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Are You a ‘Control Freak’ Caregiver?

Learn how to strike a balance between being responsible vs. demanding

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AARP;(Source: Adobe Stock Images)

“My younger brother called me a ‘control freak,’” my psychotherapy client Sally said angrily. “Just because I told him the right way to care for Mom, he called me a name!”

I understood her anger. No one likes to be called names or told they are “controlling” or “bossy.” She was a hard-working, well-meaning caregiver who had volunteered to move her mother with moderate dementia into her house to care for her. She didn’t deserve to be insulted.

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Yet I also wondered to myself if her brother Ned might have a point. In the months we had been talking, I had learned Sally controlled every detail of her mother’s life, from what time she woke up to what she wore to how she spent her days. Part of this was to use a predictable routine to help keep her mother as oriented as possible. Another part of this, though, was probably to reduce her own anxiety that something would go wrong unless she was on top of it, causing her to feel terribly guilty.

I could imagine her needing to control Ned, too, by telling him what he should feed her and which TV shows to put on during the week that their mother would be visiting his home. Even if he understood the need for predictability for their mother, it might have rankled him that his big sister didn’t trust he could keep their mom safe and happy on his own.

Does Sally understand her mother’s needs and preferences better than her brother? Almost certainly. Does that mean Ned should allow her to guide him? Possibly, but his sister’s belief there is only one “right way” of caring for their mom may seem to him picky and offensive, as if only she can be the ultimate authority on what’s good for Mom.

All primary caregivers want to provide the best possible care. To decrease chances of things going wrong, they may decide that only they know what is best and only they should take care of the care receiver because others either can’t or won’t exactly duplicate what they do. The irony is that some of these caregivers then complain they can’t get others to help them. What they mean is they can’t get others to adhere to their “right way” of providing care as they define it. Meanwhile, those others become resentful of the primary caregiver for making it too difficult to participate in caregiving activities.

There is a thin line between responsible caregiving and what other family members perceive as overly controlling caregiving. How can caregivers stay on the right side of the line, do a good job, and not alienate others who are willing, able and available to help? Here are some ideas:

Broaden view on what’s ‘right’

Caregiving is not an exact science. Except for administering medications and handling other medical tasks correctly, most of what caregivers do doesn’t demand rigidly hewing to one right way. There is usually a range of potential solutions that are right to some degree, which may work on some days in some situations but not others.

It is possible that Sally’s mother will get upset while staying with her son if he doesn’t dress, feed and entertain her as she is accustomed when at her daughter’s home. Ned will then need to talk with her and try different strategies — using the same trial and error that most caregivers use — to find the right way for him to please her. It may not be the same routine she usually follows but may work for her and him in the different context of his home.

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Explain, don’t dictate

There may be instances in which a care receiver does need a specific type of care implemented a certain way. For example, a care receiver may need to tuck their chin while swallowing a pill or take it with a spoonful of applesauce to avoid choking. That is essential information for a primary caregiver to impart to others, not with a direct order that sounds like a scolding admonition, but with a patiently explained rationale that is a respectful appeal to a fellow caregiver.

Likewise with Sally and Ned, she may be using a tone with him that triggers his old feelings about being bossed around by her. To encourage him to adopt some of her approaches with their mother, she should speak with him as a partner and equal, not her junior assistant.

Accept imperfect control

The Serenity Prayer’s wish for “the serenity to accept the things I cannot change” is a tall order for most people but especially caregivers who are trying to control their care receivers’ lives to protect them. Care receivers fall to the ground and get hurt despite having caregivers right next to them ready to catch them. They get sick despite having caregivers administering medications exactly on time. A revised Serenity Prayer for controlling caregivers might read, “I wish for the serenity to accept imperfect control no matter how hard I try, avoid blaming myself and others if things go awry, and stop feeling guilt.”

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