Caregivers play a significant role in the rehabilitation and recovery of a person with mental illness. The burden among caregivers is high, and they encounter several challenges. The strength based perspective proposes that people who confront stress regularly develop ideas, abilities, qualities, and motivations that may consistently utilizing them in the search for a better life. The present case study discusses the burden and determination of a caregiver for an individual with schizophrenia over thirty years. It was a single-subject research design. The subject represents one of the patient's caregivers from a cohort group of dropout patients. The researcher made home visits twice and collected the data by interviewing the caregiver. Subjective experiences of burden were collected through a qualitative interview guide, and a Burden Assessment Schedule (BAS) were used to measure the caregiver burden. The caregiver is a daily wager who has cared for the patient for over 30 years. She had spent a substantial amount towards the spiritual and ritual practices to cure the illness. The BAS score was 83, which shows the caregiver burden to be severe. Being a deserted woman, socio-economic adversities, dealing with the patient's symptomatic behaviour, difficulty in medication management, illness chronicity and minimal improvement, no respite care, and the ageing process of the patient and caregiver led to more burden. The determination factors of the caregiver were having a positive attitude, being nurtured with adversities, family and social obligations, emotional, informational, material and livelihood support of the rural community, skills in utilizing available resources, practicing regular daily routine activities, accepting the challenges, and being involved in social and spiritual deeds. Early identification of illness, continuity of care, and strengthening the caregiver support system, including respite care and community-based mental health services, are essential to address the caregiver burden.