Ambushed by Eldercare? You’re Not Alone
7 strategies to help you cope
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Late one night the phone rings. Your 80-year-old mother has had a heart attack and your life turns upside down, bringing worry, stress, anxiety, and uncertainty, your days punctuated by one crisis after another.
More than 54 million Americans are unpaid caregivers to their family members, two-thirds of whom are women (Matthews & Blank, 2013). Pulled in multiple directions at once, many are caring for their own children, as well as older relatives, and their numbers are only increasing as the population ages.
“It is a terrible situation to have so many people to care for and yet also have work responsibilities and other commitments—as well as the need to take care of oneself and remain sane,” says Barbara Trainin Blank, author, with Barbara Matthews, of What to Do about Mama? A Guide to Caring for Aging Family Members (2013, p. 43).
Blank, a professional writer accustomed to multiple deadlines, admits that, “Taking care of my mother may have been one of the most difficult things I’ve ever had to do in my life” (2013, p. 34). Her mother lived 180 miles away, her brother lived much closer, but in many families the weight of caregiving often falls upon one person.
Cascading stress, sleeplessness, grief, guilt, family conflicts, anger, resentment, exhaustion, and burnout—caregiving takes its toll. Psychologist Dale Larson calls this falling into “the helper’s pit” (1993, p. 38). How to stay out of the pit? Larson says to stop blaming yourself if you feel overwhelmed by caregiving and ask instead, “What can I do about this situation?” (1993, p. 55). Drawing insights from their own experience and a wide range of caregivers, Matthews and Blank offer seven powerful strategies:
- Start Planning. If you have older family members, begin asking about their values and wishes for the years ahead. Do they need to scale down, move into a more accessible home, closer to family members, or into a continuing care community? Determine what needs to be done and the support caregivers will need to handle these challenges. If your relative is intent on staying at home, who will pay the bills? Take this person to the doctor? Assist with meals and the activities of daily living?
- Get Community Support. Find out about support services in your relative’s community, such as the local Agency on Aging. Check out senior services and information online such as ElderCarelink (link is external)or SeniorsList (link is external).
- Reach Out. Network with other family members and your loved one’s neighbors and friends. Check out possible support from your relative’s church or synagogue. And consider joining a caregivers’ support group to share information and personal support.
- Take Care of Yourself. Too many caregivers wear themselves out, getting sick themselves. Watch for signs of stress and burnout. Are you:
- Feeling run down and exhausted?
- Having trouble sleeping?
- Easily annoyed?
- Getting sick more often?
- Having trouble concentrating or remembering things?
- Becoming socially isolated?
- Feeling helpless, depressed, or overwhelmed?
Caregiving is a serious responsibility, but don’t become so engulfed in it that you stop being yourself.
- Make time for a regular stress management practice. Barbara Trainin Blank says she dealt with the challenge of caregiving by walking in the mornings with a friend. Regular exercise is good for both body and mind, relieving stress, activating our immune systems, and helping dispel depression (Rethorst & Trivedi, 2013).
- Take regular breaks. Matthews and Blank emphasize the need for regular “respite care,” especially if you are caring for your loved one’s daily needs. If possible, recruit other family members. Check out senior day services and respite referrals at the local senior center.
- Keep up with your own interests. Blank stayed in touch with friends and participated in community groups—relieved to spend time with people who were not dealing with the chronic stress of caregiving. She continued to do some of the things she loves: creative writing projects, watching old movies, and donating to causes she believes in.
As Matthews and Blank (2013) found in their surveys of more than 30 caregivers, the key is to balance your own needs with compassionate care and realistic problem solving. How you handle the challenge of caregiving will make a major difference in many lives, including your own.
Matthews, B. G., & Blank, B. T. (2013). What to do about Mama? A guide to caring for aging family members. Mechanicsburg, PA: Sunbury Press. http://www.amazon.com/What-Do-about-Mama-Members/dp/1620063158/ref=sr_1_1?s=books&ie=UTF8&qid=1427846005&sr=1-1&keywords=what+to+do+about+mama (link
Larson, D. G. (1993). The helper’s journey: Working with people facing grief, loss, and life-threatening illness. Champaign, IL: Research Press.http://www.amazon.com/Helpers-Journey-Working-Life-Threatening-Illness/dp/0878223444/ref=sr_1_1?s=books&ie=UTF8&qid=1428530954&sr=1-1&keywords=The+Helper%27s+Journey
Rethorst, C. D., & Trivedi, M. H. (2013). Evidence-based recommendations for the prescription of exercise for major depressive disorder. Journal of Psychiatric Practice, 19, 204-212.
Diane Dreher is a best-selling author, personal coach, and professor at Santa Clara University. Her latest book is Your Personal Renaissance: 12 Steps to Finding Your Life’s True Calling.
The Resentful Caregiver
May 12, 2014 · By AnnMarie
I wanted to be the kind of caregiver who never got frustrated, annoyed, angry or resentful. I aimed for perfection and heroism.
It wasn’t going so well.
First, I saw my mother-in-law go to her daughter’s after staying with us for 3 ½ years. As her dementia worsened, my frustration rose. I had my own parents to look after also, although not nearly the way I had to with my mother-in-law. In spite of my frustration, I wanted to be like the Old Testament Ruth who stayed by her mother-in-law’s side and cared for her in her old age as if caring for her own mother. I wanted to be like my friend Donna who welcomed her husband’s uncle into her home and kept him there until he passed away. Now, she is preparing to have her mother-in-law move in.
But I am not like Ruth or Donna. I am me: anxious, easily annoyed, angry that I’m the only daughter, angry that my brothers live so far away and have no idea what I go through. I like to throw pity parties for myself on a regular basis. I like to recount the day’s drama with my husband, daughters, or anyone who will listen.
I knew I needed to let go of these emotions—especially the resentment towards my brothers. It was eating at me, making me depressed, and affecting my relationships with those I loved. Intellectually, I knew it was wrong and unhealthy; emotionally, I wanted to keep throwing pity parties and be angry at everyone. I kept thinking back to a long-ago conversation I had with my priest on another topic, who helped me understand that life is not meant to be a continuous day at the beach (and I love the beach.) Sometimes you have to come home, and all you have to show for it is sand in your bathing suit. One of my favorite Scripture verses comes from 2 Corinthians 12:9:
But he said to me, “My grace is sufficient for you, for my power is made perfect in weakness.” Therefore I will boast all the more gladly of my weaknesses, so that the power of Christ may rest upon me. (English Standard Version)
I love this verse because it’s a wonderful reminder that we are meant to make sacrifices throughout our lives, and in doing so, we become stronger in ways we never imagined.
I needed to embrace this Scripture verse as my own. I read articles and books. I searched the internet for resources. I printed out articles and highlighted the parts that I thought held some promise for me. I prayed for God to get me through the day.
Then it happened–only by the grace of God–I was ready to begin to let go. Somehow the intellectual part of me convinced the emotional part that I needed to turn over a new leaf. I needed to stop being a whiner, a baby, a five-letter word that starts with a ‘B’.
By the grace of God, I am beginning to be okay with the fact that one brother has gotten out of helping me by leaving this world, and the other two live 1,000 miles away. I have started reminding myself that “it’s only for a season”, as our lawn maintenance man (of all people) told me one day. I also realized that other living/caregiving arrangements wouldn’t necessarily be any easier. I can’t expect a hired hand to be responsible for my father’s medical decisions and follow-through. I would definitely get tired of driving somewhere to visit or assist my parents if they didn’t live with me. I am beginning to process this new outlook, and I’m trying to step cautiously: I know there will be ups and downs, good days and bad.
Letting go of anger, frustration and resentment, however, has lifted a heavy stone from my chest. It has lightened me, and reminded me how good peace feels when it fills your heart. I know, however, that the devil will try to tempt me down the road, especially when I’m least expecting it. I will have to put up a good fight. But by the grace of God, I am finally ready to try.
Ahhh….RESENTMENT. Here are some comments made in my book, “What to Do about Mama?”
In addition, I was faced with perhaps an even more distressing aspect of caretaking—one with which no doubt many of you are familiar, whether you’re caring for a loved one short or long distance—and that is resentment toward other family members for not shouldering more of the responsibility. Not that I necessarily expected a 50-50 split, but a more equitable one would have eased my burdens considerably. (WTDAM p. 42 )
These “non-child” relationships can bring a whole new set of emotional conflicts, such as difficulty getting along in unfamiliar roles or resentment for making sacrifices that the “children” are not willing to make. (WTDAM p. 49)
Then there’s the issue of the “others,” the ones who are not taking on the responsibility of front-line caregiving. Too often, they are the ones who second-guess or criticize you. If you haven’t felt resentment before, you will now, and that emotion can really destroy relationships. Are you prepared to cope with this ongoing stress? (WTDAM p. 73 )
There’s a resentment of my siblings happily living their lives without the worry of what’s actually going on not only in my life but also my dad’s. (WTDAM p. 79 )
Don’t set your bar too high in comparison to the standards of other involved parties. Set boundary lines and stick to them. Taking on too much commitment and making too much sacrifice breeds resentment. (WTDAM p. 192 )
Now that our caregiving has ended, the relief is so palatable that I have no more anger, resentment or bitterness left. I do not hold grudges, but I am a little wistful that the “closeness” of the past is probably in the past, and I am unsure of any potential for the future. (WTDAM p. 113)
I agree with you, AnnMarie, that it is important to let go of negative emotions, which is, indeed, not an easy task. It can help to take some concrete steps: 1) establish realistic expectations; 2) set boundary lines, and 3) communicate with the “others” to formulate a joint “contract of commitment.”
Click on the Patriot-News link below to see a Doonesbury cartoon about role reversals:
– The Patriot-News.
A response to an AgingCare.com article:
http://www.agingcare.com Home>>Caregiver Support>>Family & Relationships>>Articles>>Switching Roles: Coping with Your Rebellious Aging Parent.
When I was an Assessor for the Area Agency on Aging I often met with senior women and their daughters. When I directed a question to the senior, it was not uncommon to hear the response, “Ask my mother here,” while indicating her daughter. Clearly they were referring to the issue of “role reversal,” which can be petty doggone tricky to navigate.
In the AgingCare.com article, Switching Roles: Coping with Your Rebellious Aging Parent,
Carolyn Rosenblatt states: “You can’t just let a parent with signs of dementia or other significant memory problems go on as if nothing were wrong, even if she gets upset with you. At some point, the adult child who loves a parent must step in. You may end up setting limits, making new rules, or taking over certain decisions. This is not easy for most people. We are so accustomed to our parent making her own decisions, that to dare to tell her what to do is very uncomfortable.”
Carolyn is correct that reversing roles with parents is very difficult. But it is not always clear cut as to when to do so. When it is determined that you must step in, and the parent-child line becomes fuzzy, it is always important demonstrate respect for everyone’s roles.
An initial question to consider is: What takes precedence? Autonomy or safety? If the senior’s values and wishes are not respected and taken into consideration, you are bound to run into resistance and conflict. After all, who doesn’t want to remain in the driver’s seat of life?
It is imperative to respect your loved one’s dignity—it is, after all, empowering to retain the ability to make choices and decisions. Show respect for your care receivers’ autonomy by seeking opinions and preferences throughout the care-planning process. Promoting as much independence as possible is key. Furthermore, caregiving responsibilities generally escalate as needs multiply over time. The less able our loved ones become, the greater their sense of independence lost. And as needs escalate, so does conflict.
Two huge problem areas that Carolyn Rosenblatt mentions are driving and financial management. These are both referred to in “What to Do about Mama?” For example:
- When our parents lose their ability to drive they require assistance with transportation, shopping, and running errands. And of course, since driving is synonymous with independence for most seniors, this issue may cause particularly intense conflict. As one son recalled: “When my father insisted that my grandfather stop driving, Grandpa, a generally sweet and mild-mannered gentleman, began to call Dad on the phone to curse him out soundly. I was glad that I never had to confront this issue with my own father!”
- “As my dad began having problems managing the finances, it was difficult to ease him away from the task so I could handle the accounts. Eventually, we worked it out so he would ‘check’ everything I did, which kept him in the loop, but gave me full responsibility for handling bills.”
In my own personal caregiving situation, my husband and I felt that living in the safety of our home would allow his mother to be more independent and active for a longer period of time. We felt that although the first two years of our caregiving arrangement were really quite good, there was always an undercurrent that somehow my mother-in-law perceived me (her primary caregiver) as a threat to her autonomy.
I tried very hard to respect her independence. I tried to empower her by presenting options and respecting her choices. But if she perceived me “directing” in any way she felt her independence was threatened and I sensed her resentment. Ultimately, I felt that most of the escalating friction could be attributed to my role as an in-law caregiver. Switching roles, or even the perception of switching roles, is indeed difficult.
I often hear caregivers express different perspectives about their own children’s involvement in the caregiving situation. If we are embroiled in a difficult experience, of course we don’t want a like-burden for our kids. But is it really a good idea to shelter them from all responsibility?
As I said in What to Do about Mama? “Baby boomers are on the precipice—getting ready to fall off and land firmly on the backs of our children’s generation. And they are so young! They are, after all, our children!” (WTDAM p.1)
I think I can safely say that none of us wants to be our children’s
Some folks see caring for parents as a given:
- “I’m not really sure what I thought about caregiving in the beginning other than it was what needed to be done, and as their children, this is what we do for our parents.” (WTDAM p.86)
But, in spite of any stated “willingness” to assume caregiving responsibilities, we are resolute in our desire to not saddle our own children with like-obligation.
- “I know I don’t want the roles to be reversed and hope I never to get to that point.” (WTDAM p. 115)
- “Given my experiences, I just hope I will have saved enough money so I can hire help, too, should the need arise. I certainly don’t want my kids to end up with this much responsibility for my later care.” (WTDAM p.120)
- “We want to minimize the impact on our daughter, who is five hours away with a very busy young family.” (WTDAM p.187)
Yet others point out their perception that caregiving was a positive example for their children, expressing the hope that the experience would contribute to their children’s personal growth.
- “I feel it taught my children many valuable lessons as well.” (WTDAM p.57)
- “I think it was wonderful for my two children to witness how we cared for their grandmother. We always gave her respect and showed gratitude for all that she had done for us. She needed us, and we were there for her. Although my children (young adults) were involved in the process, I probably would have involved them even more.” (WTDAM p.196)
Some were pleased with the contributions their children made.
- “Each of our adult children had an area in which they were able to offer help and advice; each offered to do what he or she could do from a distance. Our family has drawn together as we helped each other through this.” (WTDAM p.146)
Others were not.
- “I was disappointed that my children did not develop a more loving relationship with their grandmother.” (WTDAM p.171)
- “My family had difficulty coping with the time I spent on my mother’s demands. They felt resentful at times. My children have their own lives now; they support me, but not my mom; they visit only at my request.” (WTDAM p. 219)
Some children expressed gratefulness to their parents for taking care of their grandparents.
- “I know from a personal perspective (and one of NOT being a full-time caregiver) that I enjoyed having my grandparents living with my mom. I didn’t worry about them being alone or having to care for themselves as they got older. Plus, it was enjoyable for me having the whole family together under one roof when I visited. As far as my grandparents were concerned, it was a very pleasant experience for me.” (WTDAM p. 139)
- “My daughter said, ‘Thank you, Mom, for taking care of my Grandma and being such a good example for me.’” (WTDAM p. 28)
In my own caregiving experience the greatest amount of support that we received for immediate and unplanned caregiving needs was from our son and two daughters. They involved their grandmother in all their family functions, brought their children frequently for visits, picked her up from the senior center when needed so that I could attend support group, and sometimes either visited or took her to their homes when we had no other coverage. The girls sometimes shopped for her when she needed clothing items or OTC medication, and returned and exchanged the items if they weren’t “exactly” right. Their support for their grandmother went well beyond what we had expected.
It fulfills me to know that my husband and I were good role models for our grown children. Keeping their interest in mind, I saw caregiving as an opportunity for a “teaching moment,” (well, actually more than a moment), where they would learn and internalize the real meaning of family commitment (and never did our children disappoint).”
We are glad that our grandchildren were able to know and love their great grandma, and that we gave my husband’s mother the gift of our children and grandchildren. We are proud of the love, support, and appreciation they showed her.
- “Most importantly, at least from my perspective, was that she was central to the active life we were blessed to have with our family—three of her grandchildren and eight of her great grandchildren. She was always concerned about whether the little ones would remember her after she died. A short while ago the oldest said to me proudly, ‘I was the last great grandchild to talk to Great Grandma.’ She would be pleased.” p. 206
So, no matter the perspective, ultimately our children will experience pain related to our decline and our passing. They will discover that they cannot control the process of dying. And although we cannot, nor should we, protect them from the responsibility that lies before them, maybe we can at least prepare well enough that their road will be a little smoother to travel than ours has been.