Chapter 6: Caregiving: Taking Care of Elders

We need to learn to take as good care of our parents in their second childhood as they took of us in our parents in their second childhood as they took of us in our first childhood.

Entering into a caregiving relationship offers a valuable chance to reconnect with someone for whom you care deeply. But as this person ages and becomes more infirm and demanding with each passing day the relationship can become increasingly stressful and, at times, acrimonious. Also, ambivalent or unhappy feelings from the past can re-emerge and cause pain and bitterness, unless you work through them positively.

To sidestep an unpleasant situation and to ensure that you handle caregiving as successfully as possible, you should go in for a little thought, education and preplanning.

To start with, hold a family session when your parents are well. Talk about the future, and what they would like you to do for them in case they fall stick. Involve your brothers and sisters in the discussion and hold it in a positive atmosphere. Although talking about old age and impending debility can be uncomfortable, and disconcerting, this could be the most positive approach in the long run.

Consider covering the following areas:

• Division of labour: Decide who will do what - in an unambiguous manner - when your parents need help. If one relative lives close by and decides to be the primary caregiver, its crucial that the other siblings play a supportive role. One should also find answers to the following important queries: Who will give the primary caregiver a break when he or she needs it? Who will help financially? Who will lend a sympathetic ear when the primary caregiver feels overwhelmed?
• Money: To plan for the years ahead, you should know your parents financial resources. Such information helps you avoid the pitfalls of arranging for your parents to live beyond or below their means. If youre the main caregiver, decide well ahead of time if you want financial compensation for your efforts. This attitude might seem very commercial , but may actually help in the long run!
• Insurance: Make sure your parents have taken adequate medical insurance to cover their medical expenses.
• Living will: This document puts into writing what medical measures your family member does and doesnt want to be taken in the event of a terminal illness or condition.
• Power of attorney: This legal document allows a designated person to make specified legal and financial decisions if your parent or elderly relative becomes unable to manage his or her affairs.

Try to make your caregiving relationship as positive as possible, while, at the same time, being realistic. The relationship you had with your parent as a child doesnt disappear, and if you had a friendly, easygoing rapport with your mother or father when you were younger, its likely to continue. However, if the relationship was subject to stresses, they may re-emerge. Also remember that prominent personality traits tend to become exaggerated as both of you grow older.

Caring for an older adult is very different from caring for a child. With the passage of time older persons become more dependent on others, not less. On some days, the experience may feel like an emotional roller-coaster ride: you quickly move from pity and guilt to love and on to anger and frustration.

The following suggestions can help make you a better and more considerate caregiver:

• Encourage independence: If it takes your father 10 minutes to button his shirt, so be it. The Ill-do-it-for-you attitude leads to work overload (for you) as well as increasing dependence and low self-esteem on the older persons part.
• Set limits: A highly dependent parent can be demanding. You should know your limits and learn how to refuse requests politely but firmly. You could say: No, Im too tired to go to the store today. Well go tomorrow. A failure on this count can lead to resentment and a feeling of being ill-treated on the part of the caregiver.
• Make time for fun: Break the routine occasionally by inviting friends and other family members over to watch a funny movie or play cards. A little laughter and a bit of socialising can lift everyones spirits.
• Encourage your parents to remain active: Also, motivate them to take part in community activities so that they have additional sources of support, and are not totally dependent on you.
• Share the care: When your friends or relatives offer to help, accept it gladly and gratefully.
• Take a break: This aspect is critical. You could risk your own health if you persevere for long periods without a break. Get someone to fill in for you as often and as long as needed.
• Cancel guilt trips: Youre bound to experience anger and frustration, but dont let these feelings make you feel guilty, they are normal. Your parents most probably felt the same way about you when you used to give them a hard time as a child !
• Stay active: Even though you may feel limited as far as time and freedom are concerned, do your best to keep your interests in a club or hobby alive. These activities will continue to enrich your life when your caregiving responsibilities are over.

Being a caregiver does not mean that you have to give up your own rights! The following are included in a Caregivers Bill of Rights, as formulated by Dr. Virginia Flagg.

A caregiver has the right to:

• Honest communication with the patient, his/her friends, family, and other caregivers.
• Express opinions and suggestions when appropriate.
• Expect the patient to make as many decisions and put affairs in order as much as possible.
• Make reasonable requests of the patient.
• Take care of his/her own needs without guilt.
• Express emotions in front of the patient.
• Acknowledge his/her limitations and obtain assistance from outside resources.
• Continue maintaining relationships and activities outside the caregiving role.
• Not take responsibility for decisions and actions made by the patient.