The Difficulty of Receiving

It is much harder to receive than to give, yet this truth is rarely recognized. In their zeal to be helpful, caregivers are often unaware of the countless ways they take over a dependent person's life. They may feel so entitled to get things done efficiently that they may not bother to learn the person’s preferences. After trying too long to stifle their complaints, some dependent people explode with frustration and bitterness. Caregivers are left wondering what they have done wrong.

Often, ill, frail, or disabled people are accused of pettiness. To those still able-bodied, they may seem over-focused on the trivial. Yet when independence has been lost in so many areas of life at once, small forms of control can loom large. Having tiny preferences respected can come to mean a great deal, even when a dependent person feels embarrassed at just how important these previously inconsequential details have become. When a helper takes small requests seriously, there is much less shame and thus less anger.

Another secret burden carried by those in the dependent position is wishing helpers would notice what they need without their having to ask. Asking emphasizes the powerlessness and grief of no longer being able to do these things independently. Alternatively, when helpers are able to anticipate a need and quietly take care of it, those who are dependent retain a portion of their self-respect that would otherwise have eroded.

People receiving help are typically deprived of chances to give, while feeling indebted day in and day out. They must endure the weight of almost constant passivity and uselessness. With few means through which they can pay back caregivers for help paying bills, handling loads of laundry, or running errands, the burden of gratitude can feel immense. Caregivers who accept someone’s offer to prepare a special meal, fold towels, or do mending convey the statement, "You are still valuable to us." In many situations, finding a form of contribution may require inventiveness, but it is well worth the likely boost in morale.

To be kept waiting is another affront to dignity. As soon as one person has to count on another, the helper's schedule takes precedence over the dependent person's timing. Usually, the helper tries hard to fit various tasks into a crowded day while the dependent person waits. The helper then justifies the delay: "After all, she has all day, and I have so much to do." Meanwhile, the time spent waiting becomes elongated by the awareness of helplessness, along with the tedium of anticipation. By the time the helper finally arrives, anger may leak out in a tone of voice or gesture that conveys something far from appreciation. Perplexed and resentful, the helper may wonder, "This is what I get in return?"

Caregivers who instead devise a predictable schedule for certain errands, such as rides to the store, limit their own freedom but reduce the dependent person's indignation. Dignity tends to be in such short supply in situations of dependency that any compromise in the direction of predictability can go a long way. In fact, giving back control to a dependent person in at least a few of life's basic routines can feel like a return of the self. In some instances, the caregiver may actually receive a "thank you" rather than bitterness.

It can seem the height of ingratitude to harbor bitter feelings toward those who are going out of their way to be helpful, yet a rising level of fear may further complicate the relationship between those who give and those who receive help. A dread of abandonment, somehow using up a caregiver's good will, often underlies a growing sense of indebtedness. Some people respond to this fear by trying to conceal their needs and limiting the amount of help they allow themselves to accept. Many become watchful for any signs of weariness in a helper's face, becoming suspicious that the dedication upon which they rely might be dwindling.

Candid dialogue, rather than behind-the-scenes complaining and strategizing, serves the best interests of both the giver and receiver. For example, a caregiver can admit to a dependent person, "Look, I just can't make dinner for you so often. I'm too exhausted after working all day." Then the dependent person can offer a compromise: "How about I eat those frozen meals, and we have an actual dinner together once a week?" Putting stress and conflict on the table for discussion often relieves both parties.

For pressured caregivers, taking the time to relax with the person in their care may seem unthinkable. There is so much to do and so little time. As with the other dilemmas of dependency, the solution here is paradoxical. Less is more. It is better to let certain tasks slide and take time to be together than always strive to get everything done. The dependent person wants to be seen as someone who is more than a body with endless needs. Less frequent help, given without resentment or excessive strain, feels better than poisoned sacrifice.

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No one wants to be a burden. When a helper is giving too much, the dependent person usually senses these feelings and may become increasingly alarmed. In contrast, when a helper gives only what can be given freely, the dependent person will tend to feel more secure. When a caregiver takes fifteen minutes to look at old photographs or savor a favorite piece of music together, the rest of what is done takes place in a context that has been elevated for both people. A sense of mutual enjoyment in being together, a real exchange, may be the greatest reassurance of all.

Adapted from: Wendy Lustbader, Counting on Kindness: The Dilemmas of Dependency, Free Press/Simon and Schuster, 1994.