When adult children live across state lines or have lucrative careers, choosing which adult child should care for Mom or Dad (or both) is likely to be decided by what is most convenient rather than who can do the best job.
Who Will Become the Caregiver?
When there are two or more adult children in a family, and one must take a role as primary caregiver for an aging parent, the choice is most likely to be based on convenience. It’s convenient for the grown kid(s) who aren’t going to be doing most of the work, that is. Typical excuses why caregiver duties fall to a particular family member:
It’s just more convenient – meaning no other sibling wants to do it.
- She works at home or doesn’t have a job outside the home, so she has the time to spare.
- He is the only one in the family financially able to support Mom or Dad.
- She has a spare room in the house.
- She lives close by, so it’ll be easy to move the ailing parent(s) in with her.
- She already lives close to the hospital in case of emergency.
- He has older kids that don’t require a lot of supervision or attention anymore.
- She has little kids at home, but they sleep a lot.
- He never spent much time with Dad, so it’ll give them a chance to get to know each other.
- She is divorced (single or widowed) and has no one to talk to. It’ll be good for her to have Mom around, someone she can take care of to occupy her time when she’s not at work.
- She just got married; she’ll need Mom around to show her how to do things.
- She is the best person for the job because she’s patient and has a wonderful personality.
Unfortunately, not every grown child who is “convenient” is also cut out to be a caregiver. The job of being a caregiver for an elderly person is just too demanding for some persons to manage. The decision for choosing which adult child should be Mom or Dad’s caregiver should be based on ability and not convenience. If none of the younger adults have the kind of attitude, intelligence, and skills it takes to be a full-time caregiver (or even part-time), then it may be best to pay an agency caregiver or consider residential placement.
Caregiving With Realistic Expectations
The issue of time and availability can be part of the challenge. Old relationship issues can also influence current opinions. And, the influence of in-laws may, or may not, be known. Mix all those factors together, and then take a half-step back and see what stands out.
Regardless of what some family members think about who should be doing what to care for Mom and Dad, it’s not always going to happen that way. For everyone, there are usually enough life issues to deal with in a day’s time without having to deal with what one or the other thinks another one in the family should be doing. So, from a practical, peace of mind perspective, family members can make it a little easier for one another if realistic expectations are the starting point.
Sharing Caregiving Duties
Realistically, the caregiver should expect brothers and sisters to do only what they can do. If they do more, it’s a bonus. That is, given their distances away from Mother and their various capabilities and inclinations, the caregiver should ask them to be involved in ways that are compatible with what they can actually do. For example, the brother who’s local might be willing to help with grocery shopping or seeing that the lawn is mowed. Sisters in far-away cities might be able to simply send notes to Mom from time-to-time. Some might be more inclined to send checks. The goal is to preserve family relationships in the best possible way for now, during the caregiving season, and beyond.
Crisis Mode and Caregiver Stress
When a family member falls ill, the caregiver (whether it is the well spouse, adult child, or parent) goes into crisis mode. Here’s how to recognize it:
- constantly suppressing or distracting oneself from negative feelings in order to cope with caregiving, or panicking and becoming non-functional, leaving the work to someone else;
- automatically and continually putting one’s own needs aside or on hold;
- dedicating everything one has to helping with the task at hand on a daily basis, even when the tasks are not emergencies;
- not thinking or planning long term, just dealing with what is happening in the moment;
- being constantly on guard for the next time the patient will need the caregiver;
- spending most days hovering around the patient and focusing on his or her every need.
- Family Caregivers Can Prevent Burnout by Switching out of Crisis Mode
Though operating in crisis mode is helpful in many situations, living this way over the long term puts caregivers at great risk of burnout and illness. If the goal in the household is achieving the best health possible, that should apply to everyone in the household, not just the patient. Caregivers must protect themselves from burnout to stay healthy. Caregivers can protect their own health by trying to be tuned in to when there is a crisis and when there is a lull, and to be flexible, shifting from crisis mode to a “new normal” mode of operating when each crisis is over.
Family Caregivers Need Support to Live a Normal Life
The normal operating mode is when one finds oneself:
- taking the time to listen to and process one’s own feelings, either through journal writing, confiding in a friend or counselor or attending a caregiver support group;
- paying attention to one’s own body and health needs, including exercising, eating right, seeing the doctor as needed, getting enough sleep;
- paying attention to one’s emotional, social, recreational and other needs and making plans to fit them in;
- allowing the patient to accomplish as much as he can by himself, identifying tasks that other people can be enlisted to help with;
- thinking about and planning for how life can still be satisfying;
- planning for future eventualities, putting crisis plans in place.
- While caregivers may not be able to do all of these things to the extent they did them before, incorporating even just a few of them can help reduce stress and improve caregiver health and peace in the household.
To the family caregiver, it may seem impossible to do these things while their family member is sick and guilt often sets in. However, making oneself sick too really does not help the care recipient.
Another Option- Nursing Home
Although placing a loved one in a nursing home may ensure more assistance with physical care, the staff often has a very limited view of the person for whom they are providing care. Family members often have a wealth of knowledge of how the elder once was and only wish that staff could see their loved one as the person they knew before dementia or chronic illness robbed him of his normal life, health, communication skills, and perhaps even personality.
Family and friends may wish to provide nursing home staff and roommate with a view into their loved one’s past through a variety of ways, including informal conversations, pictures and mementos, a message board, and more.
Help the Staff Understand Your Loved One Better
Many times family members and staff members see the same person in two very different ways. A resident who tends to wander into other residents’ rooms with linens may seem to have very unusual behavior until the staff realizes that she was a nursing assistant in her younger years. Learning that a depressed resident was married for 75 years to the same woman who recently died might encourage staff to be particularly mindful of an upcoming anniversary date.
Telling staff about a loved one’s past can provide them with a greater sense of who the person was before admission. Regular visits can provide an active dialogue between staff and family members. If visits are not possible, reminiscing letters to the loved ones might help staff get more acquainted if they are reading the letters to the senior.
If the elder is competent to make decisions, it is important to get consent for any information shared. If the person is not competent, family members should be mindful of what information they believe the person would have wanted to share with staff.
Many nursing homes have a bulletin board, and this could provide a great opportunity to display pictures of a family and friends and areas of interest to the aging parent. Labeling the pictures can help enhance the memory of the loved one as well as giving staff additional information. Other mementos might also be attached to the board. Creating themed bulletin boards can provide variety on a regular basis. Family members might each write a short letter or paragraph mentioning their own memories related to the theme. Examples of themes might include:
- family tree
- educational history
- military service
- favorite recipes
- types of cars owned
- sports that he or she liked to play or watch
- favorite clothing styles
- areas to which the person traveled
- music and bands he or she enjoyed
- religious activities he or she enjoyed
- holiday themes