Chapter 10
Final Words of Advice After Any Change
It would be nice if you could simply assess your loved one’s needs, decide what caregiving support should be put in place, carry through with your decisions, and then relax, knowing you’ve made the right choices. For many families, it doesn’t end up being quite that easy. Even when your loved one is receptive to assistance from family members, outside agencies, or moving to an assisted living community, there is often a period of time where he or she will struggle and possibly act out against the changes. Your loved one will need to examine and deal with new and sometimes difficult emotions and feelings, adjust to unfamiliar people providing help, or perhaps discover how to navigate through foreign living arrangements by learning the layout of the community, figuring out the way it operates, and making new friends. No matter how small the change, or how insignificant it may seem to you, your senior may experience a profound reaction to it.
Imagine how difficult this timeframe can be for a family whose loved one is not very receptive or completely against any changes to his or her life or who has dementia and can’t understand what is happening. Now get ready for another unanticipated element—you and anyone else involved in your loved one’s care may experience similar reactions.
The key to making this period of time successful for all involved is to anticipate and plan for it. The chances are high that you will experience some reaction from your loved one, whether it’s physical or emotional. If you are expecting it, you won’t be caught off guard and panic when it happens. Just as when you were researching care options, interviewing resources, and bringing the family together to make decisions, you will benefit from understanding what is happening to your loved one. You’ll need to educate yourself on ways to deal with your senior’s reaction (and yours), and make decisions on how you might handle anything you find concerning.
The “transition period,” which is what this stage is commonly referred to, can sometimes be more difficult than the stages you’ve already managed. If you’re not careful, this is when you are at risk of you or your loved one taking all the hard work, commitment, and excellent choices you have made and throwing them out the window.
The Transition Period
A transition period is the change or passage from one state or stage to another. In the world of caregiving, this might include transitions after each of the following stages:
• monitoring your loved one once you notice he or she needs support
• providing minimal assistance with daily activities
• realizing the need to juggle other commitments in order to provide assistance
• changing working hours to accommodate an increasing need to provide help
• increasing minimal support to higher levels of care, including hands-on assistance such as bathing your loved one or physically escorting him or her as your elder moves about
• hiring outside support when you can no longer meet your senior’s needs
• moving your senior in with family or to a care community
Each change, no matter how small or insignificant, can trigger a period of adjustment. Recognizing that you and your loved one are experiencing a reaction to an adjustment can help you slow down, accept that time is needed to adapt, and delay any reactions that might damage or reverse the progress you’ve made.
Common Mistakes Made during the Transition
Often, families make errors of judgment that end up prolonging the transition period or perhaps even sabotaging it. Of course, they don’t intend to, but it can be difficult for anyone involved in the change to see how their actions might cause more harm than good. Clearly, nobody wants to put changes in place that affect their loved one and then not monitor them to ensure they have the desired results. But how will you know when you are hindering the process? Here are examples of why a transition period might not successfully resolve itself.
• Participants refuse to accept that the transition will take time. It always takes some period of time to learn what to expect from the change and adjust accordingly. This includes allowing time for you and your loved one to learn and become comfortable with new routines; allowing caregivers to get to know details about your senior’s likes and dislikes in addition to his or her care needs; and developing trust between the caregivers, the loved one, and the family.
• Family members feel guilty. Even though they may realize that these changes need to occur and that they are doing the right thing, many family members can act out or behave inappropriately because they feel guilty for turning the care over to another party. For instance, they may be overly critical of the caregivers and look for reasons to make mountains out of molehills.
• Family members won’t leave the care to the caregivers. The new caregivers must be allowed to do their job. Your loved one needs to bond with them; otherwise, he or she may not grow to depend on and trust in the professionals now handling your senior’s care. It is not uncommon for family members to be asked to spend some time away from a caregiving situation so that the appropriate connections can happen.
• Family members micromanage the care. In some instances, while family members are willing to let others provide the care, they will monitor every action the caregiver takes or instruct them on how to handle their responsibilities because they feel guilty or untrusting. This can not only instill a sense of resentment but also send the message to your loved one that he or she shouldn’t trust the judgment of the caregivers.
• Family members overreact and decide it’s not working too soon. It’s easy for those emotionally involved to jump to the conclusion that a mistake was made. Anxiety and emotions are running high and family members may assume that they have acted too fast, made the wrong decision, or that things were better the way they were before. This happens to those who don’t understand there will be a transition and that it’s a normal process for everyone concerned.
Suggestions for a Successful Transition
The time it takes for your loved one to transition to a new caregiving situation will be different for everyone. For some, because their senior is willing to accept the changes and eager to adapt, the shift could be a matter of a day or two. For the majority, a normal period of adjustment is expected to take one to two weeks. On the other hand, if your loved one is completely resistant, has dementia, or exhibits behavioral problems, the transition might take weeks or even months. In this case, it might feel like a battle of the wills over who will give in first. The following suggestions will help you prepare for as smooth a transition as possible.
• Expect the transition to be challenging. Don’t assume everything will go as planned. Allow a learning curve for new caregivers and/or new living arrangements. Accept that your loved one’s displeasure over the situation is acceptable if her health and well-being aren’t in jeopardy.
• Acknowledge that the transition period is not just about your loved one. Everyone involved in your loved one’s care or who has an emotional attachment to her may experience difficulty adjusting. Pay attention, encourage open discussions, and acknowledge her feelings, but don’t rush to alter anything right away.
• Set appropriate boundaries with family members, if necessary. If there are family members who are causing dissention in the care environment and affecting your loved one’s transition, you must inform them that they will be asked to stay away until the shift happens.
• Don’t make light of the transition period. Recognize and honor the emotions and feelings taking place, but try not to succumb to the negative ones. Instead, focus on the positive benefits of the changes made.
• Understand that your loved one will likely decline slightly physically or mentally in the beginning. A temporary physical or mental decline is quite common and, in some instances, can require counseling or short-term use of medication to successfully manage mild depression, anxiety, or sadness over the changes made.
• Give the period of adjustment time. Change is hard and can make anyone feel overwhelmed or stressed. Generally, these feelings will be temporary. One of the biggest mistakes made is jumping from one change to the next because enough time to settle in was not given.
No Guilt: You Did the Best You Could
The one emotion that can derail the best-laid plans is guilt. If you fall into the trap of believing that you haven’t done enough, haven’t behaved the right way, or haven’t done the right thing, you will suffer from feelings of remorse. It’s a self-imposed burden that won’t result in productive choices.
During your journey with your loved one, you will be forced to make many decisions on his or her behalf as well as for yourself and for others affected by the situation. Many decisions will be perfect; others might be less than desirable, but necessary. There are ways for you avoid beating yourself up. The following suggestions will help you to avoid or overcome this negative and counterproductive emotion.
• Identify why you’re feeling guilty. Guilt often comes from feeling that you let someone down, that people will be mad at you, or that they will think less of you. Carefully consider whether your actions were truly wrong. Chances are, you know in your heart that you made the right decisions.
• Keep in mind that if your feelings of guilt are based on events that might happen in the future, it’s worry not guilt. People often confuse the two. Understand that neither emotion will change the future or prevent something bad from happening.
• Ask yourself, “Is there anything that I can do that will make a significant difference in the situation and how I’m feeling? And if so, am I willing to do it?” If you are struggling with your choices, reexamine what the other options were and why you made the decision you did. If you still feel that you made the correct decision and don’t want or aren’t willing to change your course of action, then you’ve done what you considered to be the right thing. Feeling guilty won’t make it easier.
• Be realistic in your expectations. Remind yourself that your time, resources, and skills are limited. Understand that there may be a gap between what you wanted and the reality of what was available.
• Refuse to judge yourself. Guilt comes from your idea of what is right or wrong. This is usually learned from our parents and our friends. It’s a perspective you use to judge yourself, and it may not be accurate.
• Move on with your life. Allow yourself the opportunity to enjoy the life you hoped for once the decisions were made and the changes implemented. What’s the point of making any adjustments if you won’t allow them to make a difference?
• Remember that you are doing the best that you can! You may not have handled everything perfectly, but you have tried to do what was right, perhaps under difficult circumstances. You would probably support and applaud others if they were in your shoes, so be as loving and accepting of your own actions.
Life is full of transitions—which are ever changing. Keep in mind that what is happening today will likely be different tomorrow, a month from now, or even a year from now. Don’t hold so tightly to the past or how you wish things were that you lose the beauty of the moment today. Appreciate the opportunity to make a difference—no matter how small—for someone you love.
“There are four kinds of people in the world:
Those who have been caregivers;
Those who currently are caregivers;
Those who will be caregivers;
And those who will need caregivers.”
—Rosalynn Carter, former First Lady