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When your caregiving best isn't enough

by Sue Lanza

Daily screaming and yelling at each other. Slamming down phones and refusing to speak to each other until "you" apologize. Experiencing the cold freeze-out of being judged from afar while you struggle to get through every day. I must be talking about teenagers, right? Been there, done that too. No, some would argue that this is even worse. This is the battle of the family caregivers: others doing less than you but telling you that you aren't doing enough. Other than run off to another country, what can you do to cope with this familiar part of the care giving journey?

Is your guilt button stuck in the "play" position? Are you feeling that you are doing the bulk of the family care giving for your loved one but you have a peanut gallery of critics grading your every move? If you nodded yes, you are definitely not alone and the need for sharing this dilemma is critical to your survival as a caregiver.

The Care Giving Cycle

No one said any of this care giving business is easy, particularly when it involves carrying for your aging parents or relatives. Studies show that often one family member, usually a daughter, is the "go-to" person for managing the care of the family member in need. The caregiving challenges can be large and unwieldy. You may be coordinating tasks such as shopping or assisting in hygiene activities such as toileting. All of these extra duties have been plopped on top of your normal busy life. You may have your own kids you are attempting to raise (remember those fun teenagers?) and a hectic career to juggle. Don't forget a spouse who wants attention and your own mental health to keep in balance. Next thing you know you are gripped in the care giving cycle.

Now add to that mix the bottled up tensions that every family has. Many families (my own included) can do well when you have short holiday visits and everyone behaves to get through the function. But things can unravel quickly when the stresses of the care giving become routine rather than occasional.

Tips on Coping with Criticized Care Giving

The most valuable tip, and the one that is hardest to do, is to try to avoid the situation in the first place. I know; easier said than done. Just like fights in a marriage often have familiar themes, the struggles among family caregivers are often about the big three: control/responsibility, money and time. If you are getting embroiled in conflict and are on the receiving end of disapproval, here are a few ideas on how to deal with it:

  1. Keep each other informed. Of course this sounds so simplistic but it is so frequently overlooked, especially when conflicts arise. Sometimes it feels easier to withhold a status report and not share because information is power. I remember a time when my mother was ill and one of my two brothers was temporarily not speaking to the other. No surprise, but I was the key care coordinator. In order to let the conflicted brother in on Mom's care details but to also maintain some boundaries (I wanted no part of their argument), I gave him updated voice mail messages on his home phone when I knew he was at work. When everyone is on the same page with direct conversations, emails or family meetings, there are fewer opportunities to bash another person.
  2. Unite over strengths and divide responsibilities. Okay, so your sister is always mad at you because "Mom gave you more money," and she lives further away. What strong points does she have that she can do despite being 2 hours away? You recall how organized she is so she becomes the one who is organizing the medical bills and checkbook. You've identified something positive and given her control plus responsibility for your Mom's care. How can she complain about you when you might judge her?
  3. Plan for the future NOW. Advanced care planning, also known as the tough decisions that some families must grapple with when a family member they are caring for is at the end of life, needs to be discussed right away. This is an unpleasant task but waiting will only make it harder, particularly if there is dissention in the group. For instance, your Dad does not have an advanced directive or living will that spells out how he would like his end-of-life issues to be handled. He now has advanced cancer and is not able to formulate his wishes any longer. Your sister thinks Dad's wishes would be to continue his life, under any conditions, no matter what. You and your brother feel that Dad expressed anxiety about being kept alive artificially. This is a distasteful discussion, but one that needs to happen early on to prevent division.
  4. Figure out the money. Talk about horrid chats; here is another one. You can avoid criticism from your relatives by having a frank discussion about the expenses in the beginning stages and then continuing the communication about the money by sending out a monthly email to the gang. I found that tedious but I would address envelopes to each of my brothers and keep them handy. Whenever I wrote a letter to the specialist's office or Mom's lawyer, I dropped a copy for them in the mail. I also cc'd them on every correspondence so they could be part of it.
  5. Forgive yourself. So you found out that you aren't perfect and maybe they did have the right to call you out on something. Contemplate it, feel it and then move on. You are too busy to spend time beating yourself up for being human.

Even with the best care giving plans, you may find yourself in battle mode with a family member and you know how much you've done. Say your piece calmly and go take a rest. You've earned it.