Self Caring

So Who Are You?

Last updated: Apr 07, 2010

analyzing mirror self-recognition
Image by TheAlieness GiselaGiardino²³ used under the creative commons attribution share alike license.

This is going to sound so basic it borders on the insulting, so please know right off that I mean it purely helpfully: How do you define yourself? Wife, husband, mother, father, daughter, son, grandchild, employee, congregant, friend, neighbor?

Caregiver?

The word caregiver is problematic to a lot of people, even those in the caregiving trenches, including the good people behind this site. In its strictest definition "“ one who gives care to another "“ caregiver is a brilliant word, an apt word. We use it often at Caring.com for lack of an equally concise description. We use it ruefully, sometimes, because we know for many of you there's still a bit of a "who? me?" disconnect about the word.

Many of us don't think of ourselves as caregivers, even when we're living the definition.

Is an adult child worried about a parent who lives 3,000 miles away a caregiver? Is a spouse carrying out the conjugal duties of "in sickness and in health" a caregiver? Does inviting Grandma or Dad to come live with you make you a caregiver? What about driving Mom to doctor's appointments and calling everyday to check up on her?

Yes, yes, yes, and yes "“- you're giving care, you're a caregiver.

It's not mere semantics. Turns out that owning the word, in whichever of its many styles and sizes fits you, can be an important part of your mental health.

I "got" the truth of this sitting at a panel at the Aging in America conference in Chicago recently, the annual event co-sponsored by the American Society on Aging and the National Council on Aging. Aging program specialist Mary Brintnall-Peterson of MBP Consulting, a professor emeritus at the University of Wisconsin-Extension, has worked with family caregivers for years and helped to develop T-CARE (T for tailored), a new system professionals can use to assess caregivers and give them great individualized care-management support, which is now being tested in four states.

Turns out its starting place to help family caregivers is to assess how they see themselves, she says. Rhonda Montgomery, a professor of applied gerontology at the University of Wisconsin-Milwaukee, who was also on the panel, has defined "caregiver identity change theory" "“ the idea that taking care of an aging loved one involves a gradual change in identity, from your original family role as spouse or daughter or whatever, to caregiver.

Your identity, it turns out, affects your stress level.

It works like this: If you think of yourself one way ("I'm just being a dutiful daughter," "I'm my husband's wife) but you're functioning another way (increasingly as a hands-on caregiver), there's a disconnect. "If you think of yourself as maybe one-quarter a caregiver, but you're functioning as a halftime caregiver, that equals stress," Brintnall-Peterson says. "You don't have a playbook for Caregiving, because you're focused on Wife. You feel uncomfortable without realizing why."

The rules in your head about your role no longer match the behaviors of your changing everyday life. This varies by situation. A wife may feel comfortable bathing her husband, because it's intimate and spouse-like, but for an adult daughter, bathing Dad is a stressor. For her, there's an identity discrepancy. To reduce her stress, she either needs to hire someone else to do the bathing or change the identity role in her head: I'm Dad's caregiver, and it's okay for a daughter to bathe her dad in that circumstance."

It's a subtle shift in thinking but holds big potential payoffs. "It's not what you're doing, it's how you feel about what you're doing that causes stress," Brintnall-Peterson says. And how you feel about what you're doing is dictated in part by what seems right or appropriate to your relationship.

Why are caregivers so reluctant to adopt the mantle of "caregiver"? In part, I think, it's because this new identity is unexpected, unwanted, and scary. Thinking of yourself as a "caregiver" makes your loved one, in turn, a "care recipient," also a new identity. We'd much rather cling to our vision of him or her as Sweetheart, Dad, Mom, Gran -- and for as long as possible.

Of course, owning up to the reality of this shift usually means we can get the person better help and care, faster. (I'm thinking especially about dementia, a situation where denial and under-diagnosis is rampant, yet early care can be quality-of-life-changing.)

And owning up to a label "“ caregiver -- that we may be ignoring or oblivious to, even though we're already living it, means we can take a giant leap toward serving our own needs better, too. Less feeling conflicted. Better able to find the right solutions. Putting a name on what you're doing is empowering, too, because you can connect more readily with others who've been forced to add a new role to their cherished old ones -- and there's nothing for stress-reduction like some like-minded support.