ARTICLES / Caregiver / When
and How to Say "No"... /
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How does a caregiver know when he or she can
no longer manage the daily caregiving routines
and planning responsibilities? What signals
alert the caregiver that he or she is in trouble
of getting lost in caregiving? Can a caregiver
who cherishes a loved one set limits on
responsibilities without feeling guilty or
morally bankrupt? These are questions at the
heart of successful, long-term caregiving.
Unfortunately, for most caregivers, these
questions do not arise until they are feeling
overwhelmed and depleted. Being able to say,
“No, I can no longer continue to provide care in
this way,” may not only save the caregiver from
emotional and physical burnout, but can also
open up opportunities of shared caregiving
responsibilities with others while deepening the
level of honesty and openness in the
relationship.
Saying “No” may seem like a harsh statement to
a caregiver who prides herself on being a helpful,
kind and loving person. In fact, most caregivers
choose to become one because they feel a moral
imperative to do so. This imperative may come from a
number of sources including family relationships and
roles, friendship ties and social expectations.
Families often select the primary caregiver from
cultural norms such as the youngest unmarried
daughter or the oldest son as being responsible for
a parent’s care. Friendship ties provide many single
elders with caregivers who act in lieu of local
family members. In the United States, the social
norm is for family and friends to provide care to
elders first before the government. Current
statistics show that the majority of elder care is
provided by families and other members of an elder’s
informal social network. Proximity is also a
component in caregiving. The closer one is
geographically to a loved one, the more likely he or
she will become the caregiver. Personal values
derived from one’s faith or spiritual practices may
lead a person to feel called to provide care. Moral
decision making based on humanistic values such as,
“Everyone has the right to stay at home if they
choose no matter what,” may encourage a person to
become a caregiver. Wherever the imperative is
coming from, the role of the caregiver is intimately
linked to that person’s code of ethics and the way
in which the person chooses to act in his or her own
life.
What does saying “No “mean anyway?
Is it a final giving up of duties that implies
the caregiver is ending the relationship and leaving
a loved one to fend for himself? Maybe the “No”
means, “I’m tired and feel trapped.” Maybe the “No”
means, “I have failed to be all I could be as a
caregiver.” Maybe the “No” means, “I can’t do what
you want me to do and I feel inadequate.” Or maybe
the “No” just means, “ I am so tired, I have to
stop.” The word “No” can have different meanings for
different people. “No” doesn’t necessarily have to
have a negative connotation attached to its meaning.
“No” can be understood as a pause, a time for
reflection, a breathing period or, “Let’s stop and
talk this over. Things need to change.”
Exploring the meaning of “No” for the
caregiver is often the first step in establishing
better emotional boundaries.
Healthy emotional boundaries are important in
helping the caregiver distinguish between his or her
own needs and the needs of the person being cared
for.
Boundaries remind the caregiver and elder that their
relationship is between two adults and that there
need to be expectations of mutual respect and
autonomy for the relationship to be successful.
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