I feel I am not doing my best to care for Gran, but I can't get motivated.

Esther fowler family asked...

How can I motivate myself to do better?

I have been the main caregiver of my grandma since Oct. 08, but as of Oct. 09 have taken over full time. I live with Gran and she required complete care. I get her in and out of bed, back and forth to potty chair, and do all cooking, cleaning, and shopping. My older sister is the legal guardian, but I am the main caregiver. I have done everything for the last 6 months, now we have hired a caregiver to relieve me every other week-end and she has been here 3x's now. The first two times were horrible, a new caregiver and Gran's dementia made for a rough week-end, but this last week-end was great and I feel I really got away and got rest. When I started this with Gran I was so motivated and determined to do everything I could to make her happy, comfortable, and well taken care of. Now, I have lost my patience with her, and once even lost my temper. I fall behind on housework and laundry. Some days I just cry. Some days I just take care of Gran's physical needs and hardly get anything else done. I am determined to keep this house and my Gran clean and well taken care of, but I am failing miserably. I need help, advice, anything...

Expert Answer

Kenneth Robbins, M.D., is a senior medical editor of Caring.com. He is board certified in psychiatry and internal medicine, has a master's in public health from the University of Michigan, and is a clinical professor of psychiatry at the University of Wisconsin-Madison. His current clinical practice focuses primarily on geriatrics. He has written and contributed to many articles and is frequently invited to speak on psychiatric topics, such as psychiatry and the law, depression, anxiety, dementia, and suicide risk and prevention.

It sounds like you are trying your best to do what you believe is right. You want to give your grandmother comfort and caring. You don't say much about why your grandmother needs "complete care" and you don't say much about yourself. When you are the primary caretaker for someone who is no longer able to live independently and you must take care of all her needs, it is inevitable that you will have bumps in the road. At times you will get angry because of the overwhelming nature of this job and at times you will get sad, in part because you feel for her and in part because of all you are giving up. I would suggest you be sure she is carefully evaluated by her physician to see if there are things that would make her more comfortable and decrease the stress involved with caring for her, and that you are doing what you need to do to get refreshed.

With regard to the first issue, your grandmother, there are many things a physician might find that can help you. If she is demented, for example, is she also depressed? Is she psychotic? Are there medical problems that may be complicating her course, such as a urinary tract infection or chronic pain or insomnia or poorly managed diabetes mellitus? All these problems and many more, have treatment options available that could improve both your lives. You also may need to step back, and with the help of her physician and your family think through whether it is in her best interest, and yours, for her to be at home rather than in a facility such as a community based residential facility where professionals could help her with her activities of daily living and you could visit and be her granddaughter again.

If you do decide it is in both your best interests for her to remain with you, then you need to balance the caretaking with activities that replenish your energy. It sounds clear that your devotion to her has kept you from getting enough time to yourself. It is critical that you take care of yourself or you simply will not be able to take care of her in the way you would like. You must have sufficient energy or like any of us, you will become fatigued, frustrated and impatient. It is critical that you get a reasonable night's sleep, ideally some exercise each day and time with peers and other family. You also need time to just simply relax. Each of us is different, but it is important that you learn about the balance that works for you, and then find ways to get there. It is also important that you do the best you can, but recognize none of us are capable of perfection. If you get angry or frustrated with your grandmother, apologize and forgive yourself. These are opportunities to step back and analyze what went wrong and then try to make changes. You may also find support groups helpful, perhaps through your local Alzheimer's Association. If you find that you are crying every day or there is nothing you seem to enjoy, I would suggest you meet with a mental health professional. Such an evaluation could help you learn whether you have developed a problem with depression and help you get proper treatment.