Last year, I received a call from Sharon, the adult daughter of a potential client, Bette. Her father, Burt, had passed away a little over a year ago from an extended battle with cancer and Bette had been his primary caregiver. Until his passing, Bette was mobile, energetic and rarely sick. Once Burt passed away, Bette became a 'different person' rarely leaving the house. Her sunny, upbeat disposition had turned into an apathetic approach to everything and everyone in her life.
Sharon shared that she admired her mother more than anyone she had ever met for being able to 'handle anything'. She had always met life's challenges with strength and optimism, being able to formulate a plan to overcome any obstacle put in her way. Now, she was little more than a shadow of her former self and unable to properly maintain the house, herself or any of her relationships. Sharon was concerned because she was unable to 'snap out of it' and Bette was beginning to decline physically.
Because Sharon's life was so hectic, she felt terrible that she could only get over to her mother's house a couple of times a week, and when she got there she was overwhelmed with what needed to be done, grocery shopping, cleaning out the fridge, making sure there was easily accessible meals to be prepared and questioning whether she was taking her medications as prescribed, etc. The house itself was also being neglected severely, with the bare minimum being done to keep things going.
While both Sharon and Bette would benefit from a home care worker, there were deeper issues that needed to be addressed. Bette had been the primary caregiver to her husband of 60+ years as he lost the battle with cancer. She had focused all of her energy and purpose into his care for several years. When he passed away, Bette faced a dual life transition. She had lost her life status as a caregiver and she was no longer Burt's wife of 60+ years. With his death she was faced with excruciating loneliness and loss of purpose. Her family had been there for her right after his death to help but had assumed that she was adjusting well and would be able to handle things. A year later, it was clear that what may have started out as a normal bereavement and grief period had extended beyond a healthy timeframe. At this time, she felt dependent on her family for care and this new dependence pushed her even deeper.
It is not uncommon for the 'strong and capable' family member in this situation to experience depression due to their history of being 'strong and capable'. Often, those around them and they themselves have the expectation that after a 'normal' period of time, they will 'pull themselves up by their boot straps', as they always have. Paradoxically, this is the person that is least likely to ask for help may be suffering silently. It is as if they are unable to see themselves as needing any help or being unable to ask for it. Additionally, physicians tend to overlook signs of depression with seniors and many assume that depression is a normal part of loss. Old assumptions and patterns are tough to overcome.
After speaking with Sharon, I advised her to make an appointment immediately with Bette's physician regarding her decline. She also had to have a gentle talk with her mother about the possibility of being able to see a brighter world through possible interventions of medication and counseling.
We did provide a caregiver for Bette for about 4 months. In the meantime, Bette's doctor found the right medications and she participated in support groups. After a while, Bette turned the corner and was increasingly able to care for herself and her home again. She now does her own grocery shopping enjoys making her meal and even invites others, primarily from her support group, over for meals. Now, when her family visits, they are able to enjoy her company and provide the companionship that only family can provide. They no longer are in the role of caregiver, which is only helping to restore Bette back to her old self.
Every bereavement experience is unique, but if you have a loved one that is not improving after about two months, a visit to their physician may be in order in addition to grief counseling. Counseling and/or medications can make the fog of depression lift, allowing them to slowly begin to feel pleasure and purpose again, the two reasons we ALL need to lead a satisfying life.
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