Whether you’re caring for your husband, wife or parent, sometimes you think you can’t do it one more day--and you certainly don’t want to! It's so overwhelming that it looks like there's no end and there are no answers. You didn't expect to be a caregiver, you weren't trained to be one, nor did you think you would do it for so many years. You're exhausted, you can't sleep, and your marriage and relationships are strained—all while you're bearing the agony of impending loss. How do you survive the endless challenges facing you?

Meet two typical caregivers. Maria’s mom, Jane, moved in with her five years ago suffering from COPD. Ed cares for his wife, Betsy, who’s been struggling with cancer for seven years. Let’s look at their challenges.

Caregiving for parents provides challenges different from caring for a spouse. When caring for parents, there's a sense of a natural order to their physical decline that can soften the pain. However, many caregivers find they experience a spontaneous regression and become the tongue-tied kid or belligerent teenager when dealing with their authoritative parent. Caring for a spouse, on the other hand, carries a special pain because this is the person you're in love with and have been intimate with. When one spouse has to parent the other, it signals the death of the marriage.

Concerns cause great stress. Among concerns many caregivers have shared with me is a sense of shock and disbelief at the angry, mean, guilt-ridden person they have become; and they wonder, "Who is this stranger living in my body?" Other fears, worries and concerns common among caregivers center on hygiene, money, decision making, disrespectful treatment, communication, and strong emotions. In marriages, sex and intimacy issues come into play too. Specifically, here's what caregivers worry about:

  • Doing something wrong that will cause your loved one to die.
  • Lacking skills or physical strength for caregiving.
  • Not handling finances and legal issues correctly.
  • Having terrible thoughts and emotions and not knowing what to do about them.
  • Not knowing how to communicate effectively with your loved one and family.
  • Getting, or accepting, help and/or getting loved ones and others to agree to it.
  • Wondering how you can still have a life while caregiving.

Five key caregiver strategies let you reclaim your life and your relationships.

As a medical psychotherapist and an 11-year caregiver myself, I have seen many lives and relationships disintegrate under the stress of caregiving. But you have options and choices to create a more positive outcome. By using key strategies, your life and your relationships don't have to be over! (There are many strategies for both men and women in my book, The Caregiving Wife's Handbook.) Here are a few to get you started.

1. Understand and handle strong emotions to lighten your load. As a caregiver, your stress and anger can spill over into everything you do, causing problems at work and affecting your ability to be compassionate. Even the most kind-hearted caregivers confess that they yell at their ill-tempered ailing loved one, delay giving them meals, cook food they dislike, and even throw plates when they complain. It's not atypical for caregivers to sometimes wish their loved one would hurry up and die. However, emotions are neither good nor bad, they just are. And they're normal during these difficult times. But too much pent-up anger or too many disturbing thoughts not only create negative outcomes, they also steal your energy. Among many healthy ways to release anger I share in my book, try writing down, for your eyes only, all the things you'd really like to say, but won't.

2. Establish expectations, and eliminate second guessing. First and foremost, get on the same page as the ill person in terms of expectations for everyone involved in their care—including those "helpful" friends. If you're the primary caregiver, discuss and agree on what you'll expect of each other and what you're willing to do and not do. No topic is off limits. By collaborating, you'll avoid having to second guess or look back with guilt or regret about your actions. Communicating collaboratively with your loved one is the single-most helpful practice you can learn and use.

Maria talked about expectations with her mom. Since Jane is of sound mind, Maria realized that, ultimately, it's Jane's right to make her own choices. Maria didn't like that until she considered what she would want if she were sick.

3. Use basic communication tips and tools. In my book, you'll learn how to raise issues, have problem-solving discussions, and create agreements about expectations. Once created, household battles and stress will greatly diminish, leaving a more peaceful and happier environment in its place. Because effective communication is what produces these agreements, it is the key to your survival. To start, bring all of your concerns out into the open—with yourself. Then sort through those concerns to determine which ones you'd like to address.

Next, utilize communication tips. For instance, Maria learned to approach her mom using “I statements” and “closed-end” questions, saying: “Mom, I'd like to talk to you about getting more help. Would Tuesday or Thursday be better for you?” She was used to her mom contradicting her, so was glad to learn it was all right to agree to disagree. Jane was very logic oriented, so Maria spoke to her in her “language,” asking her mom what she thought about an idea rather than how she felt about it.

4. Avoid enabling. A common mistake caregivers make is thinking that everything is their responsibility. This makes you resentful and makes you angry at those who aren't doing things, or aren't doing things your way. To avoid this trap, don't do for the cared ones what they really can and should do for themselves. This enabling, or controlling the ill person, creates invalids. Don't micromanage what they are able to do, even though it may be far from perfect. The less you enable, manage, or control, the more likely you are to reclaim that "nice person" you know you are and have more time for yourself.

Ed was annoyed that he always had to wait on Betsy, bringing water, pills, books, and other items to her, on demand, throughout the day and night. Even though Betsy was able to help herself, now she barely got out of her recliner. Ed hadn’t realized his enabling was making her an invalid.

5. Give yourself permission for self-care. It's okay to have fun, even if your loved one is suffering. Give yourself permission to enjoy one small thing, whether it's a short walk in the fresh air or reading a book. As you become comfortable with small steps, branch out to other self-care activities. Keep up friendships, have at least one activity that feels normal and enjoyable, and find at least one confidant. Even though you're tempted to overdo for your loved one, realize that your physical safety is important. If you break your arm trying to lift your loved one, two people will need caregiving! Get outside help when you're over your limit.

While it seems that caring for your ill family member is your biggest responsibility, in truth, taking care of yourself is number one. A broken caregiver can no longer be of service. Be gentle and forgiving with yourself. Use these simple tools and create a more pleasant and peaceful life by the time you celebrate National Family Caregivers Month 2013!

About the Author

Diana B. Denholm, Ph.D, LMHC

Diana B. Denholm, Ph.D., L.M.H.C., is a medical psychotherapist and the author of The Caregiving Wife's Handbook.

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