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Taking a vacation from caregiving: Part 1

by Carol Bradley Bursack, Editor-in-Chief

Caregiving is, by nature, emotional. When loved ones need our care, it's generally because their health is beginning to fail. As this happens, giving care can become a full-time occupation, mentally if not physically. If we decide that we need a break from the pressures of 24/7 caregiving, we often suffer emotional separation anxiety, headed by guilt. How do we cope with our emotions well enough to actually enjoy the vacation we've chosen to take?

If there is one emotion that nearly all dedicated caregivers have in common, it's guilt. We feel guilty for not giving enough when we've given all we can; we feel guilty for not being able to make someone well, when no one can do that; we feel guilty if our loved one isn't happy all the time; we feel guilty if we do something fun for ourselves. However, if we are there - right there all of the time - we have a better chance of feeling that we are doing ""okay."" If we take a vacation, we suffer more guilt, because we know our being gone will affect our elders, and also bring on a type of separation anxiety in ourselves.

Cope with Guilty Feelings, Then Do It Anyway

Planning a vacation, and actually enjoying it, will mean coping with your own guilty feelings and coming to peace with the fact that there are others who can fill in while you are gone. Often, this means hiring in-home care agencies, if you are doing home care, or even using assisted living. Nursing homes, of course, are already staffed, so that is a matter of trusting the staff with your loved one.

Making a vacation from caregiving happen will probably take a real push on your part. You may have to make a focused effort to take this step, as your own excuses as to why you can't take time for yourself could overwhelm your desire, and need, for a break.

You may want to work through the feelings, rather than stuffing them down, because unexpressed emotions have a way of working their way out at inopportune times, say in the middle of your romantic dinner on a cruise.

Support groups are a good way to work this through, if you can get to one. If you can't get away enough for a support group meeting, the Web abounds with online forums and support sites. You can do both, for that matter. Either way, I'd suggest that you make a list of concerns you have about leaving your loved one temporarily in the hands of others. Make it as detailed as you choose, and feel free to be over the top with your worries. Then, use this list when you address your worries with a group or with a caregiving friend.

Here's a sample list:

  1. Dad will miss me, and forget where I went. He'll feel abandoned.
  2. Mom will tell me repeatedly that no one can understand her needs except me, and she'll feel unloved.
  3. There will be a devastating hurricane and I won't be there to help my parents (even though they live in Ohio).
  4. The nursing home staff that has cared for my spouse or parent for five years will suddenly become abusive if I'm not there every day.
  5. Dad will have another stroke and die before I can return.

How to Handle Guilty Feelings

Now, take each of the unique items you listed, and tell another caregiver about it (or a therapist). Talk through each item until you've come to a place where you can separate real concerns for generalized fear of change. Then, look for solutions. We'll take the list above:

  1. Dad will miss me and forget where I went. He'll feel abandoned. Depending on Dad's cognitive ability, he may or may not miss you, as in he may or may not be cognitively aware that you are gone. If he is cognitively able to track time, he will notice you haven't been around. He may or may not remember you told him you'd be gone for several days, but he may wonder where you've been. The solution here is to make sure the caregiver in charge has an answer for him that will make sense to him if he asks for you. Also, you can leave written notes or pictures that may remind him of you. When my Dad was quarantined from visitors because of a flu epidemic in our community, I dropped off notes for dad at the nursing home each day, written in big black print he could see. The notes reminded him about the reason I wasn't there, and that I'd be back soon. That did help. You could do the same, only leave them for a caregiver to give to your loved one each day.
  2. Mom will tell me repeatedly that no one can understand her needs except me, and she'll feel unloved. Mom may be consciously controlling you here, or she may just feel so dependent she doesn't understand any needs but her own. Either way, you can reassure her that you have made arrangements for her care, and that you will soon be back. Be kind and loving, but tell her all is well. Then take your vacation. She'll get over it.
  3. There will be a devastating hurricane and I won't be there to help my parents (even though they live in Ohio). This is, of course, your caregiver guilt in overdrive. You are getting that feeling that no one can do everything you do for your loved ones the way you do, therefore you must be there to do it. I've been there. I know. Take your caregiver ego and give it a talking to. While your loved one prefers your constant presence, others can care for him or her for awhile and the world won't end.
  4. The nursing home staff that has cared for my spouse or parent for five years will suddenly become abusive if I'm not there every day. Time for a reality check. If you know the home and staff well, and you have no reason to believe that they are pulling something over on you now, their behavior is not likely to change in your absence. Besides, you can have other's look in on your loved one, just to make sure all is well.
  5. Dad will have another stroke and die before I can return. This can happen. He could also die while you are home getting some sleep. Or, you could die due to your own health issues. Make sure everything is in place, and then take your vacation. Obviously, if someone is in the process of dying, you would not go. Otherwise you can. There are never guarantees and if you wait for the perfect time, you won't ever go.

Finding Substitute Care is Primary to Relieving Guilty Emotions

None on the above steps will work unless you've got substitute care in place. In-home care is a very good answer if you are caring for someone at home. Nursing home staff is already in place if your loved one is in a home, so you can set up your schedule with them. The same goes for assisted living staff, only you may want to hire an in-home company to supplement your care at the assisted living facility. Any way you look at it, unless you have family members or friends to substitute for you, you'll need to get help, likely from an agency. Have a trial period, if new people are involved, so you can be sure everyone is on board and that they know your loved one as an individual. Then go, guilt free. You've done your best, so you have to let the rest handle itself. Refresh yourself with a break and you'll likely come back with more enthusiasm for your caregiving role.