The 7 Deadly Emotions of Caregiving: How to Cope

caregiver guilt

Nobody would ever choose a smiley face as the perfect symbolic emoticon for a caregiver. Caregiving for an ailing loved one is just too stressful -- often triggering damaging emotions that can not only undermine your good work but harm your health, as well. Here's how to cope:

Caregiver Emotion Trap #1: Guilt

Guilt is virtually unavoidable as you try to "do it all."

What causes guilt: Guilt stems from doing or saying what you believe is the wrong thing, not doing what you perceive to be enough, or otherwise not behaving in the "right" way, whether or not your perceptions are accurate. Caregivers often burden themselves with a long list of self-imposed "oughts," "shoulds," and "musts." A few examples: I must avoid putting Mom in a nursing home. I ought to visit every day. I shouldn't lose my temper with someone who has dementia.

Risks of caregiver guilt: Caregiver guilt is an especially corrosive emotion because you're beating yourself up over faults that are imagined, unavoidable -- or simply human. That's counterproductive at a time when you need to be your own best advocate.

What you can do: Lower your standards from ideal to real; aim for a B+ in the many aspects of your life rather than an across-the-board A+. When guilt nags, ask yourself what's triggering it: A rigid "ought"? An unrealistic belief about your abilities? Above all, recognize that caregiver guilt is virtually unavoidable. Because your intentions are good but your time, resources, and skills are limited, you're just plain going to feel guilty sometimes -- so try to get comfortable with that gap between perfection and reality instead of beating yourself up over it.

Caregiver Emotion Trap #2: Resentment

This emotion is still so taboo that many caregivers are loathe to admit it.

What causes resentment: Caregivers often feel put-upon and upset because of imagined slights by others, including siblings and adult children who don't do enough to help. Caregiver resentment is especially felt toward the person being cared for, when the caregiver's life feels hijacked by responsibility and out of his or her own control.

Risks of resentment: Without enough support or noncaregiving outlets, feelings of being ignored, abandoned, or criticized can fester into anger and depression.

What you can do: Simply naming this tricky emotion to a trusted confidante can bring some release. Try venting to a journal or anonymous blog. Know that resentment is a very natural and common response to long-term caregiving, especially if your work life, marriage, health, or outside activities are compromised as a result. Know, too, that you can feel this complicated emotion yet still be a good person and a good caregiver.

Caregiver Emotion Trap #3: Anger

Some people outwardly show their anger more than others, but almost no one is never angry.

What causes anger: We get mad for reasons both direct (a balky loved one, an unfair criticism, one too many mishaps in a day) and indirect (lack of sleep, frustration over lack of control, pent-up disappointment).

Risks of anger: Chronic anger and hostility have been linked to high blood pressure, heart attack and heart disease, digestive-tract disorders, and headaches. Anger that builds up unexpressed can lead to depression or anxiety, while anger that explodes outward can jeopardize relationships and even harm others. Managing caregiver anger not only helps your well-being but makes you less likely to take out your fury on your loved one.

What you can do: Rather than trying to avoid anger, learn to express it in healthy ways. Simple deep-breathing exercises can channel mounting anger into a calmer state, for example. Talk yourself down with soothing chants: It's okay. Let it go. Ask yourself if there's a constructive solution to situations that make you angry: Is a compromise possible? Would being more assertive (which is different from anger) help you feel a sense of control? Laughing at absurdities and idiotic behavior can provide a healthier biological release than snapping.

Caregiver Emotion Trap #4: Worry

A little goes a long way, but sometimes we can't turn off the fretting.

What causes worry: Good intentions, love, and wanting the best for your loved ones are the wellsprings of worry. Focusing intensely on the what-ifs provides a perverse kind of comfort to the brain: If we're worrying, we're engaged. Of course, that ultimately triggers more worry and upset because it's engagement without accomplishing anything.

Risks of worry: Being concerned is harmless. Overworry and obsessing, however, can disrupt sleep, cause headaches and stomach aches, and lead to mindless eating or undereating.

What you can do: If you notice worrying thoughts interfering with getting through the day or sleeping at night, force a break to the cycle. Try setting a timer and resolving to focus on something else when the five minutes is up. Then flip negative thoughts to their productive side: How can you help? Who can you call? Are there possible solutions? And don't be shy about seeking out a trained counselor to help you express and redirect obsessive ruminations more constructively.

Caregiver Emotion Trap #5: Loneliness

Your world can shrink almost before you realize what's happened.

What causes loneliness: Friends may back away out of uncertainty or a belief they aren't wanted. Intense time demands lead you to drop out of outside activities. If you're dealing with dementia, the loss of your loved one's former level of companionship is another keenly felt social loss adding to [isolation][2].

Risks of loneliness: Your very brain is altered: People with large, rich social networks have different brain structures, new research finds. Loneliness seems to curb willpower and the ability to persevere, and it can lead to overeating, smoking, and overuse of alcohol. Lonely people also have more cortisol, the stress hormone. And social isolation is a risk factor for dementia.

What you can do: Expand your social circles, real and virtual. Arrange respite help, so you can add at least one outside activity, such as one you've dropped. Take the initiative to reach out to old friends and invite them over if you can't get out easily. Consider joining a support group related to caregiving or your loved one's illness. In online support groups, you can find kinship with those who know just what you're going through.

Caregiver Emotion Trap #6: Grief

Don't think this one applies yet? Think again.

What causes grief: Although most people link grief with death, anticipatory grief is a similar emotion felt by caregivers who are coping with a loved one's long-term chronic illness, especially when there are clear losses of ability (as in dementia) or when the diagnosis is almost certainly terminal.

Risks of grief: "Long good-byes" can trigger guilt as well as sadness if one mistakenly believes that it's inappropriate to grieve someone still alive. Mourning the loss of a beloved companion is also a risk factor for depression.

What you can do: Know that your feelings are normal and as painful as "real" (postmortem) grief. Allow yourself to feel sadness and express it to your loved one as well as to supportive others; pasting on a happy face belies the truth and can be frustrating to the person who knows he or she is ill or dying. Make time for yourself so that you're living a life outside of caregiving that will support you both now and later.

Caregiver Emotion Trap #7: Defensiveness

Protecting yourself is good -- to a point.

What causes defensiveness: When you're doing so much, it's only natural to bristle at suggestions that there might be different or better approaches. Especially if you're feeling stressed, insecure, or unsure, hearing comments or criticisms by others, or reading information that's contrary to your views, can inspire a knee-jerk response of self-protection: "I'm right; that's wrong!"

Risks of defensiveness: While nobody knows your loved one and your situation as well as you do, being overly defensive can make you closed-minded. You risk losing out on real help. You may be so close to the situation that you can't see the forest for the trees, for example; a social worker or friend may have a perspective that points to what really might be a better way.

What you can do: Try not to take everything you hear personally. Instead of immediately getting cross or discarding others' input, vow to pause long enough to consider it. Remember the big picture. Is there merit in a new idea, or not? What you're hearing as a criticism of you might be a well-intentioned attempt to help your loved one. You may decide things are fine as is, and that's great. But if you start from a point of calm and confidence, the focus becomes (as it should be) your loved one, not you.


Paula Spencer Scott

Paula Spencer Scott is the author of Surviving Alzheimer's: Practical Tips and Soul-Saving Wisdom for Caregivers and much of the Alzheimer's and caregiving content on Caring. See full bio


4 days ago, said...

YES- All of them describe my life right now.


21 days ago, said...

I'm feeling a lot of the anger and resentment taking care of my 83 year old father who has not always been so nice to me in my teen years and adult life. He had a series of mini strokes about 17 years ago, and apparently had a heart attack around 2003-2004 and had triple bypass surgery. The list of his ailments is a mile long and includes untreated Diabetes, diabetic neuropathy, peripheral artery disease, nerve damage from his strokes that left him unable to take a shower or a bath, swollen feet and ankles from Diabetes, going deaf from decades of working with power tools, going blind from cataracts, gout in feet and hands (he has a huge golf ball size knob on his thumb knuckle that he refuses to get 'scraped' off under local anesthesia), one kidney smaller than the other, spinal stenosis, a dead spot on his brain from the strokes, Stage 3 congestive heart failure, can barely walk because he's in so much pain and out of breath, and though he's always had some mental health issues all his life, I'm pretty sure he's entering the stages of Dementia. He's very argumentative, has problem communicating, and gets angry when he can't communicate and blames it on the person he's trying to talk to. I recently talked with my uncle, who is the executor of my father's Trust, and my uncle said he sympathizes with me having to deal with my dad because my uncle knows how my dad behaves. At least I have some emotional support in the family. But it's really a struggle day to day because I can't carry on a conversation with my dad for fear he'll just explode in anger because he took what I've said out of context. So, I just go about my business and try to ignore him while he sleeps all day and night. But when I go to bed, I can hear him 'clomping' around on his heavy swollen feet at about 2:00 a.m., then around 4 or 5 a.m., then again around 7 or 8 a.m. and then it's quiet around 9 a.m., and he sleeps until about 2:oo p.m. I am a light sleeper, but I have a fan running for 'white noise' to drown out dad's extremely loud television. He has the TV on even when he's sleeping, but usually turns it off when he's clomping around at around 2 or 3 a.m. I am not going to feel guilty for wishing he would just die and get it over with. He's been griping and groaning for 17 years that he's going to 'die tomorrow'. He sold off a majority of his belongings except for house, tractor, and car because he thought he was going to die all those years ago. His condition is much worse than it was 2 years ago when I moved back in with him. He can't go out and do any work in the garage anymore. He is a prisoner to his recliner chair. He can't sleep in a bed, and hasn't for about 10-15 years. I don't know why he is just lingering and lingering in agony and suffering. I don't know why he keeps holding on. Dad was forced to have a doctor's appointment about 2 months ago because his prescription for Lovastatin was running out and the only way the prescription could be renewed is if he saw his doctor. He begrudgingly went. They did blood work. Then they told him to come back in a month for blood work and a Doppler study. He did. And yesterday, his cardiologist's office called and wanted him to have blood work done 3 times next month and to see his primary doctor. This makes me think that something very serious is going on and this could be an indication that he may not have much longer. And in some ways, I hope that's the case, because I can't stand to see him suffer any more and I also can't wait to get my life back. So, I watch this shell of a man who was once a strapping 6'4" and now withered down to about 5'10", but heavier than he was in his 40s. And he's miserable and that makes me miserable. I am trying to take care of myself through all of this. I am trying to exercise, eat right, make sure my quality of life in my 80s will be much better than my dad's. But the depression kicks in. Depression is often pent up anger, so it's a double edged sword we as live in caretakers must deal with. I've been a lifetime sufferer of depression, so I'm dealing with my own battles, but taking care of a father who is dying a slow, miserable death has given me a bigger struggle to deal with. I just wish the good Lord would take him soon and take him in his sleep so he doesn't have to suffer.


about 1 month ago, said...

how are you all doing now? I wondered if the holidays are going to be a problem for you. My dad passed away Dec 6 1990 and his birthday is Dec 31st. Dec is still a tough time for my mom and me. Time does make it easier to deal with these feelings but it never goes away because he is still in my thoughts almost every day. IF you are struggling with depression as many of us do you should try to find something to hang on to. when I get into my dark place I think about my grandson Jake and my granddaughter Rachel. they are both very loving and lots of hugs and concern for me. so I push out the bad feelings and remember all the good times with them. I visualize a drain and I let my bad feelings slide down the drain. I also pray a lot. How you feel is a choice. It may not seem like it but it is. I used to tell my kids you choose to get angry. Noone makes you angry. They can't make you angry if you choose not to be. You are in total control of your emotions. They are only allowed free rein if you choose to let them. However I have been in the mind set where I wasn't willing to let go of my anger or frustrations. I care about you and hope you have some fun and excitement though out the holidays. I wish you all Sunshine and Laughter and May God Bless You and Keep You in His Hands. May He give you peace and joy and love and surround you with comfort when you need it.


3 months ago, said...

Well people... I used to write about about taking care of my mom, and not being able to travel, not having the freedom to do what I want. It's never really as simple as that -- my mom passed away in March. I took care of her my entire life, but now that she's gone, do I enjoy my "freedom"? Not really. I'm actually abusing the so-called freedom and gotten into drinking. Now there's no one to question me why I came home late ... or not at all. I have no one to chat with in the late evenings .. mom used to give even a feeble smile at my jokes trying to please her. I miss that and have taken to drinking to cope with my loneliness ... coming not out of necessarily missing her, but just being alone. From what I see, care-taking can get quite complex -- you can't live WITH them, you can't live WITHOUT them..


3 months ago, said...

Ahhh Lost in Space please don't give up the site. I know you are dealing with a very depressing situation. I wish I could give you something that would help get your husband to be there for you. At the very least you can vent here and get some release from frustration for a few mins. You need friends to keep you on an even keel. No we can't fix your situation but we are there for you any way. I am keeping you in prayer and I hope things do get better. Can you get your husband to talk to anyone? at a guess I'd suppose he acts out because it frustrates him and being mean is powerful when someone feels powerless or just refuses to deal with the stress any other way. Please hang in there and let us know how you are doing


3 months ago, said...

Hi Lost in Space - I am not sure why you feel this site is useless. It's been extremely useful during my caregiving journey.


3 months ago, said...

This site is useless.


4 months ago, said...

Hes just SOOI MEAN N ITS BREAKING MY HEART.


4 months ago, said...

God help me. I can handle the medical end..since my Son was paralyzed almost 2 yrs ago..He had been diagnosed with Schizoprenia 3 years before his accident..He aldo sustained a traumatic brain injury..and all the bones in his face were broken. He fell 30 feet off of a roof. So on top of this seemingly unmanagable mental disorder..he gets a tbi. Hes so cognizant..when THEY..counted him out. But the schizoprenia is getting worse. Yes hes had med tweeks..weve tried several different meds. Hes getting worse. I dont wanna put him away. I dont know whst to do!!!! Again..the medical care..no problem..This horrible mental disorder is tearing my family apart.


5 months ago, said...

I'll add emotion trap #8: Doom Caregivers are encouraged to get right back up off the mat, do their best, be good people, seek a little help when needed assuming that it's available. But, in the final analysis, you're on your own and it never ever ends. No amount of positive thinking will get around that fact.


5 months ago, said...

I GET U RHONDAW. UNDERPAID.. NO PAY..CERTANLY NOT APPRECIATED N UNDERRATED. I GET MONEY FOR TAKING CARE OF MY SON..BUT IT ALL GOES TO HIM ANYWAY. I DONT DO IT FOR THE PITTANCE..I DO IT SO IF/WHEN THIS SUIT GOES THRU..THE INSURANCE COMPANY HAS TO PAY THE STATE BACK. WHAT I WONDER..AS A 24/7 CAREGIVER IS.. DOES A FAMILY MEMBER GET LESS PAY THAN IF SOMEONE WAS COMING IN N DOIN WHAT WE DO..I HOPE SO..OTHERWISE HOW DO THEY MAKE ENDS MEET. ITS ALL TWISTED. BEST WISHES N GOD BLESS. WISH I COYLD HELP YOU. DID U EVER TRY A GO FUND ME PAGE..IF N WHEN TIMES GET TOUGH..WHICH IS ALWAYS. HUGS


5 months ago, said...

One of the issues that have come up in my search for programs and help for my handicapped husband has been financial payment to a caregiver. If the care giver is not the spouse they can be a paid care giver through government waivers. But if the spouse is the care giver then the gov will not pay them for doing all the work needed to keep that handicapped person in their home with decent care. I have searched all the info anyone has ever given me and have in the last 20 yrs not found anything that helps the care giver spouse. My mom can be my husband's care giver in our home and she gets paid through medicaid. It just doesn't seem fair that the spouse can't draw something for a full job of taking care of a documented disabled spouse. I don't get into politics but it seems like the rules need to change to help people survive a handicapped existence for the family. I am a care giver for my autistic grandson and I get paid for that to give my daughter a break so she can spend time doing things with her other children. My mom serves that role with my husband to give me a break . But if you are the care giver for your spouse and it is a 24/7 job then there should be some financial support. You can't go out and get a job because your spouse needs you there. There should be some compensation when the handicapped spouse is documented as needing 24/7 care. Thanks for letting me vent LOL It frustrates me when I try to do everything I can to give my husband as much independence as I can so he can regain some sense of dignity and the gov ties your hands in financial ways. NOT looking for a hand out just want some recognition of what we as caregivers give up to be their support system above and beyond being their spouse. We lived on just disability for several years and let me tell you it wasn't much money!


5 months ago, said...

LovelyMe38 I feel your pain. I am my husband's caregiver. He is not able to be supportive. I really don't have anyone to be my backup. I am the backup. Do you have anyone who can give you "time off"? a family member or a neighbor? It is important to take care of your own health both physical and mental. In Iowa my husband qualified for a waiver and it pays for someone to come in and stay with my husband for awhile. Maybe your state has something similar. I'd check it out. there are also Elder care centers sometimes where the elder person can be cared for for a few hours. We don't have that here but in some of the bigger cities this is a possibility. When I went to a quilt retreat a few yrs ago I paid one of my grandsons to come and stay with my husband while I was gone. Maybe this is something to think about. I hope you find ways to get some ME time for yourself. You deserve it and need it to stay sane. God Bless! Rhonda


5 months ago, said...

You're welcome Lost in Space. I hope things get easier for you! It takes a lot of time to get through the rough spots. I've thought many times can I really live the next 30 yrs like this?? My DH is handicapped with a brain injury for those who don't know. It is possible to get through anything if you just think this one moment I am going to get through this and the next moment and the next. Take it one step at a time one day at a time one moment at a time and you can do anything. God loves you and cares about you.


5 months ago, said...

Thank u RhondaW


5 months ago, said...

LovelyMe38. I meant..CAREGIVERS..GOT A BIT MANIC THERE. GOD BLESS. PRAYERS YOUR WAY.


5 months ago, said...

LovelyMe38. I get you. Your deal is diff than mine.mine is my son..yours is HIS Mother. Nonetheless..We ARE XATEGIVETS..NOT IF OUR OWN CHOICE..WITH HUSBANDS..WHO ARENT PROACTIVE!! THEY ARENT "STUCK". ARE THEY? NO OFFENSE TO ANYONE..BUT I GETCHA. STUUUUCK!!!