Easing Your Own Caregiver Fatigue: Restoring Passion in our Professional Lives

1. Easing Your Own Caregiver Fatigue:Restoring Passion in our Professional Lives Mary Lou Kraatz, M.Ed.

2. Alzheimer’s Association, Mid South Chapter

3. How are we doing? • ¼ of employees view their jobs as the #1 stressor of their life • ¾ of employers believe workers have more on the job stress than a generation ago • Problems at work are more strongly associated with health complaints than are any other life stressor; more than family or financial problems • 40% of workers report their job is very or extremely stressful - National Institute for Occupational Safety & Health Alzheimer’s Association, Mid South Chapter

4. Part 1: Understanding Compassion Fatigue Alzheimer’s Association, Mid South Chapter

5. The History of Compassion Fatigue • Post traumatic stress disorder (PTSD) is first included in the DSM III in 1980 • Trauma may be experienced either “directly” or “indirectly” (secondary traumatic stress) • An evolution of names for secondary traumatic stress including: Secondary Victimization, Vicarious Trauma, Secondary Trauma, and finally “Compassion Fatigue” coined by a nurse, Carla Joinson, in 1992. Alzheimer’s Association, Mid South Chapter

6. Compassion Fatigue: Different from Burnout • Burn out: a state of physical, mental and emotional exhaustion caused by long term involvement in demanding circumstances. • Burn out is a process, not a condition • Symptoms are directly related to the cause • Origins are usually organizational Alzheimer’s Association, Mid South Chapter

7. Compassion Fatigue: Related but Different from Job Stress • Job Stress results when the requirements of the job do not match the capabilities, resources, or needs of the employee. • Organizational issues contribute to Compassion fatigue and if not addressed will lead to burn out. Alzheimer’s Association, Mid South Chapter

8. Compassion Fatigue: Different from Counter-transference • Counter-transference: The process of seeing oneself in the patient • Limited to certain relationships • Temporary • Compassion Fatigue is a cumulative process that is felt beyond any particular relationship Alzheimer’s Association, Mid South Chapter

9. Remembering Sam Alzheimer’s Association, Mid South Chapter

10. Professional work centered on the relief of emotional suffering of clients automatically includes absorbing information that is about suffering. Often it includes that suffering as well. - Charles Figley, 1995 Alzheimer’s Association, Mid South Chapter

11. Part 2:Am I experiencingCompassion Fatigue? Alzheimer’s Association, Mid South Chapter

12. Compassion Fatigue:Vulnerability • Exposure – daily barrage of traumatic material • Empathy – the greater the empathy the more effective the relationship and the greater the risk for Compassion Fatigue • Other factors include: emotional state, limited stress management, poor self care, poor support and disconnection with spirituality Alzheimer’s Association, Mid South Chapter

13. Emotional Indicators • Anxiety / Increased negative arousal • Numbness / Flooding • Lowered frustration tolerance / irritability • Grief Symptoms • Anger • Sadness • Depression Alzheimer’s Association, Mid South Chapter

14. Physical Indicators • Intrusive thoughts / images • Headaches • GI symptoms • Insomnia / nightmares / sleep disruptions • Decreased immune response • Lethargy • Becoming more accident prone Alzheimer’s Association, Mid South Chapter

15. Personal Indicators • Self perception/Self Talk • Decrease in subjective sense of safety • Self Isolation • Difficulty separating work life from personal life • Diminished functioning in non-professional circumstances • Increases in in-effective or self destructive self soothing behaviors Alzheimer’s Association, Mid South Chapter

16. Spiritual Indicators • Questioning the meaning of life • Questioning prior religious beliefs • Increased skepticism • Loss of hope Alzheimer’s Association, Mid South Chapter

17. Work Indicators • Avoidance of certain patients / clients • Hyper vigilant response to certain cases • Diminished sense of purpose / enjoyment • Feelings of therapeutic impotence Alzheimer’s Association, Mid South Chapter

18. Part 3: Path to Wellness:Authentic Self Care (Handout) Alzheimer’s Association, Mid South Chapter

19. Take an Inventory of Your Professional Self Care Practice • Boundaries/limit setting – not overworking • Do you take regular vacations and time off when you are sick • Do you have adequate support/help at work • Determine what aspects of work/ which clients you obsess over • Celebrate your successes • Separate yourself from your work Alzheimer’s Association, Mid South Chapter

20. Make a Formal, Tangible Commitment to Your Personal Self • Physical Rest and Nourishment • Emotional Rest and Nourishment • Frequent contact with nature and other things that are calming and nurturing to you • Opportunities for Creative Self Expression • Daily/weekly spiritual nourishment • Ongoing self assessment and self awareness Alzheimer’s Association, Mid South Chapter

21. Restoring your Passion How do your personal values and attributes fit with your professional life? (Handout) Alzheimer’s Association, Mid South Chapter

22. The ABCs of Managing Compassion Fatigue Alzheimer’s Association, Mid South Chapter

23. Awareness • Being attuned to ones needs, limits, emotions and resources • Knowing your “renewal zones” • Practicing mindfulness • Accepting and acknowledging that we are changed by what we do Alzheimer’s Association, Mid South Chapter

24. Balance • Health, Relationships, Spirituality, Work • Reconnect with your body and give it some TLC • Have a personal life! Tend to relationships • Pursue joyful activities • Notice your spiritual life – is there something beyond what we can understand? What does it mean to you? What part does it play in your life and well being? Alzheimer’s Association, Mid South Chapter

25. Connection • To oneself • To others • To the bigger picture • Connection increases validation and hope Alzheimer’s Association, Mid South Chapter

26. Part 4: Organizational Compassion Fatigue: Caring for Professional Caregivers Alzheimer’s Association, Mid South Chapter

27. Indications of Organizational Compassion Fatigue • Increased absenteeism • Constant changes in co-worker relationships • Inability of teams to work together • Desire of staff to break rules • Inability of staff to complete assignments and tasks; or to respect/meet deadlines • Lack of flexibility among staff • Inability for staff to believe change is possible Alzheimer’s Association, Mid South Chapter

28. Formats for Information & Support • Raise awareness in the organization and enlist management to proactively support staff • In-service sessions for management and staff • Acknowledge the issue of professional caregiver fatigue during new staff orientation • Hold discussion in lieu of regular scheduled staff meeting • Lunch/break room • Regularly scheduled support groups Alzheimer’s Association, Mid South Chapter

29. Disciplines to include • Administrators • RNs • Social Workers • Physicians/medical staff • Counselors • Rehab therapists • Direct Care Staff • Spiritual Care Staff Alzheimer’s Association, Mid South Chapter

30. Compassion Fatigue In-Service • Overview – differentiate from burn out • Symptoms of Compassion Fatigue • The ABCs of Compassion Fatigue management • Give time for discussion! • Explain and offer the Self Test For Helpers Alzheimer’s Association, Mid South Chapter

31. Easing Your Own Caregiver Fatigue:Restoring Passion in our Professional LivesResource list Books Figley, Charles R. Compassion Fatigue: coping with Traumatic Stress Disorder in Those who Treat the Traumatized. New York: Brunner-Routledge, 1995. Figley, Charles R. Treating Compassion Fatigue. New York: Brunner-Routledge, 2002. La Rowe, Karl. Breath of relief: Transforming Compassion Fatigue Into Flow. Boston: Acanthus Publishing, 2005. Skovholt, Thomas. The Resilient Practitioner: Burnout Prevention and Self Care Strategies for Counselors, Therapists, Teachers and health Professionals. Boston: Allyn and Bacon, 2001. Wicks, Robert J.Overcoming Secondary Stress in Medical and Nursing Practice. New York: Oxford University Press, 2006. Alzheimer’s Association, Mid South Chapter

32. Easing Your Own Caregiver Fatigue:Restoring Passion in our Professional LivesResource list Articles Costa, Donna M.(2005, November). Compassion Fatigue: Self Care Skills for Practitioners. OT Practice,13-18. Fahey, Annie (2007). The Unbearable Fatigue of Compassion: Notes from a Counselor Who Dreams of Working at Starbucks. Clinical Social Work Journal, 35: 199-205. Figley, Charles. Compassion Fatigue: An Introduction. Florida State University Traumatology Institute. See article on website: www.giftfromwithin.org/html/articles Gentry, Eric (2002). Compassion Fatigue: A Crucible of Transformation. Journal of Trauma Practice, 1(3/4): 37-61, Alzheimer’s Association, Mid South Chapter