This past March marked 29 years that my mother-in-law has lived with my wife and me. That's correct. I have lived with my mother-in-law for almost three decades! I have been called both crazy and a saint.
As a widow in her mid 60s and living close by, it made perfect sense to the three of us to bring the two households together. For my mother-in-law, she no longer had to worry about caring for a house and being alone. For us, we had a built-in babysitter for our two young sons and someone who could run some errands as we were both building our careers. Though clearly more of a win for us at that time, my wife and I had no delusions that someday the tables of dependency would turn.
Having a parent/grandparent in the house can be both a challenge and a blessing. Yes, as in any relationship, we have had our ups and downs, disagreements and temper flares. But the bond my sons have with their "Bubby" (as she is now known to all who know her) is irreplaceable and the experience and wisdom of an "elder" has often come in handy.
In July my mother-in-law will turn 95 and time has taken its toll. Though quite cognitively intact, severe arthritis has affected her functionality. She lives with chronic pain, has significant difficulty in getting up from a chair and has needed a rolling walker for over a decade. Even with the walker, her stability is marginal. She has had several falls, fortunately without serious injury. For the past three years, we have had a companion in the house during the day while my wife and I are at work. More recently, my wife assists her with showering and occasionally helps manage her personal care.
Anyone who has cared for an elderly parent in their home knows that doing so can be quite stressful. In addition to assisting with any personal needs, the daily routine includes staying on top of medication management, arranging for medical care, providing a safe environment, managing finances, arranging for care when you're away and providing adequate social interactions. A number of studies have shown that caregivers have an increase in anxiety, depression and musculoskeletal disorders. I have seen this firsthand as there are times when my wife is obviously stressed, trying to meet the demands of her mom after working a full day.
Over the years I have found several ways that help keep the stress level manageable:
- Divide responsibilities: For example, my wife manages personal needs and doctor's appointments; I manage medications and finances.
- Communicate: We take the time to discuss and assess how we are doing emotionally.
- Take a break: The occasional night out or weekend getaway keeps our lives in perspective.
There is no question that caring for an elderly parent at home is a challenge and adds to the already full responsibilities that we all have in our lives. But the satisfaction of knowing that you are providing the best care that you can far outweighs any downside. For my wife and I, my mother-in-law gave a lot to us in our younger days; now, it's our turn. Stresses aside, I know that when she is no longer around, there will be an emptiness in our hearts and in our home.
When an ill person brings up subjects that make you feel uncomfortable, it's natural to want to squelch the discussion or rapidly change the subject. However, it's very important to listen unselfishly and avoid responding with, for example: "Let's not get into that right now. Can't we discuss something more pleasant?" or "Do you really think it's helpful to dwell on this topic?"
Whether the patient asks a spiritual or theological question that catches you off guard or she wants to know about the side effects of a medication, it helps to learn how to be noncommittal without seeming evasive. You don't want her to think that you don't care or that you're hiding something, and you definitely don't want to offer misinformation that might do more harm than good.
Even for people who weren't very spiritual or religious throughout most of their lives, it's natural to experience spiritual anxiety during a serious illness. And it's also natural for this anxiety to lead to questions that caregivers might find difficult or even overwhelming. If your loved one asks, for instance, 'What's next? Will prayer help? Why did God let this happen to me?' it's best to call in a qualified cleric.
Just as most of us are not comfortable with chronic illness, we are also not comfortable with crying. When tears appear, we tend to whip out a tissue and murmur something along the lines of, "It's okay. Don't cry." From now on, continue to pass the tissue when your ill loved one starts to tear up, but don't pressure him to stop sobbing. Tears are a natural emotional release for emotions ranging from anger to sadness to fear, and can be very therapeutic.
When your loved one is uncomfortable, upset, or worried, you might be tempted to utter platitudes like, "Everything will be okay," "I know how you feel," "God has given you a long life," or "It's God's will." While we hope that these phrases will be a quick fix to problems we'd rather not deal with, the truth is that they're trite and meaningless. What's more, sugarcoating reality doesn't fool most people, and it certainly doesn't spark positive change.
Anger is a natural human emotion, and it's important to recognize that chronically ill people have a lot to potentially feel upset about. Understandably, many patients are angry that they are so sick. Plus, their pain and energy levels might make them less patient or less able to handle stressful situations. Therefore, it's not unusual for caregivers to be on the receiving end when their loved one's fuse blows for any reason.
Understanding how and why an illness is getting worse and more painful is intellectual. But experiencing it is a very visceral and emotional thing. The patient needs for you to connect with him on a heart-to-heart, gut-to-gut level, not just a mental one.