I was told by doctors and staff at the hospital my wife stayed at that a stroke can change the personality of that person. Someone who was very giving and selfless can all of a sudden become self-centered because they can no longer rely on their independence to feel comfortable about who they are. In essence, the world now revolves around them, and they have no problem letting you know. Likewise, your care receiver may now likely be concerned about one thing, and that is their care. If you allow them to get away with selfish behavior that is harmful or destructive to you, then you will become their slave and be expected to be at their beck and call. This will be setting you up for the worst kind of burnout. You must establish boundaries with your care receiver, as you should with all your relationships.
What do I mean when I say establish boundaries? Most of the time when an offense is committed against a person, it is usually because the offending party was never given the boundary that is not to be crossed. Therefore, because they do not know where the boundary is, or even if there is one, the offending party feels comfortable crossing it. Some examples would be disrespect. If a loved one is disrespectful of their caregiver, it is likely that the caregiver never made known to the care receiver their ground rule (or boundary) that disrespect will not be tolerated. It is also likely that the consequence for violating such behavior has never been communicated. A typical consequence for disrespect might be reminding them that they are being disrespectful to you, and that you will not respond to disrespect of any kind. Give them a warning and an opportunity to ask you again respectfully, (very similar to disciplining a child).Of course, respect is a two way street, so you should always treat your loved-one with the same respect you expect.
Failure to establish boundaries like described above will result in the caregiver feeling taken advantage of, not appreciated, and disrespected. Feelings of resentment, bitterness and depression may follow and may negatively affect the relationship. The caregiver may become stressed and resent their caregiving responsibilities. Eventually, the care receiver may receive poorer care, less respect, and even develop disdain for their loved one (familiarity breeds contempt). This is not a road that anybody wants to go down, especially when it is so simple to establish some ground rules in advance, and then enforce them, because they will be tested.
Boundaries may come easily to certain types of personalities, but very difficult to others. People-pleasers and those who dislike confrontation will struggle to implement boundaries. They would rather be offended and be taken advantage of than confront the loved one with reasonable rules to insure the health of the relationship. My advice to you is to get over your timidity and become more assertive. Take classes or seminars if needed. A better alternative, however, is to attend a co-dependent or enabler’s meeting like the ones that Alcoholics Anonymous or recovery groups offer. The benefits will be life-long. You will learn to change your unhealthy habits and acquire new traits that will benefit you in all of your relationships in life.
Healthy emotional and physical boundaries are the basis of healthy relationships. It is important that the care receiver understands what is allowed in the relationship, and what will not be tolerated. This is where it can get very sticky, especially if the relationship is a family member or loved one. For example, if a daughter is a caregiver to her mother, the dynamics of that relationship may take on a whole new change. Whatever difficulties the relationship had before, will likely be magnified.
Margarita Tartakovsky, M.S. writes in her article, 15 Insights on Improving Mother-Daughter Relationships,
“Mother-daughter relationships are complex and diverse. Some mothers and daughters are best friends. Others talk once a week. Some see each other weekly; others live in different states or countries. Some spar regularly. Some avoid conflict. Others talk through everything. And undeniably, there’s a hint of all these things in most relationships.”
When parents become elderly, roles will often reverse. The parent becomes the child and child becomes the parent. This is not an easy or willing adjustment for either party to make. Unfortunately, when something like a fall, a stroke, cancer, or Alzheimer’s occurs, there may be no other choice for the caregiver but to care for someone they may never have gotten along with very well. That is why it is essential for the ground rules of this new relationship dynamic to be established from the very beginning of the caregiving role. If it was not properly set up in the beginning, it is still not too late for you to establish healthy boundaries now. If you don’t, then the relationship may suffer irreparable damage, and the caregiver may likely suffer burnout, possibly leaving the loved one all alone or with less than quality care.
Continuing with my example of mother/daughter caregiver relationships, Roni Cohen-Sandler, Ph.D., psychologist and co-author of I’m Not Mad, I Just Hate You! A New Understanding of Mother-Daughter Conflict, sees three primary complaints that daughters have about their moms:
“Moms try to parent them and are overly critical and demanding. From moms’ perspective, daughters don’t listen to them, make poor choices and have no time for them.”
There are many books and blogs out there to help you improve relationships with family members that can be very helpful to your caregiving relationship and the healthy boundaries that you must establish. It is not likely that your loved one’s habits will change, however your responses to their bad habits can change. The bottom line is that your care receiver desperately needs you, which should give you an edge when dealing with any conflict. If you do it with love and respect, the only weapon they would still have is attempting to make you feel guilty. The proper way to deal with guilt was dealt with in the last chapter.. Remember, I wrote about deserved guilt and undeserved guilt and how to handle each one. Reread that chapter if you need a refresher.