As a professional caregiver, you may think you’d be able to recognize the signs of burnout in yourself. But it can also sneak up on you — like it did for Caroline Morris, a board-certified geriatric physical therapist in Alexandria, Virginia.
Morris knew she was stressed. For several years, she worked as a full-time physical therapist in an inpatient hospital setting, where she also managed weekend staffing and ended up working all the shifts nobody wanted. The hours were long, and she sometimes encountered patients who refused or resented their PT sessions. Meanwhile, other colleagues pressured her to see patients even if there wasn’t sufficient staffing and to get people discharged quickly.
“I was maintaining a full caseload and working all these extra shifts, and I had multiple pressures and demands without the resources to deal with it,” she says. “I was also working with very sick, complicated patients, many of whom were older.” It was a perfect storm for job-related burnout.
It’s common for family caregivers to experience burnout, but it can look different for professional senior caregivers. Here’s how to spot the signs of burnout in yourself, how to alleviate it and how to prevent it moving forward.
Recognizing signs of burnout
Morris’s loved ones expressed concern for her well-being, but she didn’t listen since she didn’t think they “got it.” Her coworkers understood the stressors of the job, but they weren’t pulling their weight. Feeling unsupported, she tried to soldier on without realizing it was unsustainable.
It’s not uncommon for professional caregivers and health care workers to be unaware they’re experiencing burnout, says Andrea Devoti, executive vice president of the National Association for Home Care and Hospice. Devoti is a former nurse who also ran a home health agency for 18 years, and she knows how easy it is for caregivers to lose themselves in the work. “Sometimes you put yourself into a situation — or you have been put into a situation — where you’re giving your all, giving every bit of energy, knowledge, time and effort, and you become burned out,” she says.
Burnout is a form of chronic stress and exhaustion that can manifest differently in each person, Devoti says, and its signs can be physical, mental, emotional and/or spiritual, such as:
- Eating too much or too little.
- Difficulty sleeping.
- Feeling exhausted, frazzled and/or unmotivated.
- Isolating yourself from your loved ones.
- Turning to alcohol or drugs.
- Physical complaints or health problems.
For Morris, burnout happened so gradually that she barely noticed it until her body could no longer let her ignore it. “I gained 25 pounds over three years, I had a lot of brain fog, my skin was reactive, and I was constantly fatigued,” she recalls. When she did finally take some time off, on the way to her first day back at work, she felt nauseous and realized something had to give.
How to cope with caregiver burnout
If you recognize that you’re suffering from burnout, it’s important to take action and address it mentally, physically and emotionally. Here are some ways to get started:
Take care of yourself physically
When you’re burned out, healthy habits tend to slide, Devoti says. It sounds obvious, but simple acts of self-care, such as eating a balanced diet, drinking water, exercising, taking power naps, sleeping enough and maintaining personal hygiene go a long way, she notes.
Practice stepping away
If your burnout is due to your work environment, start allowing yourself to step away for a few moments, rather than letting stress build. “When I’ve gotten in situations of frustration or anger and needing relief, I’ll go out and take a walk around the block,” Devoti says. If you work in a facility where that’s harder to do, she suggests walking the hallways or courtyard or sitting in the chapel, even if just to meditate or practice gratitude.
“You need to have emotional support to be able to do caregiving.”
— Andrea Devoti, executive vice president, National Association for Home Care and Hospice
Set up healthy boundaries
Lacking clear boundaries at work can contribute to burnout — especially for professional caregivers who develop an attachment to patients or their families and feel obligated to stay late or go above and beyond, Devoti says.
But “if you don’t put up boundaries, you’ll let this person down anyway, because if you’re not taking care of yourself, you’ll ultimately collapse or get sick,” she says. Consider how many shifts or hours you can realistically tolerate and when you need to be off the clock. Let your colleagues or patients know, then stick to these boundaries.
As Morris assessed her burnout, she realized how much she struggled to say no and to ask for and receive help. Knowing she needed to improve that to create boundaries, she started writing “ask for help” and “just say no” in her daily to-do lists as reminders to take care of herself too.
Identify who you can lean on
“You need to have emotional support to be able to do caregiving,” Devoti says, since the work requires giving so much of your time, energy and knowledge. Depending on your profession, you may also have to cope with a significant amount of loss.
Those who work with a team could utilize meetings as a time to ask for support. Independent caregivers don’t have this option, though rather than venting to family, Devoti encourages them to consider:
- Finding a friend who also works in caregiving and setting up a standing appointment. For example, a weekly coffee date to unload.
- Join a local caregiver support group.
- Pursuing an employee assistance program, which typically offers free short-term counseling and referrals.
- Seeking out a therapist.
Practice mindfulness
Mindfulness entails being observant of the present in a nonjudgmental way rather than functioning on auto-pilot. Devoti says this awareness is beneficial for caregivers, and it can be as simple as sitting on a park bench for 10 minutes to listen to birds and clear your mind. “It’s really just being consciously mindful, clearing your brain and body, and doing deep breathing for a few minutes so you’re then able to better handle things,” she says.
Morris found it helpful to implement mindfulness by linking it to routines. “When I was seeing patients in the hospital, I always had my mindful moment be when I was doing my hand hygiene before walking into the room,” she remembers. “That helped me have a distinction between what I’d just been dealing with and to be present for the next patient.”
She also noticed that she was in the habit of treating everything as urgent, so she began to deliberately slow down. This helped change her perception and reduced feelings of burnout.
Consider bigger changes
If these actions don’t provide sufficient relief, it may be worth making more significant changes. Morris recognized that her burnout stemmed from the dual stressors of working in an inpatient setting and coordinating weekend shifts. She switched from inpatient to outpatient, then later swapped the coordinator role for a staff development position, which she found more gratifying. “That was a much better use of my skills, so that helped quite a bit,” Morris says, observing that working at a job or in a role that doesn’t play to your strengths can contribute to burnout.
More recently, Morris shifted to working part-time at the hospital and focusing on the staff development position rather than clinical work and using the rest of her time to start her own health coaching business.
How to prevent caregiver burnout
If you’re not currently experiencing burnout, try these tips to keep it at bay:
Normalize taking breaks
Work breaks shouldn’t be reserved for when you’re stressed and need to cool off; build them into your schedule to let off pressure regularly. For example, Morris started eating her lunch outside, which forced her to take a break, and being around nature relaxed her.
Build an identity outside of work
Loss of identity can be a feature of burnout so avoid letting your work completely define you. One way to do this, according to Devoti: Seek friends outside of work to create more separation between your professional and personal lives.
When Morris hit her breaking point, she attended a week-long retreat that helped her shift from focusing all of her self-worth on what she does to who she is. “It was really freeing to realize that in a caregiving sense, I didn’t have to keep giving more and more to my patients in the hospital through my actions — I could be whole in myself, and that would actually be more effective for them,” she says.
“I started lighting a candle for the patients I was worried about or the ones who weren’t surviving. This externalized it and helped me stop ruminating over what I could have done differently.”
— Caroline Morris, geriatric physical therapist
Establish rituals to cope with stress
Notice what triggers you emotionally or mentally and how you can counteract that stress before it becomes unmanageable. Morris started taking a walk at the end of each work day to get comfort from nature and to help her process the day.
And when she worked in units with high death rates, such as ICU and oncology, she added a ritual to her routine. “I started lighting a candle for the patients I was worried about or the ones who weren’t surviving,” she says. “Even though I was working as a PT, I still felt really responsible for their outcome, so this externalized it and helped me stop ruminating over their grave prognosis or what I could have done differently.”
Track your health metrics
Through her coaching business, Morris is launching a health monitoring program utilizing wearable Garmin devices. She’s found that tracking health metrics with these devices can reveal you’re stressed before you may be aware of it, and it can even predict illness and flare-ups of chronic conditions.
“People can use their wearable devices to cue them into when their body isn’t handling their day,” she says. For example, if your resting heart rate average is up, it may be a sign your body is under increased stress, Morris explains.
Know that it’s as crucial to care for yourself as it is to care for others
Generously providing time, energy and support to seniors is what caregivers like you do best. But if you run yourself into the ground, you can’t be your best self for anyone. Bottom line: Taking care of yourself is just as important of a job as taking care of your patients or clients.
