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Posted: June 27, 2005

Practical Caregiving

Navigating the Fine Line of Proper Caregiving

Sometimes finding that fine line between someone truly needing help and someone just wanting help because they can get it is a very fine line indeed.

On the other hand, if you have been caring for a loved one for some time and find that other relatives suddenly want to assist as your loved one moves closer to dying, you're dealing with another "fine line" that needs careful navigating, and it's time to grit your teeth and graciously accept their offers.

Joy and Shirley are finding out how to deal with these fine lines of caregiving. They both wrote me for advice, so let's see if I can provide them with useful information and guidance.

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Hello Jean:

My Mother is now 81 years old. I have been helping her with some of her daily needs and decisions for about eight years now. My Father died 10 years ago, so she now lives alone.

My question is how can I know what care she really needs and what care she just wants someone else to provide for her?


My Mother has always been a rather dependent person. She is not incapable, just lacks in confidence. Now that she is elderly, I want to do what is right in helping her, but not have her totally dependent on me just because of her lack of confidence or needing me to be near her.

I take care of her bills because she cannot write anymore due to a physical condition with her hands. She can clean her home, cook her meals, take a shower, grocery shop and other light activity. The problem is she does not manage her time well, makes excuses and genuinely wants to be taken care of. I want to allow her to be independent but do not want to neglect her in any way. She is most willing to do things for others, just not herself. This is why I am so confused as to what she really needs help with.

I take her shopping, visit on the phone daily, pay her bills, and help with decision-making. I believe if she had the choice, she would move in with me and my husband, have me make all her decisions, pretty much do everything for her.

Do you have any suggestions as to how I might know what needs to be done to help her? How might I evaluate this? Also, I do have power of attorney for her.

Thank you for any help you can give me.

Joy C., Edison, Nebraska

Dear Joy:

Why don't you talk to your mother's doctor about this? She may not have much energy, she may be depressed, or there may be something else you are not aware of. Her feelings may even be a side affect of some medicine she is currently taking. Perhaps it's time for another complete physical examination. It is important to rule out physical and/or mental problems before you insist that she do more for herself.

If the doctors don't find anything that would stop her from doing more herself, gently insist that she do more. Find ways for her to do things she enjoys while being around other people. Perhaps her church has groups she might want to join. Or perhaps she would like to volunteer at a hospital, the blood center, or another place.

You said she always has time to do things for others, but not herself. Explain that she needs to take care of herself first. Explain that she will enjoy everything more if she takes care of herself first.


Sitting at home alone may be her main problem, or she may be facing the end of her life, even though it may be years away. It could be something else. Have you considered an assisted living facility for her? Being around other people where there are activities she can join may be exactly what she needs. Good luck.

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Dear Jean:

I need some advice. My daughter and I moved in with my grandmother a couple years ago when we found she had cancer. My daughter is 5. It has been a good situation for all of us. I am better able to take care of my daughter and help grandma at the same time. I take her to her doctor appointments and shopping, clean the house, and do anything else that needs to be done. She is in the hospital now, and the doctor says her body is shutting down. He wants to send her home.

Here's my question. She has three children. Now, that she will probably die soon, they want to suddenly come and help her. They want to take shifts caring for her. During the past couple of years, they each have visited her only a couple times a year. How should I handle this? Should I tell them that I have been taking care of her for two years without their help, and that I can do it alone now? Or should I move out so they can do it all?

Shirley B., Madison, Wisconsin

Dear Shirley:

First of all, I don't see any reason for you to move out. It is your grandmother's home, but it has become your home and your daughter's home.

If her body continues to shut down, she won't live very long. Her children should help take care of her. I am sure there are some things your grandmother would prefer that you do since she is used to you taking care of her. However, if they want to take care of her completely, let them. You have been doing it for two years now, and it might be their turn.

You and your daughter should have your own room where you can get away and your daughter can play. Your daughter may need to leave them alone at times. A child being around can upset some people at a time like this.

When people realize that their parent is going to die, they get upset very easily. Remember that you will get upset easily, also. Try to avoid fighting with any of them. Try to make this as pleasant a time as possible for everyone. Later you will feel better about everything if you do.

There is something else you need to address. After she dies, are you going to continue living there or will you need to move? That is something you should discuss with her and her children now. Hopefully, they will all agree and let you continue to live there as long as you want. If they don't agree, you may need to move fairly quickly.

She is your grandmother, but she is their mother. They do love her, even though they may not have shown it the way you have. Good luck.

© 2005 Pederson Publishing, Inc. All Rights Reserved.
Commercial use, redistribution or other forms of reuse of this information is strictly prohibited without the prior written permission of Pederson Publishing.

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Please send me your questions, comments and issues regarding the practical side of caregiving at ASKJEAN@caregivershome.com, and remember to take advantage of our professionals and experts in the Ask an Expert section of our website. You'll find it in the left column on our homepage.

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