Caring for someone who won’t care for themself

“As a caregiver, I had to accept the fact that I can’t make others do things,” says Goyer. “I can offer suggestions and be honest with them about my feelings, but I cannot change them. They

have a right to make their own decisions, even if we perceive them as bad choices, and there’s a delicate dance between pushing a bit and pushing too far.” THE BURDEN OF SOLO CAREGIVERS As

an only child, Sam,* 50, from Sonoma, California, always understood he would be caring for his parents alone. “We lived in a tumultuous state for most of my life, moving 15 times, usually

for financial reasons, which was destabilizing,” he says. As he got older, Sam became the responsible child, and both parents leaned on him more and more for support, from financial

assistance to caregiving. “You want to idolize your parents, but it’s hard not to feel angry that a lifetime of bad decision-making on their parts has led to their health issues,” he says.

Sam’s father smoked and had poor eating habits, which led to diabetes. He is also addicted to opioids, all of which has landed him in the hospital numerous times. “His lack of care drove me

nuts,” Sam says. “I’d get resources and set up appointments, and he wouldn’t go to the doctor. His edema would go untreated for too long, and instead of being proactive, he’d routinely end

up in an ambulance headed to the ER.” Instead of hammering his father with phrases like, “We wouldn’t be here if you’d taken care of yourself,” Sam focuses on what he can do going forward.

“I tell myself that I can’t change him, but what I can do is try to make this hospital stay better and push to get him home faster,” he says. “Those are the kinds of things I had to focus on

to not live in resentment.” A stroke in May landed his father in the hospital again, and with all of his comorbidities, including lung disease, he began to fail. Palliative care was called

in and then hospice, which was a game changer for Sam. Suddenly there were other people, professionals who could take over the tough conversations without emotion and try to understand his

father’s health goals. “I realized that other people’s voices had a much better impact than mine, especially as the adult child who had been there all along,” says Sam. “They are able to

navigate tough conversations and take other ones off of my plate completely.” SETTING BOUNDARIES Jennifer Guttman, M.D., a clinical psychologist in private practice in Pleasantville, New

York, stresses the importance of communicating boundaries when you are caregiving, especially with those who are noncompliant. “It’s important to maintain honest and transparent

communication so that both of you understand and can try to hold space for the complicated nature of the other’s feelings,” says Guttman. “Sometimes just being ‘heard’ and ‘known’ can make a

big difference, even when it doesn’t change the role or job requirements.” She also advises caregivers to try not to just say yes to everything before they’ve determined whether there are

others who could assist. “Asking for help is a sign of courage, not weakness, and delegating tasks is great for self-care,” says Guttman. “When we’re taking care of people we love, they also

want to see us taking care of ourselves, so be open with them about how we intend to do that and when we need time for it.” As for Sam, he says he looks for the silver lining in this hard

situation, which is ultimately heading toward the loss of his father. “I tell myself that this experience is forging the decisions I make now with my life and what I do with my body so that

I will not put my own children in this position one day.”