Picture courtesy of imagerymajestic/freedigitalphotos.net

Several weeks ago, Paula Span of the New Old Age blog wrote about “The Reluctant Caregiver.” She’s referring to someone who is providing care for someone in need of help but provides the care grudgingly rather than willingly.  She cites the example of “Mrs. A,” who provides assistance for her mother-in-law.  Mrs A “doesn’t have much affection for this increasingly frail 90something or enjoy her company; her efforts bring no emotional reward.”  Her mother-in-law expresses gratitude, but that only makes Mrs. A feel guilty.  She feels ashamed when she compares herself to other adult children who willingly provide care.  She continues to help out of a sense of obligation.

I became one of my father’s caregivers last year, joining the ranks of thousands who help an elderly relative or friend.  I wasn’t hesitant to take on that role, since my dad and I have always had a close relationship.  In my work as a psychologist, though, I have provided therapy to many reluctant caregivers. Reluctant caregivers are conflicted, having both reasons to pull back but also reasons to help.  Here are what I consider the types of reluctant caregivers—often a reluctant caregiver falls in multiple categories:

• The Injured Caregiver, who bears wounds inflicted by the needy elder.  The injury may have ended many decades ago, or it may be continuing into the present.
• The Resentful Caregiver, who bears a grudge against the needy elder, usually due to some conflict.
• The Misunderstood Caregiver, who helps the best he or she can but whose efforts or intentions are misconstrued by the needy elder.
• The Discouraged Caregiver, who yearns for a closer relationship with the needy elder but is saddened because such a relationship seems unavailable.
• The Detached Caregiver, who neither has nor wants a close relationship with the needy elder.
• The Guilty Caregiver, who is helping out of a sense of obligation and feels that her or his efforts are never sufficient
• The Overwhelmed Caregiver, whose willingness to help is compromised by the stress of other obligations.
• The Used Caregiver, who perceives other family members as having dumped the needs of the elder on him or her.

Span thinks that the reluctant caregiver deserves credit for persisting at the hard work of caregiving despite not getting much back in terms of warmth, closeness, or appreciation.  She cites the advice of a geriatric social worker who advises such caregivers to sign up early for community services that could lighten the load and to join support groups.  Of course, there may not be a group of like-minded caregivers available, so talking to anyone who is sympathetic or supportive can help.  Pastoral care is often useful, and psychotherapy is advisable if the relationship with the needy elder brings up significant unresolved emotional issues.  It’s also important for reluctant caregivers to set boundaries to keep from being emotionally damaged or used while they are in the helping role.

Reluctant caregivers often experience guilt because they don’t feel toward the needy elder as they think they should.  They don’t have either what the ancient Greeks called  storge (affectionate or family love) or phila (the love between friends).  However, the Greeks also had another term for love, agape, a sacrificial love based not on feelings but on commitment to the welfare of the other.  Christ and his followers regarded this as the highest form of love.  In seeing the elder’s needs and helping despite the lack of rewards and often at considerable personal cost, reluctant caregivers can be bearers of agape love.  That’s nothing to be ashamed of!