My mother's sense of her personal control over her life...
...was on my mind when I awoke this morning. I walked on it, still haven't come to any conclusions, so I'm writing about it.
    When one is a caregiver one's sensitivity to another's sense of personal control over her/his life is one of the trickier areas to negotiate. I realized last night, after writing my last post, that over the last two years I have not been handling this area of my mother's life as well as it could be handled, all the time thinking that I was doing well.
    It was two to three years ago when my mother began saying, "No" regularly to lifestyle changes in order to enhance her health, taking emotional responsibility for decisions she had made such as buying the house in Prescott, accompanying me on errands, visiting relatives and friends, attending business meetings, phone calls and negotiations, paying her bills, bathing on a regular basis, even getting out of bed in the morning. Being her companion and taking into account her age, as each of these hurdles appeared I took responsibility for clearing those that required action and allowed her the choice of no action when the hurdle was something that required only her action, such as appearing physically in the world beyond our homes. My reasoning has been that there are areas enough in her life where her control necessarily needs to be augmented by my involvement (in many cases, heavy involvement, such as her decision, in 1997, to buy a 'summer home' in Prescott) in order to protect her and make sure her decisions unfold felicitously as much as possible. Thus, I felt that she had a right, and I had a duty, to allow her to make what decisions and take what action (or non-action) that still lay within her grasp.
    As I look back I realize that allowing her to say 'no', in many cases, undermined her physical, mental and emotional health to the point that we have spent the last year negotiating crises in all these areas. As I let her refuse changes to a healthier, less sugar laden diet, as I allowed her to give in to her lethargy, as I chalked her decreasing involvement in the wider world up to her natural, life long tendency to keep her circle of family close around her in lieu of neighbors and friends, as I accepted her decisions not to accompany me on personal business appointments involving her affairs, I think I also undermined her ability to be present in her life.
    Both of us, especially me, have been very lucky. Within the past few months it appears as though much of what I allowed to occur in the name of preserving her personal sense of control over her life is reversible. Aside from learning an astonishing and valuable lesson about the resilience of Ancient Ones, I am grateful that I got a wake-up call late last summer that I could not ignore in the form of her health crisis.
    Now I am finding that I am having to internally scramble to redefine how to make sure that, as her sense of her life revitalizes along with her body, I do not, once again, take steps that insidiously undermine her sense of personal control over her life. I'm still not sure how to do this. For the last two and a half years gentle reasoning has not worked with her so I've begun to narrow her choices. I no longer ask her if she wants a salad at dinner, I prepare one for her and inform her that she must eat it (and she does). When we are in the store and her sugar detector locks onto a sweet treat I no longer explain the consequences of her choosing to buy and eat this treat, I say, firmly, as I did yesterday, twice, at Costco, "No. We're not playing the sugar game, anymore. We played that for two years and we almost lost." When she begins to try to turn her day into one long snack, even though the snacks we now stock are all healthful, I no longer struggle to try to figure out how to administer her diabetic medication under adverse circumstances and still have it do some good. I monitor her snacking to accommodate the requirements of her medication. When she decides to spend the entire day in bed I no longer allow this, even if I have to use physical influence (such as gently moving her body into a sitting position on the edge of the bed or catching her as she's heading for the bedroom and turning her around). When she complains that she is bored and thus has a right to give in to that boredom in bed, I tell her that she can be bored just as easily in her rocking chair as she can in bed and it's healthier for her to sit up. When she awakens in the morning not wanting to move around I remind her, firmly, that every time I've forced her to get up, bathe, eat, get dressed and accompany me on errands she has felt better and been grateful to me for having done so.
    Yet I still feel as though I haven't discovered the secret to allowing my mother the dignity of feeling personal control, even as her ability to control her life diminishes. I have an advantage, of course; I am her daughter, we know each other intimately, truly enjoy each other's company and characteristics, thus I have a well stocked collection of personal resources I can peruse to find the best, most potentially cooperative (rather than dictatorial) avenue toward this goal. I am nowhere near mastery of this task, though, and sometimes I wonder what mistakes I am making of which I am unaware and that have the potential to usher in another crisis. I'm trusted more than someone outside her immediate family. This, though, doesn't always work for us, as I am also the one in her immediate family, being her live-in companion, whose opinion and suggestions she is least likely to consider, being so familiar with them.
    We, her daughters, spring from relentlessly independent stock. It is more than preference that each of us clings to our insistence on keeping our own counsel, making our own decisions and resolutely living with the consequences without apology or regret. It is a matter of early training and, I think, genetic design. And now I am having to confront the source of these life strategies head on in my mother and negotiate around them in order to enhance the quality of her life and, in some cases, continue her life from day to day. On the one hand, the task is daunting. On the other, I believe that it is precisely my mother's strong sense of independence, individuality and self-possession that keeps her from, for instance, giving in to what could have been a fatal blood pressure crash almost a year ago.
    If you think caregiving is a matter of following a set of rules set by professionals without factoring in the uniqueness of the person for whom you are caring, you need to think again.
    The dilemma continues, amazingly, so does the exhilaration and, appreciatively, her life and mine continue...
- posted by gail rae @ 06:12   email...this post