The short-term or acute stage of caregiver responsibilities (Episode 46)

If you have ever been a caregiver in a short-term or acute situation – and certainly if that’s your situation right now – this episode is for you. While it’s typical to think mostly about the needs of the care receiver in an acute situation, you as the caregiver are in it too, whether or not other people are keeping you top of mind. In this episode, I talk about why this stage of being a caregiver can be so exhausting physically and mentally, and why it’s critical to learn to accept help from people right away.

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Transcript of episode is below.

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Transcript: Short-term or acute stage of caregiver responsibilities (Episode 46)

Hi there. I’m your host Kay Coughlin. And you’re listening to From One Caregiver to Another. I am a sandwich family caregiver. I have kids at home and I’m the primary caregiver for my mother too. But I don’t believe the old stories and traditions about being a caregiver have to be true for us as caregivers. I believe you and me we can have dreams. We deserve to say no, and to have our own lives. Nobody can do it all, but we can decide what’s okay, what’s not okay, and we can dare to live our own lives. This is episode 46.

Before we get into to what I want to talk about today. I’d like to let you know that I’ve got a workshop coming up to help you learn about boundaries as the holidays approach. And that’s going to begin in mid October. So if you want to find out when that registration is going to go live, make sure you sign up for my newsletter. You’ll find the link at my website, which is

Today I want to talk about the short term or acute stage of being a person with caregiver responsibilities.

There are four stages of being a caregiver that I talk about and they are: early caregiver, and I talked about that one last week and that’s episode 45. Then we have short term or acute and that’s what I’m going to talk about today. And then the two remaining are long-term or what I think of as more stable, and being a post caregiver.

So these four episodes together are a mini series. You can listen to them all, or you can just find the one you need so that you can get a better understanding of whatever stage you’re in right now. Or you can even direct a friend to the specific episode that would be most helpful for them.

Just a reminder in case you’re new to this podcast, this is not a podcast about how to be a better caregiver, whatever that means. This is about how to be the person you want to be, even while you have caregiver responsibilities. So when I talk about being in the stage of short term or acute caregiver, I’m talking about you, not about the person who needs care and that person would be what I call the care receiver.

As caregivers we come to be in this short term or acute stage, because there’s a big change that affects us as the caregiver. What most people would think happens, of course, is that the care receiver gets sick. So everything just kind of ramps up for a time. And often that is true, but there can be a lot of other reasons we get to this stage. For example, maybe somebody loses a job or maybe you decide it’s time to bring your mom or dad to live with you. Maybe you live far away from the care receiver and you need to hire people to care for them. Maybe the person who was the primary caregiver has a job change or decides they can’t do it anymore or moves away or passes away. And then you suddenly become the primary caregiver. So you see it doesn’t always have to do with the care receiver. In fact, more often than not, it has to do with something else entirely.

And that affects you as the caregiver. I myself have been in this acute stage of caregiver responsibilities several times. The first time I found myself in this stage was when my dad died very suddenly. And that was back in 2014. At the time, my mom, who lives next door to me now and she did then, when my dad died.

She didn’t need a lot of caregiving really in terms of physical help anyway, but she needed a lot of companionship and she needed it very suddenly. Of course, we had a lot of details to sort through, which took a significant amount of her time and of my time. And that just happens when someone dies. And we were both grieving.

So there were some things that my mom had always done very well. My mother is very capable and these things were like balancing the checkbook. Well, she asked me to keep an eye on her to make sure she didn’t slip with any of that. So it was an intense time for us in our grief as mother and daughter and in what turned out to be this short term or acute caregiver stage for me.

The other times I’ve been in this short term stage have lasted anywhere from a few days to a few weeks. My mom has a health condition that does flare up from time to time. It’s not too serious, but when it does flare up the effects on her overall mobility, well, that’s pretty profound for a little while.

And what happens is that there will be this flare up. And it always involves a fall. And then maybe there’s a short hospital stay. And then there’s her acute recovery period where I need to be with her almost around the clock. So I have been there myself, although thankfully at this point it’s never been really too prolonged.

Because there are so many unfamiliar things or unpredictable things and certainly intense things happening to you as the caregiver and also things happening around you during this acute stage, I think it would be helpful for you to understand and know what’s going on in your own brain.

Your primitive brain, and every human has this, it’s that part of our brain that evolved to protect us from threats, it’s likely to be on high alert because of all the changes happening around you, which your brain is going to interpret as a continuous stream of threats. That’s what’s likely going on if you feel like you’re more confused than you normally would be, or if you feel a lot of anxiety about the situation, or if you find yourself quite worried about how to manage daily tasks that otherwise you’d be fully capable of managing.

See your primitive brain is going to be pumping out a mix of chemicals to keep you alert to the threats or what it perceives as threats. And it’s also going to be trying to force you to react out of instinct or habit, even when you know better. And it can just be very disorienting when this goes on for a few days or a few weeks, or unfortunately it can go on even longer.

At the same time, your higher brain, that’s the part of the brain that’s in charge of analyzing and planning and decision-making or what we would actually call cognition. Well, that part of your brain is also going into overdrive because you have to learn all of the new things you need to know, and to manage the changing situation. And thinking, or cognition, takes a surprising amount of energy.

So at a time when you might not be taking care of yourself the way you normally would, you might not be eating your normal food, you might be having trouble finding time to sleep. You might not even be in your own home, surrounded with your own stuff, your higher brain is suddenly demanding a lot more from you and your body.

And so you might find yourself exhausted or feeling burned out or even confused because you’ve suddenly been jolted into a phase of what I would think of as extreme learning and possibly even extreme energy consumption. When you’re in this stage, acute or short term, you’re highly likely to find yourself reacting without thinking. Or reacting according to the old patterns that you’re comfortable with, that your brain is comfortable with. And this can be especially true if the care receiver is a family member, because in families, we have these long standing patterns and habits, we fall back on all the time. And unfortunately, especially in times of stress you’re going to see a lot of people around you reacting out of habit too. So you’re going to see lots of stress, lots of unhelpful reacting from your habits or from your gut and not a whole lot of responding in a logical or rational or thoughtful way.

And I’ve even noticed that the people who do this all the time, who are working with caregivers in this acute stage often, and I’m talking about professional caregivers, doctors, nurses, and there are others too. Well, these people tend to manage the situation in a way that is mostly dismissive of the caregiver. And that’s because it’s their job to take care of the care receiver, period. End of story. And their job is not to take care of you, the caregiver. So they’re likely to be unavailable or not know about resources available to you. They may not have time. And if it seems like they’re pushing you to the side, they are, that’s what they do. Unfortunately, the system of caregiving doesn’t make much room for us as the caregiver.

Now here’s what’s really hard to see while you’re in this acute or short-term stage. And it’s this: you’re right now establishing patterns you could end up falling into once you get into the long-term stage of being a caregiver, if that happens for you.

So if you start refusing help now, you’re going to get that. If you push away the people who want information or who are calling just because they care about you, they’re going to get used to being pushed away. This is not too big of a problem if your acute caregiving doesn’t go on for too long and especially if you don’t end up being in the long term stage of being a caregiver. But it can become a really enormous problem for you as the caregiver later, when you realize that what you’ve done is you’ve trained people not to reach out to you to offer help or to check in on you.

This is all very human, by the way, this pushing people away and refusing help. Many of us have been trained to do just that throughout our lives. We’ve been told it’s weak to ask for help or that we should be able to do things by ourselves. So I want to let you know that if you’ve done this, or if you’re doing it right now, I am not judging you.

In fact, the reason I can recognize that you might be doing this and that it might have consequences later is that I’ve done it plenty of times myself in the past.

I do want to let you know that there is hope though, because the last two times I found myself in this acute or short-term stage of being a caregiver, I made an intentional decision to do things differently. I accepted help from the people who offer. Not always, but very often I accepted their help. I made it a point to reach out to friends and therapists and coaches who were happy to listen to me talk. And I made sure to eat well, get some exercise and get enough sleep, or at least as much sleep as I could manage.

It was still hard, but it was a whole different experience for me and for my mom. What happened was we both were able to take better care of ourselves because we had more resources to rely on.

In the next episode, I’m going to talk about the long-term or what I think of as the more stable stage of being a caregiver.

Until then, if you are in this short term or acute stage of caregiver responsibilities, please remember that you have a right to tell people what’s okay and not okay. You have a right to set boundaries. You deserve to take care of yourself. And you are allowed to ask for and receive help.

Thank you so much for listening today. You can learn more about me and about all of this work at That’s facilitator on fire dot net. And there’s a lot of really good stuff there for caregivers, including links to my book and to learn more about boundaries and about human giver syndrome. If you want almost daily doses of straight talk for family caregivers and for sandwich family caregivers who want to dare to live their own lives, please follow me on Instagram. And there’s a link for that in the show notes.

If you liked this episode, please leave a review. And think of two people you can tell about it. If they’re new to podcasts, show them how to subscribe. Word of mouth is the very best way to help podcasts grow, which will help more caregivers find their way here and get help to live their own lives.

I can’t wait to be here with you again in the next episode of From One Caregiver to Another.

Kay Coughlin, CEO and Chief Facilitator of Facilitator on Fire, has a dream to create a world that is generously inclusive of all adult generations. The best place to connect with Kay is on Instagram or in the "From One Caregiver to Another" boundaries discussion community.

"Caregiver Coaching" is for family caregivers who want to dare to live their own life. Facilitator on Fire's "Building Trust Across Generations" seminar helps leaders and managers build amazing teams that are attractive to people of all ages. Kay's keynote address, "Top Myths of Leading Generations," helps businesses see the hard costs of miscommunication between generations.