Care for caregivers

"Remember that even on planes it is said that before putting on others' oxygen masks, you must put on yours first. The same rule applies to caregiving."

Mr. X was a caregiver who brought in his wife for a consultation at the psychiatrist's office. She had been diagnosed with cancer, was undergoing chemotherapy and referred for depression. During the meticulous details that Mr. X gave about his wife, it appeared he went on and on about how he was trying his best, but she just didn't seem to be getting any better. In fact, he was "angry" that despite his sincere efforts, she had remission of cancer and now even depression. He cited he felt hopeless and had started to become irritable with his wife despite knowing that was detrimental and useless. Mr. X was facing caregiver burnout and beginning to experience caregiver compassion fatigue.

Caregiving is rewarding yet stressful. Chronic conditions like cancer, Parkinson's, Alzheimer's, disabilities, certain neuromuscular degenerative conditions, mental health conditions where the person isn't functional etc. require long-term care. Caregiver burnout is a state of physical, emotional, and mental exhaustion leading to a change in attitude, from positive and caring to negative, forceful and even unconcerned.

Compassion fatigue is the loss of the ability to empathize and have compassion for other people, including the person you're caring for. Caregivers who are "burned out" may experience fatigue, stress, anxiety and depression.

It may present be as:

⁕Mood changes: low mood, lack of enthusiasm and loss of interest in activities previously enjoyed

⁕Irritability, lack of patience with the sick family member or others

⁕Hopeless, helpless attitude

⁕Anger outbursts either at self, the patient or even medical fraternity

⁕Withdrawal from friends, family and other loved ones

⁕Loss of interest in activities previously enjoyed

⁕Changes in appetite, weight or both.

⁕Changes in sleep patterns

⁕Getting sick more often themselves

⁕Resorting to substance abuse or numbing agents to escape the pain

⁕Emotional and physical exhaustion

The reason for this compassion fatigue and caregivers' burnout is due to an unrealistic expectation that as a caregiver one must always be there for the patient, endure suffering themselves and have an invariably positive effect on the health and happiness of the patient. This extreme overidentification with a 'healer' role can be confusing. Most caregivers also feel helpless with resources, may not get the help they need or may not even ask for help. Instead, they keep trying to provide the help to do more than they are able — physically, emotionally or financially. Some caregivers even see taking time off for themselves as an act of selfishness and feel guilty.

How can you prevent caregiver burnout?

⁕Identify it timely.

⁕Take mindful breaks.

⁕Trust others with the patient like you trust yourself.

⁕Ask for help. It is necessary.

⁕Exercise, meditate, eat healthy and sleep well.

⁕Join a group of caregivers or even speak to a mental health specialist.

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