Self Esteem

Mayor's Office of Employee Assistance
Self Esteem

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 left?

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.

Control 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.

Rebuilding Self-Esteem

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 self-esteem.

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
  • dancing
  • interacting with friends, old and new - form and reinforce social relationships outside the relationship with the caregiver
  • attending church
  • 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.

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