The 7 Deadly Emotions of Caregiving: How to Cope

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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 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 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.

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.


23 days ago, said...

Ok I'm posting alot but I have one more thing I want to share. I am a care giver to my husband and also to my autistic grandson. I get paid for being his care giver. Zach is now 16 and was diagnosed at the age of 2 as being autistic. it is really unusual to get a diagnosis so early but my daughter worked with 2 yr olds in day care so she knew hwen things weren't right. Now Zach is 16 and we are working on getting him to learn social skills for self help. He is a great kid but I worry about not holding expectations for him that will make him reach for more. I also have worried about him growing taller and bigger than me(which he now is) as he used to throw himself on the floor in temper tantrums or lean over me and try to physically control me. He has come aways from those behaviors but I still have that on my mind at times. It's hard seeing your grandson not be able to do things and watch him be limited in his abilities. He is mostly stuck in kid cartoons and tv shows abut he has an almost photogenic memory. he knows all the minute details about his shows as in who the directors are who the sponsers are who appeared in which shows and which episodes etc. There is very little he doesnt' now about these shows. We have hopes he will not be stuck in TV land and will some day move behond this. but who knows. It is not the same as caring physically for a loved one but it is more of an emotional stress for me. I watch him and listen to him and think about what a "normal" 16 yr would be doing now. NO they would not be watching and mimicking little kid shows. but that is what his world exists of mostly rt now. He's very smart and has a quick mind. He is very loving and sensitive to other's emotions. He is funny and usually happy go lucky. It bothers me to feel he is missing out on so much. He will probably never get married. It's completely unlikely he will ever have children. But he is the love of our lives. and we take it one day at a time. I have him at least 2 weekends a month and in the summer he stays a week or more several times. I do wonder what his adult life will be like and I hope he continues to mature. We worry about him and it is stressful to meet his needs emotionally and any other ways he needs us. Thanks for listening.


23 days ago, said...

wimped out daughter I'm glad to see you post here. my dad passed away a long time ago but he struggled with his health at home. I worked in nursing homes for 10 yrs as an aide. It is very typical for people to be angry when they can no longer do what they used to do. My husband went through some of that too. I'm sorry it is so tough on you and your sister but yes it is worth it. You will be able to look back and say I did all I could do for my parents. God Bless you and your sister for being willing to do all you can for them. I'm sure your mom appreciates all you do for your dad. Hugs my friend! we understand your struggles.


23 days ago, said...

Zak I hope you have found some ways to deal with your feelings. I understand as I deal with depression in myself and my husband went through a lot of bad stuff due to depression. He felt he didn't have anything to make his life worth anything. What I figured out is get up and get out of the house. If you aren't on medication please consider it. It's important to have interaction with other people. even if you don't feel like it. I hope you make the effort to find something that brings you happiness as in a hobby or going to a favorite restaurant or spending time with someone who cares about you. I know it is easy for me to give you advice but you have to find what works for you. I hope and pray you will find that spark again and lift your spirits. Since we are now into summer there are lots more options open for getting back into life. Remember you are not alone! We care!


23 days ago, said...

Lost in space I am so glad you are finding help for you and your son. Life is so worth living and it is better when you can reach out for help and find friends who will gladly help you! Please keep us posted on your progress. I care and I know others here do also. We have to keep each other strong! Please remember you can always come here to vent and we will listen. Life is hard without any added stress. Adding stress just means we have to work harder to stay strong for yourself and your family. I can't tell you how many times over the last 42 yrs I have sat and cried for my husband's loss of abilities. It is like stroke symptons that come and go and alzheimer's that takes his ability to process in his brain. I've had many times when I thought he was dead. He would be laying in bed with no blinking. I have had to live with a constant not knowing what will happen next with him. No it's not easy but I love him and I didn't get married to walk out the door. So we travel this path together. different than we might have been in my husband hadn't had a head injury. but are we better people for it? Yes in some ways we are. so if you are battling depression or having a hard time making it day by day remember this ____ THERE IS ALWAYS SOMEONE WORSE OFF THAN YOU ARE!!!!! Put your troubles in perspective. No I'm not saying your fear and frustration and anger etc aren't valid. Your feelings are normal for someone in your situation!!! But it could always be worse!! So if you need us we are here to listen and to comfort!! We care about you and want to help. YOU ARE NOT ALONE! post script: I always told my kids it could always be worse . when I found out I had to have surgery my 6 ft son walked behind me down the hall saying ---"Mom it could be worse!" LOL at that point I didn't want to hear my words coming back at me LOL I was miserable and I wanted to be miserable LOL


23 days ago, said...

Thank you Rhonda . Much appreciation. Startin thetapy..me n my Son. I need everything back. Mind soul body n spirit. Such a wonderful inspiration. Hugs back.


23 days ago, said...

Im so sorry about your Mom Zak. I also wasnt on for awhile. ... I pray that you find your spark again. Maybe someday..at least in many of our situations..or all for that matter.. We will get our mojo back n wont feel so EMPTY..


24 days ago, said...

God Bless those of you who have lost your parents. I help my 86 year old mother care for my 87 year old father in a nursing home. He has a lot of ailments and is in denial about all of them. He treats Mother badly and is angry. She is a successful, famous and dynamic artist who never stops working. My sister and I have to run to keep up with her. It's exhausting and we have given up a lot in our lives to help our parents. Is it worth it? Your comments here have shown me that it is. So, thanks.


28 days ago, said...

Hi Zak, Bless you, brother. Yes, I understand. My Dad died from Alzheimer's in October, wheel chair bound, then bed bound, and unsighted, and I had been with him every day, and I, too, come from a whirlwind background in the music biz. In my case, nothing will ever replace my Dad -- no person, no activity could ever do that. He is my lifelong angel -- even in his present state. I'm glad to be of retirement age, so I can do freelance work if I want. (The last thing I would ever do is re-chain to a desk or corporate malarkey. That's just me.) AND, I am now living with 88 yr old mother, full time (keeping my own apartment for later). I am also diagnosed, years ago, with Major Depression. Now, it comes and goes, thank goodness. But not without my AA group (which I mention only as my personal need, not anybody else's), and massive, aggressive therapy in the past. I will go out on a limb, as a person who is not medically qualified, and say you are depressed. There is no doubt. I hope you will find therapy and/or a support group that is meaningful, not window dressing. All best to you, and much love.


28 days ago, said...

Dear Lost in space and everyone, Those of you who read my earlier posts, would know that I was taking care of my 82-year-old mom. And you’d also know who much I was cribbing about having "lost my freedom", not able to travel, how my life is ending at 59, why is it only me who has to take care of a mom, why not John Travolta. I'd complain about my "crippled" lifestyle, and I'd blame it on lack of time and space because I had to take care of mom, who was then confined to a wheelchair and suffering from Alzheimer's or dementia. I had every right to complain -- I quit my flamboyant traveling journalism career and relocated to take care of her. I was with her nearly three years, every day. I got her medicines, applied balm to her feet, prepared food, sat with her watching TV, fed her ... She passed away due to a stroke in March. She spent a week in the ICU and when the doctors said "this is it", we (my sister came in from Canada) moved her out and she died quietly after five days. So how do I feel? After having "regained" my freedom? While this emotions zone is highly disturbing, it's also terribly baffling. Sometimes I wonder if there's really a way back. I'm starting to think it's a one-way street. You spend what seems to be a lifetime taking care of someone you love or once loved, and you think your life has ended there. For all I know, that seems to be perfectly right -- there's really no way back. You (I) have exhausted the possibilities of an unchained life in your mind, and when it really happens, you don't care. Since my mom died, I have moved to another apartment, and I'm single and would appear to have the world at my feet. I have the time, freedom, money to do anything I like. I could fly to Europe tomorrow. But I'm not doing anything. There's no spark. Even the most exotic food tastes flat. Nothing excites me, not even the idea of a date with Kate Beckinsale. Am I sad she died? No, not really ... I took care of her my entire life and I didn't want to see her in pain. I'm quite clear on that -- I have no reason to be sorry or sad.. Well it's barely three months since mom left, so maybe I will regain my enthusiasm at some point later ... but it's definitely not like what I thought life would be like "living single" again. Far cry. But the question is will I be the same guy I was three years ago. I'm sorry I didn't keep in touch with you guys for quite some time. I'll try and be here as often as possible. If I can help with any questions about "life after" .... I will try.


29 days ago, said...

Lost in space you really should check out any thing your state has to offer for help. In Iowa there are waivers you can apply for and that will get you help as in respite care - someone to come in and stay with your son for you to have a break. there are many different programs through the government you should be able to access for help. Here we have the Dept of Human Services. I 'm sure your state has something similar in your community. There is also support groups locally and your local government should have programs that might help. Our hospitals also have support groups and help available. I am positive there is help if you just search and see what is out there for you and your son. If I knew what state you are in I would be happy to do some research for you. I have had to be my husbands advocate and have done all I can to find anything that helps us in our situation. There is hope out there!! You just need to let someone help you. My husband has a brain injury waiver and it provides among other things - respite care and pays for someone to come in and stay with him so I can be "off the clock" for awhile. I would think your son would also qualify for in home health care. It's worth looking into to keep your sanity and to make both of your lives better. If you'd like any help looking to see what you might qualify for just let me know!! I love doing this kind of research into what is available. Hugs my friend!


29 days ago, said...

Had a nervous breakdown in 2004. I know how it feels and all that it entails. Hospitalized for 3 weeks. Ive HAD another one. I cant go to the hospital because there is nobody to take care of my Son.


about 1 month ago, said...

To "Lost in Space," you have got to get outside help. Even if there is no money left, you must hook up with a social worker, and my suggestion is that finding "the best one" can be done at a very reputable "homeless" placement agency. You must INSIST on outside help. You canNOT solve your own, grave, emotional, psychological, physiological and medical problems until you do. You must be a squeaky wheel, and get that help you need. Make it your only priority until it is done. Right this minute, you come first, and your son comes after that. That is the only way that will lead to success. One more suggestion -- if you can't find a proper agency or social worker right away, then get yourself to an OPEN meeting (call AA and they will direct you to an "open" meeting, locally) of alcoholics anonymous. Raise your hand at the appropriate "sharing" time, and tell them, "My name is _____. I am here because a friend of mine who is a member of alcoholics anonymous directed me to ask if there is someone in this room who will talk with me after the meeting, because I have urgent needs for my health and saving my life." There are many alcoholics in recovery who want to be of service, and they may have some ideas, because we all share similar stories. You don't have to be a member to become a very good friend of someone in the fellowship.