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The Underappreciated Family Caregiver

Strategies for handling resentment and getting few thanks

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"Your brother calls me every day," my 85-year-old mother often gushes. He lives 340 miles away and can't visit often, so his phone calls mean a lot to her. But her comment has always puzzled me. As her primary caregiver, I also call her every day, except for the several times a week I actually visit her in person. Yet she never crows proudly about my calls or visits or handling of her medications, finances, home health aides and insurance forms. I am left wondering whether she takes my efforts for granted.

Yes, the knowledge that we are doing the right thing for our loved ones should be our biggest reward. But it's nice to receive acknowledgment from the people we care for: Pats on the back can go a long way toward boosting caregiver morale.

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Otherwise, it's hard not to feel miffed. At my grumpiest moments, I resent that my brother does far less than me and yet wins kudos I never hear. That doesn't inspire me to work harder on my mother's behalf and sometimes makes me irritable with him.

There are many reasons why hard-working caregivers may be underappreciated. The aging parent may resent needing assistance and therefore begrudge thanks to her primary helper out of spite. Or the monotony of regular care routines may lull them into simply expecting a caregiver's sacrifices as part of daily life.

How can you get a little well-deserved respect without acting like an attention-seeking complainer? I have some ideas:

Toot your own horn. In the business world, employers often ask their employees for a year-end list of their accomplishments. As an executive-level family caregiver, you don't need so formal a process but ought to keep other family members informed of the myriad tasks you manage. For example, you could send out a group email describing the recent medical appointment to which you took the care receiver. Or you could convey recent financial transactions you conducted. When family members understand the scope of your duties, they may be more likely to show appreciation or even willingness to help.

Use humor. When my kids were very young and a little too demanding, I often responded half-humorously, " 'Please' and 'thank you' might help." The equivalent sly comment to prompt adults to be more courteous and appreciative is to ask, "What am I, chopped liver?" Oftentimes, care receivers become so self-absorbed with their own suffering that they stop paying attention to their caregivers' efforts. They may need a light-hearted reminder to acknowledge your work, such as, "You don't have to thank me. I'm in it for the money."

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Acknowledge care receivers' efforts. Sometimes, the best way to get thanks is to give it first. Set a tone of mutual appreciation by thanking the care receiver for all she did for you years ago. It might help her see your caregiving for her now as reciprocating her own efforts with you as a child. And thank her for any help she gives you; you will be encouraging her to assist you more, and maybe make it more likely she will thank you in return. If she does say "Thank you," always respond "You're welcome," to acknowledge the gesture.

Pat your own back. If family members ultimately can't or won't express appreciation, then you may have to accept their limitations. You can't squeeze blood from stones; you can't wring thanks from the stone-hearted. In the end, you have to appreciate yourself, knowing that you are doing good work and for the right reasons. To paraphrase an old Ricky Nelson song, you can't please everyone — or anyone — all of the time. Sometimes you just have to please yourself.

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