November is National Family Caregivers Month (NFC Month). It is a time to honor the over 65 million family caregivers in this country who take care of a loved one on a day-to-day basis. It is also a time to advocate for stronger public policy to address family caregiving issues, and to raise awareness about community programs that support family caregivers.
The theme for NFC Month 2013 is "Family Caregivers - Now More Than Ever!" To learn more visit the CaregiverActionNetwork.
If you are seeing your mother for the first time in a long time over the holidays, you may be startled by the changes you see. Click the link for help onAssessing Mom Over the Holidays.
Joan Lunden Talks About How to Plan to Be a Caregiver to Your Parents
The Difficulties of Caring for an Aging Parent
Caring for a Difficult Older Adult By Connie Matthiessen, Caring.com
Try these strategies to remain effective and sane when you're taking care of someone who's difficult.
Caring for a difficult relative or other loved one
Being a caregiver is never easy, but if you've spent much of your adult life trying just get along with a parent or another older adult you're close to, being thrust into the role of her caregiver may be excruciating.
The bad news is that if she's always been critical, grumpy, intrusive, or just plain mean, it's unlikely that old age and poor health will improve her personality much. The good news is that as an adult, you've probably become more confident in yourself and have learned to deal with her more effectively -- and if you haven't, now is your chance to learn. Believe it or not, it's possible to make your relationship work more smoothly so that you can help her through this stage of life.
Difficult people come in all varieties, from self-absorbed and demanding to angry and remote. Caregiving situations vary widely, too, of course: Your experience will be different depending on whether you're providing daily care, supplying occasional care, or coordinating care from a distance. No single approach will address every dilemma, but the following tips should make caring for the person a little easier.
You've had the double "oh no" moment -- that is, it's become clear that your parent or someone else you're tied to needs help and that you have to take a greater role in her care, and this means you'll be spending more time with someone you find difficult to be around. Perhaps you'll need to help her move to a nursing home or arrange a treatment schedule for her after her cancer diagnosis. Whatever the details, the relationship you've had is about to change. Here are some steps you can take to ease the transition:
Take time to prepare yourself. Faced with a crisis, it's tempting to make decisions quickly without thinking them through. If you have a difficult relationship with your parent or someone else you're caring for, the pressure is even more intense, and every decision is fraught. Try to spend some quiet time before you jump onto the caregiving roller coaster. Write in your journal, talk to friends, and think about what has made your relationship difficult in the past and how you can approach it differently this time.
Line up support. It's important to have buffers so you won't be standing on the front line all by yourself. Meet with siblings, other relatives, or other friends who will be giving care so you can divide the labor early on, if possible.
Bring in the experts. If you don't have family support, you live far from the person you're caring for, your relationship is explosive, or her situation is complicated, consider hiring a geriatric care manager. She can help by providing support and concrete advice about community resources, skilled nursing facilities, and other such topics. If you live far away, the manager can help you coordinate care from a distance. Take the time to find someone that you and the person you're caring for both trust. If you find the right person, she'll help you communicate more effectively with the person you're caring for.
Consider your own role. As you enter this new stage in your relationship with the person you're caring for, it's important to remember that you can't control how she acts -- but you can control how you respond. Take time to honestly consider your own role in the conflicts you've had in the past and think about how you can handle things differently. This might be a good time to see a counselor to sort through some of the guilt, fear, anger, and resentment that may have haunted your relationship -- and likely compromised other relationships in your life as well.
Coping day to day
Once she's settled and you've established a caregiving routine, she's likely to resume her usual patterns of behavior -- and may even become more difficult. Crises are frightening, but the long haul can be harder. It'll probably last a lot longer, too. You may require additional strategies to help you care for her on a daily basis.
Talk it through. Try addressing the situation directly as soon as problems arise. Say something like, "I know we've had problems getting along, but I'd like to do it differently from now on. Can we talk about how to do that?" Try to listen to what she has to say without getting defensive. Use "I statements" when you explain your experience ("I felt as if you were angry at me just now" rather than accusations such as "You act like you hate me").
Prepare to have your buttons pushed. If you consider the history of your relationship, you'll likely find some recurring themes. Maybe your mom always compares you unfavorably to your siblings or blames you for your two failed marriages. Identify these common trigger points ahead of time and simply ignore her when she touches on them. Instead of reacting angrily or getting hurt, gently change the subject -- as many times as you need to -- until she gets it.
Try something different. If your interactions are uniformly negative, think about how to change the dynamic. Are there less stressful ways that you can spend time together? If sitting together and talking usually ends in an argument, offer to clean her attic, weed her garden, or cook her a special meal. If you visit her at the nursing home and all she does is complain, suggest taking her out for a drive or lunch. Or take a tape recorder and interview her about her past. Read a book together, if she's up to it, or help her put photos in an album as a legacy project. A tangible project that you can do together can help you be close without treading on perilous ground.
Set boundaries. It's important for anyone in a caregiving position to set and maintain solid boundaries, but this is especially true if you have a difficult relationship. If you're clear about how much you're able and willing to do and stick to that, you'll be less susceptible to guilt trips and manipulative behavior. You can also set limits for how much emotional abuse you'll put up with; if she won't stop criticizing, maybe it's time to go make yourself a cup of tea.
Take care of yourself. If you're spending a great deal of time with the person you're caring for, make sure that you're doing things to replenish yourself -- body and soul. This will help you stay balanced and less reactive. Maintain a regular exercise regime to blow off steam, and arrange for regular weekends off and vacation time if you can. Some people find that being in nature or meditating helps them maintain their perspective. If your schedule doesn't permit regular breaks or time for yourself, you're headed for burnout and you need to do something to remedy the situation. If no one in your family or community can step in, check with your local agency on aging to find out if there are any respite care services available.
Join a support group. A caregiver support group gives you a place to unwind and share your story with people who are having similar experiences, which can be restorative.
Step Away From the Donut: The Perils of Emotional Eating By Carol Bradley Bursack, AgingCare.com
As far back as breast or formula feeding, most of us learned that a sweet taste meant care and comfort. As we grew into more grown up foods, we generally learn to equate certain goods with comfort. Our parents picked up on these foods and would offer them as treats. Ice cream, anyone?
Somewhere deep in our subconscious most of us learn to connect food – at least certain types of food – with nurturing, comfort and solace. Caregivers, stressed to the max from trying to stay ahead of the needs of elders or others who depend on their care, often turn to food to comfort themselves or to relax. There tends to be a "I deserve this" mentality, and caregivers do, indeed, deserve to be pampered somehow. It's human and actually very good to want to comfort ourselves when we are stressed or even bored.
Cabin Fever and Stress Eating
Picture this: a middle aged woman at home caring for her elderly mother who has stage three Alzheimer's. The daughter who is the primary caregiver knows she is fortunate to have a husband who earns a good living, enabling her to care for her mother at home, full time. However, day after day goes by and the daughter doesn't have any time for herself. She doesn't have any "me" time when she isn't on call because of her mother's needs. This can lead to resentment, even if it's subconscious.
While the caregiver's mother may not need active attention every minute of the day and night, the mother does need supervision. The daughter eventually becomes stressed from feeling cooped up without the option to leave the house. She is bored, as her mother's communication is limited and repetitive. The caregiving daughter has little interaction with the outside world.
She knows she is fortunate to be able to stay home and care for her mother. She feels guilty for her occasional resentful feelings about her situation, since she knows many other people would love an option like hers. The only thing that seems brings her comfort is food.
Lately there have been studies pointing to the fact that middle-aged women are prone to eating disorders. I'd like to see statistics on how many of those women are caregivers. I see questions on the AgingCare.com forum from women who have gained considerable weight during the months or years they've been caregiving. Many have gradually turned from seeking occasional comfort from food to what may be a full-blown food addiction. Food becomes to them the only realistic way that they can relieve their stress.
Keep Caregiving From Ruining Your Other Relationships By Carol Bradley Bursack, AgingCare.com
In the 1970s, there were ongoing debates about whether a woman could balance a family with a career. The discussions centered on being a good wife, mother and employee. The question seldom posed, in those days, was how, besides being a wife, mother and career woman, could a woman also be a good daughter?
Today, we hear about the toll elder care takes on families as routinely as we heard the former arguments in the '70s. Adult children are being faced with choices (or seemingly, assignments) they never thought about before. They are raising children or teenagers and holding down a job, when suddenly they find that their aging parents need an ever-increasing amount of attention.
Why is elder care more of an issue now than in the past? For one thing, people are living longer than they used to and, often, they are not living with good health. Yes, we all love to point to the 93-year-old guy out there playing golf everyday, and these people exist. I know a couple of elders like that and they are a joy to beh
However, many elders today are stroke survivors, or are suffering from diabetes, lung problems or dementia. Sometimes they have a combination of these ailments, and others, which likely would have caused death even a decade ago. Now, medical advances provide lifesaving options. Many of these people live – some even living fairly good quality lives – but they need assistance from family or paid attendants.
Another piece of the puzzle is that many people have chosen to have children at a later age, thus putting them in a position where they have young children and older parents at the same time. This can be a delightful combination, as long as the elders are reasonably healthy, but when they are not, the adult children of the elders, also parents of young children, can be faced with very difficult choices. These are the people now famously known as the Sandwich Generation.
Whatever the circumstances are that propel people into elder care, the problems that can come from it are myriad. All you have to do is visit the AgingCare.com community and you'll quickly see that many caregivers, both men and women, find themselves feeling pulled in so many directions that they can no longer find their soul.
They fear for their own health – mental and physical – as they try to take care of the needs of three generations, the most demanding often being the elders. Caregiving for a sick elder, especially one with dementia, can become so all-consuming that the caregiver's other relationships suffer.
When Should Seniors Turn Over the Keys? - CBS News
Detaching With Love: Setting Boundaries in Toxic Relationships AgingCare.com
When the family member we are trying to care for is impossible to please, it’s often because of long-standing family dynamics. I’m not talking about someone in intolerable pain, or someone who has little control over their brain because of dementia or Alzheimer’s. In those cases, we often need to get the help of professionals, whether it’s hospice care for end-of-life pain or a memory unit for Alzheimer’s patients who may not be safe at home.
However, many caregivers on this forum talk about caring for parents who have abused them for a lifetime. Aging, and the problems that come with it, has only made this abuse more intense. No, your parents may not be able to hit you anymore, but that loss of physical control for them sometimes can make their tongues an even stronger weapon.
Yet, it’s natural for adult children to love their parents and even want to care for them as they age. If your parents abused you when you were a child, how do you care for them without harming yourself by being subjected to ongoing criticism and abuse?
Many counselors would suggest “detaching with love.” Detaching is a method of setting boundaries to protect yourself. It can also mean that you give up the notion that you can control their behavior, and you stop allowing them to control yours. It’s hard. It takes practice. But for many, detaching works.
One thing that can help is to realize that the little kid inside of us most likely still wants our parents’ approval. When we can’t get that, even as adult caregivers, it hurts. To cope with those needs, it often helps to learn the techniques of detachment.
People detach by learning to understand that they can’t control their parents (or spouse), so they stop trying. Sometimes, just this step makes a difference, as the person who has been pushing your buttons - making you angry because he or she knows your triggers – starts to see it doesn’t work. Detaching with love means that you affirm that you love the person, but will no longer tolerate being treated with meanness or disrespect.
You set boundaries and make them clear. If the parent continues to complain just to see your reaction or to manipulate you, criticize your every move and generally abuse you verbally, you tell them you will get someone else to take care of them until you both cool off.
This takes some planning, especially if the parent is truly in need of constant care. You may need to set up an in-home service for few hours a week, then see what you can do to call them on an as-needed basis. This can be tough, but if you call around you may find a service available.
Early Grief and the Long Goodbye: Grieving Parents Before They Are Gone By Carol Bradley Bursack, AgingCare.com
Nearly everyone involved in caring for aging loved ones is experiencing grief. Often, however, we’re not aware of this grief. We have a parent who used to be strong and capable begin to ask for a little assistance. No big deal, right? We’re happy to help.But underneath, often unnoticed, there’s a knot in our hearts. We’re grieving the loss – the loss of function that made our parent need to ask for help. Weren’t they the ones who helped us? Weren’t they the ones in charge?
Generally, these changes are subtle, the grief sneaky. I remember watching my parents age in the normal fashion. I’d occasionally look at them and be startled by the realization that they were aging. But that was all I acknowledged. I never intentionally thought about loss and pain. It dwelled beneath my consciousness.
Then my dad had brain surgery to drain away fluid buildup from a World War II injury. He went into surgery knowing that if he didn’t have it, he would eventually live with terrible confusion. He came out of surgery totally demented. The combination of his age and significant scar tissue, I suppose, was to blame. Whatever the reason, our family was a victim of one of those things that only happens to “other people.”
We were suddenly thrown into a frenzy of action. There was so much to be done; there were so many decisions to make. What was best for Dad? For Mom? I became the primary caregiver, immersing myself in the task of making Dad’s existence worthwhile.
Whatever he imagined was happening, I did my best to make it so. When he was waiting for his medical degree to arrive, I made sure one did (my version looked pretty good, too, hanging on his nursing home wall.). I became his office manager. His music director. Whatever he needed, I did everything humanly possible to provide.
I had several other elders to cope with, as well as a son with chronic health problems. I didn’t have time to think of myself. Now, I look back and see what I did to myself. If I had a good friend going through all I was enduring, I would have been offering to help. I would have recognized that she was grieving the loss of the father she’d known. I would have pressed her to do some things to take care of herself. I would have suggested counseling.
What do you do when an insult is hurled your way, privately or publicly? Do you pretend you didn't hear it, hurl an insult right back, or hold it in and cry when you're alone?
How we deal with criticism -- no matter who it's from -- will determine whether we develop a tough skin or let the criticism get to us.
When insults and criticism come from a loved one, it is even more hurtful. People tend to be at their worst with the people they love the most. People feel safe enough with family to just “let it all hang out.”
Here are some tips for dealing with criticism and insults:
Don't take every insult personally. Though the insults are thrown your way, the reason behind them probably has nothing to do with you. An elder may be angry at their circumstances: growing old, losing their independence, watching spouses and friends die. This has nothing to do with family members, but unfortunately, they bear the brunt of the anger.
Detach. Pull away from the situation and look at it without ego, as if you were observing someone else’s life. Is it possible you are being overly sensitive, or has someone treated you like a doormat for no reason? A clear sense of which it is will help you find the best solution.
Realize you can't please everyone. You can be the best caregiver in the world, but people -- be it your elderly parent, siblings or friends -- can always find fault. It's human nature. Someone will find something that you do wrong, or tell you that you aren't doing something right. It's a fact of life and we can't change it. Accept this and you'll be a happier person.
Elderly Parents and Dealing with Guilt: Guilt, helplessness, and the pain of realizing that you may no longer be suited, or able, to give your elderly parent what he or she needs is an enormous burden for any child to feel (regardless of age), and it will take time and a lot of patience – with yourself – to be able to deal with such feelings about parents care.
Becoming Your Parent's Parent: Once we reach our 40's and 50's we begin to experience something we never expected and are largely unprepared for; we begin to become our parent's parent and assume the role of caregiver. By Rebecca Lippel, Greenwich Time