How to Care for Caregivers: Helping People See Through the Darkness
To get through the hardest journey we need to take only one step at a time, but we must keep on stepping.— Chinese proverb
In the human services field, there are many occasions to find happiness and satisfaction in the work. We see clients make positive changes and advances in their lives, we see them graduate from school or make better decisions, or we see them discharged from the hospital. On the flip-side, however, there are many occasions in the human services profession see only darkness or the hard things—and to feel like we aren’t making a difference.
This article will cover some of the barriers that caregivers face as they encounter different experiences in their day-to-day work. It will also cover the barriers they face when speaking to others both inside and outside the profession.
How non-caregivers can affect caregivers
I’ve had a few positions in my career as a social worker so far. I have worked in a hospital setting with adults and kids with feeding tubes, I have worked with youth who live on the street, and I have worked with people transitioning from home or hospital to care facilities. I have had the opportunity to see some amazing things, but I have also seen terrible and sad things. I have been witness to a lot of darkness and shared a space with someone who was in so much pain that the mere fact of getting out of bed was agonizing, or in so much emotional pain that suicide was a preferable option.
When I used to tell people what I did for a living, the common response was “Wow, that must be a really hard job." Everyone focused on only the dark aspects of the work I did. For example, I worked with kids with feeding tubes; babies who couldn’t eat for one reason or another or there was a risk of them aspirating. I sat with parents who had expected a “normal” baby and had to adjust to the reality that their baby was sick; that now, instead of looking for the regular milestones of development, and adjusting to life as a parent, they had to learn how to place a feeding tube inside their child’s nose and throat, knowing that if they made a mistake, they could place the tube into the child’s lungs and cause greater harm. The “new normal” for people in that situation is a highly stressful one that requires them to wake up and face each day with the potential of their child getting sick or sicker. All of that leads to parents and caregivers who are burning out, developing their own mental health problems, and a plethora of other concerns that became added to the work done with the client.
So when people said to me “that must be a really hard job," they were right. Most of the work I have done with people has had larger elements of pain and hardship than it has had of joy and happiness. There were times where I found it hard to go home and smile, or even to go into a meeting with a client or patient. If I was not seeing a child who wasn’t “normal," I was assisting with supporting a family. If I wasn’t working with a youth who was suicidal, living with some other mental health problem, or some other behavioural issue, I was still working with a youth who had nowhere else to go (this was working at a homeless shelter for youth) and whose reality was that they weren’t welcome at home.
Seeing through the darkness
With the above being taken into consideration, please be aware that those were only a couple of examples of things that I have encountered in my work, and they are not uncommon experiences. If that is true, then how do people stay in the field so long? What is it that helps people get through the days in a healthy way?
While it is easy to focus on all the negativity that we encounter, it can lead us as caregivers into a dark place of our own. This is seen behaviourally in staff members who engage in “dark humour” – jokes that seem like they are in bad taste for the situation, or jokes that, seen from the outside, appear to indicate that the person is jaded and just plain rude. It can also come in the form of extra sick days, poor performance at work, or other behaviours that give us the impression that the person is not good at their jobs. If you think about it, the person in this position got hired, so they demonstrated merit in order to get a job and get to where they are now.
In order to stay healthy in the field of human services, staff members need a few core skills that are commonly called self-care. These are practices that, as the name might suggest, are geared towards taking care of self. Some of the common techniques to help with self-care include:
Debriefing – following incidents, big events at work, or even at the end of the shift, it is a good idea to debrief with co-workers. Debriefing is the process of talking about how you felt in a situation and following a situation. It can also talk about what you might have done differently, or act as a learning opportunity for how you might approach a situation differently in the future.
Counselling – going to speak to someone who is separate from the situation you’re in who has the training to help you work through your emotions is a great way of caring for yourself. Many Human Service agencies, and in fact, many other employers in Canada offer additional benefits in the form of an Employee Assistance Program, which offers employees to access counseling, hydro-therapy, financial counseling, or a number of other supports.
Exercise – Studies show that exercise can be as effective as medications that treat depression and anxiety. It also enables a physical release of the tension experienced from stressful situations. (For more on this, check out the Atlantic's article and this article from the NCBI.)
Diet and Nutrition – While there is an obvious physical benefit to having a proper diet, nutrition and diet enables us to be clearer mentally, and to have the internal energy and resources to deal with stress in a healthy way. Studies have demonstrated the therapeutic benefits of addressing depression and/or anxiety with nutrition or the use of certain supplements. (For more on this, check out the NCBI for diet and nutrition.)
Sleeping – having a regular rhythm to your sleep patterns can be helpful in combatting certain mental health problems that might come with exposure to ongoing stress. There is evidence that demonstrates that our “circadian rhythm” is important at allowing us to feel rested after sleeping, to feel clearer when we wake up, and to handle stress more easily. Sleep also allows our brains much needed time to digest all of our experiences through a day. *Please note that too much sleep can be a sign of depression, however.
The five ideas above are the common methods that people use to deal with the stress they experience. They are, in some ways, predicated on the idea that someone will ask for help (debriefing and counseling), or will take the time to exercise, plan meals, or sleep.
Additional Ideas – Thinking Outside the Box
Here are some additional ideas I would like to propose that help caregivers cope with stress
Change your point of view – This sounds easy, but it can be a very difficult technique. For an example of this, take my experience working with kids with feeding tubes. It would have been easy for me to focus on the sick kids and let my empathy turn into sympathy. When people would say, “Man, that must be a tough job," I initially agreed with them and my world turned darker as I let myself fall into the difficulty I encountered at work. One turning point for me was changing my point of view from the sick kids and the stress that the family was going through, to focusing on the seemingly minor happy occurrences. When I changed my focus I started seeing happiness where I saw only sadness before, and when people said to me, “Man, that must be a tough job," I replied “You know, it can be. But I like to look at the exciting things. For example, this week I got to see a three-month-old take her first taste of formula from a bottle ever and the excitement from her and her parents was beautiful." Once I started to look for rays of light, the same situation that I would have called “tough” was an opportunity for so much strength, resilience, and beauty.
Talk to your co-workers and check-in – This can be a challenging thing to do. In human services, there is an unspoken (or sometimes spoken) expectation that we are expected to show up the next day, no matter what our experiences were. This can make it hard, depending on the team, to open up and be honest about how an experience have affected us.
Challenges in caring for caregivers
Often times, caregivers recognize the needs of others well in advance of recognizing their own needs. It is easier to take care of others and to acknowledge that there are supports we can offer them than it is to look at ourselves and say that we need help. Some of the ideas you can use to encourage someone to help care for themselves, or to care for a caregiver include:
Be aware of how they are “normally” – often times, as redundant as it may seem to say it, changes in behaviour signal that something is not right for someone. Behavioural change is taught in Mental Health First Aid as a warning sign for the onset of a Mental Health problem. Developing a relationship with someone, and knowing their norms is an important first step in identifying when a caregiver in your life may be in need of care.
Check in with them – If you notice something of a behavioural change in a caregiver, and they start to become short, defensive, or even aggressive, checking in with them to see what is going on for them is a good step. Changing your focus from “What is wrong with you?!” to “What’s going on for you?” is a good mental shift that is easy to say, but can be harder to pay attention to.
Be prepared for push-back – As someone who cares for others, as I said above, it is easy to focus on the needs of others, while putting our own needs to the side. Having someone call attention to our needs can feel uncomfortable, and can lead someone to become defensive. It is a common trait of caregivers to have somewhat of a superhero complex, where they feel they need to take care of everyone else, but don’t need help of their own. If you thought about asking a super hero if they needed help, chances are you would be met with some push-back and might hear, “No, I’m fine,” or “I’ll handle it myself, thanks."
Recognize that there is a fear of admitting we need help – Similar to the previous point about push-back, there is a fear that if a caregiver does ask for help that they will be seen as too fragile to continue acting as a caregiver, or a fear that they will be burdening others by sharing what is going on for them. Approaching a caregiver in a caring and respectful manner is an important step in helping them open up to asking for, or receiving care.
A useful tip for changing how a caregiver may see the idea of accepting care (love, time to themselves, time to sleep or engage in leisure activities, etc.), is to ask them “If you don’t accept _______ (see the list above) how effective do you think you’ll be in continuing to care for others?”
Talking to people who aren’t caregivers
It has been a common theme when speaking with to people who don’t work in the field or as caregivers, that there are some misunderstandings about the work being done by people in human services, and those misunderstandings lead to attitude and comments that may make it harder for caregivers to see through the darkness. Some of the attitudes I am referencing include:
- "Well, you chose this job, you should be able to handle it.”
- “Yeah, that’s a crappy situation. Why don’t you just find a different job?”
- “Wow, you get paid to do those kinds of activities?” (Often this is when we are talking about the fun relationship-building activities we do as part of our work.)
- "I have no idea what that’s like, but it doesn’t impact me so I’m not really interested.” (May not be overtly stated, though in some cases it is, but there is a sense sometimes that it isn’t beneficial in talking to people outside of the field because they can’t relate to the work.)
Even within the field, the idea of taking time off to go “get care” can be seen with similar sentiments. We can feel like we are burdening our team by taking time off, or we can feel like we aren’t good enough to do the job if we need to ask for help.
If you know a caregiver (social worker, child and youth care worker, nurse, doctor, dentist, etc.), speaking to them about their needs is important, but advocating for the change in perception of the everyday person to reframe thoughts of “Well, it’s your choice to work in this field,” to something that is more supportive is a great way of helping to allow caregivers to feel like they can ask for help.