Hospice Basics
November 7, 2017

How Hospice Workers Can Overcome Compassion Fatigue

Hospice worker leaning against wall distressed

Compassion can be a risky business.

Professionals who care for patients with serious illness should have a well-developed sense of empathy, but continuous compassion without sufficient self-care can harm even the best-intentioned healthcare professional. Fear, grief, conflict and desperation are common features near the end of life; these emotions are contagious, and the clinician is not immune.

Signs of Compassion Fatigue

Compassion fatigue has been called “a deep physical, emotional and spiritual exhaustion accompanied by acute emotional pain.” It can appear differently for everyone, but common symptoms of compassion fatigue include¹:

  • Anger
  • Depression or anxiety
  • Gastrointestinal problems
  • High blood pressure
  • Addictive behaviors
  • Difficulty sleeping
  • Physical or emotional exhaustion
  • Irritability
  • Diminished self-esteem

Coping and Self-Care Strategies

Ideally, healthcare professionals should have what researchers call “compassion satisfaction”—a sense of joy that comes from helping others. Compassion fatigue is a well-known occupational hazard; self-care can turn up the satisfaction quotient. Aside from the usual stress-busting techniques (exercise, creating boundaries, etc.), some other methods have been shown to help compassion fatigue specifically.


Research has shown that highly conscious engagement with patients and situations—moment to moment—could help protect healthcare professionals from compassion fatigue. The idea is to pay close attention to one’s own emotions and reactions (the internal reality) while consciously working to address the needs of others (the external reality). This mindful way of working, along with mindful meditation and journaling, has been shown to reduce stress, enhance well-being and increase empathy in healthcare professionals.²


In an online survey of hospice staff across 38 states, 71% of respondents reported using personal rituals such as lighting candles, praying, attending funerals and calling patients’ family members. Professionals who established rituals around their patients’ deaths scored higher on a compassion-satisfaction scale and lower on a burnout scale.³

Don’t skip the usual antidotes to compassion fatigue—eat well, rest well, get a little cardio into your day—but do add some mindful activities to keep yourself on an even keel. Then, be the rock everyone else needs to lean on.

¹Pfifferling, et al. Overcoming compassion fatigue. Fam Pract Manag. 2000;7(4):39-44

²Kearney, et al. Self-care of physicians caring for patients at the end of life. JAMA. 2009;301(11):1155-1164.

³Montross-Thomas, et al. Personally meaningful rituals: A way to Increase compassion and decrease burnout among hospice staff and volunteers. J Palliat Med. 2016;19(10):1043-1050.


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