This is one article in a series about long-term caregiving.

Each of us is born into a social environment. A family of some kind. From birth, we are immediately in relationships. We are immediately interacting with others. We can not survive alone. We depend on some persons to take care of us for years before we leave home. And, as we grow older, we are involved in many kinds of relationships. Some are more valuable to us than are others. Some are short term. Others last our lifetime, or their lifetime.

Each relationship has several distinct parts. The first is dependency. We depend on. And, we are depended upon. And life is about what we and others do in these relationships. The give and take. The habits and routines we develop with other persons. We live connected.

A second part of a relationship is expectation. What we expect from the other person. And what they expect from us. Sometimes these expectations are not equally shared. Sometimes they are disruptive. Sometimes they simmer in the background. Sometimes they become sources of open and personal conversations that can improve the relationship. The unspoken becomes spoken.

A third part of a relationship is change. Sometimes expected. Other times not. A change that may be very significant to one, and not equally so to the other. Yet, part of being in a relationship. All relationships, including caregiving, contain unavoidable dependency, expectations, and change.

Those of us who have done long-term caregiving were not at all prepared for the changes in the relationship with our sick loved one (parent, spouse, sibling, etc.). And these changes significantly influenced the dependency, and the expectations that were to come. And, those of us who are now caregivers face these same challenges. One difficult challenging change is when the former “independent” loved one becomes RESTRICTED physically and/or mentally in making decisions, and doing self care, and living a normal life, and participating in the usual habits and routines that once existed in the relationship. This shift in dependency can be very complicated and can create ongoing stress on the caregiver.

Fortunate is the caregiver who has a positive and loving relationship with the sick loved one, and together they face the changes and they deepen their love for each other. Together they accept unavoidable demands, and they commit to adapting to what is happening to them now, and what is to come. Unfortunately, not all family relationships are positive and loving. And health changes bring this out. For example, a woman came to me for counseling about her guilt. A strong and disturbing guilt. About her mother, now in poor health in a distant city. She said “She was “NEVER a mother to me, and now as the only child I must take care of her, and I do not want to. And, I feel very guilty about that.”

Long-term caregiving brings many changes, and the most difficult can be in the established relationship. These changes in dependency, expectations, and embedded feelings and attitudes must be talked about. Put on the table. Faced openly. Lest they spawn bitterness, resentment and other negative reactions.

However, some long-term caregiving brings relationship changes that cannot be talked about with the sick loved one. In these situations, caregivers can benefit from participating in a Support Group. Also, personal counseling is another way to process the impact of the changes.

Either way, regular talking confidentially can bring much needed emotional and mental relief.

About the Author

Hugh Burns is a Licensed Marriage and Family Therapist and an ordained clergyman in the PCUSA. Hugh graduated from Presbyterian College and Columbia Theological Seminary. He leads DPC’s Caregivers Support Group and has previously served as a Clinical Chaplain in a mental health center and a hospital. You can reach Hugh by email, at rhburns@protonmail.com.