Thursday, June 21, 2012

Caregiver to Your Friend: Compassion Fatigue

I thought this was a great topic to address after Tracey Carruther’s beautiful guest post here on Tuesday.

In it, she made it clear that she was deeply affected by the experience of caring for our friend, Delle Chatman, during the last two months of Delle’s life. Having already been through the deaths of multiple loved ones, Tracey still wasn’t prepared for the deep physical, emotional and spiritual effects that took her a year to address.

Patricia Smith is the founder of Compassion Fatigue Awareness Project, and author of To Weep for a Stranger: Compassion Fatigue in Caregiving. Though Delle – and Tracey’s family and friends who died before her – was hardly a stranger, Smith’s insights are relevant to anyone who cares for someone. Smith’s recent article on focused on nursing home employees.

I was teaching a workshop 20 years ago on grant writing, and two of the attendees were from a hospice. I asked them during a break, “How do you handle it?” I’d worked in the AIDS community long enough to understand the emotional toll on caregivers and friends. One of them replied, “You have to find a different definition of success.”

Caregiving fatigue is normal and often expected. The physical demands alone of taking care of someone who is seriously ill – whether family member, friend or patient – can be severe. But there is something beyond that, and it’s called compassion fatigue:

“Called secondary trauma, the symptoms of compassion fatigue can surface when caregivers identify with the patient and begin to experience their own suffering. This is often the result of unresolved pain and trauma in their own lives.”

I’m not a psychologist, but I think Tracey might agree that this is a fair description of her year after Delle died. As she said in her article, she was “good at death”: the activities and rituals surrounding a person’s final illness and death. But until Delle died, she hadn’t truly, deeply, allowed herself to grieve.

I have a friend whose father died a few months before mine. She told me later that she’d started seeing a counselor, because she was having trouble adjusting. The counselor told her she hadn’t fully grieved her mother’s death – 25 years earlier. I remember that my friend was initially outraged by that diagnosis, but at no time did she deny it.

Grief has a way of biting you in the butt when you least expect it. Like Tracey, you might be really good at the “business” of caregiving. But part of that business has to be self-care.

If you find yourself unable to move on in any way, obsessed with feelings of guilt for what you think you should’ve done, please consider getting help. There are support groups for little or no money available through hospices, hospitals and funeral homes. Don’t be surprised if your grief is fueled by unaddressed grief from your past.

Caregiving is a calling, whether you do it as your job or for a friend or family member. Not everyone’s cut out for it, which does not, by the way, make you a bad person.

But if caregiving is – or was – part of your life, if you had the privilege of helping care for your friend in their final days, remember that airplane analogy:

“In the event of a loss of cabin pressure, put your oxygen mask on first before helping anyone else.”

And keep it on as long as you need it.


Unknown said...

Having been the caretaker for both of my parents when I was in my 20s, I can vouch for this 100%. This is the first time I've heard the phrase "compassion fatigue" but oh, yes, I recognized it immediately. Thank you for this insightful and important post!

Coco Holmes said...

I love this article. It's never been easy to deal with the death of some love ones. The changes that you have to go through after could really be challenging.

Unknown said...

The emotional toll that one has to endure being a caregiver can both be painstaking and rewarding at the same time. I could only look back at the experience I had with clinics in oceanside ca with so much delight for the genuine care I received as a patient. I am truly one with you. Thanks for sharing such an emotional post.

Friend Grief said...

I think what resonated for all of you is that this is a common experience. We normally associate caregiving with family, but as Tracey showed, it can be with a friend, too.

The important thing - the really, really hard thing - to remember is to (in the words of Julia Roberts in "Pretty Woman") 'take care of you'.

Thanks for sharing!