By Betty Norman, BSN, MBA, CPHRM
According to a Yiddish Proverb, "God gave burdens, he also gave shoulders." But, what happens when those shoulders can no longer hold the weight? It’s natural to overlook your own health and well-being when caring for the health and well-being of someone else. This is one reason why employers of caregivers need to take extra care in ensuring their workforce is healthy, both mentally and physically.
Some of the risk factors caregivers are faced with are mental health issues, stress and fatigue, physical ailments and disease. These risks are often the result of caregiver burnout and compassion fatigue. In order to help mitigate these health risks, employers of caregivers must first understand their root causes.
Caregiver burnout can be described as physical and emotional exhaustion. It may be caused by excessive amounts of long-term stress and starts to occur when a caregiver feels overwhelmed and has trouble meeting constant demands. Emotional and psychological health can also affect physical health, which is why caregiver burnout manifests as a snowball effect. Some symptoms of caregiver burnout are: fatigue, stress, anxiety and depression.
Compassion fatigue, also known as secondary traumatic stress (STS), can be described as the “cost of caring” for others in emotional pain. This condition is characterized by a gradual lessening of compassion over time and may be caused by recurring or continuous emotional stress. Some symptoms of compassion fatigue are: excessive blaming, apathy, isolation from others and substance abuse to suppress emotions.
While it’s important to understand the causes behind caregivers’ risk factors, it’s also important that employers and employees are proactive in mitigating these risks. Here are some ways employers can help care for caregivers:
Create working conditions that help reduce the risk of caregiver burnout and compassion fatigue.
- Studies found that caregivers exhibit exaggerated cardiovascular responses to stressful conditions which increase their risks of developing cardiovascular syndromes such as high blood pressure and heart disease.1, 2 Promote heart healthy activities such as walking and provide regular work breaks to allow time for these activities.
- Estimates show that between 40 and 70 percent of caregivers have clinically significant symptoms of depression.3 Encourage employees to talk about how their work affects them, and create an open environment for employees to give and receive support.
- Caregivers suffer from increased rates of physical ailments such as headaches, chronic and acute pain and body aches.4 Equally distribute the caseload among caregivers. For example, if there is a patient fall or sudden UTI in one unit which creates an increased workload for the assigned caregiver, consider reassigning staff to provide additional support in that unit.
- Caregivers suffer from increased tendency to develop serious illness.5 Consider providing employees with additional support to help them understand their short-term and long-term disability benefits, and know the rights afforded to them under the Family and Medical Leave Act of 1993 (FMLA).
Promote healthy self-care habits.
- Caregivers have a 23 percent higher level of stress hormones and a 15 percent lower level of antibody responses.6 Consider training employees on self-care and life balance to help build resilience to stress.
- Caregivers who experience chronic stress may be at greater risk for cognitive decline.7 Consider implementing stress-management programs that may provide:
- Mindfulness training
- Relaxation techniques
- Cognitive desensitization
- Breathing exercises
- Studies demonstrate that caregivers have diminished immune responses, which leads to frequent infection and increased risk of cancers.8, 9, 10 Consider on-site health screenings and encourage routine doctor visits and check-ups.
- Furthermore, 35 percent of caregivers reported having difficulty finding time for themselves.11 Consider being flexible when scheduling work hours so that employees have time to exercise self-care.
By understanding the health risks associated with being a caregiver and implementing ways to help reduce these risks, employers are not only providing necessary care to their employees; they are also providing necessary care to their patients.
- King, A.C., Oka, R.K., Young, D.R. (1994). Ambulatory blood pressure and heart rate responses to the stress of work and caregiving in older women. Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 49: 239-245.
- Shaw, W.S., Patterson, T.L., Ziegler, M.G., Dimsdale, J.E., Semple, S.J. & Grant, I. (1999). Accelerated risk of hypertensive blood pressure recordings among Alzheimer’s caregivers. Journal of Psychosomatic Research, 46: 215-227.
- Zarit, S. (2006). Assessment of Family Caregivers: A Research Perspective. In Family Caregiver Alliance (Eds.), Caregiver Assessment: Voices and Views from the Field. Report from a National Consensus Development Conference (Vol. II) (pp. 12 – 37). San Francisco: Family Caregiver Alliance.
- National Alliance for Caregiving & Evercare. (2006). Evercare® Study of Caregivers in Decline: A Close-up Look at the Health Risks of Caring for a Loved One. Bethesda, MD: National Alliance for Caregiving and Minnetonka, MN: Evercare.
- Shaw, W.S., Patterson, T.L., Semple, S.J., Ho, S., Irwin, M.R., Hauger, R.L. & Grant, I. (1997). Longitudinal analysis of multiple indicators of health decline among spousal caregivers. Annals of Behavioral Medicine, 19: 101-109.
- Vitaliano, P., Zhang, J. & Scanlan, J. (2003). Is caregiving hazardous to one’s physical health? A meta-analysis. Psychological Bulletin, 129(6): 946-972.
- Vitaliano, P.P., Echeverria, D., Yi, J., Phillips, P.E.M, Young, H. & Siegler, I.C.. (2005). Psychophysiological mediators of caregiver stress and differential cognitive decline. Psychology and Aging, 20: 402-411.
- Kiecolt-Glaser, J.K., Dura, J.R. & Speicher, C.E., (1991). Spousal caregivers of dementia victims: Longitudinal changes in immunity and health. Psychosomatic Medicine, 53(4):345-362.
- Kiecolt-Glaser, J., Glaser, R., Gravenstein, S., Malarkey, W.B. & Sheridan, J.,(1996). Chronic stress alters the immune response to influenza virus vaccine in older adults. Proceedings of the National Academy of Sciences of the United States of America, 93: 3043-3047.
- Glaser, R. & Kiecolt-Glaser, J.K. (1997). Chronic stress modulates the virus-specific immune response to latent herpes simplex virus Type 1. Annals of Behavioral Medicine, 19: 78-82.
- National Alliance for Caregiving/AARP (2004). Caregiving in the U.S. Retrieved from http://assests.aarp. org/rgcenter/il/us_caregiving_1.pdf