tips for caregiversMany of us in our fifties have just finished with childrearing; now we’re going to have to reactivate those caregiving muscles and start taking care of our parents.  I’ve been thinking about this lately because I’m lucky enough to still have a grandmother alive, who turned 100 this past December.  When she was my age, I was an elementary-school girl who loved visiting my wonderful, glamorous grandmother in New York City. She taught me so many life lessons, I’m happy to be able to help her now that she needs it. The issues that surround an elderly relative, and the things I worry about and try to pay attention to, remind me, however, that love isn’t enough when one is a caregiver.

I have a dear friend whom I turn to for advice, both practical and psychological, and I asked her if I could share some of her insights on caregiving.  Karen Christiansen is a licensed psychotherapist and bereavement counselor;  she is an R.N., holds a master’s in psychiatric nursing, and completed the Gestalt Institute Program for Psychotherapy.  She also has loads of common sense!

This is my short, informal list of things I think you need to know and do if you are, or are becoming, a caregiver.

  1. Self-care. You can’t care for someone effectively and make good decisions if you are not taking care of yourself.  You know this.  Make time to see your own doctors and health-care professionals.  Exercise even if it’s just a walk.  Eat regular meals.  Take breaks, short ones during a day or week, longer ones from month to month.  Much of caregiving involves the anticipation of death and loss; give yourself permission to have fun, even when you feel sadness and grief.
  2. Know your limits physically. Is giving medication difficult? I know I’m squeamish about giving injections. I suppose I could do it if I had to, but I sure wouldn’t want to have to learn how on someone I love.  You may need to call in additional resources, a visiting nurse, or home health-care aide.  There may be a time when you can’t care for someone properly at home anymore. Look into hospice care – it’s not just for cancer patients, but for anyone who has a chronic condition that isn’t going to improve.
  3. Know your limits emotionally. It can be frustrating to take care of someone who has Alzheimer’s or dementia.  Even my inner saint feels impatient with the symptoms of dementia sometimes.  Take a break every couple of hours before you’re snapping at someone who can’t help it.  There is something called ‘respite’ care for caregivers – someone else to take over for a while.
  4. Have someone to talk to.  I’m lucky I can pick up the phone and call my friend Karen anytime and she’ll listen and have good suggestions.  But many people are uncomfortable talking about illness and old age.  Caregivers can feel isolated, because their friends don’t want to hear about it. That’s why it is crucial if you’re a caregiver to find a group or individuals you can talk to. Join a support group. Talk to a pastor, priest or rabbi.
  5. Keep handy an ongoing Here’s What I Need Help With list.  Sometimes people will offer to help and they may really want to, but need your guidance. Keep a list of things – from easy (a run to the pharmacy or grocery store) to difficult (please come and visit Mom or Dad for lunch or dinner).  That way you’ll be able to get the help you need without going blank when that nice person makes an offer!
  6. Learn enough medicine to know what’s going on and talk to the health-care professionals. Sometimes what looks like dementia, hallucinations, and mood swings can have a physiological cause.  Urinary-tract infections are common in older women and can cause confusion and disorientation. Make sure each professional knows what medications are being prescribed (including vitamins and supplements) because they can interact in unexpected ways. Just as certain medications affected your young children differently from the way they affect adults, (their bodies and metabolism are different), the elderly can also respond differently.
  7. Know your Family Dynamics.  This is a tough one. Be realistic. Family dynamics can be a subject for a whole other article.  So, are other family members helping?  Enlist them in ways they can handle and that you can handle too. It’s a generalization and very likely an unfair one, but it sure seems like more women are looking after relatives than men are. Rather than trying to change people (good luck), take a page from the Here’s What I Need Help With list (#4). Give brothers, husbands and far-away siblings tasks they can help with. Even if it’s not what you think is enough, it’s still better than nothing, and will go a long way to ease feelings of resentment and frustration, of being overwhelmed and alone (you), and being left out (them).  If your family situation seems impossible to manage, consider counseling, therapy or a support group.
  8. Money.  Not a fun topic, I know. Consider getting your name on the checking or savings account of the person you are caring for. Or a joint credit card. Or power of attorney for investment accounts.   The  time may come when the person you care for can no longer manage his or her money. Or it may become difficult for them to sign checks. You may need to make payments, pay bills and take care of financial matters.
  9. Paperwork.  Another not-fun topic.  Talk to your loved one and your health-care professional about living wills or health care directives sooner rather than later.
  10. Finally, remember why you are taking care of this person – because you love them.  Keep a mental – or real – scrapbook to remember the good parts, and the reason you love them in the first place.
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