The Alzheimer's Digest: Coping With Stressful Relatives

I Don't Know How She Does It" is the title of a new movie out later this month. It's about a working mom, but the line is an even better descriptor of caregivers, don't you think? Most caregivers (the "she's and "he's alike) juggle just as much, or more. And of all that a caregiver puts up with, sometimes the biggest stressor is an unexpected one: relationships with relatives.
I've been hearing frustrations galore lately about how it's not the care receiver, but another family member, who's driving caregivers nuts. Recognize any of these types in your life?

The long-distance second-guesser

A new report on long-distance caregivers says they're often more anxious, guilt-ridden, and disconnected than local caregivers, who can see what's happening with loved ones gradually. As a result, say researchers in the May, 2011 Oncology Nursing Forum, long-distance caregivers tend to swoop in periodically to try to deal with many issues at once, often second-guessing or undoing what local relatives have already addressed.

The point of the report was that long-distance caregivers (known as "seagulls" or "pigeons" for the way they fly in) have their own unique stress points. True enough. But they can spread chaos (or should I say, in some cases, "droppings"?) for the hands-on local caregiver.

The tightwad.

A friend's mother has cash on hand that she's been saving for a rainy day. "My dad is dying of congestive heart failure and keeps us up all night. So it's not raining, it's pouring," he says. "But Mother doesn't want to pay for extra nursing care because she hates to spend the money!"

Financial disagreements are high on anybody's stress list, but those concerning a loved one's care seem especially fraught -- especially if you're sharing in the care but don't hold the purse strings.

The conspiracy theorist / wild-hare theorist.

It's hard enough having to deal with a loved one whose dementia comes in the form of delusions and hallucinations. But it's twice as maddening when another relative is also spinning crazy theories that eat up your time and your patience: "The doctors don't want him to get better or they'll lose a client!" "She wouldn't prescribe a generic because she's in cahoots with the drug company!" Get Mom to eat this sprout-maple-syrup-alphabet soup; I heard it will cure her dementia!"

The drug addict.

Any hospice nurse will tell you about relatives who try to score the morphine or tranquilizers prescribed for a dying relative. Talk about an extra unnecessary stress!

The know-it-all do-nothing.

Then there's everybody's (least) favorite relative, the one whose idea of "helping" is to drop by for tea and criticism -- without actually lifting a finger.

How to deal:

Don't let it get personal, even when it sounds personal. Steer conversations back to what's best for the person in your care. Make like a duck and let criticisms roll off your back.
Try the communication offense: The researchers on long-distance caregivers, for example, said that keeping relatives in the loop with more information rather than less helps ease their stress.
Fight back with facts. Don't get emotional; just keep reciting what you know is in the care receiver's best interests. Enlist a neutral third party's authority: "Dr. So and So says…."
See if you can re-channel that negative energy into efforts that actually help you. For example, let a long-distance caregiver know about a specific financial contribution that would help, or give him or her a project to research, such as information about a new therapy. Sometimes people meddle because it makes them feel like they're contributing.
Keep your vents open. Sometimes you can't really do anything about these stressmakers. But you can -- and must -- protect your own sanity by off-loading frustrations to others. Share your exasperation with friends, online forum buddies, a therapist -- anyone but the care receiver.
Poke fun. At least behind their backs. Because it's a biological fact that laughter eases stress, and you need all the de-stressors you can find.
Repeat after me: "I don't know how I do it!" But you do. Thank goodness.