Caregiving and Holidays
Dr. Kaye suggested this topic, which seems timely and important, but not something I have any special expertise in. First of all, I’m a guy, so I’m generally oblivious to special occasions. Second, I’m Jewish. Third, I’m a doctor. Christmas to me means offering to work at the hospital so everyone else can stay home with family. But I’m a geriatrician and do hear from patients’ families about the added stress of holiday preparation, travel and visitors on a caregiver’s already difficult daily schedule. What I know about this topic, I’ve learned from my patients and their families.
One thing I hear frequently is that the holidays may mean that relatives (e.g. adult children) are more likely to be around to lend a helping hand. This time of year we see family members who live far away come to clinic visits to ask questions and offer insights. More family around can mean help with daily chores, emotional support, respite breaks. But it may also mean criticism, guilt-tripping and intrusive opinions from people who may be in denial about their parent’s illness. Illness in the family and holidays both tend to sharpen the underlying character of family dynamics, both positive (loving, generous, collaborative) and negative (competitive, resentful, selfish). It’s hard not to get drawn into these old teleplays, but little good will come from it. Try to stay positive, be grateful for whatever help you receive and take both criticism and praise with grace. Getting defensive will fuel the fire, so before responding to criticism, stop a moment to compose yourself and ask for more details. You may actually get some helpful insights that way. Most importantly, take time with every family member, children included, to discuss the illness that is the elephant in the room. Things like dementia, stroke and Parkinson’s disease can be very mysterious and you’re more likely to get more support from family when they have more knowledge and less fear.
The holidays can also mean added stress from the “holiday to-do list”. Reducing holiday stress by down-sizing the to-do list and letting go of the emotional need for the perfect holiday are the classic themes of holiday stress reduction newspaper columns and this one is no different. But I happened to find an exceptional approach to downsizing the holiday job list found on the Today’s Caregiver website (www.caregiver.com). The author, Michael Plotz, in turn got this from the Sudden Infant Death Syndrome network (www.sids-network.org). Make a list of holiday activities and jobs, such as going to holiday parties, setting up a tree, sending holiday cards, doing holiday shopping, visiting special people you don’t usually see, holiday baking, making homemade gifts, etc. For each activity, ask yourself the following questions: Would the holidays be the same without it? (That may be OK) Is this something you want to do differently to reduce stress and conserve energy for more important things? Do you do it out of obligation, tradition, free will (you like doing it) or obligation? You can even create a table with the list of activities along one side and the prioritizing questions along the top to help you make decisions about what is most important to you and the person you are caring for. Maintaining tradition is important for a sense of continuity and normalcy in life, but make sure those traditions are still enjoyable and are something you can realistically do with the energy and time you have. As always, doing less may allow you to appreciate the little things all the more, like the exceptionally beautiful lighting on the houses this year. I wish you all the best this holiday season and in 2015! Cliff
I can’t help but point out that Cliff began by saying that because he is a guy he is “generally oblivious to special occasions.” Well, to tell the truth, I have been guilty as well of overlooking a relative’s birthday or even my own wedding anniversary here and there. For the same reason, namely being a male, there are those who assume husbands, sons, grandsons, and other men are likely to be of little help when it comes to caring for someone in need of assistance. But this is where I have to draw the line because I’m afraid that is a lot of hooey. As I have been known to say, a “caring man” is not an oxymoron.
Approximately 40% of relatives in this country that provide help to a family member in need of assistance are male. That represents some 15 million people in the U.S. or about six percent of the population. These are usually husbands caring for a frail spouse or partner or a son caring for a mother or father. Many are grappling with the demands associated with caring for someone with Alzheimer’s disease or a related dementia (more women are diagnosed with Alzheimer’s disease than men).
Around 25 years ago I published with my colleague, Jeffrey Applegate, what I think might have been the first book that highlighted the experiences of men as caregivers of the elderly. At the time we called them “unsung heroes”, because we found their efforts to go largely unrecognized and underappreciated given the assumption by most that women are nurturing and men are anything but.
So, women may do the lion’s share of family caregiving and men may help less with personal care than women, like helping a loved one with bathing and getting dressed, and they may be less likely to be the sole caregiver in a family, but we know that, in fact, they do it for just as long (four years on average) and are just as dedicated.
During the holidays or when any special family events are being held, male and female caregivers alike, like their aging loved ones, may be confronted with extra doses of emotions and feelings, both positive and negative. I recently visited my 89 year old mother in Arizona over Thanksgiving and ended up spending a good bit of time just talking with my sister, who lives near my mother, about issues surrounding my mom’s driving, her budding relationship with her recent boyfriend, and how my mom continues to treat my sister like a child even though she is going on 68 years of age. The stress and strain of the holiday season and the gathering of relatives from around the country seem to have fueled these issues for my sister who does, I admit, carry the large majority of caregiving responsibilities since she is the child who lives closest to our mom.
Because I live at a distance and am not embroiled in the drama of that child-parent relationship on a daily basis, I had the assignment of assessing the issues as a “long distance” caregiver and did my best to do just that. As the oldest son I also seemed to be naturally assigned the responsibility of talking through these matters with my sister and mother as opposed to getting involved in personal, hands-on care. More evidence of how gender can influence the work of family caregivers.
In any case, best to remember that the holidays can bring out the good, the bad, and ugly when it comes to families and their caregiving relationships. We had lots of reminiscing and recalling of fond childhood and family memories during my Arizona visit. But those loving recollections were mixed with the more difficult and stress producing issues that needed to be sorted out as best we could. Being prepared and making time for both and everything in between is important for everyone concerned.
A happy, peaceful and healthy holiday everybody and remember to age smart in 2015! Len