Taking Care of Yourself as Well as Your Parent
CARING FOR AGING PARENTS
by Raeann Berman and Bernard H. Shulman, M.D.
Some of us are ready for the caretaker role. Among unmarried women
and a smaller number of men who always lived at home, caring for
one’s parent is a natural outgrowth of the aging process. As
Mama gets older and can no longer be as physically active as before,
the child gradually takes on caretaker responsibilities. In other
families, in which all of the children have left home, there’s
often one sibling, married or single, who simply steps in and assumes
responsibility.
In a study conducted by Dr. Ursula Lehr for the Institut für
Gerontologie at the University of Heidelberg, “Elderly Daughters
Caring for Their Old Parents,” researchers studied one hundred
daughters of middle-class German families. These women ranged in
age from 55 to 70 and were caring for parents or parents-in-law between
78 and 98 years of age. Nearly 60 percent were married; the rest
were single.
This study, and many others conducted by the Institut in the past
ten years, bears out that “family care is daughter care” and
that very often the aging daughter has to take over the care of parents
at an age at which she would have her last chance of reentering the
labor force or taking over extra-familial roles in social organizations,
political organizations, church, community, etc. These extra-familial
roles would extend her own life-space and offer her the stimulation
necessary for her mental development and psycho-physical well-being
in old age.
These daughters fell into two distinct groups: those who were coping
well and those who were experiencing conflict and stress.
The ones who coped (roughly half of the women studied) were able
to fulfill their own needs, to develop their own interests, and were
ready to assert their interests to their parents. They had put the
parent into perspective—as an important variable in their lives,
but not the most important. They also felt free to ask other family
members, friends, and neighbors to spell them so they could get out
of the house and pursue their own paths.
The other 50 percent of the women in the study were exhausted and
defeated by trying to cope single-handedly. They reported feeling
stressed by the restriction of their freedom and lack of time to
take vacations or pursue a hobby.
Researchers also discovered that coping families were those in which
the aging parent added her efforts to running the household. When
the daughter encouraged the mother to take responsibility and fulfill
some functions, the relationship was smoother. Trouble reared its
head when the daughter “took over” and treated the mother
as another child in the home. We’ve already discussed how shut
off and useless the older person without a role tends to feel. When
a care taking child includes Mom or Dad in family life, no matter
how limited in capacity, he or she still has a place. A parent confined
to a wheelchair can still help make a salad for dinner, handle the
family sewing, or fix a lamp cord.
The Sacrificial Daughter—It’s a Lonely Job
In one extended farm family, the younger daughter moved back home
after an early widowhood. Although there are nine brothers and sisters,
she virtually handles the care of her aged father single-handedly.
She accepts this role because she truly is a gifted caretaker. She
cheerfully says, “I was a frustrated nurse, I think. I loved
feeling useful, and when my kids grew up, I was always finding someone
in the church who needed help. I’m doing an important job taking
care of Pa, and I know he needs me. But I’m always tired!”
These unsung, under appreciated caretakers are often burdened unfairly.
Frequently, there’s a “let my sister do it” attitude
among the siblings. And the caretaker feeds into that by not asking
for assistance. The burden of caring for an aging relative needs
to be shared.
How to Get Help from Your Siblings
Involve everyone in the family. Of course, they’re
all busy and can only spare Mother an hour’s visit on Sunday.
And, of course, they feel you’re doing such a great job that
they wouldn’t “dare interfere” with the way you’re
running the show. These are both excellent dodges to keep you tied
to the job while they deny the reality of the situation. You must
express your exhaustion and need to get away. You can always remind
them, “If I get sick, I’ll have to send Mother to your
house.”
Demand some time for yourself, and keep after them until you work
out an arrangement. Even the busiest executive can spare one evening
a week to sit with his parent. Try to keep in mind the following:
You’re not asking for something unreasonable. It’s
only right and fair that each of the siblings takes some responsibility
in a parent’s care.
You’re not the only one in the family who can do the
job. Don’t be taken in by remarks such as: “Rosemary
is the only one of us who can handle Mother. She’s just a
wonder. I can’t handle it myself. I just fall apart.” This
is one of the oldest family tricks known to excuse laying the burden
on the “sacrificer” of the family. Of course your brothers
and sisters care about you, but if you don’t make noises
about needing help, they’ll let you carry on alone.
Sit down with your siblings and work out the financial arrangements if
you have not already done so. If your mother or father cannot be
left alone, then ask family members to contribute to the cost of
a practical nurse or sitter for those times when you need to go out.
After all, if you weren’t the “resident caregiver,” they’d
have to pay a great deal more than the cost of an occasional substitute.
If you intend to be the primary caregiver for the rest of your parent’s
life, you’ll need your physical and emotional strength. The
only way you can continue without feeling beaten down is by taking
care of yourself. You’re entitled to your own physical and
emotional health—you deserve it!
As soon as you get additional help, continue with the activities
you’ve always enjoyed. Or develop new hobbies or take a part-time
job that brings you satisfaction and the opportunity of being with
other people.
To cope effectively, you must be realistic. Accept the fact that
you can’t handle this alone, no matter how much love and understanding
you have to give. You need help, and you need to feel free to ask
for it. There is no reason to feel guilty. You can be a better daughter
or son when you realize your own limits.
Getting Help When You’re Caring for a Parent Who’s
Confused
In a recent study conducted by the Department of Psychiatry and
Behavioral Sciences at the Johns Hopkins University School of Medicine,
fifty-five caregivers of patients with dementia talked about their
feelings. The majority (forty-eight out of fifty-five) said they
felt sad, angry, frustrated, depressed, and tired most of the time.
And over half of the respondents had given up their friends, jobs,
or meaningful volunteer work.
Caring for a parent with reduced cognitive ability is hard; it takes
its toll on the family. Typically, the burden falls to one member
of the family—often a daughter. Other family members may criticize
her efforts, but they generally offer minimal support. “You
handle it” is the phrase most often heard by these brave souls.
As one unmarried daughter of an 80-year-old mother with Alzheimer’s
puts it, “I love my mother and I want to help her, but I wish
my brothers and sisters would pitch in. They don’t seem to
realize that I’d like to go to a play or out to dinner with
friends once in a while.”
In the Johns Hopkins study and others like it, the key factor in
successfully dealing with the cognitively impaired parent is social
support. Fortunately, with the “graying of America” we’re
beginning to look at this type of care giving and the enormous strains
it puts on families. There are social agencies and hospital programs
that provide relief. In some communities, there are day care centers
where you can bring your parent for a full day of activities and
training in reality orientation by a professional staff of social
workers, recreation workers, and psychologists.
Others offer sitter services in your home. You can find information
on these and many other programs if you do some digging. Start with
your doctor, your local hospital, your local social service agency,
and your state mental health association. For information on this
and other issues of coping as a caregiver, a grass roots organization
called Children of Aging Parents (CAPS) can be an invaluable aid.
CAPS began as a local support service and has mushroomed into a national
resource for caregivers. To learn more, contact them at:
Children of Aging Parents (CAPS)
P.O. Box 167
Richboro, PA 18954
Toll free: 800-227-7294
Email: info@caps4caregivers.org
Website: www.caps4caregivers.org
For an overview and approximate costs of both help in the
home and at day care centers, contact:
American Association of Retired Persons (AARP)
601 E Street NW
Washington, DC 20049
Toll free: 888-OUR-AARP (888-687-2277)
Website: www.aarp.org
National Council on Aging
300 D Street, SW, Suite 801
Washington, DC 20024
Phone: 202-479-1200
Fax: 202-479-073 5
Email: info@ncoa.org
Website: www.ncoa.org
Why Ostriches Get Headaches Too
While it’s demanding and stressful to be a live-in or live-nearby
caregiver, adult children who live some distance away learn sooner
or later that they can run but they can’t hide from the problem.
Geraldine lives over one thousand miles away from her mother. Up
until now, she has managed to avoid thinking about Mom’s problems.
Two years ago, when her mother’s debilitating arthritis made
it impossible for her to carry on alone, Mom moved in with Gerry’s
sister in their hometown of Helena, Montana.
A “wunderkind,” Gerry sailed through college, married,
went to graduate school, had two children, divorced, got her PhD,
and married again. At the age of 47, she’s riding high—in
line for a full professorship in the English department of her respected,
small college in California. Her friends all say, “Gerry’s
on a fast track.”
Gerry is one of those women with energy to burn. She runs four miles
a day before classes and looks ten years younger than her actual
age.
But recently she has not been feeling her usual glowing self. Her
sister has been calling from the family home in Helena with distressing
messages: “Gerry, I need some help with Mom. Can you come some
weekend so we can talk about it? I have a bad back, and I just can’t
manage getting Mom in and out of the wheelchair. We have to consider
our next step.”
Gerry is annoyed and upset by her sister’s calls. Her mother
has taken to calling too, sometimes talking in a frightening, rambling
way. Gerry feels put-upon much of the time now. “What do they
want from me?” she asks her husband. “I send them money
every month as it is. My sister should find a good nursing home if
she can’t handle it.”
Gerry goes to her doctor one day, complaining of headaches and problems
with sleeping. After carefully investigating and ruling out other
causes, her doctor astounds her by telling her that she’s suffering
from what he refers to as “stress syndrome.” She, who
runs four miles a day, handles a demanding, competitive career and
a family, and looks great! Impossible!
Even at long distance, Gerry’s emotional responses to her
mother’s situation are taking their toll. She’s been “hiding
out” in Ca lifornia , effectively erecting a smokescreen of
busyness to avoid thinking about her mother, but her body has been
reacting to what’s really going on—Gerry’s concern
and guilt. The most dedicated ostrich eventually gets caught. The
plain facts of our parent’s aging and the way we respond have
a way of sneaking up on us.
Managing Your Stress
When you’re caring for an aging parent, you’re likely
to feel fatigued and depressed. You spend an afternoon with your
frail and ailing father and come home drained. Yet the other parts
of your life—your career, household, relationships with family
members and friends—still need your time and energy. The demands
pile up, and if you haven’t learned to control the situation,
your body gives you warning signals.
Racing pulse, headaches, stomach pains—these are sometimes
bodily reactions to psychological pressures. And because we live
in the modem world, we use the catch-all phrase “stress” to
explain our physical reactions.
What is stress? Dr. Hans Selye, who published his findings several
years ago, is still considered a world authority on stress. He determined
that vital functions such as blood flow and hormonal activity are
influenced by mental perceptions. We may not have to face the tiger
at the entrance to our cave as our primitive ancestors did, but we
have the same “fight or flight” response to demanding
situations. When animals (including us!) perceive a situation as
life threatening, their bodies get ready to do battle or run. Our
muscles tense. Our pulses race. We breathe rapidly and shallowly.
We sweat. We feel a cold, hard rock in the pit of our stomach. Our
hands and feet feel icy because the blood has rushed to our brain.
With no tigers to confront or escape, modem human beings react instead
to our twenty-first-century, high-stress equivalents: divorce, loss
of a loved one, job changes—and the pain, loss, bewilderment,
anxiety, and guilt we feel about an aging parent.
Dr. Selye described our physical responses as “General Adaptation
Syndrome.” Over the years, our body adapts to the “tiger
at the door.” The stress hormones gather themselves for action,
even when there is no need to fight or fly. Eventually, these mobilized
hormones cause wear and tear on our bodies and lower our resistance
to injury, infection, and disease. The result may be ulcers, high
blood pressure, heart disease, colitis, headaches, frequent colds,
and other infections.
Caring for an aging parent is a stressful job. you have all the
pressures and uncertainty of a fast-paced advertising office where
the client must be satisfied. Account executives and copywriters
never know where the next zinger is coming from. New crises are the
name of the game. In many ways, caregivers for elderly parents suffer
the same stresses.
But there are some specific things you can do that will help your
body deal with stress:
Eat properly. Make sure you get plenty of fruits,
vegetables, high-fiber cereals and grains, and two glasses of low-fat
milk or the equivalent every day. Cut down on fats, fried foods,
and processed foods that are loaded with sodium. Your daily intake
should be made up of lean meat, fish, or chicken/turkey without skin
or fat.
Make sure you drink six to eight glasses of water a day. The combination
of water and high-fiber cereal foods helps to move waste from your
body quickly and efficiently. You feel lighter and more energetic
when your digestive system is functioning smoothly.
Enjoy your food. Take time. If you’re in
the habit of bolting breakfast while reading the morning newspaper,
you may want to change. Pictures and stories of war, famine, random
shootings, and the other joyous news faithfully reported by our morning
newspapers do not go down well with food. Of course you want to be
informed, but try not to ingest your news with your cereal.
If you’re not exercising on a regular basis, now is
the time to begin. Your goal should be to select an exercise
that you genuinely like, one that makes you feel good, and one
that benefits your body and mind.
You hear a lot about aerobic exercise. If you’re not involved
with fitness, you may think all aerobic exercise is strenuous pushing,
straining, and gasping. Not so. Aerobic exercise is beneficial because
it carries oxygen to all your muscles, especially the heart. It’s
continuous activity, as opposed to spurt-like bursts of exertion
(e.g., shoveling snow) that can be harmful.
Brisk walking, running, swimming, bicycling—these are all
helpful aerobic exercises. To be effective, aerobic exercise must
be practiced for a minimum of twenty minutes, three times a week.
So if you live a hectic life, you can still fit in this minimum of
exercise.
Start out slowly. Let’s assume you’ve decided that brisk
walking fits your schedule and sounds like something you can handle
(given the shape you’re in right now). Buy a good pair of athletic
shoes, pick your walking site, and get started. Walk briskly, swing
your arms, and breathe regularly. If you’re exhausted after
ten minutes, stop. On your next try, you can push it to eleven minutes.
Later, to twelve. And so on.
After exercising, let your body cool down. Slow your brisk walk
to a gentle stroll. When you reach your door, stretch your legs,
arms, and torso. Take a shower if it’s possible.
One 55-year-old woman who’s responsible for the care of her
91-year-old mother says, “I’ve come to look forward to
my swimming times as fun. At first I gasped like a beached whale
after ten laps. Little by little, I increased my endurance. When
I swim I don’t worry about anything. There’s something
soothing about the regimen—sidestroke for ten, backstroke for
ten, crawl for ten, then start over. I don’t have to plan anything.
I don’t have to think about what I’m doing. I just get
into my program and stay with it for a half hour. It’s the
most mindless, relaxing thing I do.”
Take daily time for yourself. In addition to the
time you spend exercising, make sure you take a few minutes a day
to listen to music, call a friend, enjoy a new food, read a magazine—whatever
makes you feel pampered. If you’re a dedicated clotheshorse,
treat yourself to the latest copy of Vogue or Gentleman’s Quarterly.
If you’ve always wanted to learn how to make chocolate mousse,
find a recipe, buy the ingredients, and set aside time to try it.
Buy yourself a little present occasionally. This
can range from giving yourself a cup of cappuccino in a new cafe
to buying a cassette of a favorite song. It needn’t be expensive,
just something that lifts your spirits. Buying fresh flowers for
your office desk or your home qualifies as a present.
Try to laugh every day. Deep belly guffaws are
not only good for the soul—they relax tensed abdomen and chest
muscles. Laughing makes you feel “up,” at one with the
universe. And when you feel up and look happy, you’ll affect
others with your positive outlook. You need the support of your friends
and co-workers now, if only to remind you there’s an interesting
world out there that you’re still part of.
Check your community for a yoga or stress-reduction class. The
gentle stretching movements of yoga induce a healthy mental balance.
No matter how tied in knots we may be, a yoga class with a trained
instructor can work wonders on our stressed body. Stress reduction
classes have the same magical effect. While we practice deep breathing
and visualization of pleasant surroundings we can go to in our mind,
we are setting up healthy patterns of response. For further information
on yoga concepts and programs, contact:
American Yoga Association
P.O. Box 19986
Sarasota, FL 34276
Phone: 941-927-4977
Email: info@americanyogaassociation.org
Website: www.americanyogaassociation.org
Excerpted from Caring for Your Aging Parents by
Raeann Berman and Bernard H. Shulman, M.D. Copyright © 2005
by Raeann Berman and Bernard H. Shulman, M.D. All rights reserved.
Excerpted by arrangement with Champion Press, LTD. $16. Available
in local bookstores or call 877.250.3354 or click
here.
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