurrence involves the accumulation of stressors upon a caregiver, which often culminates in a sense of burden. Although not all caregivers or families experience burden, many of them do with negative psychological results. Burden can be a pervasive and chronic condition, as caregivers feel overwhelmed, depressed, and "at the end of their rope." Burden has been studied extensively, and much knowledge has accumulated regarding contributing factors. In this chapter, selected literature will be reviewed regarding the caregiver and burden. Models of family response to neurocompromise will also be presented.