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Dorothy Sander

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The Caregiver's Silent Burden

Posted: 06/06/2012 10:08 am

My healthy and energetic husband, business partner and best friend had a heart attack at 52. We were still reeling from the affects of 9/11 on our psyches and our business, which needed our undivided attention six days a week. Our two sons were still at home, one homeschooled and one in high school, and our lives were packed full. Life has a way of throwing us curves when we least expect it and true to form, our world was quite suddenly thrown into chaos.

I operated on adrenaline for the first few days and weeks as I took on the full responsibility of our business and livelihood, the care of our children and the care of my husband. We do what we have to do, but churning relentlessly beneath the surface was the heartbreak, the shock, the fear, the loneliness of loss. The emotional ramifications were profound and lasting. He is alive and well, but on so many levels this experienced rocked my world.

Every day women and men across generations and the socio-economic landscape are faced with the difficult decisions and responsibilities inherent in the daily care of a sick or aging loved one. Caring for aging parents is a much talked about concern among adult children, but whether one is caring for a parent, a spouse, or a seriously ill or disabled child, the silent burden of the caregiver is the same. It is profound and constant.

In the midst of the extreme stress and myriad responsibilities of caring for a loved one, family caregivers are coping with one of life's most difficult emotions, that of grief and loss. A woman caring for her husband after a stroke or a heart attack, is not only picking up the slack around the house, shouldering financial responsibilities, and the day-to-day care of her spouse, she is doing so in the midst of a very real and very personal life crisis. She has suddenly lost the emotional and practical support of perhaps her most significant relationship, even if only temporarily. Every morning she looks death in the face and consciously or unconsciously wrestles with the ramifications of losing her loved one, her dreams, and her life as she knew it.

The events leading up to a caregiving situation often occur unexpectedly and without warning. There is no time for preparation. Everything is fine until one day it isn't. The change is immediate and lasting. How is one to keep his/her head above water at such a time?

So often we talk about the role of "caregiver" as if it were a hat we put on, a "temporary" upheaval in our schedules, but it is so much more than that. The grief, the loss of normalcy, not only to our life but to our relationships, lies buried beneath the surface of daily demands. The painful emotions are squelched and shoved aside by necessity and perhaps more likely, by guilt. After all, we reason, we are alive and well. Our needs are not as important as our loved ones. It's not his fault he can't be there for me. There is no time to fall apart, to grieve, or to adjust. It must wait.

When we talk about caregiver burnout, compassion fatigue or the stress of caretaking in general, perhaps the most important dimension to address is that of the emotional upheaval, the undertaking of the grieving process that often begins in earnest and lies buried in silence far too long. The caregiver needs support, compassion and guidance with the silent pain as much, if not more, than they need assistance with practical matters. By the time we move into the caregiving role, most of us are adept at problem solving and decision-making. Our real difficulty more likely rests in making sense of and coming to terms with loss.

 
 
 

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My healthy and energetic husband, business partner and best friend had a heart attack at 52. We were still reeling from the affects of 9/11 on our psyches and our business, which needed our undivided ...
My healthy and energetic husband, business partner and best friend had a heart attack at 52. We were still reeling from the affects of 9/11 on our psyches and our business, which needed our undivided ...
 
 
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03:42 PM on 07/25/2012
Caregiver burnout is a serious problem but it is also one that we should discuss as a society. To learn more about how in-home care can ease some of the stresses stemming from caregiving, please watch this short video: http://www.youtube.com/watch?v=y50zVD-7RsE
08:41 PM on 06/23/2012
This is a growing issue in society today. I wrote my personal experience here: caregiverssilence.blogspot.com/
02:01 PM on 06/11/2012
Thanks for your honesty Dorothy. You brought up two points that are really important to raising awareness of caregivers.
1. "Caring for aging parents is a much talked about concern among adult children, but whether one is caring for a parent, a spouse, or a seriously ill or disabled child, the silent burden of the caregiver is the same."
Even though our healthcare system would fall apart without unpaid caregivers, they are still very much invisible to the general public. While eldercare is being discussed a lot more in the media, we must remember that all caregivers face isolation, depression, guilt and stress.
2. "There is no time to fall apart, to grieve, or to adjust. It must wait."
One of the most painful parts of caregiving is not knowing where, when and how to open up. Often it is hard to find the time and energy to get outside to go to a support group. The internet becomes a lifeline, allowing access to caregivers in similar situations.

Thanks again for this article and for your honesty. Your story has helped so many.
11:11 AM on 06/07/2012
I shared your experience, having gone through it all after my husbands heart attack. Thank you for describing it so eloquently. I sometimes feel that because my husband survived, albeit with a seriously diminished life style and inability to work, people think my crisis is over. I still stare death in the face every morning, knowing that this is the day I might become a widow. It takes a toll far greater than the daily physical burdens of doing what he no longer can.
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Dorothy Sander
Writer/Philosopher Founder of Aging Abundantly
03:44 PM on 06/11/2012
Very true Judith. I have come to see more and more clearly how, in reality, we are all truly alone. My husband's heart attack gave me the opportunity I needed to become more independent and less afraid of being alone. It had to happen. I feared the fear of being without him as much as I feared the actual event. I was very committed to dying first!

We come to depend so much on one another in long term relationships there's no way a serious illness or sudden death wouldn't rock our world. But we are stronger than we know and there are people everywhere who understand and are willing to walk beside us and hold our hands when times get tough. That's the best there is. The rest goes on in our hearts and souls.
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widdles
Love is 4 more years of Barack Obama
04:05 AM on 06/07/2012
What a timely piece! I am currently in the process of making arrangements to have my 88 year old mother come to live with me. She has early stage dementia. It was after she broke her hip that the trauma of her medical condition has brought further decline of her mental facilities. At the moment she is in a nursing home for rehab from the break. However, I see that to keep her there permanently will only bring a rapid decline in her thought process.

So I have made the decision to have her come to live with me. I am fully aware of the toll this will take on me. My loss of privacy. My loss of a social life. My loss of self.

But until my Mom is in such an advanced state the she is pretty much no longer the person that I know and she has no idea who anyone is or what is going on, she deserves better than living in a depressing nursing home where her life consists of a small radius of a world and is dictated by the regiment of such a home.
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Dorothy Sander
Writer/Philosopher Founder of Aging Abundantly
03:39 PM on 06/11/2012
I applaud your courage widdles. I felt the same way about my mother and her circumstances. The family felt otherwise and she died in a retirement community health care facility within a couple of miles of my two sisters. Over the previous ten years she had transitioned from an apartment, to assisted living to health care. It saddens me still to think about it. It wasn't pretty for her. It seems falls and decline go hand in hand. Having your mother stay with you does not need to mean "loss of self". From what you say you are already very aware of the demands and sometimes it is in losing ourselves that we find our true selves. It sounds to me you know exactly who you are! I wish you well and would love to hear how it all works out for you.
12:59 AM on 06/07/2012
Very well said. Any kind of caregiving is out of selfless love and all caregivers deserve support. As a young, male, spouse caregiver of intersex patient, the length of the relationship of marriage was too short. Due to treatment of the patient, I lost emotional support from my trusted friend/partner, the spouse, the patient. And having a loss of emotional disconnect has to be replaced for the caregiver to go on or risk becoming a patient themselves. Due to secrecy and stigma about intersex, the caregiver has no resources and is isolated in silence. Stress causes lower immunity and can lead to sickness. Reducing caregiver stress is paramount both for the health of the caregiver and the patient.
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D. A. Wolf
Founder, Daily Plate of Crazy
04:01 PM on 06/06/2012
You've given voice to a sort of living grief that is rarely addressed openly. I remember a time when family members were less geographically dispersed and communities stronger, and these burdens could be shared. That seems more difficult now, as the way we live has shifted in the past generation.

I'm glad your husband is doing well. Thank you for sharing your experience, and speaking of it so eloquently.
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zimpeterw
A politically incorrect, contrarian ex zimbabwean
01:12 PM on 06/06/2012
That is a very good description of the stress and anguish that the caregiver has to overcome in addition to picking up the whole load of running a household and, in many cases like yours, a business.

I was lucky, I survived a heart attack at age 60 relatively well, was out of hospital in a few days and able to help with household and farm animal tasks soon after that.

As new immigrants to Canada having lost our farm and everything we owned, in the violent farm seizures in Zimbabwe a few years before, this was the straw that almost broke the camels back. The heart attack put an end to my business and my income overnight. Starting a new internet based business that would not require much physical effort was an added stressor.

The strain and worry has been much worse for my wife than I. I only had to worry about death, she has to worry about being left alone in a still unfamiliar country with no income and no support network of family and old friends, in addition to worrying about my health.

Yes, the burden is heavier for the caregiver than the cared for. I am grateful that my dear lady has been strong enough to handle it with grace and courage.
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Dorothy Sander
Writer/Philosopher Founder of Aging Abundantly
07:06 PM on 06/06/2012
You and your wife are clearly no stranger to the challenges about which I spoke! I applaud both of you for your ability to survive and carry on. With illness often comes financial hardship which certainly has been true in our case. Sometimes one wonders how it is possible to reduce stress to avoid wear and tear on our bodies when we have so many worries! And yet, I have found it necessary and possible to let go of so many things that used to cause me worry. We have to live in the now, in this moment, and as long as we have food on the table and each other, life is good.

I am certain that your wife has experienced many challenges, but being the one who is ill is not pain free! My husband's world was rocked as he, still feeling young and vibrant, was tossed into a rehab group with people much older than he. Many men depend on their ability to be strong and in control. Virility is as important to them as femininity often is to a woman. Being the receiver of care is difficult. So I would have to disagree as to whose burden is heavier, but I do know that when two people pull together and work as a team to solve a problem, they can move mountains!

Thank you for sharing a bit of your story. My best to you and your wife. You are both courageous.
11:39 AM on 06/06/2012
Write On Dorothy! I'm happy to hear your husband came through this difficult time. Part of the ongoing grief I experienced after my husband's first major illness was the underlying threat of it happening again. We can never unring that bell in our emotional baggage and I continued on an edge of low level worry throughout our marriage. Yet threats of loss simultaneously allowed us insight into living life to its fullest and not taking each other for granted, which ultimately enriched our lives. Thank you for this important topic that none of us are likely to be immune as we add the years onto our lives. As you point out, the caregiver also needs care. ~Joan
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Dorothy Sander
Writer/Philosopher Founder of Aging Abundantly
06:55 PM on 06/06/2012
Joan, thank you for your insights. The inability to unring the bell was (is) truly one of the most difficult aspects for both of us. We're a whole lot more cautious and slightly "twitchy" as I like to call it. But as you point out, knowing that this life is not forever adds a sense of urgency and appreciation for what is good now. We live less in the future and like you, we have both been enriched by our altered perspective. It woke us up to life!
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ginadeoliveira2008
Seen a shooting star tonight and I thought of you
11:28 AM on 06/06/2012
I haven't had the courage to read it. The tittle scared me enough. Here everything is still fine, I don't wanna know of the day it won't be.
11:23 AM on 06/06/2012
Being a caregiver is extremely hard at times. I have dealt with all aspects of it from my oldest son having leukemia, to various health problems of my mom and her untimely death due to complications from colon cancer and now my dad and step mom who want to remain as independent as possible. My dad is 88 and hard of hearing, but is in excellent health otherwise and has taken on the roll of caregiver for my step mom whose speech has been impaired due to multiple strokes. I live almost 40 miles away and the biggest hurdle for them and me is phone conversations. My dad will receive a bill in the mail and might not understand it and has me call the company and because of privacy laws, many companies won't talk to me. With all the automation, please hold, or for English press one, etc. my dad can't hear that or understand what they are saying and gets frustrated. Case in point, The company I called yesterday; All I wanted to know was, Did they receive the check my dad sent in April, and I get, "I can't talk to you" It's very frustrating.
05:25 PM on 06/07/2012
Get a power of attorney from your Dad and a signature card, etc. on his bank account. He relinquishes nothing and you can set up "talking rights" with all his accounts. Same with health forms. We did this 15 years before my Dad died, but in the process of aging he did have similar problems with systems not geared for a 96 year old. I eventually took over all bill paying. I was 680 miles away, but with internet banking it was easy to have the bills sent to me and to relieve him of the worry. It is so worth doing now, and not when he is unable to make those decisions.
09:53 AM on 06/06/2012
This is exactly where I am right now.I gave up everything to take care of my mother.I have been doing it for just over 4 years.I now go from burnout to numb.This is truly the hardest thing I have ever done.Thank you Dorothy for your words.
02:10 PM on 06/06/2012
My husband was diagnosed with dementia at age 36, passed at 43. I understand your pain more than you know. Support is critical, and I located an online caregiver blog that was a great resource at caregiversupport.wordpress.com/. I also checked out a book from the library on "ambiguous loss" which I found was quite interesting, as I had never really heard a term for what I was experiencing for so long. You should know you're not alone, and find comfort in that. DO NOT allow peoples opinions or attempts at guilt break you down. Nor allow yourself to be angry when the blissfully ignorant provide unsolicited advice ( I used to cringe when people would tell me how I had to take time for myself, which meant noone to look after my husband, and there were few volunteers.) Be patient with yourself as well as your mom. Take Care.
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Autismmomx4
Autism rocks! and flaps and spins..
11:50 AM on 06/07/2012
( I used to cringe when people would tell me how I had to take time for myself, which meant noone to look after my husband, and there were few volunteers.)

This is so true!!!! I have 4 disabled children and my husband is disabled. He will probably have his lower leg amputated this summer which will mean that 100% of everything will fall on me (again) for a while. My MIL has decided that she "needs" a huge 80th birthday party. She did the same at 70. Me, I'm lucky to get a card. My husband constantly expresses his gratitude that I'm not "high maintenance." But, there are days when I wish I could just be selfish and have a pedicure or go to a spa or see a play. It's not in the cards right now. And, I thought about all this yesterday as I spent the whole day at the hospital with one of my older sons. I didn't get home until 6:00 pm. I sat in that waiting room and I thought how tired I am of hospitals and doctors and meetings at the schools and the dirty house and the lack of money and......
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Dorothy Sander
Writer/Philosopher Founder of Aging Abundantly
02:30 PM on 06/06/2012
The only upside to this for you Lori is that you are not alone. Those of us who have been there or are there now understand how difficult it is. You are doing a very kind and loving thing for your mother. The trick is to find ways not to lose your own life in the process. I do have a caregiver's support group on Facebook if you just need someplace to recharge your batteries. Search Aging Abundantly Caregiver's Connect. It is a closed group so just ask to connect. There many other online options for support as well. Thanks for taking the tine to read and comment.