With "medical miracles" extending life spans, people over 85 are America’s fastest-growing age group. Half of them have Alzheimer’s disease or some other type of brain impairment, a quarter are in nursing homes, and many others need help with such practical activities as bill-paying, yardwork, driving, laundry, cooking, dressing, and showering.
While men pitch in more than they used to, 60 percent of America’s 50 million unpaid family caregivers are women. Typical, according to a recent survey conducted by the American Association of Retired Persons and the National Family Caregivers Association, is a married, employed, 46-year-old woman looking after a widowed mother who doesn’t live in the same house.
Sound familiar? Think this might be you someday? Here are some sanity-saving measures.
Find a Sympathetic Ear
Don’t kid yourself. Honored as you may be to help, this work takes its toll. Long-term caregivers struggle with anger and guilt, and are unusually vulnerable to insomnia, depression, anxiety, neck and back pain, and even illness and premature death. Vent to a friend, partner, therapist, or online. bulletin board or support group, such as those run by local Alzheimer’s associations (800-272-3900 or alz.org) or the Family Caregiver Alliance (caregiver.org).
"Ambivalence is natural," says psychologist Barry J. Jacobs, a medical family therapist and author of The Emotional Survival Guide for Caregivers. "I’m sure there are people out there who are happily selfless, but more commonly, people adopt that stance because they think they’re supposed to. They wind up burning out."
Acknowledge the Past
Were you the family’s black sheep? Its quiet martyr? Did you feel slighted in favor of a sibling? "Caregiving gives you the opportunity to repeat the same patterns and feel just as angry and disappointed as ever, or to do things differently and finally resolve issues that have gone unresolved," says psychotherapist Roberta Satow, who interviewed 50 midlife adults for Doing the Right Thing: Taking Care of Your Elderly Parents Even If They Didn’t Take Care of You. "Unless you deal with your old feelings, you can’t cope with the demands being put on you now."
Assemble a Team
If you have siblings, Jacobs and Satow recommend convening meetings, either face-to-face or via e-mail or conference call. Make a list of tasks, and find out what each person is willing to do. Those living far away may give money or handle paperwork or medical advocacy, while those close by offer hands-on care. Don’t let brothers off the hook.
Make Your Limits Clear
"Taking care of an elderly parent is an important priority, but it’s not the only one," Satow says. Balance commitments. Don’t sacrifice your relationships or your kids’ welfare. Do what you can when you can, and say no when you must. It’s better to do a little consistently than to exhaust yourself and withdraw altogether. If you can’t afford to hire help, check out local agencies on aging, which often offer respite services for lower-income families.
Be Fair About Work, Money, and Power
Family therapist Terry Hargrave has seen daughters sacrifice a decade or more to caring for a parent and then receive the same inheritance as siblings who did nothing but micromanage from afar. In other cases, daughters provided daily hands-on care while a sibling who provided no other help controlled — and sometimes withdrew from — the parent’s bank account.
Hargrave, author of Loving Your Parents When They Can No Longer Love You, suggests radical ground rules. First, give the money and power to whoever is doing the active caretaking. Second, if funds are available, pay the primary caretaker for time and lost wages, either via a regular paycheck or a bigger share of the inheritance. The payments, Hargrave says, should be at below-market rates for the work provided, and all family members should know about them up front.