4 Reasons Why You Shouldn't Be a Cheerleader When Caregiving

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People living with a life-threatening illness often hear phrases from caregivers such as “Let’s hope for the best,” or “Don’t worry, everything will be fine.” Behind the words are the best of intentions. We see the psychological pain our loved one is experiencing, and we wish to alleviate it. We become cheerleaders, believing that buoying up our loved one’s hope is beneficial. After all, we see their pain now, and thoughts of the future become secondary. Unfortunately, offering immediate relief may be less than beneficial for the long-term psychological health of a loved one. Here are four reasons why you shouldn’t be a cheerleader.

Cheerleading May Destroy Trust

The person who is being cared for needs to trust their caregiver since the relationship is one of dependence. That trust develops from many things including pronouncements such as “don’t worry, you’ll get better.” The trust is dependent upon a willingness of a loved one to expose her vulnerability and the perceived truthfulness of the caregiver who is trusted.

The wife of a man with terminal stomach cancer assured him that he would defeat the illness. Her belief in his chances of survival that nothing to do with the facts, since her husband’s oncologist was very clear that the cancer was not treatable. As a deeply religious woman, she based her convictions on her faith. Her husband, who was not religious wanted to believe her. She was offering salvation; he was expecting death.

As the cancer progressed, it became clear that facts were trumping convictions. His cancer became direr despite the prayers said by his wife. Not only did the cancer’s progress depress the husband, but it also raised issues of trust. If she was wrong about my prognosis, what about everything else she’s suggesting? As illnesses progress, more critical decisions are faced such choices between different treatment protocols and whether treatment should even continue.

If prognostic statements come true, trust is nurtured. But what happens if things don’t turn out as rosy as predicted? What happens to a relationship when a condition you assured your husband would stabilize, doesn’t? The relief he felt for a few months dwindles as his condition progresses. Unfortunately, what started as a positive statement to make him feel more upbeat, turned into an example of why a caregiver’s word shouldn’t be trusted.

What to Do: Your hope for a stop or reversal of a serious illness should be qualified. There is nothing wrong with hoping for a miracle. However, you should keep those thoughts to yourself, if for no other reason than the odds of recovery may be long. The scope of what you are professing to your loved one should be reasonable. For example, don’t tell your loved one that you know he will survive stage IV lung cancer when medical statistics say he won’t. Rather focus on what he will be able to do within a short period (e.g., visiting relatives the following day). If you can develop trust early, your loved one will be more likely to listen to your advice when difficult decisions will be necessary.

Cheerleading May Prevent Important Discussions

We often try to avoid difficult conversations. Some involve end-of-life issues; others involve changing lifestyles due to the ongoing and progressive nature of an illness. Caregivers often want to avoid the difficult discussions of how the illness is affecting a loved one or end-of-life issues. Assurances that a loved one’s health will improve or there is much time to discuss difficult topics may do little other than not preparing someone for what the future holds.

There are many things in life we wish to avoid, or at least postpone. The disruption of a relationship or style of living because of an illness is at the top of the list, only topped by end-of-life discussions. Yet, years of bedside hospice service has led me to understand that these are the issues that may interfere with a more peaceful death. Trying to deal with issues of gratitude, remorse, forgiveness, and legacy near the end of life or when an illness has progressed are difficult. It’s much better to address them as soon as possible.

A husband continued to express dismay when his wife who was diagnosed with congestive heart failure wanted to talk about her future. She was well aware that the disease was progressive and within a year, her survival would be threatened. She repeatedly began conversations with her husband regarding unresolved past issues, current changes in lifestyle, and what the future held for both of them. He consistently stopped her attempts to discuss these difficult issues. “I don’t want to talk about this,” he said. “We have plenty of time to discuss them.” He didn’t believe she had that much time left, but the thought of life without her was too much for him to bear.

Unfortunately, his reluctance to face reality reduced the opportunity for his wife and him to begin the difficult discussions that could have made her impending death easier. Within a few months of her diagnosis, her heart condition rapidly deteriorated. As her condition worsened, so did her ability to communicate with her husband since she was constantly exhausted, and focusing with a diminished blood flow was difficult.

What to Do: Don’t wait to discuss important issues, even if you’re convinced your loved one will survive her illness. There is a Buddhist saying, “Tomorrow or eternity, we never know which one will appear first.” You don’t have to discuss everything at once. Take one topic at a time. By beginning early, there will be more opportunities to finish the discussion.

Cheerleading May Not Be Supportive

Support doesn’t always have to be in the form of hope. Often, the most supportive action can be the acceptance of what your loved one is going through. One client said to me that the most positive event in her lupus journey was her husband just holding her hand during a painful experience.

We often think it is supportive to downplay the seriousness of a physical condition, even when facts indicate that the possibility of recovery is minimal. The thinking is, “I know how terrible this illness is, but if I can give her even a few moments of relief, it’s worth ignoring the facts.”

If offering support, think of two time frames: short and long term. Yes, there is a short-term value in boosting one’s hope. A loved one is depressed, and you try to bring her out of it through a positive thought. While it may be effective short-term, the depression that may occur when you loved one realizes she won’t get better, can be devastating.

What to Do: Be supportive of reasonable goals. Focus on support for what you know if doable. For example, with congestive heart failure, the notion of training for an extended backpacking trip makes no sense, yet that was the goal of one caregiver I counseled. And while it was initially uplifting for her loved one, he became depressed when his training regime was halted after two days. The short-term euphoria he experienced by thinking he could backpack, was overshadowed by the long-term depression when he realized that the goal never made any sense. Worse, he became suspicious of his wife’s understanding of what he was capable of doing. Focus on something that is doable, such as the ability to move unaided from a recliner to a bed.

Cheerleading May Be Destabilizing

Someone asked me what living with cancer for thirteen years is like, never knowing whether the disease will remain under control. I said, “It’s like being hurled into a classic 1950’s horror movie where you know terrible things will happen, but you don’t know when they will occur.” Many people with chronic or acute illnesses conjure up reoccurring thoughts during those quiet moments when the mind entertains what they have tried to repress all day. When will it come back? Will it get more severe? When will I lose those things I love?

Central to many of these thoughts is the presence of instability. Chronic and acute illnesses aren’t static. They progress and may change your loved one’s physical and emotional well-being. Instability is usually a part of most chronic and acute illnesses. Little stays the same as the illness marches on.

Cheerleading that expresses the belief the condition is stabilized sets up a false hope for your loved one. You’re asking her to believe that everything will either go back to an “even keel” or at least not progress. Yet, we know that in the majority of cases, stability is rare. It’s important to reinforce the notion that the likelihood of everything remaining status quo is minimal.

A man with lung cancer had difficulty accepting the continual changes in his physical ability as the cancer progressed. His life became a series of destabilizing events. Before the illness, he would routinely meet his friends for coffee every morning. Now, some days, he didn’t have the energy to drive his car to the restaurant. Even making arrangements to attend parties became a crapshoot. His wife continually assured him that things would change, once his condition “stabilized.” It was her way of providing him assurances that life would return to normal. If never did.

What to Do: Stability is a rare condition with most acute and chronic illnesses. Even if a loved one’s physical condition is stabilized, her emotional state is continually affected by the losses she has already suffered. Instead of pretending life has returned to a stable condition, prepare your loved one to cope with the instability endemic to most acute and chronic illnesses.

A Word From Verywell

We all want the best for our loved ones, even when the goals may be impossible to achieve. Our thoughts are often focused on the short-terms benefits of what we are doing and ignore the long-term consequences. Support should focus on both short-term and long-term consequences. Beliefs should never ignore reality.

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