Independence is the goal of childhood. Interdependence is the achievement of adulthood. Dependency is the nightmare of old age. Is there any way to do this very hard task, well?
Caveats and Yes-buts I have something I’d like to talk about. The goal of this section is to help you let go of some other emphases, even very plausible ones, and come along with me on this trip. First, I know it is true that dependency happens to young people as well as middle-aged and older people. Second, I know that there are caregivers who are more dependent on giving than the receiver is on receiving. Third, I know that what looks like a one-way dependency on the surface is often a two way dependency—not a true interdependence—when you get below the surface. And last, I know that a lot of people who face this dilemma will not have a good marriage to fall back on.
OK, having said all that, what about being permanently dependent on another person? It is true with this question, as it is with many difficult questions, that an easy and very good answer can be given. This is true in the same way that putting the ball in the basket is easy after four or five difficult and well-executed passes. The trick is in the passes, not in the shot. So the trick is in the relationship, not in the dependency.
So here is the answer that seems to me easy and good.[1] I had my closest approach to this topic when Marilyn, my wife of many years, suffered two very hard years of cancer and cancer treatment. These “easy” answers draw on that experience and on our conversations at the time.
Rule one: You can’t pay for your care with gratitude. The dependent person gets a lot of care and doesn’t give any care. She—my reference point is Marilyn, but I really believe this would work either way—will be tempted to see how much it costs the givers to be there and do all the things that need to be done and to respond with expressions of gratitude. “Gratitude” in that way becomes the coin with which she “pays” the caregivers. Gratitude is a feeling and there is nothing wrong with expressing it when you feel it, but you get the care you need when you need it and there are lots of reasons you might not be feeling grateful. Saying how grateful you are when you are not feeling grateful gets toxic pretty fast.
The question now is how the dependent person can learn not to pay in gratitude. She must know first, that if she gives in to the temptation, it will be worse for everyone. She must also know that gratitude is not expected. The service that is provided by the caregiver in a good marriage is entailed in the marriage. That what the “in sickness and in health” language is there for. It is not a contract; it is a reminder. This is not, however, the kind of adaptation that can be developed when it is needed. If this mutual respect has been a part of the relationship when both partners are whole, it will be easier to adapt it to the relationship when one is not.
Rule Two: The caregiver knows enough not to expect expressions of gratitude. He knows it is a pleasure to express gratitude when one is feeling grateful and is onerous to express it when it is only an obligation. So he is careful not to seem, in what he does or what he says, that he expects such expressions. This leaves him free to enjoy them when they are offered and free from expecting them as a matter of course.
The marriage is a mutual commitment. It means that the well one cares for the sick one. It is the luck of the draw which one of you develops the cancer or has the stroke or whose memory starts to slide. When I was doing this, I developed a metaphor that not everyone likes, but it brought some clarity to me and I still like it. It is that the marriage is like a meal in a restaurant. You pay for the food and for the preparation and for enough service to get the food from the kitchen to the table. When they agreed to serve you a meal and take your money, they took on that obligation. But, in fact, everyone one of us has been served, at one time or another, by a server who had some sense of who you were, as diners, and what would make your meal more enjoyable. It is a great pleasure to tip those people by way of saying thank you.
So in the marriage. All the care the caregiver offers is part of the marriage the way the price was a part of the meal. And if the partners both look at it like that, it enables the receiver to express gratitude where it was not expected and the giver to receive it with surprise and with great joy. That arrangement is the A game of a lot of couples, but you don’t always play your A game. Sometimes you are tired. Sometimes you are distracted. Sometimes you are in pain or fighting off despair. This metaphor reminds you where you want to be and for that reason, it is especially important when you have failed in the task to which you are both committed. Being reminded helps both of you remember what you want to do. It is a great help.
Rule Three: Be the Partner. Finally, both the giver of these services and the receiver need to know that there is only so much the giver can do. It is tempting to hold onto the job yourself, even when there are others who would be glad to help. It is tempting to do more than you should and in that way, you slide over into resentment. You might think you are hiding it, but resentment is a strong signal and the person who receives the care is a very sensitive receiver. She will know.
Again, the practicalities of finding the help you will need may be daunting, but the simple clear realization that you will need help is easy. The fact is that the person you are caring for needs a partner. She needs a partner more than she needs a caregiver. When you have burned yourself out “caring for her,” who will be her partner? Looked at in that light, all that “selfless behavior” which cost you so much seems only selfish and shortsighted. There are things only you can do for your partner. Do those. Someone must see to it that the whole collection of her needs are met. That’s your job too. But a lot of other people, some family, some friends, and some professional, need to be a part of this show. You don’t need to do all the caring; you need to do all the planning.
And for the rest, you need to be for her the partner only you can be.
The older I get, the more I appreciate the truth of the saying, “Growing old isn’t for sissies.” Many of these things are hard, hard, hard to do. But they won’t get done at all if the ideas aren’t in place and if there is a manual for how best to love the actual person who is your partner, I’ve never seen it.
[1] I want to keep “easy” in my formulation, but I’m not really an idiot. I know that “easy” refers to knowing what to do, not to the process of doing it.
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