Caregiving For Older Parents: What You Need To Know About Boundaries

“I don’t want to sleep over there anymore!”  My 63-year old father sounded like a little kid when he called me early one Saturday morning.  He and the rest of our family had been taking turns staying at my grandmother’s apartment since she’d begun the downward spiral of frequent falls and multiple hospitalizations.

I listened to my dad complain about how he had reached his breaking point.  He couldn’t get a good night’s sleep on my grandmother’s couch.  He was tired of the disruption to his evening routine.  While he was willing to continue visiting, taking her to her doctor’s appointments, and running errands, he was done with sleeping over.

We’d reached a critical point in the caregiving process.  The first family caregiver had finally established some boundaries. 

My Dad and my aunts, my grandmother’s primary caregivers, were all burning out.   Although my dad was the first one to say it, they were all exhausted, missing work, and neglecting their self-care.

After letting my father vent for a while, I responded, “You don’t have to sleep over there anymore.  You don’t have to do anything you don’t want to do.”  I think he was a little shocked that I was supporting his boundary.  

Even though my dad was very close with my grandmother and his sisters, he was reluctant to tell them that he’d hit a breaking point.  With his permission, I shared this conversation with them.  I reminded everyone that sprinkling in some home care help and maybe looking at assisted living were options as well.

My grandmother was hurt and shocked by the idea of bringing help into the home.  She also balked at the idea of moving out of her apartment.  Since my grandmother was cognitively intact, ultimately the decision to refuse home care and assisted living was hers.  

But as much as my grandmother had a right to say she didn’t want a home care aide or to move, her family caregivers had every right to say what we didn’t want to do as well.  A lot of family caregivers forget this; I know many people in my family did.  Everyone has a right to say what they will or won’t do in a caregiving situation.

I decided that I was going to remind my grandmother of this during my next “turn” sleeping over at her apartment.  Once again, I broached the topic of adding home care into the rotation of who would sleep over at her apartment.  I asked her why she was so against the idea, and she replied that she didn’t “need help;” she just enjoyed having someone visit with her all the time now.  Candidly I told her that her daughters and son were very tired and needed more breaks; home care would allow for that.  My Grandmother then became very irritable and said that everyone could stop sleeping over since she could take care of herself. 

I challenged her to do just that during my visit:  take care of yourself while I’m here.  Let’s just treat this like a regular visit.  For a full hour, I encouraged my grandmother to attempt to get her beverage from the refrigerator, to hobble to the bathroom solo, and to take her medication on time.  After just a one-hour experiment of trying to take care of herself with no assistance, she looked at me with tears in her eyes. She got it.

When we constantly “prop up” our older loved ones who are declining, sometimes they mistakenly believe that they are functioning independently.  This leads to a cycle of dependence on the family caregivers and burnout and resentment for everyone involved.  When burned out family caregivers don’t set limits, they are at risk for a number of health and mental health problems.  They are also less likely to provide good care and more likely to engage in unintentional abuse and neglect of their loved one.

Soon after this experiment, my grandmother agreed to allow home care into her apartment.  She was paired up with some lovely aides who took great care of her.  While the rest of the family still was very involved in caregiving, my aunts and my father got some much-deserved time off.

Everyone’s boundaries are different.  Think about what yours are and don’t be afraid to establish them.  I am grateful that my dad was brave enough to tell us when he’d had enough.  His declaration set into motion a much healthier caregiving experience for everyone, including my grandmother.