In Ontario, the number of chronic and complex patients who live at home is growing quickly. Among the professionals who provide home care services for these patients, caregiver burnout is increasingly common.
Frontline workers – including nurses, personal support workers (PSWs), and rehabilitative therapists, among others – are under increasing pressure as the home care landscape changes.
As a result, burnout levels are likely to increase. They could potentially even surge, creating an epidemic.
This condition isn’t just a problem for the caregivers who experience it. Because of how commonly it occurs, burnout has widespread social implications for home care patients and the province.
Can service providers and the province’s health care system prevent this situation from getting worse?
Escalating Pressure on Home Care Workers
The time is right for Ontario’s home care revolution. Our province’s population is aging. Chronic and complex conditions are on the rise. More than ever before, patients need care on an ongoing basis.
The cost of meeting these demands in care facilities would be enormous. Consider the numbers: on average, an occupied hospital bed costs $846 per day. Home care is just $55.
Studies also show something you already know if you work in the sector: overwhelmingly, patients prefer to be cared for at home.
So it’s no surprise that the government has made home and community care such an integral part of its health care reform. Last year, when the health ministry pledged $750 million to the sector, many Ontarians were impressed.
Of course, the size of this number is slightly misleading. In reality, home care still receives a relatively small portion of the overall health care budget (4 to 5% as of 2015). Yet hospitals are continuing to move patients out of acute care beds and into the community at a rapid rate.
Recently, the government announced respite care funding for family caregivers. This support is well deserved. But it begs the question: is enough being done for home care workers?
Pressure on the frontline can be intense. Nurses, PSWs, social workers, and rehabilitative therapists in the community face unique challenges – and unique stressors.
Employment in home care means continuous – and often solo – travel. It means little to no control over your work environments. It means limited opportunities to receive direct encouragement and guidance from colleagues.
Often, it means tackling unfamiliar tasks and responsibilities – because somebody has to.
Needless to say, not all home care workers are compensated as well as they could be. Even last year’s PSW wage increase wound up hurting some workers financially.
The fact is, a whole lot of professional caregivers feel overworked and under-appreciated. If this situation continues, there will be serious consequences not only for the workers involved, but for provider agencies, patients, and the province as a whole.
The Consequences of Burnout
Awareness about the symptoms of caregiver burnout is growing. Social withdrawal. Emotional and physical fatigue. A depressed immune system. The list goes on.
Suddenly, people across the country are recognizing these signs – in their friends, n their family members, and in themselves. No matter how you look at it, this newfound awareness is a good thing. But unfortunately, when it comes to discussions about burnout, professional caregivers are often overlooked.
It’s true that when home care workers provide care, they’re doing their jobs. And yes, they’re trained to do them (though little can prepare a person for exposure to the pain and discomfort of others).
But those paid to provide care are far from immune to burning out. Due to the escalating pressure on home care workers, they may be more susceptible to the symptoms of caregiver burnout than ever before.
Unfortunately, because they so often work alone, those employed in home care may be more likely to suffer in silence.
It goes without saying that a strong home and community care sector can’t be built on emotional and physical exhaustion. And the consequences of caregiver burnout can reach far beyond those who provide care.
To state the obvious, people with impossibly heavy workloads don’t always make for the best caregivers. In some cases, those who experience burnout also struggle with compassion fatigue – a state in which apathetic feelings begin to set in.
In these situations, patients suffer. There’s ample evidence to suggest that patient satisfaction is lower in care environments where nurses are burnt out or dissatisfied.
It’s also no secret that home care has a retention problem. And burnt-out workers may be more likely to leave the sector due to dissatisfaction, psychological exhaustion, and even trauma.
So, what can leaders to do to make ensuret home care workers stay healthy, passionate, and connected to their clients?
Preventing Caregiver Burnout: is it Possible?
Given the current stressors that many home care workers face, it may seem like caregiver burnout is inevitable. But there are actions that agencies can take to ensure employees continue to connect with clients and take pride in their work.
Further action from the government could go a long way. Without additional funding, ongoing assessment, and future policy changes, there’s a greater likelihood that the sector will be hit by a burnout epidemic.
For agencies, taking time to examine the number of high-pressure demands workers face is key. When an agency maintains appropriate staffing levels, it’s much easier to create a low-stress environment. Having the right number of qualified candidates is a big challenge, but meeting it can pay off in the long run.
At the policy level, the more that can be done to encourage people to enter the home care sector, the better. But some service providers will likely continue to struggle with retention.
Of course, for many workers, better pay and benefits are the keys to securing long-term loyalty. But there are other strategies that can boost retention levels, which will reduce scheduling difficulties and uneven workloads. Lower levels of burnout will result.
Nurses, PSWs, rehabilitative therapists – what motivates these workers? If you fill one of these roles, you almost certainly want to cultivate good relationships and improve quality of life for your clients. Confidence is key to conquering stress and achieving these goals.
Traveling and working alone, those on the frontlines take on high levels of responsibility. Unfortunately, there’s often very little support available to support worker decision-making. Worse yet, large gaps in care coordination often leave next steps unclear. The solution clear: better communication.
Say a client requires immediate assistance, but the attendant PSW is unsure about whether the request falls within her scope of practice. What should she do?
Perhaps a nurse finds that the documentation regarding a client’s medication dosages is unclear. How certain does he have to be to go ahead and administer a medication? Should he struggle to get a hold of someone who may (or may not) be able to clarify the situation?
The best courses of action aren’t always clear. And constantly making these decisions alone can be stressful. Setting up workflows that facilitate supportive communication and continuous coordination can streamline this process.
Is there a designated way for workers to get in touch with care team members or relevant specialists when they need to? And when they’re on the road, how do caregivers access up-to-date client information?
Luckily, technology can help. By making it easy to share and update care plans and other health information, the right digital tools can ensure every home care worker knows how to best care for their clients.
Platforms that enable two and three-way videoconferencing can also lead to more responsive care. These tools make it possible for frontline workers to receive coaching or confirmation from other members of their clients’ care teams – no matter where they are.
Ultimately, better communication starts when those responsible for funding and organizing care put themselves in the shoes of frontline workers. By working to reduce heavy workloads and provide better at-work support, home care leaders can take a giant step toward preventing burnout.
Improving Home Care – For Patients and Workers
The home care landscape is changing rapidly. Home care nurses, PSWs, occupational therapists, and other workers who work one-on-one with patients are taking on heavier workloads.
Given current circumstances, caregiver burnout may seem inevitable. But there are actions that both service provider organizations and the government can take to protect workers. It all starts with empathy – and a willingness to explore solutions and figure out what works.
Feature image courtesy of madstreetz