Caring, Stress, and Coping

14

January 6, 2020 by Jean

caregiver clipartThe phrase “to care for” has two distinct meanings. One is about warm emotional attachment to another person, to care about them. The other is about our actions to take care of another person, to be a caregiver. As those we care about age, the odds increase that “caring for” will also become caregiving.

For the past five years, I’ve been playing a minor caregiving role in the life of a good friend in declining health, taking her to all her medical appointments. This was an extension of the medical support we’d provided one another throughout our decades-long friendship. Almost thirty years ago, I traveled from Pennsylvania to Boston to be with my friend during a major surgery and subsequent hospitalization. A few years later, she returned the favor, traveling from Maine to Pennsylvania and spending a week providing me with practical and emotional support during my own surgery. In the past five years, however, what used to be mutual support has become one-directional caregiving.

During the past few months, my caregiving role has become much larger as my friend has declined precipitously from moderate cognitive impairment into full-blown dementia. I have her durable power of attorney and have taken over responsibility for all her finances. I am the one who found a nursing home placement for her when it became clear she needed that level of support. I’m the person whom the nursing home calls to schedule care-planning meetings or when my friend’s disruptive dementia-related behaviors create a problem. Suddenly, the care she needs has come to loom very large in my life.

Not surprisingly, these changes in my caregiving role have been very stressful. Research on stress tells us that the most stressful situations are those that combine high responsibility with low power, a combination that characterizes a lot of caregiving for aging friends and relatives. My friend, like me, is aging alone, without a spouse/life partner, children, or family nearby. This means that, as her closest friend and the person with her power of attorney, I feel a great deal of responsibility for her care. But her situation is heart-breaking, and there is little I can do to make it better. My lack of power is magnified by the fact that my friend has always made life decisions very differently than I do, and she rejects many of the suggestions I make for ways to make her life a little more comfortable.

I know that I need to take care of myself if I’m going to continue taking care of my friend, which means that I need to find ways to manage the stress. I generally pride myself on my good coping skills, but this situation has been very challenging. So far, I have identified three coping mechanisms that I think can work for me:

  • The first level of coping for me is to deal with the physiological manifestations of stress – all that adrenalin that makes me feel as though my gut is churning and that leads me to clench my teeth and to overeat. My strategy for dealing with this is a version of mindfulness, trying to take a few moments to focus on one or a few sensory pleasures – the beautiful sight of a rosy winter dawn or of snow-covered trees, the scent of lavender that is released as I shovel the snow along my “Lavender Walk,” taking the time to savor the taste of a favorite food.
  • The next level of coping involves trying to keep my sense of responsibility for my friend within bounds. I keep reminding myself that “I’m doing the best I can,”  and I have been working to mobilize a team of friends and relatives who can share some of the responsibility. My friend’s brother in New York and one of her college friends who is a geriatric nurse practitioner have been particularly helpful sources of support from a distance. I want to limit my visits to my friend to one a week, so I am also trying to mobilize some of her local friends to make a commitment to visit her at least once a month. My goal is for her to have company at least twice a week without me having to do all of it.
  • My best coping strategy is usually what social psychologists call “instrumental coping,” a problem-solving approach that tries to reduce stress by doing something about the situation that is causing the stress. Although my ability to change my friend’s situation is almost non-existent (beyond what I have already done to move her into the highest quality nursing home I could find), I am finding that I can reduce my sense of powerlessness by focusing on the bigger picture of care for those who are aging alone. My involvement with my friend’s care has given me an up-close look at all the ways that long-term care is not well designed for those aging alone (more about this in a later post). I am working on a proposal to make a presentation on this issue to the leadership of the nursing home, with hope that this may lead to some changes in policies and practices.

 

I know that my life is unlikely to return to the relatively carefree state that I have enjoyed since my retirement. But, by acknowledging and addressing the stress that my friend’s situation creates for me, I hope to keep that stress to manageable levels and protect my own health and happiness.

14 thoughts on “Caring, Stress, and Coping

  1. Alecea says:

    Thanks for this. My mother is in a caregiver roll right now, and this wisdom seems powerful and helpful in a difficult time.

    • Jean says:

      Alecea, I think it’s all too easy to always feel as though you could be doing more — and that way lies guilt and burnout. I find it helpful to be reminded by others that I am doing a wonderful job caring for my friend, which helps give me permission to take care of myself as well.

  2. Sue McPhee says:

    My friend, I hold you in the highest esteem for what you are doing. You have taken on a lot!!!
    And your 3-point coping strategies are so powerfully right on target.
    Please take care of you. You are so right in pointing out that “long-term care is not well designed for those aging alone.” I applaud your plan to formulate a presentation on that very subject to the nursing home administration.
    And it truly pains me to read your sentence: “I know that my life is unlikely to return to the relatively carefree state that I have enjoyed since my retirement.”
    My friend, you worked long and hard for the privilege of carefree retirement and you so richly deserve it. I hope you can find ways to return to that state soon, at least partially.
    I think that at our ages we are, year-by-year, becoming keenly aware of the frustrations and stressful situations we and our peers either are or will be facing.
    How wonderful it would be if we all took some time to address this in our own way.
    I have several clients who make sure they are visiting their aged parents at least weekly if not more, whether it be in a nursing home or their own home. Offering support, comfort and solace for the caregiver is also a way we can all help.
    I am hoping to become involved in an organization called Laughter on Call that provides comic relief for patients and caregivers: Their motto: WE BRING LAUGHTER TO ALZHEIMER’S PATIENTS, THEIR FAMILIES AND CAREGIVERS.
    I just sent them an email describing who I am and what I have done in the entertainment field. (Of course, we all know how I hate being on stage…cough, cough) 🙂
    To my great joy, they quickly responded and are eager to speak with me.
    I will keep you posted.
    In the meantime, I am beaming long-distance moral support to you

    • Jean says:

      Sue, I love the idea of bringing laughter to dementia patients and their caregivers; those moments of lightness are so important. Kudos to you for using your considerable talents in this way.
      The moral support I am getting from friends (long-distance and otherwise) is more important than I can say. I didn’t mean to imply that my life has become focused only on caregiving. One of the ways I am taking care of me is by not giving up any of the activities that matter to me. But I am a realist as well as an optimist, and I know that I am likely to be in this caregiver role for years to come.

  3. Jean R. says:

    You’ve got this. I have no doubt that you can handle anything the caregiver role throws at you. Just know that no matter how hard you try to rally the troops to make a commitment to visit on a regulate basis, it won’t last long. It’s classic in the caregiver world, especially with dementia patients..

    Do you also have to take of care of closing down her house and disposing of all her stuff, too? If so, I hope her brother or other relatives are helping with that.

    • Jean says:

      Jean, Thanks for the reality check about getting others to visit. I understand; it’s hard.

      I have put everything in place (plowing, shoveling, and automatic fuel oil deliveries) to keep my friend’s house maintained in the winter. Her NYC brother will come up in spring, go through the house with me, and help figure out what needs to be done to get it on the market. The house is full of their mother’s paintings, and other valuables. As a retired antique dealer, he is much better prepared than I am to figure out how to dispose of all that stuff.

  4. Mary-Beth Taylor says:

    You are a true caregiver. You have made some good decisions.

  5. Margaret-Ann Radford-Wedemeyer says:

    Jean, I have always appreciated the clarity you brought to a problem or situation, and I too have read what you have been writing about aging with great interest. I’m sorry I missed your last visit to Gettysburg, but I won’t let that happen if you come again!

  6. GARY says:

    Thank you Jean for this reality check. I just finished my estate plan and your blog is making me understand what might be down the road for me and my wife. All our relatives live far away and although we are a few years younger than you, my wife is already has memory issues.

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I am Jean Potuchek, a professional sociologist who has just stepped into the next phase of my life, retirement, after more than thirty years of college teaching. This blog is about my experience of that new phase of life.

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