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The cost & courage of caring - stories that spark resilience.
So what happens when you don't
just resent caregiving anymore?
What happens when you actually
start to resent the person you're
caring for?
I'm Dr.
Mark Ropolesky and welcome back.
This is a Caregiver's Podcast.
Our first conversation with Elaine
K.
Sanchez about caregiver resentment
became the most
downloaded episode we've ever
produced.
And I think that tells us how many
caregivers are
living with feelings they're
afraid to say out loud.
So this time we're going deeper.
Can you deeply love somebody and
still hate being their caregiver?
And what happens when the people
who are supposed to help you
barely show up but expect an equal
say
in what you should be doing?
Then there's an even harder layer.
What if the resentment you're
feeling
today isn't really about today at
all?
What if it's tied to 20 or 30
years of history with the person
you're now caring for?
If resentment keeps building, what
does it start doing to you?
Can it change your
relationships?
Change how you see yourself even
and start poisoning parts of your
life that caregiving
hasn't already taken?
Because at some point this stops
being just an uncomfortable
feeling.
The
question becomes what comes after
resentment if nothing changes?
And what actually has to change
before it gets that far?
If any of this sounds familiar or
if you're starting to recognize
some
of these feelings in yourself, I
really think you should hear this
conversation.
Elaine K.
Sanchez is the
founder of caregiverhelp.com and
has spent years helping caregivers
navigate the emotions they often
feel
they're not allowed to talk about.
Before we get underway, please
take a moment to subscribe or
follow the Caregiver's Podcast
wherever you're
watching or listening.
It's completely free and it's one
of the best ways to support the
show and help
conversations like this reach
caregivers who may be struggling
with things they've never felt
comfortable
saying out loud.
Elaine, your first conversation
with us about caregiver resentment
became the most downloaded episode
we've ever done.
So tell me, why do you think that
particular subject resonated so
deeply with our
listeners and watchers?
Oh, Dr.
Mark, thank you for having me
back.
It's always fun to have
conversations with you.
Well,
I think it's probably because
resentment is one of those
emotions that you cannot avoid
when you're
a caregiver.
It just simply is going to, you're
just going to feel it.
And then it really isn't a
question of will you, because you
will.
It's just how are you going to
deal with it once these feelings
start bubbling up inside of you.
I mean, Elaine, what are the signs
that resentment is actually
starting to take over a
caregiver's life
before they may even realize that
resentment is really setting in?
Probably self-talk.
I'm not a psychologist, so I, you
know, I can't say that this is
coming from
a professional education in this,
but I can tell you that, you know,
when you start to think,
why am I doing all of this?
You know, I have to do everything
for myself now, and I have to do
everything for my spouse as well.
And, or, you know, my parents, and
where are my siblings, and where
are
my children, and why am I carrying
this load all by myself?
You know, I don't know how to use
the
computer.
I don't know how to change the oil
in the car.
There are certain things that, you
know,
these people, my care receiver
always used to do for themselves
and for me, and now I have to
manage
everything for both of us.
And you get frustrated.
I often talk about the three F's
of flipping out,
fear, frustration, and fatigue.
And I think those are common
experiences for all caregivers.
And when you
are experiencing fear,
frustration, and fatigue, then
anger, resentment, blow-ups, and
guilt,
all of that just kind of follows
naturally.
So, if you had to identify sort of
the three biggest things that
build up and lead to caregiver
resentment, what would they be?
Well, if I could give you a lot of
concrete terms, like the work, you
know, the responsibility,
but I really think it is the
emotions that we have to deal
with.
And as I just mentioned, the fear,
the frustration, the fatigue.
So, let's just take them one at a
time.
Most caregivers fear how bad it's
going to get, how long it's going
to last, and how much it's going
to cost.
They fear making a mistake
that's going to cause further harm
to their care receiver.
They fear what's going to happen
to them
if it takes all of the money to
provide the care for their care
receiver.
They are afraid that
something will happen to them
before their care receiver passes.
They fear running out of money.
And
that is a big one.
That is just one of the things
that most people really do worry
about.
So, you have
this fear of, am I going to be
able to take care of this person
to the end of their life?
Will I have
the strength emotionally,
mentally, physically, financially?
And those are the kinds of fears
that can wake you up at three
o'clock in the morning.
So, then you have frustration.
And the frustration
comes from not being able to
control so many things, including
the progression of the disease,
the impact it's going to have on
your care receiver, the eventual
outcome.
And this is the big one,
the behavior of other people.
We get frustrated because we
cannot control what other people
do.
For my mother, caring for my dad,
she got so frustrated with him.
After he had his stroke,
he was given a set of exercises
that he could use to strengthen
his hand and to make his leg more
stable
so that he wouldn't be such a fall
risk.
And he wouldn't do the exercises.
He simply would not do them.
He just didn't want to.
So, he wouldn't.
And he also wouldn't give up
driving.
And she knew that
this was dangerous.
But he wouldn't do it.
And so, those were things that
really frustrated her.
And of
course, that led to more fear, you
know, of what's going to happen.
And then fatigue.
And I think fatigue
is huge.
It's experienced by every
caregiver because you have so many
responsibilities.
And a lot of times, the people who
are caregivers are older.
And if you're middle-aged, you
know,
if you're in your 40s or the 50s,
you might still be working
full-time.
You might be caring for
or still raising children.
And then you have this caregiving
responsibility on top of that.
And so, all of the demands of
managing your life plus the
demands of caring for somebody,
you're going to get worn out.
So, those three things, fear,
frustration, fatigue, lead to
anger.
And, well, maybe resentment first
and then the anger that follows.
Layer on feelings of injustice,
feelings of hurt, either recently
or over a lifetime,
or the sense that things are
basically unfair.
You can see how that could all
just sort of
layer into that dynamic of your
three Fs.
Right.
One other thing, which I think is
really important to emphasize,
which feeds really well,
it's not just the powerlessness
you may feel over the receiver to
do, be it their exercises
or what have you.
It's also powerlessness in the
system where you're facing
obstacle after obstacle,
whether it's in home care, whether
it's in the healthcare system at
large and at the institutional
level.
But those things add up too.
And I think caregivers face a lot
of them, even as a physician,
we face those kind of obstacles.
And certainly what I've witnessed
recently and seen just how the
system is basically rigged to be
obstructive, to make profits, is a
brutal thing to face.
It is.
And it's not just physicians who
face it.
It's caregivers who face it as
well.
It is.
And it's really difficult alone.
If you can have an advocate,
someone who really knows how to
work
that system.
Now, in the U.S., we have social
workers.
And there are organizations that
provide support for caregivers.
What do you do in Canada?
We've got similar infrastructure.
Some of it integrated in family
health teams in the community,
although not universally.
But we definitely have social
workers and other resources that
can be mobilized.
People who can sort of champion
and help families navigate through
scenarios.
But it's, as is always the case,
not uniformly
distributed.
And differences between urban
settings and rural settings and
academic settings and non-academic
settings.
And that becomes quite a variety.
And I think one of the biggest
things is people don't know where
to look.
I get, I have a lot of friends who
are, you know, my age and older.
And they call me, you know, can
you, can you tell me what we can
do or who we can call?
So it's simple things like, well,
not simple.
A friend recently needed to be
placed in a care home temporarily.
And the family just didn't even
know where to begin.
And fortunately, I knew someone
who could help them.
But these are, these are real life
problems.
And it's important if you can have
an advocate,
if you have someone within the
system that knows how to help you,
that's, it's, it's really
beneficial.
I can see how in the absence of
those resources, how the world is
felt on the shoulders of a
caregiver.
And do you think caregiver
resentment is usually in the end
triggered by one major event?
Or does it really still result
from the buildup of multiple small
sacrifices and little injuries
until the caregiver reaches a
point where they just feel they
have nothing left to give?
Yes, I do.
I think it can be.
There's no one big thing, right?
Just, yeah, it's just that last
straw, you know, that puts them
over the top.
And we talk about developing an
attitude of creative indifference.
Mm-hmm.
Can I share that with you?
Absolutely.
So this actually was inspired by
the letters that my mother wrote
to me.
And, and, and I discovered, um, as
I was editing her letters into the
book, that she had this three-step
process.
Every time she would come up
against a person, a situation, or
an event that caused her to be
upset, um, she would sit down and
she would write to me about it.
That would be, she would write it.
And so, uh, in the beginning, she
said that she had learned how to
detach emotionally from her
physical life and that that
allowed her to do what had to be
done to take care of my dad and to
give other people a reasonable,
reasonable amount of happiness.
But she could find her joy and
happiness from within.
And so she could stay detached.
And, and about five years into her
caregiving experience, she read a
book and the author had used the
term creative indifference.
And she said, so I am now calling
my attitude, um, my detached
attitude and attitude of creative
indifference.
And I said, well, what's the
difference, mom, between being
detached and being creatively
indifferent?
And she said, oh, hell, there's no
difference.
You can call it whatever you want
to call it.
She said, it just means not
allowing yourself to become
emotionally ravaged by the disease
or the progression of events.
And she said, I just thought that
detached sound a little cold.
So I, I like this term better.
So when I was editing the book and
I said, the first step is
awareness and she would write it
down and then she would come
around to this acceptance point.
Like this isn't the life either
one of us chose.
This isn't what we had expected to
have happen.
This isn't easy, but it is what it
is.
And I accept that I can't change,
fix, or control it.
And so this is the second step,
which is acceptance.
That you, you look at your
situation and you say, okay, what
about this situation can I
control?
And what can I not control?
And then that's, um, the third
step is action.
So when you determine that, um,
you have a problem and then you
say, is there a solution for this?
And if there is, then that's
awesome because you can make a
plan, you can execute the plan and
you can move on.
If there isn't, then you have two
choices.
You can either let it wake you up
every morning at 3 a.m.
Be the first thing you think about
in the morning, the last thing you
think about when you go to bed.
Um, or you can decide to release
your emotional attachment to it.
So when, um, in our program, um,
we, we apply these three steps of
creative indifference to every
emotional struggle.
So you take fear, you know, you
name what is causing you to be
fearful and what do you have to
accept about this?
And, and it may be that you have
to accept that, uh, this disease
is terminal, that they're not
going to get better, you know, uh,
and then what can you do?
What is the action plan?
And that can mean getting your end
of life ducks in a row, you know,
in terms of your end of life legal
documents, it can mean making sure
that you have enough support, um,
you know, financial planning, all
of those things.
So I, I have found, and I've been
doing this for many years and we
just made this an online streaming
program, um, during COVID.
Um, and, and we just, you know,
when people apply this, when you
have a problem, um, any kind of an
issue that's really causing you to
be upset.
If you apply these three steps of
creative indifference toward it,
it probably won't solve the
problem, but at least it will help
you identify it, separate it,
accept what you can and cannot
change, and then decide what
action step you're going to take.
I'm also hearing is that also
actually reserves a little bit of
space for you, the caregiver, that
you might actually have the option
to decide what you want to do with
that space.
Yes.
And how you want to exist in that
freed up space.
Yes.
And that could be hugely valuable
as well.
Yes, yes.
Thank you for pointing that out.
I think that's exactly right.
I, I think these three steps can
help give a person a sense of
control.
Um, they're not going to be able
to control or change the
situation, but they can control
their attitude and their responses
toward it.
Which goes way back in a lot of
some of the traditional thinking
of different philosophies and
religions.
Yeah.
Elaine, how does it go from, I
love you and I want to take care
of you, to, I cannot stand what
caring for you is doing to my
life?
Well, I believe in honesty.
I believe that if you admit that
to yourself, that you don't have
to protect your care receiver from
knowing it.
I think it's perfectly acceptable
to say, um, mom, I love you, but I
can't, I can't do this.
I, I've known people who have, uh,
given up so much of their own life
and family time because mom
wouldn't allow somebody else to
come into the house.
She's not going to have strangers
coming in.
Um, or, you know, a spouse who
refuses to have help.
And I say this, this is where,
when you get to that point, you
need to be honest with your care
receiver or with whoever else is
involved, whether that's children,
whether that's siblings, that you
say, and you identify this.
You know, when you sit down to
write, I am aware that I cannot do
this by myself anymore, then you
just tell them, I can't do it.
I am one person and I am, I cannot
do all of this without help.
So then you figure out, okay, what
is the answer?
Is that, um, is that more help
from the family?
Um, there was one woman thinking
about one of your past shows
talking about, uh, resenting
siblings who don't,
um, who don't contribute.
This woman just called a family
meeting and she said, Hey, all
five of us are mother's children.
And we all five have a
responsibility to take care of
her.
And this is what I can do.
And I want each one of you to
identify what you can do to help
take care of her.
So I think calling people out,
setting boundaries, asking for and
expecting people to contribute
their fair share.
It seems like if you hit that
point where you just can't stand
it anymore, it almost drops like a
bomb.
But can that shift actually happen
so gradually that the caregiver
doesn't actually realize what's
happening until resentment has
really started changing how they
feel about their loved one and the
person they're caring for?
Absolutely, because I think it's
just a day after day.
It's the Chinese water torture,
right?
It just drips, drips, drips,
drips.
And then one day it's like, I
can't do this anymore.
Uh, and when you're at that point,
I mean, it would be great if we
all had the capacity to realize
when we are starting to feel that
way.
And if we do something in terms of
self-care and getting care, um,
from other resources, then we can
perhaps avoid the blow-ups.
Um, but people get angry.
I mean, you know, it doesn't make
you a bad person to reach that
point and just to say, I have had
it.
You know, I can't do this anymore.
Sometimes it takes that, it takes
a blow-up to recognize what needs
to happen.
I mean, it sounds like when a
caregiver completely loses it over
something small.
Yes.
That explosion isn't ever really
about what just happened in the
moment, but probably reflects
months or years of anger and
resentment that are finally coming
out and being unleashed.
Yeah.
You're right.
Tell us, or remind us, because
we'd like to include it in notes,
but the title of your book?
Oh, it's Letters from Madeline,
M-A-D-E-L-Y-N, Chronicles of a
Caregiver.
And her letters were unflinchingly
honest and surprisingly funny.
I don't think my mother knew she
was funny, but to me, I just
thought some of her letters were
really, really funny.
And I think it's just because they
were so raw and honest.
So the letters that she wrote to
me during the six and a half years
she cared for my dad were just
pure, unfiltered writing.
After dad died, her letters were
never that interesting again.
Because I think she was just
taking everything that she felt in
her heart and soul, and she was
putting it on paper.
Well, I look forward to reading
that.
And you kind of wonder whether or
not that humor was actually the
space or was what was being used
in that space she created.
So that's really neat.
It is.
It is.
And it's just, there were times
when I would just laugh out loud.
And at one point I was single, and
I had a couple of girlfriends.
And whenever I would get a letter
from mom, I would call them, and
they would either bring ice cream
or wine.
And I would read the letter, and
sometimes we cried, and sometimes
we laughed, and I shared her
letters.
So that was where I began to
realize that they were pretty
unique.
You know, Elena, I'd like to delve
a little bit deeper, and it's an
uncomfortable space, but can you
deeply love somebody and still
hate being their caregiver?
Of course.
Of course you can.
It's a tough word, hate.
I love my husband with all of my
heart.
I do.
But I don't want to change his
diapers ever.
And I don't want him to have to
change mine.
And I think that when you take on
the responsibility to care for
someone at that incredibly
intimate level,
that would, I think that would
wear Mother Teresa down.
I really do.
Because of the physical aspect of
it, and I think it's easy to lose
that relationship.
I encourage people to get the help
they need and to have enough help
that they can still be.
I mean, I always want to be my
husband's wife.
You know, and I want my, I want to
always be the mother to my
children.
So, there's a certain amount of
caregiving that I am willing to
let them do, if and when the time
comes.
But I don't want them to have to
do those things for me.
Because that, for me, that is an
unfair burden on them.
And it kind of feels like an
insult to my privacy.
Does that sound egotistical?
Well, those are factors that can
really become erosive to those, as
you mentioned, very personal
relationships.
And some people don't have the
choice.
And not everybody has access to
resources uniformly.
And we know that from, it really
knows no boundaries or borders.
What would be, in the setting of
limited resources, what would be
the one thing you would turn to?
Is it just sort of an hour of help
for key things a day, if that's
all you can get?
And make sure you focus in on
having the help take care of those
key things, so that really, that
caregiving, care recipient
relationship has a chance to stay
preserved?
Is it mostly intimate, the sort of
personal care and those kind of
things, if that can be the focus,
at least to preserve, to help keep
the relationship spared of that?
I think that's an excellent idea.
And I'd never thought of it in
terms of getting somebody in for
an hour a day or three times a
week or twice a week.
Because you may only have a
parcel, right?
You may not have the money.
You may not have the resources.
You may not have the
infrastructure.
But there are a couple of things
that are available.
But maybe keep in mind that there
may be one key thing to hone in on
that preserves the relationship.
And that might be, you know,
taking care of things which
otherwise could pose more of a
strain.
Yes, I think that would be great.
You just reminded me of such a
funny story.
My dad was in the hospital.
And one of the things my mother
hated doing for him more than
anything else was brushing his
teeth.
Because he didn't chew real well.
He didn't swallow everything.
You know, and it was just kind of
a disgusting thing for her, right?
And so I had flown home.
She and I had gone out and we'd
had a pizza.
And we went back to the hospital
and I said, Mom, you go
downstairs.
I'll get Dad ready for bed.
You know, you just go get a cup of
coffee or do something.
And I'll get Dad ready for bed.
So I brushed his teeth and I saw
exactly what she was talking
about.
You know, that he still had so
much food in his mouth.
And when Mom walked back into the
room, he looked up at her and he
said,
She stinks.
And I was like, What?
And he was talking about my
breath.
We had had a pizza with onion on
it.
And he said, She stinks.
And it just cracked me up.
And I thought, you know, I thought
I was doing Mom a favor and I was
punishing Dad with my onion
breath.
And he never lost his honesty.
None of this is easy.
None of this is easy.
None of this is easy.
And it stacks up, right?
It does.
And it multiplies.
What happens when a caregiver
starts really confusing that
hatred of caregiving with a lack
of love for the person they're
caring for?
Oh, that's tough.
Oh, that's tough.
I'm an advocate of some time away.
You know, even if you can get
someone to come and sit with your
care receiver for even half an
hour so you can get out and walk
or go do something or take a nap.
I think 24-hour confinement with
someone who needs all of their
needs met, to me, that would be
worse than solitary confinement.
I think that every person needs to
carve out a space for themselves.
Now, whether that is reading when
your care receiver is sleeping,
whether it's taking a hot bath by
yourself, you know, whether it's
whatever it is that can bring you
some peace.
Maybe it's listening to music.
Maybe it's calling a friend.
Maybe it's just getting out and
going to the grocery store, you
know, without having to take
somebody along.
I think every person needs to
carve out some time every single
day that they can call their own.
And speaking of my mother and the
humor, but I don't think she was
being funny about this.
And she would take care of Dad all
day long.
And then at night, you know, she'd
get him into bed.
She'd kiss him goodnight, tell him
that she loved him.
And then she would go out to the
living room to read.
And one night she was sitting up,
and she could just get lost in a
book, absolutely just transported
someplace else.
And one night, Dad walked out, and
he walked right up to her chair,
and he looked down at the book,
and he said,
Madeline, the light being on out
here and the noise of the turning
pages, it's keeping me awake.
And she said, well, she said, you
don't have any problems sleeping
in the morning when I'm up
walking.
The dishwasher can be running.
The telephone can be ringing.
The washer and dryer can be going.
People can be coming in and going
out.
And I could park the sweeper right
next to your bed and leave it
running, and you would sleep like
you're dead.
So you know what?
If you can't sleep while I am up
reading, then you are just going
to have to stay awake.
There's some boundary setting.
Yeah, and I thought it was funny,
too.
I don't think my dad did, but it
was like, okay, she did set the
boundary.
And this was about four months
after he had his first stroke.
So he understood that that was her
time, and she needed that for
herself.
So honestly, Dr.
Mark, I think if every caregiver
set aside some time for
themselves, whether it's 15
minutes or an hour, that they can
do something that they enjoy,
something that they can look
forward to, I think it will help
them maintain their mental health
for a lot longer.
Not to get into the huge habit
literature that's out there, but
if we had to cultivate one thing
as opposed to a list of changes,
but one thing that could just
compounded have such a positive
impact.
That might be the one thing and
the one habit, and let the other
cards fall where they may.
I couldn't agree more.
That's something to work towards.
You know, it's interesting because
people often try to make caregiver
resentment more acceptable by just
saying, you don't resent the
person you're caring for.
It's just the situation.
But what happens when that
actually isn't true?
I mean, what happens when you
actually resent the person you're
caring for?
Is that a natural progression, or
is there a history there that
fuels that?
That's where the history is where
my mind went, because I thought,
you know, what if you didn't have
a wonderful marriage?
What if you really didn't love
your spouse with all your heart
and soul and being?
You know, what if your father was
abusive?
What if your mother never cared
for you?
You know, there are old
resentments from what the
relationship never was, or what
they could not be, or would not be
for you, you know, in the past.
So, of course you would resent
them.
How could you not?
I mean, if resentment has actually
turned into something like hate,
what has to happen to that
caregiver for them to reach that
point, and how do they sit with
that?
That's hard.
That's, how do you sit with that?
Do you hear, like, all of the
people you've helped over the
decades, is there a subset of
individuals who are battling with
just that feeling of...
Sure, sure.
What's unique about those
circumstances?
I was thinking of a friend I saw
in the grocery store.
It's been several years now, and I
hadn't seen her for a while, so we
pulled our carts off to the side,
and I said, how are you?
And she said, oh, I'm okay.
She said, my dad died.
And I said, oh, I'm so sorry.
I'm really sorry.
And she said, I'm not.
And I said, oh, had he been ill
for a long time?
And she said, no, he was an
alcoholic.
And she said, I can finally stop
trying to make that man love me
now that he's dead.
And I have seen this a lot with
parents and with parents who were
not loving to their children.
And I've seen those children take
care of their parents, I think,
trying to earn their love.
And I, poof, that's a tough one.
I've been lucky in that all of the
people I have cared for, I have
loved.
And they have been, and I had a
long, good history with them.
So, poof.
And I'm thinking, when I hear
that, is that really there's more
potential fuel for caregiver
resentment that isn't just about
caregiving.
It could be the 20 and 30 years
history with that person.
For example, like, what happens
when the caregiver is thinking,
you didn't take care of yourself
all this time.
You made choices for years, and
now I'm the one paying for your
choices.
Yeah, absolutely.
I don't blame them for being
resentful.
Somewhere along that path.
Yeah, I mean, somewhere along that
path, the caregiver may also
realize, you didn't just take care
of yourself, but you didn't take
care of me.
You didn't take care of me, that's
right.
So, how do you deal with that?
And I guess this is where you have
to ask yourself, what is your
obligation to this person?
I mean, does someone becoming sick
or dependent suddenly erase
everything that happened before?
Oh, no, it can't.
It can't.
It cannot erase it.
So, then it comes down to how do
you choose to deal with it?
You know, and that takes us back
to the three steps.
Okay, you are aware.
Do you want to say your dad did
not take care of himself, that he
drank too much, he smoked, he
didn't, you know, he didn't eat
right.
And now he has congestive heart
failure, and his kidneys are
starting to fail, and you're the
one that he has picked to take
care of him?
If he, if he, boy, we might need a
psychologist here.
You know, what is your
responsibility to take care of
someone who did not take care of
you or take care of themselves?
I don't have an answer for that.
So, you speak about someone being
picked or chosen by someone who's
not taking good care of
themselves, and they assume a big
burden of caregiving.
And certainly, in those instances,
sibling resentment comes up again
and again when it comes to
caregiving.
Why can it be so infuriating,
then, that one sibling is, you
know, doing most of the work while
the others still expect an equal
say in what should be done?
Oh, yes, yes.
That's not uncommon.
I had a very good friend, and she
had three siblings, two brothers
and a sister.
And my friend lived about 1,500
miles from her parents.
And she had a brother that lived
about 100 yards from them.
They were, you know, in the same,
just right next to each other.
And she had been talking to her
mother, and she said that they'd
had a snowstorm, and she hadn't
gotten her mail for six days.
And so, my friend said, well, just
call Joe and ask him to come over,
to bring it over.
And she said, well, I haven't seen
him in weeks.
So, my friend called Joe and said,
you know, you need to check on
Mom.
And he said, check on her every
day.
And she said, how do you do that?
And he says, well, I look over in
the morning, and if her light
comes on, I figure she got through
the night.
And I look over at night, and if
the light goes off, I know she
made it through the day.
So, that was his idea of checking
on her.
So, did she resent that?
Yes, she did resent that, because
she was having to get on an
airplane quite frequently, you
know, to fly halfway across the
country.
And try to line up other people to
help check in on her mother and
make sure that it was safe.
And one brother came home early
after his father's first big
decline.
And he was staying at their house
and got up in the middle of the
night and left a written note
saying,
I can't bear to see my dad like
this and my best friend.
And so, I'm leaving.
And he just didn't come back.
So, you know, the person that
ended up doing the bulk of the
work was the sister that lived
1,500 miles away,
and then the other sister.
So, the two of those really, those
two people carried the burden for
the rest of them.
You know, we always hear that life
isn't fair, and we try best to
deal with that reality.
But you kind of hope that within
families there'd be some measure
of fairness that always prevailed.
But I'm not sure that's the case
either.
It is not the case.
I had one wish for families.
That's what it would be.
Yes, and this is, I really talk
about the importance of the people
at my stage, and before they reach
my stage,
getting their end-of-life
documents in order.
Because if you get all of those
documents in place, then when the
parents or whoever dies, then
there isn't any way to fight.
There isn't a way to fight it.
Because if it is in a legal
document that this is what happens
upon their death, then they have
to follow the law.
But if it is, if it's not all
documented and legal, then it can
just become a free-for-all.
We're going to turn to Fred, our
producer, who's got a couple of
questions up his sleeve.
Hi, Elaine.
Hi, Fred.
It's nice to see you again.
You too.
For people who have been following
the show, I've been sharing
different experiences that I've
been having, you know, preparing
to care-give for my family,
just trying to ensure that
everything is set up so that that
can happen.
And I think I've started applying
my own version of creative
indifference.
Okay.
I think it's something that kind
of came to me.
You know, I didn't call it that,
obviously, because I was just
introduced to that concept through
your book.
But I've been trying to sort of
distance myself with the
understanding that I can't control
a lot of the outcomes that would
make this a lot easier for
everyone.
And particularly around my dad,
who is turning 80 in January.
He is obese.
He's losing his mobility slowly.
You know, there are all kinds of
things that he could do around his
diet and nutrition and a bunch of
other things that he sort of just
refuses to do.
But the big one right now is he's
just refusing to see a doctor.
He just will not go for a
physical.
It's probably been 10 years since
he's seen a doctor.
And I'm finding it really hard to
apply the creative indifference to
that because it's such a dead end.
And I find that with certain
challenges that caregivers face,
there's this dead end where
there's just an outright refusal
to do the thing that would make
everything else easier.
And for me, the challenge is now
not becoming resentful, frustrated
and angry that he won't take this
step.
And there's just been nothing that
anyone can do to convince him to
do this.
And he's actually said, you know,
I'll do it.
I'll book a physical.
I'll get into the doctor.
But when you hit those dead ends
where there's just no movement and
no possibility of movement, how do
you take creative indifference and
make that work in those
circumstances so that you're not
becoming resentful or worse?
So my initial thought is you and
your siblings would call for a
family meeting and or one of you
could say, you know, dad, we're
concerned.
We see that your health is
declining.
You're not making any of the
changes that you need to make.
And we're concerned that, you
know, you're either going to drop
dead or you're going to have an
incident that is going to make you
incapacitated.
And we just need to know what your
wishes are if either one of those
things happen.
Because if if you become
incapacitated, do you have a plan
for who?
Well, so wait a minute, I need to
back up a minute.
So you state you state the issue.
Right.
And, you know, we're concerned
that this might happen.
So we would like to have a
conversation with you, a difficult
conversation about what your
wishes are, because all of us
would like to make sure that we
follow your wishes.
So, you know, the first step is to
state the issue and then you ask
for permission.
Would you be willing to meet with
us to do that?
And then if he says yes, then you
you lock a time and you just say,
OK, do all of you live in the same
area?
I usually fly in, but I'm back
enough that this could happen for
sure.
Yeah.
Yeah.
So you could you know, you could
agree with your siblings that this
is what you want to do.
And if he says he'll have a
meeting with you, then you just
have your list of questions.
And it's like, OK, we understand
that you don't want to go to see a
doctor.
We understand that you don't want
to change your lifestyle.
So if you have a stroke or if
something else happens, if your
kidneys start to fail, what are
your wishes?
Does he have an advance directive?
He does have a will and he has his
estate laid out, which is the one
thing that he's been more than
willing to do to give him props
for that, for sure.
But there are certain things like
the doctor visit where we have
spoken to him and we did some
version of the family meeting and
he's agreeable.
And then he just doesn't.
It's still the dead end.
And so when it's something like
not seeing a doctor, that's the
basis for so many other care
decisions that need to happen.
Yeah.
But it backs everything up.
There's this huge bottleneck
around the fact that he just won't
go get a physical.
I mean, you can sort of tell
what's wrong with him by looking
at him and he's got his aches and
pains, which he communicates.
Yeah.
But until he goes to a doctor or
even just a nurse practitioner,
like anybody, it's pretty hard to
start to make next steps and sort
of plan for care.
So it's really those dead ends
that become the most frustrating,
at least in my experience.
So this would be where you could
make up a list of questions.
Do you have, does he have an
advance directive?
Yes.
Okay.
Does he have a disability plan?
I don't believe so.
Most people don't.
Our attorney really encouraged us
to develop one.
So I could send you a copy of it,
Frederick, so that you could have
it and take a look at it.
You know, it was just, how do you
want to be cared for if you cannot
care for yourself?
Right.
And so, you know, that could just
be, okay, dad, if you have a
stroke or, you know, your kidneys
start to fail and you're going to
need around the clock care, who do
you want to take care of you and
how do you want to pay for it?
So those are basically, those are
the two basic questions, right?
Because the dead end is there as
long as he chooses it to be a dead
end.
But all of the rest of this stuff
is going to happen.
Yeah.
Whether or not he wants it to
happen or not.
Exactly.
It's going to roll forward.
I guess that's a good plan.
I mean, placing the reality of
what's going to come next in front
of him and making him sort of
offering the chance for him to
make a decision around that for
himself might be a way to break
through the dead end.
Yeah, it could be.
You know, if he's lucky, he'll
just drop dead.
But most people aren't that lucky.
Does that sound horrible to say
that?
It's the thought that's always in
our mind.
Like, you know, this isn't going
to lead anywhere good.
It's just, can we care give in a
way that makes it easier,
essentially?
And one of the things, you know,
going back to like, you know,
previous life decisions that he's
made, one of the big issues is
that he's obese.
And so, like, we couldn't move, if
he fell down, we couldn't get him
up off the floor.
There's no way we could move him.
And so, how does he think all of
this is going to happen?
I don't think he's, I think by
creating a dead end, it's almost
like he's not having to think
beyond just that he doesn't want
to go to the doctor.
He doesn't have to deal with all
of the other steps and all the
things that are coming.
So, maybe putting that in front of
him in an honest way, in a way
that maybe feels uncomfortable and
maybe harsh, like you just said,
is the way to go.
Maybe radical honesty here is the
pathway forward.
I like what you said, radical
honesty.
I do think that this is really
important, especially when you
know that it's not just his life
that's going to be impacted.
It's all of yours.
Which makes us more frustrated
because it almost comes across as
like he's being selfish.
Yeah, he is.
Right.
Well, thank you for, thank you for
your input all day.
Yeah.
You're welcome.
Thanks, Fred, for that important
contribution and bringing and
making this just that next level
of real.
Elaine, resentment and anger can
change a caregiving relationship
between caregiver and care
recipient.
But can caregiver resentment
change someone so much that they
actually stop recognizing the
person they've become?
Hmm.
I don't know.
I mean, can caregivers end up
grieving not only the life they've
lost, but the person they used to
be?
I would imagine that's true.
I would imagine that's true.
And that is just reemphasizes the
importance of doing something for
yourself every day.
Because if you never take care of
yourself, and you're always taking
care of someone else, you're going
to burn out.
And there is another kind of
fatigue beyond physical fatigue.
There's decision fatigue, and
there's compassion fatigue.
And when a person gets to that
point where you have given so much
physically, and when you make so
many decisions,
and you just are worn out with
making decisions and choosing and,
you know, making everything work,
you get to this point that you
think, I just can't make one more
decision, I just don't care, I
just don't care.
And then you hit the compassion
fatigue.
And this is a very dangerous place
for people to be,
because this is when you reach the
point that you no longer feel like
you have the capacity to feel or
to care.
And compassion fatigue comes from
really feeling responsible and
trying to fix everybody else's
problems
and trying to keep everybody
happy.
And you can do that for a short
period of time, or you can do that
in short bursts.
But if you're doing that 24-7,
you're going to reach a point
where you simply don't have the
ability to care anymore.
And you don't want to get to that
point.
And so does a caregiver lose their
own identity?
Do they lose touch with who they
are?
Probably.
They're probably so wrapped up in
all of this pressure that is on
them to be caring for somebody
else,
to be making all of the decisions,
to do all of the physical work and
the emotional work.
Yeah, I think you can lose
yourself in that.
I mean, and what I'm hearing for
you is an excellent adaptation of
what ensues in that scenario for
caregivers.
But this is well described among
allied health professionals,
physicians, paramedics.
Anybody in the caring environment
can face those obstacles.
And in a situation where there's
so many defaults that the system
imposes on caregivers,
which just they go on to shoulder,
you can see how it's a slippery
slope where throw in some
resentment, some anger,
some feeling of deep
responsibility cultivated by years
in a relationship,
not only with the care recipient,
but with the family dynamic,
compassion fatigue sounds to me
like probably the biggest red flag
where almost it's like,
I need to intervene for me, he
being the caregiver.
Yes.
And I would say if a family saw
that of a loved one who's the
primary caregiver,
they need to wake up and intervene
and say,
this person needs a break because
we're seeing signs of total
compassion fatigue in our sibling.
Right, right, right, right.
I think that's, I think that can
happen easily.
And when you get to that point,
it's, it should be a big red flag
for everybody,
including the caregiver to know
that they need to, they need to
get some help.
I mean, it can cost you a lot.
That is the resentment.
It can cost you a lot if you live
with it for years,
but I could see that could even
start poisoning the parts of you
that caregiving hasn't yet taken
away.
Oh, sure.
It's almost like a snowball.
Of course it would be.
Of course it would be.
Yeah, so if anybody who is
listening is feeling like that,
my first suggestion would be to
see your physician,
you know, to get screened for
depression,
and to make sure that medically
you're okay.
And, you know, if you need
medication and counseling,
it would be really smart to do
that.
And to find a way to step away
from it a little bit,
to get some help and a little bit
of distance,
so that you can reconnect with,
with yourself.
And that you can look at this from
a distance
instead of everything being right
in front of your eyes
every single minute of every day.
I think there's a lot of strength
and power
that comes from the recognition of
a caregiver
saying that it's time for me to
ask for some help.
Yes.
It's a huge obstacle to overcome
because we don't and are not
programmed to really think that
way.
That's right.
That's right.
Do you think that resentment can
spread so gradually
that the caregiver doesn't even
realize
how much of their life has been
affected
until years are passed?
Well, that's a very patient
caregiver.
Mm-hmm.
Yes.
I don't think there is a
predictable timetable
because we all have the
relationships
that we had with that person
before, right?
Maybe it was good.
Maybe it was terrible.
Maybe it was somewhere in between.
So you start with the
relationship.
And then, you know, what is
expected of you as a caregiver?
What are you expecting of
yourself?
And what do you think you should
be able to do?
And what's realistic for one
person to be able to do?
And I just think, and I always
tell caregivers,
cut yourself a lot of slack.
This isn't something that you
signed up for.
It isn't something that you
anticipated or were trained for.
This is just something, this is a
huge job that was dropped on you
like it came from outer space.
And so, be gentle with yourself
and try to be as kind to yourself
as you are
to the person that you're caring
for.
You said cut yourself some slack.
I just happened to flashback to
one of our first episodes on the
podcast
that, you know, is close to 50
episodes ago
when Jeanette Yates and I were
speaking about cutting some slack.
And then we sort of came up with
in the discussion
that cutting up, giving yourself,
or cutting yourself some slack
doesn't make you a slacker.
And that really resonated in that
conversation.
I like that.
And shout out to Jeanette Yates.
Yeah, thank you, Jeanette.
It makes you a survivor,
hopefully.
Yeah.
So, at what point then does
caregiver resentment
stop being simply an emotion
but actually start becoming
dangerous for the caregiver
or the person receiving care or
even both?
Well, I think one red flag would
be
the biggest waving red flag
would be if you start having some
fantasies
about wanting to hurt them or hurt
yourself.
There, you know, there are cases
of abuse
and I tell people to hit
something.
Never a person, you know.
Go out, hit a golf ball,
throw a tennis ball up against a
garage.
Take some slap shots in the
driveway,
the hockey net.
Exactly, exactly.
Do something physical
to release some of that built-up
anger.
There was a story I spoke in Sioux
City, Iowa
one year, several years ago
at an Alzheimer's conference.
And a woman came up to me and
said,
I have an anger management program
that requires two dozen eggs a
day.
And I said, well, tell me about
that.
And she said, well, we live on an
egg farm out of town.
And she says, every morning when I
go out
to collect the eggs to sell,
I set aside two dozen for myself.
I said, okay.
And she said, and then when the
train comes by
at 3.56, I'm out there at the
tracks
and I throw eggs at it.
And, you know, if it's a long
train,
I take the aim and try to hit the
logos on each car.
And if it's a short train,
I just throw them really, really
fast.
I thought it was hysterical.
And I thought, I wonder what the
engineer
on that train thinks.
He must think, wow, that woman
really hates trains.
You know, did her husband run off
with somebody who works for the
company?
Or did she not know this was here
when they bought the farm?
You know, why could she be that
mad?
Well, it turned out, you know,
it had nothing to do with the
train.
She just had all of this anger and
frustration
built up in her.
And this was a way that she could
release it
every day at about four o'clock.
And then I thought too, you know,
well, some days, some days were
the egg lady
and some days were the train.
You know, the train didn't do
anything
to earn her throwing eggs at it.
And that happens with caregivers.
You know, some days we feel this
need
to do something physical,
to get rid of that anger and the
resentment.
And, you know, not everybody would
appreciate
having eggs thrown at them.
So, you know, find a way to dispel
some of that energy.
And then understand too that some
days
you're going to catch somebody
else's wrath
that you don't deserve.
And then, you know, when that
happens,
maybe you can think, well, I
guess, you know,
I guess today I'm the train.
But I do think that you can reach
a point
where if you start to think about
hurting them
when you have that urge to do it,
that it should tell you that you
need a break
and that you need to step away for
a while.
And if you think about hurting
yourself,
then that's a strong signal
that you need to get some help.
I mean, when caregiving has
consumed
so much of someone's life
that they start thinking,
this could be the rest of my life.
Yeah.
Like, what happens?
And when that thought becomes,
the only way this ends is when one
of us dies,
what does that tell you about how
trapped
the caregiver has become?
Yeah.
They really feel trapped.
And in some situations,
there may not be any way out of
this.
But I really encourage people
to look for respite programs
if their, you know,
if their person has dementia,
but they are still mobile.
There are some wonderful daycare
programs
where you can take them,
you know, up to four days a week.
And they can interact with other
people.
They can have fun.
They can have lunch.
There's one program called
the Respite for All Foundation.
And I think at this point,
they have 80 locations in the
United States.
And these are respite programs
that are mostly run by volunteers
in churches.
But it's a wonderful, wonderful
program.
And getting some time away from a
person
and having them have some time
away from you
is really, really important.
So if they're still physically
capable
of going out and engaging with
other people,
find a way for them to get out
and do something different
because that will make them
happier
and that gives the care receiver
some time.
If they are not capable of getting
out,
then as you mentioned earlier,
if you can get somebody in
for an hour, three times a week,
do it.
And then just leave the house.
I know this is hard for people.
A lot of times they feel like
they're really letting their care
receiver down
that, you know,
they said I would take care of
them,
you know,
through sickness and health,
till death do we part.
But, you know,
if you take a little time,
again, for yourself,
some separation,
I think that can really help.
I think that separation
has to be qualified
even one step further
and that's actually tuning out.
Yeah.
And you can't be texting
the person watching
the care recipient for that hour
six times in that hour
to check in.
You need to tune out
and really create that space.
And that's the hope.
If technology ever helps
caregivers,
the hope will be that
we're not just creating
a new digital burden
to monitor
while we're in our respite care,
but actually that's something
that...
You're so right.
Yeah.
That we can walk away.
You know,
these little devices
do have off buttons too.
is caregiver resentment
sometimes really what happens
when someone is saying
yes for months
or even years
when everything inside them
is actually saying no?
Right.
Right.
Of course it does.
And some of this
is self-imposed.
And I say this
in the kindest possible way.
we need to learn
to set boundaries
and to lovingly set boundaries.
Now,
when my mother
was talking to my dad
about staying in bed
when she was out
in the living room
reading a book,
it didn't sound
very loving,
but it was
very, very clear
that she needed
that quiet time.
And if you can
find the courage
to speak in
I terms,
you don't say
you don't,
I'm not talking
about you,
right?
I'm talking about me.
It's,
I love you
and I want
to take care of you,
but I cannot
do this 24 hours a day.
I need
to have
some time
to myself.
That's not me.
And it's
setting a boundary
and say,
I'm going to,
I'm going
to bring
some help
in three times
a week
so that I can
just get out
and just
have some
alone time.
I just need
some time
to myself.
And if they
don't like it
and they come
back,
which,
you know,
a lot of people,
especially care
receivers,
can be
pretty manipulative.
It's like,
oh,
so you want
to get rid
of me,
huh?
I do not want
to get rid
of you.
I want
to stay
healthy myself
for as long
as I can
so I can
continue to
care for you.
This is
something I'm
going to do.
I also like
this line,
I'm not asking
for permission,
I'm simply
keeping you
informed.
That's
brilliant.
Yeah.
Yeah.
Informed of
what needs
to be
happening
or what
needs to
happen
so that
this
relationship
in its
current form
has the
best chance
succeeding
in a
healthy
way.
Yeah.
Yeah.
Yeah.
And a friend
of mine
said that
to her
spouse
who had
Alzheimer's
and I don't
know if he
remembered it
but I sure
did.
I really
like that.
I'm not
asking you
for your
permission.
I am
keeping you
informed.
This is
what I
need to
do.
And if
they continue
to try
to put
the guilt
trip on
you,
you can
say
this is
what I'm
going to
do.
I have
told you
I'm not
going to
talk about
it anymore.
And then
you just
be quiet.
And if
they need
to talk
about it,
then if
they keep
harassing
you,
you just
say,
I'm done
talking about
this,
and then
you walk
out of
the room.
Or you
hang up
the phone,
you're just
done.
You don't
engage with
it any
longer.
And this
takes some
practice.
And then
if you
invite me
back,
Dr.
Mark,
next time
I'd like
to talk
about the
difference
between
earned
guilt and
unearned
guilt and
how to
stop feeling
guilty when
you haven't
done anything
wrong.
And this
is a
really
important
piece,
I think,
to connect
with anger
and resentment
and setting
boundaries.
So it's
hard for
people who
haven't set
boundaries to
do that.
That's a
really important
area to
explore.
My biggest
worry is
that guilt
that's not
reined in
can translate
to shame.
And once
you believe
in your
heart that
you're a
bad person
or a bad
caregiver and
you have
self-shame,
you're in
pretty dire
straits.
Yeah,
and that
can so
easily
just
transition
into
depression.
Do you
think,
Elaine,
that standing
up for
yourself as
a caregiver
actually can
protect your
relationship
with the
person you're
caring for?
Of course.
Of course.
Because if
you always
give in,
you're going
to feel
resentment
toward that
person.
You know,
if you are
not doing
the things
that you
want to
do,
who are
you going
to blame?
You're going
to blame
them.
So,
Elaine,
what is
that boundary
a caregiver
may need
to truly
set before
resentment
becomes
overwhelming
even if
setting it
feels sort
of selfish
or cruel
or incredibly
uncomfortable?
I think
time away,
for me,
it would
be time
away.
What would
others say,
or what
would be a
couple of
others that
other experts
might say?
Well,
I think
this depends
on if
there are
more people
in the
picture.
The one
boundary
would be
I cannot
do all
of this
all by
myself.
And I'm
willing to
do this
and I need
for you to
do that.
And then
be firm
about it.
And,
you know,
if you're
living with
this person,
let's say
it's a
parent,
right?
If you
are the
one that
is taking
care of
this parent
seven days
a week,
and you
have siblings
that don't
want to
do anything,
then you
give them
two options.
You know,
you can
either come
and take
care of
mom here,
or you
can take
mom to
your place,
or you
can provide
the money
for me to
hire respite
care.
What do
you want
to do?
I almost
create a
family pool
of funds.
for care.
Well,
that certainly
becomes a
solution if
they're not
willing to
let you
hold on
to your
boundary,
or if
they make
it impossible
for you
to hold
that boundary.
That sounds
like a good
plan B
to me.
Yeah,
yeah.
It's hard
because some
members of
the family
will have
very
logical
reasons
in their
mind
why they
simply could
not do
this,
but I
think you
need to
hold them
accountable.
There
comes a
time when
caregiving
ends.
Hmm.
Can
resentment
actually become
tangled up
with grief,
relief,
guilt,
or even
anger towards
the person
who's now
gone?
grief.
Sure.
I mean,
just think
about it.
What would
you resent?
You would
resent that
they took
so much
of your
time,
your healthy,
strong years.
you could
resent that
their
illness
prevented
you
from
pursuing
your own
dreams,
fulfilling
your own
career
potential.
You could
resent that
all of the
money that
you had
set aside
for travel
and adventures
went toward
their care.
I mean,
you can
think of
all sorts
of things
to resent
and
that's
human
nature.
So you
have to,
I think,
again,
you know,
you become
aware of
it.
Why am
I angry
at them?
And,
you know,
you think,
well,
did they
do this
intentionally
or did
they do
it out
of
carelessness?
Did they
put themselves
in this
position or
is this
something that
just happened
that wasn't
their fault?
You know,
I don't think
it really
matters.
I think
it's just
human nature
to feel
cheated
that you
don't have
this person
going forward,
maybe cheated
because you
didn't get
to do
the things
that you
wanted to
do while
you were
caring for
them.
And
how do
you work
through that?
You name
it?
You accept
that you
made the
choices
you made
for the
reasons that
you decided
were rational
at the
time.
And then
for me,
I would
think that
now you
say,
okay,
what's
next?
I have,
I no
longer have
that
responsibility.
How do
I want
to go
forward?
What do
I want
my life
to look
like now?
and then
realize that
you have
the power
to choose
your
attitude
going
forward.
We hear
so much
about
caregiver
collapse
once the
care
recipient's
gone.
Yes.
because
they've
been
now
stripped
of so
much
of
everyday
life
which
they
identified
with.
But I
wonder if
acknowledging
some of
those
little
R resentments
along the
way
might
might
actually
mitigate
against
the
chances
of
a
caregiver
collapsing
after
their
loved
one's
gone.
What do
you think?
I think
you're right.
Yeah.
I think
being honest
with ourselves
about our
emotions
and how
we're
feeling,
journaling
about it.
You know,
my mother
wrote letters
and she
also kept
a journal
and then
she made
me promise
that I
would burn
her journal
and not
read it.
really hard
for me
to do
but when
I found
it I
looked at
it and
I thought
these were
her innermost
thoughts
and she
wrote them
in a
time of
intense
emotional
upheaval
stress
grief.
She may
have said
things in
there that
would have
been hurtful
to me
or to
my siblings
and I
thought
I just
have to
honor her
wishes.
I have
her letters
and so
I
I took
her
journal
to the
dump
and
you know
it would
be
I think
it's very
healthy
to write
about
these
things
and put
them in
a safe
place
where nobody
else is
going to
find them
or at
least
leave
it to
a person
who will
honor your
wishes
because
writing it
down
writing
these
resentments
and these
griefs
and
everything
down
helps
get it
out
of
your
brain
and
it
helps
the
subconscious
mind
to
stop
waking
you
up at
three
o'clock
in the
morning
and you
can
you can
see
it provides
clarity
and it
provides
a history
if you need
that
so
I think
that's
probably
one of
the best
ways
to
prevent
the
collapse
at the
end
is if
you
take
care
of
it
managing
these
emotions
and
taking
care
of
your
health
while
you're
going
through
the
caregiving
process
it seems
like a
way to
stop
resentment
in its
tracks
from
becoming
the
final
legacy
of
the
relationship
wouldn't
that be
awful
for that
to be
the
final
legacy
of
being
wouldn't
that be
awful
if the
final
legacy
of the
relationship
was
resentment
nobody
wants
that
Elaine
what would
you say
to the
caregiver
listening
right now
who has
heard
themselves
in this
conversation
and is
thinking
maybe
for the
first
time
resentment
is
taking
over
my
life
I
I
would
say
take
a
good
look
in
the
mirror
and
think
about
all
of
the
good
kind
and
loving
things
you
are
doing
to
provide
care
for
your
care
receiver
and
think
about
how
you
would
feel
if
someone
else
was
doing
all
of
those
things
for
you
and
I
think
I'm
pretty
sure
you
would
feel
grateful
so
think
about
that
first
and
then
take
some
time
sit
down
with
paper
and
pen
and
write
down
the
things
that
are
causing
you
to
feel
resentful
right
now
and
then
give
yourself
a
little
space
maybe
wait
a
day
maybe
two
and
come
back
and
look
at
that
list
of
resentments
and
then
say
is there
anything
that
I
can
do
to
change
fix
or
control
this
and
if
there
is
if
it's
a
matter
of
setting
a
boundary
then
set
the
boundary
if
it's
a
matter
of
asking
somebody
else
to
help
or
hiring
somebody
to
help
then
do
that
if
set
a
boundary
with
your
care
receiver
and
tell
them
what
you
need
from
them
whether
that's
cooperation
whether
that's
doing
their
exercises
whether
that's
getting
their
you know
their
end of
life
documents
in a
row
whatever
it
is
so
let
them
know
what
you
need
from
them
even
if
it's
just
a
matter
of
cooperation
and
that's
where
I
would
start
I
would
just
really
start
with
identifying
my
feelings
again
cutting
myself
a lot
of
slack
not
being
a
slacker
right
and
then
setting
the
boundaries
knowing
what
you
need
to
take
care
of
yourself
caregivers
are
always
thinking
about
what
they
need
to
do
for
their
care
receiver
and
you
if
you
want
to
do
this
for
the
long
term
and
come
out
of
it
standing
up
you
also
need
to
think
about
what
you
need
to
do
for
yourself
while
you're
going
through
it
our
conversations
Elaine
always
sort
of
take
things
for
me
and
I
truly
appreciate
them
you
ask
great
questions
in
thinking
about
that
list
as
you're
going
through
it
there
may be
a couple
of
things
on
that
list
that
you
can
just
say
I'm
letting
go
of
that
off
with
it
and
to
coin
a
new
term
or
maybe
it's
not
a
new
term
but
as
we
wrap
today's
episode
up
and
think
about
what
we've
learned
maybe
compassionate
or
better
self
compassionate
indifference
might
help us
whittle
some of
those
things
off
the
resentment
list
yeah
yeah
that
wraps up
this
week's
episode
folks
thanks
for
joining
us
Elaine
it's
been a
pleasure
as
always
and
we
look
forward
to
visiting
with
you
again
thank
you
Dr.
Mark
it's
always
great
fun
talking
with
you
you
help
us
all
think
a
little
deeper
and
hopefully
the
conversations
that we
have
are
helpful
to
other
people
so
thanks
again
Elaine
thank
you
for
coming
back
and
having
this
conversation
with
us
I
think
one
of
the
biggest
things
I'm
taking
away
from
today
is
how
quietly
resentment
can
build
by the
time
a
caregiver
finally
recognizes
what
they're
feeling
it
may
already
be
affecting
how
they
see
themselves
their
family
or
even
the
person
they're
caring
for
and
I
think
that's
why
these
conversations
matter
resentment
is
an
uncomfortable
state
to
admit
but
ignoring
it
doesn't
make
it
go
away
sometimes
it
may
be
telling
you
that
something
about
the
way
you're
caregiving
simply
isn't
sustainable
anymore
so
if
you
recognized
yourself
in
anything
we
talked
about
today
maybe
the
question
isn't
what's
wrong
with
me
for
feeling
like
this
maybe
it's
what
is
this
resentment
telling
me
needs
to
change
Elaine
thank
you
again
for
joining
us
before
you
go
and
would
like
to
support
the
team
you
can
buy
us
a
coffee
through
the
link
in
the
show
notes
we're
a
small
independent
show
and
this
really
is
a
labor
of
love
and
every
bit
of
support
helps
us
keep
making
these
conversations
possible
if
you
know
another
caregiver
who
could
use
this
conversation
please
share
the
episode
with
them
thank
you
for
listening
I'm
your
host
Dr.
Mark
Ropaleski
and
we'll
see
you
next
time
before
we
wrap
up
I
wanted
to
remind
you
of
something
important
the
conversations
you hear
on this
podcast
are here
to
inform
to
support
to
spark
reflection
you're
not a
substitute
for
professional
medical
advice
care
therapy
or
crisis
services
listening
to this
podcast
does
not
create
a
doctor
patient
or
caregiver
client
relationship
between
us
if
you're
facing
a
medical
concern
health
challenge
a
mental
health
challenge
or
a
caregiving
situation
that
needs
guidance
I
encourage
you
to
reach
out
to
a
qualified
professional
who
knows
your
story
if
you're
ever
in
crisis
please
don't
wait
call your
local
emergency
number
or
recognize
crisis
hotline
right
away
you
deserve
real-time
help
and
support
the
views
you
hear
on
this
show
whether
from
me
or
my
guests
are
our
own
they
don't
necessarily
reflect
any
organizations
we
work
with
or
have
worked
with
or
been
part
of
in
the
past
this
podcast
is
an
independent
production
it's
not
tied
to
any
hospital
university
or
healthcare
system
thank
you
for
being
here
for
listening
and
most
of
all
for
taking
the
time
to
care
for
yourself
while
you
continue
to
care
for
others
I
look
forward
to
hearing
from
you