Beth Witrogen, a Pulitzer Prize–nominated journalist, speaker, and author of Caregiving: The Spiritual Journey of Love, Loss, and Renewal, shares her experiences and insights on coping as a caregiver.
What are the biggest challenges facing those caught in the “sandwich generation”?
It’s is a historic phenomenon that middle-aged adults are taking care of parents and children at the same time. Because we are living so much longer, and because economically so many adult children still need to live at home to make ends meet, the “sandwich generation” family caregiver is challenged financially, emotionally, and with housing. What this boils down to is too often a lack of time for self-care and nourishment, which can mean that the caregiver feels exhausted, frustrated, and resentful — and guilty about those feelings. And this doesn’t even include work responsibilities. It’s quite challenging to juggle work and family nowadays, and often the caregiver gets left out of the equation.
How does one tactfully and respectfully “parent” your parent?
Remember that you are not your parent’s parent; the roles are not truly reversed. The degree of respect that you had in your relationship before your loved one needed help is the degree of respect that you will offer when he/she does need help. But this can always be increased, and I find that the child-parent relationship changes immensely as the parent opens to receiving a different kind of love, and the adult child understands the parent more deeply as a person in his or her own right. So, tact and respect come through the growth and evolution of the relationship, bringing it more into present time.
What sort of coping strategies have you found that can help the caregiver stay emotionally, mentally, and physically healthy?
Meditation and prayer, some kind of calming activity, is best. Whatever grounds you will keep you centered, so a good diet, good friends, nourishing activities, and most of all watching negative projections and self-criticism are great tools for health. Again, the degree to which we have nourished ourselves and allowed self-care before we became caregivers will be the paradigm we know best as caregivers to aging loved ones.
If we ate a diet high in sugary soft drinks, trans-fats and junk carbohydrates, it would be difficult to suddenly adopt a more healthful lifestyle when we are under even more pressure. So it’s important to take care of ourselves as best we can, which can mean saying no to family, friends, and work when we really need a break for ourselves. We need to be able to rest, enjoy, and appreciate in order to negotiate this life passage without personal damage.
What if your parent refuses to accept outside help?
This is not uncommon. Many sons and daughters then martyr themselves to the cause. In some cases it is best to go ahead and bring in a third-party professional, like a private geriatric care manager. Sometimes a trusted friend or neighbor, or clergy, can come in and convince the parent that help is needed. It’s important to get a true assessment of what help is needed. Sometimes a grandchild can offer help — like mowing the lawn, running errands, or driving to an appointment. It depends on the size and nearness and bonding of the family.
How can you manage your time so that you don’t ignore or neglect your other relationships?
Determine what is truly most important. Prioritize duties. Delegate where you can. Often the legal, medical, or financial duties can be delegated to other family members who may live farther away, or elder-care services can be hired or volunteers brought in through the local Area Agency on Aging. Learn to know what is most important to you — especially your own health. This is a different time, so all relationships will shift like a domino effect.
Time management is a skill you may have had before becoming a caregiver, so multitasking may not be difficult. If you were not a good manager of time, you will need to learn very quickly how to do this. Keep in mind that caregiving takes a lot of emotional energy. It is highly stressful, so cultivate only those relationships that nourish you. You may have to pare everything down.
Is it better to place an aging parent in assisted living or hire help to come to the house?
There is no “better” in family caregiving. There are warning signs such as self-neglect, gain or loss of weight, forgetfulness, a change in functioning or personality. There are levels of change that can be managed through the in-home and community based network of aging services (found through your local Area Agency on Aging). There are more serious signs, such as tremendous forgetfulness, combativeness, serious medical issues, etc., which will require placement outside.
Most parents resist outside placement, but once they have this level of care and security, they adapt rather readily and happily. It is critical to educate yourself as to what options are available in your community, as there are many levels of assisted living, board and care homes, or skilled nursing and/or dementia-care facilities. AAAs will also have information as to records of housing violations and who are the best providers in your area.
Again, a geriatric care manager, or hospital social worker/discharge planner if your loved one was hospitalized, will be able to offer solutions. There are also many websites today offering a searchable database.
But most of all it is important to get the correct diagnoses, education as to resources available, have a family meeting to determine who can do what, and make decisions based on your reality. Many adult children take on more than they need to, thinking they can and must do it all. This can often end in disaster, with total caregiver burnout and the loved one needing to be placed outside. So the question is, better for whom? Loved one or caregiver? Your own life has to come first. That is not selfish; that is smart.
What tips or activities keep or kept you positive and helpful? How does a caregiver inspire hope in those they are caring for?
We inspire by being ourselves, by setting boundaries, and finding our own place of stillness within. When our loved ones don’t feel they are a burden to us, then that relieves their stress. Hope comes from love, and love comes from self-care as well as caring for others.
How did being a caregiver change you and your life? What did you learn about yourself?
Caring for both of my parents simultaneously taught me three things: That we have more inner strength than we know; that everyone suffers; and that everything is workable. It all comes down to what we are attached to — and what we are willing to let go of that no longer serves. Illness and death are part of aging — and no one is going to escape this. The sooner we can accept that this is a life passage and not a punishment or a mistake, we can grow into a larger role.
Family caregiving stretches our hearts and this can be painful, but the joy on the other side from having done our best, is worth everything. And love never ends, even after the caregiving stops.
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