Exploring%20Compassion%20Fatigue:%20A%20Reality%20for%20Caregivers

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Exploring Compassion Fatigue A Reality for
Caregivers

• Dr. BC Farnahm Elizabeth Pugh, LBSW, CM

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Important Information

• This education program for healthcare
  professionals was developed by The Consortium for
  Advancements in Health and Human Services, Inc.
  (CAHHS) and is facilitated by Kindred at Home via
  a community education partnership agreement.
  CAHHS is a private corporation and is solely
  responsible for the development, implementation
  and evaluation of its educational programs.
  There is no fee associated with receiving contact
  hours for participating in this program titled,
  Exploring Compassion Fatigue A Reality for
  Caregivers. However, participants wishing to
  receive contact hours must offer a signature on
  the sign-in sheet, attend the entire program and
  complete a program evaluation form.
• The Consortium for Advancements in Health and
  Human Services, Inc. is an approved provider of
  continuing nursing education by the Alabama State
  Nurses Association, an accredited approver by the
  American Nurses Credentialing Center's Commission
  on Accreditation.
• The Consortium for Advancements in Health Human
  Services, Inc., is approved as a provider of
  continuing education in Social Work by the
  Alabama Board of Social Work Examiners, 0356,
  Expiration Date 10/31/2016.
• This program is Approved by the National
  Association of Social Workers (Approval
  886684291-5172) for 1- Social Work continuing
  education contact hour.
• In most states, boards providing oversight for
  nursing and social work recognize contact hours
  awarded by organizations who are approved by
  another state's board as a provider of continuing
  education.  If you have questions about
  acceptance of contact hours awarded by our
  organization, please contact your specific state
  board to determine its requirements. Provider
  status will be listed on your certificate.
• CAHHS does not offer free replacement
  certificates to participants. In the event that
  CAHHS elects to provide a replacement
  certificate, there will be a 20.00
  administrative fee charged to the individual who
  requests it.

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Learning Objectives

• Participants completing this educational program
  will be able to do the following
• Discuss the concept of compassion fatigue.
• Identify manifestations and/or signs and symptoms
  of compassion fatigue in the following domains
  emotional, behavioral, physical and spiritual.
• Discuss coping mechanism related to responding to
  compassion fatigue.
• Identify formal and informal resources that
  support self care.

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Emotions Are Part of Who We Are

• With the materials provided, draw an image that
  represents the feelings associated with providing
  services to individuals and families during the
  end of life.
• There are no right or wrong images. Be creative

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What is Compassion Fatigue?

• A debilitating weariness brought about by
  repetitive, empathic response to pain and
  suffering, compassion fatigue is a result of
  absorbing and internalizing the emotions of
  clients and, sometimes, coworkers (LaRowe, 2005)
• "Compassion fatigue, says LaRowe (2005), is
  nothing less than secondary traumatic stress, and
  its effects are much the same as those of
  posttraumatic stress disorder (PTSD).

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Signs and Symptoms of Compassion Fatigue

• The signs and symptoms can be psychological and
  emotional
• Often signs and symptoms become behavioral,
  physical, and spiritual challenges.
• Common results of compassion fatigue include
  distraction, hypersensitivity, overload, and
  misperception in our communications with self and
  others.
• These challenges can lead to costly personal and
  professional outcomes--- depression and physical
  illness (LaRowe, 2005).

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Emotional/Psychological

• Apathy
• Low personal  accomplishment
• Frustration
• Boredom
• Anxiety 
• Hopelessness
• Depression
• Poor Concentration
• Irritability
• Alienation
• Isolation (LaRowe, 2005)

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Behavioral/Professional

• abuse of chemicals
• spending less time with patients
• tardiness and absenteeism
• making professional errors 
• being critical of others
•  depersonalizing patients 
• being sarcastic and cynical
•  keeping poor records (LaRowe, 2005)

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 Physical

•  rapid pulse 
• insomnia 
• fatigue 
• reduced resistance to infection
• weakness and dizziness 
•  memory problems 
• weight changes
•  gastrointestinal complaints (LaRowe, 2005)
•  

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Spiritual

• doubt concerning one's values or beliefs
• feeling angry or bitter toward God
• withdrawing from fellowship

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The Ultimate Costs Associated with Compassion
Fatigue

• Health Complications
• I just dont feel well, but I cant really
  explain what is wrong with me.
• Total Burnout
• This job isnt what I thought it would be.
• Termination
• You are not right for our organization.

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What Professional Caregivers Need to Know

• Counter transference is real
• Coping Skills
• Self Healing
• Where to Get Support

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Classic Approach to Counter Transference

• We review Freuds work, which states that
  counter-transference is the result of the
  unresolved issues of the helper and can
  negatively impact the helping process as it
  erodes objectivity (Corey, 1981/2000, p.155).
• This perspective of counter-transference, coupled
  with a few cautionary lectures from a professor
  or two whom we admire, likely contributes to the
  fear many human service practitioners feel
  specifically related to emotionally connecting
  with the people we support and serve.

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Understanding Counter Transference

• As we mature professionally, many of us realize
  that our attraction to the helping professions is
  deeply rooted in our desire and need to connect
  with others and to realize the power and
  fragility of our own humanness. 
• Elements of common ground and shared life
  experiences are a core aspect of connectivity
  between people. 
• For those of us who make the choice to practice
  in hospice and/or palliative care settings, the
  processes of death, dying and bereavement within
  our own personal lives often become the
  foundation of our practice. 

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Reality of Counter Transference

• Working with counter-transference is regarded as
  a positive and important therapeutic tool, an
  indispensable instrument in our work. It is the
  basis of empathy and deeper understanding of both
  the patients and clinicians own processes
  (Katz Johnson, 2006, p. 4).

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Coping Skills

• Denial, Projection, Rationalization
• These are NOT DIRTY words

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Denial

• A psychological mechanism through which a person
  escapes pain associated with reality by
  unconsciously rejecting that reality (Zastrow,
  2007).

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Projection

• A psychological mechanism through which a person
  transfers his/her unacceptable ideas to another
  (Zastrow, 2007).

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Rationalization

• A person faced with a frustration and/or event,
  finds justification by masking ones self and
  true motivations (Zastrow, 2007).

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When do Coping Skills Become Dysfunctional?

• When we rely on these skills and/or defenses to
  do our work for us and we do not actively
  engage in the healing process.
• If you do what you have always done, you will get
  what youve always got

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Self Healing

• Breaking Habits of Work
• We ARE Creatures of HABIT
• Reshaping Memories and Thought Processes
• Actively Self Direct the Construction of Memories
• Reconstruct Language to Reflect Thoughts that
  Drive HEALTHY Behaviors and Expectations

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Where to Get Support

• Natural Resources of Support
• Family
• Friends
• Coworkers
• Community Groups
• Church
• Formal Resources of Support
• EAP (Employee Assistance Programs)
• Mental Health Systems
• Private Physician
• Private Counselors/ Therapist

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Questions and Comments
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How Can You Help?

• Make a referral
• Request a speaker for your next community
  organization event or church function
• Help us recruit volunteers
• Tell others what you have heard about today
  (hospice and our organization)

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References

• Corey, G. (2000). Theory practice of group
  counseling (5th ed.). Belmont   Brook/Cole.
  (Original work published 1981).
• Katz, R. S., Johnson, T. A. (Eds.). (2006).
  When professionals weep Emotional     and
  countertransference responses in end-of- life
  care. New York Routledge     Taylor Francis
  Group. (Price, Unknown).
• LaRowe, K. (2006). Compassion Fatigue. Retrieved
  February 6, 2007, from
• www.compassion- fatigue.com  

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Questions Answers
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• Complete Program Evaluations
• Award Certificates