Mayor's Office of Employee Assistance
One of the dangers of aging and becoming dependent on others for care is that a person may lose his or her sense of autonomy and self-esteem.
After all, our sense of self is generally based on the idea that we can take care of ourselves. When that gradually disappears, what is
Caregivers, too, can lose a sense of themselves as autonomous individuals. They live their lives
continually for another person, and they may suffer
from loneliness, depression and anxiety as a result of
their loss of self.
Care receiving and caregiving both involve a dance
between dependency and control. It takes a lot of work
to walk the fine line between these two extremes and
maintain a healthy relationship for everyone involved.
Since they are ultimately responsible for the outcome of
the situation, caregivers in particular must know their
limits—to protect their sense of self while protecting the
care recipient’s sense of self as well.
The most obvious dependency in the caregiving relationship
is that of the care recipient. He or she depends on the
caregiver for many things—in some cases these are relatively
simple things like paying bills; in other cases these
are daily caregiving chores, like meals and bathing.
Ironically, however, the caregiver may also become
dependent on the care recipient. As a caregiver, you may
begin to understand yourself only in terms of your relationship
with the care recipient, and thus begin to lose a
sense of yourself as an independent person.
In response to the dependency issues on both sides of
this relationship, both the care recipient and the caregiver
may attempt to control the other.
Care recipients may time their demands and needs
in such a way that they conflict with important events
and other duties of the caregiver. They may refuse to
cooperate with their own care—not taking medications,
failing to exercise or not eating. They may also try to
manipulate the caregiver with guilt.
Caregivers, on the other hand,
may become so overworked and
manipulated that they take out
their frustrations on the care recipient
—becoming emotionally or
physically abusive in an attempt to
regain control of themselves and
their situation. Caregivers can create
dependency and care receivers
can develop dependence as a self-fulfilling
prophecy. Often, caregivers
refuse outside help, making
autonomy difficult. This is especially problematic during
the last few weeks of life, when hospice care can be an
important and critical support system.
To counteract the unhealthy extremes of dependency
and control, it is important that both the care recipient
and the caregiver have the opportunity to build their
Care recipients must be treated with respect and dignity
at all times. To allow their personalities and selfesteem
to flourish, encourage them to engage in activities
that they enjoy. This will also help them to stay
more mentally alert. Support activities such as:
listening to music or books on tape
interacting with friends, old and new - form and reinforce social relationships outside the relationship with the caregiver
sitting outside enjoying seasons
spending time with a pet
joining an exercise class
Caregivers must also make sure that they have
opportunities to renew their own sense of self-esteem. If
the caregiving becomes too much of a burden, hire
someone or invite a relative to take care of the elderly
person for a few days and leave for a mini-vacation. Take
time each day to do something you enjoy:
read a book
go for a walk or run
go out with and talk to friends
attend a movie, play or the opera
You can’t take care of someone else well unless you
also take care of yourself.