Grown adult children who help to care for an elderly parent often face burnout. Listening to them repeat themselves, sometimes feel no gratitude for the time and money expended, often be berated or yelled at— “Where is my food? What’s taking so long?” Hearing such tirades can wear on the psyche and be disheartening. We think our parent was never like this before. What’s going on? How can I continue to handle this? That’s when the resentment and guilt start to build and spill over into disagreements that might never be resolved.
It’s a huge problem. Approximately 41 million unpaid family caregivers provided an estimated 34 billion hours of care—worth a staggering $470 billion—to their parents, spouses, partners and friends in 2017, according to the latest report on AARP’s Valuing the Invaluable series
Dr. Ken Druck, Ph.D., a best-selling author, speaker, coach and therapist, has written a book, Raising an Aging Parent: Guidelines for Families in the Second Half of Life (Redwood Publishing), which offers strategies to cope. And one chapter, “How Much is Enough: The Real Responsibilities of Adult Children,” resonated with both of us—for Margaret when she cared for her mother Bea, now gone four years, and for Barbara, still very much involved in her 100-year-old mother’s weekly care.
Barbara has become used to feeling exhausted after being awakened in the middle of the night when she stays over to care for her mother during the week. She knows it’s important to give the paid caregiver a rest. Yet, she grows discouraged when her mother is unappreciative and curses at her. On the other hand, what she is doing, she feels, is honoring a promise to her late father to be there for her mother, as well as to be a loving supportive daughter and role model to her own daughters. She doesn’t feel it’s a burden but part of her family’s decision on how to cope with this end stage of life. And she has learned the importance of taking breaks away—on weekends and sometimes during the week for a special event such as a painting retreat.
She has learned to accept that her father might not have expected her to carry this heavy physical and emotional load. In fact, a recent visit with a metaphysical expert relayed the same advice. The gist of the conversation was: We make promises but sometimes they’re for the living and this is not what your father would expect or want at this time.
We recently talked by email and phone with Dr. Druck to find out how much is enough? We believe others pose this question and others to themselves, too. Here are our questions and his responses, edited and condensed.
How do we figure out what really works in caregiving on our part?
Figuring out the effectiveness of our caregiving is best when we step back and take inventory of what is getting us the result that we want as a caregiver and what's not working so well. When we give ourselves a chance to really evaluate the “bottom line,” so to speak, and do a self-audit, we see where we can make adjustments and do even better as caregivers. Asking the people we are giving care to, and others who have observed us, for their input can also be a valuable source of information.
Is there a way to know in our gut when we’ve reached our limit before we physically or emotionally collapse from exhaustion or greatly resent the role we’ve taken on?
We have these brilliant emotional radar systems that are functional as our digestive or respiratory systems. When we learn to read our own radar signals and understand emotions like anger, sadness, frustration and depletion, we can discover that we’ve reached or exceeded our limit before we find ourselves in a state of physical and emotional exhaustion. We can look in the mirror and see that we have become the resentful, burned-out version of ourselves as a caregiver and do something about it.
It might be that you’re feeling unhappy, dissatisfied, frustrated and resentful — or losing your temper with them. Talking about these signs of caregiver fatigue with a trusted confidant can also help you see the effects that caregiving may be having on you and inspire you to make some adjustments.
Is it important to get at why we’re doing it—for financial reasons, because it’s expected in our family for the daughter or eldest to do so, because we’re a type E person—the one to be everything to everybody (except maybe ourselves or for whatever reason). Does that matter?
Yes, your motivation and reason for caregiving really does matter when it comes to preventing burnout and ensuring that what you are doing adds up to a good experience in your life. Asking ourselves, “Why am I doing this?” enables us to either trust or question our motives. Getting clear about why we’re making the sacrifices and investing the time and energy necessary for caregiving for a parent can also help us redirect, rededicate, or recommit ourselves to the task. We may discover that we're doing it for the wrong reasons, such as “because I expect a big payback,” “because it's expected of me, “to show my parents I’m their most loyal and loving child,” or because we have an overriding type-E personality trying to be everything to everybody else. In that case, we can realign ourselves with a good and noble motivation, such as “I'm doing this because it's the right thing to do, because I love my mother or father, and because of the service and support and gratitude I want to show them.” Caregiving for the right reasons allows us to promote closeness between an adult child and their aging parent and prevent caregiver burnout.
When is it good to perform a check-in with ourselves? What questions do you ask yourself to determine how you’re doing and if you need to cut back or change course?
Developing the ability to do daily internal check-ins keeps us alert, aware, and responsive to the need for change. Asking yourself “How am I doing overall? What adjustments might I make to make this day go better?” is a best practice for optimal self-care. A lot of couples do this in their relationships. Asking their partner, “How are we doing?” can evoke great conversations about what’s going well and what isn’t, and what mid-course corrections we could make.
Is a support group or therapist a wise step periodically and what are the red flag signs that it’s needed—crabbiness, tiredness all the time, what others?
Support groups and therapists can be a great source of support and education. Since we can't meet all our own needs and we don't always figure everything out in our own heads or hearts, the help of a trusted confidant or a group of supporters we can trust, can add immeasurably to our lives. A therapist or support group can offer much-welcome understanding and validation for how we're feeling. They might also be able to point things out that are in our blind spots, acknowledge our exhaustion, or highlight issues we keep bringing up but doing nothing to improve. This support, strength, and encouragement to move forward and do the things that might make our lives and the lives of our parents even better can directly address red-flag signs and symptoms.
What happens when we find the relationship between aging parent and grown child deteriorating? When we dread being with the person, find we’re snapping more at the person? Should we step away for a period or cut back or what? Are there palatable activities with the aging parent that you’d recommend?
In a perfect world, we establish a line of communication and, like a line of credit in business, we can talk openly about issues that come up. This helps us form a better understanding of one another, work through our differences and turn dread back into love and enjoyment of each other's company. We can work on conflicts and differences in perspective that continues to arise instead of getting into a power struggle or have an unresolved issue resurfacing.
However, without that established line of communication, it’s not always an option to be able to communicate openly about issues. In that case, it may be best for us to step back or modify the way we're spending time with our family. Sometimes that means deciding that we shouldn't attempt certain conversations because we haven't developed the ability or confidence to talk about such sensitive matters without a third party being present. Sometimes a simple apology can clear the air and push the reset button on a family relationship.
What if dementia is involved and it’s not possible to have this type of communication?
And, of course, it’s not always possible to communicate and work things out with an aging parent who is suffering from dementia. In relationships between adult children and their aging parents or siblings where alcoholism or a debilitating physical or mental health issue is a factor and the communication has broken down so significantly that it’s irreparable, we may need to step back or seek professional help. Sometimes we are left only with the ability to salvage the positive things that remain without taking on those we just can’t change or manage.
What activities are best to do with an aging parent?
What we do with an aging parent can be as simple as watching a funny movie, playing Scrabble, or going to lunch — or as complex as going to the symphony, the theatre, or on a cruise. The key is to be fully present with them, listening attentively and talking, sharing and enjoying one another’s company. Being present also means asking open-ended questions about the things that are weighing heavily on their hearts and talking about the things that are making their hearts sing. Show them your love, support, understanding and care and open your heart to receiving theirs.
How can we reward ourselves periodically to make the “job” more palatable?
The best reward is often self-care, doing whatever is needed to refill our cup to replenish and rejuvenate us and balance the care that we're giving to help our aging parents. Acts of self-care balance out the time and energy we're investing with our aging parents. We restore our energy, diversify our activities, and rediscover that not all of life is caregiving. We also give ourselves a restorative dose of self-appreciation.
What ideas can you share so that we also tolerate better what we’re doing—making a memory book of all our good times together in photos or writings?
Sometimes we're so involved in the repetitious serial tasks of caregiving that we get lost. At the end of the day, everything just evaporates into nothing. There are subtle things we can do such as keeping notes of gratitude and appreciation to ourselves that remind us of the service we are giving and sacrifices we are making. Even if we're not hearing “Thank you” from our aging parents, things like a daily journal, memory book, or photo album can serve to document all the time and energy we’re investing in/giving to this relationship. — and that we're being a good and loving son or daughter.