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Posted: December 01, 2004

Professional Caregiving

Reluctant to Ask for Help? You Would Help, Wouldn?t You?

I am sitting in the airport in El Paso, Texas, waiting for my flight back home. I was invited to speak to dementia caregivers at the Las Cruces Senior Programs annual caregiver conference, where I was asked to address three distinct but related issues: managing difficult behavior in dementia patients, the importance of self care, and how to communicate and work with healthcare professionals who comprise the caregiving network team.

The audience of 130, half of them family caregivers, was primarily Latino. This group?s cultural and traditional mores, preventing some from accessing help from others was of particular importance to the conference planners. The conference organizers know that many caregivers in their community carry the entire burden themselves and don?t permit themselves to ask for help.

I did some research with resources that have familiarity with the ethnic issues surrounding caregiving in Latino cultures. No surprise to me, there is a powerful tradition of caring within the family, a pride in doing it solely from within, even if it costs caregivers their health and well-being, quite common in many cultures.

The impact of culture on the approach we take to caregiving is significant and cannot be underestimated when suggesting interventions with groups in particular ethnic communities. Understanding their mores and traditions, family roles and customs, is the first step to take when working within a particular cultural community.

The audience practices deep involvement with their community and generosity with one another. I used that knowledge to address the barriers to asking for help by reversing the helping scenario. It was very powerful. I asked them to hold a mirror to themselves and reflect how they felt when they have been asked to help someone, a friend or relative. Okay, so asking for help did not fit into one?s comfort zone, but how about when they were asked?

A few hands went up. I asked them to share their feelings at the time. One woman said that her friend was going out of town and asked her to watch the house, pick up the mail and paper outside daily for a month. I asked her if she complied.

?Sure,? she replied, ?she?s my friend.?

?How did it make you feel?? I asked.

?Great. I feel good when my friends ask me to help them?

Great, huh? Hmmmmm.

Another hand went up:

?I get calls sometimes to help out the local in homecare agency when they can?t find a worker. Last week I was called again.?

?And what did you do??

?Oh, of course I helped. It feels wonderful to know that people still see me as competent, and someone they can still rely on, that I am still valued.? This woman was older, but spry, energetic and clearly a spitfire.

?Wonderful?? ?Great?? These were their words. And did I forget to mention here these are the same caregivers who are having difficulty asking others for their help?

Did the audience consider that their blocks in asking might be lessened if they realized the good feeling folks have when they are asked to help. Might this apply when they requested assistance from others?

I saw some folks processing this scenario in their minds. ?If I feel honored and valued when someone asks me, why not get some help and share this feeling with my friends and neighbors?? I opined that one will find their informal safety net strengthened when trust is given, when others are allowed to share some of the care. The difficult task of asking for help can increase the involvement of the outer circle, those who want to help and want their offer to help to be accepted. They want to feel more tied in.

Family members often say they feel left out, like they are not needed, when the primary caregivers do everything themselves. Taking them up on an offer to help impacts both friend and relative. They feel more included, as does the caregiver who now can benefit from the respite from which they gain appreciation for the importance of taking care of themselves.

Caregiving, especially the job of caring for oneself by asking for assistance from others, as I saw this week, can be spun on its head with a good look in the mirror.


Sylvia Nissenboim is a licensed clinical social worker and who has been working in the field of adult day services in the St. Louis area. She is the director of four adult care and enrichment centers for the American Red Cross and also operates a personal and professional coaching firm, LifeWork Transitions, specializing in caregiving concerns, adult day care management and other aging services, such as virtual coaching and family care giving support groups. She co-authored The Positive Interactions Program, is a national speaker, and has served as president of the Missouri Adult Day Care Association and as a member of the Missouri Governor's Advisory Council on Aging..

© 2004 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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