Skills for Coping With Caregiving

We use defense mechanisms to protect us
Defense mechanisms are processes all of us use to protect ourselves from emotional pain.

When we must cope with chronic stressful situations, there is emotional pain. So, we try to protect ourselves by using defense mechanisms.

Many people can understand how defense mechanisms work by relating to how we cope with the grief associated with the death of a loved one. It could be a close friend, relative or even a beloved pet.

Often times when we first hear about the death, we have a tendency to deny it. To say, “This never really happened.” It may take some time before reality sets in and we accept the loss as real. But accept we must, if we are to continue our life in a positive way.

When a family is caring for a sick or elderly relative, a situation of continuous stress can occur.

You may feel guilty for feeling vibrant and full of life when a cherished member of the family is becoming increasingly frail.

You may feel angry to see a formally active grandparent now inactive, sick or mentally failing.

It takes love, understanding and even humor to cope in these situations.

Defense mechanisms have their place, up to a point, in helping us deal with pain. Then, like accepting the reality of any loss, we must come to terms with the situation in order to understand that defense mechanisms are only one simple part of our feelings.

Common emotional defense mechanisms include denial, avoidance, projection and displacement.

Denial- Avoidance
Denial and avoidance are similar. They both are ways to not acknowledge an event to be real. Denial is refusing to accept an event. Avoidance is staying away from or avoiding a situation.

One teen just avoided going home. Joe hung out with friends after school, sometimes getting high, or drinking in an effort to deny his pain about his dying grandpa. He figured, “If I don’t see it, it’s not happening.” Of course the substance abuse led to more problems for him in school and with his girlfriend. Ultimately, he had to face the reality of losing his favorite grandparent, the man who took him fishing as a kid.

When you avoid and deny, you are only putting off dealing with a situation. At some time in your life you will have to face what happened. Sometimes facing up to your caregiving situation and spending time with your older relative, can make a difference in their life while enriching your own at the same time.

Projection – Displacement
Projection and displacement are ways by which we avoid dealing honestly with our feelings.

Projection
Example: Kate feels guilty for being angry because her grandmother can’t remember anything. Kate may say, “Gram is mad at me, she keeps saying the same thing over and over.”

Kate is projecting her feelings and blaming her grandmother. This protects Kate from owning the anger herself.

Displacement
Example: When Andrea was a junior in high school, her favorite aunt became ill and came to live with her family. It was just around prom time and she was planning a wonderful junior prom with her boyfriend.

Unfortunately, due to family circumstances she ended up having to stay home and care for her aunt that weekend. Andrea lashed out at her boyfriend when she was actually angry with her aunt.

Like Kate, Andrea felt guilty for getting mad at her older relative. Andrea shifted her feelings to an innocent bystander, her boyfriend.

Your feelings are valid and important!
Realize that having an elderly or sick relative come to live in your home may cause you to have many different emotions. Coping with them by using defense mechanisms works in the short run, but in the long run makes problems worse.

When caregiving is stressful, talk!
One way of understanding and dealing with your caregiving situation is to talk to others who are in a caregiving family. You will find that you are not crazy, alone, selfish or an awful person if you feel angry, guilty or upset.

Talk to someone
Communication is the first step to understanding and coping.

Throughout these chapters the need to communicate has been stressed. Talk to someone, a friend, brother, sister, parent, teacher, cleric, anyone. Just talk. Talk to your older relatives. Ask them how they feel. Tell them how you feel. Communication is the first step in understanding and understanding is the first step in coping with a difficult situation.

Like other teenagers you have read about, Hanna realized the importance of communication. Read her story and see what you think.

Hanna’s Story
I remember when I was young, Grandma and I used to sit around and play games. Mom and Dad would go out for the evening and they would drop us off at Gram’s house. After my sister and brother were in bed we would sit up and watch television and play cards. Slapjack was our favorite game. Every time a jack was turned, Grandma would let me slap it! Then with a smile, she would slap my hand. We both would laugh. She always let me win.

When Grandma moved into our house things changed a lot. Our living room was turned into her bedroom. Our entire house was disrupted. It didn’t bother me that Grandma was there. What bothered me were all the nurses. They were in and out all the time. I remember feeling like I couldn’t do anything in my house for fear I would disturb things.

When Grandma started to get really sick, I was scared to death. The nurses were there all the time. I remember waking up one morning, looking out the window and watching Grandma being taken away in an ambulance. I was so scared I couldn’t leave my room. Mom came into my room and said that Grandma had another stroke. I didn’t know what that meant. I thought it had something to do with her cancer. I remember feeling very confused.

My mom and dad told me Grandma had cancer and she was very sick. I remember all these books around the house that were about dealing with the death of a loved one. I assumed this meant Grandma was going to die. When she came home from the hospital I didn’t see her very much. She was on a lot of pain medicine and hooked up to machines. I didn’t like to go in the room with her because she looked so different. Grandma was only skin and bones. She slept most of the time and when she was awake she acted very strange. Grandma kept imagining that all these crazy things were happening and she would scream. I couldn’t understand why she was like this.

I know now what cancer is and why she had it. I also know the reason she was seeing so many weird things. It was because of the medication called morphine. A simple definition of cancer is “cells that have gone berserk and are trying to take the body over. The bad cells are crowding out the good ones.

“If I could live that time in my life over, I would do a lot of things differently. My sister is two years younger than I am and I wish we had talked about Grandma. She was feeling all of the same emotions as I was, but I didn’t realize it.

I felt very alone and very guilty. Guilty because I wanted more of my mom’s time. I now know that my mom didn’t know how I felt. She thought we were too young to understand what was happening to Grandma. If I’d let her know my fear, she would have tried to help me. If I only knew I could talk about it. If I had tried to communicate, things may have been a lot clearer to me. After all, talking is the key to understanding.

Dealing With Grief
Caregivers of all ages may experience grief while their older relative is still alive. As illnesses affect some older people, their ability to function as active individuals may lesson drastically. Often feelings like “Why couldn’t it be me instead of Grandma?” or ” Why can’t it be like it always was?” are difficult to deal with.

When we think of grief we often think only of death, but other losses bring on almost identical reactions. People going through a divorce experience grief, as do people who have lost their health. Retirement may bring on feelings of grief, as may parents facing their children growing up and leaving home. You may experience feelings of grief as your environment changes when an older relative comes to live with you. Family members who have a loved one with Alzheimer’s Disease often experience the grieving process as the disease progresses.

Sharing your feelings with others will give you support. Grief can be expressed in many different ways. You may cry, withdraw from those close to you, or even laugh. Whatever way people choose to express themselves during the grieving process is okay. Community resources such as the county mental health department or hospice volunteers help people who are grieving.

We never totally become our “old selves” after experiencing a great grief. We are different from what we were before and we have grown as a human being. It is important to realize that we will live, laugh, and love again.

Recognize the possibility that while you may have feelings of grief, so too, may your older relative.

Use Your Support Network
One way to ease the stress of caring for an aging relative is to reach out to family and friends for help. Many family members do not live near each other. Therefore, neighbors and friends often act as extended family members to ease the burden of caregiving.

Make a list of people you can talk to and list people who can help you with the care of your older relative. Example: Your best friend, a neighbor who could stay with grandma while you and your parents attend an event at school. Reach out to these people.

Physical Exercise Relieves Stress
There may be times when you can not talk to someone right away. You may be feeling down and stressed out. Physical exercise can help relieve stress. Did you know that it is difficult to stay depressed after you do Jumping-Jacks? It’s true! Try it and see how you feel afterwards.