No one has to tell the more than 65 million Americans who provide unpaid care to loved ones with chronic illness that their job is difficult, stressful and exhausting—physically and emotionally.
Nor do caregivers (full- or part-time) need to hear yet again that they must build a support system so they can take breaks to pamper themselves from time to time. What caregivers need most are methods for making the day-to-day act of caregiving a little less exhausting.
What often gets overlooked: With the grueling demands of caregiving—whether it’s shopping, handling a loved one’s finances or helping with bathing and dressing—it’s easy to overlook the critical aspect of effective communication.
So often, it’s the misunderstandings, hurt feelings and unspoken expectations that drain precious energy from the caregiver at the very time he/she needs it most. Here are eight secrets to help caregivers…*
SECRET #1: Set the ground rules. It’s common for caregiving to begin with a general intention of “helping out.” However, the needs of your loved one are bound to grow over time. That’s why it is crucial for every caregiving arrangement (even with a spouse) to have a written agreement, initiated by the caregiver with input and consent from the loved one. What are you, as the caregiver, able and willing to do? How much time can you realistically commit to providing care? When creating the agreement, which can be reviewed and changed periodically, remind the ill person that it will help protect the relationship and prevent misunderstandings.
SECRET #2: Don’t give in. Whether it’s eating a food that’s not on his diet or stopping physical therapy, it’s tempting to allow a chronically ill person to have his way just to keep the peace. Do not do it. Instead, try to figure out the reason for the request. Listen closely and then repeat the request, so the person knows you’re paying attention. Take some time to consider the request, even when you know the answer is no.
When you do tell the person no, be firm but explain your reasons so you don’t come across as arbitrary. Try to find another way to address the request in a safer and/or more appropriate way. If the person is, say, asking to eat spicy foods that you know upset his stomach, offer to contact a nutritionist for advice on what else he can eat.
SECRET #3: Pay attention to body language. In many cases, a person may say one thing but really be feeling something else. For example, your loved one may say that he likes the meal you’ve prepared, but his fidgeting at the table most likely indicates that he feels frustrated with the food choice or perhaps the table setup. Or your loved one may say that he feels comfortable taking a walk in the backyard, but if he’s looking down when he makes the statement, he may, in fact, feel unsafe. Be attuned to these signals, and you’ll be better able to meet that person’s real needs.
SECRET #4: Practice listening. Many chronically ill people are angry about what they’re experiencing and need to vent. As the caregiver, one of your primary roles is to simply listen. (If you are a family member, it may be appropriate for you to help find a solution or look for someone who can.)
Let your loved one know that you’re willing to listen, as long as he’s not hurting or attacking you. If you get frustrated, say, “OK, I need to leave now. But I’ll be back in a while.” By saying you’ll be back, you let the person know you’re still in a relationship with him.
SECRET #5: Apologize if you’re wrong. If you’re spending a lot of time with a loved one, chances are you’ll forget to follow through on a request, act irritated when you should not or do something else at some point that will offend or hurt that person. If this occurs, give the person an opportunity to air his grievance. Never interrupt. After hearing out the person, repeat what he has said back to him. If it’s obvious that you offended your loved one, apologize immediately and sincerely.
If your fault is less obvious, offer to think about what your loved one has said and let him know that you’ll discuss it further the next day. When the time comes, explain what you think happened and let the person know that you didn’t intend to hurt him. Sometimes, the person may simply be looking to vent his feelings and not even expect an apology.
SECRET #6: Use the power of touch. Day-to-day caregiving can easily focus so much on the chores that need to be done that the relationship you have with the ill person gets somewhat neglected. In these cases, touch can be a powerful antidote. Simply holding someone’s hand can ease sadness. A peck on the cheek shows you’re happy to see your loved one. Touching shows acceptance, compassion and caring—and the result is a stronger bond between you and your loved one. Make sure the touch is appropriate to your relationship, and avoid touching anyone who dislikes physical contact.
SECRET #7: Let your loved one cry. Crying is a normal reaction to the sadness and suffering that often result from chronic illness. Even men need to cry. When someone cries, don’t interrupt him with, “Why are you crying?” or “Don’t cry.” Simply sit silently and look empathetic. Interrupt only if you’re handing the person a tissue.
When the tears stop, wait awhile and then say, “I can see you’re very disturbed, and this makes me feel for you.” While leaning forward with an expectant look on your face, say, “Is there anything you’d like to talk about?” Don’t force your loved one to explain the tears. Often, a good cry is all it takes to ease distressful feelings.
SECRET #8: Avoid confrontation. Do your best to avoid clashes, especially over minor issues. Use phrases such as, “As I see it…” or “In my opinion…” to suggest that you are giving your opinion, not hard facts. If you do have an argument, stay calm. Allow the other person to talk—or show anger as long as it isn’t excessive or abusive—uninterrupted. When he finishes, calmly explain your position. If the conversation is still heated, suggest that you save the discussion for later when he calms down.
*These recommendations are not necessarily effective for people with dementia—seek the advice of a geriatric psychologist if you are caregiving for someone affected by this disorder, which may affect his/her ability to communicate effectively.
