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One Crises Away From Getting Help
Pamela D. Wilson - Caregiver Subject Matter Expert Pamela D. Wilson - Caregiver Subject Matter Expert
For Immediate Release:
Dateline: Denver, CO
Wednesday, February 22, 2023


The Caring Generation® – Episode 161 February 22, 2023. How to know if you are a caregiver who is one crises away from getting help? Learn tips for managing day-to-day caregiving tasks and minimizing unexpected situations when caring for aging parents, spouses, and loved ones. 

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How do you know if you are one crises away from getting help? Family caregivers take on a lot of responsibility for caring for loved ones.

Balancing a busy life, including work, family, school, and caregiving can result in doing the things that need the most attention. But these churn and burn activities may not be the most important.

The risk of focusing on immediate tasks is that aspects that might not be a hot priority may result in problems in 3, 6, 12 months, or in the future. After all, there’s only so much time and brainpower to go around in the day.

Caregiving responsibilities can result in physical and mental burnout. So how can family caregivers avoid crises by considering longer-term issues while juggling everything that must be done today?

Let’s look at aspects that families and caregivers must know about to avoid being in crises away from getting help. Talking about getting help, needing help, or asking for help are not popular topics.

Caregiver Routines

People I know do not like asking others for help. Being self-sufficient and able to do what you want when you want to do it without needing help from others is how most people want to live their lives.

For example, look at your aging parents. While they may need your help, deep down they may be embarrassed about needing your help or may feel like they are a burden.

The involvement of a caregiver may change the daily routine of an aging parent. This happens when loved ones wait for you to become available to take them to the grocery store, to a doctor’s appointment, to pick up their prescriptions, do their laundry, and so on.

These are all routine tasks that elderly parents may have done independently for years without involving anyone else. The concept of relying on others is no different for adult children who become caregivers.

When your routine changes, you may need help from a spouse to pick up the kids from school because you must leave work and go to your parent’s home to care for them. If you have siblings, you may talk about your parents and how their health is failing.

The Responsible Child

If you are caring for aging parents, you were probably the first child to jump in and start helping without initiating discussions with your sibling or talking with your parents about the effects on relationships.

Accepting caregiving responsibilities affects life. And depending on your cultural background, caring for elderly parents may be assumed. So, discussing who will be the caregiver is not seen as a topic of debate.

You may be the assumed caregiver if you are the daughter of aging parents. This family designation can feel unfair if you have been advancing in your career, going to college, or investing time in other parts of your life.

By becoming a caregiver—all of a sudden like night and day—your life changes because you are now responsible for meeting your parents’ daily needs. And if you’re new to caregiving you may be wondering what’s wrong with a parent’s health.

Activities of Daily Living (ADLS) and Care

Let’s talk about how caregiving begins and the impact of ADLs on time and relationships. ADLs is an acronym used by the healthcare system that means activities of daily living.

These are the first areas that arise specifically for elderly parents needing care and caregivers being one crises away from getting help. The physical and mental body flourish in the absence of stress.

Human beings, like wild animals, experience everyday threats that result in stress. Basic things like experiencing hunger and the need to eat, gather or hunt for food.

Millions of years ago, daily survival depended on hunting, raising food, and farming. Today these activities still happen, but most of us do not raise chickens in our backyards. Nor do we raise cows, pigs, goats, fish, or other animals that show up in packages at the grocery store.

Not everyone has space or lives in a climate where gardening tomatoes, lettuce, fruits, or vegetables is possible. But these activities still happen.

Advancements in society have removed the stress of raising and hunting food. But that does not mean that stress related to having a job to purchase food doesn’t exist.

Similarly, most people today can’t imagine life without cell phones, computers, or television, even though daily life was without these products in the early 20th century. You might wonder how these situations relate to being one crisis away from getting help.

Once A Caregiver Always a Caregiver

If you are a caregiver, this might be your first go-around caring for another person. What I will tell you, even though you won’t want to hear it and may not believe me, is that once a caregiver always a caregiver.

Eventually, you, if single, or your spouse, if married, will need care, which means caregivers will be involved in your life. An inability to perform ADLS, activities of daily living alone, or those that correspond with health crises can result in needing care.

A lack of experience or knowledge about the aging body results in being one crises away from getting help. What does this mean?

Not having the knowledge or insight to relate daily activities to physical and mental health that transfer to needing help or a caregiver result in being one crises away from getting help. Activities of daily living include the ability to bathe or shower and complete hygiene activities.

Instrumental Activities of Daily Living (IADLS)

The ability to dress, bend over to put on shoes, button shirts, tie shoelaces, pull up pants, or pull a shirt over your head are activities of daily living. Eating is an ADL that is supported by IADLS.

IADLS (instrumental activities of daily living) is another medical speak acronym that means instrumental activities of daily living. Here are a few examples. Think of IADLs as associated with or supporting life activities.

  • To eat, you must be able to stand and cook or at least put something in the microwave
  • To cook, you must have food in the house
  • Bringing food into the home requires transportation to get to the store
  • Paying for transportation and food requires income
  • Income results from having a paid job unless you inherit money from wealthy parents.
  • Getting a job takes some type of experience, skills, or willingness to learn something new
  • Before being hired, a basic education so that you can read and write and have social skills is usually a requirement

Beyond food in the grocery stores, we depend on ranchers, farmers, processing plants and manufacturers, and transportation services to move goods and services to access them. So as you can see, the ability to access or use goods and services results from the efforts of many people.

These steps and processes are things we do not consider until we become a caregiver for other people. So, when aging parents receive help from their children, they see the end results.

Generation and Life Experience Gaps

one crises awayParents don’t see all of the work or time it takes to get the result or notice the disruption these efforts cause in the lives of their children.

The age gap between aging parents and their children complicates this lack of understanding of what it takes to be a caregiver.

Here’s an example that may make this easier to understand. When I was in my early twenties, I worked full-time and went to college at night, taking 2-3 classes at a time.

Anyone who does this knows that this combination leaves little or no time for outside activities. My Uncle wanted me to visit every weekend and help with a few things and was unhappy that I would not make a regular commitment to visit.

He was retired. He worked in a packing house as a meat cutter all his life, My Aunt stayed at home and managed the household.

Uncle’s job did not require a college education, using a computer, or having a car. He lived in a neighborhood where he could walk to work, the grocery store, or take a bus to nearby shops.

My Aunt managed the household, shopped, cleaned, made food, and did the laundry. So, my Uncle had no concept or fundamental understanding of my life’s stresses and pressures. Even if I explained them, I don’t know that he would have understood because he had no concept of going to college.

I worked to pay for a place to live and everything associated with managing daily life. This included navigating college classes, completing coursework, using a computer, maintaining friendships, and social life.

This is an example of the life and experience gap between older adults and younger persons that we do not think about even when we are caregivers. Here is another example.

My mother managed the money and paid the bills for her and my father. When she dies, I was the executor of their estate, so I went through their financial accounts, health insurance, and everything.

Reviewing the paperwork, I suspected that mom did not know how to balance a bank account because the bank statements had no reconciliation written on the back of the form. Today, most of us do not receive bank statements in the mail.

We receive statements and transact business online. We may have spreadsheets to track expenses and keep a budget.

It was shocking to me that my mom didn’t know how to balance a bank statement even though she appeared good at managing their money. She taught me to manage money and be self-sufficient.

Had I known or thought to ask, I could have balanced the bank account for her every month and been more helpful to my parents. But because my parents lacked the experience and education to know what was possible or how technology had advanced, they did not know to ask me to help.

One Crisis Away From Getting Help

It’s difficult to ask about things you don’t know about or become aware of. So these two examples of generational knowledge gaps and experiences can translate to caregivers and their loved ones being one crises away from getting help.

We are all limited by our life experiences and knowledge. We go through life and make decisions based on these experiences or advice we seek from others.

The gap is that when we become a caregiver, we have little or no experience with what happens as the body ages and health problems begin. As caregivers, we are usually younger and healthier than aging parents or those in our care.

If we have been healthy all our life, then we have no experience working with insurance companies or doctors. It can be difficult, if not impossible, to anticipate what might happen.

These challenges include the difficulties of getting a prescription filled when it’s not on the approved list of an insurance company or the time it takes to resolve an insurance issue. So, what happens is that adult child caregivers do all of this work behind the scenes, and this work affects their physical and mental health.

Too Busy to See What Is Ahead?

Stress and health problems for caregivers result in being one crises away from getting help or needing help. Caregiving responsibilities impact career and work, marriages, children, friendships, and other parts of life.

Being one step away from the next crises is similar for aging adults who refuse medical care, advice, or help from their children when help is clearly needed. Because we keep going we’re too busy to see what is ahead that we can’t anticipate.

As we discussed generational differences that relate to technology, healthcare, transportation and other advanced create knowledge and experience gaps between aging parents, their children, and grandchildren. Then there are experience gaps related to specialized expertise.

Doctors, attorneys, CPAs, auto mechanics, plumbers, and other contractors have special skills. The concept of specialized expertise or education can be difficult to understand until you experience a problem.

You may find a solution and think you have it solved. Then something goes wrong and you realize that you made a big mistake. While thinking back you realize that someone was trying to prevent you from making a mistake, you were too busy to listen, or the information provided didn’t make sense.

Caregiver Advice

In my career as a care manager, medical power of attorney, and guardian, even in the work I do to produce this podcast, videos for my YouTube channel, or manage my website, I meet people with specialized expertise.

Likewise, I have specialized expertise related to managing care and health problems. When you take an interest and learn from others you can significantly shortcut learning curves.

But most of the time here is what happens. Information is received. It’s not viewed as important or relevant.

The information goes over your head, doesn’t make any sense, or doesn’t seem necessary. Until that one thing happens that makes you say, holy moly, I had no idea this was going to happen.

And now you’re one crises away from getting help. I hope that an angel taps you on the shoulder at the right time and makes you realize it’s time to pay attention to this person right in front of you trying to help.

Teachable Moments

You have probably heard the saying when the student is ready, the teacher appears. My suggestion is to be present.

Be open-minded to view every person and every event as a teachable moment. To do this requires being mentally present instead of spinning around in mental chaos unable to notice the small things.

Being attentive to little things, like small changes in a parent’s health or something a doctor says at an appointment allows you to avoid being one crisis away from getting help. Think about your daily interactions at work or in your family and the conversations.

Are there times when you say something, hoping that another person picks up on the fact that you are upset or need help? For example, you don’t want to be pushy, so you hint or give gentle reminders instead of being direct.

Or maybe mom or dad says they’re not feeling well, but you’re too busy to ask what “not feeling well” means. The next day, dad is hospitalized and diagnosed with a heart attack and a stroke.

In my podcast called Words Matter, I talk about surface conversations, paying attention to words, and deeper conversations. Simple chit-chat about the weather or sharing information in the news may pass the time.

Deep Conversations

In relationships that matter between caregivers and the persons they care for, plus medical professionals—the depth of conversations matters to avoid being one crises away from getting help. Caregivers can avoid these conversations because they can take time and effort and feel emotionally exhausting if you’re not a skilled problem solver or communicator.

it’s okay. Learning to problem solve is possible. Becoming a better communicator comes with practice. The person you care for, your parent or grandparents, may not be great at problem-solving or be a good communicator.

Imagine what it will be like 50 or 60 years from now for the children of adults today who rely on texting for communication instead of having verbal conversations or talking on the phone. God bless these children who will become caregivers in a world that’s light years ahead of the experiences we have today.

Whose Job Is It?

So in addition to initiating and having in-depth conversations about caregiving responsibilities, time commitments, and the actual work to be done, it’s crucial to discuss responsibility specific to asking, “whose job is it?”

Caregivers want to be helpful and do more than is necessary for aging parents. The result is parents who become increasingly dependent on their children who become resentful.

This willingness to help shifts responsibility for whose job, is it? Whose job is it to take medications, exercise, and follow doctor’s recommendations? In my opinion, this is the person with the health issues.

If you are a caregiver, you may begin feeling responsible for everything, including what the person you care for does or does not do. In this situation, to avoid being one crises away from getting help, the goal is to become an educator or information provider.

As we discussed earlier, if you are managing care for a loved one and your life and time are being hijacked, it’s up to you to seek information and details to change the situation.

Dual Accountability and Responsibility

one crises away from getting helpCaregiving can present a dual accountability relationship with the caregiver and the care receiver having 50/50 accountability.

This means for as long as possible agree that there will be 50/50 participation in all aspects of care.

This includes information seeking to prepare for the future. As a caregiver when you investigate options give your loved one homework to help with the investigation. Then compare notes.

This process ensures that the caregiver is not continuing to do all the work alone. People must be invested in problem-solving to identify solutions to problems.

Medical professionals can office advice but that doesn’t mean that patients follow through. The stress of caregiving can result in feeling overwhelmed with too much information that may be very  important.

When caregivers take over all responsibilities, aging parents and others sit back and watch instead of remaining attentive and involved.

Then, when caregivers burn out and want to change the situation, aging parents may disagree, express shock that caregivers may be exhausted, or refuse to participate in change.

The Effects of Being Too Helpful

The result is that you are not working together but instead working against each other. Many caregivers find themselves in this situation with parents who refuse medical care or refuse to participate in activities that can be helpful for them and their caregivers.

Caregivers place themselves in unsustainable situations. Being too willing to help shifts all responsibility to the caregiver. As a result, parents avoid discussions or refuse to make decisions. Then caregivers feel guilty for being angry and resentful.

One way to avoid being one crises away from help is to stop being so helpful. Instead, ask who is responsible for this – whose job is this?

Who is responsible for the health problems parents are experiencing? Admittedly, mom or day may not have had the knowledge or experience to know the effects of daily smoking a pack of cigarettes on health.

Knowledge is Wisdom Gained

For example, my mother smoked a pack of cigarettes a day for many years. She died at the young age of 69 from heart disease, gastrointestinal problems, and many other ailments.

She also had a lot of other stressors in her life that contributed to these health issues that were not recognized as negatively contributing to health back then. Today we know about ACEs or adverse childhood events that are life-affecting.

ACEs include losing a parent at a young age, having abusive parents or parents with drug dependencies, or being neglected as a child. Another example is taking on caregiving responsibilities for siblings when young—so parents assign children adult responsibilities.

Children may be bullied in school. Many aspects of being a child can negatively affect health and relationships for an entire lifetime if not recognized.

Events that Tip The Scales

Caregivers may give up healthcare benefits due to life tradeoffs like potentially reducing work hours or giving up a job. It can be hard to imagine or see the effects of stress until something happens, like the event that may have occurred that tipped the scales when your aging parents first began needing help

Other examples include an ankle or a shoulder injury that you don’t have investigated by a doctor. These injuries can turn into more significant physical problems that don’t improve.

So today you do not walk as much because of ankle pain, or you can’t lift your shoulder over your head. Similarly, that small leak in your kitchen sink faucet or that noise your car was making develops into a kitchen flood or getting stranded on the freeway.

These things happen every day to someone, somewhere. The goal is to avoid becoming a person in crises by taking steps to reduce the likelihood of unexpected and highly stressful situations in your life.

This takes consistent effort, investigation, planning and maintaining a positive mental attitude. Dealing with problems, difficult people, parents who refuse care, siblings who don’t want to help, doctors who don’t understand, and health insurance companies who don’t want to help can be emotionally draining.

I understand because I’ve advocated for family members and clients in similar situations for more than 20 years. No one else will advocate for you if you don’t stand up for yourself and your needs.

It can be tiring to be the person who has to step up and persist, but if you don’t— you are the person whose life will be most negatively affected.

Summing It Up: 8 Tips to Avoid Crises

So, let’s pull all of this together – how to avoid being one crises away from needing help.

  • Recognize that the life experiences of caregivers are night and day different from parents or grandparents. This big gap can cause many problems because caregivers can assume that parents have the same knowledge and experience. And parents can view their children as 12-year-olds.
  • Parents don’t want to get old and need help. Adult children don’t want their lives tossed upside down by caregiving experiences – yet this is what happens. Accept it and find a way to work through these challenges, so they don’t take over your life.
  • Be upfront and share with parents or the person you care for the amount of time and work you put into caregiving activities. There’s no need to feel guilty. However, you don’t want to make the people you care for guilty. So the way to do this is to be sensitive and say, I can do this, but I can’t do more. We need a plan B and C for when you need more care. Let’s be practical about this, so it doesn’t negatively affect our relationship.
  • Be sensitive to the health problems of your parents even if you don’t understand them because right now you are healthy. All this can change in an instant. Many caregivers eventually suffer similar or worse health problems than the people they care for.
  • Accept that no matter how smart or experienced you think you are, there are experts out there who know more. Rather than saying no or ignoring advice, view these opportunities as lessons to help you avoid the crises that may be around the corner.
  • Stop being over helpful and making others more dependent on you. Start asking the question, “whose responsibility is this” and involve the people you care for in their care and in decisions about their care. Realize that it’s not up to you to be the rescuer, even though you may feel you have no choice. See out public assistance programs like Medicaid, Medical, or whatever your state calls these programs.
  • Don’t wait until the last minute to be proactive and create a plan. The longer you wait, the more likely you are to face a crisis that will make life more challenging. If others don’t want to talk about the situation, then opt out and say you can’t be involved until they are willing to have deep and serious conversations.
  • Learn to set boundaries and say no in a kind way by letting others know how you care and when they are willing to help themselves, take action, make choices, and move the situation ahead, you will be there.

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About Pamela Wilson

PAMELA D. WILSON, MS, BS/BA, NCG, CSA helps caregivers and aging adults solve caregiving problems and manage caregiving needs through online programs, live support groups, and an extensive caregiving library that includes articles, podcasts, videos, and webinars.

   Check Out Podcast Replays of The Caring Generation® Radio Program for Caregivers and Aging Adults HERE

Pamela D. Wilson, MS, BS/BA, CG, CSA is an international caregiver subject matter expert, advocate, and speaker. More than 20 years of experience as a direct service provider in the roles of a court-appointed guardian, power of attorney, and care manager provides one-of-a-kind support for family caregivers and aging adults interested in taking steps to be proactive about health, well-being, and caregiving. Pamela may be reached at +1 303-810-1816 or through her website.


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