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Managing Caregiver Guilt and Shame about Moving Aging Parent to Assisted Living
Jan 27, 2021
Have you helped your loved one move to a senior living or assisted living community only to find that in the midst of experiencing relief that your loved one is being cared for and is safe, you also have intense feelings of guilt and shame?
You're not alone. Many caregivers struggle with guilt and shame after moving older loved ones into a senior living community. Perhaps you feel that you've let your older loved one down, like you're not being a dutiful spouse, daughter, or son. This can lead to emotional distress and discontent.
To help you navigate the emotionally turbulent waters of caregiver guilt and shame, I've prepared 5 strategies for helping you to move through guilt and shame when helping your older loved one adjust to senior living.
5 strategies for moving through guilt and shame when helping your older loved one adjust to senior living
1. Be clear about your boundaries and share these boundaries with others.
Identify what your boundaries are. Are there certain caregiving tasks that you do not want to do, or cannot do? Taking time to get clear about your boundaries when it comes to caregiving will help you to identify what sorts of supports you will need to have in place to help your loved one, so all of the tasks do not fall to you.
I can help my dad with doctor's appointments, but he cannot live with me
I can help my mom with bathing, but I can't prepare meals
I can take mom to the doctor, but I can't manage her finances.
Now that you're clear about what you can and cannot do as it relates to caregiving, share your boundaries with others involved in your older loved one's care, like your partner, siblings, health providers, and doctors.
2. Be a friend to yourself
When you're noticing that you're being hard on yourself, like "I'm a bad daughter for moving my aging parent into a senior living community and not being here for them and the way that I imagined I would be" or the way that my parent imagined I would be. Be a friend to yourself. Respond to yourself when you're having that thought, like you would respond to a friend.
For example: This is a really tough situation. I'm so sorry that you're going through this what a dilemma. What a difficult decision that you have to make. I mean, either direction, it's going to be hard. I'm here for you.
3. Know that you're not alone
Other people in this situation who are moving or older loved one into an assisted living community, often have similarly intense feelings of guilt and shame. It may give you a little comfort to know that you are not alone. At some point in almost every caregiver's journey, caregivers feel that they have disappointed their loved one or let them down in some way.
4. Focus on positive aspects of your relationship and your contributions to your loved one's care
Guilt and shame are really good at are getting us to focus on negative aspects of ourselves. It can help to counter this with focusing on positive ways that you're contributing to your loved one's care or the relationship. For example:
I call my older loved one every day, or I do a window visit or an outdoor visit with my loved one once a week.
I call the senior living community daily to get an update on my loved one.
I was able to take my loved one to the doctor a few times last week, and then we went to lunch. And that was lovely.
Find ways that you are contributing in a positive way and focus on those. Don't let the guilt and shame have the last word.
5. Practice mindfulness
Mindfulness is essentially holding in your mind's eye your thoughts and feelings. After you finish a visit with your older loved one, take a few minutes to reflect on what thoughts and feelings are arising for you.
For example: After I leave a visit with my dad in his senior living community, I feel so sad. And then that sadness, jumps to feeling like "I'm a bad daughter", like I shouldn't have made this decision.
Taking the time to mindfully recognize your thoughts and feelings and hold space for them, free of judgment, will help you to more compassionately process these intense feelings.
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0:00 What happens when we move our older loved one into a senior living community? And when I say what happens? I mean, what happens internally in ourselves? And what are some common emotions that come up. In my close to 20 years of experience in working with older adults and their families. Some of the most common emotions I see arise are guilt and shame... and also sadness, because there are a lot of losses when we're moving our older loved ones into senior living. But today, I'm going to focus on guilt and shame, and talk a little bit about how it is that guilt and shame emerge, and then what to do about it. So I'm going to share five strategies for what to do to help you move through some of this guilt and shame.
0:51 I'm Dr. Regina Koepp. I'm a board certified clinical psychologist and I specialize with older adults and families. I created the psychology of aging podcast to answer some of the most common questions I get about aging, questions about mental health and wellness, changes in the brain like with dementia, relationships, and sex, caregiving, and even end of life. Like I say, in my therapy groups, no topic is off topic, we just have to have a healthy way of talking about it. So if you're an older adult, or caring for one, you're in the right place, let's get started.
1:33 The last few weeks I've been talking about having a conversation with your older loved one about moving into a senior living community or looking for senior housing in a long term care community or a personal care home. This conversation can bring up lots of emotions for you, the caregiver emotions like guilt or resentment, or shame. Maybe we grew up with the message that we should be providing care for our older loved ones as they get older. And then life has another story. Maybe you're working a full time job, maybe you had kids like me. Later in life, I had my kids in my 40s. So maybe you have little kids and parents who need your help. Maybe you have a full time job, maybe you're the breadwinner, and you can't provide as much care to your loved one as they need and moving into senior living or senior housing is the best option for you all as a family. But that can bring up so much emotional distress and discontent back to those feelings of guilt. Like I should be a dutiful daughter or I should be a dutiful son and move my aging parent in with me and help them out. Or I feel guilty that I can't do that I always had this vision that I would do that at some point. But somehow this decision is coming up sooner than I anticipated. This episode today will help you to figure out how to process some of these intense feelings that can come up when you're helping your older loved one or your aging parent to move into a senior living community. And I'm talking about the intense emotions that can come up for you.
3:22 How does guilt and shame even arise in this conversation around moving our older loved ones into senior living? As we were growing up, I'm sure as you were growing up, you've got messages about caregiving. So what's expected of you and your role in the family and our culture, we do this as a family when people need care. And our culture we do that as a family when people need care. Good daughters do these sorts of things when people need care. We're constantly given messages in society and media, in our churches in our families, about what to do, what caregiving looks like, and what to do when older adults need our support and care. These are important, I don't want to dismiss the realm of how important these these systems are. And these cultural values are. And at the same time, we also live in a world where we often need two incomes, to make ends meet. Maybe you had children in your 40s and now have little ones at home and aging parents who need your help and you don't have the capacity to do it all. Maybe you're also working full time. Maybe you don't have the financial resources to do it. Maybe it's more cost effective for your older loved one to move into a Medicaid supported living environment. Maybe your relationship is complicated and Maybe it would not be healthy for either of you, you and your aging parent for you to provide care in your own home. And even with all of these things said, it can bring up a lot of guilt and shame. So what's the difference between guilt and shame. So guilt and shame are similar and that they both are experiences or emotional experiences that have to do with self criticism or self appraisal. But they're different in that, for example, like shame is more focused on our character, I am bad. I'm a bad daughter for moving my older loved one into a senior living community. Where guilt is more, I did something bad, I moved my older loved one into a senior living community and that was bad.
5:52 You get the difference: "I am bad", versus "I did something bad". Now that you know what guilt and shame are and how it can show up with moving your older loved one into senior living, I'm going to share five strategies for moving through the guilt and shame.
6:11 So the first strategy is to be clear about your boundaries. And this can be tough to do. Because if you're new to caregiving, or even if you're in the middle of it, you might not know your boundaries, maybe you are okay with certain things, but not other things. But you had no way to predict that before. That's okay. You can anticipate with your what your boundaries are. And you can always change and modify what your boundaries are. But if you're clear at the outset, that it would not be a healthy arrangement for you or your older loved one for the two of you to live together. And for you to be providing care 24 seven, it's important that you know that and it's okay, to express that I can't do it, it's not healthy. For me, it's not healthy for my loved one. Okay, I also understand that some caregivers will say I have no options we can't afford for my loved one to live elsewhere. I also understand that, but just stick with me with this for a minute as we're helping caregivers who are moving their older loved one into a senior living community. So it's okay to have your boundaries, it's okay to identify it's important, in fact, to identify what your boundaries are. And then to say them out loud, like to say them out loud to your spouse, or your partner or your siblings, if they're helping and and your older loved ones care, or health providers or doctors. It's important that everybody involved in the care of your older loved one understands also what your boundaries are. And the more you can support yourself in this process by working through some of the strategies I'm going to share today, the more grounded you'll be and the more compassionately you'll be able to share what your boundaries are. So be clear about what your boundaries are, I can help my loved one with doctor's appointments, but they cannot live with me, I can help my loved one with bathing, but I am not a good cook, or vice versa. So be clear with what your boundaries are. All right, for I can I can take my older level and on the weekends, but I can't help them during the week because of my job. You get the idea. It's okay to have boundaries. And it's important that you're clear about them, and that you honor them in yourself and then other caregivers as well.
8:37 The second strategy for moving through guilt and shame, as a caregiver is to be a friend to yourself. So when you're noticing that you're being hard on yourself, like I'm a bad daughter for moving my aging parent into a senior living community and not being here for them and the way that I imagined I would be or the way that my parent imagined I would be. Be a friend to yourself. Respond to yourself when you're having that thought, like you would respond to a friend. So gosh, this is a really tough situation. I'm so sorry. You're going through this what a dilemma. What a difficult decision that you have to make. I mean, either direction, it's going to be hard. I feel for you. That's what I would say to a friend. So be a friend to yourself.
9:30 The third strategy is to know that you're not alone. Other people in this situation who are moving or older loved one into a community or a long term care, personal care home, often feel the same way and often have to work through their own feelings of guilt and shame to you're not alone. So I hope that that gives you a little peace of comfort and sense of belonging that this is a a universal experience, other people are experiencing it too, and other people are moving through it too. And you can do this.
10:06 So the fourth strategy for moving through guilt and shame is to focus on positive aspects of your relationship with your loved one, and the ways that you're positively contributing to your loved ones care. So what guilt and shame are really good at are getting us to identify all the ways that we are indeed a bad daughter, or we indeed did a bad thing. But that's not the full picture, the full picture are also positive ways that you're contributing. So instead of letting guilt and shame win by identifying all the ways that you're not being the best caregiver ever, identify ways that you are contributing positively to your older loved ones care. Like, I call my older loved one every day, or I do a window visit or an outdoor visit with my loved one once a week. Or I call the senior living community daily to get an update on my loved one. Or I was able to take my loved one to the doctor a few times last week, and then we went to lunch. And that was lovely. Find ways that you are contributing in a positive way and focus on those. Don't let the guilt and shame win.
11:23 Alright, the fifth strategy is to practice mindfulness. And mindfulness is essentially holding in our mind's eye, our thoughts and feelings. So you get still and quiet. And you focus you pay attention to what's coming up for me right now. Wow, I'm noticing when I, after I leave a visit with my older loved one in his senior living community, I feel so sad. And then that sadness, jumps to feeling like I'm a bad daughter, like I shouldn't have made this decision. So just taking the time to mindfully recognize that and hold it out will help you not to deny the feelings that's not healthy either. But also not to over identify with the feelings like That's right, I am a bad daughter. That's not healthy either. So mindfulness helps you to hold out here and observe what it is that you're actually thinking and feeling. So that you can hold it in perspective, not necessarily over identify with it. This concept comes from Kristin Neff, three part model strategy or three part sort of modules on self compassion. And actually, a couple of the tips in here actually had to do with self compassion, as well. If you're interested in learning more about self compassion, I'll link to Kristin Neff, self compassion work, it's really great. And I encourage you to check it out.
13:00 Alright, just to summarize the five strategies again. The first is to be aware and identify your boundaries, and then to share them with others. The second is to be a friend to yourself, respond to yourself like you would respond to a friend. Third is to know that you're not alone. The fourth is to focus on ways that you're positively contributing to the care of your loved one, or even just to the relationship with your loved one. And the fifth is to practice mindfulness around these intense feelings that you're having. And not over, identify with them too much and also not avoid them. That will help you process them a bit, as well.
13:45 Okay, so you have it, how to get through guilt and shame when it comes to moving your older loved one into a senior living community. I hope that you give at least one of these strategies to try and comment and let me know which strategy you plan to use, or have used.
14:04 That's all for today. Now it's your turn. All you have to do is subscribe, leave a review and share this episode with others so that they can be part of the conversation to. One last thing: A special thanks to Jhazzmyn Joiner our psychology of aging podcast intern for all you do.
14:23 Lots of love to you and your family. Bye for now.
I'm Dr. Regina Koepp
I'm a Board Certified Clinical Psychologist and Gerontologist specializing with older adults and families! As founder and CEO of Gero Champions, LLC and the Psychology of Aging Podcast, my mission is to help mental health and senior care providers meet the mental health and sexual health needs of older adults using up to date, evidence-based, and culturally thoughtful care.
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