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Reframing Negative Emotions When Life Throws You A Curve

Posted on February 10th, 2016 by karen

Help When Life Throws You A Curve

by Alana Pietrantuono, LMSW

When a loved one falls seriously ill, family members are faced with an unexpected turn of events, one that likely alters the plans they had spent their entire lives constructing. Accepting these changes is a challenge for anyone — they can leave you feeling as though your life has come to a screeching halt.

Joyce, a 35-year-old nurse, was on the verge of purchasing her first home. She had worked hard for many years and finally saved enough money to realize the dream of owning her own place. But when the health of her father, Charles, a 74-year-old Parkinson’s sufferer, took a turn for the worse, Joyce was forced to put her plans of home ownership on hold.

You see, Joyce had been her dad’s primary caregiver ever since her stepmother, Janet, passed away two years before, and it became clear to her that some serious sacrifices would have to be made in order to help her dad. She felt she had two choices: she could either quit her job and move in with her father to take care of him full-time, or continue working and spend the money she had saved for her condo to pay for his around-the-clock care at home. Charles would not consider moving to a nursing home, as he insisted he was still grieving the loss of wife and didn’t want to leave the house where he and Janet had lived together.

Joyce, for her part, was utterly destroyed by the loss of her home-owning dream. And while she felt guilty about this overwhelming emotion, she still couldn’t deny feeling angry and cheated. “I never thought that this is what my life would become,” she said at our first meeting. “I can’t even cope! But I can’t imagine leaving my father either. I would be a terrible daughter.”

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Caregiver Salvation: A Delicate Balance

Posted on October 29th, 2015 by karen

by James McGinn, LPC, NCC

“My mom had always been fiercely independent and self-sufficient all of her life,” said Deborah, who, like many of my clients, was struggling with the increasing dependence of her elderly parent. Deborah’s mom, Helen, had been a proofreader for Springfield’s Republican newspaper for decades. Although her retirement in 1986 was bittersweet, Helen was at least partially comforted by her lifelong passion for reading, which brought her to the local library several times each week. As Helen grew older and less mobile, her library sojourns became less frequent, but, fortunately, the librarian with whom she’d built a friendship would drop books off at Helen’s home on her way to or from work.

Sometime around the year 2000, when Helen was in her early 70s, she began to experience distortions in her vision that was eventually diagnosed as macular degeneration, a progressive worsening of the eyesight due to retinal damage that accompanies old age. Macular degeneration can be slowed with vitamins and supplements but has no medical or surgical cure — blindness is the unfortunate prognosis. It’s a disease that regularly impacts millions of people around the world, but it hit Helen particularly hard. Reading had always been her refuge: she’d been able to compensate for the deterioration of other abilities and functions by maintaining an active mind through her love of books, as well as by completing the crossword puzzles in the newspaper everyday. Now, however, with her sight degrading, Helen was at a loss as to how she would cope with her steadily increasing limitations and maintain what little independence she had left.

Deborah had been an active support for her mom for some time, assisting her with errands and transportation needs, but she decided it was time to take on more responsibility for Helen’s daily care. While the obvious solution in cases like this is for the child, or children, to step in as the primary caregiver, it’s a complex and stressful arrangement to say the least. In addition to handling a multitude of duties on behalf of an aging loved one, a caregiver must also contend with the reversal of the parent-child dynamic, as well as the parent’s emotional response to losing their independence and stature. In other words, aside from supervising Helen’s finances, medical treatment, and daily routine, Deborah also had to face Helen’s injured psyche, which the older woman often expressed as criticism and displeasure with her daughter’s decisions.

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Books And Movies For Inspiration And Support

Posted on September 24th, 2015 by karen

by Karen Keller Capuciati

Getting engrossed in a book or a movie can offer a pleasant escape from our daily routine. But for those of us caring for another person, enjoying a book or movie seems like a luxury we just don’t have time for. It’s critically important, though, to find time for ourselves as well — and many times we can gain more than just a break from caregiving by listening to a story someone else wants to tell.

Sometimes a well-told story can bring us a smile, or a new perspective, or inspire us in a way we couldn’t have anticipated. And, honestly, even a good sitcom has the power to turn my mood around.

Over the past four years, In Care of Dad has published many helpful accounts and advisements from the health professionals at Family Centers in Fairfield County, CT, on combating caregiver and grief-related isolation. So we asked them to share some of the titles they might pass on as recommendations to their clients.

From that list:

“The Conversation” by Angelo Volandes — This is an accessible guide to the stressful end-of-life communications with loved ones. It offers tremendously valuable advice to those of us taking care of aging parents and, ultimately, to us all. Death is never an easy topic to discuss on a personal level. In fact, many people avoid talking about it altogether, particularly when a loved one’s death is imminent. However, given that we cannot opt out of the event itself, being empowered to discuss death helps families when the unavoidable time comes. Volandes’s book is a truly valuable asset for having this important discussion.
— Amanda Geffner, MSW

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Crisis Time: Overcoming Family Barriers

Posted on August 5th, 2015 by karen

Nonno seated in front with his family.

by Nadia Fiorita

Everyone knows that family dynamics can be complicated. Sometimes there are grievances that linger for years, and other times there are relationships that just never get a chance to bloom. But when a family faces a serious health crisis, with all its inherent pain and fear, the potential for loss casts a different light on strained relations.

My grandfather — Nonno to his 14 grandkids — was diagnosed in the spring of this year with multiple brain tumors, for which his doctor recommended immediate radiation treatments. Four years earlier, Nonno managed to survive a bout of lung cancer so serious that he was given only 3-6 months to live.

My relationship with my grandfather wasn’t as good as I would have liked. We didn’t visit him much while I was growing up due to an ongoing conflict between my parents that carried over into other family relationships. But a couple of years ago my father’s mother passed away unexpectedly, and I remember being stopped in my tracks by this. I was distressed by the realization that I would never have any relationship with my very own grandmother. That struck me as very sad indeed.

So when Nonno’s health began a steady decline in the wake of a seizure and hospitalization following a radiation treatment, I decided to embrace the moment and make sure that Nonno did not depart this world before I had a chance to really connect with him. I felt that I needed to make up for lost time, so I made it a priority to see him as often as I could.

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Advocate For Your Own Health: Balancing Trust With Facts

Posted on June 24th, 2015 by karen

Nonno surrounded by his family

by Nadia Fiorita

My grandfather was diagnosed with lung cancer about four years ago at the age of 82. At the time, it was absolutely devastating news. The doctors gave him only 3-6 months to live.

I’m happy to report that Nonno (as all us grandchildren call him) surpassed everyone’s expectations and is still alive today. And he was able to survive without chemotherapy or radiation treatments, which is amazing.

Unfortunately, after a recent follow-up visit, his doctor found multiple tumors on the left side of his brain that caused Nonno to have frequent headaches. Again, this was crushing news for my entire family, especially my grandfather, since he was looking forward to going to Italy the following week.

During that follow-up visit, the doctor strongly recommended that my grandfather begin immediate radiation treatments to target the largest tumor. The doctor passed along some information about the potential side effects of radiation, but reassured all of us that my grandfather would still be able to travel to Italy after receiving the first round of treatments. My grandfather wanted so badly to believe that everything would work out that he took the doctor’s reassurances to heart and put the potential side effects out of his mind. He thought he would get better and be able to go to visit his homeland. But right after the initial treatment, my grandfather’s health began to decline rapidly: he lost his energy and his appetite, and it became clear that he was getting sicker with each passing day.

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Surviving Anxiety: How To Talk Your Way Out Of Trouble

Posted on May 28th, 2015 by karen

by Erin Tishman

Milly was a 65-year-old woman who came into my office complaining of persistent neck and stomach pain. She said she could no longer drive her car on a regular basis because the neck pain was so severe, and her digestive system was also suffering whenever she ate certain foods that she had enjoyed without problems her entire life.

Milly’s husband, Sal, had recently been diagnosed with amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig’s disease. It’s a nervous system disorder that severely weakens the muscles and impacts all physical function. Its progression is known to be very fast.

Milly and Sal did not have any children, and their extended family was living in the Midwest, where she and Sal had met. Milly never worked because Sal’s Wall Street job had afforded them a comfortable life, and given Milly the opportunity to spend her time volunteering and being a homemaker. She took great pride in her gardens and was always pleased to have company so she could show off her hard work.

When Sal was diagnosed with ALS, Milly became his caretaker on a round-the-clock basis, attempting to meet all of his needs — even just to scratch his back whenever needed. Milly’s life became consumed with helping Sal and, because of the rapid progression of his illness, she found herself forgoing sleep, getting only a couple of hours here and there, when she could.

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End-Of-Life Conversations: We Need To Talk

Posted on April 29th, 2015 by karen

Amanda and her mom

by Amanda Geffner

During my mother’s brief battle with terminal cancer, I was only 31, still single, and in grad school with career plans best described as uncertain. At the time, I placed a high priority on showing my mother — and myself, if I’m to be fully honest about it — that I was doing okay and going to be fine, despite the impending tragedy. It wasn’t a belief in which I was fully invested, but it felt like the right message to send.

I recall my mother eating tiny bits of melon (it was all she could keep down) as I modeled a dress bought from a street vendor. My brother and his longtime girlfriend quickly planned and held their wedding in her home. We wanted to let Mom know the lives she’d help create for each of us would go on, which provided her a modicum of comfort — or so I believed. I didn’t let her see the part of me that felt life would not, indeed could not, go on without her. That part I kept hidden, to spare her, and — again, to be fully honest — because I was too scared to voice this even to myself.

And so, on the day of my brother’s wedding, after the vows had been said, I sat on my mother’s couch with my head in her lap, weeping silently, hoping she couldn’t tell, and swallowing the words I couldn’t share about how much I would miss and still need her after she was gone. In retrospect, I can forgive myself, and my mother, for not managing to go there together, given each of our limits and the extent of our fears at the time, but today I find myself encouraging others to be more open with a dying loved one, if they can.

When someone we love is facing death, of course we care tremendously, but we often tiptoe around it, in an effort we perceive as protective for both our loved one and ourselves. However, our protectiveness often serves to increase our loved one’s sense of isolation, as well as our own. Instead, what we can do is acknowledge the painful truth, as well as our fear of it, and just be open and truly present with them. This takes courage, centering oneself, employing long deep breaths, and keeping oneself in the moment. Doing so allows us to better prepare ourselves and also better prepare the loved one who is dying.

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Open Dialogue: Overcoming The Need To Control

Posted on March 25th, 2015 by karen

by Michelle Krepak

“What if she forgets to turn the iron off or wakes up confused in the night or falls? What if she drives and gets into an accident and hurts herself or someone else?”

Like many of my clients, Laura was concerned about her mother’s advancing age and declining abilities. But more to the point, Laura came in for counseling regarding her own changing role with her mother. She complained that she was becoming her mother’s mother, and it felt uncomfortable for her.

Sharon, the mother, suffers from mild dementia due to Parkinson’s disease, and her bouts of memory loss and confusion have repeatedly raised concerns for Laura that her mother may not be safe living at home alone.

But Sharon is resistant to any move. She’s a nature lover who lives in rural New York, surrounded by horse farms and beautiful landscapes. She enjoys reflecting on the daily comings and goings of the birds and the deer on her property, and, of course, all her friends live in the area.

Sharon now clings to her home even more after a six-month stay in rehab and assisted living last year, during which she was treated for hallucinations and a general state of confusion that was apparently brought on by a urinary tract infection — common with Parkinson’s disease — and mixing up her medications. According to Laura, Sharon “absolutely hated” the assisted living facility because she couldn’t enjoy the outdoors and she was “surrounded by old people.”

But regardless of her mother’s discontent, Laura felt she needed to establish some “laws” of what her mother “could and couldn’t do” before leaving the assisted-living facility. Laura told me she knew full well that her mother resented her for making these demands, but she nonetheless insisted that Sharon take a neurological exam and a driving test before moving back home.

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Coming To Grips With End Of Life Wishes

Posted on February 25th, 2015 by karen

by Stephanie Haen

Little did I know when Daniel walked into my office for our first session that I would soon be faced with helping him and his wife Susan — a pair of young newlyweds — come to grips with a decision that would surely hasten the end of Daniel’s life.

Eight months earlier, at the age of 24, Daniel had been diagnosed with brain cancer. He had recently decided to forgo the prescribed treatments, as they were causing him severe pain and daily bouts of vomiting, but, more importantly, they had failed to yield any positive results. Daniel had decided that he didn’t want the time he had left to be filled with additional sickness and pain. And while he appeared to be at peace with his decision, Susan clearly wasn’t. Daniel asked me to meet with them both, to help his wife better understand his decision and come to terms with it.

As human beings, death is the one thing we all have in common. Whether it’s facing our own mortality or someone else’s, we will all experience that dreaded word at some point. For most of us, all it takes is an earnest discussion about death to unleash our fear and anxiety, even when we’re talking about someone we hardly know. But when a loved one is the focus of the conversation, our decision-making abilities are severely strained.

Often, it’s hard to understand the choices that are made when a person is facing death, disability or severe chronic pain. We are all unique in how we feel, think, and perceive ideas, especially an idea as profound as death. So what happens when a loved one makes a decision you disagree with, especially when it’s a decision you don’t understand or consider to be wrong or cowardly? How do you stand by and allow your loved one to make such a decision?

Consider the following:

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How To Avoid A Caregiver Breakdown

Posted on January 28th, 2015 by karen

by Erin Tishman

You’ve heard the term “mind over matter”? Caregivers likely take this phrase to heart more than the majority of the population. Despite the constant pressure of managing their loved one’s physical and medical needs, many caregivers simultaneously balance jobs, family and other personal matters. So they hunker down, get in a good mindset and just do what needs to be done.

Truth be told, caregivers are a very strong and resilient bunch. At the same time, however, they are human and are susceptible to breaking down emotionally. No matter how many responsibilities a caregiver can juggle all at once, there’s a good chance they’ll all come crashing down if precautions aren’t taken.

Take Ellen, for example. She’s one of my clients. For years, she thrived as a typical working mother. She held a high-profile job as a marketing executive in a prestigious New York firm. Despite long hours at work and a tedious commute, Ellen made sure she was an attentive and active parent. She volunteered at her kids’ school, never missed a sporting event and was always home in time to cook dinner and help with homework. Ellen had found a work/life balance that most people only dream of.

Last year, Ellen’s seemingly perfect schedule was turned upside down when her elderly father was diagnosed with a terminal form of cancer. He was able to manage the disease for a few months, but soon needed constant medical care. Ellen moved her father into her home and assumed the role of primary caregiver. At first, Ellen kept her regular schedule intact. But when her father’s needs grew more intensive, Ellen’s carefully balanced routine started to crumble: she was forced to miss more and more meetings at work; shuttling her kids to extracurricular activities became a challenge; and just the thought of cooking dinner exhausted her.

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