Dr. Val Farmer
Rural Mental Health & Family Relationships

Family Caregiving Involves Help From Others

October 19, 2003

I visited with Richard Miller, an associate in the school of family life at Brigham Young University about the needs of caregivers. He shared some important information on how families can cope with their challenges in providing home care for their elderly family members.

Eighty-five percent of caregiving for the elderly is family care. Only five percent of those over 65 need nursing home care. When it comes to caregiving, families are the heroes. We are also going through this experience. My 91 year old father-in-law has been living with us since last February after he lost his wife of 68 years.

- Attitude means everything. The biggest difference between a rewarding experience at caregiving or experiencing it as a burden is whether it is being done out of love or out of obligation and duty. To do this well, your heart has to be right. It is a mission. It involves sacrifice.

Recognizing the positive aspects of caregiving helps balance out the huge stress load and sacrifices the caregiver makes. A source of satisfaction is often rooted in a sense of living up to our personal values and honoring the love our parents have given us. By recognizing that we truly chose this role, it becomes easier to ask others for help in a positive and constructive way.

I asked my wife about her motives. She said she wanted to give back to her father the love and opportunities that had been given to her. "It is my opportunity." It is something she wanted to do and is glad it has worked out this way.

We also feel it is good for our 17 year-old son Trace to see the generations taking care of each other. He is learning compassion and patience along with us.

- Caregiver burden needs to be shared. Family members face enormous changes. On the physical side, family members provide all the medical assistance they can plus assist with daily living. This can be a 24 hours a day, seven days a week job. Challenges can vary with each family circumstance. Past relationships and personalities are different. The extent of physical and mental disabilities are different.

Caregivers can be overwhelmed with physical and emotional exhaustion trying to keep up with the demands of providing the care required. When an elderly spouse is the primary caregiver, that is when the most outside help is required.

Children need to be partners with the caregiving parent to ease the burden and take care of things like car repairs and upkeep, carpentry and plumbing, floor scrubbing, deep cleaning and yardwork.

Some experts believe that caregivers should be relieved at least one day a week to pursue their own lives, be with their friends and have an emotional outlet from the constant demands of care.

- There is a wide array of services that can be brought into the home. These include meals on wheels, housekeeping, companion services, skilled nursing care, and transportation. Adult day care and respite care in nursing homes are valuable resources to aid with caregiver overload and strain.

- Emotional support is even more important than sharing the burden. Behavioral and personality problems are often more stressful to family members than the actual physical symptoms. Worry and stress can be overwhelming. A person’s own emotional adjustment is the key to the quality of care he or she can give to an elderly parent.

Emotional issues such as clashes with a parent, dealing with anxiety, coping with physical disabilities, obsessions about money, memory loss, health concerns, getting lost in the neighborhood, and strong needs for attention all take an emotional toll.

My wife feels the movie, "Groundhog’s Day" with its repetition describes her life. She is experiencing a loss of freedom, her responsibility of total care and the responsibility of meeting her father’s social needs.

My attitude and support to my wife is a crucial part of her coping. I share in her commitment to her father’s care. I adapt. I listen to her and share the workload when I can.

Our friends have chipped in and have provided important backup assistance for us. Caregiving is something we can’t do alone.

- Support groups are helpful. Positive coping means seeking needed information about a parent’s problems, special needs or condition. Support groups for caregivers give an emotional release and valuable ideas on how to solve problems. Some people also choose to go for individual counseling to discuss emotionally charged personal problems and other issues.

- Brothers and sisters share in this responsibility. Families need to communicate, clarify responsibilities, plan for care, and negotiate caregiving roles. Family members have different talents, motivations, and life circumstances. Not all are suited or in a position to provide most of the care. Accepting that fact may ease family relationships. Let go of resentments of those who don't measure up.

Siblings can do what they do best. They can offer material and emotional support. They can give respite to the primary caregiver. Their willing hearts and hands can make a big difference. Conflict and criticism from siblings often is one of the greatest sources of stress - more so than the direct physical care involved.

My wife has one brother. He and his wife live in Maryland. We have worked out a rotation plan where my father-in-law lives in their home during summers.

What qualifies us for this task? A willing heart, lots of help, and a high regard for the life and comfort of our loved ones.