Wednesday, 3 April 2013

Caregiver Wednesdays- Boundaries pt.1

"Good fences make good neighbours." said the poet. Maybe his neighbour said it, too.

I have no fence on my front yard, and my neighbour and I share the space. Their kids run over my part and my dogs run over his. We both make it work, and it's not a big deal. Why? Because we spend very little time in the front yard. We use it to come and go, but seldom sit out there.

The back yard--now that's another story. In the back yard, we barbecue, and they have parties and we sit and watch the stars and their kids play. The back yard has a solid, six-foot fence, Good fences make good neighbours.

I've never been good at boundaries. Boundaries can mean confrontation, and I hate confrontation. But in a caregiving relationship, boundaries can mean the difference between being able to continue at this demanding task or falling apart. There are times when it's appropriate to say "no" or to ask someone to help or to look for other ways of doing something. The subject of boundaries is closely related to last month's topic of caregiver stress. The caregiver who has not learned when it is appropriate to establish a boundary is a stressed caregiver. You can't do it all.

What makes it so difficult is there are no hard and fast rules. Unlike fences, boundaries can move. They aren't the same for everyone, or every day. Caregivers know that the situation changes--sometimes daily. Some days are better than others, and your loved one can do more. Boundaries in caregiving have to be flexible. But you must have them.

Vicki Racker, MD, in an article called Setting Limits as a Caregiver, says, "most caregivers are more effective and open-hearted when they know where their boundaries are, and they protect them. With boundaries, we can find personal renewal while caregiving, and find the strength to cope when life gets chaotic."

How do you know when to set a boundary? What might it look like? How do I know if it needs to change? How do I deal with the guilt I feel?

These are all topics we will explore, but I will end with this story, which illustrates that there are no absolutes.

When I was caregiver for my husband, it got intense at the end. He was in hospital, sometimes for weeks at a time, and I had to keep working. We needed my income. During his last hospital stay, he was moved to the city. I worked all day, and then go to the hospital. I picked up something to eat and took it to his room, where we shared the next few hours. Then I would take transit home (an hour's trip) and begin it all again the next day. Up at 5:00 am, commute to work, work all day, to the hospital, visit and home. Obviously, I couldn't keep that up forever.

During that time, I had the strong sense that I needed to be at the hospital every night. He was alone all day, and those few hours were his oasis. Even when the kids came to visit, I still wanted to be there. I was exhausted. Wisdom would say I needed to set a boundary. My heart said I needed to keep going. What I didn't know was that we were experiencing the last few weeks of his life. Those moments together were precious and important, and I'm glad I did it.

Set boundaries, but listen to your heart.

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