A stone fence in downtown Marlborough/Photo by Douglas Flynn

Setting boundaries is a technique to help maintain the scope of caregiving to those areas agreed to and not to let the ever increasing needs or pressures by others, intentional or not, overtake caregivers with additional tasks or emotional encounters they do not want or are not willing to tackle at this time.

How does a caregiver accomplish this? First, the caregiver needs to work through what aspects of caregiving they do wish to take responsibility for and what their personal overall health needs are so they can establish the boundary.

Once the boundaries are set there is additional energy needed to maintain the boundary. Sometimes this not only needs to be stated, but then defended and justified over and over again to various people, even to oneself when negative or self-doubting thoughts surface and create feelings of guilt. This is where your emotional support team can be of vital assistance by listening, giving permission and reminding the caregiver of the sacrifices already made and the importance of maintaining the caregiver’s health and endurance.

Common Scenario: A decline in the care recipient’s health ends up with the hospital discharge planner looking to the caregiver to take on a new list of tasks that the care recipient is no longer able to complete independently, such as bathing.  This is a very important time to review boundaries and maintain the ones the caregiver wishes to keep. If the caregiver really feels uncomfortable bathing a parent it is appropriate to advocate and ask for the visiting nurse to come to the home for bathing assistance over the short term and then look for other resources/programs for the long term. Too often caregivers just accept doing more and deplete themselves to the point of ill health because people expect it. It is not common practice yet to take into account the needs of the caregiver as part of the care plan from the onset.

Setting and maintaining boundaries are skills that take time to learn. Practice with situations or tasks that evoke a low-level emotional response and work up to the more intense encounters with people or tasks that evoke an intense emotional response.  Learning any new skill is easier when the caregiver is not in crisis, so start early to give time to develop this technique. Applaud efforts and the courage exhibited in trying no matter how the first attempts turn out. Practice will improve the results and help maintain health and decrease resentment over the years to come.

Contributed by Leslie May-Chibani©2014

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