Wednesday, January 1, 2014

Caregiving 101: The Sensitive and Critical Role Reversal




        I had occasion during Christmas to talk with a lady facing the decision to place her father in a nursing home.  My husband's family had first-hand experience with the particular facility she was asking about, so I was able to share some positive things about it from our experience there.  While we were talking, I was reminded of a major situation all of us as care-givers have to deal with, that of the "role reversal".

        I first came across this term in a book I obtained for Mom when she began doing hands-on caring for her mother.  The title of the book and the author have long since left me and the only thing I remember from the book was this author's comments on role reversal.

      For anyone reading this that has never heard this term, in it's simplest explanation "role reversal" is when the parent is now receiving the care and treatment of the child, and the child takes on the care-giving and responsibility of the parent.

       And the most important thing to remember is that this reversal of roles is hard on both parties! 

     Parents are accustomed to giving instruction and advice and they expect their children to listen  and do as they are told!  Parents feel that they are always the parent.  And in one respect, that is eternally true - they will always be the parent and we will always be the child.  But when the parent is no longer able to do for themselves, either physically or mentally, it is the child's responsibility and privilege to step in and assume the adult role for the parent.  And herein is the very difficult, fine line that the child/care-giver has to walk - that of meeting the needs of the parent/care-receiver and still respecting the parent and maintaining their dignity as an adult.

      Each situation is different and the interpersonal dynamics of the pre-existing relationship of the parent and child will greatly determine the way this role reversal proceeds.  In the beginning at least, the child/care-giver must be willing to be the one to step back and take a hard look at the situation and determine how to balance the needs of the adult/care-receiver and the respect due the parent.

     From a personal standpoint, I have found that nagging and badgering doesn't work.  Being demanding and telling Mom how it s going to be is counterproductive.  There have been times, and are becoming more and more, when I present Mom with all of the necessary information and she is unable or unwilling to make the decision.  At those times, I have to go ahead and make the best decision possible based on the information at hand, and be willing to live with the consequences.  Yes, I have had occasions when I had to defend my decision by reminding Mom that a decision had to be made and she didn't make it, so I had to.  Fortunately for me, Mom knows that I have only her best interest at heart and she doesn't give me grief when I have made those decisions.

      But as a care-giver, you have to be willing to take the grief for making a decision if it happens.  Don't make decisions that the parent can make for themselves, and please don't make a decision for them out of your own frustration over their inability to make it.  Whenever possible, discuss the situation with them as this maintains their feeling of being an adult.  And when they can make some decisions for themselves, even if it is a small decision, it gives them a feeling of having some degree of control over their lives, and that retains a bit of self-respect.  

      As we have shared before, respect and honor for our loved ones comes in many forms.  While saying "Yes, Mama", or "No, Mama", "Yes, Sir" or "No, Sir" is respectful and right to do, it is not all that is required.  It also requires a right heart attitude.

      "My, aren't you a big girl!" said to an 83 year old woman who was able to eat everything on her plate isn't praise, but demeaning.  They are not children, even if their actions sometimes are childish.  They are adults used to being in control of their own lives, and now they have to let their child take care of them.  This is difficult!

      Care-giver, you position in this role reversal is especially difficult if you have never been the dominate personality.  Clashes will happen, but the desire is to make it as minimal as possible.  Sometimes it is better to say nothing than it is to argue just because you know you are right.  Proving to them that you are right and they are wrong is not the primary thing when caring for our loved one.  The important thing is to treat them with respect and love and do the best things for them.

      Remind yourself that this is a difficult role, but remember that you can do it by the Lord's grace.  Remind yourself that this is a difficult role for your loved one, but the Lord has allowed them to be in our lives at this time for our good and His glory!  Stay on your knees and keep looking up!