Saturday, March 17, 2012

The Price of Guilt

Guilt is a powerful word for being such a short one. It is a word I hear almost every day either from an adult child, a spouse, or a resident.   

Guilt often seems to supersede all other emotions.  Despite the fact that adult children are juggling many things in their lives to satisfy a parent, the children still feel guilty because, in their minds, they are still not doing enough.  Many residents feel the same because they believe their children are doing too much to make them happy.  Of course, there is the other extreme; the parent who blames their children for “putting” them in a community and is therefore determined to make their children suffer for it.

I once had a resident whose son moved her in and out of every community in the city.  He was trying so hard to please her that he would relocate her each time she became dissatisfied with the community she was living in.  He had recently remarried, and his guilt stemmed from his inability to take care of his mother at home. He was a loving and faithful son; he was convinced that he was doing the right thing by moving his mom, Marion, at her whim. When Marion became dissatisfied, he dutifully packed her belongings, paid the extra entrance fee, and settled her into a new apartment in a neighboring community. This happened on average twice a year. It was inevitable that after a few years he ran out of nearby places to take her.

My community had been one of the stops on her list.  Marion was a cantankerous old lady who was never satisfied. She complained that she didn’t receive appropriate care, and she grumbled that the food was uneatable. She groused over the color of the carpet in her apartment, she threatened to sue if the care staff was not at her beck and call; she criticized anything and everything that came to mind.  It was not surprising that the staff soon became resentful. They avoided her when they could and despite their commitment to customer service, they had a hard time responding graciously to her nasty behavior.

I spent a lot of time with Marion, defusing the outbursts she had with our care aids and wait staff – hoping my patience and kindness would convince her that we had her best interest in mind.  I was somewhat successful, and she did eventually trust me.  But, I was unable to keep her from manipulating her son, and eventually she gave me her thirty- day notice.

I tried speaking to her son Kevin. He was extremely friendly, obviously intelligent, but it was impossible to penetrate his denial concerning her behavior.  I needed him to join our team and to work with us.  I beseeched him to stop responding to her constant whining and support us in our attempts to please her. My employees were dancing in circles hoping to win her affection, but he refused to admit that his mother’s e behavior was excessively unfair.  His guilt was so all pervasive that it clouded his decisions. 

Several months after Kevin moved his Mom, I heard through an associate that Marion had been sent to the hospital and would not return to the community where she was presently living.  Strangely enough, not sure what prompted me, I called Kevin.  “Marion can come back and live with us again,” I offered.  His silence betrayed his surprise, and after a few seconds he said, his voice somewhat choked “I will ask her.”

Despite the protests from my staff, Marion returned. Her new apartment was near my office, so I visited regularly.  We became close friends. She had softened somewhat, although her exterior remained hard and tough.  She even thanked me for taking her back.  “I didn’t think anyone liked me,” she admitted. “We didn’t,” I told her candidly.  “I just felt that, despite what you thought of us, we did a better job of caring for you than our competitors.  You are entitled to good care, despite your attitude. “

Soon after her return, her health declined. After only a few weeks, our nurse admitted her to Hospice.  She died in our community.

I had one last conversation with Kevin. He still harbored the guilt. He admitted how sorry he was that he had not stood up to his mom. He regretted that he succumbed to her constant nagging. He realized his willingness to move her so frequently made it impossible for her to make friends or become a member of an assisted living family.   “When I told Marion you wanted her back,” he admitted, “she cried.  She couldn’t believe that someone actually would tolerate her enough to invite her to return.” 

“Your Mom was tough,” I answered.  “She wanted you to prove your love for her by focusing on her and giving her your full attention. The only way she could do that was to manipulate your time and energy.  She coerced you to pack her things and move them again and again.  She knew how to push your buttons.”

“I didn’t know what else to do; I wanted to make her happy,” he said regretfully. 

“And did you?” I asked.

“No,” he said sadly.