Difficult Seasons

A feeling of independence is even more important when you’ve lost some of the ability to take care of all of your daily needs.  It is a major factor in quality of life for the care receiver.

So as a care giver, it’s vitally important that you find as many ways as possible to help the person you’re caring for feel independent.

1. Some of helping them feel independent is through how you communicate with them.  Asking his  permission for even simple things, offering choices instead of commands, and taking his or her desires about things into account are big.
2. If she is not able to drive to medical appointments or to go shopping, help find alternatives that she can manage on her own.  Most independent and assisted living centers provide some type of transportation service.  Or, in many cities, there are commercial or governmental services specifically for older adults that will provide transportation for a reasonable fee.  This allows her to regain a measure of control over her life, as she can handle these activities on her own, without having to depend on you.
3. Let him do everything he can or wants to try to do on his own.  If he can do his own laundry, don’t do it for him.  If she can manage her own finances, don’t do it for her.  If he can make his own doctor appointments or handle his own insurance issues, let him.  Being able to handle these kinds of routine tasks promotes good self esteem.  When you take them away when she could do them, you take away an important source of good self image.  It’s fine to offer to assist, as long as you let her do it her way.

And I’m sure you can think of other ways to promote a feeling of independence for the person you’re caring for.

Here’s the principle:  Allow the person you’re caring for as much independence as they can handle, even when it makes you uncomfortable. Allow the person you’re caring for to live their life with as little interference from you as possible, but with as much support as needed. Don’t make the person you’re caring for more dependent on you than is absolutely necessary.

A lot of our problems as care givers are of our own making because of our style of communicating with the person we’re caring for.

In the last several posts, I’ve written about the importance of not assuming the role of parent to the one you’re caring for.  It turns out that we often sound like a parent because of the way we attempt to communicate.  We can avoid that by intentionally adopting a different communication style.

Here are some general guidelines that will help you.

1. Avoid phrases such as:  “You should …”; “You need to …”;  “You’re going to have to …”;  “If you don’t … then …”;  “Why didn’t you …?”  “I can’t believe you …”
2. Use phrases such as:  “I’m concerned about …  Would it be okay if we talked about that?”  “I’ve noticed that you’re not …  Would you be willing to discuss why?”  “This doesn’t seem to be working very well.  How do you feel about it?  Can we explore some other options together?”

This works for several very simple reasons:

• You’re showing respect.
• By asking permission, you’re restoring a feeling of control to someone who likely is struggling with feeling that they are losing control of their own life.
• Stating your observations, feelings, and guesses leaves the door open to further constructive discussion.

This approach does take more effort and thought.  And asking permission always carries a risk that the other person will say no.  But in my experience, care givers who follow this communication strategy find that it lowers the stress levels on both sides and results in achieving good outcomes.

Without doubt, the best preparation for becoming some one’s care giver is to develop an adult-adult relationship with them before you become his or her care giver.

I didn’t realize how important that was until I had already become Dad’s caregiver.  During my adult life, we’d spent lots of holidays and vacation time visiting together, and we’ve always gotten along well.  But we never had the opportunity to work together on a project, to do problem solving together, to share a responsibility as a team.

Our relationship was typical father-son.  It was built on mutual respect, love, and centered around family and church.  I didn’t give him advice unless he asked, and he didn’t give me advice unless I asked (mostly anyway).

After Mom died, our relationship did change a little.  We’d get together at least once a week for lunch, and our conversations did begin to evolve to occasional advice seeking and problem solving.

So when a health crisis occurred that required me to take some decision-making responsibilities for Dad and required a drastic change in where and how he lived, we both struggled to figure out how to relate and how to problem solve under these new conditions.  The situation was further complicated by the fact that his second wife Carol, who had recently started treatment for advanced ovarian cancer and was being cared for by her children in their home in another city, was part of the decision-making process.

I can remember vividly how uncomfortable I felt having to try to get Dad to do what doctors and family and I thought he needed to do.  I decided early on to do my best not to tell him what to do.  I attempted to become his advisor, and generally that worked quite well.

I investigated options, such as housing, and presented them to him as options, something for him to consider.  He responded well to that, and as his physical condition improved, we began working on issues that needed addressing together.  As things stabilized in his life, he increasingly became able to resume essentially all of his own decision making within his new constraints.  And by spending lots of time together and working together on problem solving, we’ve developed an adult-adult relationship that’s richer than just the father-son relationship we had before.

Looking back, there are some things I have learned, and some things I would do differently:

1. I was totally unprepared to become a care giver for Dad, and it is only through God’s providence that things have worked as well as they have.
2. If I had it to do over, I would be more intentional about working to develop an adult-adult relationship that included joint problem solving experience and teamwork before we encountered a crisis.
3. I would do even more than I did to make him feel more independent earlier, because the more independent of my help he felt, the more things he became able to handle on his own.

Maybe you can learn from my story and accept my encouragement to begin and continue working on nourishing your relationships in preparation for times of crisis.

When you become a care giver, the relationship with the person you’re caring for and even with other family members can become stressed.

Just becoming someone’s care giver changes the relationship because of additional tasks and responsibilities you have taken on and because of tasks and responsibilities that the care receiver is having to allow someone else to handle.

This situation very often leads to the care giver adopting a parental role and attitude.  This in turn tends to force the care receiver into a reactionary child mode.  We turn to this model of relating because it’s the most familiar way we know for one person being responsible for and providing for the needs of another person.

Here’s what it looks like.  The care giver gives orders.  The care receiver balks by refusing to take her medicine or maybe doing his rehab, fights back, or maybe pouts.  The care receiver gets more forceful, or tries a bribe, or attempts parental-style logic, something like, “It’s for your own good.”  The care receiver cries or throws a fit, or maybe complies, but with sullenness.

Relationally, it just doesn’t work because adults are not meant to be in parent-child relationships.  And if we act like a parent with another adult, even if we in fact are, the other person is going to respond as a child.

The relationship will suffer, and maybe even be lost.  There will be constant stress, and likely constant arguments.

So how do we as care givers preserve and nurture the relationship.  By making it our goal.  Here are three principles that will guide you well:

1. We go out of our way to not sound or act like the stereotypical parent.  We therefore don’t give orders or ultimatums.
2. We focus on respecting the independence of the person we’re caring for, even if that means that person makes some bad decisions.
3. We recognize that his or her situation has resulted in a loss of control, so we do everything within our power to restore a measure of feeling in control to them by asking permission, by offering choices, and by asking how they feel about things, how they would like to handle things.

Yes, there may be times we are forced to intervene for their protection or even the protection of others.   But even then, if we follow these three principles, we will be able to preserve and nurture the relationship.

It’s simply living by the Golden Rule, paraphrased for care giving:  Treat the person you’re caring for the same way you would want them to treat you if the circumstances were reversed.  If you do, you’ll both be blessed.

I’ve visited with him several times over the last five weeks.  He’s the kind of man you’d enjoy having a cup of coffee with, asking about his life and hearing his stories.

Instead, we’ve gotten to know each other standing outside his daughter’s ICU room as she continues to fight with everything she’s got to survive.  She’s hanging on by a thread  — again.  She’s rallied some after crashing — again.

And he’s still told me some about his life, and he’s told me some of his stories.  Except, most of what he’s told me about his life has to do with his faith, and his stories have a spiritual theme.

“My minister tells me I’m a work in progress.  Faith has not come easily for me.”

“We military guys who were tough and played hard when we were young, look for spiritual meaning when we’re old.”

“My friend nearly died a while back.  He found faith during that experience.”

I can’t even imagine what this dad’s going through, what he’s feeling.

But I know that he makes it through each hour, each day, through a growing faith that’s a work in progress.  Just like mine, just like yours.