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Posted: September 30, 2008

Build Bridges Instead of Breaking Them

Saving Relationships Endangered by Caregiving

Family caregivers pay a high price in meeting the physical, financial, and emotional demands of caring for an aging parent or spouse. But perhaps the highest price paid by caregivers is that of strained or fractured relationships with their spouses, siblings, children, and co-workers.

“We have had caregivers say in returned questionnaires that they are now divorced and attribute their divorce to caregiving . . . and they were unaware of deteriorating relationships while it was happening,” says Dale Lund, PhD and director of the University of Utah Gerontology Center.

It’s not only marriages that suffer. Lund says, “Children who live in caregiving households also experience neglect because their mothers and fathers are dedicated to being heroic caregivers to their own parents. The result is fewer family meals together, reduced privacy, fewer family outings and functions, and reduced family vacations.”

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“Time and money become identified as the issues causing family stress, but the real issues are deeper than that,” says Loren Gelberg-Goff, a licensed social worker in private practice in River Edge, New Jersey.

“There may be complaints that the caregiver is neglecting home responsibilities such as shopping, housework or doing homework with the kids” says Goff. “But especially for men, the message is really ‘I miss you’ and ‘I need you’.”

Divorce statistics provide stark evidence about the impact that caregiver stress and illness can have on a marriage.

While more than 50% of American marriages end in divorce, the divorce rate for those receiving care for “invisible” chronic conditions such as rheumatoid arthritis, Crohn’s disease, diabetes, and fibromyalgia is estimated to be as high as 75%.

And while individuals dealing with breast cancer or multiple sclerosis are at no higher risk for divorce than other married people in the United States, those with spinal cord injuries are more likely to experience divorce than their healthy counterparts. In the end, caregiving in stressful health care situations clearly takes its toll.

As the majority of family caregiving falls to working women, it is often women who find themselves especially challenged on how to care for their aging or ill loved one, their families, their marriages, themselves and their jobs – all at the same time.

In a study released by the MetLife Foundation, 50% of caregivers said they had less time for families and friends than before taking on their caregiving responsibilities. About 44% also report having given up on vacations, hobbies, or social activities.

While some workplaces offer employee assistance programs or paid leave or have the means whereby co-workers can donate their own paid leave to another employee, the number of caregivers who take advantage of such programs is startling low. Just 47% of caregivers surveyed said they sometimes asked supervisors, management, or co-workers for help or support in meeting caregiving responsibilities, while 36% said they never sought help from workplace colleagues.

“If you think you’re stressed and overwhelmed but no one else notices, then the truth of the matter is you’re lying to yourself,” says Goff. “It’s critical to take control over what you can.”

“Recognition, praise, love, or feelings of self-esteem are often the reward for caregiving and are well-deserved,” says Goff. But those positive feelings can sometimes blind a caregiver to the fact that he or she is neglecting others.

Some of the tell-tale warning signs of relationship risk include:

Deborah Newquist, director of geriatric services for ResCare, Inc., in Louisville, and past president of the National Association of Professional Geriatric Care Managers, feels caregivers must sooner or later answer this inward-looking question: “How much do you give as a caregiver?”

“Caregiving requires role changes, and each change creates stress,” says Newquist.

In addition to role changes, many other stressors are lurking, including tension between members of blended families, favoritism between siblings, resentment of non-helping family members, lost work time including reductions in pay and benefits. Then there are the core questions of how much financial assistance can be given when caregivers are lagging in meeting their own needs, planning for the education of their own children and their own retirement.

“Grief, guilt, and gripes are the three G forces that caregivers have to cope with,” says Newquist. “For example, your mother needs help, but how much help is needed may be a source of disagreement. Even if you and your family members agree that help is needed, then you need to ask: What is the best way to address this?”

Loren Gelberg-Goff offers four tested guidelines as a way for caregivers to navigate through the daily decisions that come with caregiving. She says, “I’ve learned this because I’ve lived it professionally and personally. My husband has been disabled for the past 10 years, I have a daughter who just graduated from college, and my son is in high school.”

Here are Goff’s guidelines:

Beyond learning to better manage one’s own response and emotions to caregiving, caregivers can take advantage of support groups, use respite services or seek help from their employee assistance staff or human resources office at their job.

Goff says one of the best strategies is to talk about caregiving concerns and strategies before encountering a crisis. “But few of those conversations happen between spouses and even fewer occur between siblings,” she says.

While working on relationships may indeed be additional work for the caregiver, Goff encourages caregivers to invest energy and time into self-care as well as maintaining relationships with spouses, siblings, children, co-workers, and friends. “After all, when caregiving comes to an end,” Goff says. “You really don’t want to be left facing a void of lost relationships.”

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Paula S. McCarron has more than 20 years of experience in health care, including nursing homes and hospice. She lives in Chelmsford, Massachusetts, and can be reached at paulamccarron@gmail.com.

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