A caregiver is any person who takes primary care of another person, either permanently or temporarily. Usually, it is a relationship for which there has been no planning, and anyone can become a caregiver.

Why Is A Caregiver Needed?

When a person cannot live independently, help is needed. Because of the nature of their condition, some people may find that their overall physical health is deteriorating. It is with great sadness that a loss of ability is acknowledged. After all, who is willing to admit that they can no longer drive a car? Walk? Go to the store? Prepare their own meals? Toilet themselves and take care of other personal needs?

Accepting care isn't easy, even if the person who needs the care realizes they can no longer function as before. Letting someone take over can make the person feel dehumanized and humiliated.

How Does A Person Become A Caregiver?

There are really only two ways by which a person becomes a caregiver: By decision or default. A caregiver may decide to help. Wanting to help and being able to help may be different answers to the same question: Can you help take care of this person? Again, the longer the care will be required, the harder the decision is.

A caregiver can decide that yes, there will be enough time, energy, money, and patience to help. It usually isn't a question of enough love, although outsiders often see it that way. Many people in this position are confused by guilt and feelings of obligation that are hard to sort out. In the end, it doesn't matter what the neighbors think or the rest of the family expects, but rather what is workable for the recipient of the care and caregiver.

A caregiving relationship that is thought through in advance has a good chance of success because everyone involved knows what to expect and most of the difficulties have been anticipated. This is true regardless of the caregiver's position as a family member, friend, paraprofessional, or professional, and whether the caregiver is paid or unpaid.

Caregiving By Default

Most of the horror stories about caregiving---including abusive, guilt-laden, and financially disastrous relationships---are rooted in caregiving situations where one or more of the people involved were unwilling participants. These are the caregiving situations that developed or "just happened" because "there just wasn't anyone else" or "there just wasn't any other way."

A caregiver can find himself or herself in this situation because of limited financial resources, geographic limitations, a family commitment, lack of anyone else to do the job, or a hundred other reasons. This also occurs when short-term caregiving unexpectedly becomes long-term care. Like it or not, these caregivers have to make the best of a difficult situation.

The person who accepts caregiving by default usually has no other choice. It seems, at the time, to be the only solution to a very difficult problem. Regardless of the genuine feelings of affection for the person needing care, the caregiver is placed in a difficult position. Against his or her will, the caregiver may have to share the illness to the extent of personal sacrifice or hardship. This pressure gets the relationship off to a poor start, and can keep generating negative feelings.

A default relationship would not be as troublesome if our Western culture venerated the extended family more. In cultures that revere both distant cousins and great-grandparents, taking in one or more family members is not as big a concern. Because there are more people in the house, caregiving does not fall on just one or two people, either.

Understanding The Caregiver

For many caregivers, they soon realize that the romantic notions of caregiving conceal a more grim reality. Caregiving is not always selfless love transferred to another individual in need. In fact, caregiving can be difficult and exhausting.

There is little glory involved in being a caregiver. It requires a great deal of guts. No type of care is exempt from the caregiver's able hands. No chore is too basic. When total care is required, the responsibilities may range in a single day from doing the wash or cleaning up a bowl of spilled soup to giving a shower or providing toilet help.

Caregivers quickly learn to eat when the person they are caring for eats, to sleep when they sleep, and to do the chores in a mad rush between it all. Few caregivers are praised. Few want glory. Most want just a little more help and a good night's sleep.

Certainly many people who care for a loved one would not think of having it any other way. They care so much, and it hurts to see their loved one suffer.

Still, there is a considerable toll taken from these people. It doesn't matter how much you love the person you are caring for, a caregiver is still likely to become exhausted and drained. It is not an easy job.

Sometimes, Caregivers Feel Trapped And Angry

It is difficult for a caregiver to separate himself or herself physically from the care receiver. Often, there is little or no opportunity to do so. Some caregivers feel guilty to admit it, but after a while, they feel trapped by their new responsibilities.

In the beginning, it may not seem difficult to be "on call" 24 hours a day, seven days a week. But soon, each day seems like a week long. As exhaustion creeps in and the caregiver feels more and more alone, they may begin to feel tremendous anger. This may result in an outpouring of fury and resentment.

Anger is a normal emotion, and it is certainly understandable in this situation. However, if left to fester, it will become uncontrollable and begin to affect every other aspect of the caregiving relationship. The internal stress the caregiver feels may cause him or her to become ill themselves.

Surprisingly, the problem of anger becomes even more difficult to deal with if the person receiving the care is still mentally capable. When this is the case, overwhelming guilt on the part of both caregiver and care recipient can ensue. After all, the recipient never intended to be the object of someone else's care. Guilt seems to beget guilt.

(c) copyright 1993