The capacity to care is the thing that gives life its deepest significance and meaning. Pablo Casals, World-Renowned Cellist
Longer life expectancy means we are becoming a triple-decker sandwich generation, caring for kids or grandkids, helping aging parents as well as managing our own life and medical needs, while often times maintaining a two-income household. Overwhelming! Frequently, we become victims believing the only choice is to make it all work. Stress can be incredible when striving to please everyone and be that perfect caregiver. Elderly parent care can include: medical advocacy, managing financial affairs, shopping and household duties, transportation to personal care appointments and running errands. Sometimes moving a family member home is the best choice but can be daunting managing one’s own personal life and existing responsibilities/relationships. Caregiving can also include attending to ill or disabled children (young or adult) or grandparents assuming responsibility to care for grandkids when adult children are a two-income household. Wherever you may fit in the caregiving category, and whether you are single, married, employed or not, you are juggling care and responsibilities of another and may be placing all or part of your life on hold to make caregiving work. This article offers suggestions on how to survive the role of caregiving without ultimately sacrificing one’s own health and well-being.
“When done in the right way, caring for a loved one can bring pleasure—to both you, the caregiver, and to the person you’re caring for. Being calm and relaxed and taking the time each day to really connect with the person you’re caring for can release hormones that boost your mood, reduce stress, and trigger biological changes that improve your physical health. And it has the same effect on your loved one, too.” Family Caregiving, Helpguide.org
Every caregiver deserves a cushion to refresh mentally and physically. And, those being cared for need a cushion, too! Sometimes a misconstrued belief convinces both the caregiver and the care receiver it’s best to depend on maintaining status quo, care as always managed in the past. This idea can lead to guilty feelings, straining relationships and blocking the caregiver(s) from reaching out for help and delegating responsibilities.
“If the caregiver is worn down or frustrated or responding to guilt, they are not providing the very best care that they could to their loved one. Those emotions drag us down,” explains Deborah Ford, in practice with Agape Home Care in Williamsburg, Virginia. How to Set Boundaries as a Caregiver, Caring.com
Trying to tackle it all, being available 24/7, is an unrealistic sacrifice that ultimately works to everyone’s disadvantage. Establishing healthy boundaries does not require justification or approval from anyone other than what works best for the caregiver(s), the care receiver, and communicating when help is needed for cover. It’s important to encourage the care receiver to also participate in decision making, when feasible, engaging with suitable choices to build confidence. Although best intentions, family members hoarding choices/decisions can inadvertently lead the patient to survival in a vacuum of despair, isolated by limitations. And, experiencing life on the sidelines can be a fast path to depression. Below is a list of healthy boundaries to consider.
This seems obvious on the surface but you’d be surprised how many of us behave as if we must respond to every demand with an outpouring of our time and energy. I’ve noticed my own tendency to turn requests into objects of resentment because I immediately assume each one is a “should do.”….But then, rather than an email saying, “I can’t do that,” I wondered: what if I sent an email that said, “Here’s what I can do (instead).” The Five Lessons in Setting Boundaries That Every Caregiver Must Learn, Huffington Post
- Schedule your day(s) off. This could be one full day per week or more, if you are able. Being available 24/7 is not healthy for anyone.
- Triage requests received from the person needing care, medical staff and family members. Immediate responses are usually not necessary.
- Block time each day for caregiving, time for yourself, as well as time for others. Let friends and family know your schedule, such as…I’m available after 4PM. Maintaining your own social network is needed and healthy.
- Take urgent calls. Incoming doctor calls (set a unique ringtone) take priority and having to return them is not easy; navigating voicemail, long hold times and often playing phone tag. If others know in advance why you are taking a call, (in the middle of a meeting, family time/dinner, or social event) you won’t feel rude doing so and they will (hopefully) understand, without the need for justification.
- Phone calls, not anticipated, can go to voice-mail. It’s not necessary to pick up every incoming call. Messages will be on voicemail to respond, when you are able, by return call or perhaps sending a text or email.
- Say “no”. Your full availability before caregiving may not be feasible now. Accept this and others will, too. Overcommitting will eventually affect you, emotionally and physically.
- Sleep…be consistent with a schedule. Well rested will serve you well and provide needed patience, a caregiving requirement.
- Exercise… provides needed endorphins that clear the mind and reduce stress. A rigorous daily scheduled walk is just as good as a gym workout. Keep it up!
- Embrace that you are WORTHY to have boundaries. Don’t be tempted to justify downtime and don’t be swayed to do so based on a comparison of responsibilities. The Five Lessons in Setting Boundaries That Every Caregiver Must Learn, Huffington Post says that being is more important than doing. Resist the temptation to feel...“I’ve often felt that I need to do more in order to make up for something I feel is lacking in who I am. That if I do more that’ll help everyone get past the general concern they all must have about my worthiness.”
- Manage stress in ways that work best for you. Kaiser Permanente offers solid recommendations in this posted article…Stress Management.
Boundaries That Divide and Conquer
- Identify all caregiving needs and responsibilities.
- Identify what you are able to cover and what you can delegate.
- Identify suitable choices and tasks the care receiver can have ownership. Relieves the caregiver of some tasks and inspires the care receiver with an “I can” attitude.
- Match responsibilities to family members’ time and abilities and friends offering to help...medical advocate/coordinator, banking and bill paying, financial investments, home/real estate, grocery shopping and meal planning, transportation and general errands.
- Connect with local community resources.
Seek personal referrals to local community services. Often times medical groups work with social services who can offer resources for home care, transportation services (providing transport to and from errands and medical appointments) as well as to community centers for social interaction. Always check current reviews. Well rated a few years ago may not be well rated today. I’ve identified a few outdated resources while being a caregiver. Share findings, especially to the social worker to update printed resources. Offering such feedback is graciously welcomed! My favorite transportation resource is Get Up and Go through the Peninsula Jewish Community Center.
Time Saving Boundaries
- Mail order prescriptions is easy! Avoid driving to a pharmacy and long lines.
- Email medical staff for non-emergency medical communications through protected online healthcare portals. Email directly connects to medical staff and avoids long phone hold times and the need to leave lengthy voicemail messages. I have found emails are forwarded to covering medical personnel if the email recipient is out of office. Email is also ideal to include photos of suspicious skin issues, healing wounds or other pertinent health concerns.
- Request phone medical appointments instead of office visits, which can often suffice for follow-up exams. If needed, during the call, physician can suggest and schedule an office visit.
- Text message medical staff if permissible (HIPAA concerns), especially great when communicating with medical coordinators, physical therapists and occupational therapists managing appointments. Huge time saver!!
- Seek in-home nursing if offered by your medical group to avoid medical office visits for in-person routine follow-up checks.
- Refuse automatic appointment scheduling, if this does not work for you. It is frustrating to receive a notice about a follow-up office appointment that isn’t feasible and calling the medical office (HOLD time) is the only way to reschedule. An 8AM appointment for someone in their 80’s and your commute is an hour away? You can request another time!! I share from experience.
- Forward mail to avoid accumulation before you or a family member can get to the mailbox. This is also a time saver for the family member paying bills.
- Paperless, if feasible, for all bills and monthly statements. Considering online auto bill payment, too.
- Set up online ordering and delivery such as Amazon Prime Account for shopping, including groceries. Most grocery stores also provide online accounts and grocery delivery. HUGE time saver!!
- Use an online shared organizer, such as HUB, sharing calendars, lists, tasks, etc, with all those involved in caregiving duties, which prevents additional coordination/communications, overscheduling and efforts being duplicated.
- Use an online meal organizer for extended families, friends, church groups and neighbors who want to help and prepared meals are needed. Meal Train is a great online resource.
- Group text or email is ideal to communicate needs and updates to family sharing in caregiving. Text is best for urgent and brief notes. Email is ideal for lengthly updates and to file pertinent information in email folders for easy access, when needed.
- Use an online connection portal, such as Caring Bridge, to keep all family and friends up-to-date at the same time, when dealing with a chronic health journey.
- Be transparent with family members involved with caregiving. What one family may know the other may be seeking an answer. Avoid unnecessary duplication and communicate what you are working to solve/know… so everyone is aware.
It is far too easy for a caregiver(s) to neglect personal needs and existing relationships. Guard against feeling stressed and succumbing to a feeling of obligation and guilt, which can lead to unrealistic expectations. Be aware of extreme fatigue, which can skew reality when overshadowed by false perceptions, leading to bitterness and resentment damaging to relationships. Managing your emotional and physical needs, is, your responsibility. Establish boundaries to shape a healthy team instead of being or feeling like a solo act, wherever you may fit in the caregiving category. Find time to honestly assess what you can and cannot do. Reach out for help. Delegate where possible. Include the care receiver to cover suitable responsibilities, which will inspire and build confidence. Respect everyone’s time and contribution, including your own. We can all be effective caregivers and still live life joyfully. Communicating needs and seeking outside resources offers the opportunity to spend quality time with those in care. TRIAGE yourself! Be an effective caregiver and give yourself permission to take care of your needs, too.
- Family Caregiving, Helpguide.org
- How to Set Boundaries as a Caregiver, Caring.com
- The Five Lessons in Setting Boundaries That Every Caregiver Must Learn, Huffington Post
- Stress Management, Kaiser Permanente
- Get Up and Go through the Peninsula Jewish Community Center.
- The HUB, online tool to share calendars, lists, tasks, etc.
- Meal Train, online meal organizing website
- Caring Bridge, online communication portal for sharing chronic health journey updates
- 6 TIPS FOR CAREGIVERS TO SET REALISTIC BOUNDARIES AND EXPECTATIONS, DAILY CARING