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In Association with

Taking Care of Yourself as Well as Your Parent



by Raeann Berman and Bernard H. Shulman, M.D.

Some of us are ready for the caretaker role. Among unmarried women and a smaller number of men who always lived at home, caring for one’s parent is a natural outgrowth of the aging process. As Mama gets older and can no longer be as physically active as before, the child gradually takes on caretaker responsibilities. In other families, in which all of the children have left home, there’s often one sibling, married or single, who simply steps in and assumes responsibility.

In a study conducted by Dr. Ursula Lehr for the Institut für Gerontologie at the University of Heidelberg, “Elderly Daughters Caring for Their Old Parents,” researchers studied one hundred daughters of middle-class German families. These women ranged in age from 55 to 70 and were caring for parents or parents-in-law between 78 and 98 years of age. Nearly 60 percent were married; the rest were single.

This study, and many others conducted by the Institut in the past ten years, bears out that “family­ care is daughter care” and that very often the aging daughter has to take over the care of parents at an age at which she would have her last chance of reentering the labor force or taking over extra-familial roles in social organizations, political organizations, church, community, etc. These extra-familial roles would extend her own life-space and offer her the stimulation necessary for her mental development and psycho-physical well-being in old age.

These daughters fell into two distinct groups: those who were coping well and those who were experiencing conflict and stress.

The ones who coped (roughly half of the women studied) were able to fulfill their own needs, to develop their own interests, and were ready to assert their interests to their parents. They had put the parent into perspective—as an important variable in their lives, but not the most important. They also felt free to ask other family members, friends, and neighbors to spell them so they could get out of the house and pursue their own paths.

The other 50 percent of the women in the study were exhausted and defeated by trying to cope single-handedly. They reported feeling stressed by the restriction of their freedom and lack of time to take vacations or pursue a hobby.

Researchers also discovered that coping families were those in which the aging parent added her efforts to running the household. When the daughter encouraged the mother to take responsibility and fulfill some functions, the relationship was smoother. Trouble reared its head when the daughter “took over” and treated the mother as another child in the home. We’ve already discussed how shut off and useless the older person without a role tends to feel. When a care taking child includes Mom or Dad in family life, no matter how limited in capacity, he or she still has a place. A parent confined to a wheelchair can still help make a salad for dinner, handle the family sewing, or fix a lamp cord.

The Sacrificial Daughter—It’s a Lonely Job

In one extended farm family, the younger daughter moved back home after an early widowhood. Although there are nine brothers and sisters, she virtually handles the care of her aged father single-handedly. She accepts this role because she truly is a gifted caretaker. She cheerfully says, “I was a frustrated nurse, I think. I loved feeling useful, and when my kids grew up, I was always finding someone in the church who needed help. I’m doing an important job taking care of Pa, and I know he needs me. But I’m always tired!”

These unsung, under appreciated caretakers are often burdened unfairly. Frequently, there’s a “let my sister do it” attitude among the siblings. And the caretaker feeds into that by not asking for assistance. The burden of caring for an aging relative needs to be shared.

How to Get Help from Your Siblings

Involve everyone in the family. Of course, they’re all busy and can only spare Mother an hour’s visit on Sunday. And, of course, they feel you’re doing such a great job that they wouldn’t “dare interfere” with the way you’re running the show. These are both excellent dodges to keep you tied to the job while they deny the reality of the situation. You must express your exhaustion and need to get away. You can always remind them, “If I get sick, I’ll have to send Mother to your house.”

Demand some time for yourself, and keep after them until you work out an arrangement. Even the busiest executive can spare one evening a week to sit with his parent. Try to keep in mind the following:

You’re not asking for something unreasonable. It’s only right and fair that each of the siblings takes some responsibility in a parent’s care.

You’re not the only one in the family who can do the job. Don’t be taken in by remarks such as: “Rosemary is the only one of us who can handle Mother. She’s just a wonder. I can’t handle it myself. I just fall apart.” This is one of the oldest family tricks known to excuse laying the burden on the “sacrificer” of the family. Of course your brothers and sisters care about you, but if you don’t make noises about needing help, they’ll let you carry on alone.

Sit down with your siblings and work out the financial arrangements if you have not already done so. If your mother or father cannot be left alone, then ask family members to contribute to the cost of a practical nurse or sitter for those times when you need to go out. After all, if you weren’t the “resident caregiver,” they’d have to pay a great deal more than the cost of an occasional substitute.

If you intend to be the primary caregiver for the rest of your parent’s life, you’ll need your physical and emotional strength. The only way you can continue without feeling beaten down is by taking care of yourself. You’re entitled to your own physical and emotional health—you deserve it!

As soon as you get additional help, continue with the activities you’ve always enjoyed. Or develop new hobbies or take a part-time job that brings you satisfaction and the opportunity of being with other people.

To cope effectively, you must be realistic. Accept the fact that you can’t handle this alone, no matter how much love and understanding you have to give. You need help, and you need to feel free to ask for it. There is no reason to feel guilty. You can be a better daughter or son when you realize your own limits.

Getting Help When You’re Caring for a Parent Who’s Confused

In a recent study conducted by the Department of Psychiatry and Behavioral Sciences at the Johns Hopkins University School of Medicine, fifty-five caregivers of patients with dementia talked about their feelings. The majority (forty-eight out of fifty-five) said they felt sad, angry, frustrated, depressed, and tired most of the time. And over half of the respondents had given up their friends, jobs, or meaningful volunteer work.

Caring for a parent with reduced cognitive ability is hard; it takes its toll on the family. Typically, the burden falls to one member of the family—often a daughter. Other family members may criticize her efforts, but they generally offer minimal support. “You handle it” is the phrase most often heard by these brave souls. As one unmarried daughter of an 80-year-old mother with Alzheimer’s puts it, “I love my mother and I want to help her, but I wish my brothers and sisters would pitch in. They don’t seem to realize that I’d like to go to a play or out to dinner with friends once in a while.”

In the Johns Hopkins study and others like it, the key factor in successfully dealing with the cognitively impaired parent is social support. Fortunately, with the “graying of America” we’re beginning to look at this type of care giving and the enormous strains it puts on families. There are social agencies and hospital programs that provide relief. In some communities, there are day care centers where you can bring your parent for a full day of activities and training in reality orientation by a professional staff of social workers, recreation workers, and psychologists.

Others offer sitter services in your home. You can find information on these and many other programs if you do some digging. Start with your doctor, your local hospital, your local social service agency, and your state mental health association. For information on this and other issues of coping as a caregiver, a grass roots organization called Children of Aging Parents (CAPS) can be an invaluable aid. CAPS began as a local support service and has mushroomed into a national resource for caregivers. To learn more, contact them at:

Children of Aging Parents (CAPS)

P.O. Box 167

Richboro, PA 18954

Toll free: 800-227-7294




For an overview and approximate costs of both help in the home and at day care centers, contact:

American Association of Retired Persons (AARP)

601 E Street NW

Washington, DC 20049

Toll free: 888-OUR-AARP (888-687-2277)



National Council on Aging

300 D Street, SW, Suite 801

Washington, DC 20024

Phone: 202-479-1200

Fax: 202-479-073 5



Why Ostriches Get Headaches Too

While it’s demanding and stressful to be a live-in or live-nearby caregiver, adult children who live some distance away learn sooner or later that they can run but they can’t hide from the problem.

Geraldine lives over one thousand miles away from her mother. Up until now, she has managed to avoid thinking about Mom’s problems. Two years ago, when her mother’s debilitating arthritis made it impossible for her to carry on alone, Mom moved in with Gerry’s sister in their hometown of Helena, Montana.

A “wunderkind,” Gerry sailed through college, married, went to graduate school, had two children, divorced, got her PhD, and married again. At the age of 47, she’s riding high—in line for a full professorship in the English department of her respected, small college in California. Her friends all say, “Gerry’s on a fast track.”

Gerry is one of those women with energy to burn. She runs four miles a day before classes and looks ten years younger than her actual age.

But recently she has not been feeling her usual glowing self. Her sister has been calling from the family home in Helena with distressing messages: “Gerry, I need some help with Mom. Can you come some weekend so we can talk about it? I have a bad back, and I just can’t manage getting Mom in and out of the wheelchair. We have to consider our next step.”

Gerry is annoyed and upset by her sister’s calls. Her mother has taken to calling too, sometimes talking in a frightening, rambling way. Gerry feels put-upon much of the time now. “What do they want from me?” she asks her husband. “I send them money every month as it is. My sister should find a good nursing home if she can’t handle it.”

Gerry goes to her doctor one day, complaining of headaches and problems with sleeping. After carefully investigating and ruling out other causes, her doctor astounds her by telling her that she’s suffering from what he refers to as “stress syndrome.” She, who runs four miles a day, handles a demanding, competitive career and a family, and looks great! Impossible!

Even at long distance, Gerry’s emotional responses to her mother’s situation are taking their toll. She’s been “hiding out” in Ca lifornia , effectively erecting a smokescreen of busyness to avoid thinking about her mother, but her body has been reacting to what’s really going on—Gerry’s concern and guilt. The most dedicated ostrich eventually gets caught. The plain facts of our parent’s aging and the way we respond have a way of sneaking up on us.

Managing Your Stress

When you’re caring for an aging parent, you’re likely to feel fatigued and depressed. You spend an afternoon with your frail and ailing father and come home drained. Yet the other parts of your life—your career, household, relationships with family members and friends—still need your time and energy. The demands pile up, and if you haven’t learned to control the situation, your body gives you warning signals.

Racing pulse, headaches, stomach pains—these are sometimes bodily reactions to psychological pressures. And because we live in the modem world, we use the catch-all phrase “stress” to explain our physical reactions.

What is stress? Dr. Hans Selye, who published his findings several years ago, is still considered a world authority on stress. He determined that vital functions such as blood flow and hormonal activity are influenced by mental perceptions. We may not have to face the tiger at the entrance to our cave as our primitive ancestors did, but we have the same “fight or flight” response to demanding situations. When animals (including us!) perceive a situation as life threatening, their bodies get ready to do battle or run. Our muscles tense. Our pulses race. We breathe rapidly and shallowly. We sweat. We feel a cold, hard rock in the pit of our stomach. Our hands and feet feel icy because the blood has rushed to our brain. With no tigers to confront or escape, modem human beings react instead to our twenty-first-century, high-stress equivalents: divorce, loss of a loved one, job changes—and the pain, loss, bewilderment, anxiety, and guilt we feel about an aging parent.

Dr. Selye described our physical responses as “General Adaptation Syndrome.” Over the years, our body adapts to the “tiger at the door.” The stress hormones gather themselves for action, even when there is no need to fight or fly. Eventually, these mobilized hormones cause wear and tear on our bodies and lower our resistance to injury, infection, and disease. The result may be ulcers, high blood pressure, heart disease, colitis, headaches, frequent colds, and other infections.

Caring for an aging parent is a stressful job. you have all the pressures and uncertainty of a fast-paced advertising office where the client must be satisfied. Account executives and copywriters never know where the next zinger is coming from. New crises are the name of the game. In many ways, caregivers for elderly parents suffer the same stresses.

But there are some specific things you can do that will help your body deal with stress:

Eat properly. Make sure you get plenty of fruits, vegetables, high-fiber cereals and grains, and two glasses of low-fat milk or the equivalent every day. Cut down on fats, fried foods, and processed foods that are loaded with sodium. Your daily intake should be made up of lean meat, fish, or chicken/turkey without skin or fat.

Make sure you drink six to eight glasses of water a day. The combination of water and high-fiber cereal foods helps to move waste from your body quickly and efficiently. You feel lighter and more energetic when your digestive system is functioning smoothly.

Enjoy your food. Take time. If you’re in the habit of bolting breakfast while reading the morning newspaper, you may want to change. Pictures and stories of war, famine, random shootings, and the other joyous news faithfully reported by our morning newspapers do not go down well with food. Of course you want to be informed, but try not to ingest your news with your cereal.

If you’re not exercising on a regular basis, now is the time to begin. Your goal should be to select an exercise that you genuinely like, one that makes you feel good, and one that benefits your body and mind.

You hear a lot about aerobic exercise. If you’re not involved with fitness, you may think all aerobic exercise is strenuous pushing, straining, and gasping. Not so. Aerobic exercise is beneficial because it carries oxygen to all your muscles, especially the heart. It’s continuous activity, as opposed to spurt-like bursts of exertion (e.g., shoveling snow) that can be harmful.

Brisk walking, running, swimming, bicycling—these are all helpful aerobic exercises. To be effective, aerobic exercise must be practiced for a minimum of twenty minutes, three times a week. So if you live a hectic life, you can still fit in this minimum of exercise.

Start out slowly. Let’s assume you’ve decided that brisk walking fits your schedule and sounds like something you can handle (given the shape you’re in right now). Buy a good pair of athletic shoes, pick your walking site, and get started. Walk briskly, swing your arms, and breathe regularly. If you’re exhausted after ten minutes, stop. On your next try, you can push it to eleven minutes. Later, to twelve. And so on.

After exercising, let your body cool down. Slow your brisk walk to a gentle stroll. When you reach your door, stretch your legs, arms, and torso. Take a shower if it’s possible.

One 55-year-old woman who’s responsible for the care of her 91-year-old mother says, “I’ve come to look forward to my swimming times as fun. At first I gasped like a beached whale after ten laps. Little by little, I increased my endurance. When I swim I don’t worry about anything. There’s something soothing about the regimen—sidestroke for ten, backstroke for ten, crawl for ten, then start over. I don’t have to plan anything. I don’t have to think about what I’m doing. I just get into my program and stay with it for a half hour. It’s the most mindless, relaxing thing I do.”

Take daily time for yourself. In addition to the time you spend exercising, make sure you take a few minutes a day to listen to music, call a friend, enjoy a new food, read a magazine—whatever makes you feel pampered. If you’re a dedicated clotheshorse, treat yourself to the latest copy of Vogue or Gentleman’s Quarterly. If you’ve always wanted to learn how to make chocolate mousse, find a recipe, buy the ingredients, and set aside time to try it.

Buy yourself a little present occasionally. This can range from giving yourself a cup of cappuccino in a new cafe to buying a cassette of a favorite song. It needn’t be expensive, just something that lifts your spirits. Buying fresh flowers for your office desk or your home qualifies as a present.

Try to laugh every day. Deep belly guffaws are not only good for the soul—they relax tensed abdomen and chest muscles. Laughing makes you feel “up,” at one with the universe. And when you feel up and look happy, you’ll affect others with your positive outlook. You need the support of your friends and co-workers now, if only to remind you there’s an interesting world out there that you’re still part of.

Check your community for a yoga or stress-reduction class. The gentle stretching movements of yoga induce a healthy mental balance. No matter how tied in knots we may be, a yoga class with a trained instructor can work wonders on our stressed body. Stress reduction classes have the same magical effect. While we practice deep breathing and visualization of pleasant surroundings we can go to in our mind, we are setting up healthy patterns of response. For further information on yoga concepts and programs, contact:

American Yoga Association

P.O. Box 19986

Sarasota, FL 34276

Phone: 941-927-4977




Excerpted from Caring for Your Aging Parents by Raeann Berman and Bernard H. Shulman, M.D. Copyright © 2005 by Raeann Berman and Bernard H. Shulman, M.D. All rights reserved. Excerpted by arrangement with Champion Press, LTD. $16. Available in local bookstores or call 877.250.3354 or click here.

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