Carers Need Self-Care

Much of the focus in the resources on mindfulness is on ways to help people who are suffering from conditions that are debilitating such as mental illness or chronic pain.  Very little of the resources focus on ways to help carers in their role – ways to manage the physical and psychological toll of caring for someone else on a constant and extended basis.  Carers are the overlooked group – forgotten by others and themselves.

Carers: people who care and support others

Carers come in all shapes and sizes  – adults looking after ageing parents who may be suffering from Alzheimer’s disease; siblings caring for a family member who has a mental health condition such as schizophrenia, anxiety or depression; or anyone caring for someone suffering from a physical condition such as paraplegia, chronic pain or cancer.  According to Carers Australia, carers are people who provide unpaid care and support to family members and friends who have a disability, mental illness, chronic condition, terminal illness, an alcohol or other drug issue or who are frail aged.

The toll of caring

The “burden of care” can be felt both physically and psychologically.  The physical toll for carers can be excessive – they can become exhausted and/or accident-prone, suffer from sleep disorders or experience bodily symptoms of stress such as irritable bowel syndrome, chronic fatigue or related conditions like fibromyalgia. The physical toll of caring can be experienced as cumulative stress and lead to chronic conditions that adversely affect the carer’s long-term health.

The psychological toll of caring can also be cumulative in nature and extremely variable in its impact.  Carers can experience negative emotions such as resentment or anger, despite their compassion towards the person who is being cared for.  They can become extremely frustrated over the paucity of time available for themselves, the opportunity cost in terms of inability to travel or to be away for any length of time, the lack of freedom (feeling tied down), the lack of improvement in the condition of the person being cared for or the financial impost of caring (preventing desired savings/purchases or home improvements). 

Carers do not have inexhaustible personal resources – physical, psychological and financial.  They can suffer from compassion fatigue which can be hastened by emotional contagion resulting from close observation of, and identification with, the pain of a loved one.  Hence, carers can experience depression, anxiety or grief – reflecting the emotional state of their loved ones who are suffering.

The toll on carers has been the subject of extensive research.  For example, Emma Stein studied the psychological impact on older female carers engaged in informal aged care.  Sally Savage and Susan Bailey reviewed the literature on the mental health impact on the carer of their caregiving role and found that the impact was highly variable and moderated by factors such as the relationship between caregiver and receiver and the level of social support for the carer.

Being mindful of your needs as a carer

The fundamental problem is that carers become so other-focused that they overlook their own needs – their need for rest, time away, relaxation and enjoyment.  Normal needs can become intensified by the burden of care and the associated physical and psychological stressors.  Carers tend to neglect their own needs in the service of others.  However, in the process, they endanger their own mental and physical health and, potentially, inhibit their capacity to sustain quality care.

Carers can inform themselves of the inherent physical and psychological consequences of being a caregiver, particularly if this involves intensive, long-term caring of a close loved one (where feelings are heightened, and the personal costs intensified).  Mental Health Carers Australia highlights the fact that people who care for someone with a mental health illness are increasingly at risk of “developing a mental illness themselves”.

Self-care for the carer

One of the more effective ways that carers can look after themselves is to draw on support networks – whether they involve family, colleagues or friends; broad social networks; or specific networks designed for carers.  Arafmi, for example, provides carer support for caregivers of people with a mental illness and their services include a 24-hour carer helpline, carers forum, blog, educational resources, workshops and carer support groups. Carers Queensland provides broader-based carer resources and support groups.

Carers tend to go it alone, not wanting to burden others with “their” problem(s).  They are inclined to refuse help from others when it is offered because of embarrassment, fear of dependency, concern for the other person offering help, inability to “let go” or any other inhibiting emotion or thought pattern – in the process, they may stop themselves from sharing the load.

Carers could seek professional help from qualified professionals such as medical doctors or psychologists if they notice that they are experiencing physical or psychological symptoms resulting from carer stress.

Mindfulness for carers

Carers can use mindfulness practices, reflection and meditation to help them cope with the physical and emotional stresses of caregiving.  Specific meditations can address negative feelings, especially those of resentment and the associated guilt.  Mindfulness practices can introduce processes that enable the carer to wind down and relax – such as mindful breathing, mindful walking, mindful eating or using awareness as the default when caught up with “waiting” (a constant companion of the carer role).

Carers can employ techniques such as body scan to relax their bodies and release physical tension.  Deep, conscious breathing can also help in times of intense stress such as when experiencing panic. For people who are religious, prayer can help to provide calm and hope.

Dr. Chris Walsh (mindfulness.org.au), offers a simple mindfulness exercise for self-care by carers in his website article, Caring for CarersThe exercise involves focusing, re-centering, imagining and noticing (thoughts, feelings and bodily sensations).

As carers grow in mindfulness, they can become more aware of the stress they are under and the physical and psychological toll involved. This growing awareness can lead to effective self-care through social and professional support and meditation and/or mindfulness practices. Mindfulness can help carers develop resilience and calmness in the face of their stressful caregiver role.

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Image by Sabine van Erp from Pixabay

By Ron Passfield – Copyright (Creative Commons license, Attribution–Non Commercial–No Derivatives)

Disclosure: If you purchase a product through this site, I may earn a commission which will help to pay for the site, the associated Meetup group and the resources to support the blog.

Can Your Experience Compassion Fatigue?

Kelly McGonigal in her presentation for the Mindful Healthcare Summit challenged the widely held belief that you cannot experience compassion fatigue. Many people contend that compassion fatigue does not occur because the heart is capable of endless kindness and love for others. Kelly maintains that motivation and goodness of heart are not sufficient to prevent the depression and burnout that can result from compassion fatigue. She asserts that compassion has to be supported by adequate self-care if it is to be sustained.

Compassion and the stress response

Kelly argues that compassion is like the stress response when viewed physiologically. Compassion floods the body with hormones such as dopamine and marshals the body’s energy to relieve the suffering of others. However, while this can be very energising and exciting in the short term, compassion takes its toll in the longer term both bodily and mentally, as we do not have endless physical and mental reserves.

The possibility of compassion fatigue can be increased where a helping professional or carer experiences vicarious trauma or moral distress – the latter being defined as being required to do things that clash with a person’s values or moral perspective, a frequently occurring ethical dilemma within the medical profession.

Compassion fatigue

Kelly suggests that compassion fatigue occurs when a person lacks the energy and resources to pursue their motivation to care in such way that it achieves personal satisfaction (activates the reward system). Outcomes achieved fall short of personal expectations and/or the expectations of others, despite the strength of the caring intention. The compassionate person feels exhausted and feels that the more they give the less they experience satisfaction – the gap between input of energy/time and the expected satisfaction increases, leading to burnout. The depletion of energy and satisfaction could be the result of factors outside the helper’s/carer’s control – such as structural blockages, breakdown in information exchange, overwork or under-resourcing.

Compassion needs nourishment

One of the issues that exacerbates the problem of compassion fatigue is the belief in the endless capacity of an individual to be compassionate through the goodness of their heart or the purity of their intentions. As a result of this false belief, helpers/carers fail to take the necessary actions to nourish themselves (and their compassionate action) and/or are reluctant to accept compassion extended to them by others.

Personal nourishment can take many forms – getting adequate sleep, meditation (especially self-compassion meditation), listening to relaxing/inspiring music, prayer (whatever form it takes) or drawing strength and healing from nature. It also requires an openness to receiving compassion from others – challenging false beliefs such as “no one else can do this”, “I will be seen to be weak if I accept help from others”, “I really shouldn’t pander to my own needs by having that short break or having a reasonable period for lunch”, “I can’t afford to become dependent on others for assistance”. Additionally, positive social connection– to offset the tendency to withdraw under extreme stress– is a critical source of self-nourishment.

As we grow in mindfulness through meditation our awareness of others’ suffering and our motivation to help are heightened. The capacity for compassionate action is not limitless and needs nourishment. Central to this nourishment is self-compassion.

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Image by DarkWorkX from Pixabay

By Ron Passfield – Copyright (Creative Commons license, Attribution–Non Commercial–No Derivatives)

Disclosure: If you purchase a product through this site, I may earn a commission which will help to pay for the site, the associated Meetup group and the resources to support the blog.