Compassion Fatigue: How to Know if you Care Too Much

Senior and Hospice care professional compassion fatigue Compassion fatigue impact

Anyone senior care or hospice professional can experience Compassion Fatigue. Nurses, doctors, counselors, veterinarians, therapists, social workers, chaplains, emergency response workers, and people caring for aging parents are vulnerable.

Dr. Charles Figley, an expert on the subject, describes Compassion Fatigue as, “ a state experienced by those helping people in distress; it is an extreme state of tension and preoccupation with the suffering of those being helped to the degree that it is traumatizing for the helper.”  He goes on to say that “The capacity for compassion and empathy seems to be at the core of our ability to do the work and at the core of our ability to be wounded by the work”.

Compassionate fatigue results from the cumulative impact of taking care of people living with serious illness, trauma, abuse, or severe conditions.”  It’s different than job burnout, which is dissatisfaction with our employment situation, not necessarily the work itself.

Compassion is our feelings and thoughts when we witness the suffering of another and the desire to alleviate the suffering. Sometimes 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. Perhaps it’s attachment that leads to compassion fatigue, not compassion itself.

A perfect illustration involves Jane, a therapist working in a nursing home. She describes walking into an elder’s room 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, alone.

Jane 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.  But she conjured up the courage to stay present and focused her attention on this woman rather than the outer condition. The fear softened. She gently stroked the woman’s shoulders and she told Jane, “That feels good.” Jane shared that following the visit instead of fear she felt good knowing she had made a difference by connecting with this woman. She was able to drop the attachment to the fear and sadness which allowed her to be present and both she and the woman were uplifted in the process.

How can you recognize compassionate fatigue?  

Some of the symptoms may seem like “normal” stress responses and you may associate them with your work. After all, we live in a pretty stressful world these days. Some characteristics of compassion fatigue include:

  • Withdrawing from others
  • Difficulty connecting with clients- detaching
  • Feeling angry that other caregivers don’t understand the nature of your service
  • Life feels too serious
  • Turning to compulsive or addictive behaviors such as overeating, overspending, alcohol, smoking, etc.
  • Physical symptoms: headaches, gastrointestinal symptoms, muscle tension.
  • Fatigue and apathy
  • Difficulty concentrating
  • Avoiding clients. Calling in sick or postponing appointments
  • Thinking that this work isn’t for you (when you know in your heart you really love it)

It’s important to recognize the symptoms so that we avoid reactions or relieve them if they arise. The answer lies in self-care.  Training about self-care typically includes physical support like regular exercise, getting enough sleep and good nutrition. However we shouldn’t stop there. Nancy Jo Bush, an oncology nurse, says that self-care also includes setting empathetic boundaries; self awareness and self forgiveness; being in tune with one’s spirituality and finding hope. The experts agree that reaching out to others and developing a support system is critical, therefore, who would you turn to if you needed the support of an understanding friend?

One hospice professional advises, “Lighten up and don’t forget to laugh.” That reminds me of an old Joni Mitchell lyric, “Laughing and crying, you know it’s the same release.”  So, thanks, Joni. We’ll all try to remember that!