Raising a family is stressful. Caregiving for an older parent or grandparent is stressful; and when you throw in a major health crisis, schedules unravel, emotions become strained, and tempers flare.
My friend Matt* experienced this recently when his 79-year-old grandmother had a heart attack. June Bug, as he affectionately calls her, took him in when he was 15. (His dad left when he was a toddler and his mother had issues with drugs and alcohol.) With June Bug’s loving support and strict discipline, Matt finished high school as well as college. When Matt married Hollie* and had children of their own, June Bug became their primary babysitter. Caring for the children while Matt and Hollie worked brought her great joy and provided her with a new purpose in life.
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She loved spending time with her three great-grandkids. However, on the day their oldest boy started first grade, Matt noticed she seemed a little down. When he asked if something was wrong, she said, “I’m just afraid that as the kids get older, there will come a time when they no longer need me or want to spend time with me.”
He assured her that there would never come a time when they didn’t need her or want to spend time with her. He had never considered the fact that she might leave them until she called at called at 3 o’clock one morning and said she was having chest pains. She never complained or asked for help, so Matt knew it was serious. He called 911 and met the ambulance at the emergency room. The weeks that followed were filled with fear, stress, and numerous setbacks. She was readmitted to the hospital two times in three weeks. Every time the phone rang, Matt feared the worst.
June Bug’s health and her needs became Matt and Hollie’s major focus, but that didn’t mean any anything else came to a stop. They both had to go to work every day. Matt coached two of his sons’ baseball teams. Hollie was committed to helping with their daughter’s gymnastics program. Groceries still needed to be bought, meals had to be fixed, laundry had to be done, and the grass in the yard continued to grow.
As one crisis lead to another, Matt’s stress increased. He said there were times when he knew he wasn’t thinking straight. Hollie got upset with him one day when she opened the mail and realized he had missed paying two bills, which resulted in $50 in late charges. One night, Matt came home voraciously hungry after working all day and spending several hours with his grandmother at the hospital. He became agitated with Hollie when he discovered he couldn’t even scrounge up the makings for a sandwich, because the only bread in the house was spotted with mold.
By the end of the third week, the tension between them that had started with a few minor irritations developed into full-blown cold shoulders. When Hollie pointed out the things he hadn’t done, as well as things he hadn’t done right, Matt said it made him feel inadequate and ashamed. Those feelings were unfamiliar to him and the only way he knew how to react was to get angry.
Gradually, June Bug’s condition stabilized and she started feeling better. At that point, I suggested he and Hollie try spending a little one-on-one time together – maybe go for a weekend get-away or at least out to a nice restaurant dinner.
I felt like crying when Matt said, “I think she would enjoy checking into a hotel by herself, but I don’t think she’d be very interested in spending any one-on-one time with me right now.”
What happened with Matt and Hollie is not at all unusual. Caring for a loved one requires a lot of time and energy, especially when there’s a medical crisis. Family dynamics become complicated, because each person is dealing with his/her own fears and concerns in addition to taking on more responsibilities and having less time to deal with the tasks of everyday living.
It isn’t unusual for family caregivers to ignore their own health. Exercise can become limited to walks down hospital corridors. We tend to grab handy-but-unhealthy meals on the run, and if worries are keeping us awake at night and we become sleep deprived, it’s almost guaranteed that nerves will get frayed, thoughtless things will be said, and relationships will suffer.
How can you prevent your marriage from falling apart when elder care issues require immediate and concentrated attention?
Nothing will make it easy, but here are five steps that might make it more manageable:
1. Acknowledge the Crisis
Recognize that this situation is going to require a lot of time, effort, and energy. Talk with your spouse about what needs to be done to meet your care receiver’s immediate needs, and identify what each of you can do to help support the other in order to maintain some balance in your family’s routine.
2. Express Your Fears
In the midst of a crisis a lot of family caregivers fear the death of a loved one. Sometimes, we’re afraid that they will survive, but may no longer be able to enjoy a good quality of life. We worry about being able to provide the level of care they need, and we get concerned about how we’ll pay for professional care if we can’t manage it ourselves.
Facing your fears and talking about worst case scenarios will not bring them to fruition. It can actually help you and your spouse and other family members get organized and make decisions.
3. Ask for Help
It’s important to understand our own limits. Most of us can find the emotional and physical energy to deal with a short term crisis. Asking friends, relatives, and even neighbors for help is not a sign of weakness. Most people would be happy to pick up a prescription, fix a meal, or provide a few hours of respite. A friend of mine once said, “When you refuse offers of help, you deprive other people the opportunity to do something that will make them feel really good about themselves.”
4. Ask for Forgiveness and be Willing to Grant It
When you are providing care for a loved one, working a full-time job, and managing all the needs of a growing family, your nerves will get rattled and your patience will get stretched thin. At times like this, you really need to cut yourself and your spouse a lot of slack.
If you make a mistake or say something mean or thoughtless in a tense moment, apologize immediately. There is tremendous healing power in the words, “I am sorry. Please forgive me.”
There’s also a lot of power in the words, “I accept your apology. I know this is a hard time. I’m here for you, and we’ll get through this together.”
5. Establish a Plan for Some Pleasure After the Crisis
It can help to recognize that there will be a turning point. Your loved one’s situation will get better, or it will get worse. Trust that you will figure out what you need to do to adapt and adjust to whatever comes next.
In the meantime, make some plans for you and your spouse that aren’t centered on hospital or nursing home visits, kids’ activities, or work obligations. Suggest to your spouse that you figure out something you could both enjoy doing together once the situation is under control. It could be an activity as simple as a hike out in nature, or something as extravagant as a trip to an exotic location. The what, where, and when doesn’t matter nearly as much as having a shared vision of doing something together that will help you reconnect as a couple.
Let Go of Anger and Resentment
When I saw Matt last week, I asked, “How are things going?”
He said, “A lot better.”
When I asked him what had changed, he said, “For starters, June Bug didn’t die, and we finally got some sleep. But I guess the biggest change came when Hollie decided to forgive me.”
I was surprised by that statement, and when I asked him to elaborate, he said, “Maybe she didn’t actually forgive me. My birthday was last week, and I think she decided she didn’t want to wreck it for me.”
He went on to say, “When I thought I had lost her support, it made me doubt myself, and I began to think that I could lose everything that matters. When she stopped being mad at me, I started feeling better about myself and her.”
Keeping a marriage together while raising children and caring for elderly parents or grandparents takes a lot of effort and energy, a tremendous amount of flexibility, and a really good sense of humor. And sometimes, if you can be willing to be the first one to stop being mad, you can release just enough tension to keep it from all falling apart.
Elaine K Sanchez is a caregiver speaker, the author of the unflinchingly honest and surprisingly funny book, “Letters from Madelyn, Chronicles of a Caregiver, and the co-founder of CaregiverHelp.com, a video-based program that helps family and professional caregivers cope with the anger, guilt, depression and grief associated with caring for those who can no longer care for themselves. She and her husband, Dr. Alex Sanchez, have developed a number of online continuing education courses for mental health professionals. The courses are hosted on PDResources.com.
*Names and identifying details have been changed to protect the privacy of individuals.