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Caregiver Guilt is Good
by Vicki Rackner MD

Mary said, “I feel guilty all the time. When I'm with my father, who just went into a nursing home, I feel guilty I'm not with the kids. When I'm with the kids, I feel guilty about neglecting my husband. And when I take that occasional trip to the gym, I feel guilty about letting everyone down.”

Guilt is a common feeling in the landscape of caregiving. Guilt can propel you to be the best you can be…or it can immobilize you.

Dark feelings, like guilt, sadness and depression are all real and normal for caregivers. These painful feelings serve the same function as any other pain you experience. It's your body's way of saying, “Pay attention.” Just as the pain of a burned finger pulls your hand from the stove, so too guilt and other painful feelings can help keep you safe, guide your actions and optimize your health.

You have a picture of who you are…what values you hold, how you relate to others and how you conduct yourself. Let's call this person the “Ideal You.” Guilt often arises when there's a mismatch between your day-to-day choices and the choices the Ideal You would make.

Your actions may not be in line with the Ideal You. . Actions not aligned with values can cause guilt. Your Ideal You may be the kind of mother who attends all of your kids' soccer games. When you miss a game to take your dad to the doctor, you're falling short. You may have needs that are not in line with the Ideal You. Your Ideal You may not need to eat, sleep or exercise. You then feel guilty when you even recognize those needs, much less act upon them.

You may have feelings that are not in line with the Ideal You. You might feel angry about the injustice of your loved one's illness. You might even feel angry at your loved one for getting sick! The result of recognizing those feeling can be a healthy dose of guilt. You may even feel guilty about feeling guilty!

You may long for answers to the question, “Why did my loved one get sick?” You may think that if the Ideal You acted more often than the Real You, your loved one would be healthy. What if you served healthier meals? What if you called 911 instead of believing your husband when he said his chest pain was just “a little heartburn.”

The truth is that you do your best and you did your best at the time.

I would love to offer a magic tip for eliminating guilt from your life. I cannot. If you're the kind of person prone to guilt, your most effective strategy is learning how to manage guilt so guilt serves you rather than imprisons you.

Here are some tips for managing guilt:

Recognize the feeling of guilt. Unrecognized guilt has a way of eating at your soul. Name it. It's like looking at the monster under the bed. Sally said, “Sometimes I feel better just saying to myself, 'I'm feeling guilty about not bringing my brownies for the school bake sale.'”

Look for the cause of the guilt. What is the mis-match between the Ideal You and the Real You? Do you have an unmet need? Do you have a feeling like sadness or anger that you would rather not feel? Do you need to change your actions so they are aligned with your values?

Take action. Get your needs met. If you need alone time, find someone to be with your loved one so you get it! Identify your feelings. Dan said, "I hate to admit this to myself, but I'm resentful that Dad's illness changed all of our lives. Once I put it into words, I told myself this has been tough. And I reminded myself how fortunate I am that we have what it takes to take care of Dad." Change your actions so they're in line with your values. Clara felt guilty because her friend was in the hospital and she didn't send a card because it was hard to get to the store to buy one. Her guilt propelled her to buy some beautiful blank cards so it would be easier to drop a note to a friend the next time.

Ask for help. You can call a friend and say, “I'm going through a hard time. Do you have a few minutes just to listen?” You may want to renegotiate the contributions your family members make Have a family meeting and say, “Our lives have been a lot different since Grandma got sick. I'm spending more time with her. Let's look at the job chart and figure out how we'll get everything done.” It may be time to reassess your volunteer commitments to reflect your new caregiver role.

Revisit and reinvent the Ideal You. Who is this person who is the Best You? What legacy do you want to leave? What values do you hold dear? Then, when you wake up in the morning and put on your clothes, imagine dressing the Ideal You and making moment-to-moment choices that the Ideal You would make.

Copyright © Vicki Rackner MD, 2006

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