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How Guilt-Ridden Caregivers Can Set Limits

To make long-term caregiving sustainable, consider some boundaries

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“We all have multiple roles,” I am telling about a dozen family caregivers at this How to Care for Aging Parents workshop. “We aren’t just adult children to our aging parents, but we are often spouses to our life partners. Parents to our children. Siblings. Aunts. Let alone dedicated workers in our jobs.” Several group members nod their heads in agreement. This idea makes intuitive sense to them.

But then I add, “We can’t give all of ourselves to only one of our roles — being a family caregiver. We have to set limits on the time and energy we spend caregiving to conserve ourselves for the other roles as well.” Their head nodding stops. No one speaks for a moment. They look uncomfortable. I’ve seen the same scenario play out in hundreds of other caregiver presentations over the past 30 years. The thought of setting limits on caregiving is making them feel guilty. The crime? Being a bad daughter or son and letting a parent down.

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The concern is understandable. Adult child caregivers generally want to be there in Mom’s hour of need to show their love and give back to her for all she has given them in their lives. But none of them are comfortable with, say, putting off their teenage child who needs help with math homework or a relationship breakup or chronic anxiety because Mom is feeling lonely and wants company. Caregivers may not have the capacity to provide all the help to all the family members who rely on them.

That’s the gravity that pulls would-be caregiving superheroes down to earth, forcing them to accept the normal reality of their limitations. As I explain to the attendees at this workshop, I typically say to caregivers, “Everyone has limitations about what they are available, willing and able to do. What part of caregiving will be especially hard for you? What are your limitations?”

The caregivers here are still quiet when I tell them that because all caregivers have limitations, it is a good idea for them to intentionally set limits on how much they give to any one family member to try to be fair to all. I say this is the best way to sustain caregiving over time. A few of them look at me curiously. How can they set those limits, they seem to be asking, in a way that causes minimal guilt? Here are some ideas.

When guilt is unavoidable, choose freely

Faced with their limitations, some caregivers try to overcome them — even making believe they don’t exist — by sleeping less and pushing themselves harder to do more for all the people they feel responsible for. This often leads them to wear down and then feel guilty that they have “failed” or are insufficiently loving. If they are fortunate, at this point a sad truth will dawn on them: It is impossible for them to be everything to everyone. As consolation, they do have the choice to be some things to everyone (e.g., call Mom on the phone but stay home to be near the struggling teenager) or all things to someone (e.g., devote themselves to Mom but have a spouse care for the teen). Do such compromises still cause guilty feelings? Very much so. But when there are no perfect options, the only pragmatic thing to do is to prioritize needs and choose to use your available energies for the most good in a given instance. Paradoxically, exercising that power of choice can feel freeing.

Conservation isn’t neglect

When caregivers set limits on what or how much they do for an aging parent, they rarely do so with a begrudging spirit. Rather, caregivers are bowing to the reality of the multiple pressures they are under, given the circumstances of their lives. Being smart and strategic about the choices they make can help them do more, not less, for a parent in the long run. For example, allowing themselves to sleep more may mean they are cheerful, not haggard, when in the parent’s company. Getting their teenager on a better track may mean they can then bring their full attention to a parent’s concerns.

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The ultimate imperative

It is sometimes hard for caregivers to accept that their responsibility is to help safeguard a parent’s emotional and physical well-being as they age, not provide all necessary care themselves (regardless of what that parent might prefer). Setting limits doesn’t undermine that commitment. Even if a parent is living with the caregiver and wants only that caregiver to provide necessary hands-on assistance, it is still okay to ask others (a home health aide; another family member) to provide that help at times. We all must find other pathways toward caring for the people who raised us and all other family members as best as possible, whether we feel a little guilty about it or a lot.

Barry J. Jacobs, a clinical psychologist, family therapist and health care consultant, is the coauthor of Love and Meaning After 50: The 10 Challenges to Great Relationships — and How to Overcome Them and AARP Meditations for Caregivers. Follow him on Twitter and Facebook.

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