Caring Effectively for Others Without Losing Yourself Marcia Lattanzi Licht, LHD, RN, LPC (303) 494-8456 MLLicht@comcast.net Course Materials & Disclosure Course materials including handout(s) and conflict of interest disclosure statement are available to download with this course. This presentation is for educational and informational purposes only. It is not intended to provide legal, technical or other professional services or advice. Session Objectives: 1. Identify the range of whole person needs and responses involved in caregiving. 2. Discuss the unique challenges and satisfactions involved in caregiving roles. 3. To examine the experience of burnout and compassion fatigue. 4. Examine creative ways of meeting the demands and potential of professional caregiving. 1
Our human nature is such that we need to be helpful, thoughtful and generous as much as we need to eat, sleep and exercise. - Harold Kushner, When all you ve wanted isn t enough Whole person needs and responses: Caregiving Caregiver Stress Responses ÜPhysical ÜEmotional ÜBehavioral ÜUnderstanding your personal signs and symptoms 2
Major self-care concerns Personal vulnerability, resilience Overload Expectations, assumptions Working climate Isolation Signs of distress Caring without losing yourself Your degree of well being Obstacles that inhibit your well being Elements of your work that limit your well being Vulnerability Episodically vulnerable dealing with recurrent disease Inevitably vulnerable us as we reach old age The vulnerability of grief all can be lost 3
We fear growing old lest we no longer be useful, that is, able to do things which show others that we have worth. We equate our value with our performing. Eugene Borowitz Stressors and Strengths Healthy adaptation involves balancing. stressors with personal strengths and resources. What s your current level of stress and satisfaction? â Stop the world - I quit! â Crisis â Close to the edge â Too high â A little more than I d like â Just right - normal for me â Life s a little dull â Too low â Ho-hum - zzzz 4
Dealing with Stressful Situations Change the Change your situation reaction Avoid the stressor. Accept the stressor. Alter the stressor. Adapt to the stressor. Satisfactions and Rewards in Caregiving What brings individuals to work in the field of death, dying, and bereavement? 5
Helping is the instinctive response of an open heart. - Ram Das & Paul Gorman Individual Coping * Activities Time Alone Outlets for Emotional Expression Rituals Personal Philosophy *Lattanzi, M.E. An Approach to Caring: Caregiver Concerns in Hospice Approaches to Pediatric Care, C.A Corr and D.M. Corr, Eds,, New York: Springer, 1985. Coping Strategies Problem solving, cognitive restructuring Identification, expression of emotion Relationship accommodations Supportive resources and networks Maintenance of physical health Spiritual perspective 6
What factors help to sustain professionals in the caregiving process? Dealing with Stress - Individual Characteristics Open communication Warm relationships, at work and home Confidence, in self and others Ability to trust Function as a team member Dealing with Stress - Individual Characteristics Tolerance of ambiguity, discomfort Ability to deal with own limits, vulnerability Ability to interact with community resources Sustaining beliefs 7
The attitude toward caregiving Overwhelmed or feeling of success Feel joy or burned out Not related to the tasks required Difference is attitude Oh, this is not a trouble. This is what she would have done for me. People who were most successful and dealt with caregiving as a joy and an opportunity and considered it a volunteer job, a choice R. Montgomery, University of Kansas, Lawrence Gerontology Center Research, 1991, in R Carter, 1994. Burnout and Compassion Fatigue Experiencing Burnout A state of frustration brought about by devotion to a cause, way of life, or a relationship that failed to produce the expected reward 8
Burnout A syndrome of Physical and emotional exhaustion Growing negative selfconcept Loss of concern for others (clients) Dynamics of Burnout Need for distance Withdrawal from the system Loss of selfesteem Attitudes that can lead to Burnout t Inflexible on a stand you ve taken t Identify too closely with activities t Worry about preserving your image t Take yourself too seriously t Unclear about goals 9
Compassion Fatigue Compassion fatigue is a form of burnout that manifests itself as physical, emotional and spiritual exhaustion. To prevent or recover from compassion fatigue, take time for self-reflection, identify what's important and live in a way that reflects it. To sustain yourself at work, develop "principles of practice" -- guidelines of personal integrity that articulate the parameters of your personal values. Commit to live and work within these principles. Compassion Fatigue Self-Assessment Personal concerns commonly intrude on my professional role. My colleagues seem to lack understanding. I find even small changes enormously draining. I can't seem to recover quickly after association with trauma. Association with trauma affects me very deeply. My clients' stress affects me deeply. I have lost my sense of hopefulness. I feel vulnerable all the time. I feel overwhelmed by unfinished personal business. Warning Signs of Compassion Fatigue Although experiences vary, the following red flags may indicate that you have compassion fatigue: Abusing drugs, alcohol or food Anger Blaming Chronic lateness Depression Diminished sense of personal accomplishment Exhaustion (physical or emotional) Frequent headaches Gastrointestinal complaints 10
Creative ways of meeting the demands and potential of professional caregiving The Reward The real grace of conscious service is the opportunity not only to help relieve suffering, but also to grow in wisdom experience greater unity and have a good time while we re doing it. Effective Self-Care Support b Shared feelings b Shared tasks b Support seeking b Beliefs b Spiritual practices 11
The Typical Support Equation* 20 % 25 % Self Spouse/S.O. 55 % Environment > People > Activities * Simington Professional Resiliency: An Essential Skill in Preventing Burnout and Compassion Fatigue High levels of cumulative stress in professionals negatively affects their resiliency, therefore making them more susceptible to compassion fatigue. Defining Resilience: A resilient individual the ability to get up and get going stays the course; does not give up anticipates rather than fears the future sits loose recognizes there is hope in the midst of difficulty draws on past successes for support and to guide actions identifies inner resources & strengths - Wagnild & Collins 2009; Wagnild 2010 12
How Resilient Are You? Your ability to handle and bounce back from stress depends on many factors, including a: Sense of control Optimistic attitude Strong support system Healthy body Ability to adapt to change Ability to handle unpleasant emotions Belief in a higher power or purpose Confidence in yourself Sense of humor Five essential characteristics of resilience Perseverance Self-reliance Equanimity Coming home to yourself (existential aloneless) Purpose in life (meaningfulness) Wagnild 2010 Purpose in Life (Meaningfulness) Most important characteristic of resilience Basis for the other four characteristics Life without purpose is futile and aimless Purpose provides a driving force; it pulls us forward Our purpose usually finds us What in my life has the most meaning Ask yourself Is this why I do the work I do? Am I where I should be? - Wagnild 2010 13
What responsibilities do formal and informal caregivers have towards others and towards themselves? Dimensions Self Disclosure Nature of their goals How they play How much they are themselves in relationships Degree of empathy and knowledge of others S. Jourard, The Transparent Self Keeping your spark Having a life outside of work Loving the people close to you Living the lessons you are learning Enjoying your days 14
Personal Reflections There is a need for each of us to make peace with our own lives. ------------------- Every person is different. ----------------------- You look at your own fallibility because you are constantly faced with limits... There is something you must always remember you are braver than you believe, stronger than you seem, and smarter than you think. ~ Winnie the Pooh References Wagnild, G. M. & Collins, J. A. (2009). Assessing resilience. Journal of Psychosocial Nursing, 47(12):28-33. Wagnild, G.M. (2010). Discovering your resilience core. (on her website) Wagnild, G.M. & Young, H. (1987). Resilience Scale. Wagnild, G.M., & Young, H.M. (1993). Development and psychometric evaluation of the Resilience Scale. Journal of Nursing Measurement, 1, 165-178. http://www.resiliencescale.com/index.html 15
Course Evaluation & Post-Test Thank you for viewing this course on the Hospice Education Network. To conclude this course and to obtain a certificate of completion, you must finish the evaluation and post-test. 16