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A Year-End Commitment To Healthy Caregiving

Posted on December 31st, 2014 by karen

by Ed Moran, LCSW

Well, it’s that time of year again. Out with the old and in with the new. Each January 1st we vow to make drastic changes in the way we live our lives. We promise to eat healthier, lose weight, get more exercise, or quit smoking. We vow to spend more time with those we love, and less time with those who bring us down. We pledge each year to be nicer, to work harder, and to stop losing our temper in traffic.

We make these promises with the best of intentions, though I’m sure we can agree that most often our expectations are unrealistic. After all, trying to keep these resolutions will require significant time, effort and emotional energy, none of which the average caregiver can spare.

Caring for a sick loved one can easily take over your life. Whether you’re by their side at all times or not, it’s an enormous commitment that monopolizes your thoughts and emotions. Indeed, it starts to feel like we exist for the sole purpose of meeting their needs. Many take on this role without a second thought. Others feel pressured to take it on and maybe don’t even realize what kind of responsibility they’ve undertaken. Either way, full-time caregivers have very little brain space left over with which to engage New Year’s resolutions. That’s not to say the need isn’t there, that there aren’t things we can do to help handle emotional pressure and lead healthier lives.

For example:

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In Care of Dad: A Look Back At 2014

Posted on December 24th, 2014 by kim

by Kim Keller

I remember when I was a kid, rolling my eyes at my parents when they’d talk in wonder about how fast time goes by. Of course, that was a long, long time ago, and here I am now thinking, where did 2014 go? I don’t roll my eyes any longer. Now I just smile knowingly.

And at the end of December, my parents would sit around and reflect on all that had happened that year. I thought it was kind of silly then, living in the past and all, but I see the wisdom in that now, too. You should always bring along the lessons and whatever good life has to offer.

In that spirit, here’s a look back at In Care of Dad in 2014:

“I will never leave you — no matter what happens I will always be with you.”

Unbeknownst to both of us at the time, those would be the last words my father would ever say to me. That one sentence would carry me into my fatherless future, like a road map to guide me on the sometimes perilous, sometimes heartbreaking, always blessed journey of my life.

— Ann Meyers Piccirillo, Always Your Daughter, January 22, 2014.

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Building A New Life After Loss

Posted on November 19th, 2014 by karen

by Linda Weatherseed, LMSW

It was a year after her husband’s death when my dear friend Mary confessed that she felt totally worn out, lackluster and disinterested in everything. “I don’t know who I am anymore,” she said to me. “I feel so empty.”

Mary’s husband, John, had been her college sweetheart. After graduation, they both got jobs in New York in the advertising field. Aside from their work, they had many interests in common, including hiking, travel and the theater. Four years after meeting, they married, and in five years time their son Brian was born.

Mary initially cut down on her work hours to stay home with Brian, and eventually she gave up work altogether to be a full-time mom. John was a devoted husband and father who couldn’t wait to get home at the end of the day to see his family. Mary was the kind of wife and mother who worked tirelessly to give her family a secure and happy environment. John and Brian were the absolute center of her world.

Then, at the age of 47, after 21 years of marriage, John started to feel unusually fatigued. At first he thought he’d just been working too hard, but a series of blood tests revealed the awful truth: John had cancer. Brian was 16 at this time, a high-school junior. After the initial shock of the diagnosis, Mary and John, always optimistic, decided they simply had to do everything possible to combat the cancer and pray for the best. Unfortunately, after a two-year battle with the illness, John died at home with his beloved Mary and son Brian by his side.

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Saying Goodbye To The Blame Game

Posted on November 12th, 2014 by karen

by Ed Moran, LCSW

I saw them again last evening. I’ve never met them but I see them every night, walking hand in hand, taking their after-supper stroll. While I tend to be lousy at guessing ages, I suspect they’re both in their mid-seventies, and I like to imagine they’ve been married forever.

Next month, 18 years will have passed since my father lost his battle with colon cancer. This couple I see every night reminds me of what’s been taken from my mom, from me, and from my three siblings. That should be my parents on that nightly walk, holding hands, enjoying each other’s company. I suppose what I’m saying is, sometimes I still get angry, and sometimes I still want to know why.

But what I’ve discovered over time, through all these years of personal introspection and working with the bereaved, is that people spend an inordinate amount of time conjuring up blame when friends and family pass away. And they aren’t the only ones who struggle with blame. Victims of illness also get in on the exercise — it seems there’s more than enough blame to go around.

When a behavior is so common, there’s probably something of value in it. So what does blaming do for us? For many people, assigning blame creates the pretense of order in an otherwise chaotic situation. For example, a cancer diagnosis normally rocks people to the core. It shatters their sense of security. For some, it seems the only way to restore control is find out who or what is responsible. A smoker will blame their lung cancer on cigarettes. A drinker will blame their liver cancer on alcohol. Same thing goes for the wife of the smoker, and the children of the drinker. They all get in on the blaming. Someone who led a clean and healthy life, with no obvious risk factors, might choose to blame God. The possibilities are endless when the blaming begins.

Blame tends to reflect a sense of guilt for having gotten so sick. I’m being punished with this illness because I wasn’t a good person. I must’ve done something wrong to wind up with this illness. What did I do? It’s a common response because it offers a rationale (regardless of how irrational it might be) to explain an otherwise inexplicable turn of events. But it’s a dangerous path to start down. It can be extremely difficult to extricate oneself from that line of thinking, and it can drain one’s emotional energy that’s better suited to building the internal strength that’s needed to fight for survival.

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When Grief And Guilt Prolong The Pain Of Loss

Posted on October 1st, 2014 by karen

A zinnia means: I mourn your absence.

by Erin Barone

Sarah was 35 years old, with two small boys and a husband who abruptly passed away due to a brain tumor. While her husband Sam had complained of steady headaches, Sarah would blame it on stress from his job as a financial advisor and simply tell him to take some Tylenol.

After a few months of unrelenting headaches, though, her husband finally decided to see a doctor, whereupon he discovered that he had a brain tumor requiring immediate surgery. Sadly, Sam did not survive the procedure, dying on the operating table.

Since his death, Sarah has frequently made comments like “I didn’t choose this life for me, and I especially didn’t choose this life for my two little boys.” She also blames herself for having minimized the severity of her husband’s headaches, often stating, “I should have listened to him more, I should have told him to go to the doctor sooner, and then maybe they would have been able to save him before the tumor grew so big!”

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Unresolved Grief: It’s Complicated

Posted on September 10th, 2014 by karen

by Erin Doeberl

Kate was a 38-year-old mother of three and sister of two. She had lost her eldest sister, Jane, unexpectedly to suicide. It was a terrible shock for Kate — this was her big sister, the one who understood Kate the best and was always there for her. “How could I not know?” Kate would sometimes exclaim to herself. “What am I going to do now?”

Kate began suffering regret, remorse and guilt almost immediately following the news of Jane’s death. Kate’s reaction was not unusual. The first few months after the sudden death of a loved one bring about a variety of different feelings, sometimes a sense of pervasive numbness, other times a rapid shift of emotions, like a roller coaster ride.

Kate expected to be emotionally inconsistent for a while. But a year and a half later, she was still feeling the same way, except possibly worse. She found herself avoiding anyone associated with Jane. She stopped calling Jane’s husband and didn’t reach out to anyone else in Jane’s family, not even around the holidays, which only exacerbated her feelings of loss and loneliness.

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GOOD GRIEF!

Posted on July 23rd, 2014 by karen

by Amanda Geffner

Jeannie couldn’t understand why, two years after the sudden death of her husband Bob, she still felt a hole in her life. Why can’t I move on? she wondered. Why can’t I control these periodic waves of sadness?

It was especially trying when the Fourth of July rolled around. She and Bob had always organized and hosted an annual party, a genuinely gala affair. She knew how much these gatherings meant to her son and daughter, both teenagers, and she wanted to make it the same for them this year, but she couldn’t. She felt exhausted, overburdened, sad and abandoned. She wasn’t up to making the extra effort or pushing herself. She wanted someone to reach out to her, not the other way around.

But most of all, Jeannie felt guilty for feeling all of these negative emotions.

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Processing Grief When A Loved One Is Lost

Posted on June 25th, 2014 by karen

Ed Moran at age 17 with his dad.

by Ed Moran, LCSW

Not too long ago I was paying a visit to the local Walgreens store. It was the day before Father’s Day, and, as one would expect, the greeting card aisle was loaded with sons and daughters, some young and some not so young, fishing through what was left in the racks. I smiled as I walked past and chuckled to myself. That would have most certainly been me in that aisle, sifting through the worst of the worst cards, the rejects left behind by people with better time management skills than I have. Then it hit me: 15 years have passed since the last time I needed to buy a Father’s Day card. Could it really be that long? It truly feels like yesterday, in some ways, since Dad was laid to rest. A lot has changed since then, yet a lot has remained the same.

As a therapist working with the bereaved, it’s sometimes hard to fully set aside one’s own losses. The stories that are shared in therapy are emotional and deeply personal, yet almost everyone can identify with them. Some losses are sudden while others involve long-term illness and prolonged caregiving. The relationships with the lost loved one can be extremely close or extremely complicated, which can certainly impact how one processes grief. However, regardless of the nature of the relationship, there’s no doubt that grief can put even the strongest person through an emotional roller coaster ride like no other. One client described it as “kind of bi-polar,” feeling fine one moment and bursting into tears the next, with no apparent trigger. This would often keep that client at home, due to the fear she would have an emotional outburst at an inopportune time. When someone is grieving, it can feel like the hurt is never going to heal. There are things we can do, though, to help work through the pain of loss and work toward a new normal.

Try to remember that what you’re feeling is normal. Sadness is a natural response to loss, and it may come and go for quite a while.
Surround yourself with supportive people. This is particularly important when the dust settles and the calls and outreach become less frequent.
Don’t isolate. Try to reengage in life as soon as you can. Isolation can magnify the sadness and depression associated with grief.
Maintain your routine. Bereavement can cause us to become loose with discipline and let go of healthy things like diet and exercise.
Get plenty of exercise.
Share stories of your lost loved one. Or ask others to share their stories with you.
Try to get plenty of sleep. Even without a loss, a lack of quality sleep can leave us feeling sluggish and reduce our tolerance for stress.
Avoid soothing with drugs or alcohol. It can contribute to feelings of depression and also interfere with quality sleep.
Seek counseling. Grief can make you feel alone and disconnected. A bereavement group can provide a supportive environment that allows you to identify with others.

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Building Trust: Blended Families In Crisis

Posted on May 28th, 2014 by karen

by Erin Doeberl

Caregiving is a challenge for any family — it can be an overwhelming and exhausting task. However, blended families (meaning families that include stepparents, stepchildren, half-brothers, half-sisters, etc.) face an even greater challenge.

Linny and Jack were married for 27 years before he died in August 2013. During this time, Jack’s four grown children from a previous marriage became Linny’s family as well. “I worked really hard at bringing the family together,” Linny said. “Jack was the love of my life, and his kids obviously meant a lot to him. So I did whatever I could to make us all a family.”

When Jack developed Alzheimer’s, Linny was his primary caregiver, as his kids all lived out of state. As the disease progressed, his care demanded more than she could provide for him at home, even with hired help. “Jack was a big man, and I couldn’t lift him if he fell,” Linny explained. “I carefully chose an Alzheimer’s Care facility for him to move into. It was a terribly painful and difficult choice for me, but I didn’t see an alternative.”

Jack’s kids, though, were not happy with Linny’s decision. They would visit once or twice a year and were devastated by what had become of their father. They questioned the facility and the quality of his care, and seemed to blame Linny for the tragedy that was in no way her fault. The kids suggested she move their father back into the house, but without offering to share in any of the caregiving responsibilities.

“They would go back to their own homes,” Linny said, “and be comforted by their spouses. But I was alone through all of this. The man that had always comforted me was no longer able to. It was a very trying, lonely time for me. I tried to do the best I could.”

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Successful Caregiving: One Family’s Strategy

Posted on April 30th, 2014 by karen

by Myra Marcus, Ph.D.

The concept of successful aging has become familiar to us. It relies on the combination of three factors: avoidance of disease, maintaining high cognitive and physical functioning, and having an active and meaningful social life. But is there such a thing as “successful caregiving”?

From the vantage point of the client/patient, it might mean that their physical, social and emotional needs are met sufficiently. But how would a caregiver define success? Does it simply mean that their loved one is kempt, nourished and free from bedsores? Or is it something more intangible, such as helping the patient have a “good death”? It is a subjective term that relies on the caregiver’s perception of what constitutes compassionate care.

Sarah, Ellen and Mary were three sisters who lived in different states. The age difference between them, from eldest to youngest, was 12 years. Their parents lived in an adult community in Florida. Through the years the sisters visited regularly, although not always at the same time. When their mom died suddenly, their 90-year-old father was left to fend for himself.

He was able to function autonomously for several years, but, during one of her visits, Mary noticed cognitive changes: memory lapses, confusion, and decreased ability to manage his day-to-day activities. Since none of the daughters lived close by, they decided that a division of labor among them was needed.

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