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Health Information Mastering the Middle - Part 2

Delegating can help "sandwich generation" caregivers cover all the bases.

Given the often extreme demands of caring for both older adults and children, "sandwich generation" caregivers can start to feel overwhelmed. And when you're exhausted and stressed all the time, it can take a toll on your physical, mental and emotional health.

That's why, says Kate Krajci, LCSW, a social worker with Rush Health and Aging, you shouldn't hesitate to delegate.

"You may feel uncomfortable asking others to get involved and take on some of the responsibilities you're currently handling. But the worst that can happen is a person says 'No,' and you have to try someone else," Krajci says. "You might be surprised, though, how many people actually want to help and are just waiting to be asked."

Here, Krajci offers some strategies for getting the support you need.

Q: When you realize you're overwhelmed and decide to ask for help, how do you go about it? Where do you start?

Krajci: The first step is to look at what is actually on your plate. Think it through and write a comprehensive list of all your caregiving and child care responsibilities.

Be as specific and detailed as you can. I've found that if you ask a person to do something specific, he or she is more willing to say yes or consider doing it. So instead of "Prepare meals," write, "Cook dinner for Dad every Monday and Thursday."

Q: How do you decide which tasks to delegate and which to keep?

Krajci: Start by dividing your list into two columns: the things you're not very good at or don't like to do; and the things you do well or like to do. We all have strengths and preferences, and the things you might try to delegate first are those things you don't do well or enjoy.

Q: What's the best way to figure out whom to ask for help with each task?

Krajci: Social workers will advise you to start with what's comfortable for you — asking people you know or the person you're caring for knows: family, friends, neighbors. Getting this "informal support" is usually a win-win situation. The people are familiar, and you don't usually have to pay them or can pay them in an informal way, like taking them to lunch.

Think about who in this informal network might be willing to help out. Who has approached you and said, "How can I help?" or has a close relationship with you or your family and might be willing to lend a hand.

Then, look at each person's strengths and try to match his or her skills with specific tasks.

Q: If you're used to doing tasks a certain way, how can you let go and trust that others will get it right?

Krajci: I'm sure most of us have, at one time or another, said, "Only I can do this the right way," or, "It’s easier if I just do it myself."

But you need to allow that maybe it doesn’t have to be the "right" way or the "best" way. Maybe it just has to be done, because continuing to do it the right or best way — which means you're always doing it — will lead to burn-out.

Q: How can you temper your expectations about how much others are willing to pitch in so you aren't disappointed or resentful?

Krajci: You should always be sensitive to other people's limitations. We must acknowledge that just as we're trying to set limits for ourselves, it's OK for other people to set limits, too.

That's where being strategic and specific with your asks can get you more positive replies. The brother who has an 80-hour a week job and a child with special needs is probably not the best person to ask to pick your kids up after school every day. But he might have time to call the pharmacy twice a month to refill your Mom's prescriptions.

The key is conveying your needs in such a way that the family member doesn't perceive the situation as, "Mary is coming at me with her laundry list and just blaming me for not helping."

Instead, you want to set the stage for the conversation to be, "Let's talk about what Mom needs right now. These are the things Mom needs. How can we work on this together?"

Keep in mind that you may have to compromise. Will your brother agree to do one small task? Yes. Would you like it to be more? Absolutely. But is it better than nothing? Yes.

Hold onto those wins even though they might seem small. Getting one task off your plate is still one less thing you have to do. And maybe in the future your brother will have more time and be willing and able to take on more responsibilities.

Q: What if there isn't anyone you can ask for help?

Krajci: Your informal network might actually be larger than you think. I encourage people to be creative and think outside the box. For instance, a lot of people get support from faith and school communities.

But if you can't find enough help from your informal network or don't have an informal network, that's where you have to start thinking about more formal services, like federal and state agencies, not-for-profit organizations and out of pocket service providers.

You can also find lots of great community resources through the Rush Resource Centers. And learn more about aging and caregiving through Rush Generations, Rush's free health and aging membership program.

The essential thing to know is that you're not alone. Help is out there; all you have to do is reach out.

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Please note: All physicians featured in Discover Rush Online are on the medical faculty of Rush University Medical Center. Some of the physicians featured are in private practice and, as independent practitioners, are not agents or employees of Rush University Medical Center.

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March-April 2014

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