Reggie Gooch led an active social life, gardened and traveled the world with his wife Millie -- until she was diagnosed with Alzheimer's disease and soon needed round-the-clock care.
Every morning for two years, Gooch, who's now 98, rose at 4 a.m. to prepare and have breakfast with Millie. He stayed by her side all day long until 10 p.m. in their Hollywood, Calif., home.
"The furthest I could get away would be the entrance hall to pick up the mail," said Gooch, a former carpenter who helped his wife in real estate. "I don't think I could have gone on much longer."
He gave up hobbies that once gave him joy -- growing vegetables and pruning a myriad of trees in a community garden. "Everything came to a dead stop," he said.
Millie Gooch found peace and died in February at age 102, but her beloved husband of 76 years was left physically and emotionally exhausted.
Gooch, like thousands of other Americans, was suffering from compassion fatigue, a term used to describe the symptoms of secondary post-traumatic stress caused by caregiving.
Caring for others too much can hurt, according to the Compassion Fatigue Awareness Project, no matter how old you are or in what capacity you're providing care.
"You take on the pain of others and suffer, bottled up, angry and suppressing feelings," said project founder Patricia Smith. "Your impulse is to rescue. You don't have any personal boundaries, but you become isolated and lose your self-care in the process."
Without paying attention to their own needs, caregivers can turn to destructive behaviors such as substance abuse.
"It's a natural consequence of stress," said Smith. "In healthy caregiving you are 100 percent present in their care with empathy and compassion. But it's unhealthy when things in your own life are not resolved and you take on their suffering as your own."
More than 65 million Americans, about 29 percent of the population, is providing care for someone who is chronically ill or disabled and spend an average of 20 hours a week looking after a loved one, according to the National Alliance for Caregiving in collaboration with AARP.
Gooch split the caregiving tasks with a home aide, but the mental focus that was required for looking after his dying wife was draining. They couldn't let Millie out of their sight, for fear she would wander off.
"I am a strong person, but one of us had to be with Millie all the time for the last two years," he said. "I fed her by hand in bed for the last two or three weeks. It was dreadful. I had run out of gas; the engine had run out of power."
Compassion fatigue can affect anyone who is involved with the care of others -- from medical professionals to funeral directors to financial advisors "in a downturn," according to Smith.
In one shocking case earlier this year in Sunnyvale, Calif., a mother "so tired" from caring for her 22-year-old autistic son, shot him, then turned the gun on herself.
"There was help, but she couldn't find it," said Smith, who has written a guide to healthy care giving, "To Weep for a Stranger."
Smith experienced compassion fatigue firsthand, working not with people, but with animals at a shelter that housed 45,000.
"You see how society treats them, the abuse and neglect," she said. "Part of the work is also euthanasia, killing the animals you love.
"People called with all kinds of horrible situations -- rattlesnakes on their front porches to hoarders. We got 65 guinea pigs that had been starved."