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For ten years I was the caregiver for my mother. This started off gradually, with post-surgical recovery from breast cancer, followed by heart surgery, complications from diabetes, macular degeneration, then a stroke that left her with global aphasia, and eventually dementia. We lived through all of the issues discussed on this forum - the refusal to leave her apartment, the refusal to accept anyone's help but mine, the anger, resent, distrust, the hell on my marriage, the crazy-making failures of the healthcare system, I have six siblings but it fell to me, etc. All of it.


It was a rough ending to what had been a beautiful mother-daughter relationship. While she died in good care, I carry a tremendous amount of sadness and guilt about how it all went down, not to mention anger and resent with my siblings. After ten years, these feelings have mellowed, but they are not gone. If anyone brings up the subject, I'm in tears before too long.


It took me about three years after my mother died to get my life back to "normal". Part of that was finding work in a new place. I started my own business as a Personal Assistant, doing light office work for small businesses and private individuals. One of my first clients was an elderly man. He did not need caregiving, but someone to manage his bank account and mail and some business he was involved in. It went that way for a couple of years. Then he moved to a retirement community, and asked if I would continue working with him. Soon after, he started showing signs memory deficit and then dementia. His son got involved in his care, at my insistence, and I witnessed a train-wreck happen, where the care was managed so poorly. My client had an unnecessarily troubling demise. It was very frustrating, and it triggered a kind of PTSD from my experiences with my mom.


While working at this retirement community with this client, word-of-mouth got me three more clients who lived there, needing similar help - mail, bills, errands. One of the clients I have taken on at this place, whom I've become very close to after four years, is now experiencing memory deficits and signs of dementia. She is a holocaust survivor - tough, stubborn, independent. Her strong will reminds me a great deal of my mother. She also has low vision from macular degeneration, and just like my mom, is stoic and sometimes childish about dealing with this challenge. We are at the point now where she is calling me every day needing my help and attention, and simultaneously starting to resent me. It's my mother all over again. I am falling into the hero syndrome and recoiling from it at the same time. Yesterday, we had a very bad day out, with anger and frustration on both sides. She needs more help than I can give her, which I am trying to arrange for her, but she refuses to accept that she needs it, while calling on me to do more and more. I have several other clients, and I do not have the time, even if I had the willingness. I can feel myself getting drawn in, but the emotional place we are in is not good for either of us. My spouse recognizes where I am at and is concerned. I am trying to engage the administration at her retirement community to step in, but to my client that is tantamount to betrayal. How can I gracefully find my way through this in a way that will not hurt my client and dear friend? I am even asking myself how I let myself get back to this place?

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I know exactly what you mean. Every word. It’s a catch 22. A fine balance.

To stay in the game of life dealing with elders, we have to gird up for the long haul.

You must DETACH. Not abandon. But detach emotionally. If you read the messages here often you can read in the replies those who have detached successfully and those who have detached and are still in great pain and those who don’t and go down with the ship. Many talk tough but when they share about what’s going on with their own elders, there is a lot of pain.

And of course there are many many levels of detachment.

Just think about the healing professions and how you’ve been treated by them over the years. It’s a skill set to plug in, do your job, offer compassion and love and yet remain emotionally intact to offer yourself to the next human in your life that needs you.

Some of us are unable to ever give to the fullest degree again. As you correctly identified it, PTSD. The brain recognizes the slippery slope you are on and the warning lights are flashing. Detach.

The ironic thing is it appears that the better job you do, the longer it lasts. But are you really doing a better job when you allow yourself to deviate from what you see as correct action and she will see as betrayal. A small example. My aunt will say to her bather. “Don’t tell 97 that I have this rash on my arm”. The bather tells me immediately. Aunt has figured this out. Gets upset but gets over it. She loves her bather. The bather has to tell me. It’s her job! With dementia the lines get blurred.

Your friend might get upset but you have to act with integrity. You have to remain true to YOU first of all.

Thats where the good book comes in.
“Being Mortal: Medicine and what matters in the end” by Atul Gawande.
This book helps ELEVATE your thinking and your loved ones thinking. Or it did for me. If you haven’t read it, please do. We all need a reminder that we aren’t here forever.

So lovingly Detach and at the same time Elevate your involvement. Not neglect but elevate.

The service you offer to your paying clients is a form of elevation. Somewhere you crossed the line and allowed yourself to engage on a deeper level. You are human. She became a friend. A good friend I imagine.
It is a matter of self preservation. It sounds like you have a living and caring husband.

Slowly but firmly extricate yourself to the degree that you can once again breath.
Set boundaries. Meditate. Exercise. Regain your balance. Take time to heal.
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There may be no way out for you without hurting her, not because of anything you do but because of her.

You are not obligated to continue with this client. If you are suffering PTSD because of it, please don't sacrifice your wellbeing to deal with a paying client. I understand you have grown to love and cherish her but you can't change her, you found that truth out with your mom. So before you die of a heart attack or stroke, resign and let someone else find a path of help for her.

Your not betraying her, you are protecting yourself and right now, she doesn't care about you, it is all about her. You can't win, concede and move on.

Hugs!
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