With 80 percent of middle-aged couples having at least one living parent, the “Sandwiched Generation” is learning to adjust to the reversing roles of child and parent – to confront the demands of caring for those who once took care of them. In other instances, spouses are faced with situations in which they become the primary caregiver for their partner. In all such cases, difficult personal adjustments often must be made.
People over the age of 85 comprise the fastest-growing population group in our country; and the prevalence of disability in this group is 51 percent. When an older family member needs help, most people face a conflict between their desire to provide assistance to their relative and the many other commitments crowding their lives. Figuring out how to balance loyalty to their relative with these other demands is not easy. One of the most common pitfalls is to end up doing a dance between guilt and resentment.
The situation begins when caregivers try to give too much time to their older relative. When they get tired of this, they feel resentful. Reacting to this resentment, caregivers cut back on what they are giving. They hold to the limit for a while, but soon start to feel guilty about all that they are not doing on behalf of their relative. The guilt then drives them back into giving too much. This shift 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.
The first and most important concept in resolving the problem is to understand that no one wants to be a burden to others. Caregivers best express dedication to an older relative by finding ways to help that do not burden their lives. When they stop giving too much, they may be able to enjoy spending rime with their relative. Being enjoyed means more to an isolated or ill person than any number of obligatory phone calls and visits. Next, caregivers must realize that they cannot take away a relative’s loneliness, no matter how many times they phone, visit or go on outings together.
Separation from lifelong friends and the loss of meaningful activities are consequences of aging that caregivers cannot rectify. It helps to recognize the unavoidable truth that the hours of companionship they provide for their relative go quickly and the empty hours still pass slowly.
Another helpful notion is that a rested caregiver can be a good caregiver and an exhausted caregiver is no good for anyone. Lacking this insight, many people feel that to go on enjoying life while their relative is confined to home is contrary to the meaning of dedication. They deprive themselves of out- of-home activities and personal pleasures. But such deprivations actually become detrimental to their health and detract from their ability to provide good care over the long run. A direct method for stopping the dance between guilt and resentment is to understand the three concepts outlined above:
- no one wants to be a burden;
- family members cannot take away a relative’s loneliness; and
- a rested caregiver is a good caregiver. With this understanding as a basis, the caregiver can begin a new dance by setting realistic limits, by accepting help and by learning how to rest.
Setting limits requires respectful honesty Any change in long-standing routines should be accompanied by an 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 less irritable with you all week if I do this.” Acknowledging that the change will be hard for their relative is the essence of respect, as is describing the benefits that will accrue for the caregiver once the change is made.
Accepting help may be experienced as an admission of weakness or failure, rather than the strength that it becomes when it is put into practice. Some caregivers insist that no one else can take care of their relative like they can. Any help is perceived as intrusive or deficient. Caregivers caught in such binds often need to jolt themselves into tending to their own needs by asking themselves, “What will happen to Mom if I keep on going like this, working until I drop?” An exhausted caregiver isn’t good for anyone.
Leaving a relative with a substitute caregiver from time to time is essential, yet many people find this difficult. When their relative protests at being left behind, they cancel their plans out of guilt. A better response in such instances is the truth: “Mom, I know you hate being left with a stranger, but I’ve got to get out or I’ll be too grumpy with you.”
Learning how to rest effectively is an individual matter. No two people relax in the same way. Taking a long walk, spending time with a sympathetic friend or playing bridge may provide a break from the daily reality of caregiving. Some people find that regularly attending a caregiver support group reduces their guilt and resentment more than anything else. Even when a weary caregiver is unable to leave the home, watching a sunset, talking on the phone or taking a short nap may be energizing. Such pleasures can revive a caregiver for the days ahead.
Out-of-town vacations are particularly valuable for boosting a caregiver’s morale, but few ever carry out such plans. Most are stymied by worry that something might happen while they are gone. The question, “What is the worst possible thing that can happen while I’m away?” may inspire practical steps, such as discussing emergency plans with substitute helpers and preparing a notebook listing critical phone numbers, medications and daily routines. Testing out short vacations, such as weekends away, may help caregivers realize that they can gain more patience and enthusiasm for the care by spending a little time away.
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 selfsacrifice and deciding to spend time only if it can be given freely. It is better to do less for someone and look forward to calling or visiting than to engage in the dance of guilt and resentment.
By Wendy Lustbader and Nancy Hooyman