About a year or so ago, when I was nearing the end of an almost-four-year run as a primary caregiver for my mother-in-law, who has Alzheimer’s, I got into something of an argument with a friend over this sentence:
“Let me know what I can do to help.”
I was trying (and apparently failing) to explain how this is actually one of the least helpful things you can say to someone in crisis. My friend thought I was unspeakably ungrateful for not seeing it as anything BUT helpful.
I could see her point, to some extent. Before my husband and I moved into my mother-in-law’s house to help care for her, I’d also regularly said this to people who were going through divorces, navigating terminal illnesses, or caring for loved ones. I’d drop it casually into conversations, or post it on Facebook threads, and feel as though I’d at least done something. Five years ago, if someone had told me how unhelpful I was actually being, I’d have been insulted, too.
So let me explain, again.
Last year, we had to move my mother-in-law into a memory unit in an assisted living community. Her needs had far exceeded our ability to safely care for her, even with aides coming in 5 days a week. I was crazed with grief, anxiety, guilt, and terror for the last 6 months of her living with us. I could barely take care of myself, let alone express what it was that I needed. This is because ongoing emotional distress can actually alter one’s neurocircuitry. This, in tandem with the medication I was taking for anxiety (I was at the maximum dosage for this particular medication, which created fairly significant issues with word recall), made me – at times — physically incapable of voicing what it was that I needed.
That’s perhaps an extreme example, but then people in crisis have all kinds of internal and external factors working against them. These were my specific liabilities. There’s also the fact that many people are ashamed to ask for help, or feel that they’re expected, for cultural reasons, to be “strong.”
So when we say “Let me know what I can do,” the person in crisis is hearing: “This is one more thing I’m going to be responsible for.” When people would say this to me, I understood that it was coming from a sincere place, but my ability to rationally process it was so compromised by the daily trauma of watching my mother-in-law deteriorate, hearing it would actually make me even more stressed out.
So what can we say or do?
- Offer concrete assistance. Even if you think what you’re offering is insignificant, it can actually make a huge difference. A childhood friend dropped off a cooler with about three dinner’s worth of food (and a bag of Mint Milanos). My former hair stylist emailed me a Starbuck’s gift card. A friend of mine in California sent me a book she thought I’d like. My husband’s stepsister took my mother-in-law with her to run some errands, so that we got a couple of hours to ourselves one Saturday afternoon. Little gestures like that moved me to tears and made me feel a little less isolated from the world in all of this. Offer what you can; it will be appreciated.
- Avoid platitudes. You know, try to avoid saying things like, “God doesn’t give you any more than you can handle!” Humor goes a long way in making someone feel a little better. Every time someone posted a picture of a sad teddy bear on my Facebook wall, I wished it said something like, “Sorry your mother-in-law pooped in the wastebasket again!” instead of a generic greeting-card sentiment. But that’s just me.
- Just listen. Another thing I desperately craved was the ability to rant and cry over what was happening without feeling judged, and without being interrupted by suggestions as to what I could be doing better. I just wanted to tell someone how sad and angry I was and not hear for the umpteenth time about the Alzheimer’s patient who was given an iPod to listen to and how maybe we should try that (for the record, we did; after about 2 days, my mother-in-law yanked it from the dock and threw it across the room). It can be tough to listen to someone who seems overly self-pitying at times; but please just listen.
We all want to do the right thing for a friend in crisis. We stare helplessly at our screens or our feet as these friends express pain and fear. To say “let me know what I can do” feels like the most natural response. And it is natural. But it’s also loaded. Nowadays, I try not to say, but do.