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Care for the Caregiver
by Mark Sichel, LCSW and Alicia L. Cervini

Being a caregiver to an ailing spouse, a sick child, an ageing parent, or a sick friend is a uniquely difficult undertaking. Sadly, caregivers, who deserve nothing but the highest reward for their dedication, instead can receive a host of psychological and emotional problems for their trouble. The unrelenting demands of being a caregiver can take their toll on the individual, causing anger, confusion, anxiety, and depression. The sad irony is that the caregiver who succumbs to these negative emotions, is less effective as a caregiver, a family member, a friend and an individual. It is about time that we recognize that the caregiver needs and deserves care, too: care from himself, care from his loved ones and even care from his sick partner.

The most jarring emotion that flares up and surprises a caregiver is anger. Frequently, the caregiver will find himself feeling angry toward his ailing loved one. The anger does NOT mean that the caregiver is unfeeling or unloving towards his sick partner. People commonly feel angry with their loved ones for taking ill, despite the fact that their loved one obviously did not want to become sick. The anger is an irrational --but natural-- symptom of the fear that we ALL experience when we think about the impending loss of someone close to us. The caregiver, however, because of the nature of his relationship with his sick partner, is usually beset with guilt when his anger arises, feeling as if he is somehow betraying his loved one or failing at his duty.

Experiencing anger as a caregiver, while unpleasant, is understandable and common. Though it is never easy to accept irrational feelings of hostility and resentment toward an ailing loved one, it is vitally important for the caregiver to do so. The entire family needs to understand and encourage the caregiver to vent his frustration, fear and anger in a healthy way. Refusing to acknowledge and deal actively with the anger will only result in a repression of the anger. A caregiver who does not deal with his anger may find himself acting it out in ways hurtful to both himself, as well as to his sick partner.

Repressed anger does not go away, it simply bubbles up later in unexpected, unhealthy expressions of resentment and bitterness. Repressed anger, in this instance, causes a vicious cycle: the caregiver wracked with guilt grows more angry, which in turn makes him feel more guilty, which in turn makes him more angry and so on. If a caregiver gets trapped in the cycle of guilt and resentment, he often ends up depressed, unable to process his feelings, and ultimately sinks into inactivity and lethargy.

The anger will be easier for a caregiver to deal with if:
  • family members who are not in the caregiver role lend an understanding and empathetic ear to the caregiver and allow him to express his feelings when he chooses

  • the caregiver understands that his anger is natural, understandable and forgiveable, and he need not feel guilty for accepting it and expressing it in healthy ways

  • the caregiver maintains a life for himself outside of his caregiving role, which will both provide him with the proper venues for expressing anger, as well as enable him to balance his anger with some joy and happiness

In our normal lives we get angry from time to time. Imagine if, in the midst of a bout of anger, all of your outlets for dealing with your anger --exercise, the company of friends, your favorite videos, long bubble baths, etc.-- were abruptly unavailable to you. What a nightmare! When a caregiver shuts himself off from the aspects of his life that were important to him before he became a caregiver, he is putting himself in precisely that position -- just when he needs those supports the most. To maintain strength and sanity, and impart that strength and sanity to his ailing partner, the caregiver must not neglect his own needs.

The Internet is a uniquely helpful venue in which to validate feelings of anger, fear, and uncertainty. An online support group can be ideal for a caregiver that is perhaps homebound with his loved one, but still needs emotional support, therapy, and a place to voice his feelings. In addition, the anonymous nature of support groups on the Internet can make it easier for a caregiver to voice feelings that he feels uncomfortable sharing with family or friends.

Dealing with emotions in a forthright manner, as they arise, will help to cast an optimistic light over both the giver and the receiver of care. Studies have shown a direct link between the immune system and a positive outlook. Keeping hope alive is clearly the best medicine. Resignation and despair in any area of life is a sure-fire recipe for defeat.

If you're a caregiver reading this article, thank you for giving so much of yourself to another human being. Review the Caregiver's Bill of Rights to help you through this difficult time, and please avail yourself of whatever sources of support you can find to help sustain your hope, strength and encouragement.

*The names of all clients have been changed to protect their identities.

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