When Terri Taylor’s parents lived in San Antonio, Texas, she and her sister often found themselves making the five-hour drive from their homes in Dallas to help out with this and that. When Taylor’s father was 95 and her mother 88, the sisters helped their parents move from San Antonio to Dallas. Two years and several health emergencies later, it was clear that their mother’s advancing dementia and father’s health problems necessitated moving them to an assisted living facility.
During the process of packing up their home yet again, Taylor’s once-sweet and compliant mother became so difficult—resisting the idea of moving, accusing Taylor of throwing her possessions away, unpacking recently packed boxes—that Taylor found herself losing patience.
“I would say cruel things and be snippy with her,” Taylor says. “Here I am, fighting with a 90-year-old woman while I’m intruding on her life in such a horrible way, taking her things and packing them.”
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Taylor knew she was fighting with the dementia, not the person, and was racked with guilt over her lost patience. “It’s like being angry at a 2-year-old—a very verbal 2-year-old. She can’t understand what I’m telling her.”
Taylor was suffering from compassion fatigue: As much as she loved her parents, the stress of caring for them over the years was draining her well of empathy and compassion.
“It happens to people in emergency care rooms, chaplains, first responders—any specialty that provides empathic support of other people.”
An element of burnout, compassion fatigue usually occurs within the context of helping other people, says Lekiesha Sumner, director of the health psychology program at Cedars-Sinai Medical Center in Los Angeles. “It happens to people in emergency care rooms, chaplains, first responders—any specialty that provides empathic support of other people.”
And that includes home caregivers, for whom burnout is actually starting to be considered a public health concern, Sumner says. “This is a chronic strain on family members.”
Some amount of compassion fatigue is inevitable for any and all of us, says Ken Druck, author of The Real Rules of Life: Balancing Life’s Terms With Your Own, consultant and expert in resilience, who has worked with 9/11 first-responders and families as well as parents of children killed in the Newtown and Columbine massacres.
“There are elements to just being human that during the course of a normal life—whether it’s with aging parents or overextended with small kids or during a stressful transition—we enter periods where we are way overextended,” he says. “And then our capacity for empathy and compassion, our ability to give to other people is compromised. We are out of whack.”
Especially in helping professions, a little bit of detachment is healthy for keeping in balance, Druck says. “But it’s another thing to be so detached that you become cynical and objectify the people you’re helping.”
And the consequences for the helper can be worse than just a few snarky words, Sumner says. “It can lead to a sense of demoralization, less productively, almost a disorientation—questioning the value of one’s work, a lot of fatigue and poor decision-making.” And, she says, medical problems can also follow when people under that kind of stress don’t make good lifestyle choices.
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The antidote to compassion fatigue is self-care. Some institutions codify this; Mother Teresa required that nuns take a year off their duties every four or five years, for time to heal from their work. But, says Druck, in some organizations, burnout becomes part of the culture. “People cover up their burnout lest they be punished for it, demoted for it.”
And for people working independently, such as home caregivers and aid workers out in the field without nearby support, self-care must be self-motivated. This isn’t always easy for people who have chosen helping professions, or whose support system is limited, but it is crucial.
Steps to Avoiding Compassion Fatigue
1. Tend to your own physical needs.
Start with the basics: eating healthfully, getting adequate sleep, not relying on alcohol and drugs to soothe you.
2. Build time off into your schedule.
A few hours to yourself every week can be a real tonic. If necessary, enlist or hire someone to help you on a regular basis.
3. Find someone to vent to.
“People need a space to be able to express the range of feelings and thoughts they have about helping, without feeling judged or criticized,” Sumner says. “Sometimes you will feel angry, outraged and irritable.”
In addition, talking things through aloud can help you gain perspective on what you’re doing, Druck says. If you have an option, you might even ask yourself whether you want to continue doing the draining work. “When we become so parched ourselves and automatic and we’re just going through the motions of somebody who’s a caregiver, it’s time to call timeout and to really evaluate what we’re doing.”
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If, by the way, you are not suffering compassion fatigue yourself but think someone else is, the best thing to do is ask—in a nonjudgmental, non-accusatory way, Druck says. “Incorporate noticing in your asking: I can’t help but notice that you look really tired, or you’ve been impatient with me, or you seem to be angry with the world.” From there, just listen, ask questions, don’t jump to conclusions and allow the person to vent.
4. Do a thorough audit on your self-care practices.
“Ask yourself, What am I doing that’s draining and depleting me, what am I doing that gives me energy?” Druck says. Make a plan and implement it, including, if necessary, negotiating with your boss and telling people why, for example, they might be hearing no from you more often than they once did.
5. Banish guilt.
The same people who are susceptible to compassion fatigue are often those who enter helping professions or situations because they are compassionate, empathetic people—who are likely to feel guilty about cutting themselves any slack in their duties. Guilt, shame, perfectionism and an inflexible self-image as a helping, compassionate person can be saboteurs of self-care, Druck writes in his free downloadable handbook of self-care.
But implementing a plan of self-care is actually respecting your best impulses, he says. “Give yourself a pat on the back for honoring the kind of giving person that you are by taking good care of yourself.”
Taylor’s parents are moved and settled now. Although Taylor is still stressed by her mother’s confused predawn phone calls and her father’s medical emergencies, she’s also found bittersweet relief in staying aware that this too shall pass—her parents won’t live forever, and the best thing she can do right now is take deep breaths and appreciate their time together.
“There are some positive effects in caregiving,” Sumner says. “It can give people meaning and make them feel needed, and it can strengthen the relationship.”
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