At Home: The Professional Caregiver

Generally speaking, I have a lot on my plate. As a psychotherapist in private practice, I wear many hats and have many roles. Since I am a business owner and a one-woman show, I do everything that keeps the business operating and growing every day. The work I do as a therapist, under the umbrella of the business, is another role. I also own a home, I am a wife and a mom to a pack of four-legged creatures. My husband and I have a homestead that sits on five acres with a small flock of hens and a small garden. As a New York City gal who lived in a 600-square-foot apartment (or smaller), five acres is substantial - that's a lot of grass to mow! And plants to water, garbage to haul or burn, and wreckage to clean up after a thunderstorm with downed limbs and branches. My husband and I each have clearly defined jobs and responsibilities and operate like a well-oiled machine. We both have a lot to care for including caring for one another. We have a wonderful partnership and most of the time, things run fairly well with a bump here and there to maneuver over. We are not perfect - we both struggle with chronic pain and as we age, we move a bit slower, have more aches and pain, and often comment on how much we notice the changes we go through that are different from when we were younger. 

This past July, we hit another big bump. It was a planned bump, we knew it was coming for months, and we were able to prepare as best as we could. This bump I am speaking of was heart surgery my husband had to go through. We planned for a week in the hospital and weeks of recovery. What we didn't plan for was the pacemaker he subsequently needed, the severe pain that has been difficult to manage, a longer-than-expected hospital stay, the lifestyle change that would be thrust upon him as a result, and all the emotions and grief that accompanied us both through it all. 

This is not my first rodeo. I am a caregiver by nature and I chose a  profession as a caregiver. I had felt prepared in many ways to face this experience my husband was to endure due to my professional experience as a medical social worker from working on the inpatient cardio-thoracic unit in a major NYC hospital. I have been a caregiver for my husband in varying degrees through physical health conditions. However, this has been quite different, some of it was not anything I could have anticipated. I have learned a great deal about the partnership of husband and wife, the role I take on as a wife that extends to also stepping into others roles at times. I have learned that just because I love this man and would do almost anything for him, I have limits, get tired and frustrated, and no aspect of me or my caregiving role is perfect. I am full of human flaws coupled with a generous heart and glorious passion. I am vulnerable and when you share your entire world with another person, build a life together, a home, and everything intermingles, it can be messy and downright frightening when facing the fragility of life and health right in the face. Eye to eye I stared my vulnerability head-on and settled in for a long battle. 

Close to two months post-op, I think we are coming out on the other side. Though healing will continue for several months, and we continue adjusting to a new way of life that includes different parameters, I feel optimistic that we will find a new normal again. I feel an easing from all the external pressure as my husband continues recovering and his strength returns. I am continuing to learn and grow in my roles and carrying with me an awakening of sorts. This short-term crisis has reinforced my knowledge of the need for sustainability in all my roles. And with this lived experience, I felt the embodied need.

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Here are some things I have learned that I need to be reminded of and I hope will be hopeful to all the caregivers reading this:

• You cannot be perfect. We all make mistakes. I forgot instructions, confused medications and schedules (the chart as a reference was helpful), and failed to remember many things. Give yourself some grace here, as you are going through a lot.  
• You have a right to all of your emotions. I experienced anger, frustration, fear, and sadness - to name a few. None of these are good or bad or less valid because I am not the one who had surgery, emotions are valid and occur simply because we're human. Let yourself feel them, talk with someone about them, and cry if you need to. Feeling emotions allows for them to resolve. 
• Try not to have rigid expectations - for yourself and your partner. My expectations were challenged often, from the pacemaker he required after heart surgery and the extended hospital stay to his entire healing process. Be willing to adjust these expectations and outcomes that are out of your control. 
• Learn to say no to things you cannot do, including aspects of caregiving. You may not want to provide injections, change wound dressings, or bathe your partner. You may need to ask for assistance. I said no to things that surprised me like washing dishes. It was just one more thing on my already full plate. I opted for using paper plates for 50% of our meals.  
• Learn to accept help from others - family, friends, and other professionals. I am independent, strong, resilient, and cannot do everything. I had to allow myself to let my friends help with yard work, taking care of animals, and more. You are allowing them to give you a gift - it feels good to give to others - so let them!
• Build resilience by finding purpose outside of caregiving, believing in yourself, developing a positive social network, embracing change, practicing positive affirmations, being optimistic, and nurturing yourself. 
• Identify your needs that do not include your role as a caregiver. I need downtime and time alone, so I grabbed moments where I went outside to take a walk, stayed in the shower longer, or picked up a book.  
• Remember to care for your vessel! Fuel your body with good nutrition by eating regular, well-balanced meals. Exercise is essential even though it may be hard to find time. It is the best cure for depression or a sad mood, alleviates stress, and will also help you to sleep better at night. Exercise can be short intervals such as walking, an exercise video, stretching, or yoga in your living room. Make sure to get adequate sleep as often as you can. I went many nights lacking sleep and burning the candle at both ends. When I could, I would grab a quick nap or go to bed earlier than usual. 
• Most importantly, remember that taking care of yourself is as important as taking care of someone else - more important as you cannot give away what you don't have.    

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