Good Grief!

Baby Boomers are increasingly finding themselves in the role of care giver for aging parents, spouses and sometimes other relatives and friends.  While the tasks of this role may vary, depending on the situation, there are some elements in common.  One is to understand and to cope with grief.

When a death occurs we expect that we will grieve.  We may even be familiar with the stages of grief, which were originally outlined in the pioneering work of Elizabeth Kubler Ross.  Those stages are Shock and Denial, Bargaining, Anger, Depression and Acceptance.  There are some variations of these basic five which since have been added by therapists working with death and dying.

Individuals go through these stages in their own way and time, sometimes returning to a stage they have experienced earlier, sometimes not.  As you might guess there are no hard and fast rules to the process.

Last night in the wee small hours of the morning, when I was lying awake (don’t you just hate when that happens?  I sure do!) it occurred to me that the thing that makes this even more complicated for care givers is that there are two parallel but separate grief processes going on.

The person who is in declining health or circumstances, feeling ill or exhausted, is losing independence, as well as possibly their home and familiar surroundings and routines.  In addition they may have a loss of career or income which adds to their anxiety.  They will be grieving these losses, and possibly facing the end of life.

The care giver has their own stresses of providing support and help while juggling the ongoing demands of their own life.  Most Baby Boomers are employed or running businesses, maintaining family relationships, sometimes still supporting older children and often helping to care for grandchildren.  And personality differences and old relationship issues inevitably get amplified by the stress that both are experiencing.

To complicate things further, the caregiver will at some point begin his or her own grief process.  After all you may be facing the loss of someone dear to you. And it is emotionally distressing to see them suffer. Being aware of it helps of course, but often that’s not the case.  Caught up in daily demands, you might not realize that grief is playing a part in what is going on. 

The care giver may be in denial, or bargaining.  She may be feeling angry and not seeing that the source of it may be her grief.  Depression may be passed off as a result of all the stress.  And the demands of providing care may make it more difficult to get to Acceptance.  Of course the folks involved in this are not likely going through the stages at the same time.

Here are some suggestions for those who find themselves in such a situation.

  • Carve out a little quiet time.  Even 10 minutes helps. Unplug from all your electronic devices including cell phone and the computer. Sit in a comfortable place, take 5 deep breaths and relax your body.  Just sit and soak up the silence.
  • Listen to your thoughts and dreams.  Take 20 minutes in the morning to do some unedited speed writing in your journal.
  • At the end of the day write a list of what you are grateful for and don’t forget to include some appreciation of yourself.
  • Do a little reading about grief and see if you can identify where you are in the process.
  • Find a listening ear and share your feelings and express your needs if you are aware of them.
  • Arrange for respite care for the person you are providing care for.  There are lots of options for this depending on the situation.  It may entail asking other relatives or friends to fill in for you so that you can get a break.  Or if there are medical concerns the doctor’s office or Area Agency on Aging may point you in the right direction for some support.
  • Make a point to take good care of your nutritional needs.  Drink lots of water, go for a walk and arrange for the best sleeping conditions you can. Take the TV out of your bedroom.  Go to bed on time.
  • This might be a great time to get a massage, see an acupuncturist or learn to meditate.  Meditation in particular is amazingly helpful.  Keep it simple and you can do it.
  • Make use of EFT or Meridian Tapping to discharge the tension that comes up with difficult emotions. It is very helpful in clearing the way for effective decision making.
  • Remember that this might be a marathon and not a sprint.  Treat yourself accordingly.

Most of all, good grief requires us to pay attention to our inner life and nurture ourselves.  This is a challenge when the outer life is especially demanding, as it is for care givers.  Know that it will pay off in sustaining yourself, keeping you energized and eventually helping you move to acceptance and then recovery.

Help for the Caregivers

Last evening I was listening to a friend who is feeling overwhelmed, frustrated and exhausted by the increasing demands on her time and attention in caring for her father.  He is still living in his home and is experiencing increasing problems due to a long-term chronic lung condition.  My friend is an only child and now that her step-mother is deceased, is really the only living relative to care for her dad.

She has a routine schedule for visiting him and doing the household tasks that he is no longer able to do.  Grocery shopping, cleaning, meal preparation and laundry are taking up more of her time, as well as driving him to medical appointments.  Recently she has noticed that he is bathing and changing his clothes less often because of his breathing problems.

Some friends have invited her to an annual trip to the beach, but she is doubtful that she should go out of concern for her dad.  Will he be safe on his own?  Would he be able to get help if he had an attack?  His mind is clear, but he has been unwilling to ask for help or accept help from anyone other than his daughter.  He has always been a proud, independent man and he has objected to her suggestions that he hire a housekeeper for instance.

After some brain storming with a group of friends, this is what we came up with:

  • Contact the Area Agency on Aging, a federally funded program that serves the needs of the elderly, the disabled and their caregivers  assisting them to age in place, or stay in their own homes as long as possible.  With an intake, my friend and her father can get a list of services he qualifies for, information about approved agencies and what any costs may be.
  • Since my friend has medical and legal power of attorney, and permission to speak with her dad’s physician, she will make an appointment to discuss her concerns about his increasing difficulties as he does activities of daily living, and see what the doctor recommends and might authorize as medical support through Medicare.
  • Get an electronic alert device for her dad to wear so that he can press a button and get immediate help in case he falls or has a breathing crisis when he is alone.  The agency that provides service for the device will check to see if an ambulance needs to be called, and will also call his daughter.
  • Talk with her dad and explain that getting help with the household will not only benefit him, but her as well.  If he is reluctant to have someone come in to clean and do laundry, he will likely accept it more readily in order to help her out.  She thinks that he may accept more help if it means that he can stay in his own house, which is very important to him.  She will need to be very assertive and direct about her own exhaustion and need for relief from the workload of maintaining her household as well as his, and maintain her work at her job.  Hopefully the doctor will support her in laying out the options for her dad.
  • My friend needs to schedule regular time off for herself.  She agreed to take advantage of a yoga class that she can access with her gym membership.  Getting exercise, practicing relaxation techniques such as deep breathing and meditation will give her some stress relief and help her maintain her own health.  After all, if she collapses and gets sick, both of them will be in trouble.  She also admitted that she is like her father in being the stalwart martyr and not asking for help and support when she needs it.  She made a pact with her circle of friends to call them when she wants company or needs to vent or have an afternoon doing something fun.  I have a feeling that they are going to hold her to it.

I was thinking of the frequently used quote by Hillary Clinton, who said that it takes a village to raise a child.  Often it is also true that caring for the elderly takes a village, and that establishing that village is a life saver for the caregivers.

A Word to the Caregivers

“Pray and move your feet.”
~Quaker saying~

No doubt it’s a function of my age and the generation I am a part of, that I have been thinking a lot lately about a challenge that many Baby Boomers are facing.  We are called the “Sandwich Generation” because many of us are still supporting and launching our children into adult life while at the same time taking on responsibilities for supporting and caring for our aging parents.

Just as my siblings and I are more intensively involved in caring for our 93 year old mother, who has been able to remain living in her home, I am hearing from friends and clients that they are also occupied with the various tasks of care giving.  The practical day-to-day aspects of keeping an elderly person healthy and safe mean a lot of decision making.  And in addition, the emotional challenges of this huge task have to be handled too.

As I thought about all this it occurred to me that it is a new category for the blog that I would like to address.  Care giving certainly constitutes a life change, although not necessarily one that we chose or even anticipated.  How we handle the challenges can be a learning experience in more ways than one.  And as in any other life stage, the choices we make will either contribute to our growth and maturity or if we choose to avoid and ignore it, we will deal with the consequences of that too.   

While I have not done a formal survey, here are some of the issues and questions that have come from my own experience as well as those of others:

  • How do you handle the role reversal of now being the adult to an aging parent who is less capable and more vulnerable?
  • What do you do about the legal and medical complexities of an elder’s care?
  • What do you do about old sibling conflicts that arise during this process?
  • How do you cope if your siblings refuse to help or get involved?
  • How can you cope with the increased burden of care as your time, energy and financial resources may be impacted?
  • How can you support your parent as they deal with this change when it means less independence and possibly worsening health conditions?  And how can you get support in coping with the stresses of change for yourself?
  • Where can you find reliable and high quality help for everything from solid legal, financial and medical advice to home health aides or nursing care?
  • Is it possible to keep care giving from taking over your entire life?
  • How can I take care of my parent and still stay healthy myself?
  • How can I set healthy boundaries for myself and not look like an unfeeling jerk?  My parent can be demanding or the situation is demanding in itself, and I’m afraid of being swallowed up.
  • How do I deal with age-old conflicts that may come up as I care for my aging parent?  He or she wasn’t the ideal parent and I still have issues with some of the things that happened when I was growing up!
  • This experience is making me think about my own aging and health and I’m feeling scared about my own vulnerabilities.   
  • I’m feeling scared and sad about my parent’s condition and eventual death.

This is not an exhaustive list, but one that will give us lots to explore and ponder.  As with any category or topic of the blog, I hope to shed some light on the questions and provide some resources and tools for you to consider.  I would love to hear any additional questions or comments that you would like to have addressed.  And please leave your comments about your own experiences so that we may all benefit.