By Alice D. Domar, Ph. D. and Janet Taylor, M.D., MPH

All families require a continuous effort to balance everyone’s needs and wants. Even when one is not in a caregiving role, that “one big happy family” feeling is often fleeting.

Stress levels in most families tend to be affected by the constantly changing demands placed on different family members. Adding a caregiving role almost always increases the levels of tension and anxiety in a family.

Uncharted Territory

When a grandparent, parent, or child needs constant care, it can not only completely disrupt all family routines, but also can leave the caregiver(s) feeling ill prepared to cope with uncharted territory. There are no courses on how to balance the needs of a disabled parent versus the day-to-day needs of your children. It’s difficult to leave a healthy child in the care of others while you tend to the constant needs of a care recipient. It’s normal for family members to feel jealous and abandoned by the tasks imposed on the caregiver. Look for signs and recognize those times where the whole family needs some special help. Also, realize that it isn’t your sole responsibility to meet all the family needs single-handedly.

Counseling Options

Family counseling lessens the caregiver’s sense of responsibility for meeting everyone’s needs and gives each family member the chance to have their feelings known in a safe environment. There are many forms of therapy—individual, couples, siblings, and family. Or you could try group therapy. You need to carefully think about the individual needs of each family member, as well as the resources available to you. 

Many facilities, such as hospitals, mental health centers, hospices, nursing homes, and community centers offer various forms of counseling. The best form of therapy is tailored to specific needs, for example, support groups for siblings of chronically ill children. Ask the group leader what other resources may be available.

Finding the right counseling may take some research and testing of several options. 

LLuminari expert Alice Domar, Ph.D., wanted her 8-year-old daughter, Sarah, to get therapy when her grandmother was admitted to hospice care. The hospice only offered a support group for children who had lost a sibling. However, the hospice also had a play therapist who worked successfully with Sarah one on one. “I started looking for group care, but the individual counseling actually fit our needs beautifully,” said Dr. Domar.

Hidden Feelings

Be aware that your caregiving role may affect children beyond what they admit. They may hesitate to talk about their feelings of sorrow or distress since they may not want to burden you further. Giving them the opportunity to voice their issues individually is healthy, and indirectly decreases the burden on you and the rest of the family. Family counseling can help the family work together as a team coping with the crisis, thus decreasing resentment and distrust.

According to LLuminari expert Dr. Janet Taylor, “family counseling is important because it offers the opportunity for a structured approach to a painful or chaotic life event. A skilled therapist can elicit insight and enhance communication, two important building blocks that can improve family functioning.”  

Sometimes family reactions are not directly related to caregiving situations, but are conflicts and power struggles that may have existed from childhood: siblings competing for parents’ attention; feelings of one child being favored. Counseling can help siblings resolve old differences, or at least put them aside while focusing on caregiving goals. Be sensitive to disagreements, emotional or irrational behavior in your family. It may be time to enlist the help of an objective third party to facilitate communications and even recommend options.