Taking care of aging parents can be challenging and if done for a long period of time it can be stressful. Many people feel their life has been sacrificed and forgotten because time is mainly spent over taking care of their aging parents. To help understand common challenges someone may face when taking care of their aging parents and self care tips for caretakers of aging parents, I have interviewed therapist, Shireen Oberman LCSW.
Tell me a little bit about yourself.
“I am Licensed Clinical Social Worker in private practice since 2006. I completed a double masters degree program between USC and Hebrew Union College in Social Work and Jewish Communal Service. Following graduation, I completed a two-year post-graduate fellowship at the Department of Psychiatry and Mental Health at Cedars-Sinai Medical Center where I worked in the adult inpatient, outpatient and Substance Abuse programs. I since worked in a variety of clinical settings including Jewish Family Service of Los Angeles and UCLA’s Counseling and Psychological Services. Now I am working fulltime in my private psychotherapy practice, one of my clinical focuses is working with adult children caregiving for their aging parents. In addition to providing individual therapy, I conduct a weekly Caregiver’s Support Group.”
“Currently I am also one of the primary caregivers of my 99 year-old grandmother.”
What are common challenges that someone may face when taking care of their aging parents?
“The “Sandwich Generation” is growing larger and more adults are balancing caring for their own children while caring for their aging parents. As healthcare and long-term care are becoming more expensive, it is becoming increasingly common that adult children are becoming their parents’ primary caregivers. There are several unique challenges that these caregivers do not anticipate but quickly run into.”
“Loss of Personal Identity ‘” When adult children are new to caregiving, there is so much pressure to balance the lives of their own children, the welfare of their parents, and their personal identity. Many caregivers, who have been in this position for a more extended period of time, describe feeling a loss of their personal identity as they feel the needs of their own families and their parents takes precedence over their own needs.”
“Role Reversals ‘” Many adult children speak of having to “parent” their parents in what is an awkward and uncomfortable role reversal. While there might be certain mental and physical issues that exacerbate these feelings, such as dementia or Alzheimer’s, our parents do not become our children when caregiving. They continue to deserve our respect and to be consulted with before making any large decisions (i.e. moving into an assisted living facility, advanced directives). Maintaining this perspective can be difficult and frustrating, but it’s important.”
“Feelings of Loneliness and Guilt ‘” With so many adults taking on caregiving roles, loneliness and guilt continue to be two of the most common feelings that caregivers bring up. Many caregivers feel isolated by their responsibilities towards their parents, whether they are living with them or living far away. It is difficult to verbalize not only the complex emotions that emerge watching one’s parent physically or cognitively decline, but the very common feelings of sadness, frustration, and guilt that emerge as well. What particularly reinforces feelings of guilt and loneliness is the common anticipation of relief once the parents have died, relieving the caregiver of their responsibilities. Acknowledging that these feelings exist is difficult for many caregivers who fear others will interpret that sentiment as wanting their parents to die, when it is really a reflection of how much caregiving can take over one’s life.”
“Legal Decisions and Paperwork ‘” In addition to the emotional and physical challenges of caregiving, there is the added challenge of possibly taking on the legal decision-making and paperwork. If the aging parent is suffering from severe cognitive decline, their children may be placed in the awkward position of anticipating what their parents would have wanted for themselves. Discussing these issues, particularly advanced directives like signing a DNR (Do Not Resuscitate) form, can be difficult especially if the caregiver and their siblings have very different views as to what their parent would want. Disagreements between siblings can be especially challenging, particularly if there is a real or perceived imbalance between responsibilities. As the sole caregiver, it can even be more difficult because there is the perception of carrying sole responsibility for their parent’s well-being.”
What type of impact can taking care of aging parents have on someone?
“Stress and Anticipatory Grief – Caregiving takes not just time, but emotional, physical and psychological strength. While being the caregiver can provide a closeness and connection to one’s parents that many don’t experience since childhood, it also can give rise to old hurts and wounds. Caregivers often describe struggling with the personality changes they see in their parents and feeling a sense of grief of having lost the parent they remember from childhood. Caregivers may also discuss anticipatory grief, or fears and thoughts about how they think they will mourn once their parent has passed. This type of anticipation can often cause more stress because of the anxiety it induces.”
“Marital and Family Conflict ‘” Taking on caregiving responsibilities can be not only isolating for the caregiver from their peers, but be isolating from their life partners and other siblings. Disparities between caregiving responsibilities can create conflict in even the closest of sibling relationships as one sibling may feel that they are sacrificing their personal life more than the other. It also can be a source of tension between partners, particularly of the caregiver’s parents who require a lot of attention, and their partner’s parents are either still healthy or no longer living.”
How can a caregiver of aging parents take care of themselves?
“Appropriately Organizing and Delegating Responsibilities ‘” No one person can handle the responsibilities associated with caregiving alone. Being organized and delegating responsibilities can help alleviate stress as well as prevent burnout. Whether it be working with siblings or contacting a social worker for case management, is vital that caregivers have others to help with everything from long-term decision making to taking their parents to medical appointments, grocery shopping, etc.”
“Maintaining a Personal Identity – While the needs of one’s parents and/or children may take precedence of the caregiver’s own needs, it is imperative that caregiver’s maintain a sense of their own personal identity. However one cares to define maintaining a personal identity, preserving these important interpersonal boundaries can keep exhaustion, stress and frustration at bay. It is also important in the long run as inevitably one’s caregiving duties will come to an end, and with that the identity of caregiver.”
“Having a Strong Support System ‘” The toll of caregiving an aging parent is enormous and cannot be handled alone. Every caregiver needs a strong support system of friends, family, and community members to lean on. These are the people that will just allow them to vent, take on small responsibilities in times of great stress, and ultimately hold their hand through the emotional roller coaster of caregiving.”
What type of professional help is available for someone who is taking care of aging parents?
“While friends and family can be hugely supportive in times of stress, there is no substitute from the support provided by either a therapist or a caregiver’s support group.”
“Caregiver’s Support Group – When the isolation of caregiving is overwhelming, being able to meet other caregivers can be greatly helpful. Caregiver’s Support Groups not only focus on the psychological and emotional challenges of caring for aging or ill parents, it can also be an added resource for information and referrals.”
“Supportive Psychotherapy ‘” Sometimes group is not enough or is not the right fit. Individual or Family supportive psychotherapy can allow a safe space for individual caregivers or families caregiving together to discuss challenges, frustrations and future planning for their parents and the family as a whole.”
Thank you Shireen for doing the interview on caregiving aging parents. For more information on Shireen Oberman or her work you can check out her website on www.shireenobermanlcsw.com.
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