Friday, January 18, 2008

Four More Psychospiritual Levels of Family Caregiving

Level Four: Love

When our physical and emotional safety is assured and we have the willpower we need to make a plan of action and follow through, the most natural result is a desire to make loving decisions. Unfortunately, caregivers can be so concerned about doing what is loving for their relative that they forget to do what’s most loving for themselves. Caregivers who struggle on this level appear to willingly throw their lives away in order to provide the level of care they believe is right. They might do the self-care needed to stay physically healthy but never make time for their deepest heart’s desires. Eventually, however, this can lead to severe depression and illness can become the result.

These caregivers need acknowledgement of how loving they are and support to continue acting from a place of love. But, spiritually, they need to hear that refilling their own cups so they can give freely of their reserve is ultimately the most loving act for all.

Level Five: Communication

Love doesn’t do much good if you can’t communicate it. Caregivers struggling on this level complain that nobody really listens to them when they say what they need or report horrible family conflicts stemming from miscommunication or lack of communication on their parts.

I coach a lot of caregivers to communicate in ways other people can hear. I also encourage people to spend time listening to their inner voices so they can be clear about what they are asking for. Spending time each day in solitude, in prayer or meditation or by using art therapy, journal writing and other forms of creative expression can work wonders. Other people benefit from conflict resolution workshops or support groups where they are encouraged to express their feelings and ask for what they need.

Level Six: Perception & Imagination

I’m always surprised by how often caregivers allow themselves to be straight-jacketed by nothing more than illusion. A person living in the lap of luxury, making more money than I’ve ever even imagined for myself, will tell me he can’t afford to pay for services while a person in a run-down trailer park living on a tiny fixed income gives me a big donation check. There are caregivers who tell me that their severely demented relative couldn’t possibly be so badly off because “look at how good he looks” and others, dealing with only the mildest of memory loss, who insist their relative should no longer have their independence.

How a person perceives him or herself can also get in the way of healthy caregiving. Whenever caregivers see themselves as inadequate in some way their stress level and depression scores go way up. If they see themselves as prisoners every caregiving task becomes a hated symbol of oppression; if they see themselves as playing the role of guardian angel every caregiving task becomes a source of pride. Sometimes the biggest task is to help people see things from a different perspective.

Level Seven: Spiritual Belief & Purpose

Because caregiving stirs up so many moral issues, caregivers often talk to me about the role spirituality plays in their lives. Studies have shown that spiritual people have significantly lower levels of stress and my experience as a family consultant bears this out. Some people tell me their lives are blessed to be able to share so much love and to be of service to the people in their lives. They tell me times are hard but God never gives them more than they can handle. When I give these caregivers a standard depression scale test their scores are often the lowest of anyone I meet despite caregiving situations that rival clients with the highest scores. I am always humbled by how even the frailest elderly caregivers can be so strong and determined when buoyed by spiritual devotion. It is hard to ignore the value of such empowering beliefs.

Essentially, this level is about life purpose. Caregivers who operate from a sense of purpose have a clarity about their actions that is almost startling. They know that caregiving gives them an opportunity to fulfill that purpose and use my services to gather the resources they need to accomplish their chosen task. Others believe their deepest purpose lies elsewhere and choose to do what they can do as caregivers while maintaining adequate time and energy for their true callings. All caregivers who operate from a place of commitment to their highest goals tend to make choices that are empowering, clear and decisive.

Full Circle

It’s wonderful to be full of inspiration and higher purpose but if that purpose stays in your head and is never realized in physical reality it doesn’t do much good. We have to use all the abilities we develop along the way. We envision where we want that higher purpose to take us (Level Six) and communicate our hopes and dreams to others as we make our decisions and plans (Level Five). We gather community to support our heart’s desire (Level Four) and use our willpower to follow through on our intentions (Level Three). We find healthy ways to enjoy the process of getting to our intended destination (Level Two) and use all the physical resources at our disposal to bring our ideas to fruition (Level One).

That brings us full circle and makes it clear, I hope, that one level is not more important than the others. They all work together. They all are paths for personal growth and development, and caregiving, within this framework, is the perfect catalyst for this to happen.

This blog is an excerpt from The Spiritual Journey of Family Caregiving, available now through

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