Emotional Tools Unique To A Family Member Caregiver

This is the second in a series on caregiving, provided by my friend Barbara Shaffer. Part One of the series can be found here.

Although being a caregiver can have its rewards, it can also be a draining job because of its myriad of responsibilities and stressors. For a family member who is the caregiver, the impact can be even greater because everything is more personal. It’s not just a job.

Depression and anxiety are common. If the caregiver did not have a choice about being in that role, especially if others in the family refused to help or be involved, the burdens can be harder to bear, the days even more lonely, and the resentment more potent. When a family member who is asked to help either fails to show up or fails to carry out the customary duties, the caregiver can experience intense feelings of frustration and even betrayal.

Examples of Family Caregiver Stress

Kim, the adult child who lived closest to her mother, would stay with her mother every weekend to make microwaveable meals for the week, as well as cleaning the apartment and cleaning up her mother. As her mother’s dementia progressed, Kim took a Family Leave from her job to live with her mother and care for her increasing needs, while also continuing to care for her own house and pets. When Family Leave ran out, she used her sick days, hoping she could put off the surgery she needed. One of her brothers, who visited occasionally, routinely threw out food he deemed inappropriate for his mother. This helpful brother also installed some really cool technology that Kim’s mother couldn’t possibly remember how to operate, leaving her without TV, her only entertainment and distraction, for several weeks.

Kim harbored resentment and guilt. Her resentment was due to her brothers’ lack of constructive involvement and encouragement and their “let Kim do it” attitude. And she was angry at her brother’s audacity to disrupt procedures she had put in place, because he thought he knew better. Guilt gnawed at her because she didn’t always want to care for her mother. She was exhausted. But shouldn’t she want to help her mother? And weren’t her brothers good men who had families to look after? The internal conflict between resentment and guilt further sapped Kim’s energy. When her mother died, Kim was haunted by regrets and feelings of inadequacy.

Annie struggled with depression and anger. Not having siblings or heathy relatives, she rented her house out and moved into her mother’s house permanently to care for her. Her mother’s increasing dementia caused her to wander, to be critical, to have episodes of rage, and to cry inconsolably about (deceased) friends and relatives who never came to visit any more, urging Annie to go out and look for them. Annie heard harsh, uncensored criticism of her weight and her teenage daughter, as well as delusional accusations about immorality and theft. In the face of that emotional and verbal mistreatment, she felt painful guilt about her impatience and anger.

Betty lost her self-confidence (and sometimes her temper) when her elderly aunt relentlessly criticized her, complained about the meals she ordered for delivery, and resisted going to doctor and treatment appointments. She shunned Betty’s offers to help with hygiene, budgeting, and bill-paying. Betty just couldn’t do anything right. Fearing what other family members would think of her if her aunt spoke negatively about her to them, she became anxious and sleepless. Betty was thankful she didn’t live with her aunt; weekly visits were hard enough.

Dealing With Both Grief And Relief As A Family Member

One of the hardest and most unique emotional tolls a caregiver family member may have to deal with is the simultaneous occurrence of grief and relief. Grief can come from the loss of the loved one, or from a long-term disappointing, conflictual relationship, or from the realization that some things will never be – dreams and plans unfulfilled, the future not shared with that one.

On the other hand, there’s relief, which seems so wrong to be feeling. Understandably, there’s relief from physical exhaustion and mental fatigue. There can be relief from a harsh relationship. There can also be relief from bearing witness to pain and suffering, the indignity of illness and death in a formerly robust loved one. It can be deeply confusing to feel both emotions strongly and wonder which one is the true one. Both, in fact, are true.

Ways To Provide Self-Care

A family member who is also a caregiver, and doesn’t get to go home at night to their “real world,” must be especially diligent about self-care because they are marinating day after day in a stressful, depleting situation.

Joining a support group, finding someone to talk to who will hear you out and won’t try to make you feel better fast, and keeping in touch with positive friends are all good ways to reduce the feelings of isolation and depletion. Journaling regularly is a more private way to offload burdensome emotions and thoughts.

A more targeted means of expression is to write an unsent letter to the care recipient or to other family members, expressing love and care; disappointment and anger; and/or resentment, regrets, and guilt.

A person of faith can engage in faith practices that are encouraging and comforting. Prayer can be particularly helpful. One of the most beneficial activities is keeping a gratitude journal because it requires the writer to notice daily blessings and positive things they might otherwise miss.

All these activities will help lighten the load a bit and increase the energy needed for the tasks at hand. Taking time to pursue them is a wise investment in the present and in the future.

Barbara W. Shaffer, PhD, is a licensed psychologist in private practice in Pennsylvania. She has more than 40 years of experience and has helped many people manage stress in their lives, including many caregivers.

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