By Vicki Rackner, M.D.

Fern said, “I wish the calendar would flip directly from November to January. We just got settled into our routine since Mom moved in with us. As I look at my calendar, all I see are more things on the to-do list, extra burdens, and the chaos of disrupted schedules.”

Fern is not alone in her wishful thinking that the holidays would simply pass! The celebration of Christmas or Hanukkah or Kwanza can destabilize any family.

Family caregivers know this better than most; those who attend to the needs of aging parents, a sick spouse, or a family friend already live on the edge of a delicate equilibrium. As Gary so colorfully said, “Since Dad had his stroke, my life is held together with rubber bands and bubble gum. I’m concerned that Christmas will herald its collapse.”

This season, intended as a celebration of shared joy and connection with family and loved ones, may often be a time of burden and a reminder of alienation and losses.

Here are several common holiday traps that family caregivers fall into and how to avoid them. It all comes down to freeing yourself from ideas about what should happen. Give yourself permission to celebrate the holidays in a way that works for you and your family. You might find that these tips help you look forward to the holidays, and to truly enjoy every moment.

Trap #1: Planning for the worst.

Many caregivers think, “This could be Dad’s last Christmas, so I want to make it really special.” Wouldn’t it be great if we came into the world with an owner’s manual that included the expiration date! I have seen patients defy all medical odds and laugh about the doctor who gave them six months to live—20 years ago. On the other hand, there are the tragic untimely deaths, and unanticipated events.

Since we simply don’t know what will come, we should all celebrate as if this is our last holiday season! Rather than live for the “what-ifs,” just enjoy.

Trap #2 Creating Norman Rockwell scenes.

The idea of a picture-perfect holiday has an emotional tug that’s particularly seductive to family caregivers. It‘s an expression of the longing to return to earlier carefree days of health and vitality.

While there is no perfect holiday celebration, you can create holiday rituals that are perfect for your family. Say at a family meeting, “Our lives are different this year, so we need to think about how our holiday celebration will be different. What are the two or three things that make the holiday special for you?” You can even ask your loved ones to rate their importance of holiday events or ideas on a scale of 1 to 10.

For most people, it’s the little things that make the big difference. For example, Russian Tea Cakes, or the special hand-embroidered tablecloth, or playing board games. It may not be the “big” things that you might have expected. By knowing what makes the holidays special for your relatives, you can create a montage event that truly brings together the best of all worlds.

Trap #3 Buying your way out of guilt.

For those of the sandwich generation, caring for both our children and our parents, the guilt that someone is getting short-changed looms over us. Who doesn’t wish there were more hours in the day so that children and friends (and even the person in the mirror) would get more time and attention? The life of a caregiver leaves big gaps. If you have tried to fill this gap with gifts, you may find that it does not work very well.

All family members, including kids of all ages, need to know that they are loved and treasured. Gifts are one way to say this; what most people really want is more of you.

Consider a different kind of holiday present, like a coupon for 10 minutes of undivided attention each day, or a trip to the ice cream store, or a visit to the zoo. The YouCard can include a list of reasons this person is so special to you.

In fact, at a holiday dinner you shine a spotlight on each person at the table, with each guest offering a story that demonstrates why the spotlighted person is special. You can even write them down on 3x5 cards and give them wrapped in ribbon or mounted on a collage. Gifts such as this may mean significantly more to loved ones…and they won’t cost a dime.

Consider inviting your kids into an act of giving rather than receiving by touching the lives of those less fortunate.

• Serve a meal at a shelter.
• Invite a lonely neighbor to your house.
• Look for a chance to give a stranger a $20 bill, or whatever you can afford.

Trap #4 “Smile!”

The instruction given before every photo captures the tone for the entire holiday season. Over and over we’re told there’s a right way to feel during the holiday, and that is to be happy. Family caregivers have a spectrum of feelings that rise to the surface during the holidays, and those feelings may include sadness or anger or disappointment. It IS sad that it’s not safe for Dad to live alone any more.

It IS sad if Mother needs to go to a nursing home. Set aside some time to acknowledge those dark feelings. Suppressing the feeling does not make it any less real, and adds to the holiday burden.

Trap #5 Party on!

If you are a healthy extrovert—someone who gets recharged from being in the presence of others—you are in your element in December. Party on! However, for those introverts who get recharged by spending time alone, or those who have limited pep because of illness, the holiday season can be emotionally depleting. There is still hope for a joyous holiday celebration. It just requires some advanced planning. Plan a social calendar that’s reasonable for you as a caregiver and for your loved one. Be realistic about your energy limits before you make endless commitments, and ask family members to do the same.

If either you or your loved one is an introvert, it’s perfectly reasonable to respond to an invitation with, “Thanks for the lovely offer. Unfortunately, we have other plans. I’m sure you’ll have a terrific time, and I’m sorry to miss it” The host does not need to know that your other plans are a nap. You may know someone who has rigid ideas about how holidays are celebrated. Who’s on the gift list and what’s an acceptable gift and which parties must be graced with an appearance. John says, ”Caring for my sick wife offers many gifts. Maybe the most important is the invitation to look at our life in a new way. Almost out of necessity I stripped down our holiday celebration.”

Many come to understand that there’s no holiday rulebook or present police! Your life became different when you became a family caregiver, and it’s time to do things differently.

Free yourself from the idea that there’s a right way to celebrate the holiday. Look to your family and decide how to make the holiday work for you, and then adjust the family expectations. That’s the recipe for celebrating the blessings in your life and the joy and love you share with others.

This article originally appeared in MedicalBridges e-news, December 2007. Please visit www.MedicalBridges.com for more information.