Family Caregiving as Opportunity for Growth
By Avery McKenzie, MA, SPT, LPCC
The increase in the overall age of our population has far reaching impact on family dynamics, and on what the aging process entails. The U.S. Census Bureau reports that by 2050, the nation’s elderly population will more than double to 88 million, and the more frail, over-85 population will quadruple to 19 million. This dramatic growth will require an increase in care facilities, outpatient care support structures, and informal familial care. And according to Richard Suzman and John Beard (“Changing Role of the Family,” Global Health & Aging, National Institute on Aging, October 2011), for the first time in history there are more adult children in their 50s and 60s with surviving parents and more younger generations having contact with their grandparents and great-grandparents. The increase in life expectancy brings with it new opportunities for growth, healing, and connection in intergenerational relationships, and I’d like to focus on how these things can come through family caregiving. How might supporting our loved one through (often challenging) mental, physical, and emotional changes impact our relationships? How might this process influence the roles we play in one another’s lives? It is an understatement to say that witnessing the changes in our loved ones that occur with aging can be painful, sad, distressing, and anxiety provoking. The host of emotions that accompany this process can run the gamut, from periods of extreme emotion to moments of numbness and denial. There is no one right way to experience the depth of coping with change in the person we love. It feels critical to focus on how we can support our loved ones while still meeting our own needs within the relationship. How can this time period be one of growth, resolution, and learning, for caregivers and for the family system as a whole? I’d like to focus on three ways that being a family caregiver provides an invitation for profound healing.
Changing Roles with the Care Recipient
As a care recipient’s needs change, depending on what their diagnosis and progression may be, personality shifts often arise. This is especially true for individuals with symptoms of Alzheimer’s or other dementias, or other neurodegenerative diseases. Traditional roles held in family systems over the course of the lifetime before their needs changed might get shifted significantly and suddenly as they change with their disease. For example, children might need to begin providing financial support for their parents, may be granted power of attorney to make important decisions of care, or may shift into a role of providing emotional stability when the care recipient begins having more moments of confusion or distress. These types of shifting roles can create a cornerstone for self-individuation. We can view these changes as a time of opportunity to develop our own individual journey, without others’ ideas of what the perfect path “should” look like, potentially holding us back from our truest expression of self.
Some people who experience personality shifts soften with their increasing vulnerabilities and needs, which can allow for more honest and authentic communication than has ever been available in the relationship before. In moments where our loved ones soften and their hearts feel open, caregivers may find an opportunity to broach unresolved subjects that have been taboo or felt too threatening to discuss in the past. The ability to have more direct, honest communication can allow us to express an unresolved past conflict and to strengthen the depth and trust within the relationship in the present moment. The expression of love, forgiveness, or a long-awaited apology may become possible in family caregiving situations as intimacy and closeness build.
On the other hand, it is challenging when someone we love begins to display extreme episodes of agitation when they may have been ‘happy-go-lucky” for the majority of their life. It’s painful when they can no longer remember or recognize their loved ones, or when they lose the ability to accurately remember past events. When these challenging situations arise we have an opportunity to ask ourselves, “How can I be more compassionate in this moment, and respond in a way that I would like to be responded to if I were in that state of confusion?” We might realize and grow into the understanding that this person cannot provide the resolution we are seeking. It is up to us to let go of any existing resentment. We can learn to provide acceptance and forgiveness to ourselves, rather than needing it from our loved one anymore. Caregivers can give themselves permission to stop seeking others’ approval, permission, or acceptance on a wider scale in their lives — and become more confident to create their own unique identity moving forward.
One key to traversing this time of change is to grow our ability to be flexible and to work with our own inner reactions and responses. We can learn to transmute moments of suffering into opportunities for growth. A shift in internal perspective helps create spaciousness to respond co each moment as truly needed, rather than reacting from habitual behavior patterns that might not be the most compassionate intervention. By being able to relate with our loved ones in the present moment, without tinges of past regret or future expectations, we create room for healing and growth within the relationship and for ourselves.
Changing Roles with Other Family Members
Changes with the care recipient inevitably initiate shifts in the historical roles held by each family member, and can be disruptive and confusing to a family system. There are many areas of consideration between siblings, aunts, uncles, and extended family members that might need attention. Financial contributions, coordination of proper care at home or in a facility, managing medical appointments, the amount of time spent with the care recipient, and so on. It can be quite challenging at times to resolve these issues, and there is opportunity both for deepening family ties and for more conflict, resentment, and anger! Sometimes it is the moving-through conflict part that helps us get to the resolution and healing between family members. There is an opportunity to grow in our skills, advocating on our own behalf within the family system. There are opportunities for recognizing and developing our personal boundaries, for becoming more aware of our limitations, and for learning how to ask for help when things become overwhelming. It can be scary at times to challenge long-held familial roles, but it also can invite all members of the family to show up in a different capacity than they have in the past. One example may be an individual in the family who has long been thought of as unreliable, who begins to spend increasing amounts of time with the care recipient as their needs change, thus challenging that antiquated belief in the system. This could offer a new opportunity to be more connected with the whole family.
Increase in Authenticity and Self-Awareness
At the core of our beings we want connectedness and authenticity with the ones we love. What does it mean to authentically connect with our loved ones, and how can this help create a positive relationship with our care recipients? Authentic people in our lives are those who are easy to be around and with whom we feel safe. These individuals are perceived as honest, trustworthy, genuine, passionate, kind, helpful, and truthful about their shortcomings. They feel emotionally available, show vulnerability as they work through the challenging aspects of their lives, and recognize how they impact others. By being authentic in each moment, a caregiver has the ability to express frustration and confusion as challenges arise, while still sharing their love and desire to provide support.
Family caregiving is a powerful venue for developing self-awareness. For example, moments of aggressive behavior provide a mirror to see how we normally react to anger. Do you notice yourself being triggered and acting in an angry, sad, or frightened manner toward your care recipient? Or are you able to hold a larger perspective that, for instance, your loved one is over stimulated by the loud noises coming from the action-packed movie on the television, but lacks the awareness to express the root of their discomfort? Imagine the shift in your relationship with the care recipient if you are able to express your needs and experiences of the present moment, rather than just reacting harshly, and how that ability to see and be seen might allow you both to show up as your most whole selves. As you begin to practice this level of self-awareness, it’s easy to notice the transitory nature of emotions and sensations. This practice can lead to a deepening of awareness toward the preciousness of life and a path to taking the challenging moments with a grain of salt.
Being a family caregiver can be a time of great transition, emotional growth, and personal healing if you carry the intention to let it be so and bring effort to the process. It is a ripe opportunity to use challenges as food for transformation. Just as the lotus flower blooms through muddy water, so can opportunities be born out of murky situations. The three topics discussed above are by no means the only areas where growth can occur, but I hope they can be guideposts on the journey. As our society continues to age, the opportunity to use relationships with our elders increases. By utilizing resources available in our community and by taking good care of ourselves along the way, caregiving can be a potent and powerful experience for ourselves, our siblings and friends, and for the care recipient.
Avery McKenzie, MA, SPT, LPCC, is a team leader with Windhorse Elder Care.