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How to alleviate compassion fatigue

Compassion-fatigue-200Caring too much can hurt. When a caregiver provides care to another without practising authentic, sustainable self-care practices on a daily basis, a secondary traumatic stress syndrome known as compassion fatigue can occur. Patricia Smith explains a model of caregiving that can avoid the syndrome.

22 August 2014

Caregivers from all professions such as psychologists, nurses, social workers, teachers, morticians, animal welfare workers and family members are at-risk for compassion fatigue.

Causes of compassion fatigue include placing the needs of others before our own needs, lack of personal boundaries, unresolved past pain and trauma, overdeveloped sense of responsibility, among others. If not attended to, this has the ability to devastate the life of a caregiver.    

Fortunately, traditional caregiving practices are changing. The idea of one person taking full responsibility of providing care to another person is slowly fading away. In its place is a new concept embracing the idea of partnership, where both the caregiver and the person receiving care work together to effect help, hope and healing.

This new model of providing healthy care to others is emerging across the helping professions as well as with family caregivers. No longer is caregiving seen as a one way street where a caregiver is put in the position of being traumatized by another person who is incapacitated, in pain, suffering or preparing to die.

True empathetic, compassionate care is now viewed as a two-way street.

While being of service to another, a caregiver is called upon to be the receiver and bearer of the “gifts” the suffering impart to those who cross his or her path including medical professionals, family members, friends or religious guides.

For a caregiver, there is much to be learned from those in pain and suffering and those about to die. And for those in pain, who are suffering and in the process of dying, there is a wealth of wisdom to be shared.

In 2000, an Oregon hospital inaugurated an in-house program called No One Dies Alone. The purpose of the program was to provide companionship and care to a dying patient when no family members or friends existed or couldn’t be present. Often, the need for this service is requested by a member of the chaplain services staff who is called in to comfort the patient or, in Catholic hospitals, provide Last Rites.

Compassionate Companions, as these program volunteers are called, receive training and schedule caregiving rituals where they are present onsite with the patient anywhere between one to 36 hours. The program caught on and is now offered throughout hospitals and hospices nationwide.

In my healthcare public relations work, I interviewed a number of associates who volunteer for the No One Dies Alone program in one of the hospitals where I serve. What I learned was surprising to me.

Every volunteer told personal stories highlighting the life-affirming gifts that flowed between caregiver and patient. Incidents of trauma appeared to be at a minimum and in its place was a spirit of love, empathy and compassion.

At the end of each interview, I asked the caregiver what he or she does to “fill up” and provide authentic, sustainable self-care in order to continue to do the intense work they do. Many offered ideas such as walking in the woods, being with loved ones, or enjoying hobbies such as journaling. One of the chaplains answered in this way: “When I hold the hand of a dying person, I am filled up.”

In the new mode of caring, patients hold up their end of the process and take an active role in allowing their lives, no matter how debilitating, to retain a level of quality and dignity. This includes completion of advance directives, wills, organ donation forms, and other end-of-life documents that help family members avoid heart-wrenching decisions.

Compassion-fatigue-couple-Derrick-Tyson-Flickr-250Patients are asked not only to appreciate and value the care they are receiving, but they are also being asked to reciprocate in kindness, patience and respect. A quality of life remains no matter how dire the circumstances.

I have worked many years for a health system that promotes holistic wellness: body, mind and spirit. Physicians, nurses and associates who work for this health system respect all persons, particularly those who live in poverty.

The everyday work ethic is based on the idea that a patient actually enters into a healthy caring relationship with his or her care providers. The relationship is based on respect, trust and honesty – a partnership where everyone involved does his or her best to create both a culture of curing and a culture of caring.

Why is the idea of a caregiver being on the receiving end of these processes so important? Latest studies show that the most effective way to lower compassion fatigue levels, along with practicing authentic, sustainable self-care, is to raise compassion satisfaction scores.

According to Beth Hudnall Stamm, PhD, compassion satisfaction is the pleasure we derive from being able to do our work well. Higher levels of compassion satisfaction are related to our ability to be more effective, healthy caregivers.

Dr. Hudnall Stamm, retired director, Institute of Rural Health at Idaho State University, has spent her professional career creating the Professional Quality of Life Self-Test.

This test is the best tool available to measure burnout, secondary traumatic stress and compassion satisfaction levels. Those needing care are also encouraged to retain their personal power and advocate for their own health and well-being, to whatever extent is possible.

I don’t believe there is a caregiving organization or business that wouldn’t embrace this ideal. Mutual respect, trust and honesty lead to better communication, effective listening, fewer incidents of abuse, less stress and burnout, and most important, lower levels of compassion fatigue and higher levels of compassion satisfaction.

The Compassion Fatigue Awareness Project created the following Caregiver’s Bill of Rights in hopes of raising awareness of the life-giving work accomplished by caregivers worldwide. The 12 directives remind caregivers of their need to give as well as receive:

As a caregiver I have the right…

…to be respected for the work I choose to do.

…to take pride in my work and know that I am making a difference.

…to garner appreciation and validation for the care I give others.

…to receive adequate pay for my job as a professional caregiver.

…to discern my personal boundaries and have others respect my choices.

…to seek assistance from others, if and when it is necessary.

…to take time off to re-energize myself.

…to socialize, maintain my interests, and sustain a balanced lifestyle.

…to my own feelings, including negative emotions such as anger, sadness and frustration.

…to express my thoughts and feelings to appropriate people at appropriate times.

…to convey hope to those in my care.

…to believe those in my care will prosper in mind, body and spirit as a result of my caregiving.

Patricia Smith is the Founder of the Compassion Fatigue Awareness Project.

Images: (Bottom):  Derrick Tyson via Flickr under a Creative Commons licence.


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