Caring Currents

Beware an Unexpected Source of Caregiver Stress

Last updated: Oct 22, 2009

A lonely rose...
Image by HAMED MASOUMI used under the creative commons attribution license.

As caregivers, we're often hardest on ourselves, trying to live up to impossible standards of "doing it all," "doing it right," and so on. But sometimes we inadvertently make the load even more strenuous -- by doing or saying things we believe to be correct in the moment, but which we wind up regretting. And that regret, in turn, adds to our caregiver guilt and caregiver stress load.

I know: It's almost impossible to guess when regret will come back to bite you. In the moment, a choice may seem so reasonable. But since preventing bad moves is one of the best ways to avoid regret over them, I asked around to see what others would think twice about if given the chance. Four main categories of caregiver regrets came up "“ or at least, four so far!

  • Making promises you can't deliver.

"I'll never put you in a nursing home" is Numero Uno.

  • Making choices not rooted in reality.

I thought of this one when I saw this new research from Columbia University showing that patients who die in the hospital in the United States are almost five times as likely to have spent part of their last hospital stay in the ICU than patients in England. (For people over 85, the difference is eight times higher in the US!) There's a huge bias here to aggressively use intensive care services no matter what "“ even in patients who are very elderly or ill and, in reality, who are unlikely to have a positive outcome or vastly improved quality of life. Given that most people, according to other surveys, would prefer to die at home, it seems there's an impulse to continue to "do everything" in the medical arsenal. Yet caregivers often regret having done this, wishing that at a certain point they'd switched to focusing more on the quality of life remaining and on ensuring a "good death" for their loved one.

  • Denying an indulgence that in the big picture, wouldn't cause much harm.

One friend told me of his 80-something mother happily eying a margarita he'd just ordered: "That sure looks good!" But my friend knew his mom's medications warned against taking alcohol, so he first pointed this out, then relented and ordered Mom a virgin version. But by then, the bloom was off the moment. The substitute drink wasn't a hit. "I wish I could turn back the clock and order the drink. She didn't go out to eat that much, and it would have made her so happy."

Not to imply our parents deserve a free pass with booze, but I had a similar alcohol regret. My mother liked an evening glass of wine (well, two), but I always gave her a hard time about it: "If you didn't drink anything that weight would come right off!" When she was on hospice, in an attempt to please her, I told her she could have anything she wanted and did she want her chardonnay? Ice cream? By then, she didn't care for any of it. My mom was in her 70s and caring for her mom and my dad when I was haranguing her about an evening glass of wine. Was I saving her health, or denying her a simple pleasure? And was it my call to impose my habits on her?

  • Not spending money on the right things.

What's "right"? Things that make the ill person happy. So, for example, one woman wished she'd spent more money on fresh flowers and less on vitamin supplements she thought would make her mother healthier because she took them herself. Another wishes she'd saved less for the possibility of catastrophic care needs and spent it instead on elder companion services to keep her mom company during the day when she had to be at work, or on traveling together while her mother could still get around.

Anything that you regret? I ask not to make you feel more guilty (!), but in the hope that your own experience might make a fellow caregiver think twice and avoid beating himself or herself up over a similar regret"¦.