Empathy on Empty: Compassion Fatigue and Chronic Stress with Caregiving

Caregiving for elderly people, people with chronic conditions, or mental health disorders can be challenging and can take a substantial toll on the caregiver. Learn more about caregiving, how it causes burnout and compassion fatigue, and how to care for yourself when caregiving.

What is caregiving?

A caregiver assists with the daily needs of another person. Caregivers can be individuals trained in providing care, assigned from an agency and paid, or they can be family caregivers and provide care usually without being paid with minimal or no training. Caregivers may provide care for a parent, spouse, other relative, or an unrelated person. The level of care varies for each person, but caregiving tasks may include grocery shopping and meal preparation, housework, managing finances, or transportation to appointments. Depending on the individual, it could also involve helping them get dressed, move around their living space, eat, bathe, and deal with incontinence.

According to a 2020 report from the AARP and the National Alliance for Caregiving (NAC), more than 1 in 5 Americans have provided care to either a child with special needs or an adult in the past 12 months. Use of respite care nearly doubled from 8.5% in 1999 to 15.7% in 2015.¹ While caregiving can be rewarding and fulfilling, it can also take a toll on the individual, especially when caregiving for a family member.

Caregivers are at an elevated risk of developing mental health issues—such as depression and anxiety.² Findings also suggest that caregivers who experience social and emotional burdens related to caregiving are at risk for problematic alcohol use. Alcohol use and abuse by caregivers is a cause for concern, as both their health and the health of their care recipient is at risk, particularly if they are responsible for assisting their care recipient with activities of daily living.³

What is caregiving burnout?

Caregiver burnout is a state of physical, emotional, and mental exhaustion and may include a change of a negative shift in attitude. Burnout can happen if you take on more than you are capable of physically and financially without the proper support. Another cause is having unrealistic expectations such as expecting a positive effect of your care for a patient or loved one who has a progressive disease.⁴

What are the symptoms of caregiver burnout?

• Withdrawal from friends and family
• Loss of interest in activities you used to enjoy
• Feeling blue, cranky, hopeless, and helpless
• Changes in appetite, weight, or both
• Changes in sleep patterns
• Getting sick more often
• Emotional and physical exhaustion
• Using alcohol and/or sleep medications too much
• Feelings of wanting to hurt yourself or the person for whom you are caring

Compassion fatigue

Compassion fatigue is a condition beyond burnout, which describes a stage of extreme tension and stress. Unlike burnout, compassion fatigue is a secondary stress disorder caused by exposure to the traumatic experiences of the person who they are acting as caregiver for.⁵ The waning or lack of empathy associated with compassion fatigue comes from the slow burn of taking on the emotions of those you care for and makes it difficult to be compassionate. Compassion fatigue can occur as an occupational hazard with people employed as caregivers, or it can occur with family caregivers.

Indicators of compassion fatigue include difficulty sleeping, growing irritation over minor issues that did not bother you in the past, angry outbursts, feelings of hopelessness, heightened anxiety, and physical symptoms including headaches, stomach aches, and body pain. Other red flags include the decreased desire to stay up to date on current events or becoming uncharacteristically rigid and controlling.

How to care for yourself while caring for others

Create a day-to-day self-care plan, which includes things you enjoy like going for a walk, connecting with people you love, taking a lunch break, or listening to your favorite music. Spending time in nature also has a positive impact on the mind and body.⁶ To help manage the stress of caregiving, it is important to consider all of the following:⁷

• Accepting help
• Setting realistic goals
• Joining a support group
• Paying attention to your own health needs
• Connecting with your EAP or mental health provider

Uprise Health assists our members who are caregivers by connecting them with telephonic or in person support. Our members can also use our digital EAP platform to learn how to sleep better, practice mindfulness, and stress management.

Support is important. Learn how we help our members improve self-care, find the right coach or counselor that can help, and stay attuned to their own needs and mental health.

Caregiver Resources

• National Alliance for Caregiving
• Family Caregiver Alliance
• ACL: National Family Caregiver Support Program
• National Institute on Aging Caregiving Information
• Alzheimers.gov Caregiver Resources
• USA.gov Caregiver Support

Resources

1. 1. https://academic.oup.com/gerontologist/article/58/6/1021/3869094
   2. https://www.apa.org/pi/about/publications/caregivers/practice-settings/assessment/tools/mental-health-caregivers
   3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2906825/#:~:text=Alcohol%20use%2C%20particularly%20alcohol%20use,with%20activities%20of%20daily%20living
   4. https://www.webmd.com/mental-health/signs-compassion-fatigue
   5. https://www.webmd.com/mental-health/signs-compassion-fatigue
   6. https://www.verywellmind.com/are-we-running-out-of-empathy-5215836
   7. https://www.mayoclinic.org/healthy-lifestyle/stress-management/in-depth/caregiver-stress/art-20044784