When an older family member needs help, many people contend with burnout as they struggle to find the time to provide assistance to their relative amidst the many other commitments crowding their lives. Often, it is hard to figure out just how much help is really necessary. Some caregivers try to give too much time to their older relative and end up feeling resentful. Disliking this feeling, they cut back on their assistance and hold to the limit for a while, until they start to feel guilty about all they are not doing on behalf of their relative. This dance between guilt and resentment goes around and around, until caregivers are able to recognize the cycle and choose a better approach for both themselves and their relative.
No one wants to be a burden to others. This is the first and most important concept in resolving the dilemma. The best way for caregivers to express dedication to an older relative is to find ways to help that do not excessively burden their lives. When they stop giving too much, they may be able to enjoy spending time with their relative. Being enjoyed means more to an ill or frail person than any number of obligatory phone calls and visits
You can't take away someone's loneliness. No matter how many times caregivers phone, visit, or take their loved one on outings, there will always be the time in-between contacts for the person to feel the sadness of separation from lifelong friends and the loss of once cherished activities. These are consequences of frailty or illness that caregivers cannot rectify. It helps to recognize the unavoidable fact that the hours of companionship they provide for their relative go quickly and the empty hours still pass slowly.
A rested caregiver can be a good caregiver and an exhausted caregiver is no good for anyone. It is imperative to go on enjoying life while providing assistance to a loved one. Self-care is not selfishness. The person who counts on another for assistance needs the caregiver to remain in the best possible health and a flexible, nurturing state-of-mind. These vital attributes cannot be maintained when caregivers deprive themselves of out-of-home activities and personal pleasures.
Many caregivers need to jolt themselves into tending to their own needs by asking a question like, "What will happen to Mom if something happened to me?" Anything that reduces a caregiver's stress ultimately becomes a gift to the person who relies on them. At first, it can feel like something is being taken away when limits are set on the care, but what is gained is greater security for the dedication both parties want to preserve.
Respectful honesty goes a long way. When first setting limits, the best course of action is telling the truth as respectfully as possible. For example, a daughter who needs to cut back on how much time she spends with her mother on the weekends may do well to offer a clear explanation: "Mom, I'm so busy at work that I've got to have some time to myself on the weekends. I know that's when you're the loneliest, but I'll be much more relaxed if I come over once rather than twice. I want to enjoy my time with you and not be watching the clock." Acknowledging the disadvantage for their relative is the essence of respect, as is putting the change in terms of a concession being made for the caregiver's sake. This allows the ill or frail person to be the one granting a favor, rather than merely enduring a loss.
Out-of-town vacations are particularly valuable for boosting a caregiver's morale, but many things can interfere with carrying out such plans. When a loved one protests at the idea of being left in the hands of someone unfamiliar, many caregivers cancel their plans out of guilt. A better response in such instances is recounting why this time away is so badly needed. "Mom, I know this may be hard for you at first, but I really need this rest so I can go on giving you the best of myself." Many caregivers also get stymied by the anxiety that something might happen while they are gone. It is often helpful to think through the question, "What's the worst possible thing that can happen while I'm away?" Practical steps can be taken to address these concerns, such as discussing emergency plans with substitute helpers and preparing a notebook listing critical phone numbers, medications and daily routines.
Many people find that attending a caregiver support group reduces their distress more than anything else, because they get to commiserate with others in the same situation. When this isn't possible, coming up with strategies for renewal that are easy to enact and do not require much planning can also make a big difference. Taking a long walk, soaking in the tub without interruption or spending time with a good friend may provide crucial relief.
Caregivers often feel that they lose no matter what they do; doing less for their loved one seems to yield nothing but anxiety and guilt, and doing too much leads to resentment. All-or-nothing options seem to loom, such as, "It's my career or my mother; I can't tear myself in half." Adopting a more flexible way of thinking about the situation is based on learning to avoid self-sacrifice and embracing the concept that a rested caregiver has more to offer. Testing out short vacations, such as weekend trips, may help caregivers realize that they can gain more patience and enthusiasm for the care by spending even a brief time away. It is better to do less for someone and look forward to the time together than to engage in a perpetual dance of guilt and resentment.
Adapted from: Wendy Lustbader and Nancy Hooyman, Taking Care of Aging Family Members, Free Press/Simon and Schuster, 1994.