Balancing Caregiving and Ongoing Responsibilities

As we all know, caregiving by itself can be a full-time commitment. Add in work, family, and other responsibilities and it can be enough to drive you crazy. Unfortunately, those other areas of your life do not just disappear while you concentrate on caring for your loved one. Caregiving can interfere with your performance at work, your relationship with your partner, or the care of your children. Your life can become a difficult balancing act.


Work

Doctors' appointments, patient needs at home, and unexpected crises make it nearly impossible for you to maintain a regular work schedule. However, keeping your job may be very important to you for any number of reasons. Whether it's for the salary, medical benefits, or personal satisfaction of working, you should not give up your job too soon. With some convincing of your boss, you may be able to work more flexible hours, where you could come and go at different times, but work the same amount of hours. Another option would be to ask if you could work from home on some days or at certain times. Also, if you are able to afford it, you might be able to switch to a part-time position. Finally, "job sharing" may be an alternative for you, which would entail sharing the responsibilities of one job with other employees.

Unfortunately, not all employers are flexible and/or understanding about the plight of family caregivers. That is where the Family and Medical Leave Act (FMLA) comes in -- to protect working caregivers. This law states that every U.S. employee working for a company that employs 50 or more people is entitled to 12 weeks of annual unpaid leave in order to care for a family member. This leave can be taken in one block of time, or in days at a time. Though employees do not get paid during this time, they continue to receive health insurance and other benefits, and are assured that their jobs will be there when they return.

Tips for coping with work:

	Talk to your supervisor about your situation and needs in a way that expresses your concerns, both as a caregiver and a dedicated employee.
	Be understanding about your employer's needs and work with him/her to agree on a plan that works for everyone.
	If possible, ask family members or friends to stay with or check in on the patient when you are at work.
	Look into home care options for the time when you are at work.
	Try to view your job as respite time away from caregiving. It is time for you to focus on concerns other than the patient, and have time to yourself.
	If on leave, you should check in with your employer frequently to stay aware of what is happening at work, and to keep the employer informed about your situation.
	If you feel that you are unable to handle your job, resign before there are any hard feelings.

The stress and time involved in caregiving can take a toll on your relationships with family members. You may find that you have less time to spend with your healthy loved ones, less energy to play with your children, less intimacy with your spouse, or less patience with your siblings. Such changes can create conflict. It is not uncommon to experience short tempers, disagreements, and withdrawal within the family.
 
You may also notice transitions in the dynamics and roles of your family. Suddenly, you may be making important decisions that your spouse/partner used to make, you may feel like a parent to the mother or father who has always taken care of you, or you may be responsible for household duties for the first time. These personal and family shifts can be uncomfortable.

If you have a spouse/partner, other than the patient, here are some tips for preserving a positive relationship:

	Talk openly with your partner about your concerns and emotions.
	Try not to take your frustrations out on your partner.
	If you spend a lot of time away from your partner due to caregiving, make sure to express your feelings about being away from him/her. Make the most of the time you do have together.
	If you need help and you think that your partner can assist you, ask him/her.
	Reassure your partner about how you feel about him/her by telling and showing him/her.
	Schedule periodic "dates" with your partner when you can be alone and spend some time away from the house.
	Seek professional counseling if you and your partner are not able to communicate effectively, such as arguing frequently.
	If sex is an important aspect of your relationship, you need to protect this. Seek professional help if you are having problems with intimacy in your relationship.

If you have children, or there are children being affected by the illness, here are some tips for helping children adjust:

	Talk to children about the situation, giving them a clear explanation without scaring them.
	Involve children in caregiving by telling them how they can help out.
	Try to keep things as normal as possible in your children's lives.
	Make time to do something with your children as often as possible, so that they do not feel neglected.
	Pay attention to your children's behavior. If they are acting different, this may be a sign that they are looking for attention.
	Make sure children know that they are loved by showing them affection and praise.
	Try not to take out your frustrations on children when they have done nothing wrong.
	Many times, young children have unrealistic notions that they are responsible for their parents' distress. Be sure to explain to children that they are not to blame for any of the emotional or physical distress that they may be witnessing in the family.
	Prepare children on how to talk to other kids about the situation, in case it comes up in conversation.

If you have siblings, here are tips for avoiding and dealing with sibling conflict:

	If caring for a parent, share the responsibilities of caregiving with your sibling(s) by dividing duties as evenly as possible.
	If necessary, ask your sibling(s) for help. Be clear and specific about how they can help you.
	Keep the lines of communication open with your sibling(s) and frequently update them about how the patient is doing.
	Have regular family meetings to discuss responsibilities and reassess the plan of care for the patient.
	Address any issues with your sibling(s) directly. If you feel that they are not giving you enough help or support, let them know.
	If you are unable to get help from your sibling(s), have the patient suggest ways in which they can help.
	If you are not satisfied with your sibling's help, try to accept whatever they do offer and seek help from other relatives or friends.
	Recognize if old sibling rivalries are re-emerging and address them before they get out of control.
	Express your anger, resentment, jealousy, or other emotions regarding your sibling(s) by talking to a close friend, family member, or therapist.

If you have in-laws, here are some tips for coping with possible problems:

	Remember that the patient is the foremost concern and try to work with your in-laws to ensure that the patient feels that way.
	If your in-laws would like to be involved in caregiving, let them know how they can help in a clear and specific way.
	Keep in mind that people can act out of character when they are stressed. Try not to take it personally if your in-laws act differently toward you or take things out on you as they try to cope with the patient's illness.
	Communicate openly with your in-laws about the patient's illness and treatment.
	Make sure your in-laws are aware of the patient's wishes/advance directives to avoid disagreements if the time comes that decisions must be made for the patient.
	Talk through issues that arise between you and your in-laws. Be respectful, but do not be afraid to express how you are feeling.
	Do not bring up past conflicts between you and your in-laws. Airing old dirty laundry will only serve to make the situation more sensitive between you and your in-laws.
	Try to be forgiving and not hold on to hurt feelings, anger, or resentment.
	Remember that regardless of how you feel about them, your in-laws are still family. If you need to vent, talk to someone other than the patient about your feelings.

Other Caregiving Duties

If you are a caregiver who is responsible for caring for more than one person, you face demands above and beyond those of other caregivers. Whether it's caring for children or an additional ill relative(s), multiple caregiving makes it almost impossible for you to attend to your own needs. However, the added burden of caring for more than one person makes it all the more important for you take care of yourself. You must take some time to address the emotional strain and physical toll of caregiving.

Tips for multiple caregiving:

	Do not attempt to do everything yourself.
	Recruit other family members or professionals to help with some of the caregiving duties.
	Look into services that might help reduce your strain, such as getting a baby sitter to watch the kids, hiring a night sitter, or a home health aid to help with the patient.
	Force yourself to take breaks to renew your energy.
	Don't carry the emotional burden of caregiving by yourself.
	Don't push yourself too hard.
	Look into other options for help at home, including homecare and volunteer services.
	Remember that your health is of utmost importance if you are going to be able to continue caring for others.