Caring for yourself

Recognising your needs 

People on their end-of-life journey don't travel this road alone. The health care workforce team caring for them are on this end-of-life journey too, and also need to be mindful of taking care of themselves.

Grief and self care

The emotional nature of working closely with clients and their family at one of the most difficult times of their lives can be challenging. While this can be rewarding and fulfilling most of the time, it can be overwhelming and difficult to face at other times.

For health staff whom are only occasionally involved with end-of-life care, this role may be confronting and distressing. In primary health care settings, a journey that started as providing health care for a client with a chronic disease may eventually transition into end-of-life care. Sharing the end-of-life care journey can sometimes leave health professionals and workers stressed, fatigued, and emotionally drained. It's normal for health care providers to become attached to the people in their care, especially when a relationship has existed for a significant period of time.

Health care workers can experience some of the symptoms of grief when witnessing a decline in the health of the people they care for, and when they have passed on. This is especially so for Aboriginal and Torres Strait Islander Health Workers, who often also have a personal or kin-based relationship with their clients, in addition to providing health care for them. Naturally, deeper feelings of grief are likely if you know or are related to the grieving families. Aboriginal and Torres Strait Islander workers experience a high number of deaths within their client, family and community groups. The accumulation of bereavements and losses within Aboriginal and Torres Strait Islander communities has a profound impact and can intensify and prolong grief and loss experienced by Aboriginal and Torres Strait Islander workers. [1-3]

Tips for self-care

As a person providing health care at the end of life, it is important to take care of yourself too. You can’t do the best job you can for your community, your patients and family if you don’t look after yourself. It is important for your health that you acknowledge your grief. Staff mentoring and coaching plays an important part in self-care for the health workforce as they go on the end-of-life journey with their patients. De-briefing and sharing experiences with a colleague may help, as might spending time with your friends and family. You may also find it useful to record your thoughts and feeling in your personal journal. [2-4]

The National Centre for Education and Training on Addiction (NCETA) have produced a wellbeing resource kit for Aboriginal and Torres Strait Islander alcohol and other drug (AOD) workers. The Feeling Deadly, Working Deadly: Indigenous AOD Worker Wellbeing Resource Kit is aimed at reducing stress and burnout, and enhancing wellbeing amongst Aboriginal and Torres Strait Islander alcohol and other drug (AOD) workers. The kit was developed based on focus groups and interviews and identified stress-management strategies that supported their resilience and fostered their ability to deal with difficult circumstances. It is filled with practical self-care suggestions that are relevant to all members of the health care workforce.
The kit includes:

• A worker wellbeing tip sheet for workers which lists traditional, recreational, social, personal, and work-related strategies that individual workers can use to care for themselves (page 3). It is filled with practical self-care suggestions that are relevant to all members of the health care workforce.
• An Indigenous Workforce Development Checklist for organisations to facilitate Indigenous alcohol and other drug worker wellbeing and reduce work-related stress.

Useful resources 

This video from End-of-Life Essentials provides advice on self-care and why it's important:

• Self-Care video

The Australian Institute for Loss and Grief offers workshops for Aboriginal and non-Aboriginal service providers who are working with or have a desire to work with Aboriginal people and want to develop a deeper understanding of grief emotions and phases of grief:

• How to Use Loss & Grief to Enhance Bi-Cultural Awareness, Safety & Inclusion to Enable Indigenous People to Access Mainstream Services. One or two day workshops.

The following resources for are relevant to self-care for the Aboriginal and Torres Strait Islander health workforce:

• Beyond Blue have produced a video for the Aboriginal and Torres Strait Islander health workforce called Stories for keeping strong - Keep yourself healed. It shares workers tips and strategies for looking after themselves.
• The Feeling Deadly, Working Deadly: Indigenous AOD Worker Wellbeing Resource Kit from NCETA helps to reduce stress and enhance wellbeing for Aboriginal and Torres Strait Islander workers.
• Rising spirits: Grief and Loss is a website from the Aboriginal Health Council of South Australia is an information resource for the Aboriginal community and service providers.
• A presentation by Charmaine Mullins and Catherine Jacka from PEPA on Maintaining the spirit of caring: self-care and sorry business (373kb pdf).
• Psychologist Damien Howard has complied Staying strong stories (2.4MB pdf), a series of stories from Aboriginal people about what keeps them strong.
• Menzies School of Health Research. The Aboriginal and Islander Mental Health Initiative at Menzies School of Health Research has developed the Stay Strong App (for Apple and Android), which uses Indigenous specific content and imagery to improve wellbeing.
• Miriam-Rose Ungunmerr-Baumann describes a special quality of Aboriginal people called Dadirri: Inner Deep Listening and Quiet Still Awareness. The Miriam-Rose Foundation have produced a video of Miriam-Rose Ungunmerr-Baumann describing Dadirri as a way that connects us and nurtures spiritual wellbeing. Dadirri embraces the special respect for nature, sacred relationship with the land, and strong sense of community felt by Aboriginal people.