Caring for the elderly
As Indians, the concept of family that we hold includes not only our parents and siblings but also our grandparents, uncles, aunts and other relatives. The idea of family obligations and loyalty is something we think of as sacrosanct. Perhaps this is one of the reasons why our family system has managed to stay more intact than in the West. As one of the by-products of such a system, many of us have elderly family members and relatives living with us. It could be our elderly parents, grandparents, aunts or uncles; someone we have grown up with and whom we love, respect and have committed to take care of. However, as many of us realize the hard way, caring for the elderly is no easy task. It definitely has its ups and downs. This article aims to bring out some of the challenges that caregivers of the elderly often face and their impact on the family.
Jayashree, 54, is married and lives in Bangalore with her husband, Girish, 57 yrs, and two grown children. She also works full time as an accountant in a prestigious firm. Recently, her elderly widowed father moved in with them after having lived on his own for many years after his wife’s death. His health has recently taken a turn for the worse and he had a hip transplant surgery few months ago which makes it difficult for him to walk much. He is completely dependent on Jayashree and her family for his care. He has become more paranoid in the last few years and begins to panic every time Jayashree or the kids haven’t returned home after 7 pm repeatedly asking why they aren’t home yet. He makes unreasonable demands at home, never seeming satisfied with anything his family does for him. He calls Jayashree at her office 3-4 times a day, repeating some chore he wants her to do immediately. When the family is at home, he spends much of his time with them complaining about his worsening health. Jayashree and her family cannot make many outings or have much of a social life because they cannot leave her father alone at home. He never shows any appreciation for the work they do for him neither does he seem to understand the sacrifices they are making for him.
Lately, Jayashree has started to feel impatient and frustrated with her father. She is exhausted all the time and gets frequent headaches. She snaps at her father when he asks for something and later feels very guilty and upset about her behavior. She keeps wondering how someone who was so strong and uncomplaining in his younger days could have changed so much. She feels like she needs a break from him and his demands and is holding on by a thin thread to herself-control.
Now, if you read the case above, it is very easy to understand what Jayashree and her family is going through. Many of us might have had similar experiences with elderly members in our own families. The father in this case appears to be a cranky, difficult person who seems like the villain of the story. Perhaps, it would help us to understand him and what he might be going through so that we can put his behavior in context.
For many elderly people, the decline in their physical functioning makes them feel helpless and dependent on others. None of us would like to feel that we are incapable of doing something. It makes us feel defeated. This feeling of incapacity and helplessness can often make elderly people feel frustrated and angry with themselves and those around them which they show through their temper tantrums and stubbornness. They often think of how much they were able to do in their younger years and feel bitter about their current situation.
Sometimes, some of them might feel like they are a burden on their family. This makes them feel guilty and unhappy. If they don’t have others of their own age(spouse/older relatives/friends), they might feel like their trials and tribulations are not understood by those who are younger. Also, a fear of death which is approaching fast might make some older people want to cling closely to their family. Seeing one’s spouse and friends die can be traumatic. It seems like much of what they loved in the world which was familiar to them-their partners, friends, work- is all in the past. The world around them now is something different and not completely understandable. They might ask repeated questions about tasks (like sending email, using cell phones) which are routine to the younger family members. This results in the younger family members, like Jayashree, becoming impatient and annoyed at having to answer the same questions repeatedly. Let us try to put ourselves in their positions for a moment. Just try to imagine what you would feel like 40 yrs from now when everything you know and love about your world-movies, music, gadgets, and people- has changed indescribably. You feel like your best days are behind you. Now, you feel like a relic from the past. It is a difficult feeling to live with on a daily basis. These might be some of the things which Jayashree’s father is experiencing which make him the ‘cranky, difficult’ man he seems to be today.
It is important not only to understand what the elderly are going through but also to be aware of what we, the caregivers, might be experiencing ourselves. Many of the symptoms Jayashree is experiencing fall under what is known as ‘Caregiver Stress Syndrome’. It has only recently been recognized in the medical world that people who are constantly taking care of elderly, disabled or chronically ill people experience a tremendous amount of stress themselves. This has an impact on their own health and state of mind. Caregivers might start experiencing health problems like fatigue, sleeplessness, stomach problems, low immunity to diseases, heart problems, slow wound healing and so on. Many caregivers do not get to spend any time on themselves. They are not able to relax, have fun and take a break from the constant demands of taking care of the person who is dependent on them. If we are caregivers taking care of an elderly person in our family, we might have to sacrifice our social lives and become quite isolated, taking care of the person all by ourselves.
Caregiver stress increases when there isnt enough caregiver support or help from other members of their family. Obviously, this leads to many mixed emotions in the caregiver. On one hand, you love and care deeply about the person you are taking care of. On the other hand, you might often feel frustrated, angry and resentful that they need so much of your time and attention. Then, you feel guilty about becoming angry or because you are not able to give the elderly member everything he/she asks for.
It is very important for caregivers to remember one thing: Everything you are feeling (the anger, love, guilt and resentment) is perfectly normal. Taking care of someone who probably used to take care of you once is very difficult. It is hard to get used to the change in the person you love. It is natural to feel angry or frustrated when you are tired and someone is making too many demands of you. It is crucial to remember that even caregivers need breaks from their responsibilities if they don’t want to become burnt out. It has been found that delegating the caregiving responsibility and spending quality time with one’s spouse, friends or other family members is very helpful in recharging one’s energy. Caregiver support can also be provided by support groups formed by other caregivers experiencing the same issues.
Robert H. Goddard puts it well saying “Resolve to be tender with the young, compassionate with the aged, sympathetic with the striving, and tolerant with the weak and the wrong. Sometime in your life you will have been all of these.”
If you are struggling with the duties of a caregiver or feel that the loved one you are taking care of might benefit from counselling, we can help you at TalkItOver.
1. LeRoy A. Exhaustion, anger of caregiving get a name. CNN.com Health Section. 2007.