Our Needs as Loved-One and Caregiver

Abraham Maslow’s Hierarchy of Needs

I remember when my therapist reminded me that my husband was in survival. She was referring to the most basic of human needs as defined by Abraham Maslow in his Hierarchy of Needs

I had been complaining that my husband no longer seemed interested in the things that usually drew us together—like reading and discussing new books or exploring new concepts. Increasingly, I was feeling alone and disconnected from my husband. 

Abraham Maslow was an American psychologist who theorized that humans have five basic categories of needs: physiological, safety, love/belonging, esteem, and self-actualization. Though controversial, his elucidation of needs rings true in many ways and, as a caregiver, I found them helpful.

When my therapist spoke of my husband being in survival, she was referring to the basic physiological needs, such as breathing, food, water, sleep, sex and the maintenance of consistent levels of these essentials. Suffering from MS, my husband was not at all confident that these needs were or would be met. He could no longer work and was becoming increasingly dependent on me. Even sex was problematic.

Where once he had felt safe and secure, his second basic need—safety—was no longer assured. His body was changing, and his health was deteriorating. Working was out of the question now, and our financial resources were being stretched. He didn’t feel safe at all.

Though he felt my love and we had a strong sense of belonging together, his social connections were becoming increasingly limited as friends fell away and his mobility issues limited where he could go and what he could do. He no longer belonged to his work community and his involvement in the larger community was diminishing.

His self-esteem was on a downward trajectory. He was losing confidence in himself now that he could no longer work. This led to a lowering of self-respect, and he wondered if others respected him as much as they once had now that he was becoming “different.” 

In terms of self-actualization, it was becoming more and more difficult for him to accept the facts of his drastically changing situation. He wondered who he was now and who he would become. Fortunately, he nourished his creative side through drawing and painting in his journals and taking photographs that he enjoyed editing on his computer. Here he could be imaginative and spontaneous. This gave him relief from his worries and a growing avenue for self-actualization. Creativity was a wonderful coping strategy that helped him relieve stress and live in the moment. It was both satisfying and empowering.

Meeting these needs, as outlined by Maslow, is linked to our sense of well-being. When they are not met, our sense of well-being diminishes. Add this to the physical pain and limitations of disability, and it was no wonder that my husband and I were sometimes out of sync. 

My challenge was to continue nourishing my own self-esteem and growth in self-actualization while recognizing that often my husband would be preoccupied with much more basic needs. With this knowledge, I became more compassionate when he was anxious and moody, and I appreciated and encouraged his creative pursuits. I also found that being a caregiver helped me to meet my own higher needs as identified by Maslow. While my psysiological and safety needs were well enough met—or else I would not have been able to do all that I did for my husband—caring for him brought us closer together in love and belonging. As I grew more as a caregiver, I grew in confidence and achievement, and this increased my self-esteem. For me, caregiving became a new way of self-actualization as I became creative in my role as a caregiver, learning to solve new problems and accepting the facts as they emerged while finding ever new ways to live fully in the moment.

Caring for My Mother

I’ve been writing about caring for my husband when he had multiple sclerosis, but I also cared for my mother during the last years of her life. It was a strange shift in rolls. As an adult child, I took it for granted that she could take care of herself; in fact, I never thought much about it. But as she aged and her medical problems grew, her need for care grew, too. As time went on, more and more, I was the one in charge. Eventually, I had to place her in a board-and-care home near me.

I often felt like an inept juggler as I tried to balance the demands of my job, my commitments to my husband, and the needs of my mother. My husband was well then, it was before he had MS, and I felt torn between doing what he wanted and doing what I felt I should be doing for my mother. I would have liked her to come live with us, but he didn’t want that. And to be honest, it wasn’t entirely what I wanted, either. His three daughters had just moved out and were on their own. We both wanted time for ourselves.

Even though I spent a good deal of time with my mother and watched over her needs, I still felt guilty. I felt selfish and guilty when I put my marriage first. She didn’t feel that way; she always told me how much she appreciated all I did for her and what a good daughter I was. But I knew I should do more, yet, somehow, I couldn’t. 

In truth, I handled all the logistics well, such as taking care of her finances and overseeing her medical needs. We spent time together and shared wonderful moments when we talked deeply about things important to her. Still, I wish I could have been more emotionally present those times I was preoccupied with my own problems. With a stressful job and sometimes-demanding husband, I sometimes lacked the empathy I wish I could have shown her. 

It’s a comfort to remember some words my cousin spoke to me when I was raising my three stepchildren and having a hard time: “Are you doing the best you can?” she asked. I replied that I was. “Well,” she said, “that’s all anyone can do.” Perhaps that applies to my care for my mother, too.

‘Tis the Season

Photo by Joran Quinten Unsplash.com

And the season can be hard. If your loved one is ill, depressed, angry or just distant, this can be an especially hard time. Or maybe he or she welcomes the holiday spirit, but just can’t participate in the old ways that were once so easy and dependable. At time like these, the burden of creating holiday cheer falls on the caregiver’s shoulders. We are lucky if we have friends and family who can help us carry that burden.

My husband, Michael, was never one to welcome the holidays, even when he was healthy and well. Perhaps his negative attitude went back to childhood disappointments. We raised his three daughters from a previous marriage, so, eventually, he rose to the occasion, buying a slew of gifts to put under the tree. 

Michael died on the first of January, New Year’s Day. Since that time, I face the new year with trepidation and sorrow. Yet, I remind myself that New Year’s Day is an auspicious time, and as such it was an auspicious time for him to transition. Keeping this in mind, I hold the thought that each new year will bring me closer to finding peace and happiness even as I mourn his passing.

May the holidays bring you the strength, peace and joy you need, wherever you find them and however they manifests. Blessed be.

How Do We Handle Our Loved-One’s Criticism?

Photo by Kalen Emsley on Unsplash

I remember when my husband Michael expected me to read his mind. When I didn’t immediately recognize what he needed, he accused me of ignoring and neglecting him. For instance, one day when he was struggling to transfer from his wheelchair to his stair lift, I was standing to one side, waiting to see if he needed my help. I was doing this because he had told me in no uncertain terms that when I jumped in to help him, I was undermining his independence. So, I was waiting to help if he asked me to. Instead, he became angry at me for “Just staring at him.” Later, with the help of our therapist, he realized that I couldn’t read his mind; he needed to let me know what he wanted.

But all of us don’t have a helpful therapist to clarify matters. So, what do we do? 

Well, it isn’t easy. First, it helps to take a deep breath and get centered. Then, decide to respond rather than to react. Responding means to act responsibly. Reactions are often unconscious and based on old defenses that may no longer serve us. In the moment, you might ask him or her what they would like you to do. If their response is an angry one, and they are in no immediate danger, it might be wise to suggest talking about this later, when the air has cleared. Then, perhaps, you can reach an agreement on how to proceed in the future.

In your conversations, addressing feelings is always helpful, such as, “When you did or said (this) I felt (this).” For example, “When you yelled at me and accused me of just staring at you, I felt hurt.” And your loved-one might say, “When you didn’t help me, I felt afraid and alone.” To have an honest conversation like this, we must be willing to recognize our own feelings and to be vulnerable and trusting enough to share them. You may have built trust in your relationship on many levels, but if you are entering new territory as patient and caregiver, new acknowledgements and agreements may be in order. One caution: Statements such as “When you didn’t help me, I felt you were being mean and selfish” are not about your feelings. They are accusations, and they will trigger defensiveness in the other person. This is not helpful. 

An honest conversation about your feelings may not work perfectly at first, but then, if you can talk honestly about what worked and what didn’t and how it can work better next time, perhaps you can become closer and more trusting of each other. Becoming a compassionate caregiver is always a work in progress. We are all human, and mistakes are unavoidable. If at first things don’t work out, just try for more clarity next time. Mistakes are our best teachers.