Dr. Seuss once said, “To the world, you may be one person. But to one person, you may be the world.”
From your perspective, who is most present in your every day? Who supports you, offers companionship, and imparts meaning into your life? For many of our readers, it is a caregiver. If you’re the caregiver – it may be the senior you care for.
When we find ourselves in situations that call for it, most of us know to approach elder care gently. We take notice of and are sensitive to the frail health of many seniors, but we should also be more intuitively careful about two underlying things: the senior’s perception of their care and the caregiver’s feelings surrounding their service.
Pride, a common obstacle to the honest conversations we should have with people who mean the most to us, frequently inhibits individuals from admitting how hard it is to accept dependence on care from others. More specifically, many have difficulty acknowledging that this dependence is often crucial to wellbeing. On the other hand, maybe you have sacrificed a bit of pride to care for someone other than yourself. You may feel that you are crucial to someone else’s health and happiness, but at the cost of providing for your own. Yet at the preservation of the care recipient’s sensitivities, you may not complain about it. On the positive side, you may feel infinite gratitude towards your caregiver if you are a senior. Caregivers might also enjoy the reward of having a fulfilling purpose.
When a senior comes to need long-term care (typically after a health crisis and hospital discharge), both the senior and their family can undergo extreme stress. Suddenly, life is different. Before a health crisis, seniors are capable of independent living, whether it be at home or in a senior community. They can move about on their own, cook, clean, dress and use the bathroom in complete privacy. All of this is altered if health problems require someone else to provide for a senior’s long-term care. The task of long-term care might come unexpectedly upon a person who never planned for the responsibility. Both parties involved might feel trapped, guilty or lost. Wondering about what the other person feels about you might even be a big source of anxiety.
First of all, know that you are not alone in feeling guilt or loss of self-esteem while you either receive care or provide it. You are not to blame for what you might feel during this kind of experience. A lot of these feelings are contingent on external factors that occur during difficult situations. There are things about aging and long-term care that you cannot control.
However, your perception and accommodation to the changing environments around you are within your control. No matter what negative feelings you might have as a senior or a family caregiver, there is always a brighter side. Read this article for some tips on achieving peace of mind when accepting dependence on care from others.
Where is care received?
Look at the situation where the senior receives care. Is it in their home? Is it in an independent senior living community? In a nursing home? In hospice? A senior’s comfort level with care relates to the amount of service provided in their living situation, and the type of service provided. The level of dependency a senior has in his or her living environment affects how good or bad they feel about it.
In independent living facilities, seniors have relatively high autonomy, but a lower need for care unless they prefer more. A study in Houston, Texas reported one elder in an independent living facility saying, “You feel like you are independent [here] because you are paying your rent and everything, and you can lock your door and nobody bothers you… When you lose your independence, you lose everything.” Perhaps the perceived loss of independence is why 29% of older people would rather die than enter a full-service nursing home, according to the Journal of the American Geriatrics Society.
Besides independent living facilities and nursing homes, there is the option of a senior receiving long-term care within their own home. In fact, most seniors prefer this option today. In such an intimate setting, where seniors can feel uneasy to open their home and privacy to a stranger, seniors’ loved ones typically become main caregivers or managers of care. This can cause problems for some families.
While some seniors believe that children have the obligation to care for their elderly parents, respondents to the Houston survey said it would be more “dignified” for a trained health professional to care for them, rather than their children. Children of seniors who become caregivers are reportedly more often the eldest daughter. A daughter supervising a parent’s bathing or toileting, for example, may cross boundaries they have not encountered before. In contrast, trained health care workers use the professional-functional type of touch to care for their patients. Though unfamiliar at first, a trained professional’s contact is impersonal and almost businesslike, which allows for seniors to relax in a mental “boundary.” Caregivers such as these are accessible in any kind of senior community and can be hired through agencies for visits to your home.
Who cares for who?
As mentioned, a senior’s eldest daughter is widely predicted to become the main family caregiver. Spouses are just as likely to care for senior citizens, though. While most of us go our entire adult lives without depending on care from a close loved one, this filial piety is actually a traditional norm for families in some cultures.
In Confucian philosophy, filial piety is the virtue of respecting one’s elders. This philosophy is why many collectivistic Asian cultures make senior care a family duty. Behind the virtue is a feeling of obligation to “return the favor” of a parent’s care during childhood. Americans who are grateful to their parents for their upbringing tend to share the same desire to care for their parents in return. But for Asians, Asian-Americans and Americans alike, demands clash between a rising elder population and a shortage of time and resource in an advancing world.
The press for time, energy, financial resources and the attention of a caregiver can cause stress. The stress directly felt by a caregiver is almost never positively perceived by a senior benefiting from care. Especially if a caregiver is a loved one, it can pain seniors to see them under pressure to provide for needs on top of their own, or worse – at the sacrifice of their own. If this is part of why it is hard to accept dependence on care from others, take a good look at the relationship between “Who cares for who?” and imagine ways that you can be on the giving end of it.
A senior who receives care from another is not always just a passive recipient. The elderly have much to give back. Our elder years can be some of the richest times in our lives, especially since we have experience, lessons and insight to share. You might be the one person your caregiver sees most every day, so take comfort in their presence and remember that they want to do the same in yours. Gratitude expressed verbally or in body language tells your caregiver that their work is valuable. Respectful feedback on the quality of their work will not only help you but also strengthen the caring spirit and skill of your helper. And as you have done with any other friends in your life, share good news and interesting things with your caregiver, laugh, debate, entertain and enjoy each other’s company.
What you may not know about:
Accepting dependence on care from others is a two-way street. Seniors receiving long-term care must find a way to accept that they need someone else for activities of daily living. Caregivers must understand what it takes for a senior to be receptive of care in all physical and emotional capacities to maximize the quality of their care. To mutually ensure this goal is accomplished, these things are important to know about:
- Dignity – Dignity is essential to happy living for the elderly. The Houston study said seniors defined “dignity” as the respectful treatment of the elderly as adults, not children, and that it’s upheld by humane, attentive care provided by others. So, a senior’s dignity can greatly hinge on their treatment from others. If treatment is wrongful, dignity is damaged. If it is good, dignity prospers.
- Perception of Control – Losing control over health, financial resources, environment and at times mental ability feels devastating to some seniors who have been building these things for their entire lives. The perception of control is what matters most when dealing with a senior who feels these losses. In a Journal of Gerontology article titled, “Compensating for Losses in Perceived Personal Control over Health,” a senior’s individual self-evaluation of his or her social identity can buffer the loss of control they feel. Seniors who acknowledge positive past impacts of their strengths will see that in ways, the control they used to have rewarded them later on. We all lose various abilities over time, like growing out of shoes we can no longer use. The honest, unwavering passage of time is another, yet harder pill to swallow. Next, seniors should realize it is okay to relinquish some control for the purpose of ensuring their health.
- Willingness to Adjust – Many caregivers have encountered the senior who is unwilling to accept care or be compliant with a health specialist. Unless the care is somehow detrimental to the senior’s wellbeing, this mental block against accepting dependence on care from others is counter-intuitive. A good caregiver wants to do what it takes to make a senior healthy, happy and content. If a senior is unwilling to accept the services that lead to this, they will be unhappy, unhealthy and discontent. Realize the win-win situation you have in accepting care from a genuinely concerned caregiver. If you’d rather let your health suffer than benefit from someone else’s help, you are on a path towards loneliness and self-sabotage.
- Loneliness – In the mentioned Journal of Gerontology article, loneliness was found to be a predictor of both chronic health conditions and perceived health. In other words, lonely seniors are more likely to have serious health problems and believe they are unhealthier than they actually are. Caregivers should know that senior citizens are at high risk for social isolation, and seniors should avoid isolating themselves at all costs.
- Personal Choice / Preferences – At the forefront of understanding how to accept dependence on care from others is knowing preferences of the senior and of the caregiver. From the beginning, when families are shopping for care options following a hospital discharge, they must take the senior’s preferences into account. Know the level of independence and control your senior loved one wants to maintain. Find the best services that encourage safe independent living as much as possible. Caregivers have preferences, too. If you are a caregiver, do not deny any strong feelings that say you should or shouldn’t be doing what you are doing. You are valuable to who you care for, but if you aren’t the best fit for the job, call for help.
“Accepting Dependence on Care from Others,” by Michelle Mendoza, Amada contributor.