Loving Care

At work, they called me “Queen of the SOAP notes.” This was before computers took over hospital units and nurses and doctors actually used pen and paper to communicate. I thought SOAP notes were pretty neat.

S… What symptom does the patient describe?

O… What do I, the nurse, observe?

A…What is my assessment of the situation?

P…What is my plan?

I liked SOAP notes because they allowed me to go into detail, think through a problem, and show how I came up with a plan — even if the plan was to call the resident at 4 a.m.

Ah, the PLAN part of SOAP!  It was to be the source of my greatest stress as caregiver for my parents.

Mom and Dad were great. I was an only child, but they never spoiled me. In fact, as I grew, they became my best friends. So when they needed help, not only did I want to come to their rescue, but believed my experiences as a nurse prepared me to resolve their issues. Unfortunately, it did not work out that way, and I shortly became frustrated.

You have been there. Mom will not eat much, so you cook all her favorites and bring them to her home. A week later, they are growing mold in the fridge. Aaaaaaaagh! Or you take Dad to PT and he refuses to do his exercises. You fear more loss of mobility, but no warnings on your part make a dent. Your anger and frustration are all human responses that are so normal you would be odd if you did not feel them. Then you feel guilty for your anger, and this adds even more to caregiver stress. I think the words “caregiver, stress and guilt” go together like “peanut butter and jelly on toast.”

A throwaway remark by a hospital social worker blew a hole in my dutiful, “professional” approach to caring for my parents. Mom had been hospitalized and, because Dad had his own health issues, I requested (yes YOU can request) a discharge planning meeting. Social worker, staff nurse, Mom, Dad and I sat in a circle and discussed what Mom would need so she would do well upon discharge and Dad would have help managing her care.

“Susan wants to make everything perfect for her mother,” said the social worker at the beginning of the meeting.

I don’t remember what else she said, because I thought, What? Someone should tell Susan that that is totally impossible. No one can make everything perfect for anybody. And if Susan can’t do that, Susan doesn’t have to try for perfection!  

 In that moment, I realized the Queen of SOAP notes had been trying to achieve the impossible. It was as if God took his finger and added another commandment to his original ten.

“You shall not take responsibility for that over which you have no control.”

That meant (be still my beating heart!) while I continued to help my parents, I should not become stressed and angry if my great plans do not pan out. After all, God is in charge of outcomes, not me. I decided I would give things my best shot and then just lean into his sovereignty. I admit this went against all the “work hard and it will pay off” messages I had received all my life; and I still need to remind myself of this often. I discovered that not everything was on me, after all. Proverbs 3:5-6 became my mantra. “Trust in the Lord with all your heart, and lean not on your own understanding; in all your ways acknowledge him and he shall direct your paths.” (NKJV)

If you are not comfortable with that “let go, let God” approach, not taking responsibility for that over which you have no control still makes sense simply because it is logical.  From a worldly perspective, I would say “It’s above my pay grade. Don’t like the outcome? Talk to corporate.”

It took me a while to learn not all problems are clarion calls to action on my part. One day, my mother was complaining about something. I sighed, thinking here was another problem to solve when she said, “Look. You can’t solve this problem No one can. I just want tea and sympathy.” Was that all? Of course I could sympathize. That is when I learned sometimes all our loved ones want is for us to be there emotionally for them.

When people are deep in a terminal disease process, we grasp at anything we think may help even a little. It is a desperate time. Often interventions do not work as we hoped, and we feel discouraged. I learned to find peace and joy in the small victories — like a smile, one good day, one meal enjoyed. I recall Jesus telling the disciples that worrying about tomorrow will not change a thing. Each day has enough grief, so do not look down the road for more.

Now as a caregiver for my husband, I have tasks I do not want to do, that I do not have time for, issues I do not want to deal with. By now, I have learned worrying will only create stress. Yes, a negative event or situation is a source of stress, but my reaction to it determines the degree of stress I feel. I am not responsible for all things and cannot control my husband or his body, nor should I. Knowing that fact helps me turn to God and feel His peace even in a whirlwind of chaos.

In other words, I will try to no longer take responsibility for that over which I have no control.

What methods do you use to reduce caregiver stress?

What causes you the most stress or guilt?

What advice would YOU give a caregiver?