Compassion Fatigue in Caregivers: Defining, Preventing, and Treating

 

Almost every caregiver experienced “one of those days” when they left work feeling physically and emotionally exhausted. They wondered if their chosen career path was a mistake. Although having some days like this is a normal part of the job, when those days pile up, it could lead to something more serious. The ongoing stress of caring for those with trauma and suffering, along with other workplace stressors, takes it’s toll. Compassionate caregivers may find times when empathy becomes difficult. This is a serious condition called Compassion Fatigue.

What is Compassion Fatigue?

Compassion Fatigue is a work-related stress response to the everyday pressures of caring for those with trauma and suffering. It is exclusive to those in the caring professions–nurses, doctors, psychotherapists, counselors, social workers, and other caregivers. Some have considered it a “cost of caring.” This condition results in the caregiver having difficulty feeling empathy and compassion for their patients. It is a relative of burnout–the feeling of exhaustion and frustration from continuous exposure to stress in one’s occupation. Some texts consider it synonymous with Secondary Traumatic Stress.

Symptoms are varied and, unlike burnout, develop relatively quick. Typical symptoms include:

  • Deep physical and emotional exhaustion
  • Irritability
  • Avoidance of patients
  • Diverting conversations about trauma
  • Increased cynicism
  • Loss of career enjoyment
  • Increased absenteeism
  • Difficulty with interpersonal relationships
  • Hypersensitivity or insensitivity to emotionally charged stimuli
  • Insomnia
  • Trouble concentrating
  • Poor decision-making
  • Difficulty separating personal and professional life
  • Headaches
  • Gastrointestinal difficulties
  • Increased drug and alcohol use

If left untreated, feelings of hopelessness, depression, and anxiety could also occur.

Though anyone in caregiving professions are susceptible to Compassion Fatigue, there are a few common risk factors. Women are more likely to develop it than men. Those working directly with patients are more at risk. Caregivers with fewer health care qualifications and less experience are generally at a higher risk.

Compassion fatigue directly impacts the quality of care patients receive. Caregivers aware of this condition are more likely to practice preventive self-care skills and seek necessary support.

Preventing and Treating Compassion Fatigue

When attending to others’ complex needs, caregivers often neglect their own. It is crucial for caregivers to address their own self-care needs. To some it may seem selfish, but if someone is coming into work each day with a combination of the above symptoms, how effective will they be?

Self-Care

Manage Work/Life Balance

Recreation Therapists know the value of a positive leisure lifestyle. They spend their days teaching and exposing others to meaningful recreation experiences. Caregivers and Recreation Therapists should assess their free time. Do they have positive outlets for stressful days? Do they engage in fulfilling activities on their off days? Finding leisure pursuits that bring joy, accomplishment, and a sense of well-being helps offset a stressful work environment.

Create Boundaries

Recreation Therapists and caregivers often work nontraditional hours in intense environments. People outside the organization may not understand the nature of their work. For these reasons, many in caring professions find friendships with their coworkers. Oftentimes these friendships revolve around discussions about the workplace. A nice dinner with coworkers becomes a gossip and venting marathon. It’s great to get along with your working peers, but boundaries need to be set..

Find friends with common interests that don’t work in the field. Join a group or volunteer for a cause you enjoy. As a Recreation Therapist, wouldn’t you rather talk about the enjoyment you get from your leisure pursuits?

Self Assessment

Compassion Fatigue symptoms vary in intensity. It is important to “check-in” with yourself every few days if you feel the tugs of Compassion Fatigue. Create a personal scale based on the severity of your symptoms. For example, on a scale of one to ten, a three may be physically tired and irritable. A seven, on the other hand, could involve trouble sleeping and social isolation.

Develop self-care interventions for each number on your Compassion Fatigue scale. With a solid plan in place, it is easier to execute. The “three” mentioned earlier could mean a little time doing a simple yoga routine or taking a walk in nature. The “seven” may involve calling a non-caregiver friend to chat then taking a soothing bath. As Recreation Therapists we often create individual treatment plans for our clients. Use that knowledge to develop your own.

Be Well

General wellness not only improves quality of life, it helps prevent Compassion Fatigue. A varied, healthy diet, regular exercise, and mind/body techniques have significant health benefits. As Recreation professionals we often teach our clients about these wellness activities, but how often do we engage in them? Take a quick assessment of your leisure time activities. See if there are any small changes you could implement. A smoothie instead of coffee? A brisk walk instead of another half-hour with Netflix? Getting a phone app to teach a yoga routine?

If caregivers want the best for their patients, they must take good care of themselves.

Explore Spirituality

Individuals with religious and/or spiritual involvement tend to have a better life satisfaction and coping mechanisms. Although less people are identifying with organized religions, personal spirituality interest is on the rise. Spirituality refers to a person’s set of beliefs that bring meaning to his or her life. It involves finding a higher meaning of the day to day routine, and developing a connection to the world shared with others. Meditation, journaling, and introspection are great ways to begin one’s spiritual journey. Of course, belonging to a church or faith-based community also increases spirituality. Simpson’s 2005 study, showed as one’s spirituality decreased, the likelihood of Compassion Fatigue increased.

In the Workplace

Change Your Workload

Talk to your supervisor or human resources coordinator. See if an employee assistance program or similar resources are available. Brainstorm ideas with your supervisor to change your schedule or decrease exposure to traumatized individuals. Bring solutions to stressful situations in your workplace. A temporary caseload downsize would be much better than leaving the field completely.  

Request Education

See if your company could conduct an inservice about Compassion Fatigue. Put some literature in the breakroom. The more everyone in your workplace knows about this condition, the better they could identify it and support one another.

Support Your Coworkers

Some coworkers experiencing Compassion Fatigue may deny or feel embarrassed about it. They may feel as if it is defect in their character or sign of weakness. You don’t have to chase someone down with a pamphlet every time they look exhausted or irritable. Say a kind word, crack a joke, or offer to help if they seem overwhelmed. A supportive work environment is well-being for your place of employment.

Be a Mindful Manager

If you manage other caregivers, check in with them. Observe their behaviors. Show gratitude for their contributions. Be empathetic to their situations. Too often we get immersed in our own busy schedule to see someone struggling. If one of your team members is having difficulty, give them duties that highlight their strengths. Change schedules and caseloads if possible. Don’t see their struggles as a burden, but an opportunity to make changes that strengthen the team. Many caregiving fields have high turnover. Focus on workers being satisfied instead of stretching them too thin.

 

Compassion Fatigue is a serious condition that, unlike burnout, could manifest quickly. Substandard patient care, depression, and anxiety result when issues are not addressed. In extreme cases, leaving the profession, deteriorating interpersonal relationships, and suicide can occur. Education and self-care prevent the symptoms from spiraling out of control.

Seek counseling if you are overwhelmed by symptoms of Compassion Fatigue. Use the resources your company provides. Find balance in your life. Be the best you, so you could be the best Recreation Therapist or caregiver.

What self-care strategies do you use to help with stressful days? What outlets do you find most effective?  

 

Resources

Compassion Fatigue Awareness Project

Compassion Fatigue Self-Tests

 

References:

https://www.researchgate.net/publication/312301246_Compassion_fatigue_A_meta-narrative_review_of_the_healthcare_literature

Secondarytrauma.org. Retrieved 19 April 2017, from http://secondarytrauma.org/secondarytrauma.htm

The Cost of Caring: 10 Ways to Prevent Compassion Fatigue. (2016). GoodTherapy.org Therapy Blog. Retrieved 19 April 2017, from http://www.goodtherapy.org/blog/the-cost-of-caring-10-ways-to-prevent-compassion-fatigue-0209167

Preventing Compassion Fatigue. (2017). Psychology Today. Retrieved 19 April 2017, from https://www.psychologytoday.com/blog/happiness-in-world/201209/preventing-compassion-fatigue

Simpson, L. R., & Starkey, D. S. (2006). Secondary traumatic stress, compassion fatigue, and counselor spirituality: Implications for counselors working with trauma. Retrieved March 22, 2007, from http://www.counselingoutfitters.com/Simpson.htm

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