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Compassion Fatigue and Caregiver Burnout – Psychology


The psychotherapists are the ones who deal with patients experiencing terminal illnesses. They develop close relationships with these patients while they take care of them. However, the relationships can cause psychological problems to the caregivers. The caregivers suffer from different forms of stresses. The common one is burnout. Burnout is a state where the caregiver develops mental fatigue leaving him or her empty and energy drained (Espeland, 2006). Presently, the common form of burnout affecting the caregivers is compassion fatigue. This type of burn out is more persistent than the normal one, though it emerges suddenly. The symptoms of compassion fatigue are more adverse than regular burnout symptoms (Portnoy, 2011).

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Aycock and Boyle, 2008 define compassion fatigue as a severe malaise resulting from taking care of patients who are in pain or suffering terminal disease. The condition is mainly caused by the death of a patient with whom the caregiver had close and long time professional relationships. Mathieu, 2007, on the other hand, defines compassion fatigue “as the cost of caring for patients in their emotional and physical pain”(6). It causes in caregiver deep physical and emotional exhaustion. The pain makes the caregiver feel exhausted hence affecting his/her relationship with their patients, their colleagues, and families. Consequently, they lose interest and enjoyment in their work and increase cynicism at work, which can eventually lead to depression.

According to Sabo 2011, compassion fatigue is the natural way of the body to react to a traumatizing occurrence resulting from caring for a person close to you. In this case, the caregiver develops a very close relationship with the patient. This closeness between the caregiver and the patient causes the caregiver to develop insatiable compassion for the patient. Consequently, the suffering of the patient traumatizes the caregiver.

Warning signs of compassion fatigue

Compassion fatigue develops gradually in one’s life. It starts with compassion discomfort, compassion stress, followed by compassion fatigue. At all these stages, the caregiver develops the symptoms gradually. During compassion fatigue, the lack of energy surpasses someone’s ability to recover hence causing negative physical and psychological results (Boyle, 2011). Compassion fatigue also develops and becomes more suppressing with the condition of the patient. As the patient continues to be more and iller, the caregiver becomes more and more concerned hence develops strong compassion for the patient.

According to Portnoy (2011), early symptoms include headaches, fatigue, lowered resiliency, interpersonal conflicts, moodiness, frequent colds, and a lowered sense of accomplishment. If left untreated, the early symptoms advance quickly to compassion fatigue (Portnoy, 2011). These early symptoms indicate the onset of the warning signs of compassion fatigue. There is, therefore, need for early treatment of these early symptoms.

In the National Survey of the Work and Health of Nurses performed in 2005 in Canada, nearly a fifth of the nurses showed that their mental health affected their productivity. It revealed that over half of the nurses took time off work because of the physical health while a tenth took time off due to mental health reasons (Mathieu 2007).

Since compassion fatigue is an occupational condition, it mostly affects caregivers of patients with terminal illnesses. This means that one warning sign of compassion fatigue is caring for a terminally ill patient. Also, the close relationship developed between the caregiver and a terminally ill patient is a warning sign of compassion fatigue. The care that the caregiver gives to the patient leads to the formation of a close relationship between them (Mathieu, 2007).

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Caregivers are at a risk of emotional exhaustion, which is a result of their compassion and empathy for the patients (Bush, 2009). In this case, when the caregiver develops this kind of compassion and empathy, he or she does everything he can to save the patient. This results in both physical and emotional exhaustion on the part of the caregiver. Very strong compassion and empathy for the patient by a caregiver is, therefore, another warning sign of compassion fatigue.

Indicators and effects of Compassion fatigue

Compassion fatigue has several indicators. First, the caregivers lose interest in everything they enjoyed doing this job. The caregiver also experiences emotional disengagement hence avoids social relations and prefers isolation. Also, the person will feel a sense of hopelessness. Since compassion fatigue is a process, it progresses to depression if not treated (Day & Anderson, 2011). Compassion fatigue patients may also experience overwhelmed exhaustion, especially to newly employed caregivers (Aycock & Boyle, 2008).

Portnoy, 2011 notes that compassion fatigue affects the main areas of one’s life. The affected demonstrate irritation, withdrawal; they are moody, and even his or her appetite changes. Spiritually, the person feels a sense of hopelessness, loss of faith, and even questions religious belief that he had. Emotionally, such a person experiences anxiety, guilt, anger, as well as numbness. Somatically the caregiver will experience breathing difficulty, sweating, dizziness, low immunity, and difficulty falling asleep. Moreover, compassion fatigue affects the cognitive thinking of the caregiver. Such affected people begin to experience rigidity, apathy, disorientation, and low or no concentration.

If left untreated for a long time, compassion fatigue can bring adverse results to the caregiver. These adverse signs are fatal and may lead to the eventual death of the person affected. The patient starts experiencing extreme anxiety, having suicidal thoughts, and even depression. At this stage, the patient requires professional help from a professional counselor (Mathieu, 2007).

The state of burnout weakens the caregivers’ mind hence affects their actions. This implies that the condition affects both the patient and the caregiver (Gentry, 2002). Figley (2002), asserts that compassion fatigue lowers the caregiver’s productivity. Once the caregiver’s productivity reduces, the patient has little hope of recovering since the caregiver cannot give him the attention and care he deserves.

Management of Compassion fatigue

Even though compassion fatigue is a complex condition that greatly affects most caregivers, it is manageable. Its management involves three main categories. These categories are work and life balance, work setting, and education. There is need to occasionally inform the caregivers on the issue, for instance, there should be training that will encourage the caregivers to balance their lives in that they have time to deal with their challenges without negatively affecting their work. In their working setting, there should be available counselors who the caregivers can talk to during difficult times. They shall provide emotional support. On the other hand, there is a need for empowering caregivers with communication skills. This will help them open up and share their feelings hence lowering the cases of compassion fatigue (Boyle,2011).

According to Mathieu (2007), compassion fatigue is a preventable condition. There are several strategies that an organization or institution should undertake to report lower cases of compassion fatigue among their staff. First, the organizations should encourage the staff to speak openly on compassion fatigue in their workplace and help each other. Also, organizations should make plans to encourage regular breaks for relaxation.

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Moreover, there should be the formation of peer support groups within the organizations that the staff can share freely. Besides peer support groups, there should be available professional counselors to handle severe cases. Lastly, organizations should encourage every staff member to do their hobbies during their free time. This would ensure that the staff has ample time to relax their minds hence prevent fatigue (Mathieu, 2007).


Compassion fatigue is a common condition among caregivers who deal with terminally ill patients. It is an extreme burnout, which appears suddenly with minimal or no signs. It leaves the caregiver extremely exhausted hence affecting their productivity. It results from the caregiver having close professional relationships with the patients. The major early signs include frequent cold, headaches, low or no motivation, moody, and even interpersonal conflict (Portnoy, 2011). However, the condition is treatable with a consideration of three main areas: work setting, education, and work-life balance.

Every organization should ensure that their staffs have sufficient time to rest to facilitate a balance between life and work. Organizations should also encourage good communication among their staff. Moreover, organizations would reduce the case of the condition if they allowed their staffs to have enough time to rest, attend peer support groups, and have available counselors for severe cases.


Aycock, N. & Boyle, D. (2008). Interventions to Manage Compassion Fatigue in Oncology Nursing. Clinical Journal of Oncology Nursing, 13(2), 183-191. Web.

Boyle, D. A. (2011). Countering Compassion Fatigue: A Requisite Nursing Agenda. The Online journal of issues in Nursing, 16(1), 40-45. Web.

Bush, N. J. (2009). Compassion Fatigue: Are you at risk? Oncology Nursing Forum, 36 (1), 24-28. Web.

Day J. R. & Anderson, R. A. (2011). Compassion Fatigue: An Application of the Concept to Informal Caregivers of Family Members with Dementia. Nursing Research and Practice 1(1)1-8. Web.

Espeland, K. E. (2006). Overcoming Burnout: How to Revitalize Your Career. The Journal of Continuing Education in Nursing, 37(4), 76-79. Web.

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Figley, C.R. (2002). Compassion Fatigue: Psychotherapists’ Chronic Lack of Self Care. Psychotherapy in Practice, 58(11), 37-61. Web.

Gentry, J. E. (2002). Compassion Fatigue: A Crucible of Transformation. The Journal of Trauma Practice, 1(3/4), 37-61. Web.

Mathieu, F. (2007) Running on Empty: Compassion Fatigue in Health Professionals. Workshops for helping professionals, 1(1), 6. Web.

Portnoy, D. (2011). Health Progress. Journal of the Catholic Health Association of the United States, 1(1), 47-52. Web.

Sabo, B.(2011). Reflecting on the Concept of Compassion Fatigue. The online Journal of issues in Nursing, 16(1), 1-10. Web.

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