Linda was aware that her mother, Rose, was not getting better. This was Rose’s third emergency visit in a month for shortness of breath. Rose was 86-years-old and had a bad heart valve that triggered congestive heart failure.
After Rose described her symptoms to the physician, Linda prompted her mom to speak up by saying, “We need to talk about this.” The physician picked up on the cue and asked Rose if this situation was hard for her. Rose was eager to share that she no longer had quality of life. Linda was eager to help her mother in the transition to end life, but didn’t know where to begin. Did Linda have a personal philosophy about caregiving?
Family caregiving is a noble, yet humbling experience. You’re at the mercy of those who need more from you, but who often want less. Linda didn’t feel comfortable with making decisions for her mother, but Rose was eager for Linda to help. Your best tool is to use reverse psychology: try not to play it smart. Establish humility at the outset through adopting a “pea-brain” philosophy. Patients expect little from know-nothing caregivers who have more questions than answers.
Playing dumb fools your patient into thinking he or she needs to maintain the upper hand. You become less of a servant and more of a supervisor. Your perceived pea-brain becomes a front to a more meaningful caregiver philosophy. The caregiver’s “P-brain” consists of being proactive, poised and parental. Caregivers who have “P-brains” are surprisingly gifted and less likely to disappoint. A caregiver’s philosophy needs to be geared toward success, not failure.
Incorporate these three aspects of the “P-brain” into your caregiving philosophy:
Being proactive, you can see 10 feet ahead and years down the road. The ability to see Rose struggling with activities of daily living and making medical decisions automatically puts Linda in the caregiver role. Seeing your patient declining leads to believing you can help. You can guide the process without telling your loved one what to do.
People who can tell what other people think are mind readers. Your patient is rarely certain about what he or she wants long-term. Before you can tell what your loved ones want, you need to be able to read their minds ahead of time.
In being proactive, you need to define caregiving before caregiving defines you. Caregiving will drown you until you learn to swim with the sharks, which will attack you from all sides. You have to be thick-skinned to ward off doctors’ orders and patients’ demands. As a caregiver, you need to be self-assured and self-defined through developing poise.
“Steady as she goes” is the art of being poised and a powerful asset for caregiving. Self-assurance tells others, “I’ve got this.” This does not mean you have all the answers. It simply means that you know when and where to ask for help. You begin to recognize being wobbly before collapsing. The following three rules will help you stay poised:
Frankness is a virtue. Being open and honest about your intentions will help with making medical decisions. Linda’s goals need to be consistent with Rose’s wishes. But the choice between merely staying alive and quality of life serves as a reminder that there can only be one best response.
Choosing between wishful thinking and a doable plan is the responsibility of a caregiver. Hope becomes a four-letter word when your patient’s medical condition becomes unmanageable. The next step beyond the hope of your loved one getting better is balancing the good with the bad. Being poised allows you to find the middle ground to viewing the end of life as strictly being bad.
When you give a little, you get a little. When you choose your own battles, you declare what matters to you. This is the art of compromise. An open-minded caregiver has the ability to roll with the punches. Your philosophy must align with creating a win-win situation.
Parents usually set the ground rules and tone of the conversation with their children. It boils down to saying, “Don’t talk to me like this. I’m not your friend, I’m your parent.” Like Linda, caregivers take on the role of parenting their patients. Parents don’t let their children make poor decisions. Similarly, caregivers can’t allow their patients to make poor medical decisions.
The parent-child relationship builds upon co-dependency. Each person has practical and emotional needs. Good communication skills are important in getting what you need out of the relationship. Ironically, getting out of the relationship becomes the ultimate goal for parenting. The “empty nest” must be anticipated as an opportunity for Linda to regain her life.
The best parents teach their children self-sufficiency. Spoiling your children can lead to their feeling helpless and acting whiney. By instilling confidence in your patient, you provide him or her dignity. Self-sufficiency gives patients the strength they need to feel independent.
Your caregiving philosophy needs to align with patient autonomy. Allowing your patients feel as if they are in charge serves their best interests and takes some of the burden off of you.
What do people like about your personality? Are you fun-loving or organized? Do you see the glass half-full or half-empty? Do you tell it like it is or mince words? Do you like to speak on behalf of others or prefer to listen to what they say? Do you know how to act when the physician walks in the room?
While Helen was telling the ER doctor about her medical complaints, her daughter, Joan, was sitting in the corner reading her book. At one point, the doctor caught Joan glaring at her mother with a look that could kill. Her eyes conveyed that it was time for her mother to die if she was so miserable. Misery loves company. Yet your personality informs you about how miserable you want to be as a caregiver.
Like Joan, you are not required to be someone different while being a caregiver. You may have been chosen to care for your loved one by default, but why not make the best of the situation instead of being upset? You might question, “Why is this happening to me? Why am I called to be a caregiver?” This “why” suggests that you have the personality for it Your “why” is what makes you step up and be recognized as the best person for the job.
Joan was stuck between a rock and a hard place – the rock of needing to be a disciplinarian and the hard place of her mother aging. Her only option was to polish the rock through “romancing the stone.” You romance the stone through three aspects of your personality.
You are who you are. This stone-cold fact can be either rejected or accepted. Most caregivers believe they need to be careful about what they say and do. They might feel as though they’re walking on eggshells, trying to not upset their patients’ medical conditions. You, however, have very little to do with your patient’s illness. Your patient has a right to his or her own feelings and you have a right to have yours. Your best intention is to be yourself.
The hard facts of a loved one facing death and dying are devastating. Sometimes it feels as if little stones are being hurled at you. Other times the big boulder is rolling toward you. You may not see the rocks at first, but then they hit you like a personal assault. More than likely, you’ll become angry. You work hard to shore up your loved one and then experience rockslides.
Be receptive to softening your anger through your personality. Everyone has a soft side to his or her personality. A gentle, generous and passive part of one’s nature. When the going gets tough for your patient, you can either get tough or soften up. Most caregivers are romantics at heart. Using this part of your personality allows you to become less angry.
Romance opens the door to your being creative. It permits you to fall in love and be fascinated with a person, place or thing. This enthusiasm is generally short-lived, but will often stay with you for a lifetime. The love that exists in caring for another will wax and wane. The task of caregiving may last three months or three decades. You need to make the most of it if you intend to walk away from the situation feeling blessed by the experience.
Romancing the stone is like polishing a stone and making a gem out of it. Or taking a plot of land and making a garden out of it. This doesn’t happen by accident. It takes a lot of blood, sweat and tears. No one expects it to be easy, yet your personal satisfaction during the process is paramount. You need to feel a sense of accomplishment at the end of the day.
With each thrown stone of something bad happening, you can sculpt it into something good. Your “why” becomes purposeful. Your personality allows “the stone that the builder rejected to become the cornerstone.” Your personality can allow you to see the future in a positive light. That stone at your feet might be the beginning of a new foundation.
Your being firmly determined to do something stems from your personality. Being a go-getter or laid- back is an attribute of your personality. This encircles you like a fortress. It prevents you from being influenced or susceptible to outside forces. It’s your best defense against fear.
You prevent fear from getting the best of you by not giving it attention. Your best defense is to stop worrying about what might happen. The foundation of caregiving is not to care too much. Don’t be afraid of what happens, but realize how to use your personality when the situation with your loved one takes a turn for the worse.
Resolve to have strength under fire. Use the best part of your personality to allow you to cope. Many people find humor to see them through. Others tend to dance around illness. Still others are more matter of fact. Whatever speaks to your nature is what makes you an authentic caregiver. Resolve to let your personality shine though as you care for others.