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Why Expectations are Critical for Healing

Margery Pabst - June 03, 2011 01:20 PM

Expectations can be a tricky business.  Set them too high and people get frustrated; set them too low and you get complacent and lazy.  In the context of caregiving, what is a caregiver to do?  On the one hand, all of us know that keeping your care partner engaged and stimulated with events to look forward to is critical, yet setting yourself and your family up for some degree of failure isn’t good either.

All of us are aware of those who treat patients and partners in a patronizing way, giving them little in ways that encourage self-worth, self-reliance and decision-making.  Let’s make it a goal to avoid this situation!

In his ground breaking book, “Treat Me, Not My Age”, Dr. Mark Lachs notes in his sub-title, ‘The Older You Get, the Trickier it is to Navigate the Health-Care System’.  One of Dr. Lachs key points is that the healthcare and government systems treat us as our numerical age, while EACH OF US is unique with varying needs and expectations for ourselves.

How can we ensure that expectations are appropriate not to our age but to the appropriate level for each person?  Here are some tips to consider for yourself and others.


First,  observe the body language around you as your care partner/loved one is treated.  Ask yourself these key questions:

Is my care partner given direct eye contact?

Is my care partner given direct attention?  Does the physician or medical  professional sit by my care partner rather than stand over him/her?

Does the health provider watch for non-verbal signals that indicate my care  partner wants to talk, ask questions, and make decisions?

Second, observe how questions and statements are made by medical professionals.  Ask yourself these key questions:

Is my care partner addressed directly or does the health provider address only  the caregiver, using the third person? (i.e. “I think she needs more medication for  her condition”.)

Does the health provider stop talking and provide space and time for the  caregiver/patient to respond and give information?

Does the conversation include positive, uplifting comments that encourage  progress?

Third, ask the questions listed above in the context of family dynamics by inserting the words ‘family member’ instead of medical professional into the question.


What can caregivers do to change the dynamics of conversations to ensure that the patient/loved one is included, treated with dignity, and encouraged to make decisions about treatment?  Ensuring that your care partner is included will raise expectations for both their emotional and physical well being.

First, address the care partner directly by asking questions like “So mother what would you like to do?” and encourage him/her to ask questions and make decisions.

Second, encourage those around you to directly address the person with questions and comments.

Third, raise expectations to an appropriate level for the patient by encouraging everyone, the patient, medical professionals and family, to set goals that include benchmarks for progress.

We all want healing to occur quickly.  By inviting participation and encouraging progress, the successful caregiver can make it happen.

Margery Pabst is eCareDiary’s host of the “Caregiver and Physician Conversations” radio show, that focuses on discussions between caregivers and physicians about the challenges confronting patients and their families. Listen to the archived shows here.

Margery Pabst is the co-author of “Enrich Your Caregiving Journey”, the winner of the “2010 Caregiver Friendly Award”.   She is the host of eCareDiary’s “Caregiver and Physician Conversations” heard on BlogTalkRadio the last Tuesday of each month at 2PM EDT.  Margery also writes the feature, “Ask the Caregiving Coach”.  For more information, go to

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