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The cost & courage of caring - stories that spark resilience.
Do you owe your parents the rest
of your life?
And what do you do when you love
someone, but you can't keep being
their caregiver?
Welcome to this week's episode of
the Caregivers Podcast.
I'm your host, Dr.
Mark Ropaleski, and you can call
me Dr.
Mark.
Therapist Angela Caldwell is back
today, and today we're calling
this episode
10 Years of Caregiving Therapy in
One Hour.
We're taking the questions behind
some of our most shared
conversations,
along with questions caregivers
keep asking in support forums and
putting them directly to Angela.
I want her honest take based on
her professional experience.
What would she advise?
What's she seen happen?
What's she seen that works?
And what is likely to happen if
nothing changes at all?
Before we begin, please follow or
subscribe wherever you're watching
or listening.
Leave us a rating and share this
podcast with another caregiver you
think really needs it.
You can also support our small
independent team by buying us a
coffee through the link in the
show notes.
Angela, welcome back, and let's
get straight to it.
Angela Caldwell, welcome back to
the Caregivers Podcast.
We're so happy you're here to join
us again.
Thank you for having me again.
It's so nice to see you guys.
Well, in the tradition, let's get
straight to it.
We want to hear from you.
We want to hear from your
experience.
So, Angela, tell me, do you owe
your elderly parents care for the
rest of your life?
Oof, okay.
Yeah.
Yeah, you do.
So, it's really not for the rest
of your life.
Ideally, how am I about to say
ideally about dying?
Ideally, you owe it for the rest
of their lives.
So, hopefully, if life works out
the way it's supposed to, you
know, the elder generations die
before we do.
If you are caring for your elderly
parents, the hope is that it's not
for the rest of your life.
It's for the rest of their lives.
Obviously, things can work out
differently, but you're talking to
a family therapist, Mark.
I'm a person who roots for
families.
And if they are parents, they
sacrificed, hopefully.
They sacrificed quite a lot in the
early developmental years of our
lives.
And I like the idea of paying
back.
And we sacrifice a lot for them in
return at the end of their lives.
Where does the responsibility end,
though?
You mean, like, how far do we go?
How far do we go?
And what if we lose our sense of
identity as an individual because
of the all-consuming nature of
caregiving until the end?
Well, that's—you probably just
nailed it right there.
We go as far—we go all the way to
the point where we don't lose our
sense of identity.
If we are finding ourselves
absolutely consumed by the tasks
of caregiving, we probably have
gone too far.
There's some pretty harsh
realities that we have to face as
a society where we might envision
our elders living these, you know,
contented, peaceful lives.
And sure, they may have their
medical conditions that we have to
tend to, but we have a vision of
them, you know, living in our home
or their home or an assisted
living facility or dying sweetly
and nicely in their sleep.
The harsh reality is that not all
families are going to be able to
provide that.
That's the tough answer.
So you might be in one of those
families where you're going to do
the best you can, and I really
like what you just said, so let's
say that that's the limit.
You're going to do the best you
can up to the point where you
don't sacrifice who you are.
You don't sacrifice so much that
you have lost your way in your own
life.
Okay, well, what we just did right
there is we declared a limit.
That's the limit.
And if that means that your parent
is not going to have this ideal
sunset of their lives where they
get to die peacefully in their
sleep and in a very nice assisted
living, well, that's the reality
then.
You hear a lot these days about
when people give advice about what
it was like growing up to people
today, and they say, well, you
know, your parents did try their
best.
In many cases, I think for a
caregiver to remind themselves
regularly, hey, I'm trying my best
here.
It's not perfect, but I am giving
it my best.
And I think that should really be
an exercise that we should embrace
regularly.
1,000% if you, and if you embrace
it, I've noticed this with my
clients, we work a lot on them
granting themselves that grace,
forgiving themselves for being
less than perfect.
And can I tell you something cool
that ends up happening then?
So if they can get there, yeah, if
they can get to the point where
they can forgive themselves for
being human, for being limited,
for being boundaried, if they can
forgive themselves for that, what
ends up happening is I notice
there's a shift in the way that
they talk about other people.
They start extending that grace
and forgiveness to other people in
their lives.
They start, you know, if I have,
I'm thinking of a mom I had last
week in my office, sitting with
herself, beating herself up on not
being good enough, not doing
enough, not showing up enough.
And by the end of the
conversation, because I kept sort
of fighting back and saying,
you're doing the best you can,
we're all human, we're all
limited.
By the end of that conversation,
she actually, there was a point
where she turned to her daughter
and her daughter was disparaging
someone.
And she said the words to her
daughter, hey, they're doing the
best that we can, or excuse me,
they're doing the best that they
can.
And that was, that was like,
that's, that's what happens if we
start granting grace to ourselves.
We can't help it.
We start granting grace to
everybody else.
That sounds like there's a
potential for a turning point
there.
I think that's really something
important for people to hear.
Yeah.
But these answers about caregiving
for the rest of their lives, does
your answer change if the parent
was a loving parent or they were
an abusive one?
No, and I bet your listeners want
me to say yes.
No, it doesn't.
I'm, I'm a, as corny as this may
be, Mark, I am a take the higher
road kind of girl.
I am a, I'm, I'm a be the better
person kind of girl.
If your parents were awful, here's
another hard truth.
I guess we'll be doing a show full
of hard truths.
If your parents were awful, bad
news, that is the best that they
could do.
The best that they could do was
awful.
That was it.
That was the best they had.
That was the best they could do
given their limitations, given,
given the way that they were
raised when they were kids, given
the, the obstacles that they had
to overcome, given an anger that
they never got over, given a, a, a
grief that, that, that never got
processed.
Whatever their story was that
turned them into not such a great
parent, we don't punish them for
that.
At the end of our lives, we are so
vulnerable.
The end of our lives can be so
damn terrifying.
The end of our lives can be so
lonely.
We, we need, we need our kids to
show up and, and help us out and
throw us a bone.
Um, and so, no, unfortunately, as
much as I, I, I probably, your
listeners are thinking like, but
it's not fair.
No, it's not too bad.
What have you seen happen when
someone keeps giving because they
feel they'll always owe it?
Say that again.
What, what's the question?
So, what have you seen happen when
someone keeps giving of themselves
beyond self-sacrifice and
witnessing their identity just
dissolve simply because they feel
they will always owe it to their
parent?
Yeah, so, um, that's when I see,
um, a, a certain kind of emotional
cancer grow.
That's a scary one.
So, someone who gives limitlessly,
like, without some kind of
boundaries around the giving,
without some kind of limits like
you and I just discussed,
um, that's a dead end.
There's only one way that that
story goes.
That person becomes, um, the, the
name of the emotional cancer is
resentment.
And even though we think of
resentment as kind of a smaller
anger or, or some kind of, some
kind of minimal anger, it's
actually a killer.
Um, resentment is a slow growing
bacteria in your emotional self.
Um, that person who gives and
gives and gives and gives and
gives out of obligation, they no
longer are able to take any kind
of satisfaction or joy.
They're no longer allowed to, to,
they, they, they're not able, they
haven't put themselves in a
position to be able to give out of
love or out of choice.
And so, what happens is they
become resentful.
That resentfulness is dangerous
because it leaks.
It is the, it is the most
pervasive, dangerous of all of the
emotions.
They become resentful toward the
one that they're caring for.
But then they become resentful
toward the doctors and nurses and
the hospital and the system.
And then they become resentful
toward their family members who
aren't helping as much as they
are.
And then they become resentful of
other families that don't have to
carry this burden.
And then they become resentful of
their entire lives and how they
got themselves into this position
in the first life.
And that person dies angry.
They die angry and resentful and
they live with this sense of
injustice that can really, really
eat your soul up.
I can see where resentment can be
fueled by external circumstances
just that are not working in your
favor as a caregiver.
No one's helping.
The system is just broken and that
you're not able to get easy access
to appointments.
And then there's, there's a
problem with the pharmacy and
there's a problem with this and a
problem with that.
And it all falls on you and it
generates almost an external
resentment or an externally fueled
resentment.
But what I'm hearing from you is a
different resentment.
It's one that starts deep within
oneself as a result of our initial
choices and how we approach
caregiving.
Am I correct in seeing those two
separate sides of the coin?
Yes, yes.
And the reason there's a, there's
a distinction to be made there is
because of the way you worded the
question.
Because what I loved about your
question is you cut right to the
heart of what happens to someone
who overgives, who overdoes it.
Kind of hidden in your question
was what happens to someone who
does it out of obligation and
can't find any kind of positivity
in their caregiving.
And that, so that's, yes, that's
a, that's the poisonous kind of
resentment.
We, we become resentful, like you
said, of external stimuli.
We become, you know, the hospital
that won't, won't give us an
appointment soon enough or, or a
doctor who won't get back to us to
give us results of some test.
That resentment is, yeah, maybe,
maybe the way to say it is that
resentment has better prognosis.
We can, we can get over that a
little bit faster, hopefully,
because we feel like we've got
allies around us.
But when you're resentful of, of
your task, when you're resentful
of the person you're caring for,
when you're resentful of the
people around you, that's a
dangerous one.
You want to, you want to stay away
from that one.
So here's one, Angela.
My siblings know caregiving is
crushing me.
They still don't help.
When do I stop bothering to ask?
Never.
Never.
It doesn't take a lot out of us to
ask for help, so you're not really
losing anything there.
It's not really any skin off your
back.
Keep asking.
Keep asking.
Keep asking.
Keep asking.
Keep one tiny candle of hope lit
inside of you that they will
answer the call for help.
But if they never show up and that
candle keeps getting blown out,
what do I do as a caregiver if
they just never step up?
Slash their tires.
No, I'm kidding.
Don't say that.
That will be what you're
describing as one version of the
disappointing relationships that
we have in all aspects of our
life.
What do I do?
Does a caregiver change and one
day if faced with their need of
help, do we play the payback game
or do we be our unique, authentic
self and step up for our sibling?
I mean, again, you're talking to
someone who wants to step up all
the time.
If we start playing payback, what
happens to our society?
I just don't like, not only what
does that do to my integrity and,
you know, at the end of my life,
I'm going to have to face God or
Athena.
I don't even know who we're
supposed to face at the end of
life.
But, like, I want to be able to
show up with a good resume.
I want to feel good about myself.
Mark, the reason I can sleep at
night sometimes is because even
though I lost, I fought the right
fight.
I fought the good fight.
It's because I stepped up when I
needed to step up, when that was
the right thing to do.
So, you're talking to someone who
says, just keep stepping up.
Just keep stepping up.
And if it means that you get beat
up, okay, at least you're stepping
up.
It kind of feels like you lose
anyway.
So, don't you want to lose being a
classy person?
Right?
Don't you want to lose being the
person who stood by her integrity
and stood by her values?
If you're going to lose anyway,
lose looking good.
Lose feeling good about yourself.
I agree.
When you hear, I'm starting to
hate them, what do I do with that?
How do you respond?
Oh, yeah.
So, the antidote to hate is
empathy.
You are calling to mind many
cases, family cases that I have in
my office where someone is feeling
the contempt, feeling some hate
toward another family member.
Here's the thing, I hardly ever
have a family member where it's
not unjustified, where actually
when you hear what the other
family did to them or has treated
them or a characteristic in their
personality, whatever it is, you
kind of think like, yeah, if I
were in your shoes, I'd probably
hate them too.
The antidote to that is to use a
superhero version of empathy.
And it works.
It works.
I can get my clients out of that
sort of tar pit of hate by having
them step outside of their bodies,
climb inside the body of that
parent, sibling, whomever.
See the world from that person's
perspective, but not just like the
current world, like go back in
time to how that person
experienced the world as a child
and what they were exposed to and
what they got robbed of and how
they, how they were wronged and
how, what they're, what the way
that they're behaving, the way
that they're behaving now isn't
right.
And it may not be forgivable, but
it is understandable.
It's always understandable.
It doesn't mean that we excuse it
and it doesn't mean that we
necessarily forget it.
In fact, I would argue that we
make some adjustments around our
own behavior based on what we know
about this person, but it is
understandable.
And if you can get to the point
where you can understand why
someone is awful or did an awful
thing or whatever it is, then the
hate dissipates and you get to be
in your logical brain and make
some decisions about how much time
you're going to spend with this
person and make some decisions
about how thick your boundaries
are going to be with this person.
You're going to make some
decisions about what you're
willing to give and what you're
not willing to give.
But that becomes a beautiful sort
of unemotional calculation as
opposed to a hate-driven or a
contempt-driven calculation.
So make room for understanding and
help dissolve the hate that way,
but then reposition yourself to
think strategically of how you can
navigate around their presence and
still be who you are.
How come you always say what I say
so much better?
You're so much more succinct than
that.
Yeah, but I'm listening to you.
That's the luxury.
Well, Angela, similarly, can you
love someone and actually resent
caring for them?
Oh, that's beautiful.
In my field, we call that a
dialectic.
A dialectic, two competing ideas
that can coexist.
Yes, yeah, so dialectics are real.
You know, it's funny that you
bring that up, Mark, because I am
currently in this writing phase
where I actually am writing a lot
about, now this is in reverse, how
hard it is when you're raising
kids, actually, to help them
understand the dialectic of, I
love you, and also I have to
discipline you.
And how hard that is, and how hard
that is, and how hard that is,
because in a kid's simplified
mind, they can't think about, you
know, complex abstract concepts.
That doesn't make any sense.
How can you love me but also take
my PlayStation away?
You know, that makes me cry and
makes me hurt, so that's a hard
one to wrap their heads around.
And I make this argument that it's
hard for adults, too.
It's hard for us, too, to separate
someone's actions from who they
are.
It's hard for us to separate our
love for a human from what we have
to do for that human.
I think the sort of a cheat,
here's an easy way to get to that,
is thinking about it in the
reverse.
When you think about, like, an
infant, God, if you've ever had an
infant, your own children, you
can't measure your adoration and
how much you cherish that person.
You can't, your heart explodes for
love, and you, if you have to sign
one more damn permission slip and
get them to one more damn soccer
practice, and you have to, all of
the burden of raising a child that
creates such resentment in us,
well, we can do it there.
We can separate our resentment
about the burden from the child
that we love.
What if we applied that same
algebra to a person we're caring
for, someone older than us, that,
of course, you deeply love this
person.
Of course, you want peace and
contentment for them.
And also, ugh, what a pain in the
ass that you have to do all these
things for them.
Ugh, what a pain that they've
reached a point in their life that
they can't do it for themselves.
Those are two separate, coexisting
ideas.
How long does it take to get good
at juggling that dialectic and
actually coming out on the calm,
present side of it?
Okay, let me tell you why I love
this question.
As a therapist, the thing that
frustrates us the most, there's a
lot, you guys, the thing that
frustrates us the most.
I'm going to tell you my angle of
it afterwards, okay?
Okay.
I can't wait to hear it.
What frustrates us the most is
that our clients think that when
they come to therapy, that's the
therapy.
And then they go out the other six
days of the week and they have
their life.
And then they come back and that's
the therapy.
And that is so frustrating to us
as therapists.
We say it's the other, no, no, no,
other way around.
You're supposed to come to therapy
and we're supposed to troubleshoot
what you've been working on all
the other six,
the other six days are the
therapy.
And so what we're trying to say is
if you want to change this thing
about you or this thing in your
life,
you actually have to put in the
disciplined practice of it.
You actually have to be working on
this when you drive to work every
morning this week.
You have to actually work on this
when you're cooking dinner every
night.
You don't just work on it in
therapy.
So what I love about your question
is this idea that we measure how
much time it takes to get good at
something.
Well, how much time does it take
to get good at anything?
Well, it depends on your
deliberate practice.
I can become a really good tennis
player if I practice two hours
every single day.
If you want to be as good as me,
you also have to practice two
hours every day.
You can't practice one hour a week
and expect to be as good as
somebody who's practicing every
day.
How long does it take for us to
get our heads wrapped around
difficult, sophisticated
dialectics?
Well, if you practice every day,
if you're disciplined and you put
the effort into changing the way
you're thinking about something,
speed of light, a week, quick.
I think that awareness can
actually free up some space and
some energy to actually buy in.
Caregivers are so exhausted and I
think often that extra needed
effort can almost seem
insurmountable.
But if you make room for it and
some space for some of those
groundwork type thoughts and then
start from there,
I think it can really open things
up.
But getting back to that
resentment,
when is that resentment something
a caregiver can actually work
through?
And when is it a sign that it's
just the care arrangement that has
to change?
Well, that's a great question.
I wonder if the answer is,
I wonder if the answer is kind of
like how,
the way I'm thinking about it
right now is how a scientist would
isolate a variable.
And so we were caring for my
father-in-law out here in
California
California and he was mean to me.
He was irritable and he snapped at
me and he was unhappy
when I would come to him in the
facility.
I noted, and that, yeah,
I had some resentment about how I
was kind of a punching bag there.
I had a realization that when we
took him out of the facility
and he maybe spent time at our
house for the weekend
or we took him out for dinner or
out for lunch or something
or we, or even in the car on the
way to a chemotherapy appointment,
his demeanor would shift.
And so maybe that's, I'm saying if
we isolated him from,
if we isolated the variable,
we took him out of the care
facility in this case,
we started thinking, wait a
second.
It's, I'm not, this, what I'm,
what this, I'll call it a symptom.
The symptom that I'm seeing in my
father-in-law
seems to be caused by the
facility.
So this happened to us actually.
And when we realized that, the
adjustments that we made,
we found out that he was being
woken up in the middle of the
night
because they were being too, I
don't know,
they were, my word is rulesy.
They were supposed to be
medicating him every six hours,
but that meant that they were
waking up when he,
waking him up when he was
sleeping.
So we make an adjustment there.
We say, stop doing that.
We found out that he was being
interrupted like that
when he was trying to do other
things.
So we kind of made a rule with the
facility
and they were, fortunately for us,
they were agreeable to it.
Stop interrupting him.
Just stop interrupting him.
Give him his meds when you can,
but don't interrupt him.
And then when he became less
irritable,
my resentment toward him,
obviously, lifted.
And so that was a sign that I
wasn't resentful at him.
I thought I was.
That I was resentful at systemic
functioning.
Maybe that's what you mean by,
how do I know if I can work
through?
Well, you have to be able to tell
the difference first.
Now, not all of us are in a
position
to always be able to tell the
difference.
My other answer would be,
we can work through any resentment
with that antidote,
with empathy and compassion,
kind of seeing it from our loved
one's point of view,
seeing it from even a doctor's
point,
from someone else's point of view,
you can work through any kind of
resentment.
I think that the trick to your
question is,
how do I tell the difference
between resentment and
frustration?
Frustration would be
circumstantial,
as opposed to resentment,
which is kind of like a bacteria
that grows inside your body
and you take it with you
from circumstance to circumstance
to circumstance.
So maybe that's another way
to kind of distinguish
what can I solve right away
and what needs to be looked at
with some deeper introspection on
my part.
You know, fighting infection with
antibiotics,
sometimes if you start early
enough,
you'll quench the infection and
it's gone,
but sometimes the body's response
to infection
takes over and despite
antibiotics,
there are overwhelming changes in
the body.
Is there a point in caregiving,
using your analogy,
where you've recognized
that smoldering infectious
resentment,
but yet it doesn't look like
anything
is going to help settle it
and something else needs to change
before it takes over the whole
body?
Is it a relationship that needs to
change?
Is it a living arrangement?
Are there big moves?
Have you noticed in individuals
who just sort of hit that point
where something big needs to
change,
where it's not going to be the
luncheons
or anything like that,
but a big upheaval needs to change
to preserve the caregiver
because they're on that steep
precipice?
Yeah.
Forgive me for using kind of,
you know, mundane practical
examples,
but...
Practical's good.
Yeah, some of the big changes
that I have seen
that I've gone through
is if you are finding
that you are becoming so resentful
of the entire process,
let's say it's because,
this is a common one,
because you can't afford the right
facility,
because you can't afford the right
doctor,
whatever it is,
if it comes down to financial,
yeah,
for your own health,
you might need to sell an asset.
And we wanted to hang on
to my father-in-law's house.
That was not going to work for us.
My husband was drowning
in having to pick up the slack
where the facility,
you know,
let it go.
And we decided to sell his house
and pump some money
into a different course.
That's a big one.
That's a big one.
And it's a dangerous one, too,
because you might end up,
you know,
you don't want to sell an asset
that just creates even more
resentment
because you wanted to hold on
to your own asset.
That's a big shift that has to be
made.
You talked about siblings earlier.
If you are in a family
where siblings are willing to
help,
I had a family I worked with two
years ago
where they sort of put it to the
sibling
to say,
we can't do it anymore,
you have to come here and help.
You need to pick up,
the sibling was in a different
state
and they said,
you need to come
and I don't care if you live with
us,
I don't care if you find an
Airbnb,
I don't care if you find an
apartment,
you need to take over,
we have to tag out.
That's a big drastic thing
that can shift.
There's probably...
I can imagine in family therapy,
you've encountered a lot of
circumstances
and a lot of discussions about
that,
but we have lots of listeners
who write back in the comments
saying,
we tried having those
conversations
and they just didn't listen.
Is there a next strategy
when you hit that first wall
or do you just keep reading the
riot act
and hoping that it clicks at one
point?
I mean, you can kind of do both
at the same time.
So you asked me earlier,
do you ever stop asking for help?
No.
Just keep asking,
keep asking,
and keep hoping that someone's
going to help.
What's going to happen,
and here we go with another harsh
reality,
the car is going to crash.
If something doesn't give,
the car is going to crash.
There is going to be
a fall down a step
and the loved one's going to
end up in an emergency room
and they're not going to be able
to afford something
and the siblings, let's say,
are going to see
how dire things have become.
You would hope at that point
that they would step up,
but sometimes it actually takes
a rock bottom
for people to wake up.
And unfortunately,
many of us are in families
where nothing is going to change
until the car crashes.
Now, we're not hoping for it.
We're not facilitating the car
crash,
but something bad's going to
happen here.
Someone's going to get kicked out.
Someone's going to get evicted.
Someone's going to fall.
Someone's going to get crushing
medical debt.
Something bad is going to happen
and the siblings are going to know
about it.
And usually, I mean, again,
I work with families in trouble
all the time.
Usually, unfortunately,
it's that wake-up call that people
need.
And by that point,
somebody's suffering pretty bad.
I'm sure there's a listener
somewhere saying,
even in that wake-up call,
there was no response.
And I think that's where
we need to apply the skill
that you spoke about
is that that individual
is probably incapable
of going beyond this limit of
function
where they are now
and maybe I need to let it go
and look at my own caregiving
situation
with grace and introspection
and reaffirm that I'm doing the
best that I can
and I might feel better and do
better
without trying to mobilize
any other help from that sibling
who just does not step up.
Despite even the car crash.
Does that make sense?
That is 100% correct.
And then there's another piece.
So yes, so just kind of
focusing on what you can do,
dealing with the task at hand.
What's going to happen
is your loved one is going to die.
And then you have a big process in
front of you
because now what you are looking
at
is a pretty severely damaged
relationship
with a sibling.
Sometimes the relationships you
can recover
and you can heal from them
but it requires some pretty
serious remorse
and perspective on the part of the
sibling.
Other times what you're looking at
is a grieving process
and this is a weird one
because it's grieving someone who
hasn't died.
You grieve the loss of the sibling
you should have had.
You grieve the loss of the sibling
that you thought you had.
And that's painful.
It's a complicated bereavement
because it's a lot easier
to grieve someone who's dead,
a lot harder to grieve someone
who's alive
or to grieve an idea
or to grieve a fantasy.
But that's what therapists do.
We help people grieve
and really go through all the
stages of grief
of a dream or a fantasy
or a relationship they deserved
but didn't get.
But that comes next.
You can't do that in the moment.
It comes once the caregiving role
has ended
and you deal with the pieces that
were left.
That's one of the biggest pieces
that you will face.
Angela, family caregivers sitting
in your office
telling you,
I love them
but I feel like I will only get my
life back
when they die.
What does the caregiver do with
that?
That is a signal to a therapist
that you have gone too far.
So that's a signal to a therapist
that you have given too much.
Remember that boundary
that you sort of established in
your question.
And so what therapists will do in
that situation
is start looking for places to
pull back.
A lot of times when people say
that,
what has happened is something
called habit
or routine.
What has happened is
because they've given so much,
they have naturally fallen into a
rhythm
about what their day looks like.
And what therapists will listen
for
and successfully discover
are the openings
where you didn't have to do that
thing that morning
and you didn't have to give that
thing that afternoon.
In fact, this thing that you keep
doing,
you don't have to keep doing.
Those are hopeful conversations
actually.
And you have your clients
start clawing back pieces of their
lives.
And the other thing is we reframe
it.
We don't say when this is over,
I'll have my life back.
We help reframe it as right now
in this chapter of where I am in
my life right now,
this is a part of it.
This is a part of my life.
When this person dies,
I'll be in a new chapter of my
life
and I don't know what it's going
to look like.
There's no going back.
I always yell at my clients
about when they want to go back to
normal
or back to their life.
There's no going back.
We are different now.
We've gone through an experience
now.
We've evolved and changed our
viewpoints
of people in the world.
We've matured.
We've gained experience.
So now whatever happens next isn't
a going back.
And going back is going backwards
anyway.
What we do now is go next.
We go, we look at,
okay, so now here I am.
I've cared for this person.
That part of my, that chapter
closed.
What new chapter is this now?
And then when you're feeling
trapped,
what lens do you look at that new
chapter?
Is it a question of saying,
I can provide good quality care
and support
while eliminating these two other
three steps
along the way to achieving that
point
and using that time for me
or using that energy for me?
How does the caregiver deal with
that new reality
as you're describing,
like the new phase, the next
phase?
How do they get there?
You know, this is going to be a
weird answer
and you might be mad at me for my
answer.
No.
Don't.
Don't deal with it.
That's overthinking it, in my
opinion.
Let it happen.
Know that it's coming.
Don't, it's sort of,
I don't know, isn't that kind of
how life will naturally,
you will naturally,
whether you want to or not,
the next chapter is happening.
And I don't know if there's,
I don't know if you,
I don't know if you're supposed to
do anything about it.
It's going to happen with or
without you, kind of.
And so you're going to be in this
caretaking,
caregiving chapter for a minute
and then that person,
then that caregiving role will be
over,
so that committee will dissolve.
And now you're going to be in this
next part of your life,
whether you prepared,
whether you processed,
whether you did any thinking or
any planning,
you're going to be there anyway.
What you can do,
and this is kind of cool,
is in the,
before when I was saying kind of
clawing back parts of your life,
you just do a little at a time
because that's just how life
works.
Claw back the pieces that you
think you might like to plant
and see how it grows.
If there's a friend group
that you're kind of wanting to
become a part of,
plant it, you know,
maybe you see them once a month
for a while,
hoping that when this role is
over,
that becomes a big part of your
life.
Maybe there's a skill or a hobby.
Maybe there's a,
maybe you had a career that you
had to press pause on
or a dream that you were working
on
that you had to press pause on.
Maybe what you do here
is kind of claw back parts of that
that you can get rolling again,
knowing that when this part of
your life is over,
okay, you planted a seed there
and you can start to nurture it
and start to grow it into
something,
well, that's it.
I don't want to say anymore.
Let it grow.
Don't do a lot of thinking and
dreaming
about what it's going to be
and don't get too,
I always tell my clients,
don't get too married to visions
that are very specific.
Get married to a way that you
would like to feel
and then see if you,
you know, when you clawed back
parts of your life
and planted some new seeds,
see where they are at this new
part of your life
and nurture them at that point.
It kind of reminds me what
Charlotte Biala shared with us
in terms of picking those things
that are aligned with your
authentic self
and that steal those moments
and if it's a cup of coffee,
savor it and make the time for it
and reinforce the self that's
still present
and all of those little hacks that
you describe,
you really hope that they have the
high value
than that they're really well
self-aligned
as opposed to prescribed from some
top 10 list somewhere
that's really impersonal but very
generic.
Yeah.
Yeah.
Yeah.
I agree with everything she said.
Yeah.
So when a caregiver says,
I don't know if I can survive
another year of this,
what are you hearing behind that
statement?
Exhaustion.
Utter exhaustion.
I have a,
I got lucky because I have a thing
that I say to,
you don't just hear that from
caregivers,
you hear that from people who are
going through
painfully long processes of
anything.
So,
so I tell them,
I say,
you are making the mistake
that mountaineers tell you to
never make.
So Mark,
I,
my dad actually was a mountaineer.
He climbed,
I mean,
he took me to Everest.
He,
he,
he,
he climbed all the,
all the big mountains all around
the world.
And in the trekking,
the actual like mountain climbing
part that I got to join,
I got to join him for a couple of
them and the guides,
they would always say a good
mountaineer never looks at the top
of the mountain ever.
A good mountaineer only ever looks
at their boots.
They never look at the top of the
mountain because if you look at
the top of the mountain,
you'll quit.
What they will do is they'll look
at the bottom of the mountain.
They'll turn back and see how far
they've come.
They'll,
they'll,
they'll give themselves a reward
every couple of days and see how
far up the mountain they are.
But they never let themselves look
at the top of the mountain because
of what you just said,
because they'll go,
I'll never make it.
I can't go that high.
So instead they say,
keep your eyes on your boots.
What you try to make is the next
step.
You don't try to make it to
another year.
You don't try to make it another
five years.
You make another step.
And that's the trick.
That's,
you gotta,
we gotta steal a page out of the
mountaineer's book.
That sounds like wise advice.
I would think focusing on the top
two might put you in that little
bit of extra rush and that extra
pressure,
which may
put you in a
position where you might not take
the time to acclimatize.
Yes.
That's a good analogy.
Yes.
What have you seen
when
caregivers actually wait too long
to address that
and they just keep going exhausted
and exhausted?
Dangerous stuff.
I have a couple of people in mind
that I'm thinking.
I see substance abuse.
I see clinical depression.
And then I see recklessness.
What happens to people that let
exhaustion go too long and don't
pull back, don't use positive
thinking or empathy or compassion
or they don't claw back parts of
their lives or they don't put a
limit on their giving.
They,
they,
they can become reckless.
They can start,
maybe it's like an apathy that
overcut,
they start just kind of giving up.
They start going like,
well,
I just,
I just can't.
I just can't.
It's too much.
And they don't,
they're not careful with anything
in their lives.
They're not careful drivers.
They're not careful with their
money.
They're not responsible friends
and relatives.
They become reckless.
That's dangerous.
Substance abuse,
obviously,
and that's dangerous.
Clinical depression can be
dangerous.
if you don't get help immediately.
Bad stuff,
Mark,
bad stuff happens if you let the
exhaustion go too long.
So is there a first sort of
warning sign that you would
encourage caregivers to be on the
lookout for before you hit those
more serious stages?
It's day,
it's,
it's day one.
This is,
this is what,
this is what I'm,
I'm,
I'm saying when the therapist gets
so frustrated about.
your body is giving you
information all the time.
So when we say like,
you know,
at what point do I respond to my
exhaustion?
The moment you have it,
the moment you have exhaustion,
you say,
oh,
okay,
this is what we talked about in
therapy.
You say,
oh,
I'm exhausted.
I gave too much today.
Rather than wait,
you know,
I'm sorry,
I'm bringing it back to therapy,
but you wait a week and say to
your therapist,
yeah,
I'm just,
I was so exhausted this week.
I just kept going and kept going.
And then the therapist says,
you,
you can't do that.
You're,
this is,
when you are exhausted,
your body is giving you
information.
Take the information,
respond to the information so that
it doesn't go so long.
Pay it,
don't pay attention to it in our
meetings here.
Pay attention when you're driving
home.
If,
if this,
if you tonight go home and you are
absolutely exhausted,
that's your body talking.
You cannot give as much tomorrow
as you gave today.
You gave too much.
You cannot stay up later tonight
than you stayed up last night.
You cannot eat less today than you
ate.
You have to eat more and sleep
more and give less.
That is the signal.
The day one of exhaustion is the
signal.
I'm going to have to listen to
your advice.
We hear this often,
Angela.
I promised I'd never put them in a
home.
Now I can't safely care for them
anymore.
How do you tell them?
I can't keep that promise.
Are you asking,
how does the caregiver tell the,
the loved one?
I can't keep that promise or,
or Angela,
a lot of caregivers say this.
I promised I'd never put them in a
home.
Now I can't safely care for them
anymore.
How do I tell them,
the person I love,
that I can't keep that promise
and still protect our
relationship?
I have found that in most cases,
the loved one already knows.
I have found that the caregiver
who is worried about breaking the
news
to the loved one
is maybe worrying about something
that the caregiver is already
aware of.
because I'm thinking of so many
relationships
where the,
in most cases,
it's a son or a daughter.
Sometimes a sibling has to break
the news.
It looks like we need to put you
in a home
and has all the explanations
and has rehearsed the speech
and has prepared for
all of the justifications and
explanations.
and in those conversations,
most of the time,
the loved one
not only saw the writing on the
wall,
but understands
the amount of love and effort
that is going into doing
as much as possible.
It might not be everybody's first
choice.
I say that with a little giggle
because I am thinking of other
families
where they would prefer
to be in a home, actually.
But most families,
it's not their first choice.
And so nobody's,
you know,
happy about it.
Nobody's celebrating it.
But there's,
there's a lot more forgiveness
on the part of the loved one
than you might think.
They,
they know,
they understand.
Obviously,
a different story
if we're dealing with
dementia,
a different story
if we're dealing with
a loved one
who isn't
present in the moment
for a given reason.
And,
and that,
and this is an awful thing to say,
I can't believe I'm going to say
this one.
I'm going to say it.
In those cases,
don't worry
because they won't remember
tomorrow.
They can't,
they can't keep up with you
anyway.
So it,
so you don't worry so much
about those cases.
But yeah,
I would say in most cases,
your loved one knows.
Your loved one can see you.
Your loved one can see
the pain in your face.
Your loved one can hear
the pain in your voice.
They,
they know.
They,
they,
they know.
They're not stupid.
They've been on this planet
longer than you have.
They can do the math too.
Don't,
don't sweat it.
What if you hear
that a loved one said,
you promised you're abandoning me.
How does the caregiver
live with that guilt bomb?
Um,
any therapist
worth their salt
will tell you
that is their problem.
That is a personality problem.
That's a,
that is a
classic textbook symbol,
symbol,
that is a classic textbook signal
that your loved one
has a different kind of problem.
And I tell you what,
if your loved one says that to
you,
that's not the first time
in your life you've heard that.
A loved one that says things like
that
to a caregiver
who is breaking their back
to help them,
that,
that we're talking about
a personality disorder.
We're talking about a severe
mental health issue.
That is not on you.
Do not accept that guilt.
Do not take that on.
You are doing everything
that you can.
And when they try to throw
your promise in your face
when you are breaking your back,
that's,
that's not your problem.
That is,
that is for them
to deal with either
with a therapist,
a priest,
a goat yoga,
God.
I don't know what.
They have to deal with that.
Even if they never agree
that I made the right decision
in the end?
Yeah.
Just stick with that line
of thinking, right?
Absolutely.
Absolutely.
I can't imagine there is
a listener here
that isn't breaking their back
trying to do the right thing
for their loved one.
But you say it's not
the first time
and often that guilt
is so conditioned
in so many different
life experiences.
How do you manage guilt
when it surfaces
from the depths
of the caregiver
and it feels like
it's eating them up inside?
Okay, so Mark,
here's the truth
of that question.
That isn't new.
It is highly unlikely
that that dynamic is new.
In that case,
the caregiver
has not identified
a very problematic dynamic
that has likely existed
since childhood.
In that case,
I want the caregiver
in therapy.
I want the caregiver
to seek help
so that they get
a third party,
they get one of us,
they get a therapist
to say,
okay,
this person
has been problematic
for you
for your entire life.
This guilt
that you have been
conditioned to take on
was never yours
to begin with.
This is a manipulation,
this is a relational tactic
that unfortunately
we see quite commonly
and we see it
from people
who are not mentally strong.
We see it from people
who are mentally unstable
and they do this
to their loved ones
so that they
are delivered
from any responsibility
or accountability.
the loved one
needs some supportive therapy
where they see
sort of the pathology
in their loved one
that this does not belong
to them.
So you got that, right?
Someone comes to you
in that circumstance,
there are the tools
to rebuild
the self
while you distance yourself
from that
pathologic behavior.
It's possibly a gift even.
If you find yourself
in that situation
if a caregiver
finds themselves
in that situation
with a loved one
and they are
just heartbroken
that they have this
say promise
being thrown back
in their face
and they seek help
from a therapist,
that's a gift
because that therapist
can help you see
this has existed
the entire relationship.
By the way,
not just with you,
with everyone
in this loved one's world,
they do this to everyone,
not just you.
that can be
liberating, Mark.
That can lift
a weight
off of your shoulders
to realize,
oh my gosh,
this whole time
this wasn't my issue.
This was their issue
that I was accepting
as mine.
Angela,
you're an experienced
dynamic family therapist.
So,
who comes first?
Your sick parent,
your marriage,
or your kids?
kids,
but is the parent
acutely sick?
Like,
did we,
do we have to call 911?
911 comes first.
A sick parent meaning
kind of a chronic illness
or in,
I imagine you're asking
kind of like
in a caregiving situation.
Kids come first.
Kids come first.
Kids don't,
don't come first
when,
let's see.
Kids don't come first
when
the caregiver
needs to get
to an appointment,
but the kid
really wants
to have a play date.
In that case,
the appointment
comes first
and you make
arrangements
for the play date
to come second.
But if it comes
to your love
and attention,
children
need it
more
than adults.
not giving
children
proper love
and attention
has a damaging
lasting effect
their entire lives.
Not giving
an adult
love and attention
can have a damaging
effect on a relationship
that's repairable
in the next couple
of days.
So what if
meeting your parents
needs means
repeatedly letting
your partner
and your children
down?
You got to make
it up to them.
You have to be aware
that you are doing
that and you have
to set aside
time.
You have to set
aside time
to make up
for the loss
of love
and attention
there.
traditionally
you have to
say out loud
to them
that you know
what is happening
right now
that you can see
what's happening
right now.
You have to say
out loud to them
I know that I am
choosing my father
right now
or I know that I'm
choosing so and so
right now
I haven't forgot
about you
I wish I didn't
have to make
this choice
and I'm coming
back.
The other thing
that would be
very healing
to your marriage
or your children
is to choose
a time
that you can
do it
you have to
find the one
that you can
do it on
where they can
see you
choose them
over your
father
over your
loved one.
So when they
can witness you
answer the phone
and say I'm
sorry dad
I can't come
right now
I'm with my
daughter
or something
like that
if they can
actually witness
you making
a choice
of putting
them first.
So what are
people's biggest
regrets then
about how they
handled those
scenarios
when they look
back?
Probably
probably
they regret
missing out
on so much
of their
children's
lives.
That would
be their
biggest regret.
When they
look back
and they
see
so I
have this
very specific
example for
some reason
it's in my
mind.
There's a
facility
well a lot
of the
facilities in
my area
they provide
transportation
to and
from
hospital
and
doctor's
appointments
if you
make
arrangements
enough
in
advance
and
that
example
is
coming
to
mind.
If the
facility
provides
transportation
but your
loved one
hates it
and doesn't
want it
then or
you have
a guilty
obligation
like well
I really
should be
the one
to be
at the
appointment
the biggest
regret
would be
if you
choose to
not take
advantage
of the
transportation
and instead
drive your
loved one
yourself
and in
doing so
you missed
the last
game of
the season
or in
doing so
you missed
opening night
of the
play
that I
find my
clients
have a
very very
hard time
forgiving
themselves for
that seems
to be a
regret that's
difficult
to overcome
and when
they look
back they
say I
should have
gone to
the last
game of
the season
there was
a bus
he could
have just
taken the
bus
there was
a shuttle
there was
a driver
he could
have just
taken the
shuttle
I should
have gone
to the
last game
of the
season
and that's
a big
regret
because
there's
not another
last game
of the season
you missed
it
you weren't
there
it's a
powerful
feeling to
imagine that
sense of
regret
yet
someone's
hardwired to
make the
decision to
actually get
in their
car and
instead of
using the
transport
provided
pick up
their loved
one and
bring them
to their
appointment
what's the
hardwiring that
fuels that
decision
that you
ultimately
regret
it's a
should
it's a
should
we are
we can
when it
comes to
caring for
another
person
whether it's
an infant
or an
elderly person
or a sick
person or a
dependent
we can
if we let
ourselves
we can
drown
in a
tidal wave
of shoulds
we can read
books and we
can go online
and we can hear
our friends
you should be
doing this and
you should be
doing that
we can have
echoes
from our
past
we can
have
other people
influencing us
on what we
should do
and that we're
the daughter
so we should
we're the son
we're the
siblings
so we should
and you can
drown
under those
shoulds
those shoulds
are external
right
they come from
the external
circles of
influence
they come from
society around
us
recognizing
that
helps
recognizing
that the
should is
coming from
the outside
helps
you can
you can
you can
almost
stop it
keep it
at bay
push it
away
and say
hold on
hold on
that's
what society
says I
should do
but what do
I need to
do
what do I
need to
do right
now
we've enjoyed
visiting with
Amy Vasterling
a couple times
and that's
what she refers
to as
the model
the model
that shapes
us from
the beginning
which
often
dissociates
us from
our authentic
self
yeah
yeah we
sign up for
the model
instead of
building our
own self
and then
it's your
own self
that regrets
that you
didn't go
to the
game
yes
yes
Angela
before we
wrap it up
a lot of
listeners want
to know this
are you allowed
to take your
life back
even if
your loved
ones may
never get
their lives
back
no question
is going to
make me
cry
of course
you are
of course
you are
allowed to
take your
life back
and of course
you ready
for it
should
take your
life back
your loved
one
wherever
they are
whether you
believe in
heaven
whether you
think they
died and
became part
of the
trees
wherever
they are
they want
you to
take your
life back
they want
you to
enjoy the
time you
have left
on this
planet
absolutely
you can
have your
life back
I couldn't
think of a
better way
to close
today's
episode
about
that wish
onto you
the caregiver
wherever you
are
from a
very special
person
who might
be somewhere
else right
now
but is
wishing just
that for
you to
take your
life back
thanks for
joining us
today and
providing us
with the
curbside
consult
with the
practical
tools and
hints about
what can be
done and
what's
accessible if
we just
put ourselves
to it
thanks for
funneling some
of those
experiential
moments you've
had as a
dedicated
professional for
our listeners
today and
as always
we look
forward to
seeing you
again and
folks that
wraps up this
week's episode
of the
caregivers
podcast I'm
your host
Dr.
Mark
Ropolesky and
we look forward
to seeing you
again take
care
Angela thank
you for being
so direct
about questions
that can be
so difficult
to say out
loud and
if you the
listener recognize
your own
situation today
choose one
question from
this conversation
to bring to
someone who
can help you
think through
what happens
next and if
this episode
really helped
you please
follow or
subscribe to
the caregivers
podcast wherever
you're listening
or watching
leave us a
rating or a
review share
a comment share
it with another
caregiver who
might need to
hear this
conversation if
you'd like to
support our
small independent
team you can
buy us a
coffee through
the link in
the show notes
I'm your host
Dr.
Mark
Ropolesky thank
you for listening
and until next
time take care of
yourself because
you matter too
and you're not
alone
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 we're
not a substitute
for professional
medical advice care
therapy or crisis
services listening
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 are
part of 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
health care 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