When One Parent Is Caring for the Other

Quick summary

If one of your parents experiences a health crisis and the other is healthy, your role in the caregiver equation is still an essential one. As long as your healthy parent is willing and able, she'll likely be the primary caregiver -- but she's still going to need your help and support.

Caring for the caregiver

In her book How to Care for Aging Parents, Virginia Morris points out that when a parent falls ill or is diagnosed with a serious disease, everyone tends to focus on that parent. But your healthy parent also needs your attention -- now and in the days and months ahead.

In a crisis situation it's natural for loved ones to be concerned about the patient. If your father has just been diagnosed with cancer, for example, or suffered a stroke, your first concern is bound to be for him, ensuring that he get the best possible care. This will be your mother's primary concern as well, and she's apt to neglect her own health and emotional needs as she focuses on your father. The best way for you to help both your parents is by caring for the caregiver as well as the patient.

• Consider your healthy parent's experience. It's important to realize that while your ill parent faces a physical crisis, your healthy parent faces a crisis almost as profound. If your mother has just received a terminal cancer diagnosis, for example, your father must come to grips with the fact that he's losing his life partner, as well as their dreams for the future. If your mother has been diagnosed with a condition like Alzheimer's or Parkinson's disease, your father could face years of care giving -- and the prohibitive financial pressures that go with it. You can't change this reality, but your empathy and reassurance will help your parents face the difficult times ahead.
• Promote nutrition, sleep, and exercise. A health crisis triggers adrenaline in everyone involved, and it's easy to forget to take care of yourself. Try to make sure your healthy parent is getting enough sleep; eating regular, nourishing meals; and exercising whenever possible. If your father is hospitalized with a heart attack and your mother doesn't want to leave his side, offer to stay with him for a few hours each day so she can go home to shower and take a nap. See that she gets out regularly for a brisk walk in the fresh air. Bring her special foods or protein shakes if she's skipping meals, and consult her doctor is she's having trouble sleeping. If she resists eating or taking breaks, remind her that she won't be any help to your father if she gets sick, too.
• Expect some denial. Don't be surprised if your healthy parent seems to be in denial about the gravity of your other parent's health condition. For example, your mother may mention plans for a trip to Tuscany next summer, even though your father just suffered a major stroke. It's likely that she hasn't yet fully absorbed the impact of the blow she's received. Gently remind her that she doesn't have to make any major decisions until she learns more about your father's prognosis.
• Encourage her to discuss her feelings. Whatever the nature of the health crisis, your healthy parent is probably in shock and groping to understand the nature of her spouse's condition. She may also be beginning to think about what's in store and to comprehend the devastating loss she's suffered. In a quiet moment, check in with her about how she's doing and offer to be a sounding board if she wants to talk through her grief, her fear, or her plans for the future. Help her tap into resources in the community, including eldercare services and hospital support groups.
• Let her talk even if it hurts. As much as you want to provide support, you may find that it's painful to listen as your healthy parent expresses fear and grief over your other parent's condition. You're experiencing your own grief, which makes it scary and threatening to hear about hers. Resist the urge to change the subject or end the conversation quickly. She needs to express her feelings, and you're likely to find that sharing yours brings you closer -- and comforts you both.

How you can help day to day

When the health crisis has passed and your parent is in a stable situation, either at home, in the hospital, or in a nursing facility, your healthy parent will need you more than ever.

• Offer to help -- and keep on offering. You may find that your care-giving parent declines your offers of help, either because she prefers managing on her own, doesn't want to inconvenience you -- or a combination of both. If this is the case, try proposing a few specific tasks that you could take over to ease her burden a little. For example, suggest that she give you a grocery list every week so you can pick up provisions for her when you do your own weekly shopping. Or bring a meal by once or twice a week so she won't have to worry about cooking.

If she likes to run her household her own way, she may be more open to help with your father's care. Offer to take your father to his medical appointments, make arrangements for his treatments, or simply have lunch with him once a week so she can do errands. If you live far away, visit home frequently and arrange to stay with your father for a few days at a time to give her regular breaks.

If your mother continues to refuse help, bring up the subject a little later. She may be more willing to accept help after she's settled into a care-giving routine and your father's condition is improving.

• Stay in close touch. Whether you live down the street or across the country, it's important to stay in close touch with your healthy parent. Call regularly, and set up family conference calls if you and other family members live far from each other. Visit as often as possible to give her company and support.
• Keep channels of communication open. Make sure your healthy parent knows you want to hear how she's doing. When you call or drop in, don't just ask how your father is. Find out how her day went and what her concerns are. Try to draw her out and encourage her to complain, grieve, or express anger if she wants to. Communicate your appreciation for all she does for your father, and let her know that you think she's doing a good job.

What to watch out for: Signs of burnout

Care giving is extremely stressful and exhausting. According to the Family Caregiver Alliance, depression among caregivers is twice that of the general population, and burnout rates are also high. As the caregiver's caregiver, you should watch out for these red flags so you can help your healthy parent avoid burnout:

• Symptoms of depression. Depression symptoms can include sleep problems (sleeping too much or too little), loss of appetite or overeating, lack of interest in usual activities, unexplained physical problems, and irritability.
• Health problems. If your healthy parent starts to have health complaints, it could be a symptom of exhaustion, depression -- or both.
• Resentment. As the primary caregiver, it's normal for your healthy parent to feel occasional frustration toward her spouse, but excessive or irrational resentment could be a sign of burnout. For example, if your father has Alzheimer's and your mother seems to constantly nag and criticize him for forgetfulness or clumsiness, that could be a sign that she's overwhelmed and exhausted.

What you can do:

• Take signs of burnout seriously.
• Make sure your healthy parent gets enough breaks and support.
• Arrange for regular respite care.
• Help your parent find a caregiver support group.
• Suggest that your parent consider joining Well Spouse, an organization that provides information and resources for the spouses of those with serious health conditions.
• If your healthy parent is overwhelmed or exhausted, brainstorm with her about whether it's time to hire a regular in-home caregiver or make other living arrangements. Your local agency on aging or a geriatric care manager can help you sort through available resources and options.