CAREGIVER BURNOUT

Caregiver Burnout and its Effects on Elderly People Depression

Caregiver Burnout and its Effects on Elderly People Depression

Introduction

Burnout refers to a loss of energy, which usually happens when persons feel 'burned', in both physical and psychological terms. Burnt out persons show signs of distress in their daily behavior and feel that it is almost impossible for them to perform normally because of exhaustion (Zarit, 2006). Although sometimes used synonymously, burnout differs from other psychological problems health care professionals may develop, such as: (1) stress (a variety of negative feelings and reactions accompanying threatening or challenging situations, which may produce numerous symptoms that vary according to persons, situations, and severity, including physical health decline as well as depression); (2) vicarious trauma (a process developed by professionals who care for people who have experienced trauma, and feel responsible and committed to helping them owing to the effect of the extreme severity of their problems; this is usually related to humanitarian work1); (3) moral distress (distress usually suffered by professionals who feel tension between a moral or ethical decision they believe to be right and obstacles that make it difficult to practice and implement; this is more common in nurses working in intensive and critical care settings and is related to organizational constraints and tensions among professionals2); and (4) compassion fatigue (also known as secondary traumatic stress disorder, which refers to a slow decrease in compassion over time, usually related to repeatedly showing compassion for people with continuous and irresolvable suffering).

According to Vachon, compassion fatigue has some of the characteristics of burnout; however, contrary to burnout, the person can still care and be involved (Vachon, 2006). The person who suffers from burnout develops a 'progressive loss of idealism, energy and purpose experienced by people in the helping professions as a result of the conditions of their work'. Burnout syndrome can be defined in its multidimensionality: (1) emotional exhaustion, understood as a feeling of exhaustion and failure of the person to give more of the self; (2) depersonalization, in which the person's relationship with patients and colleagues becomes cold, distant and guided by cynicism; and (3) lack of personal and professional completion, which may manifest itself by a sense of incompetence and inability to respond to requests or by a sense of omnipotence.

Care for the elderly people may lead health care providers to physical, psychological and emotional exhaustion, with occurrence of burnout. Several ethical decisions must be taken in this environment, most of which are related to: (1) the autonomy of the patient and the fulfillment of advance directives; (2) euthanasia and assisted suicide; (3) withholding or withdrawing treatments (such as hydration or nutrition); and (4) a decision not to resuscitate (Tremont, Davis & Bishop, 2006). On the other hand, caregivers to the elderly are mostly confronted with death and dying, which, consequently, could contribute to their own suffering. Usually studied as a psychological issue, burnout has an ethical framework related to three features: (1) an increase in patients' vulnerability owing to ...