The care-giver�s responsibility for self-care

Below are extracts from an interview with dr. Charles Figley, Director of the Florida State University Traumatology Institute:

�Compassion fatigue is a state experienced by those helping people in distress; it is an extreme state of tension and preoccupation with the suffering of those being helped to the degree that it is traumatizing for the helper.

�Often, this leads to poor self care and extreme self sacrifice in the process of helping. Compassion fatigue have symptoms similar to posttraumatic stress disorder, such as the lack of sleep, due to the worker working too hard, and not leaving the work, putting in long hours, as well as not being able to separate from the work psychologically.

�Those who are selfless and compassionate have an Achilles heel -- they don't pay enough attention to themselves. So we have to save them from themselves.�

Source: Compassion Fatigue: An Expert Interview With Charles R. Figley, posted 10/17/2005 at http://www.medscape.com/viewarticle/513615.�

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Ethical principles of self care in practice

At the Academy of Traumatology (Green Cross) dr Figley developed proposed standards of self care, which are excellent guidelines to the caregiver. Extracts are shown below:

The principles of self care declare that it is unethical not to attend to your self care as a practitioner because sufficient self care prevents harming those we serve.

Ultimately it is your own responsibility to take care of yourself, and no situation or person can justify neglecting it.

Self care ensures your respect for the dignity and worth of the self: A violation of self care lowers your integrity and trust.

Standards of Humane Practice of Self Care

Universal right to wellness: Every helper, regardless of her or his role or employer, has a right to wellness associated with self care.
Physical rest and nourishment: Every helper deserves restful sleep and physical separation from work that sustains them in their work role.
Emotional rest and nourishment: Every helper deserves emotional and spiritual renewal both in and outside the work context.
Sustenance modulation: Every helper must utilize self restraint with regard to what and how much they consume (eg, food, drink, drugs, stimulation) since it can compromise their competence as a helper.

Standards for Establishing and Maintaining Wellness

A. Commitment to self care

Make a formal, tangible commitment that is written, public, specific, with a measurable promise of self care.
The self care plan should set deadlines and goals connected to specific activities of self care.
Generate strategies that work. Such a plan must be attainable and followed with great commitment and monitored by advocates of your self care.

B: Strategies for letting go of work

Make a formal, tangible commitment of letting go of work in off hours and embracing rejuvenation activities that are fun, stimulating, inspiriting, and generate joy of life.
The letting go of work plan should set deadlines and goals connected to specific activities of self care.

C. Strategies for gaining a sense of self care achievement

Set strategies for acquiring adequate rest and relaxation that are tailored to your own interest and abilities.
Set strategies for practicing effective daily stress reductions methods, tailored to your own interest and abilities in effectively managing your stress during working hours and off-hours.

Inventory of Self Care Practice -- Personal

A: Physical

Effectively monitor all parts of your body for tension and utilize techniques that reduce or eliminate such tensions.
Ensure effective sleep induction and maintenance.
Effectively monitor all food and drink intake and lack of intake with the awareness of their implications for health and functioning.

B: Psychological

Effective behaviours and practices to sustain balance between work and play
Effective relaxation time and methods
Frequent contact with nature or other calming stimuli
Effective methods of creative expression
Effective skills for ongoing self care include assertive�ness, stress reduction, interpersonal communication, cognitive restructuring and time management.
Effective skill and competence in meditation or spiritual practice that is calming
Effective methods of self assessment and self-awareness

C: Social/interpersonal

Social supports of at least 5 people, including at least 2 at work who will be highly supportive when called upon.
Know when and how to secure help -- both informal and professional -- and that the help will be delivered quickly and effectively.
Social activism: Being involved in addressing or preventing social injustice that results in a better world and a sense of satisfaction for trying to make it so.

Inventory of self care practice -- professional

Ensure a balance between work and home: Devote sufficient time and attention to both without compromising either.
Set boundaries and limits: Make a commitment and stick to it regarding: time boundaries and overwork, therapeutic/professional boundaries, personal boundaries, dealing with multiple roles (social and professional) and realism in differentiating between things one can change and accepting the others.
Get support and help at work through peer support, supervision/consultation/therapy and role models and mentors.
Generate work satisfaction by noticing and remembering the joys and achievements of the work.

Source: http://www.spiritualcarecollaborative.org/docs/workshop_handouts/M2.15 Rutland, Knowlton, Desjardin, and Kinzbrunner.pdf

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The Caregiver's Bill of Rights

As a caregiver I have the right�

To be respected for the work I choose to do.
To take pride in my work and know that I am making a difference.
To garner appreciation and validation for the care I give others.
To receive adequate pay for my job as a professional caregiver.
To discern my personal boundaries and have others respect my choices.
To seek assistance from others, if and when it is necessary.
To take time off to re-energize myself.
To socialize, maintain my interests, and sustain a balanced lifestyle.
To my own feelings, including negative emotions such as anger, sadness, and frustration.
To express my thoughts and feelings to appropriate people at appropriate times.
To convey hope to those in my care.
To believe those in my care will prosper in mind, body and spirit as a result of my caregiving.