Caregiving and Resentment

Pamela Wilson, The Caring Generation, recently discussed the topic of resentment as it applies to conflict that develops when a caregiver feels forced to choose between a spouse and caring for an elderly parent. Actually, Pamela has done a number of podcasts about how resentment is significant to a wide variety of caregiving scenarios and you can check these out here:  You searched for resentment – Pamela D Wilson | The Caring Generation

But the story I want to share today is how resentment played out in my own caregiving experience. I am going to tell this story by sharing excerpts from my book, What to Do about Mama?  by Barbara G. Matthews and Barbara Trainin Blank.

First of all, there was never any resentment between my spouse and me that involved the elderly parent for whom I cared.  Why? Because the elderly parent was his.  Yes, I was the caregiver for my mother-in-law. 

I need to go way back in time to lay a foundation of the relationship I had with my husband’s family. It is very significant to the way I, as a daughter-in-law, ended up becoming the primary caregiver for my mother-in-law. In 1966, my first day at college, when all the freshmen were trolling about checking out members of the opposite sex; I met my future husband. I learned that David came from a military family and that his dad, mom, brother, and two sisters were all still living in Germany. I met David’s family the following summer when they returned to the States, and I was thrilled to be included in their family life. My own family had sort of disintegrated after my father passed away a few years earlier. I always felt cared for and included by David’s family, and that did not change after we married. 

What to Do about Mama? p.7

My father-in-law passed away, suddenly and unexpectedly, during in his sleep one night.

My in-laws lived in Florida, where they had moved in 1971. It was unusual for them to live in one place for so long, since Dad had been in the military for thirty years. Mom did not drive, and David and I extended an open invitation for her to live in our hometown. Mom wanted to stay in Florida and felt she was able to, despite not driving. She would come north three or four times a year and stay about a week with each one of her four children.

What to Do about Mama? p.8

After my mother-in-law’s health began to decline, we began to look for various living options in our hometown, which we would show her when she came to visit.  However, when she remained resolute about staying in Florida and we did not pressure her.  But after a visit, my husband’s brother became alarmed about his mother’s safety.  After returning home he recruited one of their sisters as an ally and the two of them began in earnest to enlist the family’s help to convince Mom to move north.

The general consensus was that if Mom would agree to the move, our hometown was probably the best choice because of the proximity of family members. In addition to David and me, our three grown children lived in the area, as well as one of Shelley’s sons. Shelley and Sandy each lived about two hours away, and it was expected that Scott could fly in easily. We anticipated that they would all make frequent visits.

What to Do about Mama? p.9

Initially, my mother-in-law moved into an apartment in a supportive independent-living retirement community in our town. We had an expectation, based on prior discussions, that Mom’s move would afford his siblings the opportunity to spend more time with their mother. The sister who had advocated for her mother to move north visited monthly, but we were disappointed that the other two did not increase the frequency of their visits.  Still, the arrangement worked quite well for two years, until the inevitable crisis moment occurred, permanently changing the direction of our lives—both ours and hers.

David’s and my decision to take Mom into our home was based on two main objectives: first of all, to end the cycle of injury, hospitalizations, and nursing home stays; and secondly, to help Mom meet her goal of seeing her last grandchild graduate from college. Additionally, since I worked at Aging, I had been living a life filled with old, sick people both on and off the job. In retrospect, I guess that didn’t change.

What to Do about Mama? p.12

Adjustments were required, and adjustments were made, but altogether we had another good two years.  But then, as is inevitable, my mother-in-law’s health began to disintegrate, taking family relationships right along for the long downward slide. Why?  Because of resentment. 

I began to harbor hard feelings toward my in-laws—because they were unwilling to make sacrifices anywhere near the level we were making.  And of course, the resentment was not one-sided.  We had a family meeting, but my husband’s siblings reacted defensively and angrily–their resentment probably stemming from guilty feelings.

Worst of all, when caregiving became increasingly more difficult, to the point of being unmanageable, it became requisite to mitigate new deficiencies on an almost daily basis.  It was then that my mother-in-law expressed her resentment by saying, “Everything is for your convenience!”  It was all downhill from there. 

Going into the arrangement, I thought we did a lot of things right.  But ultimately, we had made too many assumptions and had received too little commitment.  Our expectations had been unrealistically high.

Despite a good multi-decade relationship, the difference in our family cultures and its impact on who we were as people was just too vast. Once the trouble began, interaction among all parties became increasingly difficult, and then impossible. That was the quicksand I never saw in my path. Ultimately, my husband and I have come to believe that it takes a caregiver to understand a caregiver. They did not understand.

What to Do about Mama? p.40

 


Caregiver Stress Webinar

Click on http://youtu.be/GfKS98UTjB4 to view a UCLA Health Webinar on “Surviving Caregiver Stress” by Linda Ercoli, PhD.

Young Man with His Hand on His Forehead

ALL STRESSED OUT

Every caregiver who watches the webinar will find something that resonates with their own unique caregiving situation.

Some of the points that resonate with me are:

  1. Caregiving stress is impacted by the length and the load of the caregiving experience.
    I was caregiver of my mother-in-law for seven years, four in my home. The last two years were characterized by escalating physical decline in conjunction with increased caregiving needs. What had been an overall positive caregiving experience became unmanageable.
  2. Caregiver stress is increased when there are fewer uplifts (positive perceptions).
    I had assumed my caregiving role as a means to “give back” and show my appreciation.  When I sensed my mother-in-law’s air of resentment, the positive perceptions of the arrangement eroded.
  3. Caregiver stress is impacted by role changes.
    My mother-in-law was fiercely independent. She could not accept what she perceived as a “relinquishment” of control, such as when I began to set up her medications.
  4. Caregiver stress is greater when there are perceived problems relating to the family, as well as the care receiver.
    We called a family meeting to discuss our need for increased support relative to increasing needs.  My husband’s siblings were defensive.  As relationships diminished, stress increased.  As noted above, when my mother-in-law felt her “autonomy” decreased, her “animosity” increased.
  5. Coping strategies include “doing for self” through exercise, nutrition, activities, etc.
    When I took time for myself or looked for ways to meet increasing needs, I was accused of being selfish. My mother-in-law stated, “Everything is for your convenience.”
  6. Coping strategies include availing yourself of opportunities for respite.
    When I utilized hospice respite, I was again labeled as “selfish.”
  7. Coping strategies include finding support.
    I joined to a support group; it was instrumental to maintaining my sanity and making difficult choices.
  8. Coping strategies include setting limits.
    When my sister-in-law said she could not have Mom for Christmas because there would be three dogs and a grandchild there, my husband told her we would have one dog and seven grandchildren—our “request” was not negotiable.
  9. Caregivers should be aware of escalating caregiver burden:  exhaustion, medical problems, unrealistic expectations, poor relationships, the need to control an uncontrollable situation.
    Providing my mother-in-law with ambulatory support became unsafe since I was now in need of bilateral knee replacements.
  10. Caregivers should plan and prepare to transition to other care models when the burden becomes too great.
    Although she did not want to leave our home, my mother-in-law moved to her daughter’s home when I could no longer care for her safely.

Barbara Matthews


Moving In!

In “Me and These Men” May 5, 2014, MKC posts:

Five Tips for Not Losing Your Mind When Your Parent Moves In.

There are PLENTY of ways to lose your mind once your parent has moved in—but prior planning certainly does help.  I address this same topic in my book, “What to Do about Mama?” on pages 72-73 and 77-78.

Providing Care in Your Own Home 

As much as you think you can look dispassionately at the situation and develop realistic expectations, frankly, no one can imagine the scope of what he or she is getting into. How can you know the unknown? 

But certainly, if this is the choice you make, be sure that you and your spouse or partner are as prepared as possible. Your home needs to be made safe and handicap accessible, with equipment such as grab bars and shower chairs. Throw rugs should be removed from walkways. It is best if you can provide one-floor living capability, which can be an extra challenge if there is no bathroom facility on that level.

Discuss how responsibilities will be divided among those living in the home, as well as those providing outside support. Don’t forget to talk about finances. Bringing your loved one into your home will put extra demands on your budget. Make sure you will have opportunities for respite and time for yourself; don’t “lose” yourself in the process of caregiving. 

Most importantly, consider whether your relationship is strong enough to handle the demands of living together. If you have problems historically, they will continue or even get worse. Even if you believe you have gotten along well, be prepared; there may be some surprises you just didn’t foresee. Keep all the household members in mind—are there personality clashes? 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?  

If you opt to bring your loved one into your home, establish an open line of communication. Talk about and listen to expectations on both sides. It is so difficult to respect everyone’s roles when the parent-child lines become fuzzy. To encourage a positive and cooperative atmosphere in your home:

Designate a personal space for your loved one that is not too isolated from the rest of the household. Fill it with his or her belongings, collectibles, and mementos.

  • Talk about individual routines, and try to accommodate everyone’s needs as closely as possible without compromising your household and family values. Will you have enough time for other family members? If your spouse or children are required to sacrifice what they hold dear, the household climate will become a breeding ground for resentment and conflict. Remember that family support is vital if the living arrangement is to be successful.
  • Emphasize household customs, and solicit support for avoiding unneeded disruptions. Will you be able to maintain important lifestyle concerns such as employment, social life, and vacation plans? Are you prepared to make adjustments?

  • As a family, discuss what you each value and what causes you stress.

  • Set boundaries in the relationship, but make sure to schedule time together.

  • Help the care receiver develop new activities and friendships.

  • Encourage mutual respect based on communicating wants and needs, not giving orders. Stress the importance of being open and honest with each other. This is particularly difficult when your care receiver goes around you to complain to the “others,” which also sets the “others” up to second guess your actions. Direct communication is the key to avoiding misunderstandings. 

Barbara Matthews

 


Shared Responsibility

An AgingCare.com article “Getting Your Siblings to Help with Caregiving” by Linda Hepler, BSN, RN, stresses the importance of sharing caregiving responsibilities with siblings and makes suggestions about how to accomplish a cooperative family relationship.

See: http://www.agingcare.com
Home » Caregiver Support » Family & Relationships » Articles » Getting Your Siblings to Help With Caregiving

Hepler states that when an elderly parent’s health begins to fail, one adult child generally becomes the primary caregiver. And while this may work well for a time, it can eventually cause resentment when you find yourself shouldering most of the burden—especially if other siblings live nearby yet don’t help out. She then goes on to make the following recommendations:

  • Call a family meeting
  • Make a written agenda
  • Do as much listening as talking
  • Be specific about what you want
  • Divide up tasks
  • Don’t expect total equality

Hepler stresses that it’s normal to experience tricky dynamics when siblings get together as adults, since childhood jealousies and rivalries as well as historical grudges may resurface under the pressure to work together and make sacrifices.

Hepler recommends that if all else fails, an option for getting past stressful communication is a relatively new concept—family mediation—an informal process in which a neutral third party sits down to help people in conflict to better understand their individual interests and needs so that they can agree upon a workable solution to the problem.

Hepler emphasizes that even when successful in achieving a better distribution of responsibility, it’s important to communicate, communicate, communicate.

We have discussed the family meeting previously (See the February 22, 2014 entry: “Family Meeting”), but the concept of “shared responsibility” with siblings cannot be overstressed. It is a major concept in my book, “What to Do about Mama?” and is central to chapter 2, in which I recount my own personal caregiving story, including experiences with family meetings and family mediation. Following are some excerpts from the book, relevant to this topic:

  • A productive family meeting can build a strong foundation for family caregiving. Do you share common values? Talk about what is most important to all of you—autonomy or safety. Establish common goals. Divide responsibility based on the strengths and abilities you bring to the family. It is important to be specific. Develop a contract that delineates the commitments family members have made, and solidify those commitments with signatures that verify that everyone understands and agrees to the plan. Be sure to date the contract in case changes are needed later on. WTDAM p.54
  • You’ve taken on the responsibility of family caregiving. You may have held a family meeting to set up a care plan. In an ideal world, all the family members would have done their best to foster a nurturing caregiving relationship among everyone involved—parent(s) and children alike. You have embraced mutual trust, respect, kindness, and patience. You have rejected guilt and resentment. You communicate effectively, based on listening to what everyone is saying. You compromise when problem-solving to find the solution that works best for everyone. You and the family have assigned tasks according to individual strengths and skills and with an awareness of individual needs. You share caregiving responsibilities, and have found that teamwork reduces tension and brings your family closer together. It even promotes the possibility of healing old wounds. You keep your expectations realistic, and your family members, in turn, provide you with needed emotional support. They allow you to vent and take steps to alleviate your stress.

    How well does this describe your family’s caregiving experience? In the real world, when there’s a pressing need to collaborate and make important decisions (especially with a resistant parent), you may not all be in top form, but, rather, anxious and overwhelmed. Your relationships may be knocked off balance by the magnitude of caring for aging or failing parents. Feelings for each other shift, sometimes weakening the ties and intensifying sibling rivalries of the past. There may be jealousies related to perceived “favored children” or worries about issues of inheritance. A frequently reported caregiver frustration is the lack of consistent help from other family members; a large portion of sibling caregivers (40%) end up having serious conflicts with each other. Most of us do not even see that we are about to become mired in the quicksand until we step in it and it begins to suck us down. WTDAM pp. 107-108