Rita Watson: When caregivers need care, too
Published on 06 January 2014
egiving is becoming a part of the fabric of our society, interwoven with family members, nursing professionals and hospice workers.
It is estimated that some 31 percent of all households in this country are taking care of a family member who is ill, disabled or elderly.
Caregiving is often filled with blessings. Hospice workers involved in end-of-life care can appear to be angels. But caregivers often experience stress on a daily basis.
At the 66th annual Gerontological Society’s Scientific Meeting in New Orleans in November, Sally Hill Jones, an associate professor at Texas State University School of Social Work, talked about the risk for burnout and secondary trauma.
Jones explained, “Most professionals enter hospice work envisioning the ideal death, which often includes the healing of relationships, resolution of regrets, a peaceful and pain-free death for clients, and manageable grief for families.” She questioned what happens to motivation “when reality falls short of the ideal and goals are unattainable or different from those of clients.”
For hospice professionals to provide valuable healing or peace to clients, she said, “It is key that they acknowledge their own vulnerability and the need to process their feelings, particularly grief, along with the associated pain and enrichment it includes.”
Jones has devised a wellness plan for hospice workers and caregivers that she discussed with me. It is based on some of her thoughts expressed in a 2008 article, “A Delicate Balance: Self-care for the Hospice Professional,” that she wrote for Today’s Geriatric Medicine. The plan involves emotional and cognitive self-care, expressing emotions, soaking up joy, being mindful of warning signs, and tending to one’s spiritual needs.
Emotional and cognitive self-care involves making time to routinely express, soothe and release emotions, including grief, said Jones. “Identifying individual emotional stress indicators, such as increased crying, irritability, anxiety, numbness, self-doubt or addictive behaviors, is important.”
Expressing and soothing emotions includes crying when you must, even if a movie or music is needed to “jump-start” a good cry. Other methods include writing, creating, listening to music, talking with confidants, enjoying hot baths, being held, cuddling a pet, using aromatherapy or massage, meditating, being mindful, praying, gardening and even cleaning.
Soaking up joy means treasuring times and successes you experience, as well as enjoying pleasurable activities and laughing often to fill up resource reserves.
Being mindful of warning signs such as overextending one’s self, or having an inability to set limits — instead of handling conflicts focused on solutions — is important because it is often at these times that people begin blaming or personalizing.
Tending to one’s spiritual needs is important because, as Jones noted, “End-of-life work is often spiritually rejuvenating, since it involves clients’ big-picture concerns. However, these can get lost in the details of paperwork and finding resources. As such, staying attuned spiritually includes reading sacred texts, praying, attending services, connecting to nature, listening to music, meditating and engaging in creative endeavors.”
“Self-care is not optional,” she added. “Those in hospice work who tend to the source of their gifts will find a long career of privilege as a compassionate sojourner in many clients’ unique lives. However, this gift must be protected. Hospice workers are often there as clients approach their final passage.”
She said, “I am working now on the effectiveness of self-care planning.” And she is supporting hospice organizations and governmental policy that regulate hospices to give hospice workers manageable caseloads that allow them to spend the time they need with patients and families, and still have personal lives.
With researchers and families questioning aggressive end-of-life treatment, hospice workers and their health and well-being become increasingly more important to care.
Rita Watson, MPH, is a 2012 MetLife Foundation Journalism Fellow through the Gerontological Society of America and New American Media who was a 2013 travel grant recipient.