“Mother expects me to drop everything and come visit her in the nursing home whenever she calls.  She just doesn’t get that I have a family and a job that I’m responsible for, too.” 

This dilemma is not uncommon among caregivers who, despite their best efforts, often find themselves conflicted over their personal needs and their elder’s sense of entitlement.  This article outlines older adult issues, how to reframe guilt and to create a better balance in caring for loved ones.

What is entitlement?  Simple stated, entitlement is an attitude marked by a you-owe-me quality.  A person feels deserving of another’s time or money or material things despite the cost to the giver.

What are the causes entitlement?  There may be many.  For starters, picture someone tilting her head slightly, putting the back of her hand on her forehead and groaning, “After all I’ve gone for you.”  Someone with a martyr complex is one cause of entitlement.  This doesn’t just begin in old age; usually it’s a lifetime of playing the victim.

On the other hand, for someone who’s been independent all his life and is now faced with failing health, medical complications and the need to move from home to a residential care facility (or into a family member’s home) may also develop a sense of entitlement.

Other causes might include people with personality traits or disorders such as narcissism (I-am-the-center-of-the-universe with no regard to you) or extreme dependency.  Older adults who are fearful of sickness or death or experiencing loneliness may feel entitled. 

The onset of dementia during the early stage in which a person knows s/he is losing memory may at times create a dependency; however, in my experience with clients, most want to remain as independent as possible to “prove” they still have their faculties.

People who by nature are critical, judgmental and non-empathic sorts think nothing of intruding on others’ times with demands and complaints if they don’t get their way.  And many nursing homes which bend over backwards to accommodate the older adult can see a rise in residents who feel a strong sense of entitlement.  When a person is used to getting her/his way, it can become problematic for family caregivers if the loved one demands the same from them.

Let’s talk about caregiver guilt!  As a former secondary school teacher, I always like to start with definitions.  Guilt is the moral rightness or wrongness of an act.  That mean if you’ve done something immoral, illegal or unethical, you have a right to feel guilt.  

Have you ever said, “I feel so guilty eating this cookie” or “I felt so guilty when I said no to helping with that project.”  We sling the word guilt around quite a bit.  With it comes a weight we experience which translated means, I must be a bad person.  

How about, “I felt so guilty putting mom in a nursing home, because I PROMISED her I’d never do it.”  That action is neither immoral, illegal nor unethical.  Reframing what you feel, e.g., sad, regretful, bad about it—these are appropriate and real feelings and can help reduce the amount of heaviness you feel when you use guilt.

Caregiver tips to ward of entitlement.  Rather than getting sucked into negative feelings, making excuses to the older adult or outright arguments, try these:

• Establish healthy boundaries.  That means sticking to your routine of work, raising the family, limiting phone calls if they become excessive.  In other words, don’t allow another to have you drop everything to take them to a doctor appointment (or whatever).  Let your older loved one know the hours you can drive that week, and ask them to schedule around your availability.
• Do a reality check.  Ask yourself, how would my close friends say I’m doing? 
• Attention Type A personalities.  Get over perfectionism.  Not everything you do has to be 100%.  A 93% is still an A.
• Redirect comments.  When zingers are thrown at you because an elder says, “I didn’t raise you to be so selfish,” say “Mom, you taught me everything I know.”  Then change the topic to something lighter. 
• Enlist family members’ help when possible.  This might mean asking them to help driving to appointments, taking turns visiting, helping with yard work if your loved one is still at home.  For out-of-towners, ask brothers or sisters to help by contributing money if needed for groceries, gasoline, the extras often needed that you usually purchase.  Even the cost of small items mounts up over the months and years. 
• Communicate directly with your parents regarding their fears.  Many people dance around topics such as illness, wills, last wishes, fears about aging and more.  Many times the older adult is ready and willing to talk, but no one asks. 
• Make your own self-care a priority.  Right now, make a list of three to five close friends of yours.  (Stop and take a moment to do this.)  Did your name appear on the list?  We know how to take care of friends; we need to treat ourselves the same.  Do you take time to exercise? relax? pray? read a good book? reward yourself with a treat now and then? You know what I’m talking about. 
• Give yourself a break.  Be compassionate with yourself.  Know that you’re doing the best you can with your circumstances. 

Practicing these tips will help prevent us from developing our own sense of entitlement and to ease into our elder years with more grace.

About Patti

Patti Bertschler is a clinical counselor, mediator, author, trainer and co-owner of Northcoast Conflict Solution in Seven Hills, Ohio. She is co-author of TRUCE! Using Elder Mediation to Resolve Conflict among Families, Seniors and Organizations (©2004) and Elder Mediation:  A New Solution to Age-Old Problems (© 2009).  Her booklet 88 Tips for Shy Introverts: Becoming Personally and Professionally Assertive was published in 2010.  Patti can be reached via website, www.ncsmediation.com or by calling (216) 236-6200.