One of many fears about aging is having no one to care for us. Many of us try to insure that this does not happen to our loved ones.
In recent years, the proportion of people in the general population living to advanced age has dramatically increased. Along with this comes more age-related infirmity, which has created increased burdens and stresses on family caregivers emotionally, physically, and financially. These stresses can quite often test family loyalties and endurance.
During my work with the at-risk elderly, I often saw heart-wrenching situations in which a middle-aged, live-in child caregiver was faced with a difficult decision: placing their elderly parent or relative in a long-term care facility, or keeping them at home. Often, the caregiver is an only child or the “stranded” sibling who is “left” with the responsibility. Usually, the caregiver is a woman, as women traditionally have fallen into the role of caring for others—often to the point of seriously neglecting their own needs.
All of the above factors have resulted in an increase in clients in their 50s and 60s who I see in my psychotherapy practice. Many are part of the so-called “sandwich generation”: those caring for their elderly parents while raising their own children. These clients are often depressed, bitter and resentful.
The following recommendations may help to ease the caregiver’s stress:
Seek support. This can be the most challenging, because stressed-out caregivers may be too “frozen” in their anger or sense of helplessness to take the necessary steps to receive social, emotional, and professional support. In many situations, caregivers do not have family or friends to rely on. My job as a family therapist and social worker is to empower caregivers by helping them see that, in spite of their feelings of isolation, they still have choices.
Numerous resources offer help. These include certified home health agencies (CHHAs), geriatric case managers, clinical social workers, and local community organizations or places of worship. Catholic Charities is a well-known non-sectarian social service agency that has a presence in cities throughout the United States. Some clinical social workers make “house calls” to elderly clients, which may be covered by their health insurance. This provides counseling and support to the client and can provide some relief to the caregiver as well. If applicable, check with your job’s human resources department to see if your benefits include access to organizations that can advise you on elder care issues and resources.
Join a support group. It can be a huge help to know that others share your problems. Support groups are particularly helpful for individuals caring for relatives suffering from Alzheimer’s disease and other forms of dementia. Contact the Alzheimer’s Association (alz.org) to locate a support group in your area, and other resources and information. They also have a 24-hour support line: 800-272-3900.
Take care of yourself. Empower yourself for your own sake and as a caregiver by getting regular check-ups. Take time for relaxation, exercise, and other things you enjoy. Do something nice for yourself at least once a week, like reading, going to a movie, getting a massage, or spending time with a friend. This is good for both your physical and mental health.
Set limits. Allow yourself to set limits on the time and energy you devote to your elderly family member and others. You might limit phone calls to certain hours. Sometimes you must explain to your parent that you care about them very much, but you also need time for yourself to “recharge” and that some of their demands are unfair.
Honor the elder’s mindset and history. In trying to set limits and repair problems in your relationship with your elderly family member, be mindful of their emotional state and fears, as well as their unique personal history. This will help you in “choosing your battles” and considering when to introduce any changes in their care. When you are having difficulties dealing with their current emotions and mood, try to remember the good times you have shared over the years.
Consider senior living arrangements or nursing homes. As painful as it might be to consider such a move, it is often the best solution for both elder and caregiver. Evaluate the patient’s degree of autonomy, their medical needs, and your ability to help them manage all their needs—even with paid caregivers—while they are at home. Try to fight against any feelings of guilt as you make the decision that is best for your family.
I encourage readers to share your own advice for coping with the stresses and responsibilities of caregiving, as well as any other thoughts you might have.

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