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Compassion Fatigue: When Caregivers Go Beyond Burnout

Compassion Fatigue: When Caregivers Go Beyond Burnout

Most long-term caregivers have times where the fatigue and frequent frustration of providing care for a vulnerable person can border on burnout. Even though I’ve handled caring for multiple elders’ situations reasonably well, there have been times when I’ve wondered how much longer I could keep it up.

Those times have come dangerously close to burnout, but I have always moved through them with a focus on faith and self-care. Since my darkest days, however, I’ve learned that there is another stage that exists beyond burnout—one that can be extremely scary. This stage is called compassion fatigue.

Many readers have had feelings similar to mine. Some have even told me that they feel they have progressed beyond burnout. In the interest of helping these readers, and clarifying how a somewhat common feeling of caregiver burnout can turn into compassion fatigue, I looked for assistance. After some research, I contacted Christine M. Valentin, a Licensed Clinical Social worker in New York City and the state of New Jersey and asked her to educate all of us about burnout and compassion fatigue.

Christine has a Master’s Degree in Social Work. For the last six years, she's owned a private counseling practice where she works with adults who are experiencing anxiety related to work, relationships, family, multiple sclerosis and/or caring for a loved one with Alzheimer's disease. Prior to her private practice, she worked for six years with older adults and family caregivers in various non-profit organizations in NYC.

CBB: Christine, as I mentioned above, I’ve read about compassion fatigue and heard it sometimes used interchangeably with caregiver burnout. Can you please explain what this phenomenon actually is?

CMV: Compassion fatigue is an extreme state of great tension and stress that can result in feelings of hopelessness, indifference, pessimism and overall disinterest in other people's issues.

With regard to caregivers, this can manifest through actions like yelling, hitting or neglecting a loved one. Basically, any action that is not characteristic of the caregiver’s typical behavior but is now present and consistent could be considered a result of this condition.

While some may simplify and attribute this change in behavior to frustration and/or resentment, it is important to understand that this is not something that occurs overnight. It is the cumulative result of days, weeks, months and years of managing caregiving responsibilities that are often unrecognized, seemingly endless, emotionally demanding and physically exhausting. As a result, it is not uncommon for feelings of frustration, resentment, hopelessness, guilt and/or a diminished sense of self to manifest.

CBB: How do long-term caregivers who are close to or already experiencing burnout avoid reaching an even more dire state?

CMV: Being proactive is one of the best ways to combat this or at least prevent it from getting out of hand. First and foremost, be aware of the warning signs:

Feeling overwhelmed, exhausted and drained

Not wanting to be around your loved one (choosing to work late, daydreaming about no longer having to care for them, etc.)

A decrease in patience and tolerance

Angry outbursts that are uncharacteristic of your behavior

CBB: Being aware of the changes in your behavior is obviously the first step toward preventing compassion fatigue. What comes next?

CMV: The next step is to begin making yourself a priority and tend to, at the very least, some of your needs. While many caregivers feel this is impossible to do, it is important to understand that if you don't make time for yourself, no one else will.

Therefore, allocate at the very least five minutes each day to eat, pray, dance, laugh, walk, sing, read an inspirational quote, meditate, chat with a friend, the list can go on and on. My point is to give yourself a mental and physical break from actively caring for a loved one. The ability to do so in small bursts can allow you to begin the practice of adequately caring for yourself and hopefully get you to increase these efforts moving forward.

CBB: What else would you suggest?

CMV: Having a non-judgmental outlet to express your thoughts can also be beneficial. Outlets like writing in a personal journal, talking with a confidant, or seeking advice from a healthcare professional can help you with processing your feelings and offer a safe place to release pent up thoughts and emotions.

CBB: What if a reader is experiencing what they now recognize may be compassion fatigue?

CMV: If you find yourself already experiencing these feelings and symptoms, then let others know and seek professional help. Believing the feelings will not subside, especially while you are still actively caring for a loved one, can cause some individuals to become depressed, develop panic attacks and/or potentially put their loved one in harm's way.

CBB: Thank you for clarifying this for us Christine. Readers can get more information about you and your services on your website.

From my point of view, the courageous caregivers who comment on the Agingcare forum, as well as in other groups about caregiver stress and burnout, need to take especially aggressive steps to take care of themselves to avoid these emotional and physical complications. Seeking professional help could be a good approach even for burnout, but seems to be necessary when caregivers reach the more advanced stage where their feelings lean toward compassion fatigue. Practicing proactive self-care is as beneficial for the care receiver as it is for the caregiver.

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