University of Wisconsin - Extension

MADISON, Wis.—As a family caregiver you experience many stressful situations and you respond in one of three ways: you can assertively change the situation, you can leave the situation, or you can adapt in order to live with the situation and not feel so frustrated. All of these options are appropriate and useful in many caregiving situations, says Mary Brintnall-Peterson, University of Wisconsin-Extension program specialist in aging.

“The way a caregiver thinks about a situation often directly affects the way they feel about it,” Brintnall-Peterson says. “Often when caregivers are angry, their emotional state is so overwhelming that they don’t notice the thoughts they are having. These thoughts are typically extreme and negative, and they tend to perpetuate the state of being angry.”

Caregivers can take three steps to manage this frustration and anger. The first step is to recognize the thoughts that fuel it. The second step is to evaluate those thoughts and attempt to see an event from different angles. The third step is to change those thoughts and develop more helpful or adaptive thoughts that promote coping rather than anger.

Some thought patterns seem to keep us “stuck,” or lead us to feel more distressed and upset. These thought patterns are not necessarily wrong or right, but when one is in a particular caregiving situation they may not be helpful. To help caregivers recognize them, Brintnall-Peterson provides a list of the most common unhelpful ways of thinking:

1. Thinking in “All or Nothing” Terms

This is the tendency to perceive things as either all good or all bad. An example would be a family caregiver who thinks they are the only person who can give care to their loved one because one time when they were gone a family member forgot to give him/her their meds. This reinforces the idea that they are the only one who can provide quality care.

2. Mental Filtering

We use mental filtering when we filter out the positive things in life and focus on the negative. A caregiver may be using a mental filter when he or she becomes preoccupied with one problem behavior and ignores any positive aspects of caregiving. Common ways of filtering include over generalizing, exaggerating or reducing the significance of events, and discounting the positive.

When people generalize too much, they conclude that one event reflects the way things will always be. For example, they might say, “no one will ever understand how difficult the situation is.” People may exaggerate or reduce the significance of events, either exaggerating negative qualities, or minimizing positive qualities. They might say, “Sure I’m good at managing my husband’s medications, but who wouldn’t be able to do it when all you have to do is put them in the pill case,” or “How can I take care of our household finances when my husband always did it and I can’t even balance our checkbook?” Others may discount the positive and minimize compliments received from others. Instead of accepting a compliment, caregivers may say, “Well I could be doing more.”

3. Jumping to Conclusions

We jump to conclusions when we reach a negative conclusion without having all the facts about a situation. We commonly do this by Mind Reading and Predicting the Future. Mind Reading is when someone makes an assumption about what the other person is thinking. They might say, “David said he would care for Dad today, I think he just said that to get me off the phone.” In Predicting the Future, a person makes assumptions that negative things are going to happen, or that people will respond in a negative way. They may imagine that a doctor visit will not go well. They will worry about this future possibility, rather than enjoying the present. They might say, “If I give him a bath, he’ll just fall and hurt himself.”

4. Thinking “I Should”

The problem with saying “I should” is that the statement has more to do with opinions than with reality. We usually say “you should” to others when we think we know what is best for them. We may feel frustrated when they disagree with us. By saying, “I should” to ourselves, we may end up feeling depressed and angry, because what we “should do” is not what we really want. A caregiver might say, “I should not even consider putting Mom in a nursing home. I must carry on.”

5. Labeling

Labeling is a form of generalization. Instead of seeing our faults as only one part of our selves, we single them out as a reflection of our entire selves. For example, a caregiver may act impatient in caring for a family member, and then conclude that they are an impatient person, or “stupid” or “no good.” They might say: “I’m a bad daughter because I’m selfish. I want to go out and have a good time but I have to stay home.”

6. Personalizing

We personalize when we assume responsibility for a negative event when we’re not to blame. A caregiver may feel embarrassed by something her relative says to someone, as if the sick person’s behavior were a reflection of her abilities as a caregiver and not just a symptom of the illness. They might say: “If I hadn’t left town for two days, my father would not have fallen down and broken his hip.”

If you find yourself as a caregiver getting stuck and using some of these unhelpful ways of thinking, just remind yourself that you can control what you are thinking and you are doing the best possible job you can as a caregiver. Monitor yourself and remember that family and friends are sources of assistance and you also need to care for yourself. For more information consult: http://www.uwex.edu/ces/flp/caregiving/careres/index.html . This web site contains links to all types of resources for family caregivers. You can also consult your local UW-Extension office or your local aging department.