Did you know that in 2019, “burnout” was classified as an official medical condition by the World Health Organization (WHO)?
The burnout diagnosis, according to the American Institute of Stress, is defined as a “syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed.”
Burnout is sometimes referred to as compassion fatigue, especially among health care providers, service members, and first responders, who are often witness to painful or traumatic moments on the job.
Caregiving is tough work, and it can weigh on even the strongest and most resilient employees physically, mentally, and emotionally. With the added, immense stress of serving on the frontlines during a global pandemic, the risk of burnout is at an all-time high. In this article, we’ll discuss ways providers can recognize the symptoms of caregiver burnout, steps they can take to prevent it, and offer tips for coping with and healing from this serious and all-too-common health condition.
Causes & Symptoms
In order to proactively prevent and treat burnout in caregivers, it’s critical to understand how and why burnout happens in the first place.
When does burnout occur?
Burnout can occur when caregivers don’t get the support they need, or if they try to do more than they can reasonable handle. Specifically, factors that lead to burnout may include:
Unrealistic Expectations: Given the amount of care, emotion, and energy they put into their work, many caregivers expect their involvement to have a positive effect on the patient’s health and well-being. Unfortunately, caregivers may witness the opposite effect with time—especially in cases where the patient is suffering from progressive diseases such as Alzheimer’s or Parkinson’s.
Role Confusion: Entering the role of a caregiver can be confusing, as it tends to be an all-consuming job. In consumer-directed environments, it can be difficult for a person to separate their role as a caregiver from their role as a spouse, lover, child, friend, or in another close relationship.
Lack of Control: Not having the money, resources, and skills to most effectively care for their patients can leave caregivers feeling defeated and depressed. This feeling of lacking control is particularly widespread now, as while COVID-19 vaccines have been developed and distributed, there is still so much about the virus that remains unknown.
Unreasonable Demands: While some caregivers place excessive pressure upon themselves, it’s common for the family members or loved ones of those they’re caring for to expect more from aides than reasonably possible. This can become overwhelming for caregivers, and may also trigger feelings of guilt and inadequacy.
Holidays: Though the holidays can be a stressful time for everyone, they can prove particularly challenging for caregivers. Their patients may feel depressed around the holidays if it is the first year after a spouse has died, or there may be holiday traditions that they look forward to but can no longer participate in.
What are the common symptoms of burnout?
According to the Maslach Burnout Inventory (MBI), which has been recognized for more than a decade as the leading measure of burnout, the condition can be divided into three main components:
- Feelings of energy depletion or exhaustion
- Increased mental distance from one’s job, or feelings of negativism or cynicism related to the job
- Reduced professional efficacy, or feeling as if they’re not accomplishing anything at work
These feelings may surface as the following symptoms:
- Irritability, hopelessness, and helplessness
- Changes in appetite, weight or both
- Getting sick more often
- Decreased interest in activities previously enjoyed
- Changes in sleep patterns
- Withdrawal from family, friends and peers
- Emotional and physical exhaustion
“As an agency, we typically start noticing burnout if the caregivers are not acting themselves,” said Catharine Weaber, Vice President of Strategy and Business Development at Angels on Call, a licensed homecare service agency based in Pennsylvania. “This could mean they are more tired, calling off, not performing tasks as well, or appearing depressed or moody. Sometimes, a client might call in to give us a hint. Clients tend to notice signs and symptoms earlier because they see the caregiver more frequently and know their personality and routine.”
“Caregivers are often caring for a loved one, or someone through an agency to whom they become close,” said Weaber. “There are a lot of emotions around change in condition regarding health and the aging process, and it can be very difficult to see someone you care about decline.”
A decline in health, or getting older, can also require a higher level of care, which can be physically strenuous for the caregiver. Caregivers are so busy caring for others, they often forget or simply lose the time to care for themselves.
Certain stresses of homecare are inevitable, but there are steps providers can take to prepare their caregivers for common challenges on the job and lessen the risk of them burning out.
- Set practical work schedules. “Overtime can be great for the caregiver monetarily, but it can also lead to exhaustion and emotional burnout,” Weaber said. “Even if a caregiver says they want to work 12-16 hours a day, 7 days a week, encourage at least one day off, and give suggestions for rest and relaxation.”
- Ensure you have COVID-19 safety measures in place. This will ensure your caregivers that your agency is doing everything it can to keep them and your patients safe, and will make them feel more in control in a time when so much is still uncertain.
- Have a backup plan. To ensure your patients’ primary caregivers can take a break when necessary, communicate with your clients and their families to get a backup plan in place, either through informal supports, or by training additional caregivers on the client’s plan of care.
- Provide self-care incentives. To reward those hard-working caregivers who go the extra mile, Weaber offered some tips: “Give them a day of PTO and a gift card for an activity the caregiver enjoys that is not related to work. An easy way to do this is during onboarding – include a small questionnaire asking what they like to do for fun.”
- Pay attention! As providers, it’s easy to get bogged down with the day to day and forget to take a moment to check in with caregivers and ask how they’re doing. You don’t need to clear time for a lengthy conversation—just knowing that their employer cares enough to consider their well-being can be enough to lift their spirits and boost morale.
- Do your best to appropriately match caregivers to clients. For example, if a caregiver is newer and doesn’t feel comfortable operating a Hoyer lift, avoid putting them on a high acuity case that requires transfer assist. The better your match, the happier the caregiver. The happier the caregiver, the better quality of care for our clients.
- Train them to care for themselves as they will care for others. When constructing a training plan, be sure to incorporate tips for self-care as well. Afterall, if your aides are going to be successful on the job, they must also take the steps to keep themselves mentally, physically, and emotionally healthy.
While it’s typically not as easy as “bouncing back”, burnout is treatable!
Be mindful that caregivers may try to push through the burnout, especially if they’re struggling financially, but that will only exacerbate the problem. Kindly remind your aides that in order to do their job well, they need to be well!
“During the safety instructions on a flight, the attendants always say, ‘Secure your own oxygen mask before trying to help others,’” Weaber said. “That’s because you can’t assist someone else, if you are not well. The same thing applies to caregiving. If a caregiver is struggling personally, they cannot be the best caregiver to others.”
As a provider, do your best to create an environment where caregivers feel comfortable approaching you or another appropriate member of your staff if they’re facing an issue on the job. Just knowing that they are not alone in their struggle, and that someone understands where they’re coming from and may even have been in their situation before, can be tremendously helpful.
You may also want to consider organizing bereavement groups among your staff. When your team members lose a client, it can feel as if they have lost a friend. A small group session may provide the perfect outlet for your employees to express the pain of the loss and help them through the grieving process.
It’s characteristic of home healthcare professionals to want to do everything in their power to heal the people they care about. But in more severe cases of burnout, you simply might not have the resources to help your caregivers recover. Still, you can help by proactively researching resources in your community. Provide the caregiver with a comprehensive list of therapists in the area, and include grief counseling groups that can be found locally as well. While many have moved their meetings online during this time, others are holding socially distanced gatherings.
And while you’re caring for your caregivers, don’t forget to care for yourself! Running a homecare agency is a very difficult job, and managing caregivers, patients, and payers can be all-consuming. To lighten your load, consider a homecare management system like HHAeXchange, which seamlessly connects providers, payers, and caregivers in one platform. By breaking down barriers to effective participant care in the home, HHAeXchange helps homecare agencies better manage their day-to-day activities and improve workflow efficiencies. To learn more about how HHAeXchange can help you, your caregivers, and your business, schedule a demo.