Nursing your parents

Nursing and caring—the two words go hand in hand. There are many reasons to go into nursing, but the end result is the same: You spend your workdays (or nights) caring for other people. Whether you teach people to stay healthy, help them get better, teach them to live with their illness or condition, or care for them during their final days on earth, your job is to help, educate, nurture and provide the most intimate kind of care.

Because of the very nature of nursing and because most nurses are women, many nurses are also caregivers to family members. For many generations, women have been caring for their aging parents. It’s a part of life. It’s not unusual to meet someone who remembers having a grandparent living with them as they lived out their final days.

But there’s a big difference between the care of older parents a few generations ago and now. In fact, we see it every day in our work. People are living longer, they’re living longer with chronic illnesses and they’re fighting battles with diseases that would have killed them a generation ago. Whether it’s controlling diabetes or treating an infection, improvements in modern medicine have enabled us to prolong our lives. One device has made a big difference in survival just on its own: the pacemaker, a small electronic device that keeps your heart ticking and ticking and ticking, no matter the condition of the rest of your body.

A poignant article on this subject, “What Broke My Father’s Heart,” was published in The New York Times on June 14, 2010. Writer Katy Butler relates how her once-healthy and vital father had deteriorated both physically and mentally following a stroke. And yet, a cardiologist recommended her father have a pacemaker inserted so he could survive a hernia surgery. Like the Timex watch of old, that pacemaker kept ticking, despite her father’s declining health. And as his quality of life dropped, along with his wife’s from the stress and strain of being a caregiver, the pacemaker never gave up. Unwilling to say that he was a burden, neither Katy nor her mother acknowledged that this wasn’t the kind of life Mr. Butler would have wanted to live and that the care was taking a heavy toll on his wife. At what cost did that pacemaker save his life?

Other nurses who have ailing parents may face the same issues. Their parents too are living longer with more chronic illnesses, needing more care. After spending your days caring for strangers, can caring for your parents, who essentially become your live-in patients, become too much?

Elizabeth Shean, a 49-year-old RN in New Mexico, has been caring for her 80-year-old father for the past six months, after he moved into her home. Elizabeth and her sister had shared the care of both parents for the past 20 years, and Elizabeth welcomed the decision to move her father into her home. Despite being a nurse and knowing what was involved, Elizabeth says it hasn’t been all smooth sailing.

“Taking care of a parent is a whole other ball of wax compared to caring for patients,” she explains. “I don’t get to leave my ‘patient’ and go home at the end of the day. My patient is always in residence and there’s a complex emotional dynamic between us that is constantly evolving as Dad’s dementia worsens. The situation is more exhausting than any nursing gig I’ve ever had, that’s for sure!”

While Elizabeth has the traditional “dad moved in” scenario, the other common scenario is being lived by Barb Needham, an LPN in Connecticut. At 57, Barb is the sole caregiver to her mother, who is now 88 years old. Barb’s dad passed away two years ago. After her father died, Barb noticed that her mother was declining cognitively, quite quickly. Barb moved to be closer to her mother once it became evident that she needed more care than could be given by distance.

Every day, Barb visits her mom after work to prepare supper, do the chores and get her mother into bed. Barb then goes home, only to return to her mother’s at 5:30 a.m. to get her up for the day before Barb begins her own day as a home health nurse, caring for older patients.

While it seems that Barb may not have a life of her own, she doesn’t see it that way. “I get together to have breakfast with my fiancé, I have a motorcycle and I like to take that out,” she says. “My brother tries to come up at least once a year and that’s when I get a break. He is so wonderful with her.”

Being a nurse has helped Barb because of the skills and knowledge she needs to use with her mother. She’s able to see her mother for who she is and what she needs, and yet remembers how much her mother cared for her when she was a child, leaving Barb with the goal of caring for her mother until the very end. She feels she owes her mother this care.

Elizabeth points out, however, that being a nurse in a family caregiving situation can be a double-edged sword. “On one hand, I feel more confident in certain areas,” she says. “For example, if Dad falls, I don’t freak out because I know how to assess him for serious injuries and dress wounds, and I know when to call 911. Another advantage is that Dad’s doctors tend to listen to me more (I believe) because they view me as a colleague, not a layperson. On the other hand, sometimes it’s not good to ‘know too much.’ Sometimes, I think ignorance would be bliss. Sometimes, I think it would be great not to know what it means when Dad’s legs swell or he’s using accessory muscles to breathe.”

Having outside help is important, whether it’s professional and formal or unofficial and casual. Elizabeth has a home caregiver so Elizabeth can go out to work. Barb, on the other hand, is able to manage with a few helpful neighbors who pop in and visit her mother, making sure she’s okay. For support, Barb is able to lean on her fiancé for help, seven years into their relationship. Elizabeth also credits her husband for being very helpful: “I could never do this without the unflagging support—both moral and physical—of my non-nurse husband, that’s for sure.”

How do you reach out for help?