Looking after yourself in care work
You spend your days caring for others. The body, heart and mind that do that work deserve care too.
Why care work wears you down, and lifts you up
Care work is rewarding and draining at the same time.
Caring for older adults can be deeply rewarding. Researchers call the good feeling of helping others well “compassion satisfaction”. The same work can also bring compassion fatigue and burnout, especially when there isn’t enough time or help.
NIOSH says challenging working conditions, such as staff shortages, harassment and violence, drive burnout among health workers, and that workplace policies and practices need to change, not just individual coping.
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- Boundaries: caring deeply without losing yourself
- Compassion fatigue, and what refills you
- Moral distress, and how to speak up
- Shifts, bodies and recovery
- Support at work, and when to get help for yourself
- Teamwork and handoffs
Read more
- Healthcare workers: compassion fatigue, moral injury and shift-work sleep across health care
- Moral injury: when distress runs deep
- Night shifts, travel & time away: a shift-work sleep plan
- Recovering from burnout and Understanding burnout
- Residents’ mood & behaviour: safety when residents are aggressive
- When a resident dies: your grief after a death
By the numbers
Burnout, harassment and support among U.S. health workers.
Health workers
Care aides
Close, but not too close
Caring deeply about residents without losing yourself.
Many care workers love their residents. That closeness is part of what makes care good. But without some limits, it can lead to exhaustion, favouritism or heartbreak.
Nursing home staff describe grief care as a balance between being involved and keeping an appropriate distance.
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- A resident offers money or a gift: check your workplace policy, and thank them warmly either way
- A resident or family asks for your personal number: offer the work number instead
- You find yourself spending all your spare time with one resident: notice it, and share your attention fairly
- You keep coming in on days off to visit: ask whether it fills you up or drains you
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- Feeling guilty whenever you take a break
- Feeling that no one else can care for them properly
- Skipping meals and breaks to “just finish”
- Thinking about residents constantly at home
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- “I can’t stay now, but I’ll come back before my shift ends.”
- “I wish I could. Let me ask the nurse who can help.”
- “That’s so kind. Our rules say I can’t accept it, but thank you.”
Compassion fatigue and what refills you
Why care work drains you, and what protects the joy in it.
Compassion fatigue is emotional exhaustion from caring for people who are suffering. The Healthcare workers guide explains it in detail. Here is what research says about care settings for older adults.
A study of 760 care aides in 28 long-term care homes found that a more supportive work culture was linked to more compassion satisfaction and less burnout. Not having enough staff, time or resources was linked to more compassion fatigue and burnout.
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On hard days, it is easy to remember only what went wrong. Deliberately noticing good moments, a resident’s smile, a family’s thanks, a calm shower that used to be a battle, helps balance the scales.
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If you feel drained, it may be because the work asks more than one person can give. Feeling burnt out in an understaffed home does not mean you are weak or uncaring.
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- Dreading shifts you used to enjoy
- Feeling numb or short-tempered with residents
- Getting sick more often, or sleeping badly
- Losing the sense that your work matters
Moral distress and speaking up
When you know what a resident needs, but can’t give it.
Moral distress is the pain of knowing the right thing to do but being unable to do it. The Healthcare workers and Moral injury guides cover moral distress and moral injury in depth.
A review of 49 studies found common triggers include heavy workloads, lack of staff and equipment, rigid rules and hierarchy, and the responsibility of speaking up for patients and families.
Examples care staff describe
- Following a family’s wishes that seem to go against what the resident wanted
- Rules that seem to put paperwork ahead of people
- Rushing a resident who wanted to talk, because ten others are waiting
- Seeing someone sit wet or alone because there aren’t enough hands
- Watching care at the end of life that doesn’t feel peaceful
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Moral distress often eases when you can act on your values, even in a small way. Raising a concern clearly with your nurse or manager is one of the most powerful things you can do.
A simple structure (SBAR)
- Situation: what is happening now
- Background: what led up to it
- Assessment: what you think the problem is
- Recommendation: what you are asking for
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If you believe a resident is being abused or neglected, follow your workplace’s reporting process straight away. Residents can also be helped by the Long-Term Care Ombudsman program in every U.S. state.
Shifts, bodies and recovery
Looking after the body that does the caring.
Care work is physical: lifting, turning, walking miles of hallway, often on nights, weekends and doubles. The Healthcare workers and Night shifts, travel & time away guides have shift-work sleep plans. Here are reminders that matter most in care work.
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- Ask for a second person rather than straining alone
- Report pain early, before it becomes an injury
- Use lifting and transfer equipment every time it’s in the care plan
- Wear supportive shoes and stretch after shifts
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Skipping breaks feels like helping, but running on empty makes mistakes and short tempers more likely. A ten-minute break is part of safe care.
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- Change clothes before you go home
- Decide what you will do to rest tonight
- Name one thing that went well
- Take three slow breaths in the car or at the bus stop
Teamwork and handoffs
Passing on the person, not just the tasks.
Communication breakdowns are one of the main causes of things going wrong in health care, especially at handoff. A review of the SBAR handoff tool found moderate evidence that structured communication improves patient safety, including in nursing homes.
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- Any change in health, mood, eating or sleep
- Anything they are worried or excited about, like a family visit
- Safety concerns: falls, skin, refusing care
- Something kind to know: “She loved the music this morning”
- What upset them today, and what helped
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The housekeeper who chats every morning, or the cook who knows who stopped eating, often spot changes first. Good teams make it easy for everyone to pass on what they see.
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- “That looked rough. Are you okay?” after a hard moment
- Including new and agency staff
- Offering to swap a difficult task
- Thanking each other by name
Support at work
What good workplaces do, and what to ask for.
Burnout is not only about how you cope. In 2022, health workers who trusted their management had fewer burnout symptoms, and those who faced harassment reported far more anxiety, depression and burnout.
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- Clear processes for reporting violence
- Debriefs after deaths and difficult incidents
- Recognition for every role
- Safe staffing, so there is time to care properly
- Supervisors who listen and follow up
- Training in dignity, communication and end-of-life care
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- Ask for a debrief or a moment of remembrance after a death
- Ask whether there is an Employee Assistance Program (EAP), which often offers free confidential counseling
- Bring ideas to staff meetings, in writing if that’s easier
- Suggest a peer buddy system for new staff
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OSHA advises employers to have a written workplace violence prevention program, to involve direct-care staff in spotting risks, and to investigate every report promptly.
When to get help for yourself
If the work is following you home, reach out.
It is time to talk to someone if you dread every shift, can’t stop thinking about residents at home, feel numb or tearful most days, are drinking more to cope, or feel hopeless.
Where to start
- Talk to someone you trust at work or at home.
- Contact your Employee Assistance Program, if your workplace has one.
- Talk to your clinical provider about how you are feeling.
- Ask about counseling or a support group for care workers.
📝 Worksheets for this guide
Fill these in privately in the app. Your answers stay on your phone.
Sources
- Journal of Applied Gerontology (via PubMed) (2025). Care Aides Compassion Fatigue, Burnout, and Compassion Satisfaction Related to Long-Term Care (LTC) Working Environment (Rahman A, et al.)
- National Institute for Occupational Safety and Health (NIOSH), CDC. Impact Wellbeing
- Centers for Disease Control and Prevention (CDC) (2023). Vital Signs: Health Worker Mental Health
- U.S. Bureau of Labor Statistics (BLS) (2025). Home Health and Personal Care Aides (Occupational Outlook Handbook)
- Journal of Advanced Nursing (via PubMed) (2016). Grief and loss in older people residing in nursing homes: (un)detected by nurses and care-assistants? (Van Humbeeck L, et al.)
- PLoS One (via PubMed) (2024). Triggers and factors associated with moral distress and moral injury in health and social care workers: A systematic review of qualitative studies (Beadle ES, et al.)
- BMJ Open (via PubMed) (2018). Impact of the communication and patient hand-off tool SBAR on patient safety: a systematic review (Müller M, et al.)
- U.S. Administration for Community Living (ACL). Long-Term Care Ombudsman Program
- Occupational Safety and Health Administration (OSHA). Healthcare: Workplace Violence
This guide is for education and self-care. It is not a diagnosis or a substitute for professional care. Please talk to a counselor or clinical provider about your health. Reviewed October 2026.
