caregiving

Supporting staff that help the most vulnerable in San Francisco

Community Forward SF is a non-profit that works with and supports the most vulnerable and underserved communities in San Francisco: adults and older adults, who are or have been chronically homeless, those who are dually or triply diagnosed, those with chronic medical conditions, substance abuse issues and mental health needs and those who are BIPOC, LGBTIQQ. Community Forward SF offers medical, emergency, and transitional shelter, supportive housing, and a large array of wrap-around services such as mental health services, case management, substance abuse treatment, and domestic violence support to meet clients where they are at when they access the service.

The nature of the work they do results in front-line and clinical staff at Community Forward SF witnessing loss, suffering, and distress on a daily basis which can lead to emotional strain, empathy fatigue, or overwhelm. This strain on the staff has only increased since the pandemic. 

In response, Community Forward SF is partnering with ZCP who will deliver four monthly sessions to Community Forward SF’s clinical staff. These sessions will cover the role of mindfulness in exploring and regulating emotions, compassion for yourself and others in a caregiving role, the role of loss in caregiving, and how to approach maintaining healthy boundaries. 

Suzanne Adams, PhD, the Vice President of Clinical Services at Community Forward SF explained why she approached ZCP to support her staff: 

“Mindfulness is an integral part of a cultural shift I hope to impart on not only for our clients’ wellbeing but for our clinical team, as well. Our clinical staff manage the demands of difficult jobs–feelings of activation, coping with vicarious trauma, and issues of burnout–while also being called to address the essential need of self-care. I reached out to Zen Caregiving to provide the education, resources, and emotional support to my team that can help them in all areas of their experience.”

Sessions will begin in January 2022 and will run until April 2022. 

If you are interested in how ZCP can support you and your team, please contact sarah@zencaregiving.org to learn more.


If you like what you read, please join us and enroll in one of our courses, share our work with someone you think will benefit from it, or support us through a donation.

Companionship and Compassion: The benefits of ZCP Volunteers on a palliative care ward

Camille Tacderan is the Daytime Charge Nurse on the South Three (S3) Palliative Care Ward at Laguna Honda Hospital, where ZCP volunteers have served for over 30 years. We spoke to Camille about the value the Volunteer Program brings, her experience of working through the pandemic, and her excitement about the Volunteer Program starting up again. 

You have spent many years on the ward with the volunteers. What impact do you see them having? 

Residents really benefit from having volunteers on the ward to interact with. It can be as simple as them sitting and talking with a resident in the Great Room [the communal area of the ward], or for some residents who are non-verbal just being present with them or holding their hand. Also, the volunteers are on the ward weekly and often have regular visits with residents whose conditions are changing over time, so they build a relationship with them and can tailor their interaction to that resident’s current needs. 

They also support the families of residents. What is special about S3 is that it allows family members to be family members. They don’t have to be medical caregivers and instead can live their own lives and visit as sons and daughters, or spouses. The volunteers are a big part of that specialness because families know that even if they can’t be there to sit with their friends or relatives, the volunteers can be. And that is really reassuring. 

For staff, more than anything else, it is just knowing that there is someone to sit with a resident when they aren’t available to do so. As staff, we are looking after a number of patients and sometimes can’t sit with people as long as we would like. Especially when that person is approaching the end of their life, it is comforting to know that the volunteers are available to be with that person in their last moments. 

“It is comforting to know that the volunteers are available to be with that person in their last moments.”

You worked through the pandemic when volunteers weren’t able to visit the ward in person. How was that experience for you?

The pandemic was really challenging. On a personal level, there was a lot of anxiety around safety for yourself, your family, the residents, and the other staff on the ward. 

The ward closed to visitors and volunteers early in March 2019 to protect residents and stayed closed until mid-2021. During this time a lot of residents didn’t understand what happened, some didn’t recognize staff with masks on, and some clearly missed the interaction they had with volunteers and family. For staff, it was also very difficult as we were busy adapting to new protocols and keeping residents safe, and it was at this time, when we were busier than ever, that it would have been wonderful to have the support of the volunteers who could also be with the residents. 

The volunteers have started to come back in person to the ward. How do you feel about that?

I’m really excited as the volunteers are such a big help. We are getting more younger residents joining the ward, who are alert and will be in the ward for a long time so have a big need for social interaction from those around them. With our workload, the staff can’t always provide that level of interaction, which is where the volunteers come in. 

Some of these younger residents come to the ward having experienced a lot of social isolation. Some have been living in COVID hotels, experiencing a lack of contact and services. Some have been living alone at home or in an SRO. It is so nice to know that they can get the companionship and interaction they want, need, and deserve when they get to the ward, thanks in a big part to the volunteers. 

As the hospital is run by the San Francisco Public Health Department, we are the safety net of the city. Our residents may have been living outdoors on the streets with no family or connections and it is lovely to know that they can come to this ward and spend the last few days, months, or years of their life being cared for and that they knew there were people around them who did care about them. 

“What we do on the ward is give the residents love.”

What we do on the ward is give the residents love. They are warm, get three hot meals a day, and get taken care of physically and emotionally. Volunteers are a crucial part of this as they fill the gaps when the staff can’t be there. And that is what makes the ward such a special place.


If you like what you read, please join us and enroll in one of our courses, share our work with someone you think will benefit from it, or support us through a donation.

The Challenges of Caregiving

From a recent study conducted by the AARP and the National Alliance for Caregiving,

“…there are more than 43.5 million adults in the United States who have provided unpaid care to an adult or child within the last year. 34.2 million of these Americans provide care to an adult age 50 or older. On average, a family caregiver will spend over 24 hours each week providing care to a loved one, although many report spending over 40 hours per week on caregiving duties.”

Caregiving, in any capacity, can be quite rewarding but it also comes with its own set of challenges. For some, caregiving can be stressful, overwhelming, strenuous and frustrating. Asccare.com lists a number of difficulties for you to pay close attention to, here are a few;

  • Depression and isolation
  • Sleep deprivation
  • Emotional and physical stress
  • Lack of privacy
  • Being afraid to ask for help
  • Financial strain
  • Managing time

Coping with any one of these challenges can be trying though many of you face multiple challenges on a daily basis. Thankfully there are mindfulness-based tools and approaches to help you build emotional resilience to maintain delivery of high-quality and compassionate care to your loved ones.

Our Mindful Caregiving Education (MCE) introduces caregivers to mindfulness-based approaches and tools to help build their emotional resilience and work with stress. These approaches help caregivers successfully navigate the unique and challenging situations that can arise in caregiving. Through mindfulness-based education, you can build the skills needed to take on the common challenges of caregiving.

Zen Caregiving Project’s Mindful Family Caregiving, Four-Part Online Series, starting April 7, helps family caregivers find support and community while sharing resilience-building tools to improve the caregiving experience. This online series will help you:

  • Increase the capacity to cope with discomfort and suffering
  • Create a plan for maintaining self-care
  • Establish healthy boundaries in relationships
  • Deepen and sustain compassion for self and others

I invite you to take a moment and consider our Mindful Family Caregiving course and see if it fits with your schedule. If you have any questions, feel free to email us at education@zencaregiving.org

Emotional Support For Caregivers is Vital, So Why Aren’t We Talking About It?

Caregiving has got a bad rap

A lot of what we read about caregiving paints a very negative picture. Caregivers stressed by their caregiving responsibilities are at higher risk of experiencing fatigue, depression, and social isolation than non-caregivers, and some studies found that caregivers had decreased life expectancy compared to their non-caregiving equivalents.[1]

An interesting review of the research in the field from a professor at John Hopkins University points out that it isn’t caregiving per se that leads to these negative impacts, it is the stress response that caregiving can produce. In the case of research into life expectancy, those caregivers who were not over-strained had the same life expectancy as non-caregivers and, what’s more, in a few studies, caregivers had a longer life expectancy.[2] This leads to the conclusion that if we can find ways of helping caregivers reduce the stress they experience, we can protect them from the negative impacts of caregiving. Maybe we can even help them benefit from the positive effects of caregiving, such as a sense of purpose, increased confidence, and a deep connection.[3]

How can we reduce the stress of caregiving?

Stress occurs when a situation exceeds the resources that the caregiver feels they have to deal with it – we can all relate to that feeling of overwhelm and anxiety when we feel we are not able to manage the situation in front of us. 

We can, therefore, reduce stress in two ways. The first is by changing the situation the caregiver is in so that it doesn’t exceed their resources to cope with it. Family caregivers can face a lot of situations that could contribute to a feeling of overwhelm, e.g., carrying out medical tasks with little training, the physical and emotional fatigue of many hours caregiving, adjusting to the loss of a relationship, loss of time for yourself and increased financial strain to name a few.[4] In response to this, there is a large number of caregiving programs that try in various ways to improve these external circumstances and support the reduce their external stressors by providing practical, logistical, and financial support to caregivers.

The second way to reduce stress is by building up the emotional resources of the caregivers. This helps them to feel more able to meet skillfully and cope with situations as and when they arise (life has a habit of presenting us with “interesting” events and situations when we least expect it!). This emotional resilience approach is the approach that Zen Caregiving Project takes in its Mindful Caregiving Education. In our courses, caregivers are taught mindfulness-based tools and strategies to help acknowledge, understand, and skillfully respond to challenges that arise in their caregiving. By teaching these skills, we are increasing the caregiver’s emotional resource or capacity, meaning they feel able to cope better with more situations whenever they happen and reduces the likelihood of them becoming overwhelmed and stressed. 

It’s not an either/or

Here at Zen Caregiving Project, we champion all efforts to support the vital and powerful work that caregivers do, and we realize that a combination of both approaches described above is optimal. We are, however, sometimes surprised that emotional resilience-building is seen as “nice to have” rather than the essential skill we feel it is. Caregiving courses often focus on practical skills related to ADLs, or activities of daily living, like how to bathe or lift someone, or how to navigate the complex health systems. Yet, skills to support emotional resilience are conspicuously absent. Typically, suggestions for self-care when presented focus more on discrete activities such as doing regular exercise and having long baths. Both are great, but it’s best to address the problem of stress once it’s arrived rather than building a set of skills that strengthen emotional resilience and minimize the stress in the first place.

Skills that build emotional resilience aren’t magic cures. Still, we would argue they are equally as important as the more practical skills, both for the caregivers’ wellbeing and the quality of the care they provide to their loved ones.[5]

Work with us to build emotional resilience in those who need it

Here at Zen Caregiving Project, we offer our courses directly to caregivers and also work with partners in a range of sectors to build in emotional resilience into any caregiving support they provide. We hope to continue to raise awareness around and meet this vital need and welcome conversation and collaboration with the network of amazing organizations that work tirelessly to support caregivers. 

[1]National Academies of Sciences, Engineering, and Medicine. 2016. Families. Caring for an Aging America.

[2] The authors hypothesized that the positives of caregiving such as having a feeling of purpose in your life, and a connection with the person you are caring for, could explain the longer life.

[3] See Families. Caring for an Aging America for a good overview of the positive and negative impacts associated with caregiving

[4] It is no surprise that in the research caregivers with greater external challenges (such as caring for a loved one with greater needs, greater time spent caring and caring for people while on a low income) all experience higher stress than those with less external challenges.

[5] A study by Ankuda et al (2017) found that those individuals whose caregivers had poor wellbeing were more likely to be admitted to the Emergency Department and have higher Medicare Expenditures.

Mindful Family Caregiving Course

December 14, 2019 (9:00am - 5:00pm PDT/San Francisco)
1161 Mission Street, San Francisco CA 94102
$160 Benefactor / $130 Standard / $90 Student/Accessibility

Our Mindful Family Caregiving Course helps family caregivers find support and community, and shares resilience-building tools to improve their care experience.

Instructor: Roy Remer

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