Caregivers are allowed to cry

Caring for an aging relative involves physical, psychological, emotional and financial demands. It can be particularly challenging when the person has heavy hands-on needs, a difficult personality or mental impairment.

Caregivers may experience a variety of distressing emotions along the way. The most common ones are as follows.

Guilt - because, unlike their relative, they enjoy good health; they haven't, until now, been significantly involved in their relative's life; they have mixed feelings about being a caregiver; they sometimes lose patience with their relative; they made a promise that they would never place their relative in long-term care and they're not sure if they can keep it.

Resentment - because they have had to make sacrifices, such as giving up a job or leisure pursuits or letting other relationships slip; their relative has treated them badly in the past; their relative is demanding and critical and they don't feel appreciated; family members aren't pitching in; family members are critical of their care provision.

Frustration - due to the helplessness of being unable to reverse their relative's illness; personality differences between them and their relative; having to contend with "nuisance" behaviors, such as repetitive questioning and rummaging; being unable to reason with their cognitively impaired relative.

Anxiety and fear - stemming from safety concerns, such as falls or, if their relative has dementia, household accidents, wandering away from home or physical aggression; concerns about what the future holds in terms of their relative's disease progression and care needs and their own physical and mental health.

Loneliness - arising from social isolation; feeling no one understands what they are going through; having to do things alone that they used to do with their relative; being unable to relate to their relative in the usual ways due to changes in his cognition.

Sadness - because their relative is gradually losing his abilities and perhaps also his personality; joint plans for the future must go unrealized; they can't imagine life without their relative.

Anger - that their relative is ill or disabled; he is overly dependent; he refuses recommended equipment or community supports. Feelings of anger may be directed toward God, their relative, family members or health care providers, or may be generalized. Caregivers may also be angry at themselves for taking on the caregiving role or not being more assertive with their relative, family members or health care professionals.

While a certain degree of stress is inevitable, when left unchecked it can lead to burnout. Physical warning signs include fatigue, memory problems, sleep difficulties, significant weight loss or gain, frequent illness and development of chronic health problems.

Some emotional red flags are frequent crying, frequent irritation by small annoyances, difficulty controlling one's temper and feeling overwhelmed, inadequate or hopeless.

In severe cases, burnout can lead to abuse of the care receiver. This signals the need for immediate help.

Coping strategies

If you are a caregiver, read on for some strategies to help keep stress manageable.

Look after your health: eat nutritious meals, get adequate rest, exercise and schedule regular medical checkups.

Do something to give yourself a daily break - perhaps quietly enjoying a cup of tea, reading something uplifting, writing in a journal or listening to music.

Stay connected to your friends, your parish community and other supportive groups.

Focus on your relative's abilities, not disabilities, and the things you can still do together.

Acknowledge your relative's right to make decisions you disagree with (provided he is mentally capable).

Let go of past grievances. Seek counseling if necessary to help you move forward in your relationship with your relative.

Don't promise your relative you will never place him in long-term care because you don't know what the future holds.

Take things one day at a time. Be extra good to yourself on difficult days.

Remind yourself that you are doing your best and are only human. Give yourself permission to feel all emotions that surface.

Join a caregiver support group in the community or on the Internet.

Accept offers of help. Ask other family members to share the load and be specific about what you need.

Find out from your local office on aging about community support services and take full advantage of them.

Petsche is a clinical social worker and a freelance writer specializing in family life and eldercare issues.

© Arlington Catholic Herald 2009