Compassion Fatigue - Don’t
Wait Until it Hurts You.
Because of the demanding nature of working in long-term care, primary care givers, and many professionals including nurses, run the risk of suffering from burnout and
compassion fatigue. By adopting healthy lifestyle choices and focusing on
burnout and compassion fatigue prevention, you can minimize work stresses and
their toll. The author is a leading social gerontology expert in the caregiving
industry and he provides insight for both the caregiver and the recipient in
this wonderful article.
“To work out this plan,
you need the support of your husband”, I told Krishnaprabha explaining the care
plan of her mother in law. “If not better to place her in a care facility” I
gave the second option.
“No sir, he will not
understand and he always says that it is my duty, as if he has no stake in
this”, Krishnaprabha complains about her plight of singlehandedly (mis)managing
a rheumatoid patient with slight dementia.
“Three
years of caring for my mother in law with dementia, I’m exhausted! What hurts worse is when a clueless husband tells you
that the reason my mother in law is so bad is because I had neglected her. That
was very ignorant. I worked, like a donkey, hard at home doing my family’s
chores, and also worked years at jobs myself. I’m worn out, no more it is possible. But now-a-days, the sleepless nights really gang up on me. I can’t do
this kind of work any more …. I can’t care anymore” Prabha decided to call off her ‘caregiving
assignment’.
You’ve heard of burnout, but may not have
heard of compassion fatigue. As more and more family members like Krishnaprabha
become caregivers, it is important to be learning about this term. A heavy
workload and never-ending tasks may make you wonder if you’ve developed
compassion fatigue. What is it and what can you do about it?
Krishna Prabha
is a typical case of Compassion Fatigue. Caring too much can hurt. When primary
caregivers focus on their infirm loved ones without practicing self-care,
destructive behaviors can surface. Apathy, isolation, bottled up emotions and
substance abuse head a long list of symptoms associated with the secondary
traumatic stress disorder now labelled: Compassion Fatigue.
In general, Compassion
Fatigue is a state experienced by those helping people or animals in distress;
it is an extreme state of tension and preoccupation with the suffering of those
being helped to the degree that it can create a secondary traumatic stress for
the helper.
My experience
with ‘long term caregiving’ suggests that caregivers play host to a high level
of compassion fatigue. Day in, day out, primary caregivers struggle to function
in care giving environments that constantly present heart wrenching, emotional
challenges. Eventually, negative attitudes prevail.
Compassion fatigue is caused by empathy. But when there is involvement, it is the
natural consequence of stress resulting from caring for and helping traumatized
or suffering people. The more commonly used term, ‘burnout’ and compassion
fatigue may overlap. The American Institute of Stress, defines this acute stress as “vicarious traumatization” because it’s
caused by working with those who are suffering from the consequences of a
traumatic event.
When you detach from the scenario, there will
not be any empathy. Very few people can do this and most care providers have
overwhelming feelings
and thoughts when they witness the suffering of another and the desire to
alleviate the suffering knowing very well that they are in a helpless
situation. Often we confuse compassion with
attachment, which is our own personal investment in the outcome of the
situation. In other words, when we think we feel compassion we are
actually wrapped up in our own emotional needs rather than the needs of the
other person. Mostly it’s attachment that leads to compassion fatigue, not
compassion itself.
It is not only the family members
who have compassion fatigue. A perfect
illustration involves Milan, Nurse Manager working in our care facility. She
describes walking into the room of 87 year old, Muniratnamma, a new admission,
and feeling stunned by what she saw— an
extremely thin, emaciated woman with severe bruising and discoloration on her
arms and legs sitting in her wheelchair. The bruises were the result of severe
abuse by her son and daughter in law. Milan described her first reaction as
fear which turned to sadness for this woman’s condition and knowing that she
really couldn’t do anything to change it.
As part of preparing this article, I
discussed this topic with two nurse managers from our care facilities. Both
expressed a sense of being overwhelmed, mostly by the feeling that what
stresses them most is beyond their control. “Typically, we entered nursing to
make a difference in the lives of others, not realizing the extraordinary range
of job duties this entails. In addition, we often have to face illness,
decline, and the death of the very people we care so deeply about, and for whom
we strive so hard to provide high-quality care. Residents and families need
support, staff have their coping struggles, bosses can be demanding, and we are
expected to step in and know just what to do. Sometimes we wonder what we do,
why we do?”, Milan was open about her negative feelings.
“Nurses and care providers have demanding
jobs, and at times it may feel like you are carrying the weight of the world on
your shoulders. Given the pressures of care home life, we are susceptible to
emotional, mental, and physical exhaustion brought on by continuous demands
that include the needs of residents and families, staffing issues, reporting
compliances, and surprise visits by management representatives”, Swetha adds.
As
a social gerontologist, I suggest the family care providers, to consider the
following before the compassion fatigue sets in:
·
Don’t pause your life.
·
Practice self care
including, yoga, exercise, small breaks and socialising.
·
Consider placing the ‘patient’
in a care facility for ‘Respite Care’.
·
Consider a vacation.
·
Ask the other siblings
or relatives to provide care for a fixed period in every year.
·
Get additional support,
in the form of home nursing.
·
If nothing works, then
opt for institutionalisation.
·
Place interest of the
patient as utmost important, rather your conveniences.
·
Above all, come to terms
with the helpless situation you are in and be pragmatic when it come to long
term care.
Prevention steps I would list out to help professionals
get life back under control include the following. Few of this are applicable
to family care providers.
·
Start
each day with a relaxing ritual such as 15 minutes for meditating, journaling,
stretching, or reading something inspirational or interesting.
·
Adopt
healthy eating, exercising, and sleeping habits.
·
Set
boundaries to avoid overextending yourself at work.
·
Take
a daily break and set aside time to completely disconnect.
·
Nourish
self-creativity by choosing fun activities that have nothing to do with work.
·
Learn
to manage stress.
·
Add
vacation time to your life.
·
Care
for your spiritual self.
Accepting the presence of compassion fatigue in
your life only serves to validate the fact that you are a deeply caring
individual. If you sense that you are suffering from compassion fatigue, your
path to wellness begins with one small step: awareness. Appropriate awareness
can lead to insights regarding past traumas and painful situations that are
being relived over and over within the confines of your symptoms and behaviors.
Healing begins by employing such simple practices as regular exercise, healthy
eating habits, enjoyable social activities, journaling, and restful sleep.
Somewhere along your healing path, the truth will present itself: You don't
have to make a choice like I mentioned above the likes of Krishnaprabha. It is
possible to practice healthy, ongoing self-care while successfully continuing
to care for others.
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