If you feel stressed out in your job at times, you’re not alone. Caregiving is a stressful job and many frontline caregivers experience stress at work at some point. However, those caring for elders have a particularly elevated risk of becoming stressed.

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Caregivers working with geriatric clients face many sources of stress on an ongoing basis:

• Taking care of dying clients

• Lack of knowledge in dementia care

• Conflicts with other caregivers

• Heavy workload

• Inadequate pay

• Job dissatisfaction

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Since repeated exposure to stress inevitably leads to burnout, caregivers working with the elderly are also the most vulnerable to it.

FROM STRESS TO BURNOUT
Although closely related, stress and burnout are two different things: Stress occurs when we face a situation that we perceive as too difficult or impossible to deal with. Burnout is the result of too much accumulated stress and is defined as a feeling of physical and emotional exhaustion.

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When we experience stress, we feel under pressure and become tense, anxious and irritable. We all experience a certain degree of stress in our workplace, and most of us cope with it. However, if we are constantly under pressure, stress builds up, coping becomes more and more difficult and, eventually, burnout sets in.

 

WHAT IS JOB BURNOUT?
Burnout is characterized by mental, emotional and physical exhaustion. It’s serious, because it can cause problems with much of
your entire life, not only the job, but its effects can spill over into your personal life as well and even lead to depression, if it goes on long enough and is severe enough. Symptoms of burnout include:

• Loss of interest in work

• Loss of interest in life

• Decrease in productivity at work

• Withdrawing from social contacts

• Difficulty sleeping

• Difficult relationships with family, friends and colleagues

• Disillusionment with career or family

• Short temperedness

• Constant tiredness, lack of energy and frustration

• Negative self-image

• Low sense of self-achievement

• Negative job attitude

• Increasing thoughts of death

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WARNING SIGNS
Usually, there are warning signs if you are developing job burnout. For example, you may start feeling anxious before going to work, or you may even dread the prospect of going there. You may tend to arrive late. And, once you arrive, you may have difficulty getting started, or focusing on your tasks for more than a few minutes.

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You may seem to have lost all your enthusiasm for the job. And you may feel annoyed if your colleagues show concern for you and your lack of participation in conversations and jokes. You may even be contemplating the idea of leaving your job.

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Prevention remains the best approach to burnout. And because burnout is the result of chronic exposure to stressful situations, the most effective way to avoid it is to learn how to prevent stress.

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WHAT CAUSES BURNOUT?
Healthcare workers, especially frontline caregivers and those involved with providing care to dementia clients, are particularly
vulnerable to burnout because they are continually exposed to many stressors. For example:

• Working with clients in the advanced stages of dementia

• Assisting clients through the dying process

• Helping clients who are experiencing pain too difficult to control

• Experiencing unresolved grief following the death of a client

• Being unable to provide effective care due to insufficient training or lack of time (this is particularly true for newly hired and dementia caregivers)

• Having distress over unwanted overtime

• Overworking yourself or working multiple shifts in a row

• Having difficulty in relationships with colleagues, patients or patients’ families

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In a study by researchers of the University of Minnesota School of Nursing, in Minneapolis, 96.4 percent of a sample of 726 nurses said it is essential to cope successfully with stress. In the study, the most commonly used strategies were exercise, eating healthy, massage, relaxation and prayer.

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ELIMINATE NEGATIVE THOUGHTS
Ongoing negative thoughts are a major cause of stress. This is because they further increase your anxiety and aggravate the pressure you feel under. In addition, negative thinking can make you perceive something as stressful which, in fact, is not. But, with a little practice, you can eliminate these negative thoughts.

 

One of the UK’s most prominent experts in stress management, Professor Steven Palmer, of City University, London, has the following advice for developing a positive attitude and avoiding negative thoughts:

• When presented with a difficult task, consider it as a challenge and a learning opportunity. Avoid thinking, “I will never be able to do it.”

• Don’t blow things out of proportion; see them in the right perspective.

• If you do something wrong, focus on doing better next time. Avoid thinking, “I am a failure.”

• Never assume that other people have negative thoughts about you – that you are not up to the job, for example.

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USE HUMOR
Humor can also help you get through your workday with a positive attitude, and has a direct beneficial effect on your health, as well, since it helps release anxiety and pressure. In fact, healthcare experts now encourage the use of humor as an effective method for coping with stress and preventing burnout.

 

ESTABLISH A BALANCE BETWEEN WORK AND PERSONAL LIFE
Finding and maintaining a healthy work-life balance may be difficult for a number of reasons. First, a caregiving job involves being
away from home for long hours, which reduces the amount of time available for family, friends and leisure. Second, some staff also need to stay connected to work during non-working hours, by text or by phone. This, according to new evidence published in the Journal of Nursing Management, makes it even more challenging to maintain a balance. Third, family commitments, such as caring for school-aged children or older family members, may make it hard to concentrate on job tasks and, therefore, contribute to work-life conflict.

Here are a few tips to help ensure a healthy balance between your work and personal life:

• Cut out unnecessary activities. Make a list of things in life that really matter to you – family, work, health, etc. – in order of importance. Then, see if you are spending too much time on activities that are not a priority. If so, eliminate them.

• Learn to "disconnect." Don’t bring work home unless necessary; avoid answering work-related emails or making work-related calls as much as possible. Keep your work and home life separated as much as you can ... although with home care professionals that can be difficult.

• Plan for leisure time. Enjoy activities other than work. Plan for fun and socializing opportunities; cultivate old interests and hobbies or develop new ones. Enjoy each one of these leisure activities at least once a week.

• Learn to delegate. Accept help, for errands and house chores for example, when this is available.

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TAKE CARE OF YOUR HEALTH
Caring for others requires continuous physical and psychological effort. This commonly leads caregivers to neglect their own health. And since poor health reduces the ability of coping with stress, by doing so, they unwittingly increase their risk of burnout. More suggestions include:

• Eat a healthy and balanced diet.

• Maintain a healthy body weight.

• Cut down on caffeine.

• Control alcohol consumption. Keeping a log of what you drink can help you realize whether you are drinking too much.

• Exercise regularly. Aim for at least 20 to 30 minutes on most days. Exercise, if done regularly, is an effective stress reduction tool.

• Don’t smoke. Smoking is one of the most damaging habits of all – both to you, and those around you who are breathing your second-hand smoke.

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EXPERT RECOMMENDATIONS
In addition to the previous interventions, stress experts recommend:

• Use your right to say "no." If you feel overwhelmed or have been asked to perform tasks you are not skilled for or things that are not in your priority list, just say "no" and don’t be afraid to ask for help if you feel you need it.

• Use relaxation techniques. These can include deep-breathing exercises, massage, yoga and progressive muscle relaxation. They can also be activities you simply enjoying doing such as listening to music, reading and gardening – or something as simple as a warm bath or contemplating a view can help. Aromatherapy massage combined with music appears to be particularly effective at reducing stress-related anxiety as well.

• Stay in control of your anger. It is common to become angry when under pressure. But this further increases stress and may  compromise your health and relationships.

• Learn to manage your time. This involves making a list of your tasks at the beginning of each day, both at home and at work. Be realistic when allocating time to each task and allow for contingency time. Leave non-urgent ones for later in the day.

• Make to-do lists ... they can help you stay organized and under control. Making to-do lists can also help with eliminating procrastination, which is a common stress-producing problem for those who have it.

• Look for career enhancement opportunities. Since job dissatisfaction due to lack of skills has been reported in studies to be associated with burnout, opportunities for learning and career development are also an important part of an effective burnout prevention plan.

• Talk to your supervisors. Finally, if you try different things and just cannot get your burnout situation resolved, that’s the time to ask for help. Go to your supervisor and tell them that you are having problems with too much stress and burnout. It may well be that your supervisor can make a few changes in your schedule and work environment that can be of considerable help in resolving the situation for you. You can discuss with your supervisor areas that you think are particularly troublesome and where you’re having the most stress and difficulty. Perhaps something as simple as more training may be needed ... if you think so, tell them this.