Self Care

KEYPOINTS

  • Caring for someone at the end of life can be a tremendous challenge and will have different impacts on people
  • Family/caregivers and health care professionals caring for those with cancer, AIDS and other illnesses may experience burnout, compassion fatigue and vicarious trauma
  • People may encounter a range of physiological and psycho-spiritual experiences associated with stress and burnout
  • Personal strategies and work environments impact the stress experiences of health care professionals and teams
  • While caring for others, taking time for self-care is vital for our own well-being
  • Self-care involves paying attention to how we are impacted by the work and responsibilities, and accessing the resources that are helpful
  • Everyone has different emotional, physical, social and spiritual ways for caring for themselves

CONSIDERATIONS

Family/Caregivers

Family/caregivers often play a primary and critical caregiving role. A variety of factors may impact people’s capacities and experiences in providing care. Some examples include:

Personal and psychological domain

Factors that impact caregiving

  • Coping mechanisms
  • Relationship to patient
  • Type and stage of illness/disease
  • Family conflict
  • Comfort/skills/knowledge in providing different levels of care
  • Previous caregiving experiences
  • Age and physical ability
  • Pre-existing mental health conditions

Socio-economic domain

Factors that impact caregiving

  • Social/cultural practices and expectations of caregiving
  • Isolation from social support system
  • Dislocation from home and community
  • Poverty and financial strain
  • Access and affordability of medications and medical supplies

Spiritual domain

Factors that impact caregiving

  • Ability to maintain and participate in spiritual practices
  • Access to spiritual supports

Practical domain

Factors that impact caregiving

  • Access to health care professionals for support
  • Availability of medications and medical supplies

Family/caregivers and health care professionals are vulnerable to stress and burnout. The following are examples of physiological and psychosocial/spiritual experiences that people may encounter. It is important to monitor the frequency, intensity, and duration and their impacts in order to implement helpful strategies.

Physiological experiences

  • Stress and chronic fatigue
  • Headaches
  • Body pain
  • Changes in sleep
  • Stomach disorders
  • Numbness
  • Poor concentration
  • Changes in appetite
  • Muscle aches
  • Difficulty breathing

Psychosocial/spiritual experiences

  • Feelings of powerlessness
  • Helplessness
  • Loss of hope
  • Withdrawal from family and social system
  • Survivor guilt
  • Fears about the future
  • Resentment for the demands and responsibilities of caregiving
  • Guilt around care provided
  • Unresolved and/or difficult grief
  • Spiritual/religious concerns
  • Distress, depression and anxiety
  • Drug and alcohol use

STRATEGIES

The following questions may be helpful in assessing the experiences of family/caregivers and our own experiences:

  • “How are you doing with caregiving for …?”
  • “In caring for …, what do you feel you are doing well? What are you finding challenging?”
  • “How are you feeling physically? Have you been experiencing any problems such as …? How often and for how long”?
  • “How have you been feeling emotionally? How have you been coping with the range of feelings and emotions?"
  • “How are you caring for your self?” What do you find helpful in giving you the strength to do what you do?”
  • “What does your personal support system look like? What support do you find most helpful?”

Everyone is different in how they experience and cope with stress, burnout and compassion fatigue. It is important that people access the resources and tools that are most beneficial to their own well-being. Caring for ourselves gives us the strength to care for others.

SOURCES/REFERENCES

  1. Cairns M, Thompson M, Wainwright W. Transitions in dying and bereavement: a psychosocial guide for hospice and palliative Care. Victoria (BC): Victoria Hospice Society; 2003.
  2. Cane P. Trauma, healing and transformation: awakening a new heart. Capacitar Inc; 2005.
  3. Downing GM, Wainwright W, editors. Medical care of the dying. 4th ed. Victoria (BC): Victoria Hospice Society; 2006.

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