Caring for a Difficult Older Adult

By Home Instead Senior Care/caregiverstress.com
Photograph courtesy of Home Instead Senior Care

Being a caregiver is never easy, but if you've spent much of your adult life trying to just get along with a parent or another older adult you're close to, being thrust into the role of his caregiver may be excruciating.

The bad news is that if he's always been critical, grumpy, intrusive, or just plain mean, it's unlikely that old age and poor health will improve his personality much. The good news is that as an adult, you've probably become more confident in yourself and have learned to deal with him more effectively -- and if you haven't, now is your chance to learn. Believe it or not, it's possible to make your relationship work more smoothly so that you can help him through this stage of life.

Difficult people come in all varieties, from self-absorbed and demanding to angry and remote. Caregiving situations vary widely, too, of course: Your experience will be different depending on whether you're providing daily care, supplying occasional care, or coordinating care from a distance. No single approach will address every dilemma, but the following tips should make caring for the person a little easier.

Getting started

You've had the double "oh no" moment -- that is, it's become clear that your parent or someone else you're tied to needs help and that you have to take a greater role in his care, and this means you'll be spending more time with someone you find difficult to be around. Perhaps you'll need to help him move to a nursing home or arrange a treatment schedule for him after his cancer diagnosis. Whatever the details, the relationship you've had is about to change. Here are some steps you can take to ease the transition:

• Take time to prepare yourself. Faced with a crisis, it's tempting to make decisions quickly without thinking them through. If you have a difficult relationship with your parent or someone else you're caring for, the pressure is even more intense, and every decision is fraught. Try to spend some quiet time before you jump onto the caregiving roller coaster. Write in your journal, talk to friends, and think about what has made your relationship difficult in the past and how you can approach it differently this time.

• Line up support. It's important to have buffers so you won't be standing on the front line all by yourself. Meet with siblings, other relatives, or other friends who will be giving care so you can divide the labor early on, if possible.

• Bring in the experts. If you don't have family support, you live far from the person you're caring for, your relationship is explosive, or his situation is complicated, consider hiring a geriatric care manager. She can help by providing support and concrete advice about community resources, skilled nursing facilities, and other such topics. If you live far away, the manager can help you coordinate care from a distance. Take the time to find someone that you and the person you're caring for both trust. If you find the right person, she'll help you communicate more effectively with the person you're caring for.

• Consider your own role. As you enter this new stage in your relationship with the person you're caring for, it's important to remember that you can't control how he acts -- but you can control how you respond. Take time to honestly consider your own role in the conflicts you've had in the past and think about how you can handle things differently. This might be a good time to see a counselor to sort through some of the guilt, fear, anger, and resentment that may have haunted your relationship -- and likely compromised other relationships in your life as well.

Coping day to day

Once he's settled and you've established a caregiving routine, he's likely to resume his usual patterns of behavior -- and may even become more difficult. Crises are frightening, but the long haul can be harder. It'll probably last a lot longer, too. You may require additional strategies to help you care for him on a daily basis.

• Talk it through. Try addressing the situation directly as soon as problems arise. Say something like, "I know we've had problems getting along, but I'd like to do it differently from now on. Can we talk about how to do that?" Try to listen to what he has to say without getting defensive. Use "I statements" when you explain your experience ("I felt as if you were angry at me just now" rather than accusations such as "You act like you hate me").

• Prepare to have your buttons pushed. If you consider the history of your relationship, you'll likely find some recurring themes. Maybe your dad always compares you unfavorably to your siblings or blames you for your two failed marriages. Identify these common trigger points ahead of time and simply ignore him when he touches on them. Instead of reacting angrily or getting hurt, gently change the subject -- as many times as you need to -- until he gets it.

• Try something different. If your interactions are uniformly negative, think about how to change the dynamic. Are there less stressful ways that you can spend time together? If sitting together and talking usually ends in an argument, offer to clean his attic, weed his garden, or cook him a special meal. If you visit him at the nursing home and all he does is complain, suggest taking him out for a drive or lunch. Or take a tape recorder and interview him about his past. Read a book together, if he's up to it, or help him put photos in an album as a legacy project. A tangible project that you can do together can help you be close without treading on perilous ground.

• Set boundaries. It's important for anyone in a caregiving position to set and maintain solid boundaries, but this is especially true if you have a difficult relationship. If you're clear about how much you're able and willing to do and stick to that, you'll be less susceptible to guilt trips and manipulative behavior. You can also set limits for how much emotional abuse you'll put up with; if he won't stop criticizing, maybe it's time to go make yourself a cup of tea.

• Take care of yourself. If you're spending a great deal of time with the person you're caring for, make sure that you're doing things to replenish yourself -- body and soul. This will help you stay balanced and less reactive. Maintain a regular exercise regime to blow off steam, and arrange for regular weekends off and vacation time if you can. Some people find that being in nature or meditating helps them maintain their perspective.

If your schedule doesn't permit regular breaks or time for yourself, you're headed for burnout and you need to do something to remedy the situation. If no one in your family or community can step in, check with your local agency on aging to find out if there are any respite care services available.

• Join a support group. A caregiver support group gives you a place to unwind and share your story with people who are having similar experiences, which can be restorative.

• Seek counseling or mediation. If the person you're caring for is able and willing, try seeing a counselor together. She can help you communicate more effectively and change some of the patterns that have poisoned your relationship.

• The tough get going. If you've tried everything and your interactions are uniformly unpleasant or worse, it's time to consider other alternatives. Talk to family members or close friends and see if you can find ways to minimize your contact with the person. Offer to take on caregiving jobs that don't require much interaction, such as paying bills or dropping off meals. If all family members have problematic relationships with the person, pitch in to hire someone, if you can afford it. Caregiving is bound to be hard, but no caregiver should be abused.

• Have reasonable expectations. With patience and lots of luck, you may be able to make a breakthrough in your relationship with the person you're caring for. But it's important to keep your expectations relatively low and to be willing to practice a little acceptance when things get rough.

The fact is that most people don't change much: He's unlikely to grow substantially less difficult, no matter what you do. You could have years of caregiving ahead; if you go into it with an open heart, it can present an opportunity for growth and healing -- despite the many frustrations along the way.

• Be open to a new relationship. In the movie The Savages, two adult children are wrenched from their respective lives and thrown together to care for their elderly father. The father was abusive and distant when they were young, and they haven't seen him in years. The movie neither dwells on this history nor glosses over it, and there are no tearful reproaches, apologies, or reconciliations. The fact is that the father is now a confused and helpless old man -- and his children rally to help him.

In the same way, you may find that being a caregiver is different from being that person's child or niece. No matter how flawed he is, in the end he's still someone you're connected with, and he needs your help.

Home Care Services: Contact a Home Instead Senior Care office today to learn more about the wealth of home care options available for older adult clients. From enhanced senior nutrition to medication reminders to transportation to and from doctor's appointments, seniors can choose the services that can most benefit them and help increase their wellness. Discover the benefits of in-home care.

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