What is Compassion Fatigue Among Caregivers?

As a family caregiver have you ever experienced anxiety, depression, or PTSD? These are real mental health challenges many of us face day-to-day caring for an aging loved one.

In fact, a recent CDC study found that at least 66% of unpaid caregivers for adults experienced an adverse mental or behavioral health symptom.

The reality of burnout and compassion fatigue is prevalent throughout the caregiver community. The topic of burnout and compassion fatigue has been very visible throughout COVID-19 and impacts essential workers just the same as it does family caregivers.

Before we go any further, let’s take a look at a few of the American Institute of Stress' definitions to understand what differentiates burnout from compassion fatigue.

Compassion Fatigue - Also called “vicarious traumatization” or secondary traumatization. The emotional residue or strain of exposure to working with those suffering from the consequences of traumatic events. It differs from burn-out but can co-exist. Compassion Fatigue can occur due to exposure in one case or can be due to a “cumulative” level of trauma.

Burnout - Cumulative process marked by emotional exhaustion and withdrawal associated with increased workload and institutional stress, NOT trauma-related.

Primary Traumatic Stress - Primary stressors are those inherent in the extreme event, such as what was immediately experienced or witnessed, especially those things most contributing to a traumatic response.

What is Compassion Fatigue?

In a little more detail and context, compassion fatigue is a widely accepted concept that includes the emotional, physical, and spiritual distress of those providing care to someone else. What that means is the caregiver can experience an unexpected, significant emotional or physical pain, suffering, or other condition.

This is distinct from caregiver burnout.

Compassion fatigue is a secondary traumatic stress disorder. What that translates to is it is an unconscious reaction to another person’s traumatic experience. This can create extremely high levels of emotional stress.

Consider the day-to-day life of a nurse experiencing someone else’s traumatic event every day. This has a real emotional and physical impact.

The same is true for family caregivers who also have no separation from the workday and being at home.

You may experience a range of different thoughts and feelings. For example, a family caregiver may feel any range of the following:

  • Exhaustion (physical and/or emotional)
  • Feelings of dread or guilt
  • Irritability, anxiety, or anger
  • Difficulty sleeping
  • Difficulty making decisions
  • Feeling disconnected
  • Trouble finding meaning in caregiving
  • Self-isolation

Another way to look at the symptoms of compassion fatigue is to consider how they impact you cognitively, emotionally, behaviorally, and physically.

The U.S. Administration for Children and Families describes where and how we may experience compassion fatigue and the ways it may show up for each of us.

As you review the chart, consider whether you or a family member have felt or experienced any of the thoughts or emotions described.

Cognitive

  • Lowered Concentration
  • Apathy
  • Rigid thinking
  • Perfectionism
  • Preoccupation with trauma

Emotional

  • Guilt
  • Anger
  • Numbness
  • Sadness
  • Helplessness

Behavioral

  • Withdrawal
  • Sleep disturbance
  • Appetite change
  • Hyper-vigilance
  • Elevated startle response

Physical

  • Increased heart rate
  • Difficulty breathing
  • Muscle and joint pain
  • Impaired immune system
  • Increased severity of medical concerns.

A significant amount of research suggests that compassion fatigue is common throughout family caregivers, especially those dealing with complex cognitive and physical conditions. There are strategies that can help prevent and manage compassion fatigue. In addition, you can identify the signs of compassion fatigue.

To help all family caregivers, use the following guide to help you prevent, identify, manage and discuss compassion fatigue:

Prevention

  • Balance of work & life
  • Build in relaxing time
  • Connect with nature
  • Learn to say ‘no!’

Manage

  • Focus on your self-care
  • Find professional support (i.e. therapy)
  • Lean on others for support
  • Join a support group
  • Consult medical advice

Identify

  • Monitor symptoms
  • Pay attention to personal behavior changes
  • Ask others for feedback

Communication

  • Enhance your ability to communicate
  • Share your experience
  • Ask for help

Additional CDC Findings of Compassion Fatigue on Caregivers

At least one adverse mental or behavioral health symptom was reported by more than one-half of respondents who were aged 18–24 years (74.9%) and 25–44 years (51.9%), of Hispanic ethnicity (52.1%), and who held less than a high school diploma (66.2%), as well as those who were essential workers (54.0%), unpaid caregivers for adults (66.6%), and who reported treatment for diagnosed anxiety (72.7%), depression (68.8%), or PTSD (88.0%) at the time of the survey.

Adverse conditions also were more prevalent among unpaid caregivers for adults than among those who were not, with particularly large differences in increased substance use (32.9% versus 6.3%) and suicidal ideation (30.7% versus 3.6%) in this group. Click here to learn more.

Click here to learn more about the CDC's findings of compassion fatigue on caregivers.