The Caregiver Cup Podcast

Navigating Boundaries: From Why to How in Caregiving Communication

January 23, 2024 Cathy VandenHeuvel Episode 197
The Caregiver Cup Podcast
Navigating Boundaries: From Why to How in Caregiving Communication
The Caregiver Cup Podcast
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As a caregiver, the rain of responsibilities can be relentless, but I've learned that the right umbrella can keep you dry and standing strong. It took me revisiting the trials of managing my mother's care after her lung cancer treatments to truly understand the weight and worth of setting healthy boundaries. This episode is a heart-to-heart on why erecting these protective barriers is essential for caregivers, and how doing so can be the very lifeline that keeps us afloat in a sea of demands. We navigate the delicate balance between professional duties and the intimate role of caring for a parent, sharing how to carve out space for yourself without apology.

Crucial to any caregiver's toolkit is the ability to communicate these boundaries with grace and firmness. I bring you real-life scenarios, like coordinating with my brother on our mother's medical appointments, to show you how setting clear expectations is done. We also tackle the finer points of working with healthcare professionals, maintaining patient privacy under HIPAA laws, and managing the influx of visitors. For those looking to transform their caregiving journey including deepen their boundary-setting skillset I point you toward the Empowerful Caregiver School. Join me as we affirm that the respect and support we give to our loved ones as caregivers is also ours to claim.

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Speaker 1:

Well, hello, my friend, and welcome to another episode of the Caregiver Cup podcast. Today we're talking all about healthy boundaries because, as caregivers, we are told to set healthy boundaries. But how do we do that when our life is already chaotic, or when we are a people pleaser, or when we've tried but it doesn't work? In today's episode I want to break it all down, from why to how to handle the challenges and not giving up if they don't work. The first time, the second time, the third time. I've talked about this specific topic back on episode 122, practicing Caregiver Self-Love Through Healthy Boundaries. So that's another one we talk about Healthy Boundaries, and episode 121, the one right before it, setting Healthy Internal Boundaries Without Caregiver Guilt. But what I'm trying to get at it's been a while and I want to bring back and talk more about setting healthy boundaries as a good reminder to us to take a step back and recheck again. But I haven't truly talked deeply about the pushbacks and the challenges that you and I get when we set healthy boundaries. I could go on and on and on about all of the stories that I need that I've had as a caregiver when I set healthy boundaries and it didn't work or people thought I didn't care anymore, and so on and so forth. So let's back up and start with why healthy boundaries are so very important.

Speaker 1:

I love to use the analogy of an umbrella yes, an umbrella. Imagine it's a rainy day and you just took the time to do your makeup and your hair looks phenomenal. And you're meeting your girlfriend for lunch and you put on your best outfit and you look in the mirror and going, wow, I look really good today and I feel good about it. You can't find a close parking spot and you're at the restaurant and you know that you're going to have to get out into the downpouring rain outside, and so you lean into the back of your back seat of your car and grab your umbrella, because you could either run really fast, but you know your hair and everything will be drenched and you look so amazing today and besides that, you're going to be out of breath, your feet and your clothes may be wet, and then you're going to get into the store and the restaurant and you're going to feel miserable. Like I said, instead you grab your umbrella and you can walk protected, and you can walk into the store or the restaurant, the restaurant, without getting your hair wet and your makeup wet, and maybe your shoes get a little wet, but you feel really good. Well, the rain and umbrella analogy to me is like imagine caregiving challenges as raindrops falling on you. Setting boundary is like using an umbrella to shield yourself. It doesn't stop the rain, but it helps you navigate through it with greater ease and you're not wet.

Speaker 1:

So why are boundaries needed, you might ask, or you might continue to ask yourself, because caregiving changes our relationships. If you are caring for a parent, our relationship will shift now probably from the daughter to now being their caregiver and their advocate and as the, if you have an elderly parents. As the time changes, it gets get you take on more and more responsibility. It could be a gradual shift over several years, or a sudden shift in the case of, like hospitalization or a disease that's chronically diagnosed. Regardless of the pace of the progression, responsibilities change over time and these changing responsibilities require that you and I reassess our boundaries. If you haven't given much thought to boundaries prior to now, this is the time for you to evaluate your roles, or reevaluate your roles, your relationships and limits, so that you and those traveling with you on your caregiving journey feel respected and supportive. Boundaries will protect you from burnout. It will shield you from added stress. In addition to relationships changing with your loved one, relationships change with your siblings and friends as well. Boundaries will help you determine who is on your care team, who is only adding drama to the experience. You will find yourself in the new role of communicating and coordinating care for your family members, and it can feel awkward and intimidating, but boundaries will help you balance managing professional interactions with people who are helping with the intimate situations too. It really just gets everybody on the same page and nobody's questioning or assuming or there's no unsaid boundaries.

Speaker 1:

Boundaries may be set to protect our time, our emotions, our energy, our compassion reserves and our values. That's a big one our time, our emotions, our energy and really any values that we have. When we set and communicate boundaries, we're respecting ourselves and we're respecting others. Boundaries are truly limits that we set to protect our physical and emotional well-being. It's kind of a sidebar. I was listening to the Haudenosaunee show today and, whether you're a huge Madonna fan or not, she didn't show up for one of her concerts. I don't remember where out east it was, and she showed up. The concert was supposed to start at seven and she didn't show up until nine o'clock and there was no beginning show or anything like that. That would be a huge boundary for me and apparently there's a class action suit and everything but as a sidebar. So when I thought about time limits, the limits that we set as boundaries protect our physical and emotional well-being, and boundaries also are guidelines and rules that are communicated to define what behaviors you will accept from those around you and what responses will be if the boundaries are crossed. Boundaries are rules that help us define who we are and what we believe to be our responsibilities. Boundaries are set around communications, interactions and behaviors.

Speaker 1:

So most caregivers I speak with, including myself, have never set healthy boundaries, then we've never spoke about them. I didn't. I just did what I needed to do and I assumed everybody understood and we just assumed that everything will fall into place. Major, major point there. And if you haven't set healthy boundaries, this is something that you're going to want to go ahead and do. So, first of all, you are not alone If you don't really have boundaries and you haven't communicated them. I want you to continue to listen on. Just know you can start now. You can start anytime. It may be a bit harder to shift right now if if you have a boundary that you need to change, but it can be done. I've done it numerous times.

Speaker 1:

The main areas in your caregiver life that you should be setting healthy boundaries are and I have have him in like three point five categories. First of all, a healthy boundaries should be your personal well being your emotional, your physical, your spiritual, your psychological health. You, your boundary. Can you have to sustain your world? Another area is your loved one and two year loved one, but also for your loved one, you may be the person that has to speak for your loved one, and so what would be those healthy boundaries? And the third one is your family, friends and team of support, and in that boundary I also put you like your health care team. You know being that one as well. Now you have to break down what expectations and healthy boundaries look like in each of these categories.

Speaker 1:

While setting healthy boundaries can feel selfish, the opposite is true. Well maintained boundaries are a gift to yourself. Let me say it again well maintained boundaries are a gift to yourself and those in your caregiving circle. The confident, the confidence to stand firm with, will come from being clear in your intention and in your communication. Practice will make the process get easier and easier.

Speaker 1:

Let's start with your personal well being boundaries. What things do you need to sustain from a caregiving perspective? What things do you need To be at your best, what things are non negotiable for you? I hope you're saying things like sleep, sitting down and eating a good meal, staying hydrated, getting breaks and more. Think about what your body and mind need to go ahead and feel joy, feel healthy, and if you're not feeling it, you need to start asking yourself Another thing you can't sustain caregiving twenty four seven without taking care of yourself. You can't.

Speaker 1:

The umbrella analogy is like the perfect example. You can't stop caring completely, but you should be refueling and reef and resting, because if you don't hold an umbrella over yourself, you're going to become so can wet, shivering, freezing and all of that kind of stuff. You should be saying yes to help and no to things that will go ahead and hurt you from a well being perspective. I really encourage you to take some time and to do it in your phone, to journal it out and really identify what are those boundaries that Either are being crossed right now or those boundaries that, if you stick to them you're going to be at your better self. If you are a people pleaser, know that you say yes to everything. You have to be honest with yourself. You feel guilty when you say no, but also think about what it does to you when you are exhausted in your people pleaser. Better yet, think about the times when your emotions got the best of you and ask yourself if your boundaries were crossed.

Speaker 1:

There's going to be some times where you're going to have to go all in an emergency situation or, you know, something happened that's understandable, but what are the things that are self induced or things that you need to shift and change? Think about the times where you feel anger, resentment. Is it because you're exhausted? Is it because you're doing too much and you haven't set a boundary? Or, you know, think about your exhausted, crying, fatigue, emotional, negative. What has caused that?

Speaker 1:

Those are usually signs that you need to take a step back and look at your boundaries. They may be that. They may be about you pushing your boundaries, but it also can be others are pushing your boundaries and that may be something. Maybe you have created a calendar and people are canceling on your calendar and you're the backup person and you can't be the backup person all the time. That person needs to find somebody else to support if they can't help mom or take mom grocery shopping, because maybe you work every day. I'm just throwing out that as an example. Most of the time it's because we don't communicate our boundaries or communicate effectively that we feel this. Here's an example.

Speaker 1:

My mom understood I worked during the day. I work during the day. I worked my corporate job and I managed a team of 18 to 20 people. We took care of onboarding for 7000 new hires a year and so I managed that. But I worked at home and during the day. My mom knew that and she pushed the boundary, sometimes by texting or calling or asking me to do things for her during the day and if I'm back up, when we first started caregiving, I shared my job, had flexibility to my parents and with working at home, I could set my own hours and get her to appointments and make some of those calls and and planning things that I needed to.

Speaker 1:

But eventually I found myself pushing back when she added things like her hair appointments or grocery shopping or she needed To go ahead and do something that was, in my eyes, not medical or not for her health and it was just for enjoyment. Well, I had to explain to her that flexibility boundaries were specific to her health appointments, but I never clearly explained that to her and If I went back explaining that my focus during the day was my job and what I was doing helped a little bit. And I also had to explain the consequences of taking too much time off for her non-medical issues and how they affected my projects, how they affected my stress, how I had to then take personal time off and I only have so much personal time and I want to use some of that time for enjoyment, not for running around. We had to find a better solution. It was such a difficult conversation, but it was so necessary. So let's talk more about your loved ones' expectations.

Speaker 1:

Many caregivers I speak to ask for advice about their loved ones making comments to them that are hurtful or negative demands of them, and they're starting to feel anger or resentment or depression or whatever it would be. What do you do Like? Here's a few examples what do you do when your loved ones' demands become too much? What do you do when your loved ones' comments are hurtful? What do you do when your loved one yells at you and my first response always to them is is this the way they've always been or is this something new? Because of their disease or their injury, or maybe their mental status or whatever? Because, dennis, I know that Dennis becomes elderly and not himself when he's not feeling well, especially post-chemotherapy treatments, and I would have to wait and talk to him after he felt a little bit better and I would have those conversations about the comments or the outbursts and how he was feeling. We even would bring some of those to his appointments and talk to the doctor about it to see maybe we need to go ahead. And at one point he took some antidepressant medications Then.

Speaker 1:

Secondly, after we have that discussion, I usually with my clients if you talk to your loved one and if they are still being disrespectful and hurtful, you have to go ahead and look at a hard healthy boundary, because you don't deserve this. And I have some tips for effectively communicating this. First of all, I talked about making sure the right timing is important. Then you have to be clear on your intention and your healthy boundary so that you can be clear in your communication, respectfully and with a few words as possible. Communicate your boundary Like I did with my mom, explain to her that I have to be at work, I have to work my 40 hours, and the best time for me to do that is during the day, and when I take my time away during the day, I have to work at night, and then I don't get my sleep. You know you have to have those conversations and then the word, the request, or word the request in terms of what you need and what and why you need it, rather than using the words you, for example, I need some space right now, rather than you need to stop. Or I love you and want to help you, but I don't deserve to be yelled at. I'm doing my best here and going ahead and sharing those words share the consequences to. If the boundary is crossed, like if you yell at me, I will ask you to try it again. That's what I did with my husband and we had this little cue. Can you reword that for me? Because you're hurting my feelings and if you don't speak nice to me, I will, then, whatever it will be, and so you need to go ahead and do that, and one of my things is be firm and unapologetic. Don't apologize for your healthy boundary. You're doing a compassionate deed for them. I have another example for you.

Speaker 1:

My mom didn't answer the phone I might have shared this in a previous podcast when she was after her lung cancer treatments. One of the things that she wanted to do was rest and relax. And I said you know what? I'm not going to bother you a lot and I'll check in with you on FaceTime and we'll do some FaceTimes during the week and I'll call you or text you just to see how you're doing. Well, she wouldn't answer her phone, she wouldn't answer her text. She had a landline as well and she wouldn't answer that. And I would call and call and call and eventually the I would have to go check on her and she was maybe less than five miles away, but it is. You know, you got to go ahead and get in the car, you got to go, drive over there and you go check on her.

Speaker 1:

And I didn't go ahead and explain the healthy boundary to her. I just assumed, by me saying I'm going to go ahead and call you and that sort of thing, it would be okay. But I went over there and probably did the worst type of effective communication because I was so flippin' mad when I would go over there and she'd be sitting in her lazy boy or she'd be going ahead and she'd be laying in bed, but she would be awake. Thank goodness I had a key and I finally had to sit down and have a heart to heart conversation with her by saying when you don't answer your phone, I assume the worst and I go over there all frantic, all nervous, afraid to even open the door because I think something has happened to you. And so when you call, or when I call or text, and you don't feel like talking which is okay, you still need to go ahead and respond and saying I'm okay, but I don't feel like talking today, I'll talk to you tomorrow. That would be perfectly fine.

Speaker 1:

But I had to set those clear expectations with her so that I wouldn't go ahead and be in a panic after day after day after day, or the flip side of the point coin is, if there was something wrong and I assume that she just wasn't answering her phone, well, that could be even worse. So that was one expectation that I had to go through afterwards and I think we run into this all the time. We're continually, continuously running into new avenues where we're going to have to set expectations. The big thing you want to do is not get emotional or defensive back, and I did, and that's how I've learned now not to do it. You almost have to fall or you have to make the mistake, because by getting defensive or emotional, then your loved one senses that you're upset. But what most of us do we apologize for being emotional, upset, when it's truly is something we shouldn't be apologizing for or feeling guilty for. And so when you can go ahead and think about how you're going to respond to your loved one or to a family member, take a deep breath, maybe wait until you processed it a little bit and then have the good conversation, which is going to be much more effective.

Speaker 1:

Don't forget setting healthy boundaries are needed with your family and your team, those who are helping us care for our loved ones, or anyone who impacts the care that they might provide for your loved one. Personal boundaries are complicated because you can't see them and they may need to change with circumstances. Healthy boundaries will help relationships feel supportive rather than strained under stress of caregiving. So boundaries will help prevent resentment that can result when we give up too much of our life to caregiving or a well-meaning person offers unwelcome advice or attempts to help in a way that is not helpful. It may be simple as filling out, maybe a calendar and having family members and having family member meetings once a month. For my mom we would have a calendar on her wall and she would list out all of her appointments on that wall so my mom could see it, and then underneath that we would write in who's going to support mom and at what time, and then I would take a picture of it and we would put it onto our main communication page, which helped. So that would be like an expectation or ways to communicate and stay connected as family members, because if you have family members taking your loved one to appointments and you can't be there as a primary caregiver all the time, how are you getting the information regarding your loved one? How are you staying connected? What is the expectation Like for my brother John? He wouldn't go in with my mom and that became a healthy boundary that we needed to go ahead and talk through, because I needed somebody in there with mom so I could go ahead and hear, or the doctor needed to know that Kathy wasn't there today, so can you put all the information in the notes. So, whatever it would be, you need to have that communication plan Also.

Speaker 1:

Another healthy boundary is my brother and I had a text chain that we used. Eventually, my sister was part of that text chain and I also had to be honest about what we can each commit to, because it was assumed that, because I was closer, I was the one that would be taking care of mom the most, versus I was the one working, and so we had to have those really good conversations, those good family meetings. We had to have conversations with her doctors about who's going to be coming to the doctor's appointment, how to communicate with the doctor. I became really good at communicating with our primary care doctor, explaining that I would send them an email and that's how she liked it saying my brother, john's gonna be taking mom in for her follow-up visit. Today I cannot be there due to a work conflict. Here are her concerns and here are my questions, and then the doctor would go ahead and take care of those questions and put them in the notes, and most of the time she would just pick up the phone and call me, which was wonderful.

Speaker 1:

Another thing is setting boundaries around. One thing that comes to mind is around visitors for your loved one or protecting their space, because your loved one may not always be able to communicate with the loved one If they're in the hospital. Can they accept visitors? How many visitors should they really have there? When my husband was at a stem cell transplant, communicating to them that they couldn't have visitors to do to the COVID rules, but when they opened it up, what type of visitors did he want? And we just wanted immediate family For my mom.

Speaker 1:

She had so many grandkids. My mom had tons of grandkids I don't even know she knew how many she had, and I think it was 14 or 16 and then great-grandchildren. That was something my mom was very proud of and at one point she became she's like oh my God, they stayed until nine. They stayed until 10 o'clock. Oh my gosh, no, another one wants to visit tomorrow. At one point I said to mom what is reasonable for you? And she didn't feel comfortable saying no. And so, as caregivers with my brother, we said okay, we're gonna have to set some healthy boundaries, because she can't go ahead and make meals for the grandkids like she used to and then entertain them until nine, 10 o'clock at night and then do the dishes. That's just too much for her and so let's go ahead and just set a rule across the board that she's gonna visit one grand kid a week and they have to go ahead and leave by a certain amount of time. Or when she was in hospice it was an hour. You can come and visit for an hour. You have to call in advance and we went ahead and put those healthy boundaries in.

Speaker 1:

Don't forget boundaries and expectations in your values with your loved ones health team as well. I talked about the doctor ready, but it may require you to fill out legal forms and HIPAA laws and access your loved ones records and talk about your doctor and speaking with your doctor. The very first time I went in with my mom to with her doctor and that was kind of the transition to say my mom, I'm now my mom's primary caregiver. We filled out everything, but I'm now going to be helping her monitor her care and her medications and be her liaison. Mom is still able to make a lot of her own decisions and answer her own questions, but I wanna take team with her now and that opened the door up and thinking about who will be accompanying your loved one at all of the appointments and being able to do that.

Speaker 1:

Now, if you have, like, nurses coming into the home or into wherever your loved one is staying, or AIDS or physical therapy, you wanna communicate and talk about expectations and boundaries, because how are you getting updates and how are you being alerted to things that your loved one, they may have noticed, or their progress or whatever it would be, because you can't assume they're going to tell you. You can't assume they're going to go ahead and keep you informed on everything. They may just come in, do their job and leave and think that the loved one's going to go ahead and communicate that Everything from if you have a cleaning person coming in, are you being specific about what time, what they need to clean all of that stuff, to changing the bedding and towels and that kind of thing. You need to communicate your expectation to bathing, even if your loved one says I don't wanna bath today. You're going to be specific about saying mom might fight it, but there's expectations that they need to bathe every day or every other day, whatever it would be. You might be also saying they expect you at this time and if you cannot be at this time, then give them a call or text me to let me know that you're running late and what communication channels they're going to learn as you go. But those are things that you need to be very clear on because you can't just assume it If they're not going to be there. You want to call as soon as possible or you want them to go ahead and tell you 24 hours in advance because you might be expecting a nurse to come in and that's your time where you're going to go ahead and do something else and you have something planned. Then all of a sudden they don't show up. Now they broke the expectations and boundaries.

Speaker 1:

Now let me end with a few things in this episode by saying I only skim the surface. And boundaries are such a huge topic. We discuss these in great lengths in the Empowerful Caregiver School. We do an entire live session on it. I have a whole lesson devoted to it. It requires you to really accept and understand the gift of healthy boundaries and being able to see the importance.

Speaker 1:

Briney Brown has a really good quote. First of all, let me back up. If you are interested in looking through the Empowerful Caregiver School, I want you to go out to kathielvancom forward slash Empowerful and I'll put that in the show notes, to go ahead and see that this is a six week program where you go through this transformation, but one of the results driven transformations is healthy expectations and shifting to communicating and knowing that. Okay, now let me talk and give you Briney Brown's one of her quotes that I'm sharing today.

Speaker 1:

She talks about compassionate. People ask for what they need. I truly believe we are, as caregivers, compassionate. They say no when they need to and when they say yes, they mean it. They're compassionate because their boundaries keep them on. They keep them out of resentment and thinking about that. When you're resentful and mad, you might be mad at that loved one, but truly is it because of you not setting healthy expectations and communicating it? Another thing that Briney Brown says is daring to set healthy boundaries is about having the courage to love ourselves even when we risk disappointing others Absolutely. We have to be mindful and understand our compassion and our boundary connection, because it enables you to act in accordance with your heart and use compassion to set healthy boundaries in accordance with your own personal values. You value your time, you value your well-being, you value your sleep, you value a good relationship with your loved one, and if you're not setting healthy boundaries, that resentment is going to eat away at that relationship.

Speaker 1:

As caregivers, we face many common barriers that impede us from acting with compassion. Think about it, including exhaustion, anger, resentment, fear. When our boundaries are consistently crossed, these barriers increase in size and intensity. They become so overwhelming that we use words like stuck. We can't do this anymore. As caregivers, it can feel like our compassion has all oozed out of us. This leaves us feeling empty and angry and wondering who we have become, and so mindfulness helps us maintain and protect our boundaries. It is these boundaries that help protect our compassionate reserves. Without boundaries, this swirl of emotions can create turmoil and I'm doing like a tornado turmoil. We can use mindfulness to be aware of what is going on inside.

Speaker 1:

So let's take the hard step today and identify our need for healthy boundaries and embrace the list of healthy boundaries we create. Then, once we create these healthiest boundaries, then the next step and you know what I talk about here is taking one or two, just pick one or two and start with that. First step then would be to communicate it, to talk to yourself, then talk to a friend or a fellow caregiver, and then whoever needs to know about your healthy boundaries, like your loved one or your family. Don't forget to explain why you're setting the healthy boundaries and the benefits of the healthy boundaries and outcome. Embrace it and stay firm. Allow yourself to feel these icky feelings of emotions, but don't let your crazy brain talk you out of this healthy boundary. Be grateful to yourself for incorporating this healthy boundary and standing firm, and then also thank your loved one or recipient of that healthy boundary. Thank you for allowing me to go ahead and taking that time in the morning for myself, because I show it better for you. Let them see the positive effects of everyone honoring the healthy boundary. Let them see that you're happier. Let them see that you appreciate them. You might even say, if they've been yelling in the past, you could say well, thank you for asking kindly. I really, really appreciate it. It makes this life so much easier.

Speaker 1:

Maintaining healthy boundaries is a must. One caregiver said the care you give to yourself is the care you give to your loved ones. Isn't that true? Caregivers deserve to exercise, to sleep right, to have hobbies and enjoy their lives too. Boundaries are meant to protect you and the person you care for, to preserve your caregiving relationship and to create a more functional partnership with all of the people that you work with. By showing the courage to value your own needs, you enhance the quality of your caregiving experience that you're providing.

Speaker 1:

All caregivers experience the emotions of stress, frustration and anger. So no feeling you have as an invalid or not valid. One way to honor these feelings is to set healthy boundaries. It's not productive for anyone to deny your needs, your undeniable needs, for sure. So, to end here, a glowing caregiver gives glowing care, and it all begins with healthy boundaries. I hope you enjoyed this episode. This one is such an important one and it is so hard, but it is so necessary. So start small, my friend, and start working through them. Remember you're going to fail, you're going to go ahead and have to try again, but don't give up on the healthy pieces for yourself. Stay in tall, stay in firm, make sure that you are doing what's best for you because, again, you have to sustain this caregiving life. Have a good week and we'll talk to you again next week, same time, same place. Bye for now.

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