Plan Now For Unexpected Caregiver Changes Later

Post 47

Those of us who are in any position of caregiving—paid or unpaid-- may find it difficult to share the responsibility of caring for our care receiver(s). This is true of teachers, family members, counselors, doctors . . . . I’m even finding it true with myself as I care for the former puppy mill dogs I’ve adopted. But what happens to the person (or puppy) who’s receiving care if you are no longer able to be there for them? A teacher may be out for an extended sick leave, a family caretaker might suffer a mental or physical breakdown because of the stress of 24/7 caregiving, a counselor could move and be unable to continue her practice virtually . . . and one day every caregiver will retire.

Obviously, you are important to the care receiver, and you will be missed. No one can ever completely replace another significant person. Nevertheless, it is crucial to ensure that your care receiver will receive excellent care even if you aren’t able to give it to them any more. Clearly, if you work for an organization or company, they will hire someone qualified to take your place. Yet the transition might be difficult if you haven’t taken any steps to train someone or to allow a colleague to shadow you. And it would be most helpful if you leave some notes about ways that you handle important situations, unique habits of the individual, and what they’ve come to expect from a caregiver in different situations. I suggest that in whatever caregiving situation you are in, you start taking down notes now—just in case there is no time to prepare when you must say good-bye.

I want to share with you my suggestions on items you might take notes on; however, I’m sure that you will think of others that are pertinent to your situation. Obviously you will give specific instructions about health and medicine and physical needs such as toiletry care, so below I concentrate on items you might forget to mention.

Let’s start with the care receiver’s environment as perceived by the senses—We might not realize how important our personal environment is when we are capable of controlling it. However, when it is beyond our control, it becomes extremely important (and more so for a person who is highly sensitive*). What positive and negative responses has the care receiver shown to the following in relation to the environment around them? It will be most helpful to indicate their strongest reactions.

Sight—colors, people, TV, photos, animals, movement, crowds, space

Sound—loud noises (by type if necessary), soft noises, music, voices, TV, radio, crowds, water

Taste—sweet, sour, bitter, warm, cold, tangy, specific foods and combinations

Smell—deodorizers, cleaners, perfume, cooking odors, body odors, environmental odors

Touch—firm, gentle, cold, warm, handshake, hug

(Invasion of our personal space seems to cause the most fear. What type of reassurance does the person need before they are touched to receive care or a greeting?)

Next you might consider the ways the care receiver responds to your care and other common situations —What causes them to feel Fear? Happiness? Trust? . . . Include anything that you can see a definite or possible cause. Even if you don’t have the slightest idea why they respond as they do, if it’s a common reaction, it would be good to put it into writing so that a new caregiver will be prepared.

Examples:

1. Ms. Maples enjoys having her hair brushed —it seems to calm her and she is more likely to settle down before bedtime if you take time to brush her hair.

2. Jimmy hates peas. If you want to avoid a temper tantrum, it would be best to give him another vegetable—he really likes carrots and green beans and will be very excited to see them as part of the meal.

3. Mom is deathly afraid of getting her blood drawn. She will yell at the top of her lungs “You’re killing me! You’re killing me!” Please warn the lab technician ahead of time and encourage everyone in the room to remain calm. Afterwards it might help to calm her down if you play or sing her favorite music on the way home. (Here explain her favorite radio station or provide a CD or a list of songs.)

In addition to preparing the new caregiver, preparing the care receiver for the possibility of your absence will help the care receiver fare better, especially if she/he has learned to accept care from others. If you have been the sole caregiver and the person has been isolated, slowly socialize the care receiver so that they interact with others and build up to having someone else care for them occasionally, even regularly if possible. Begin by having a person or people visit for a short time. Ideally this will happen with the new caregiver before the complete change occurs, but we all know that life is less than ideal. At least having visitors will give the care receiver the opportunity to learn to trust others. As the care receiver becomes comfortable having others around, you can ask the visitor(s) to do small caregiving tasks, such as bringing a drink of water or serving a meal. Eventually the goal is to have someone who comes in to relieve you at least one day a week. Then if you are no longer able to care for her/him, the care receiver will be accustomed to being cared for by someone else.

Another way caregivers can help care receivers not to be too dependent on them is by letting them take on more responsibility for their own care. Unless your care receiver is unable to move you might be able to think of one or more ways that the person can learn to help themselves—even if you have to help them a bit as they do so. I found in my mom’s case she enjoyed rolling her hair even though her attempts were certainly not perfect. As her Alzheimer’s progressed, I rolled her hair, and she handed me the foam curlers. Eventually she just wore a night cap on her hair most of the time—which she usually put on herself. In every situation we need to encourage the care receiver to be as independent as possible.

If you find that allowing the person more independence cramps your style or causes you to feel less important, then consider what provokes this feeling. We need to be careful that we don’t keep the care receiver completely dependent out of our own emotional need to be needed. We might not realize our own toxic caregiving relationship because it may have developed from our behaviors and attitudes learned as problems arose in our childhood.** Both for your sake and the care receiver’s, reach out to a health professional or counselor if you need help with your emotional or psychological state at any time while caregiving. The caregiving profession/situation is known to be difficult on a person’s physical and mental health, so please take care of yourself as you are taking care of someone else.

* If you are not familiar with the personality trait of high sensitivity (in scientific terms called Sensory Processing Sensitivity), please read some of my blogs under the heading HSPs for more information on ways in which high sensitivity affects caregiving.

**For a detailed discussion on family dynamics that can create a toxic caregiving situation, please see this article:

https://www.google.com/amp/s/www.connellylaw.com/amp/why-caretaking-turns-toxic- caring-for-the-caregivers-part-3