THAT'S MEN:Carers involved in long-term or chronic care need to remind themselves that they are choosing to care
IN A RECENT column, I wrote about the stresses involved in caring for somebody whose condition is terminal, and also about the stresses involved in being the person who is cared for.
Subsequently, I wrote about the tendency of human beings in conflicts to torment others, and about the importance of personal and moral choices in avoiding such behaviours.
A reader pointed out that both of these columns are particularly applicable in cases where a person is caring for somebody with a chronic illness. The person with a terminal illness is coming to the end of his or her life. Chronic conditions, however, can go on for decades. This can be very stressful indeed for both parties involved in the caring.
Medical advances, my reader said, mean that people survive strokes, head injuries and other conditions that not long ago would have resulted in death. Similarly, there are certain permanent disabilities that used to shorten the life span considerably, but with which people can now live for a very long time.
That is all to the good and worthy of celebration.
But caring in this situation can be extremely challenging. The parties are bound by ties of love and duty, but they are also trapped by these ties. Coping with this can bring serious stresses. And because love as well as duty is involved, there is an emotional seesaw that goes with it.
"Some days are great, others are truly awful," said one reader.
When caring can go on for decades, when dreams and plans have to be set aside by both parties, the two people in the situation "need ways of coping, rationalising and living well through their situation".
This, said the reader - who is a carer - makes the power of personal choice just as relevant to the issue of caring, as it is to the life and death choices I wrote about in an earlier column.
But that column talked about people who do terrible things in war. It argued that certain conditions led them - and could lead any of us - to behave in this way. The way to escape from behaving in this way, I argued, was through a personal moral choice to do things differently.
Surely it is a bit much to apply this to caring for another person?
Well, it seems to me that some cases of elder abuse arise from "caring" situations. In such situations, abuse - unjustifiable, of course - stems from almost unbearable pressures, perhaps a family trying to cope with child rearing, financial problems and caring for an older person all at the same time.
Needless to say, there are cases in which people are abused out of pure greed: financial abuse in other words. And no doubt there are cases in which the older person is getting paid back for past behaviour.
But sometimes the stress coming down on the family leads to a situation in which it is all too easy to snap, and to take it out on the person being cared for. Some families are more susceptible to stress than others; some handle it better than others.
This is why it is such a shame that the Government's Fair Deal on nursing home care has been postponed. Affordable long-term care is vital in the fight against elder abuse.
But what can a carer do to avoid taking out his or her frustrations on a person being cared for?
Equally, what can the person being cared for do to avoid emotionally abusing the carer? A person who had done a great deal of work with carers once told me that carers in very difficult situations need to remind themselves daily that they are making a choice to care. The purpose of this is to lessen the sense of being trapped and the resentments that can go with such a sense.
My reader echoes this point in saying that surviving the difficult periods of being cared for or caring "is about exercising a daily active personal choice".
"On good days, it is easy," my reader added. "On bad days, without a conscious and personal commitment to acting morally, the challenges may seem insurmountable."
Padraig O'Morain is a counsellor. His book, That's Men, - the best of the That's Men column from The Irish Timesis published by Veritas.