careviger compassion


As you know all too well, working in the world of home care is very rewarding and also very demanding. Constantly helping others, either directly or indirectly, and being involved in the drama of so many lives can take a toll. As an agency owner, you have to concern yourself with the well-being of your caregivers. They are the lifeblood of your organization and the primary source of your value to your customers. However, keeping yourself and your office staff healthy and happy are just as vital to your business success.

A True Story of Compassion Fatigue

Laurie’s agency was doing great, growing steadily and gaining a well-earned reputation for superlative care. Along with the growth came the associated problems and demands. New clients meant staffing and hiring challenges. Increased shifts meant more opportunities for caregiver call outs. Growing is the goal, but growth comes with added demands, pressure, and stress.

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As she contemplated this, the on-call phone rang again. She had recently changed the ringtone because her kids had come to dread what it meant for their mom’s mood. She could see that the caller was the daughter of one of her newest clients. She groaned and reached for the phone. This person was very anxious about her mom’s situation and seemed to need endless reassurance. Laurie felt a rush of panic when she answered the phone.

It was starting to seem like this was becoming the norm. Laurie didn’t want to look at a phone, let alone answer it. Everyone was getting on her nerves. Every phone call was another crisis. She was starting to doubt her decision-making skills. Laurie was not enjoying her work and neither were the people around her.

Laurie recounts: “I went to three client funerals in 10 days, still grieving my own mother’s death. I remember losing patience with the adult daughter who was complaining about her mother, thinking ‘at least your mother is still alive!’ I knew something was wrong when I felt angry at my caregiver who called out because she needed to take her sick baby to the hospital.”

What is Compassion Fatigue?

While workplace burnout is well recognized, the concept of Compassion Fatigue is not. Burnout can happen in almost any job environment. Tedium and stress can build up and make a person less and less tolerant of a given situation. Although Compassion Fatigue is different, it does have some very similar symptoms. Also referred to as secondary traumatic stress syndrome, it comes from repeated exposure to other people’s problems, anxieties, and crises, and the anticipation of more to come. Every time the phone rings it could be another crisis.

In a home care setting, the crisis environment is made up of not only the health concerns of clients and the resulting stress it puts on their families, it also includes issues surrounding caregivers and staff. Everyday life struggles that affect individual employees like child care, car troubles, and money issues all have an adverse effect on agency staff.

Add to this the regular stress of your own personal home life—children, spouses, bills, the nightly news, politics, maybe even caregiving for your own parent or loved one—and even the strongest person can succumb to Compassion Fatigue.

“All of us who attempt to heal the wounds of others will ourselves be wounded; it is, after all, inherent in the relationship” (Figley, 2002)

One of the especially corrosive effects Compassion Fatigue can have is to bring about a loss of empathy. For example, when a potential new client calls because her mom just fell and broke her hip and she needs to vent about it, you may find yourself unable to draw on what used to be an endless supply of patience.

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Compassion Fatigue Symptoms

How do you know if you are affected by this? Here are some common symptoms to check:

Do you…

  • … cringe when the phone rings?
  • … lose your patience easily?
  • … feel like you are at the end of your rope?
  • … feel like crying?
  • … find your friends and coworkers annoying?
  • … isolate yourself and stay away from people?
  • … find that your work is suffering?
  • … have a negative attitude?
  • … make poor or rash decisions?
  • … feel scattered and not focused?
  • … have nightmares and aren’t rested when you wake up?
  • … get mad at the dry cleaners? Yell at the pharmacist? Hate the paperboy?
  • … sometimes feel as though you just don’t care anymore?

If you answered “yes” to several of these questions, you may be experiencing Compassion Fatigue. The good news is that becoming aware of Compassion Fatigue can help you deal with your situation quickly. Recognizing it is only the first step, but it is a huge one!

“With support, insightful information, and authentic self-care, you can begin to understand the complexity of the emotions you’ve been juggling and, most likely, suppressing. Most people never take the time to understand how their jobs affect them emotionally. Give yourself credit for moving forward and affecting change. Your hard work will pay off.” – Patricia Smith, (link:

Coping Strategies

Here are some specific, actionable things that can make a real difference in your life and business. It is important to be proactive rather than reactive. The great thing is even if you do not experience Compassion Fatigue now, each of these steps will almost certainly improve your ability to run your business effectively.


  • Acceptance is crucial.
  • Become educated: Learn and read about Compassion Fatigue.
  • Lose the guilt. The very nature of being a caring person can lead you to overextend yourself and be susceptible to Compassion Fatigue, but there is a lot you can do to minimize or even prevent it.

Reduce exposure through delegation

    • Reduce or eliminate being on-call.
      • Have a dedicated “After Hours” cell phone for clients and caregivers.
      • Have your staff share the on-call responsibilities. It can be an overwhelming task for only one or two people.
    • Establish clear boundaries through explicit policies to help manage demanding clients, family members, and caregivers.
      • Let clients and caregivers know that you may not answer your personal cell phone. They should first call the office or the after-hours line.
      • Include your office and after-hours phone number on your voice mail message.

Schedule downtime and fun

      • Schedule time to work on the business, not in it.
        • Do not work 24/7.
        • Turn off the email notification sound on your cell phone.
        • Don’t let your cell phone own you!
      • Take a vacation or a staycation.
      • Spend time doing things that nurture you.
      • Schedule gym time.
      • Get out of the office for lunch.

Talk with others in similar situations

      • Network with colleagues to share stories and strategies.
      • Talk with family and friends, but be aware that individuals who are not in a similar business may not understand what you are experiencing.
      • Attend industry conferences (HCAOA, NAHC, DecisionHealth, etc).

Healthy Solutions

      • Eat right, get exercise, get plenty of sleep.
      • Practice self-care with meditation, deep breathing, and “me” time.
      • Learn how music therapy, journaling, art therapy can help you and provide enjoyment to your life.
      • Create a healthy work life/family life balance.
      • Be aware of excess alcohol consumption, prescription pill usage etc.


In closing, while Compassion Fatigue is quite real and not uncommon to experience at one point or another when working in the demanding home care industry, fortunately, there are many ways to deal with it. We encourage those who are or have experienced Compassion Fatigue to talk about it with fellow industry colleagues, so we can be a collective support system to one another. As the need for home care services increases in the coming years and the industry grows to meet demand, we think there is no better time than now to start a conversation about this issue.

Figley, C. (Ed.). (2002). Treating compassion fatigue. New York: Brunner-Routledge.

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Laurie Miller -Shoshana


Laurie Miller
In 2006, Laurie founded Apple Care and Companion, a non-medical home care agency located in Dallas, Texas. She has held every position in the company and is currently the hands on Administrator. She co-founded the Compassion Fatigue Symposium based on her own experiences with compassion fatigue. She is a long-term board member and former two-term president of the Dallas Area Gerontological Society.

Rosemark - Tom Voiles


Tom Voiles
Tom Voiles is President of Shoshanan Tchnologies, Inc., provider of the Rosemark System, a complete business management software for private duty care agencies. Voiles has more than 20 years of experience in private duty home care technology and operations. He has worked with hundreds of home care agency operators and staff in the U.S. and Canada, developing systems and approaches to help streamline daily agency management tasks and optimize overall business performance.

Article originally published in the 2017 Home Care Benchmarking Study

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