Caring for a loved one who is ill or elderly and needs support can be incredibly challenging. However, it’s a challenge millions of Americans face each year.
According to a report by the National Alliance for Caregiving and AARP, more than 34 million people in the U.S. provide unpaid care for someone over 50 each year. One in four of those caregivers do so more than 40 hours each week.
Caregivers perform a variety of tasks. Some focus on handling finances and medical and insurance matters, providing transportation, and managing the household, while others provide very personal care, such as bathing, feeding, dressing, toileting and acting as a companion. Some caregivers do it all.
In the best of circumstances, this can be very trying. Caregiving often requires time away from jobs, family, other responsibilities and social activities. It can lead a caregiver to experience emotional, mental and physical health problems.
How family dynamics affect your ability to provide care
In circumstances where familial relations may be strained or where there is a history of abuse or neglect, the challenges that come with caregiving may seem insurmountable.
“The stresses and strains related to family dynamics and how they can affect caregiving is not often discussed,” says Colleen Linnertz, LMFT, a bereavement counselor and advanced care planning coach with Sharp HospiceCare. “Even though caregiving takes time away from work and family and the other roles we play, we often feel like we don’t have a choice, but it does not have to be a black and white scenario.”
Caregivers who may have previously experienced abuse by the family member they’re caring for — and may continue to experience abuse — will often report that they do not want to provide care, but feel guilt, societal pressure, and hope that a relationship might be repaired or that love once denied can be earned through their care. Some do not have the financial or other resources to remove themselves from the responsibility of caregiving.
Tips on caregiving amid conflict
Linnertz says that open discussion is paramount. Your past relationship, current relationship, time constraints, financial concerns — anything and everything related to your role as a caregiver — should be discussed with all involved. It is also important for caregivers to have others they can talk to about their role as a caregiver, whether it be a partner, friend, religious leader or professional therapist.
She recommends these additional six tips for caregiving when there may be conflict:
- Try to understand the reasons behind behaviors. Along with physical pain, some people may feel elevated anger and fear when ill or experiencing age-related memory lapses or dementia, which can cause them to lash out verbally or physically. Lifelong or new mental illness may also factor into negative behavior and can worsen with age or illness. Treatments, including medications, can help and may need to be adjusted over time.
- Learn how to set boundaries. You can offer compassionate care while also expressing that you won’t tolerate abuse. Discuss consequences, such as hiring in-home care services, for abusive or disrespectful behavior and follow through when appropriate. Don’t allow yourself to fall back into negative patterns of arguments and anger — stay calm and speak in short, simple statements to reinforce the agreed-upon boundaries.
- Seize the opportunity for forgiveness. Try to focus on the present, rather than the past, and meet your loved one in a place of compassion rather than judgement or resentment. You cannot change what happened in the past, but you can accept the current situation and choose to approach it with a positive attitude and open heart.
- Seek support. You are not alone; family, friends and professionals can help. Learn about resources in the community, such as caregiver support groups or respite care, and find ways to take breaks and rejuvenate. Even a walk around the block can allow you an opportunity to breathe and center yourself enough to continue providing care.
- Be kind to yourself. It is very natural to experience feelings of doubt, resentment, helplessness and grief when caring for another. Try to focus on the good that you are doing and feel confident that you are doing enough. It’s also important to acknowledge that you, too, are hurting and must take care of your own health and well-being.
- Recognize that change and decline will likely continue. Your job is not to heal your loved one, but to be present and offer care to the best of your ability. In illness, there is much change and with change can come intensified emotions and behaviors. Educate yourself about what to expect, what some behaviors might signify and what resources are available to you if needed. Amplified aggression, increased falls, loss of coordination and lack of appetite may indicate that your loved one may be ready for a higher level of care.
When caregiving might not be constructive
If these tips and added support do not relieve some of your caregiving-related stress or your relationship further deteriorates, it is important to recognize that there are legitimate reasons to step away from the caregiver role. It is vital to be able to recognize your personal limits as well as the needs of the person requiring care. This is especially true if a traumatic or abusive history clouds a caregiver’s judgement and they cannot provide compassionate care or may even feel compelled to return abuse.
“There is a time when caregiving may not be possible if the dynamics are irreparable,” Linnertz says. “It’s OK to recognize that you shouldn’t be in the caregiver role — or, at least, alone in that role. You have to be willing to discuss your concerns and solicit support from the resources and people around you.”