Choosing Between Spouse and Elderly Parent – The Caring Generation®

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The Caring Generation® – Episode 70 January 27, 2021. On this podcast for caregivers, Pamela D Wilson caregiving expert discusses Choosing Between A Spouse and Elderly Parent. Guest, Dr. Mark Goulston shares tips for family caregivers and healthcare workers can manage situations that feel out of control. 

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Choosing Between Spouse and Elderly Parent


0:00:04.6 Announcer: Caregiving can sometimes feel like an impossible struggle. Caregivers may be torn between taking care of loved ones and trying to maintain balance in life. The good news is that it doesn’t have to be that way. The Caring Generation with host Pamela D. Wilson is here to focus on the conversation of caring. You’re not alone. In fact, you’re in exactly the right place to share stories and learn tips and resources to help you and your loved ones. So now, please welcome the host of The Caring Generation, Pamela D. Wilson.

0:00:38.7 Pamela D. Wilson: This is Pamela D. Wilson, caregiving expert, author, and speaker. Welcome to The Caring Generation, focusing on conversations about health, well-being, caring for ourselves and aging parents, all tied together with humor and laughter essential to being a caregiver. Podcasts of this weekly show are available on your favorite podcast apps, Apple, Google, Spreaker, and my website at Click on the Media tab and then The Caring Generation. The topic for this caregiving program is Choosing Between Spouse and Elderly Parent. If you are a caregiver, it’s okay to say out loud, “Caregiving is ruining my marriage.” Not being honest about the stress that caring for elderly parents places on your marriage can end a marriage. During this program, we’ll talk about situations that result in spousal caregiver resentment and how to avoid choosing between spouse and elderly parent. The guest for this show’s health and wellness segment is Dr. Mark Goulston, who joins us to talk about managing caregiver stress in uncertain times. He’s the co-author of a book, Why Cope When You Can Heal: How Healthcare Heroes of COVID-19 Can Recover from PTSD, and another book, Trauma to Triumph: A Roadmap for Leading Through Disruption and Thriving on the Other Side. He is a board-certified psychiatrist, a fellow of the American Psychiatric Association, and a former assistant clinical professor of psychiatry at UCLA.

0:02:17.4 Pamela D. Wilson: Let’s talk about resentment related to choosing between spouse and elderly parent and thoughts that caregiving is ruining my marriage. Caregiving daughters and sons run into the same roadblock of time. There’s only so much time in a day if you are a working caregiver and managing a career, trying to taking care of your family, and maintaining a relationship with a spouse. According to a Boston Center for Aging study, adult children caregivers devote on average 77 hours a month to care for an elderly parent. When you think about it, this equates to about two weeks of full-time work or essentially having a part-time job that consumes 20 hours of your time each week, or basically working 60 hours a week. Where does this extra 20 hours a week come from? It comes from choosing between spouse and elderly parent time. It comes from eliminating things that are good for you like exercise, participating in hobbies or social activities that you enjoy, and that energize you. Spouses who say, “Caregiving is ruining my marriage,” understand that giving up everything that makes you happy and devoting this time to caring for elderly parents can result in being a little miserable. When nothing in life gives you joy, caring for an elderly parent can feel exhausting, resulting in having little energy or time to give to your spouse.

0:03:50.3 Pamela D. Wilson: Spouses tell me one of their greatest wishes is to get a few hours of uninterrupted sleep if they are a caregiver. How many of you feel this way? Choosing between spouse and elderly parent can be a losing proposition for caregivers. The resentment experienced by the caregiving daughter or son can rise dramatically. If the person being cared for is a mother-in-law or a father-in-law, refuse to allow your marriage to be destroyed by parents or parents-in-law. Caregivers ask how to manage when you no longer like the person for whom you care. If that’s your situation, you might be interested in The Caring Generation Podcast, Caring for an Elderly Parent You Don’t Like. This and all the podcasts are on my website, Go to the Media tab and scroll down to The Caring Generation.

0:04:42.6 Pamela D. Wilson: So where do you start with resolving the resentment that might eat at you every day from worrying about choosing between spouse and elderly parent? The first person to prioritize is your spouse. Begin the conversation about the strain that caregiving is placing on your relationship. Ask the question, “Why are we allowing this to happen?” Discuss the imbalances that exist in the caregiving relationship. Are you holding down a full-time job and caring for an elderly parent? Does your spouse hold down a full-time job and take care of the house and other projects? How can you compromise to choose between spouse and elderly parent relationships? Can you trade off caring for an elderly parent every other week? Can you hire in-home caregivers to give you a week or two off each month?

0:05:34.7 Pamela D. Wilson: Prioritizing marriage means that you need time and space away from caregiving. A little time for yourself and time with your husband or a wife to avoid choosing between spouse and elderly parent. With the demands of caregiving, it isn’t easy to balance relationship time. You’ve heard the statement, “Something’s gotta give.” Something has to give when thoughts of caregiving are ruining my marriage, and choosing between spouse and elderly parent are the only thoughts on your mind. The winner must be your marriage and you. Don’t allow an elderly parent to make you feel like choosing between spouse and elderly parent is your only choice. If you feel resentment about caring for an elderly parent—whether it’s your parent or an in-law parent—say something. Speak up. Begin talking about the amount and type of care that you’re providing. Decide who does what. Have this conversation to understand that the who, in this case, may not be you or your spouse. Your elderly parent may have to pay to bring in outside help and support if they want to stay at home. Be honest with yourself about the time, effects, and demands of caring for an elderly parent. I know many of you feel like this is your responsibility. That is fine, but how will caregiving affect your career, your family, and your income in the short and long term?

0:07:00.0 Pamela D. Wilson: Research confirms that many adult children financially contribute to the cost of care for elderly parents. If you are in a financial position where you can pay for care for elderly parents, that is wonderful, but many caregivers are not. Look into Medicaid services if your elderly parent is low income and does not or will not have enough savings to pay for care for the rest of their lives. Plan to identify different options for care. The earlier that you begin having these conversations—so that you can avoid choosing between spouse and elderly parent—the easier it will be to prioritize your marriage while making sure that your elderly parent has care. We are going to continue to talk about how to separate the work of caring for elderly parents and maintaining that very, very important, amazing partner or spousal relationship in the second half of this program.

0:08:01.8 Pamela D. Wilson: Up next, we’re going to be talking to Dr. Mark Goulston. He joins us to talk about managing caregiver stress for family caregivers and healthcare providers in this time of COVID and with everything that’s going on with health and well-being. Helpful tips for caregivers and aging adults are in my Caring for Aging Parents Caregiving Blog. It’s on my website at And if you’re looking for an online caregiving community that is not on a social media channel—I’ve been asked by caregivers about this—people seem to be going away from social media, check out The Caring Generation community. It’s on my members-only website, This is Pamela D. Wilson. You’re with me on The Caring Generation. Stay with me. We’ll be right back.


0:09:20.7 Pamela D. Wilson: This is Pamela D. Wilson, caregiving expert on The Caring Generation for caregivers and aging adults. Joining us is Dr. Mark Goulston. Dr. Goulston, thank you for joining us.


0:09:34.2 Dr. Mark Goulston: Thank you for having me, looking forward to this and seeing if we can give some help to these caregivers.

0:09:41.2 Pamela D. Wilson: So, you have a book out, it’s called “Why Cope When You Can Heal? And it talks about the effects of COVID on healthcare organizations. What is the impact of job losses, furloughs, canceling, elective procedures on the mental state of the healthcare workers?

0:10:00.1 Dr. Mark Goulston: Well, of course, they’re anxious. They’re uncertain. They’re overwhelmed. That’s why it’s really important to know if you’re a leader. What healthcare workers need to hear from leaders—and leaders need to understand that they can’t avoid this because when people are uncertain and anxious, they look to their leaders. And what’s on their mind? If you’re a leader and you’re listening to this—what they want from you and if you can put the politics aside— I think Governor Cuomo, when he was doing the briefings, models this. What’s on people’s mind is what just happened. Tell us what just happened. And then what’s on their mind is, what does it mean to us? What does it mean to me? Will we get through this? What do you need? What are you going to do? What do you need me to do? And how often are you going to speak to us?

0:11:00.4 Dr. Mark Goulston: And I think we saw with Governor Cuomo—again, politics aside this is not a partisan issue—I think he did a good job during the briefings, and I think President Biden is trying to follow this also. So the more people feel anxious and out of control, the more they look to their leaders. And the effect is—we’ll get into this is—when you’re feeling this state, and you feel kind of trapped, there’s a tendency to pull away. There’s a tendency to withdraw. Which you can understand because you want to lessen all the stimulation when you’re overwhelmed. But the problem is, if you pull away and stay away, you become prey to your imagination. And as someone once told me. “When you’re in your own mind, you’re in enemy territory.”


0:11:46.4 Pamela D. Wilson: That is so true. So can you put this in the perspective of patients? So how are patients and consumers being affected by these healthcare shortages and being worried if they can even get the vaccine?

0:12:00.5 Dr. Mark Goulston: Well, it’s the exact same thing. They’re feeling uncertain, they’re feeling anxious, and they’re looking for answers. They’re looking for reassurance, and so they need to get that from their healthcare providers. And the healthcare providers are looking up—it’s like a daisy chain effect looking up to leaders—to be able to reassure people that we’re going to get through this. One of the most eloquent quotes I heard from someone was, “It comes down to learning to live with life never being the same again.” Someone shared that quote with me when they had gone through a trauma, and they turned a corner. When they said, “What it comes down to is living with life never being the same again,”—we did that after 9/11. When people have cancer, they do that. And so, just because we think we can’t get through it doesn’t mean we can’t because we all always have.

0:13:00.5 Pamela D. Wilson: And I was reading in one of your books, there was a mention about healthcare workers saying that they don’t feel that it’s okay to talk about the stress that they’re experiencing in the workplace. Where does that feeling come from?

0:13:13.7 Dr. Mark Goulston: Well, one of the things we talk about in Why Cope When You Can Heal is that when you’re going through distress—it’s not the post-traumatic thing—you’re in the trauma. What happens is, a lot of times, you have to—there are thoughts and feelings that can take you off course. Because what’s happening is—and we talk, we have actually an algorithm in the book in which healthcare workers—and we’re talking about frontline people and first responders, the people in nursing homes. What happens is when you see something that horrifies you, it triggers a sense of terror and high anxiety. You can feel fragile, and you feel panicky. But then what kicks in is if you’re very duty-bound to your clients and your patients, to your colleagues—what happens is when danger kicks in—it triggers this adrenaline rush. Not as in excitement, as in just dealing with the danger. NBA players can play a whole game with a broken leg when they’re running on adrenaline. But then, of course, when the game is over, they find out they fractured their leg. Well, the same is true for a lot of people going through these stresses. That as long as the adrenaline is pumping, it enables people to push away the thoughts and push away the feelings that if they give into, they feel will take them down.

0:14:43.6 Dr. Mark Goulston: And this is a real challenge because when we talk to healthcare centers, they say, “Look, we’re sympathetic to what they’re going through, but they’re afraid to have them give in to their thoughts and feelings because they have to function.” So one of the things that we’re recommending is that healthcare workers meet with their colleagues and not so much get into their feelings, but get into their solutions. Talking about how are you able to stay focused? How do you push away the scary thoughts and scary feelings? And we recommend people doing that in a group because when you do it in a group and you bond with each other, it actually releases something called oxytocin. That’s the bonding hormone. And the bonding hormone actually lowers another hormone called cortisol, the stress hormone. So the more that you can talk with your colleagues—but talk focused on getting through it—at least when you’re going through the trauma, that bonding can actually help you get through it together.

0:15:50.3 Pamela D. Wilson: And then I’m going to ask you a question. We may have to go out to a break. But so the healthcare professionals feel they’re pushing away these thoughts and feelings, when do they get to deal with these thoughts and feelings, or what do you recommend besides these groups?

0:16:04.9 Dr. Mark Goulston: Well, there’s something that we talk about in Why Cope When You Can Heal. It’s called a relief distress exercising journal. We’re really encouraging journal writing. Because what happens when you write in a journal, it belongs to you, and it’s a way of you actually empathizing with yourself. And the way that the distress relief exercising journal works is we recommend you think of someone living or dead who is there for you. Think of a mentor, think of a parent, think of someone who just believed in you. And then, there are certain prompts that you write down in the journal. And the prompts are, they’re saying to you, “You can get through this.” And then they say, “Write down the day and date because it’s a journal. You’re going to—it’s a journal—you’re going to walk your way through. But it looks like we’ll finish up the remainder of the steps when we get on the other side of the break.

0:17:02.0 Pamela D. Wilson: Yes. So we are going to head out to a break, Dr. Listeners. We will be with Dr. Mark Goulston after this break. This is Pamela D. Wilson. You’re with me on The Caring Generation. Stay with us. We’ll be right back.


0:17:31.7 Pamela D. Wilson: This is Pamela D. Wilson, caregiving expert. You are with me on The Caring Generation. We are back with Dr. Mark Goulston. So Dr. can you finish up the answer to that question about the relief distress journal?

0:17:43.7 Dr. Mark Goulston: Yes. Absolutely. In fact, what I’d like you to do, Pamela, is—I would like you to imagine that something very upsetting has happened to you, and you got tweaked. And I’d like you to imagine either a mentor, a spouse, a parent, a teacher. And this is what they say to you. So imagine you’re upset, and these are the steps they say. They say, “Pamela, you’re going to get through this.” And you feel they’re caring for you. Write down the day and date. You write it down. What just happened? You write down in a sentence or two what happened. Then they ask you, “Pamela, what did you think when it happened?” I thought it was the beginning of the end. I don’t know what to do to. “Pamela, what did you feel when it happened?” I felt scared. I felt overwhelmed. I felt like I don’t know that I can take it anymore. And then here’s the most important one. “What does it make you want to do?” So what’s the impulse that you want to turn into words instead of acting on? I feel like running away. I feel like just closing myself up and just hiding out.

0:18:48.0 Dr. Mark Goulston: And then imagine them saying to you, “Pamela, take three slow breaths.” You take them in. You feel that person caring about you. And then they say, “What would be a better thing to do?” “And actually, the better thing to do is talking to you about this and remembering how much she cared about me. Appreciating you. Being grateful. I feel less alone. “And why would that be better?” Because I feel calmer. I feel like I don’t have to act on the impulse. And actually why this works— I don’t know if you could track that, when I was saying it, Pamela. Why it works is when you can imagine someone talking you through it, and I mentioned this before, it releases oxytocin. You actually feel a bonding experience with that person in your mind. And as that goes up, as you feel cared about by that person and you imagine them. It lowers your cortisol and the stress. And when it lowers the cortisol and the stress, you calm down, and you’re able to think clearly. I lost my ACE mentor three days ago, that was Larry King. I had breakfast with Larry King for two years every morning. And so he’s been talking to me because that helps me calm down.

0:20:02.9 Pamela D. Wilson: Well, and during the break, we were talking about how to help families get through this—because you live in Los Angeles. People who have been in lockdown for a long time may be getting on each other’s nerves. Can you share those thoughts?

0:20:16.0 Dr. Mark Goulston: So there’s an exercise that we’re asking families to do, and it’s called the HADA exercise, H-A-D-A. And we ask families that at the end of every day, for each person to ask each other, what was the most upsetting thing that happened to you today? And then HADA stands for—did you talk about either feeling Hurt, Angry, Disappointed or, Afraid? Hurt, angry, disappointed or, afraid. And there’s a lot of research, much of it done out of UCLA through a psychologist named Matthew Lieberman. That when you give people the right word to express what they’re feeling, it lessens agitation. And this is also a good thing for you to do with yourself when you’re caring for an elderly parent who’s really taking a lot of energy out of you. Because, often, that can trigger those things.

0:21:18.5 Dr. Mark Goulston: It’s also a good thing to have conversations like this with your spouse. Because sometimes, if you’re a caregiver or caring for an elderly parent, you can neglect your relationship. And using those four prompts, what was the most upsetting thing that happened today, and talk about did you feel hurt? Did you feel angry? Did you feel disappointed? Did you feel afraid? And you can switch the order of them. But that’s an order that a lot of people feel because when people feel hurt, they often don’t feel hurt, they go to anger. Because their hurt makes them feel too vulnerable. And then when they express the anger, they get it off their chest. And then they calm down and say, “I’m not angry, I’m just disappointed. I’m just disappointed I don’t have more patience with my elderly parent. I’m just disappointed that they seem to be taking advantage of me.” And then the final thing, What are you afraid of? “Well, I’m afraid that I’m just going to run out of patience. I’m afraid I’m going to be snapping at my parents. Yes, they’re difficult, but they raised me. They cared for me, and I want to do what’s right for them.”

0:22:26.6 Pamela D. Wilson: And then so we have this COVID, and frustration I noticed was mentioned by healthcare workers in your book, who—the cases are going up. The consumers aren’t doing everything. Some people don’t want to take the vaccination. How do we get everybody to listen and understand the importance of the precautions to not get COVID, and then why people should get vaccinated?

0:22:50.7 Dr. Mark Goulston: People push back when you’re telling them they have to do something. It’s human nature. So what you really want to do is when people aren’t wearing masks, when people aren’t taking precautions, rather than jumping down their throat, let them do that and then say, “Tell me what goes, what’s behind your decision to not do it?” And what you want to do is the more you allow them to talk and the more they feel cared about you, the more they may calm down and the more they may listen to reason coming from you.

0:23:25.9 Pamela D. Wilson: That makes sense. And then what other advice can you offer to healthcare workers and family members about seeking early help to manage all this stress before it gets—before they’re off the charts?

0:23:40.8 Dr. Mark Goulston: Well, the more you—look, the more you push it down and push it away to survive—you know that something is building up inside you. And you can say to people, “Look, you’re functioning on the surface, but do you feel this increasing pit in your stomach like something’s wrong?” And if they say yes, you could say, “Talking about it can lessen that and help you get through it.” And they can use some of the exercises that we’ve talked about on the show.

0:24:10.7 Pamela D. Wilson: Perfect. Dr. Goulston. I thank you so much for joining us. Listeners, if you want to be able to share this show, the podcast will be up in about a week on my website at You click on the Media tab and then The Caring Generation. This is Pamela D. Wilson. You’re with me on The Caring Generation. Stay with me. We’ll be right back after this break.


0:24:48.7 Pamela D. Wilson: This is Pamela D. Wilson, caregiving expert, author, and speaker on The Caring Generation. If you’re looking for a caregiver support group, articles, programs, or you want to be part of a caregiver community that isn’t on social media, you can visit my members-only website, it is, and join my caregiver community there. Let’s return to the subject of choosing between spouse and elderly parent, and thoughts of caregiving is ruining my marriage. This leads to the question of who does what? In some families, who does what means that the wife ends paid employment to raise children and take care of an elderly parent full-time. In other families, deciding who maintains more of a balance for spouses who want to continue working may be the discussion.

0:25:38.6 Pamela D. Wilson: In either situation, unexpected instability—like with COVID. Like we talked about with Dr. Goulston can add a lot of stress to caregiving situations. We have job losses, moving for a job, struggles and stress at work, having to devote more time to work, the needs of children, or being diagnosed with a health issue can be very concerning. Add to that financial problems, and a long list of added stressors that can make caring for an elderly parent feel like one more thing to do that results in less time for you.

0:26:11.3 Pamela D. Wilson: It’s no wonder that caregivers who were previously healthy begin to experience a lot of health problems. When you feel stuck between choosing between spouse and elderly parent, express appreciation to your spouse. Say thank you for the little things. Being thankful, appreciative, and gracious goes a long way to maintaining balance in all of our relationships. Resentment and feelings of being unappreciated can make it difficult to crawl out of that resentment trap. When we take for granted the things that a spouse does for us, like simple things—taking out the garbage, making dinner, helping kids with school work, and other projects, our relationships can become unbalanced. Caring for elderly parents can absorb time and attention and make it difficult to notice what’s happening outside of care activities. Our brains go on overload. It’s important to make marriage and partnerships a team effort.

0:27:06.9 Pamela D. Wilson: Continue to talk about who’s doing what. More importantly, make a little bit of time each day for a check-in. Even if it’s only to catch up on the day or update each other on an elderly parent’s care situation. Choosing between spouse and elderly parent responsibilities can help maintain focus on you as a couple. On the subject of couple time, make sure to schedule time. Caregivers tell me that elderly parents become angry or frantic if they plan to take a few days off or take time away. Allowing the moods of an elderly parent to dictate your marital relationship is like parents allowing the children to ruin their marriage. Set your priorities. I suspect that your parents had pretty firm boundaries about what was acceptable behavior for you as a child. Set the same boundaries with your elderly parents. Be a united front. End choosing between spouse and elderly parent conversations. Make choosing between spouse and elderly parents an off-limits topic.

0:28:10.8 Pamela D. Wilson: If your elderly parent speaks poorly about your spouse, stop that conversation. Set excruciating, clear boundaries about your marriage being a priority and not allowing an elderly parent to interfere. In addition to making time for each other, make sure that you both have your alone time. That alone time could be going to the gym, participating in a hobby or activity, or even maybe spending a weekend with friends. While couples and families recognize the duty and responsibility of caring for an elderly parent, few realize the damage that being shortsighted about that toll that caregiving takes on marriage and family relationships. The toll of caregiving brings up that idea of self-care. Taking care of your parents and your health. Pull out a photo of your wedding day. What did you as a couple look like when you married? How differently do you look today? Is your appearance night and day different, or have you been attentive to maintaining your appearance?

0:29:13.1 Pamela D. Wilson: The more we add into our lives, like having children, pursuing a time-consuming career, taking care of elderly parents, the more we want to talk about priorities and make sure that we are on the same page as a couple. It can be hard to do that. Those are conversations that may not happen if one partner feels uncomfortable speaking up. That gap is similar to letting small annoyances get to you until you snap. Things like toilet seat up, toilet seat down, leaving dirty dishes in the sink instead of putting them in the dishwasher. When small annoyances are discussed early, they stop being issues that cause resentment to enter into relationships. It’s the same thing with making sure that couples have the same priorities and an understanding of who agrees to do what in the care of an elderly parent and what a situation might look like 6 or 12 months from now. It’s important to think about that future. Having those discussions can go a long way to keeping resentment at bay and eliminating thoughts of choosing between spouse and elderly parent.

0:30:24.6 Pamela D. Wilson: Have you considered making an elderly parent schedule so that it’s easy to keep up with what is happening when? That schedule might include doctor appointments, picking up prescriptions, visits to your parent. Creating a calendar allows couples to see the time that is devoted to the care of a parent. Now, that calendar is not an idea to keep score or trade favors about who does what. The idea is to recognize the time-consuming aspects of helping an elderly parent so that you can plan ahead to make alternative plans. As a couple, never assume that once you enter into a caregiving relationship with an elderly parent that that situation is forever. While many elderly parents would love for you to take care of all their needs forever, doing so usually is impractical. In thinking about caring for elderly parents, it’s good to create a plan that you agree to review monthly, quarterly for potential changes. Think of that plan like making a business plan at work, a sales plan, marketing plan, or any other type of plan. An elderly care plan is just that. It’s a plan for you to review and adjust as needed.

0:31:41.6 Pamela D. Wilson: We’ll talk more about care planning for elderly parents after this break for choosing between spouse and elderly parent relationships. The manual on how to be a caregiver, how to plan and coordinate care and work with the healthcare system is in my online caregiver course. It’s called Stay at Home: Taking Care of Elderly Parents at Home and Beyond. More help is in my book. It’s called The Caregiving Trap: Solutions for Life’s Unexpected Changes. Information is on my members-only website at This is Pamela D. Wilson, caregiving expert, author, and speaker. You’re with me on The Caring Generation. Stay with me. We’ll be right back.


0:32:40.8 Announcer: This is Pamela D. Wilson, caregiving expert, consultant, and speaker. You’re with me on The Caring Generation. If your company isn’t offering caregiver support programs, maybe it’s time to ask your human resource department to support working caregivers by offering caregiver education and support programs. Send them to my website, Let’s talk more about making care plans for elderly parents. Admittedly, documenting an elderly parent’s care needs and putting a plan in place for care can seem like a time-consuming activity. Still, though, if it can help avoid having to choose between spouse and elderly parent, that effort can go a long way. It’s worthwhile. Creating a care plan is like building a how-to manual so that choosing between spouse and elderly parent never becomes a reality. If you create the care plan with sufficient detail, anybody who has the care plan should be able to step in and care for your elderly parent without missing a beat.

0:33:39.0 Pamela D. Wilson: Care plans can have different sections. For example, a list of all medical doctors, medical history, medications. The more detail you put into this, the easier it will be for somebody else—not you—to step in when you need a break to avoid choosing between spouse and elderly parent. Other sections of the care plan can include details about personal care, laundry, picking up prescriptions, and other one-on-one tasks. Creating a care plan and keeping the information updated also includes identifying how to bring outside help into that caregiving situation. Taking these steps can give you the freedom of taking time away as a couple. In the choosing between spouse and elderly parent dilemma, how do we get balance? Let’s talk about hiring paid caregivers for a minute. Elderly parents might refuse care initially from outside caregivers. Refusals can be an ongoing issue unless you can explain that you, your spouse, and your family want more time together without your elderly parent. Receiving outside care may not be a choice if your parents want you to remain involved.

0:34:49.7 Pamela D. Wilson: Most married couples hide the effects of caregiving and choosing between spouse and elderly parent from elderly parents, and rightly so. As a married couple, you want to retain a level of privacy. Even though you realize that your actions led to the present situation. How do you delicately remove yourself from being the primary caregiver for an elderly parent? Begin by shifting the topic to time management and the desire to focus on the relationship with your husband or your wife, or your family. Maybe you need to spend more time helping your children with school work. Maybe you and your spouse want more time together. Thoughts of choosing between spouse and elderly parent result from not having enough time or energy to focus on spousal relationships, family, and activities that you enjoy. Choosing between spouse and elderly parent doesn’t mean that you are taking sides. The choice is deciding to prioritize your marriage and your health.

0:35:51.3 Pamela D. Wilson: Choosing between spouse and elderly parent doesn’t mean that you don’t care. It means that you do care. But you care about your marriage, and you realize that there is a limited amount of time in every day. As you watch the situation with an elderly parent, you realize that you might be in your parent’s situation some day. What if the time that an elderly parent exceeds the time that you and your spouse can contribute? If you have a care plan, you can discuss time and care needs as part of that discussion with your parent. Understand though it’s a delicate conversation. Your elderly parent might feel that you don’t care. They might make you feel guilty. Expect that. The bottom line is that your elderly parent may have care needs that you can’t continue to meet and remain happily married.

0:36:46.6 Pamela D. Wilson: Talking about care planning means talking about money and how to pay for caregivers and other outside care. If you are an adult child caregiver, you might feel guilty making an elderly parent pay a caregiver when you are stressed, but you’re available. Ask yourself, “Is your time really free? What have you given up in your life to be helpful? Is choosing between spouse and elderly parent really something that you want to do?” If you need help identifying costs of care about care planning, listen to The Caring Generation podcast. It’s called “The Cost of Caring for Elderly Parents.” Talking about care needs and cost can make it easier to plan for your parents running out of money and the possibility of placing an elderly parent on public benefits that are called Medicaid, Medi-Cal, the name differs by state. But if we all live long enough, the cost of care may eventually exceed our monthly income or our monthly savings. That’s a realistic discussion. It might feel like it’s a difficult conversation to have, but it is a realistic conversation.

0:38:02.1 Pamela D. Wilson: Thinking about a plan for hiring paid caregivers, what you want to do is identify and interview several care agencies. But know that hiring a care agency, it’s not without effort. Somebody has to manage and oversee the caregivers. While you may be giving up visits to your elderly parents, you might be taking on added phone calls and communication. Over time though, having paid caregivers can be a significant help if you can make it through their initial training and make sure that the caregivers work well with your elderly parents. If an elderly parent balks at the idea, make it clear that having caregivers in the home is a must if your elderly parent wants to remain living at home. If not, then start that serious discussion about elderly parents moving to a care community.

0:38:48.3 Pamela D. Wilson: To begin, set up a time to have your elderly parent meet the caregiver or several caregivers. So that mom or dad feel like they have some choice in choosing that person who comes into the home. Determine a schedule that gives you enough time away to re-establish a regular routine and make time to spend with your spouse, your family, and perform some outside activities. Set regular times for phone calls to elderly parents and a visit time, so they know what to expect. Establish some supervisory time to work with that care agency. And make your visits with elderly parents pleasurable. Don’t be tempted to do the work that you hired the caregivers to do. Quality time, making memories is something that you can’t get back after your elderly parents are gone.

0:39:36.5 Pamela D. Wilson: The same goes for quality time with your family. If you’re having thoughts of caregiving is ruining by marriage or choosing between spouse and elderly parent, put those thoughts on hold. Talk to your spouse. Figure out a way to make the situation work for everybody, knowing that your marriage and your spouse is your first priority. If you’re a caregiver wondering how to get guardianship of parent, you can learn more about my new online course on my members-only website, This is Pamela D. Wilson, caregiving expert, author, and speaker. You’re with me on The Caring Generation. Stay with me. We’ll be right back.


0:40:31.1 Pamela D. Wilson: This is Pamela D. Wilson, caregiving expert, consultant, and speaker on The Caring Generation program for caregivers and aging adults. Share my website,, with everybody you know. One in four people are caregivers looking for hope, help, and support that is here every week on The Caring Generation. Choosing between spouse and elderly parent is a situation that none of us want to find ourselves in. If you are in this situation today, use these suggestions from this podcast to prioritize your marriage. Think about your situation and the long-term consequences of turning into your parents who need care. How will this affect your children—if you have children? What plans can you make today for your care when you are older? What happens if you don’t have children. Who will care for you? It’s never too early to start thinking and planning for what happens when we age. Few married couples imagine caring for elderly parents to become, so time-consuming. Even fewer imagine the thoughts of choosing between spouse and elderly parent.

0:41:32.1 Pamela D. Wilson: If you are an adult child watching your parents go through this scenario, if you’re caring for your grandparents, watch closely and learn. The quality of your health today and the actions you take to remain healthy have a long-lasting effect on the rest of your life. How many of you attend regular doctor appointments? Get the recommended vaccinations and preventative screenings? If not, why? Are you too busy to take care of you? While we all juggle parts of our life, making you a priority is just as important as not having thoughts of choosing between spouse and elderly parent. Caring for elderly parents is easy for some, and it’s more difficult for others. Next week on the show, the topic is, “I Hate Doctors: Why Caregivers Don’t Trust the Healthcare System.” And what you as a caregiver or an adult can do to get the care you want. A lack of time with patients and rushed care can result in doctors making mistakes when diagnosing patients.

0:42:34.9 Pamela D. Wilson: If you are a caregiver, it’s very possible that you’ve experienced what I call glitches when working with the healthcare system. How many hours have you had to spend on the phone with insurance companies who might tell you that a doctor is in-network versus out-of-network, or that a treatment or a procedure was approved for your elderly parent on health insurance, but you receive an invoice that says exactly the opposite? Trying to get providers to bill your health insurance correctly can be a frustrating challenge that can take months to straighten out.  All the while, you’re getting bills that are incorrect, and you’re expected to pay them. Then let’s talk about a parent or you not feeling well? You see the doctor, but they’re not getting to the bottom of the issue. They’re not offering any solutions. There are so many answers to why caregivers don’t trust the healthcare system. I’ll share these concerns on The Caring Generation podcast next week.

0:43:26.6 Pamela D. Wilson: If you’re struggling to get the care that you want for yourself or a loved one, don’t give up. Solutions exist, but you may have to be persistent and willing to learn to get the care that you want. Information for caring for elderly parents is in my caregiving course called Stay at Home: Taking Care of Elderly Parents. It’s on my website at I want to thank all the caregivers who continue to complete the caregiver stress assessment. It’s that caregiver survey on my website. You can go to the Contact Me button and scroll down to click on that survey. If you are listening live to the show tonight, next week, you can listen to the show in podcast format on my website at It’ll be up every Wednesday, and you can also catch it on your favorite podcast apps, Apple, Google, Spreaker, and other sites.

0:44:15.8 Pamela D. Wilson: Also, if you are looking for a caregiving group to join, I have one on Facebook. My page is Pamela D. Wilson, Caregiving Expert. I also have a group off of social media per request of caregivers, that’s on This is Pamela D. Wilson, caregiving expert, consultant, and speaker. God bless all of you caregivers. Sleep well tonight. Have a fabulous day tomorrow and a great week until we are together again.


0:44:44.1 Announcer: Tune in each week for The Caring Generation with host Pamela D. Wilson. Come join the conversation and see how Pamela can provide solutions and peace of mind for everyone here on Pamela D. Wilson’s The Caring Generation.


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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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