First the good news: Many caregivers say the experience warms and strengthens their bonds with the loved ones in their care. Too bad that so many of their other relationships -- with a partner, children, siblings, friends -- can become strained to the point of breaking by a caregiving journey.
Spouses and kids of those caring for an aging parent, for example, may feel neglected. Friends can't relate and drift away. Siblings disagree, get jealous -- or don't lift a finger to help and are resented. Fully 80 percent of caregivers in a 2009 Caring.com survey reported that caregiving strained their marriage or other relationships. Half of caregivers (53 percent) say that their caregiving takes time away from friends and other family members, according to the National Alliance for Caregiving (NAC). Almost one third of caregivers said that their emotions interfered "a lot" with their social lives, found a 2011 UCLA Center for Health Policy report.
And it all happens almost without your realizing it. "The risk of caregiving is that you gravitate toward newness -- you have to pay attention to your time and your energy in the new situation or crisis," says Carol D. O'Dell, a Florida-based speaker on caregiving and the author of Mothering Mother. "And you ignore all the quieter people and situations in your life."
Net result: isolation, tension, resentment, a perceived lack of support, lost sources of support -- and a lot more stress in an already overstressed life.
Caregivers who have sacrificed time with family and friends are far more likely to feel high emotional stress (47 percent) than are those who have been able to maintain the time they spend with family and friends (14 percent), says the NAC.
Here are seven protective buffers against relationship stress:
Problem: You have to focus on the neediest person.
Protective step: Consciously decide that your other relationships matter.
It's easy to take loved ones for granted because they're (almost) always there for us. But when you're stressed, it pays to bring a little intention to your relationships. "You have only so much time, love, and energy to throw around," O'Dell says. "If one person is at the 'top of the totem pole,' it means someone else is at the bottom."
Run a mental patrol of the important people in your life. You may not be able to maintain exactly the same pre-caregiving relationship, but it's important to stay attuned to their cues and complaints. Simply knowing to pay attention can help you avoid missing crisis situations with those quiet loved ones currently lower down on the totem pole.
Problem: You don't have time for one another.
Protective step: Create rituals you can share together.
The nice thing about rituals is that they don't have to take up a lot of time -- who has that? -- but they concentrate your togetherness in meaningful ways. Create small events for various loved ones that you can both look forward to -- a monthly lunch with a best friend, an after-dinner walk around the block with your mate, popcorn and a movie with your child on Friday nights.
Making couple time a priority is one of the most effective ways to protect a marital relationship, say marriage experts and Charles and Elizabeth Schmitz. The same holds true for bonds to children, other family members, and friends, says O'Dell. You can bankrupt yourself emotionally by caregiving, and that's not what it's meant to do," says O'Dell, who took care of her mother for a decade.
Bonus: Rituals break up the tedium of caregiving for you, which also eases stress.
Problem: Your friends' concerns seem trivial compared to yours.
Protective step: Force yourself to "stay in the game."
A common experience for caregivers is that looking after someone who is frail or sick is, after all, dramatic business. Previous shared interests, like shopping or gossip, may seem trivial and easily forgotten.
In the short term, that's completely understandable, O'Dell says. In a caregiving crisis, it's often necessary to put this role above all. The people in high-quality relationships know they aren't always even-steven; sometimes one side needs to lean on the other more. But few relationships can sustain a big tilt over the long haul. "There is life after caregiving, and you're going to want those relationships to jump back into," she says.
She recommends forcing yourself to send the birthday card or make the call congratulating someone on a promotion or big life event, even when it's the last thing you feel like doing. "Force yourself to be a friend sometimes," O'Dell says. Reaching out is also reassuring and inviting to friends who may be hanging back, uncertain how to approach you in your time of crisis.
Problem: You're wearing out your welcome.
Protective step: Vent, but only so far.
Every caregiver needs "safe havens," people to whom he or she can safely blow off frustration and resentment, and share the other mixed feelings about caregiving. At the same time, though, your responsibility is to not use your nearest and dearest exclusively as sounding boards. Relationships are by definition reciprocal. So, for example, set a timer and agree you'll vent for ten minutes before moving on to other topics.
Be a listener as well as a complainer -- everyone has stressors in his or her life.
Problem: Nobody can relate.
Protective step: Realize that others have a hard time walking in your shoes.
It's difficult for nonprimary caregivers to see things from exactly your vantage point, so try not to expect them to. Friends who aren't caring for a mate with Alzheimer's can't begin to imagine it. Your teenager may love Grandma but developmentally can't help seeing herself as the center of the universe.
What helps: Finding a caregiver support group or online caregiving community, where you can vent about your stresses with others who know exactly what you mean. This has the added benefit of freeing up your communication with friends and family so that it's not exclusively about caregiving.
Problem: You fall into disagreements about caregiving.
Protective step: Agree to disagree.
It's blessed but rare where an entire clan is in agreement about every decision regarding a parent's care. Accept that there may be disagreements. Some you'll win, some you'll lose. There's rarely one right way to handle things. If siblings are in denial about a situation, give them time. It's rare for all sibs to be on the same page at the same time.
When you can't compromise, consider the services of a family mediator -- a paid professional or unpaid senior family friend who can be a neutral party in sorting through differences with an eye toward resolutions that are in the parent's best interests and that everyone can live with.
Problem: You feel utterly unsupported.
Protective step: Know that it's OK to turn some relationships loose.
Sometimes friends or even siblings fall away in the chaos of caregiving. If a relationship can't stand up to being on the back burner for a while, or if arguments over it bring you to the breaking point, sometimes it's healthier to cut the other party loose. (For spouses and kids, obviously, this is a less viable option.)
Try not to take it personally; sometimes stress brings relationship casualties.
"Sometimes friends drop you when you're a caregiver, and that's OK," says TV-radio commentator Leeza-Gibbons, founder of the Leeza's Place communities for caregivers. "Not all of them will be able to make the caregiving journey with you -- but your solid friendships can still be there for you."
Paula Spencer Scott wrote this article as part of a MetLife Foundation Journalists in Aging Fellowship, a project of New America Media and the Gerontological Society of America.