Compassion Fatigue Solutions

My dad earned his pilot’s licence before the start of World War 2 and, when I was a kid, he would often tell me stories about his flying days. When he enlisted he became an instructor and spent thousands of hours in the back seat of a Harvard aircraft “teaching young hopefuls to fly”.

After a student learned the basics of safe flying, it was necessary for them to know where the dangers were highest… how to recognize a potential problem and how to correct for it before it was too late.

Night flying meant learning to fly with instruments, not their eyes, and not just relying on their own sense of well-being. This is the core of the message that he taught me which would surface many years later when I became his caregiver during his journey through dementia. “Flying by the seat of your pants” became a wonderful metaphor - an image of how I needed to care for myself in order to continue to give quality care to him.

The lesson that I remember from him was that flying an airplane by instruments is very different from flying by our human senses. When we can see clearly, our eyes and our inner ear, which measures our sense of balance, reinforce and correct each other to ensure that we maintain proper orientation to the world around us. We can control ourselves by our senses or as the pilots say “Fly by the seat of our pants”. The pilot knows the sensation of what a safely operating airplane feels like.

At night there’s an additional challenge. The pilot’s eyes don’t give reliable information so the pilot is left with their sense of balance. Our amazing human bodies have limits of what can be detected. Although sudden or large changes are easy to recognize, one of our body’s weaknesses is identifying very gradual change. A pilot who tries to fly by the seat of his or her pants at night can’t detect if the airplane is very slowly going into a spin or a dive. Their body’s motion detector in their inner ear can’t be reoriented because their eyes can’t see in the dark. Their body might tell them “You’re level, you’re OK” but they are not…. dangerously not OK. Only the instruments can give them the feedback that tells them “Your feelings, your sensations, are getting confused. The instruments are correct. Make changes now for your safety and the safety of those with you.”

So what’s “Flying by the Seat of your Pants” got to do with being a caregiver for someone living with dementia? Caregiving means taking on additional challenges. Although we can see the changes in the person living with dementia for whom we are caring… the good days, the bad days, the losses in their capabilities… what we miss are the changes in ourselves, the constantly increasing changes in the demands on us as caregivers. It sneaks up on us. “I’m OK. I’m handling this fine” is such a common reaction… and usually it’s not true. Like the pilots, our bodies don’t detect those little changes that accumulate and our bodies and minds are not good at telling us that we’re not taking good enough care of ourselves… that we’re actually headed into a fatal dive. We tell ourselves that we’re doing fine when in reality we should be asking others for help.

So what’s the key to safety of the caregiver? How do we observe the necessary warnings so that we can ensure that we don’t do damage to ourselves by “Caregiving by the seat of our pants”? The answer is our “Instruments”. What are those external measurements telling us that we need to pay attention… information that doesn’t agree with how we feel but will help us change from a dangerous spin? There are many. Our friends telling us that “You’re looking tired” or “We’ve missed you” or “I’m concerned about your level of stress” are messages that we need to heed. Checklists for measuring Caregiver Burnout are another. The Alzheimer Society, the Victorian Order of Nurses, and several other groups have them. But don’t just measure yourself alone. Have a friend who understands the demands of dementia, knows you and will be honest with you, help you through the checklist. Listen to their opinions about how they think you are doing. If you become a damaged caregiver, then your setbacks limit the quality of care that you are able to give. Taking care of yourself means taking better care of the one living with dementia.

And if you catch yourself saying “No, really, I’m doing fine”, then you’re probably flying by the seat of your pants. It’s a good time to believe your instruments, change how you are taking care of your own needs, and stop your undetected fatal dive.

Jack Henderson, a former caregiver.
Been there… done that. And I also needed several family and friends to tell me “Listen Jack, you’re NOT doing OK. We know the signs. You’re headed for burnout. Take better care of yourself.”

©Jack Henderson, 2009 Feb 26