Many of us are aware of the various stages in the bereavement process, denial, anger, bargaining, depression and acceptance. But what is not so well known are the various stages in care-giving.
As part of family life we are called at various times to take on the mantle of carer. Many of us first experience this role as parents but depending on particular family circumstances there are many who are called to take on the role of carer from a very young age.
There are even people who do not recognise or see themselves as carers. ‘This is just the way life is’.
Last week I spoke with a woman who through her own experience of caring for her daughter has become a strong advocate for all carers. This inspiring woman gives generously of her own time in connecting and supporting carers throughout Donegal.
“What I would like is for carers to recognise that there are various stages in care-giving,” she said.
“I feel it is really important for each and every one of us to be aware of these stages and of the need to look after yourself as well as your loved one.”
The first stage is ‘Shock and Mobilisation’. When a loved one is diagnosed with an illness or a disease, many unanswered questions come to the fore. “What does this mean, short term, long term, should we go for a second opinion? The carer learns to how to ‘fight not flee’.”
The world that was is now replaced by what seems to be a life of uncertainty. A ‘new normal’ is created. At this stage it is important for the carer to do pleasurable activities not related to the dependent one.
The next stage is the ‘Boomerang’. The original illness comes back or there are complications from treatments. These new challenges draw on the strength of the carer. Complimentary and non-medical treatments may help re-energise and enable the carer to reduce stress levels and boost the immune system.
‘Playing God’ the carer has to learn that many aspects of life are out of their control and serenity comes from accepting this reality.
The carer is charged with providing all the necessary duties of daily living, cooking, washing, feeding, dressing, driving etc. The carer may begin to experience fatigue, insomnia, even panic attacks.
The carer at this stage often becomes the only person the caree trusts. The carer through time may begin to question their ability to carry on. He or she is experiencing ‘burn out’ and may feel ‘I can’t do this anymore’. He or she may even wish for an illness that requires hospitalisation, so that they can get some rest. At this stage the carer urgently needs to get help, to arrange for breaks either from family, friends or respite care.
Some carers dismiss self-care as being selfish, but self-care is vital for survival. “It is not thinking about yourself more, it is thinking more of yourself”. This allows for a further stage, ‘The Coming Back’. Laughter, faith, taking time each day for self-care will greatly benefit the carer.
‘The In- Between stage’, is the time when the carer recognises their loved one is not going to get well. This period can extend over a number of years and what is important is that the caree makes decisions relating to his or her future and what goals they want to achieve. Very often at this stage a programme of palliative care can be put in place.
During the final stage, ‘The Long Goodbye’, the carer has to finally accept that their loved one will pass on. It is a time when both the loved one and the carer can be supported by family, friends and the relevant health professionals. To be a loving presence for both the living and the dying is a privilege and a gift which is bestowed on all.
These Eight stages of Care-giving were identified by Journalist Gail Sheehy who cared for her husband for 17 years.