caring for elderly family

Illustration: Julien Pacaud

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You're Doing Fine
When a friend of mine was dying, she said something I'll never forget. "Guilt is useless," she began. "If you did something wrong, let it go. If there's something you're doing wrong now, do better. If you can't do better, forgive yourself. I want to die in peace. The last thing I need is for you to drag your guilt in here."

Being a caregiver is hard. Being a caregiver burdened by guilt is immeasurably harder. That burden affects the quality of care, which creates still more guilt, and so on, until everyone gets so miserable, they just sit around drinking.

Guilt may seem to be an uncontrollable force, the result of factors you can't change. But guilt originates with us, not our situation. It wells up from our own judgment that we've done something wrong. Guiding a loved one through the final chapter of his or her life is a task so hard it weakens your ability to see your behavior objectively. The result: lots of guilt.

To let go of the guilt you feel as a caregiver, you must be kind to yourself, and you must befriend three things many of us would prefer not to: death, our limitations, and the structures we depend upon for help.

The most crucial of these steps—acquainting yourself with death—flies in the face of our socialization. Our culture sees illness, decline, and death as evil opponents. We encourage one another to think this way. Fight cancer! Rage, rage against the dying of the light! We celebrate stories of people who remain vital, healthy, and sexy—yes, sexy!—long after most folks their age are pushing up daisies. Hooray!

Except then they die.

But only always.

By contrast, consider traditional Tibetan culture, in which children are encouraged to ponder their own demise, where the word for body can be translated as "something you leave behind," and where revered teachers like Gyalse Rinpoche advise, "If you have got to think about something, make it the uncertainty of the hour of your death." Does that upset you? Then you're at war with one of the few certainties in life.

You must also make friends with your limitations. Start by honestly assessing what you are capable of, and I don't mean in some ideal world where you're always rested and you have all the money and time you need and the sun shines upon you forever and ever. I mean be honest about what you can accomplish on a bad day, when you're tired and sad. Treat this most limited version of yourself with the kindness you'd show an overtaxed friend. Sit yourself down. Pour yourself a cup of tea. Cry.

Having a support system is also necessary. Nobody should even try to attempt this alone. So ask for help. Almost anyone can do something—bring food or flowers, stop by to visit. Be grateful for the help you receive. Be kind to the doctors, nurses, and administrators you meet. Dealing with systems that exist to support the elderly can be infuriating, so if you lose your temper, forgive yourself. But remember that it's as easy to say "Thank you" as it is to say "Screw you," and the effects are worlds apart.

Befriending what is unavoidable—mortality, your limitations—and availing yourself of whatever aid you can find may require a hefty shift in perspective. But supplanting fear with friendship can, at the very least, allow us to tolerate what we once thought intolerable. And at best, it can transform despair into peace.

— Martha Beck