[MOL] For Our Caregivers... [01025] Medicine On Line

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[MOL] For Our Caregivers...

Expert Commentary: Overcoming Compassion Fatigue =20

September 4, 1998=20

You're drained, tapped out, have little energy to give others. =

We've all been there. Usually, after a little break we revive and step =

back up to the plate. What happens, however, when these feelings don't =

pass - going beyond fatigue and turning into something much worse, like =

apathy? This could spell trouble for those caring for an elderly parent =

or sick child, or for health care professionals rendering care to =

others. In this InteliHealth interview, one of the nation's leading =

medical experts talks about compassion fatigue, a condition that plagues =

many individuals working in and out of the home. What actions can you =

take to prevent this serious occupational health hazard and risk to =

caregivers in general?=20

Q: What is compassion fatigue?

A: This term has replaced the more familiar term "burn-out." It =

refers to a physical, emotional and spiritual fatigue or exhaustion that =

takes over a person and causes a decline in his or her ability to =

experience joy or to feel and care for others. Compassion fatigue is a =

one-way street, in which individuals are giving out a great deal of =

energy and compassion to others over a period of time, yet aren't able =

to get enough back to reassure themselves that the world is a hopeful =

place. It's this constant outputting of compassion and caring over time =

that can lead to these feelings.=20

Q: What causes it?

A: Compassion fatigue comes from a variety of sources. Although it =

often affects those working in care-giving professions - nurses, =

physicians, mental health workers and clergymen - it can affect people =

in any kind of situation or setting where they're doing a great deal of =

caregiving and expending emotional and physical energy day in and day =


Q: Who is most at risk of developing compassion fatigue?

A: Although those in the health care and mental health professions =

are most at risk of developing these feelings, it is not limited to =

these arenas. It affects those who don't work outside the home as =

severely as those who do. Take someone who is actively engaged in taking =

care of a family member, especially during a crisis period when there is =

a higher need to give out feelings of compassion and sensitivity. If the =

crisis doesn't pass quickly and the individual continues functioning at =

this level, he is just as susceptible to compassion fatigue over time as =

those in high-risk professions.=20

Q: What are some telltale signs of compassion fatigue?

A: First, you should understand that it's a process. It's not a =

matter of one day, you're living your life with a great deal of energy =

and enjoyment, and the next, you wake up exhausted and devoid of any =

energy - both physical and emotional. Compassion fatigue develops over =

time - taking weeks, sometimes years to surface. Basically, it's a low =

level, chronic clouding of caring and concern for others in your life - =

whether you work in or outside the home. Over time, your ability to feel =

and care for others becomes eroded through overuse of your skills of =

compassion. You also might experience an emotional blunting - whereby =

you react to situations differently than one would normally expect.=20

Q: If you have this condition, what can you do?

A: The most critical need is to acknowledge that you may be =

experiencing it. All of us have multiple demands and energy drains in =

our lives - some positive, some negative - which all require a great =

deal of emotional and physical attention. There are, however, many =

hands-on things you can do to mitigate the feelings of compassion =

fatigue. For one, start refocusing on yourself. Before you can tend to =

and be sensitive to the needs of others, you have to take care of your =

own well-being. This can be as simple as getting plenty of rest, =

becoming more aware of your dietary and recreational habits, and cutting =

out negative addictions in your life like nicotine, alcohol and =

caffeine. Remember, the healing process takes time, as does the =

development of the problem.=20

Q: What if you're in a high-risk profession and the feelings don't =

pass? Should you quit your job, request a transfer or take an extended =


A: All of these are options depending on your situation. Sometimes =

people who witness a lot of trauma as part of their jobs - like law =

enforcement agents, paramedics and fireman - will opt to choose =

different lines of work. Even if they recuperate and successfully combat =

these feelings, they sometimes feel they don't want to begin again the =

process of exposing their heart and feelings day in and day out. For =

others, a vacation may do the trick. Vacations are healthy, restorative =

interventions that can head off negative feelings so that they don't =

progress beyond the point of no return. Transferring to another unit =

either temporarily or permanently is another alternative. A job that's =

more mechanical and less human service-oriented can sometimes give =

people just the respite they need to regain their balance and their =

empathy towards others.=20

Q: Is there anyway to prevent compassion fatigue?

A: Preventing compassion fatigue is really the key. It's much =

easier to stop it from occurring in the first place than it is to repair =

things once it sets in. You have to continually practice good emotional =

health maintenance along the way and maintain some sort of balance in =

your life. There has to be a portion of your life inn which you need to =

take, rather than give. Beyond practicing fundamental self-care skills, =

you need to put yourself in situations in which you see the positives in =

life, for example, attending a field trip with your child where you're =

truly enjoying the experience, or volunteering where you're able to give =

and receive. Sometimes, you can't prevent compassion fatigue from =

occurring. We see this a lot with individuals working in professions =

with a high degree of human interaction and human service. However, =

practicing some of these techniques can restore your ability to feel =

compassion for and sensitivity to the troubles and difficulties of =


Q: If you're in a health care profession, could you be a danger to =

your patients if you have compassion fatigue?

A: Maybe yes, if you took the scenario to its extreme; however, =

this isn't what usually happens. What typically occurs is a numbing of =

feelings or a distancing and detachment from a patient and his family. =

It rarely results in a serious medical mistake, but rather prevents the =

individual from bonding and connecting with those under his care. It's =

akin to being on auto-pilot in which those affected put up an interior =

wall to separate their feelings from the tasks they need to do.=20

Q: What if you're caring for an elderly parent and develop these =


A: You need to seek assistance from others - siblings, relatives, =

friends and neighbors - to give yourself a breather. You also might =

rotate duties with a sibling, for example. If you're the one responsible =

for accompanying your parent to chemotherapy sessions - a highly charged =

and draining event - you might let your brother or sister do that task =

for a while while you pick up another.=20

Q: We're all bombarded with bad news everyday just by listening to =

the news or reading the paper. Can this desensitize us as well and what =

can we do about it?

A: We live in a world in which the media constantly bombards us =

with images of poverty and violence, bringing us to a point where we =

almost shut down because it becomes too emotionally taxing to feel for =

others. One way to prevent this from happening is to refrain from =

watching the news or reading the paper for a while. This mild escapism =

can help prevent your heart strings from being constantly tugged by all =

the sad things taking place in the world.=20

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