Rose Oliver and Frances Bock, authors of Coping with Alzheimer’s, contend that when it comes to guilt, we only have ourselves to blame. “Guilt is the punishment you inflict upon yourself for the ‘crime’ of having human limitations.” We all know it would probably be more productive if we made encouraging rather than disparaging comments to ourselves, but where do we begin?

Most of us start out by caring for a relative or a friend with love in our hearts. If we are caring for a father who was once a cold disciplinarian or a wife who was once a nag, it may be more difficult, but our intentions are usually good.  As time passes, however, many of us are in conflict about wanting to stay and wanting to go. We want to do “the right thing,” but we want the caregiving role to end.  And that’s when the guilt surfaces.  How can we wish for the person to go away or die?  Oliver and Bock note that the wish to be free of the burden is understandable and almost universal to caregivers. To try to stop such thoughts “is like demanding that night not follow day.”

Instead, Oliver and Bock suggest that we need to set realistic standards for ourselves, and that begins with clarifying definitions. Many people confuse “caring for” with caregiving.  In fact, many people who are caregivers do not identify themselves as such because they feel they are doing what they have always done – caring for (and about) a spouse or parent.  They may be doing more than they once did, as the person they are caring for deteriorates, but they still see it as a natural role.  Spouses identify their care with marriage vows (“in sickness and in health”), and children often see it as “payback” (“they raised me for all those years; I can do as much for them”). 

Even when “caring for” can mean “doing it all,” from balancing the checkbook to dressing and bathing the person, caregivers may see it as their “duty”; a requirement of being a “good” wife, husband, daughter, or son. 

Oliver and Bock also note, “Caring for a person means love, concern, and commitment. Caregiving means taking care of that person.  You can love your husband, show him all the affection that you have, and at the same time, share the caregiving with another person, be it a friend, family member, or a paid helper. Doing so doesn’t diminish your affection and it doesn’t tell you, or the world, that you are an uncaring person.”

Staff who work in residential care communities know that it takes a minimum of three people for a 24-hour shift, plus at least two extra people to cover days off. Thus, at a minimum, family caregivers are trying to do the work of five paid people in any given week. Residential care communities have specialists – nurses, activity directors, kitchen staff, social workers, housekeepers, and others – who handle the many challenges of daily care.  Simply put, you have the option to share the care!

When did “independence” become a greater virtue than “interdependence”? Asking for help is not easy for many of us, and getting help is rarely as simple as a single phone call.  You may have friends, neighbors, and people of faith who are willing to lend a helping hand.  There are helpful government programs and services available as well, but these often go unused until a caregiver reaches a crisis. Why wait until then? 

If you are overwhelmed by the responsibilities of caregiving, consider reaching out for help. Other people may be willing to help by cooking a meal, mowing your lawn, cleaning your house, or just giving you a well-deserved break. As a result, you are likely to feel relieved and your helpers are likely to feel pleased for the opportunity to do something positive for someone in need.  An oft-quoted line from Sue Bender’s book is, “accepting other people’s generosity is a form of generosity.”

It may seem odd to suggest that you can relieve some of your guilt by doing less and accepting more, but try it. For example, you can accept what others do and accept that some things can remain undone. The alternative is to discover, like author Erma Bombeck did, that “guilt is the gift that keeps on giving.”

Contact the Eldercare Locator, a public service of the U.S. Administration on Aging, for information about services provided by your local Area Agency on Aging, state government, and other services and programs throughout the U.S. Call (800) 677-1116 or visit http://www.eldercare.gov.

The Benefits of Counseling

By Daniel Kuhn, MSW, Mather LifeWays Institute on Aging

You may sometimes feel the need for a confidante with whom you can share private thoughts and feelings. If the person you are caring for once filled this role, then you may feel the need to find someone else to assume this role. You can depend on a friend or a relative to a certain point; however, a relationship with a nonjudgmental and objective "outsider" may be a refreshing alternative. Counseling with a professional within a confidential atmosphere may also help alleviate the stresses associated with caring for a loved one.

Counseling is a valuable but misunderstood resource. Seeking professional help oftentimes has a stigma attached to it, and many people cling to the notion that they must "go it alone" and "be strong" when facing difficult situations. In our society, self-sufficiency and privacy are highly regarded values that can get in the way of reaching out for help. Yet, knowing one's limits and recognizing the need for help may actually be a step in the right direction.

Some of the benefits of engaging in a one-to-one counseling relationship may include:

• developing more effective ways of handling crises
• coming to terms with grief
• learning to balance your own needs with the needs of the person in your care
• learning about useful community resources
• planning for the “long haul”
• discovering the depth of your inner strength
• finding personal meaning in the midst of adversity

 Social workers, psychologists, psychiatrists, licensed professional counselors, nurses, and pastoral care workers are employed in a variety of settings ranging from hospital to mental health agencies and churches. Trained to provide individual and family counseling, they may use a variety of approaches and techniques to help others regain a sense of equilibrium in their lives. Some professionals practice long-term psychotherapy while others focus on solutions to specific problems on a short-term basis. Time-limited and problem-focused counseling for a current dilemma may be all that is needed.

When seeking the services of a qualified counselor, it is advisable to obtain a recommendation and check out his or her credentials. Most professional groups are licensed through a state department of regulation and accredited through their own professional organizations. Most counseling services are covered in part by health insurance, and many not-for-profit agencies offer a sliding-fee scale. Additionally, many communities have a designated mental health agency that offers counseling and referrals to counselors in private practice.

Daily Affirmations for Caregivers

By Bernie Siegel, M.D.

• I love myself.
• I respect my own needs.
• I am able to ask for what I need.
• I am open to receiving.
• I can ask for help and support.
• I am kind and gentle with myself.
• I deserve care.
• I know how to nurture myself.
• I replenish my energy by eating healthy foods.
• I take the time to exercise daily.
• I have all the energy I need.
• I am compassionate with myself and with others.
• I am able to feel and express all of my emotions.
• I forgive myself and others.
• I am able to renew and refresh myself.
• I take time for fun.
• I love and trust in the process of life.
• I am whole and alive.
• I am at peace with myself.
• I trust that I am doing the best that I can.
• I am enough.
• I am loved.

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