Thinking Ahead to a Caregiver Role
12 essential steps couples need to take now to ease caregiving transitions in the future
By Ed Shanahan
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As couples age, one partner often winds up playing caregiver for the other. It's a simple fact of life, and one backed up by the numbers. Of the estimated 44 million people in this country who identify themselves as caregivers, some 14 million serve as caregivers for a spouse — a figure certain to swell as the baby boomer generation continues to mature.
Once one partner assumes the role of caregiver, the dynamic of the relationship can't help but change. And while it's not an easy transition, it can be a successful one. The key is to start now and plan together how you will deal with every issue involved in caregiving. You can't always predict who will be the one needing help and who will be providing it, but there are plenty of ways to strengthen the abilities of both to rise to the occasion.
Share your concerns.
It's never too soon for couples to begin talking frankly about the way they want to handle various decisions as the years pass. Donna Schempp, program director for the Family Caregiver Alliance, calls this the "what if" conversation. "What would you want me to know if this happens, what would you want me to do?" Talk in the most concrete terms possible: What if you're confined to a wheelchair? Be clear about what you agree and disagree on. And remember: It's an ongoing dialogue, not a one-time-only conversation.
Consider your surroundings.
Is the home where you live now the place you want to be for the long term, even if one of you gets ill? "Do we like it here and want to stay here, no matter what?" is the way Eleanor Ginzler, AARP's vice president for livable communities, frames the question. If so, will the house meet your future needs? The most important factor: Is there the potential for first-floor living, meaning a full bath and a room that can serve as a bedroom? And if eventually you need to consider some kind of assisted living, start researching options now — including what you'll be able to afford. Remember, Medicare won't cover everything.
In many relationships, spouses have defined roles: He handles the money, she cooks the meals. In anticipating a future when one of you is the caregiver, you'll need to find ways to enable one person can handle everything. "So many people end up in trouble because one person doesn't know how to do what needs to be done," Schempp says.
Learn about your partner's condition.
You need to be well informed about his or her medical condition: medications, doctors, test results, upcoming screenings. Don't wait until you're in the throes of caregiving to learn this information. By that time being in the dark about your spouse's illness can be potentially dangerous.
Protect your own health.
"If you don't take care of yourself, who's going to be there to take of your husband or wife?" says Deborah Halpern, communications director of the National Family Caregivers Association. Caregiving in itself can take a heavy toll. According to the National Academy of Sciences, family caregivers who experience extreme stress can have as much as ten years shaved off their own life. So it's imperative that you make your physical, psychological, and emotional health a priority.
Make it all legal.
In the event of incapacitating illness, you'll need to have the legal authority to act on the plans you've made as a couple and to pay the bills or execute any legal documents that arise. Make sure that your wills, living wills, advanced health care directives, and any other documents you need are properly executed now.
Get what you're due.
There are a host of services, from government and nonprofit sources, available to caregivers. AARP has a wealth of resources on its Web site (), as do the National Family Caregivers Association () and the Family Caregiver Alliance (). Another great resource for finding out about services in your area is the eldercare locator, which is searchable by zip code. Find it at eldercare.gov or call 866-677-1116.
Believe in yourself.
When it comes to caring for another, especially someone you love, it's important that you feel confident in what you're doing, Halpern says. "If you don't believe your decisions are right, you're setting yourself up to fail right away," she says. "You've got to believe that your gut instinct is what's best for your loved one." Having plenty of "what if" conversations now can help boost that essential self-assurance later.
Call for help.
Just because you're the main caregiver doesn't mean you have to do it all alone. Children can help; family and friends can, too. You can seek assistance at your house of worship, a community center, or a local charity. "When caring for your husband or wife," Halpern says, "it's not a sign of weakness, it's a sign of strength to reach out for help."
Speak up for yourself.
Whether it's the spouse that you're caring for or the doctor trying to rush you out of his office, you've got to make your own needs known. "Set down some ground rules," Halpern says. "Say, 'You know what, I need 30 minutes for myself.' Or you may want to say to your kids, 'I need help.' If you aren't clear about your needs, stress and unhappiness will build."
Recharge your friendships.
It's a common caregiver complaint, Schempp says: "I've lost my best friend, I've lost the person I can talk to, the person that I did stuff with." Over time, couples grow to rely on each other so much that when the dynamic shifts and one person isn't able to provide all they could in the past, the other is left facing a major void. It's wise to think now about strengthening social ties beyond those you share with your spouse or significant other.
Start living healthier now.
Finally, it's important for couples looking to the future to do "all the boring stuff," as Schempp calls it: eating right, exercising, getting enough sleep. Taking these steps won't just improve the quality of your life now, but will reap benefits for years to come. It's helpful to remember that if someone else is going to be relying on you, you'll want to be the best version of yourself that you can possibly be.
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