Caregiving and Control

When it comes time to accept a little help, not everyone says, “Yes, please!” It doesn’t matter if the offer comes from a dear family member or a professional caregiver, the answer can often be, “No way!”

Dr. Barry J. Jacobs, Psy. D., clinical psychologist and co-author of “AARP Meditations for Caregivers” and author of “The Emotional Survival Guide for Caregivers,” answered a few questions about the need for control and how to navigate it to help individuals continue to have their best quality of life possible.

Does a need for control over one’s life change with age or is it set in their character throughout life?

We are each born with a certain temperament that does generally affect how we approach living. Some of us will be more laid back and easy-going. Others--call them Type A--will be hard-driving, organized and detail-oriented. Those latter folks will place greater importance on controlling themselves and their environments as a means of better ensuring their survival and that of their loved ones.

That said, I do believe the need for control changes over the course of our lifetimes. We are born helpless and dependent and, of necessity, have to accept help from others. Then we reach an age when we are more physically and emotionally self-sufficient and take pride in our independence and sense of mastery. (In our American culture which celebrates individualism, that pride is reinforced.) As we move toward having our own families, we often need to learn to temper our individual pursuits for family needs and to become more collaborative. As we grow older and our physical and, perhaps, cognitive abilities begin to decline, we are then back in the position of having to accept greater assistance from others--sometimes against our will.

How does a need for control manifest when someone is older and may need help with daily activities? For example, it could appear that they are afraid of doing things in a different way.

As way of preserving our independence and our sense of self-identity, many of us resist accepting help as we age. It is as if we believe the old adage that if we give an inch, others will take a yard. In other words, if we allow others to do anything for us, then we lose who we've been and are rendered helpless again. Accepting help is viewed as dis-empowering, rather than as a means of getting a boost up in order to live the way we want to. We therefore block others' efforts to help us as a way of maintaining control over our lives and empowering ourselves. We say, "Thank you but I can manage my own pill box" even when we may have already made mistakes with taking the wrong pills at the wrong time. Or, worse, we say, "I can still sit on my rider mower and care for my own property" even though our physicians have told us we are at risk for heat stroke. We double-down on who we've been and how we've always done things--even at our own peril.

I talk with older adults and their family caregivers all the time about the importance of "receiving graciously." I think this is one of the most difficult things to do in life because it requires that we accept change and adapt to it, even if we don't like it. It also requires that we embrace allowing others, such as family members, to give back to us for all we've done for them in the past. What I frequently point out to older adults is that there is giving in receiving. That is, when they give adult children the opportunity to step up and assist them, then they are providing them with the chance to grow and mature and feel good about giving.

How can control be detrimental to one’s quality of life?

Control can cause rigidity and stubbornness. It can lead us to reject help that we really need and consequently place ourselves in harm's way. If we mix up our pills and then wind up in the hospital, then we are not helping ourselves. If we don't use our walkers and then fall and break bones, then we are not helping ourselves. If we reject our adult children's offers of help out-of-hand because we don't want to feel diminished or burden them, then we are not helping ourselves or them. We have to be smart and not so prideful. We have to adapt.

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