What Is Enabling? --- Guest Post

Enabling the elderly is not a topic that is discussed frequently. It is however something doctor's will discuss with you if you bring it up. Or if they suspect that they sudden "failings" your loved one may be exhibiting are because you are doing so much for them that they don't have to do things for themselves. 

Not all elders will allow enabling. Many like to be independent. But others will bask in over-coddling, and demand more. If you keep allowing it, you may be setting them up for a future of health problems. If you indulge an elder by waiting on them "hand and foot" , when they don't need that level of care, you could be contributing to functional, muscular, and cognitive decline. 

Today's guest author speaks about enabling from personal experience, and why sometimes, you have to learn to say NO.

Becoming a Caregiver and Learning About Enabling

The first word that leapt from the page when I first began to explore the world of caregiving was the word "enabling".  As a new caregiver, I had no idea what that meant.


 I was not a reluctant caregiver.  I was just sort of thrown into the task without knowing that I was becoming a caregiver.  One day I got a message from my nephew saying that my mother wanted me to call her.  


When I called her, she was frantic.  She was swearing that she had suddenly lost her eyesight completely, which had been failing due to macular degeneration for some time, and that she needed me to come get her immediately.  I assured her that I would be there the next day.

I live in Oklahoma.  She lived in Arkansas at that time.  Two of my daughters and I got up the next morning and drove the 200+ miles to her house to see what was going on.  She lived next door to my aunt and uncle and I hadn't heard anything from them about her suddenly needing assistance of any sort.  To tell you the truth, my aunt and uncle were just as confused about her sudden decision to move over here as we were.

The first indication that something was seriously wrong should have been that she was totally unprepared to go on a long trip when we arrived to get her.  She had packed her medication and a small suitcase.  She wanted to "move", so we grabbed what would fit into my small car and headed back to Oklahoma.



On the way, she insisted that she had to come live with us because she was blind even though we couldn't tell that her eyesight was any worse than it had been a few weeks earlier.  In addition, she told us all about the people she couldn't "trust" and how they were trying to take her things.  The list included my aunt and uncle and I must admit that she was very convincing.  We assured her that she could stay as long as needed.

This was our introduction to dementia, although we didn't know that at the time.  I just assumed that my mother, who had always had a habit of bending the facts in her favor, had some secret reason for wanting to come that she wasn't willing to share yet.



When you are dealing with someone who is elderly, you have a tendency to overlook those little personality quirks and humor them.  That is a normal human reaction to anything weaker than you are and it works really well in short-term situations.  However, when translated to a long-term care situation, it translates to enabling.  It is bad for the recipient and bad for the caregiver.

How is Enabling Bad for the Receiving Person

Unlike clinical situations, family caregivers are caring for a loved one.  They want to provide the best care they can out of simple devotion to that person.  Which means it is only natural that you would want to pet them and coddle them and allow them to do whatever they wish.  They are, after all, usually a parent or grandparent and we have a cultural obligation  to show them the utmost respect.


There may come a time, however, when your elder may not have the same mental acuity that they had before and their behavior or habits may become erratic.  Some even develop self-harming tendencies.  They may lash out at others.  Or, they may simply engage in activity that is completely unlike their former selves.

These changes are hard to accept but they are a natural part of the aging process.  Conditions such as dementia or Alzheimer's actually change the chemistry of the brain.  Sadly, sometimes it is to the extent where the person may look like your loved one but be a completely different person.  If caught early, medication can slow down the process so that they don't lose their mental faculties as quickly, but there is no cure and it will worsen at a gradual pace no matter what you do.

Once the process of change has begun and reached a certain point, your roles become reversed.  This elderly person that you have turned to for guidance and instruction is now your responsibility.  It's very difficult to re-teach yourself that you must be the authority figure for this person.  Let's look at some situations where enabling, and by that we mean always saying yes, could be harmful to your loved one;

• If your aging loved one develops visual impairments such as glaucoma or inoperable macular degeneration, allowing that person to cook could lead to serious burns or scalds or a potential house fire, possibly even death.

• If your elder is a smoker and insists on smoking in bed and you do not stop it, it could lead to severe burns and a house fire, possibly even death.

• If your aged loved one has the mental acuity but a severe balance problem, yet they insist on being able to go outside unsupervised and you don't put your foot down and refuse, you could be spending several hours in the emergency room with a possible fracture.  Elderly people fall fast and hard.

• If your elderly person has behavioral issues such as throwing their food, sometimes with the dishes, or displaying aggressive behavior such as pinching, hitting or biting, then you are allowing them to exhibit some of the same negative behavior that you would not allow a child to do.  Just like a child, the elder sometimes needs a firm "NO", perhaps even a timeout, to defuse the situation.  Please discuss all aggressive behaviors with a doctor as soon as possible.  It could be a sign of a more serious development in their condition that needs medical attention.

The Golden Years truly are a reversion to a more child-like state.  Your parent or grandparent may surprise you by spitting, biting, throwing things, or purposely wetting themselves.  Negative behavior should never be encouraged or allowed.  On the other hand, they may turn into someone really whiny or someone really sweet.  Just keep in mind that the way they've always been is NO INDICATION of how they will be once the chemistry of their brains change.

How is Enabling Bad for the Caregiver:

Have you ever heard the expression "Give them an inch and they'll take a mile"?  That could quite possibly be the outcome of enabling bad behavior in an elderly person.  Yes, it is easier to coddle them or pet them or give in to their every whim for a few blessed minutes of peace and quiet, but, in the long run, this type of enabling may lead to such a demanding person on your hands that you are literally pulling your hair out.  What begins as a subtle trend towards wanting something RIGHT NOW could become a habit that you regret ever allowing to get started. 

You don't have to say no all the time.  However, if there is a safety issue concerned or if it just seems like the elder is choosing moments that they know are the most inconvenient for you to demand instant gratification, then you would be well-advised to learn to say no.



 It is not going to hurt Mom to wait five minutes while you finish putting dishes in the dishwasher before refilling her water cup.  And it certainly won't hurt Pop to wait long enough for you to come around to his side of the car before trying to get out and risking a fall.

Stress is the greatest curse of caregiving.  With enabling, you have it both ways.  If you enable and their behavior becomes worse, there is the stress of dealing with an impossible elderly person who always wants their way.  In fact, they demand it.  Loudly.  You, dear caregiver, end up having no life to speak of other than waiting hand and foot on a person who is never sated.



Your reward for this is an ever-increasing stream of demands.  If you dare to NOT enable, you may face anger, back-biting, petulance, sulks, or perhaps retaliation by your loved one.  That's okay.  Hang in there.  The best way of dealing with any behavioral issue, whether with pets, children, or the elderly, is simple consistency.  If you are consistent and fair in your dealings with your loved one, you may find that they stop making that particular demand.  That, of course, doesn't mean that they won't find another one to test your patience later.

Final Thoughts:

When dealing with a loved one such as a parent or grandparent, it is easy to feel guilty about not caving every time a demand is made.  Perhaps you feel that your parent always dropped everything for you.  Or, perhaps, he or she insists that they did even though you don't really remember it.


Either way, we have a natural tendency to allow our elders to get away with far more than we would pets or children.  Sometimes to the extent where we end up spending so much time on them when it isn't really necessary that we neglect ourselves, our children, grandchildren, our pets, our marriages and our homes.


 It's very noble of you to do so.  It is also becoming a martyr.  Unless you are striving for sainthood, it is probably not in your best interest to allow this to happen.  You will only wreck your own health and peace of mind.  Caregiving is hard enough without martyrdom.  Don't become an enabler.

/qg

About Guest Author Qulia Goodman

My name is Qulia and I have been invited to guest blog on this site.  I am a Family Caregiver and, unlike many of the readers of this blog, I am not a medical professional.  I took on the task of caring for my then 92 year old mother with no formal training in long-term care and absolutely no concept of the enormity of the task before me.