Ask an Expert
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FEBRUARY 2021 TOPIC: Trials & Tribulations of Primary Caregivers
Deborah Gilboa, M.D. (a.k.a. Dr. G)
Physician & Resilience Expert |
OUR EXPERT:
We have been told to “avoid stress” so much that experiencing stress feels like its own failure. Resilience expert Deborah Gilboa, M.D. (a.k.a. “Dr. G”), works with families, organizations and businesses to identify the mindset and strategies to turn stress to an advantage. Renowned for her contagious humor, Dr. G inspires audiences with her illuminating stories and provides no-nonsense prescriptions for character development. She works with groups across multiple generations, to rewire their attitudes and beliefs toward a common objective and create resilience through personal accountability and a completely different approach to adversity. Dr. G is a leading media personality seen regularly on TODAY, Good Morning America and is the Resilience Expert for The Doctors. She is also featured frequently in the Washington Post, The New York Times, Huffington Post, and countless other digital and print outlets. Dr. G is a board certified attending family physician and is fluent in American Sign Language. In addition to being a graduate of University of Pittsburgh’s School of Medicine (where she is also a professor) and Carnegie Mellon University, she is an alumna of Chicago’s Second City Improv Theater. Her diverse background and experiences add to her credibility and lively storytelling. Dr. G resides in Pittsburgh with her four boys. |
My mother is 83 and lives alone in a small apartment. Due to her physical limitations, I take care of her errands, grocery shopping, laundry, and driving her to most appointments. My mother’s relationship with me has always been complicated. I realize she is in pain and frustrated because she cannot do things she used to, but she loses her temper easily. Unfortunately, I bear the brunt of these outbursts because I’m the only one she sees on a regular basis. Disagreements quickly escalate into her screaming how she hates me, blaming me for her unhappy life. She eventually calms down and apologizes, then acts like nothing happened! I try to let it go, but the last tirade ended with me threatening to walk out. I don’t want to turn my back on my mother because I’m the only one helping her. Any advice on how to continue to help her but protect myself as well? ~ Lori (NY)
Lori,
I’m so sorry you’re in such a painful and frustrating situation in this chapter of your mom’s life. You don’t mention that she has a diagnosis that makes her unable to control her outbursts and language, so I’ll assume there isn’t one. I hear that she has pain, and that deserves empathy. But empathy is not the same as having no boundaries in how you allow yourself to be treated.
You’ve taken a really important step in resilience in recognizing that you need to find more options in your situation to manage the loss and discomfort you’re feeling when your mom behaves this way towards you. You’ve likely come to realize that only she can control her behavior. The behavior you’d like her to change is how she handles her irritation and to stop insulting and intentionally hurting you. The behavior you can change is in how you interact with her.
When we find ourselves ready for a change, as you are in considering how to get this situation to be different, we first think of what we could lose. If you refuse to allow this behavior to continue without stepping away, you may be worried that you will lose your relationship with your mom or lose the respect of others who feel you’re abandoning your mom.
In the face of change, we also feel distrust. Would a change on your part really lead to a change on her part? Could you stick with a change that you decided to make, or would you cave in and go back to your old patterns.
Once you decide that a change is even possible, you might worry about how uncomfortable it would be. You might worry about how your mom is doing and perhaps feel guilt that you aren’t there. You might get calls from her with even worse accusations!
But Lori, you do have choices. You can choose to let her know that you need to feel respected even when someone is angry with you. You can say that you won’t return to someone again and again who insults and harms you this way. You can choose to help her find a hired caregiver to do most tasks, or reach out to her house of worship or community center or Area Agency on Aging to help her find a companion. You can let her know where the line is in terms of her behavior, and that you will tolerate and forgive anything up to that line, but you will not stick around for anything past it.
You can choose to show her empathy without allowing her to treat you shamefully. You can be resilient, even in this awful situation. You deserve that.
My problem is finding time for other family members. I have no quality time with my husband – he’s supportive, but it’s frustrating. Basically, I feel like I don’t do anything outside of work and caregiving. My health is going downhill. I understand that if I don’t stay healthy, no one wins. But there doesn’t seem to be enough hours in the day for self-care either. The traveling back and forth (my dad is almost an hour away) gets very taxing. He doesn't seem to think he needs help, and he also doesn't realize how much I'm doing. Any suggestions? ~ Donna (CA)
Donna,
I have no doubt you’re doing a great deal for your dad and that the travel is hard. Is it possible that you can make a few small changes that would open up a bit more of your time?
You’re absolutely right that you’re feeling pressure from all sides, and this can take a real toll on your physical and mental health. I hope some of these practical suggestions will work to take some of the pressure off and allow you to align the way you’re spending your time closer to the things you want to prioritize in each of your relationships.
I have been a caregiver to the elderly for 12 years. Since I have been wearing a mask, I find it’s difficult to communicate with my elderly patients. Some of them already have hearing loss, and it only makes it worse now that I have my mouth covered. There are times when I have to step back and remove my mask which makes me concerned for their safety. Frequently, I find my patients aren’t aware of the concept of wearing a mask, and they get insulted when I wear one in their home. Any suggestions on how to handle this? ~ Mary (NY)
Mary,
Thank you for the work you do. I appreciate your empathy, compassion and insight. There is a mask that is often used by folks in the Deaf and hard-of-hearing community that has a cloth surround with a plastic middle to allow people to see your mouth and aid in communication. Your voice will still be muffled somewhat, but the visual cues really help.
When you are asking your patients to wear a mask, a few different things might help. You can give them a chance to do you a kindness by saying, “I’m wearing a mask so I can protect the medically at-risk clients I serve, and I’m asking you to wear one to help me do that, too.” Also, you may tune into the news with your client - on TV, radio or the internet - and show them a program explaining the use of masks in the community, so you have some facts to share that come from a source they find credible. Lastly, you could just let them know you’re worried and that it would really help you do a better job caring for them.
I hope one of these suggestions will be helpful in your situation, and thanks for your work.
Lori,
I’m so sorry you’re in such a painful and frustrating situation in this chapter of your mom’s life. You don’t mention that she has a diagnosis that makes her unable to control her outbursts and language, so I’ll assume there isn’t one. I hear that she has pain, and that deserves empathy. But empathy is not the same as having no boundaries in how you allow yourself to be treated.
You’ve taken a really important step in resilience in recognizing that you need to find more options in your situation to manage the loss and discomfort you’re feeling when your mom behaves this way towards you. You’ve likely come to realize that only she can control her behavior. The behavior you’d like her to change is how she handles her irritation and to stop insulting and intentionally hurting you. The behavior you can change is in how you interact with her.
When we find ourselves ready for a change, as you are in considering how to get this situation to be different, we first think of what we could lose. If you refuse to allow this behavior to continue without stepping away, you may be worried that you will lose your relationship with your mom or lose the respect of others who feel you’re abandoning your mom.
In the face of change, we also feel distrust. Would a change on your part really lead to a change on her part? Could you stick with a change that you decided to make, or would you cave in and go back to your old patterns.
Once you decide that a change is even possible, you might worry about how uncomfortable it would be. You might worry about how your mom is doing and perhaps feel guilt that you aren’t there. You might get calls from her with even worse accusations!
But Lori, you do have choices. You can choose to let her know that you need to feel respected even when someone is angry with you. You can say that you won’t return to someone again and again who insults and harms you this way. You can choose to help her find a hired caregiver to do most tasks, or reach out to her house of worship or community center or Area Agency on Aging to help her find a companion. You can let her know where the line is in terms of her behavior, and that you will tolerate and forgive anything up to that line, but you will not stick around for anything past it.
You can choose to show her empathy without allowing her to treat you shamefully. You can be resilient, even in this awful situation. You deserve that.
My problem is finding time for other family members. I have no quality time with my husband – he’s supportive, but it’s frustrating. Basically, I feel like I don’t do anything outside of work and caregiving. My health is going downhill. I understand that if I don’t stay healthy, no one wins. But there doesn’t seem to be enough hours in the day for self-care either. The traveling back and forth (my dad is almost an hour away) gets very taxing. He doesn't seem to think he needs help, and he also doesn't realize how much I'm doing. Any suggestions? ~ Donna (CA)
Donna,
I have no doubt you’re doing a great deal for your dad and that the travel is hard. Is it possible that you can make a few small changes that would open up a bit more of your time?
- Can you use some of your drive time for that self-care you talked about? A phone date with your husband, catching up with family members or friends you miss, listening to a concert or podcast or author you love?
- Could you make a list of all the things you do for your dad? Then decide what you and he feel could be delegated to other family members, neighbors or an aide or errand runner for him. That will leave you going out to see him more often for the tasks and experiences you want to do and less often for the day-to-day that could be done by others.
You’re absolutely right that you’re feeling pressure from all sides, and this can take a real toll on your physical and mental health. I hope some of these practical suggestions will work to take some of the pressure off and allow you to align the way you’re spending your time closer to the things you want to prioritize in each of your relationships.
I have been a caregiver to the elderly for 12 years. Since I have been wearing a mask, I find it’s difficult to communicate with my elderly patients. Some of them already have hearing loss, and it only makes it worse now that I have my mouth covered. There are times when I have to step back and remove my mask which makes me concerned for their safety. Frequently, I find my patients aren’t aware of the concept of wearing a mask, and they get insulted when I wear one in their home. Any suggestions on how to handle this? ~ Mary (NY)
Mary,
Thank you for the work you do. I appreciate your empathy, compassion and insight. There is a mask that is often used by folks in the Deaf and hard-of-hearing community that has a cloth surround with a plastic middle to allow people to see your mouth and aid in communication. Your voice will still be muffled somewhat, but the visual cues really help.
When you are asking your patients to wear a mask, a few different things might help. You can give them a chance to do you a kindness by saying, “I’m wearing a mask so I can protect the medically at-risk clients I serve, and I’m asking you to wear one to help me do that, too.” Also, you may tune into the news with your client - on TV, radio or the internet - and show them a program explaining the use of masks in the community, so you have some facts to share that come from a source they find credible. Lastly, you could just let them know you’re worried and that it would really help you do a better job caring for them.
I hope one of these suggestions will be helpful in your situation, and thanks for your work.
