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Yes, You Can Say No

Knowing where a caregiver should draw the line

BY:LINDA CHILDERS

It's Friday night, and just as you're walking out the door for a much-anticipated evening with friends, the phone rings. It's your elderly mother calling for the third time that day. She's lonely. She wants to chat. And she asks if you wouldn't mind picking up some items from the store and dropping them by her house.

So, how do you decline without feeling guilty? How can you be a consistent and loving caregiver while also setting effective boundaries? And how do you politely explain that you have a life?

"Drawing boundaries with elderly relatives who are asking for more than their loved ones can provide is a common issue," says Anne Rosenthal, a geriatric care consultant and director of Community Care Management at the Reutlinger Community for Jewish Living in Danville, California. "Frequently, the individual who struggles most with this problem is the devoted adult child who has an unreasonable parent."

Explain Your Limits
To combat the guilt, Rosenthal says it's important for you to acknowledge all you are doing for your loved one and to establish healthy boundaries. These are limits you can explain to delineate what you are willing to do and what behavior you will tolerate. If you're going against your own personal values to please the person in your care, allowing him to take as much as he can from you or letting him direct your life, you aren't setting healthy boundaries.

Without clear boundaries being established, caregivers often stretch themselves too thin, feel like a doormat and put their own needs aside. Lack of clear boundaries can lead to increased stress, depression, anger, low self-esteem, addictive behavior and burnout.

"Medical transportation, shopping and arranging for services take significant amounts of time," Rosenthal says. "If a caregiver can keep in mind that she isn't neglecting her loved one when she says no, it can help her be more realistic about what she can and cannot do."

Rather than cancel those much-anticipated Friday-night plans, for instance, Rosenthal suggests responding with: "Mom, I really enjoy spending time with you but I have plans tonight that I can't cancel. Can I call you tomorrow?" Or try this: "I can take you on Sunday at 10 a.m., after I pick up Lisa from her friend's house. Lisa needs a new pair of shoes and we can all go shopping together. It will be fun."

Be Prepared with a "Fiblet"
If, after you and your loved one have discussed boundaries, she continues to be extremely resistant, Rosenthal suggests offering a "geriatric fiblet."

"A ‘geriatric fiblet' is a white lie used to spare the feelings of an older person," Rosenthal explains. "Telling your mom you can't come by because you're headed out to a work-related meeting would be a geriatric fiblet."

Joy Loverde, author of The Complete Eldercare Planner, says an integral part of caring for a loved one is setting healthy boundaries and ensuring that you're also taking the time to care for yourself. "Caring for a loved one can challenge the best of us—mentally, emotionally, physically, even financially," she says. "When caring for a parent or spouse, guilt often takes over and dictates how much you do." She suggests asking yourself, "Do I need to do this for my loved one or can she do this for herself? Is this a priority? How do I feel about doing this? Am I doing this out of guilt or necessity? Am I the only one capable of helping my loved one?"

The answers to these questions can help you create healthy boundaries through a development of greater self-trust, self-respect and self-care.

"Setting healthy boundaries doesn't mean being self-centered. It means negotiating so that everyone gets heard, honored and loved in the process," says Trina Swerdlow, a hypnotherapist based in Danville, California, and author of The Stress Reduction Journal: Meditate and Journal Your Way to Better Health.

Swerdlow suggests that you, as a caregiver, start by having a sense of where your healthy personal boundaries need to be. The second step is to teach others how to treat you and to ask for help if your plate is full.

"It's easy for caregivers to think their loved ones should know their limitations," Swerdlow says. "But unless they are psychic, you need to let them know what you are capable of giving in terms of time and assistance. You don't need to be confrontational," she adds. "Simply ask for what you need in ways that honor yourself and others. Use ‘I' statements."

Have a Talk with Yourself
"As caregivers, it's often hard to shake the idea that we're responsible for every aspect of our loved one's care," says Pat Samples, of Brooklyn, Minnesota, author of Daily Comforts for Caregivers. "It's easy to take on more and more responsibilities and believe that you're the only one who can properly care for your loved one and that no one else can do it as well as you do."

The solution, Samples says, is often to quiet your mind through soothing music, prayer, meditation or relaxation and to try to look at your life objectively. Ask yourself if you are feeling stressed, overwhelmed or even resentful about being a caregiver. Do you wish you had more time to pursue your own interests, or just a day to get away and simply do nothing?

"If you feel someone is making unreasonable demands on your time, take a step back and question whether this is something you really need to do or if you're doing it out of guilt or obligation," Samples says. "Setting healthy boundaries involves saying no and refusing to do something if it would lead you to feel stressed out, hurt, disrespected, resentful or angry."

Comments

So often we're talking about

So often we're talking about parents in caregiving -I am caregiving a husband. This article was wonderful.

To Betty

Glad you enjoyed the article. You're right that many articles do deal with caring for a parent, but Caring Today understands the needs of spousal caregivers. Read my blog, The Caring Mind, and you'll likely be able to relate to many of the experiences I describe regarding my caring for my late wife. Also, we've got many Caregiver Profiles about people--both husbands and wives--who care for a spouse. "Suddenly, a Caregiver", which is our interview with Lee Woodruff is one such story. Others include: "In His Corner", the story of Muhammad Ali's wife Lonnie; "A Hero's Homecoming", about a wife caring for her injured husband upon his return from Iraq; "Constant Care", about a man caring for his wife who has scleroderma; and "Dance of Life", about a woman caring for her husband who's had a stroke. There also is the caregiver profile entitled "In Sickness and In Health", about a woman's caring for her MS-afflicted husband. I hope these articles and their associated Lessons Learned help you in your caregiving efforts.

response to article then some

I am so tired of hearing to ask for help. I have gone to every church and agency and the health dept.

I inherited mom's care when dad died suddenly a year ago Christmas. Along with already being in grad school and a nurse, I have severe fibromyalgia.

I cannot get help even legally. The prob is my brother, who asked me to care and live with mom but hoards her money, and I am at a third of my usual income, uninsured, and he gives me no money for her or for respite for me or even to get her to day care, etc. I have NO help and can't even get a friendly visitor one hour a week.

I know the issues. I just cannot get help or get even an atty to get him to see the light.
I have been to the hospital with a heart attack scare and the $4000 bill for tests. Now I have erosive esophagitis so severe that I could not even get water down..and fibro is worse and I have less money for medical for me.

She and Dad have lots of money in the bank, I just cannot get it for her.

I got a small amt of help for respite from the county but the agency never showed and woman emailed me terrible nasty criticisms. I am very thin tho i make her great meals, never eat half the time

I know I am depressed. I know I need respite. I cannot get time or money for my care...not a minute for me until bed, now cannot sleep for 6

Bro never helps at all, just calls every nite for 16mos at dinner when I'm running and going in a hundred directions.

I am doing an internship paper survey and project on this, if anyone wants to do my survey. We all need to write to our legislators for people like me who are saving the taxpayers billions yet getting no tax stipend or help.

If you know of a resource for me, even elder abuse, call or write. Mine or Mom's church never has spent a half hour for me or us to help; yes, I do ask.

debra