Managing Caregiver Overwhelm in Decision Making

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As a caregiver responsible for making decisions for elderly parents, some decisions are irreversible. Experiencing caregiver overwhelm is the feeling of being unsure if your choices are correct when you are also feeling emotionally distressed.

Caregivers respond to unexpected situations that are ongoing. As a result, some decisions made in haste are regretted later. There are also occasions when something that seems like the right thing to do backfires.

What to Do When You Don’t Know What to Do

Watch this video for suggestions managing through situations that feel overwhelming.

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Where Caregiver Decisions Can Go Sideways

Mistakes are more likely to happen when decisions are rushed or not thoroughly evaluated. For example, how many of you take these actions and then second-guess yourself?

  • Make decisions without having enough information
  • Don’t have a grasp of the situation because you don’t know the right questions to ask
  • Fail to identify the short and long term effects of a decision and then have regrets
  • Believe, but don’t verify, information that turns out to be inaccurate and causes problems
  • Allow your or the emotions of others to influence a decision
  • Allow guilt to influence or delay making a necessary decision

Because caring for elderly parents is an emotional endeavor, separating emotions from facts to make good decisions takes extra effort and concentration.

Being Clear Headed

Being clear-headed may mean seeking advice in any situation that requires you to make a decision that will impact you and other people. When this arises, talk with a trusted family member, friend or consult a professional caregiving expert. Better decision-making results when you can set aside emotions and the chaos of a situation to focus on the facts and realities and learn from the experiences of others.

Gaining clarity in decision-making is a step-by-step process that results from identifying problems, confirming assumptions, and creating a list of options linked to short and long-term effects. Again, it is helpful to have access to someone who has made a similar decision to ask about the pros, cons, unexpected, and expected results.

While facing the reality of making a decision can result in the need to manage caregiver overwhelm, more problems can arise when time-sensitive decisions are delayed. Procrastination or hesitancy for caregivers often results from limited experience and the inability to project future results.

Decision-making difficulty is a factor for all individuals who lack experience. Sometimes, trial by error or doing it yourself becomes a path to evaluate less critical decisions. To successfully make decisions for elderly parents, family caregivers must become excellent investigators and verifiers of information.

Navigating Unfamiliar Territory in the Healthcare System

When faced with making a medical or healthcare decision, an initial reaction might be to take the recommendations of others who appear to have the knowledge and background to assist by virtue of their physical presence in a doctor’s office, hospital, skilled nursing, or assisted living community. Unfortunately, many family members in crises attach themselves to the first sympathetic or empathetic person they meet without determining if this person is a reliable source of information.

Questions to ask:

  • Has this person personally been in a similar situation before?
  • Who else was involved?
  • What were the decisions, the choices, and the results?
  • What are this person’s formal expertise, training, and length of time in their position?

Not all healthcare providers or employees have been in the situation of a family caregiver making a life or death decision yet give their opinions freely without considering the consequences. Based on my personal experience, an individual making recommendations without fully understanding the background of the situation will be more likely to provide erroneous recommendations.

Verifying information for reasonableness and practicality specific to your situation is critical when receiving recommendations. What works for other people may not work for you or your loved one if unwillingness exists to implement the recommendations. 

Asking questions to understand the thought process or the advisor’s recommendations is essential. Doctors and other healthcare providers can assume that patients understand their explanations. Most do not, which results in a danger zone for family caregiver decision-making.

Recognizing the Experience of Family Caregivers

Healthcare professionals often overlook the experience and knowledge of family caregivers. As a care manager and agent under power of attorney for clients, I experienced doctors and other care workers rushing to make decisions or recommendations without full knowledge of my client’s situation.

In one situation, a nurse on staff at a nursing home told me that she believed my client was  “was actively dying” and needed immediate hospice care. In another, a doctor on staff at a hospital intensive care ward told me that my elderly client should not be treated for pneumonia.

Because I knew the health conditions of my clients and their past responses to treatment for a urinary tract infection and pneumonia, I directed treatment. In both cases, had I not strongly advocated for my client’s needs, they would have died prematurely. Instead, bot lived for several more years.

Family caregivers in these situations may have allowed the nurse and the doctor to direct care and then blamed themselves for the deaths of loved ones. Noticing when you feel stressed or uncertain can help you take steps to manage feelings of caregiver overwhelm and stand up for the needs of a loved one. 

Realize that your day-in-day-out experiences as a family caregiver are valuable to diagnosing health conditions and helping doctors and others care for your loved ones. There are times when no detail is too small as it may shed light on a health issue that may be difficult to diagnose.

Make sure you share information and are not intimidated by others who may have more education or experience. You are on the front lines caring for an aging parent or spouse every day. Never allow a healthcare provider to make you feel unimportant. 

Advocating for the Needs of Loved Ones

Family caregivers in first-time crises situations may not know the steps to evaluate a decision or advocate for care needs with healthcare providers, insurance companies, and others.  Elderly who need care—when a caregiver is not present with them—may lack the ability to speak for themselves, especially when health takes a sudden turn for the worse and they don’t feel well or appear delusional.

Uncertainty and a lack of experience can result in a lose-lose situation.  For example, a family member lives with regrets because of making a wrong decision that resulted in the premature loss of a loved one’s life.

An older adult signs consent or admission paperwork without thoroughly reading or understanding what their signature means. An accident happens later in the hospital or a nursing home, and no one is held accountable for negligent actions. Family caregivers also sign documents without reading them, which results in similar problems.

Consulting an Advocate

While most caregivers and the elderly are unaware that professional advocates exist, an experienced caregiving advocate can help provide clarity, ask the right questions, and support decision-making that results in a positive outcome in situations of uncertainty. Taking steps for managing caregiver overwhelm is important for the caregiver’s well-being and the day-to-day care of loved ones.

Decision-making in caregiving and healthcare can be anxiety-producing for family caregivers. As a result, mental and physical burnout often occurs for the caregiver, resulting in poor decision-making and unintentional poor care or neglect of the needs of elderly parents.

Steps for managing caregiver overwhelm include thinking critically and asking why, how, or what questions. Next, consider what-if scenarios and options not previously considered. Being open-minded to consider various options may result in better solutions. Instead of limiting choices to your experiences, managing caregiver overwhelm means looking at all available options and making the best decision.

Before you make a decision that will irrevocably change your life or the life of another person, make sure you deliberate and take the time to investigate options, play devil’s advocate, and educate yourself. Decisions made in crises can be more problematic to correct if at all possible.

The negative outcome of many decisions made in haste could be forever changed if given a thoughtful moment and non-emotional consideration.  When in doubt about making educated decisions, seek a professional advocate to support you and your loved ones. Bottom line, trust your knowledge about the care situation and develop a trusting relationship with an advisor who can help you today and in the future.

Looking for More Caregiver Advice? Read Other Articles in Pamela’s Caring for Aging Parents Blog.

© 2022 Pamela D. Wilson, All Rights Reserved.

Article by: Pamela D. Wilson, MS, BS/BA, CG, CSA is a national caregiving expert, educator, advocate, and speaker. More than 20 years of experience as a court-appointed guardian, power of attorney, and care manager serve as Wilson’s platform to increase awareness of caregiving as an essential role in life. She is a content developer, author of all articles on this website, and videos on her YouTube Channel. Wilson hosts and produces The Caring Generation® podcast and is the author of the book The Caregiving Trap. You can reach Pamela by completing the Contact Me Form on this website.

About Pamela Wilson

PAMELA D. WILSON, MS, BS/BA, NCG, CSA helps caregivers and aging adults solve caregiving problems and manage caregiving needs through online programs, live support groups, and an extensive caregiving library that includes articles, podcasts, videos, and webinars.

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