Beyond Compassion Fatigue: Motive-Based Approaches to Sustaining Compassion in Palliative Care

Compassionate care is vital to quality palliative care and integral to the provision of spiritual care at the end of life. But is sustaining compassion costly for healthcare providers (HCP), impacting their emotional and spiritual wellbeing, professional purpose, and moral self-image? Concerns about the costs of compassion for carers have gathered pace in a growing healthcare literature on compassion fatigue. Critics, however, argue that compassion fatigue lacks adequate conceptualisation, querying whether it fits with HCP’s own perceptions and suggesting it lacks utility for identifying interventions. This article contributes to this debate about moving beyond compassion fatigue, by bringing new psychological research on compassion as a motivated choice to bear on these questions and demonstrating its potential for illuminating interventions to support compassion in palliative care contexts. It proposes a focus on motive-based interventions which serve to tip the cost–benefit analysis in relation to compassion and thus support HCP motivation to feel and act compassionately. A key implication of this approach is that sustaining compassion is not up to individuals alone, as can often seem to be the case with ‘self-care’ paradigms. Rather, there are multiple ways institutions and society can play a role in motive-based interventions to sustain HCP compassion and wellbeing. The final section explores one example in the form of institutional support for spiritual care education