Caring for people is a vocation which demands the ability to engage at a personal level with the patient. People coming into working in aged care are often not sufficiently prepared for managing death or palliative care goals creating stress and burnout. Burnout can be characterised by exhaustion, cynicism and inefficacy which can significantly impact on patient care.  Self-care is important in managing burnout that can occur as a result of working in a palliative care setting.
This page discusses the evidence in support of self-care strategies for carers in palliative care.
In theories of caring it is suggested that the vulnerable partner in the relationship is the patient, however it may be realistic to acknowledge that both partners - carer and the patient are vulnerable in the palliative care relationship. Palliative care is unique in that the service focuses on the needs of the dying rather than maintaining or improving functional capacity  and it is estimated that 50% palliative care staff are at risk of poor mental health as a result of work stress. 
In the time in which care is provided, relationships may be formed causing significant grief when a patient passes. This can create a dilemma in how caregivers are expected to provide care that is not emotionally disconnected from the patient, whilst also protecting themselves emotionally. [3,5] Palliative care staff not equipped with adequate coping strategies are at risk of ‘burnout’. Studies suggest this may be largely due to the nature of the work but it can also be exacerbated by other work stressors such as heavy workloads and a lack of resources. [1,2]
Employers therefore, have an obligation to their staff to promote wellness and wellbeing.  It is proposed that with training and intervention, care givers can acquire skills in self-care, which can assist staff in finding their role deeply rewarding and even protective of burnout. Palliative care staff that engage in activities of self-care such as reflection, employing some emotional distance and who engage in activities where they feel supported by other team members, are more likely to work in palliative care long term and are less likely to suffer from work related burnout. [1,2]
Quality of the evidence discussed is generally high, however the systematic reviews are based on primarily qualitative data and in non-aged care contexts. Findings lack clear conclusions on how to teach resilience or self-care in a palliative care setting despite a consensus that it is important in preventing burnout.
Further research: More research is required, particularly for aged care staff and regarding how to engage staff in self-care strategies, on which best practice guidelines could be based.
Page updated 22 May 2017