The issue here is when the patient gets tired of the whole 'illness thing'.
It's understandable; constant pain and debility, with perhaps no prospect for better days ahead, will wear out anyone. It may not be something the caregiver can 'deal with', but it's important to know what's going on...and to do what one can in support.
It's also important to document, because it's not only the course of the illness that can cause a loss of morale; many medications (or combinations thereof) can do this as well. The patient's medical team needs to know.
The symptoms of a patient who's getting tired of it all include:
A changed attitude - the husband or wife who was cheerful and upbeat in the face of pain and the devastation of life turns dark and brooding, or simply shows an attitude of I-don't-care.
Loss of interest - a person who followed the news won't bother, and what hobbies have been pursued remain untouched for a prolonged period
Preoccupation with death rituals - meticulously planning one's own funeral is hardly a good sign.
Changed emotions - sudden irritability - or calm in a previously temperamental individual - can be a harbinger of fatigue, that the effort just isn't worth it any more.
Resistance to, or outright refusal of, medications or treatment - this is one of which I'm guilty; not having insurance, I'm not going to beggar my wife with tests and treatments that might not even help. I've written myself out of the future, and no longer think I'm worth trying to save.
Lack of self-care - refusing (or resisting) washing or changing clothes is pretty common. I've lately gown a Duck Dynasty-style beard, but it's not because I don't care; shaving (or being shaved) just plain hurts now.
Isolation - refusing to leave the house (if it's possible) or see visitors is a sign of disengagement with the world
Expressed lack of self-worth - the patient who says, "My life is a waste" is clearly in trouble.
What can you do? Again, the first priority is letting the medical team know. This is where keeping a journal can be vital.
Don't nag, plead, or cajole. You'll run into an almost reflex resistance, and may strengthen the behaviour.
Set boundaries. Don't accept careless personal hygiene when the patient is capable of taking care of him or herself. You have to live in their company; be firm, and don't accept slovenliness out of either pity or a desire to avoid confrontation.
Be positive. For whatever the patient can still do to contribute to the household, be generous with praise. Don't let it sound condescending, but recognize the effort and what energy it may have cost.
Finally, and very importantly, remember that this is not about you. Your patient may try to personalize the fatigue and attendant depression, but it's only because you are the nearest target.
But you didn't make him or her sick, and you're doing your best to help. Don't let anyone, even (and especially) the patient, take that away from you.
I have another blog, "Starting The Day With Grace". The focus is a grace quote from someone you might not expect (like, say Mick Jagger) and a short commentary. I hope you'll join me.
Marley update...he's probably going to be moved to a sanctuary, and Bay County will revise their 'dangerous dog' codes.
WE ARE MAKING A DIFFERENCE!
He's up over 200,000 signatures, but PLEASE keep the pressure on. If you haven't signed, please do! Please click o his name in the paragraph below.
If you have a moment, I'd like to ask you to visit Change.org to consider a petition to free a 'death row dog' who has been separated from his family for ten months over a misunderstanding. Marley was saved from Afghanistan by a US serviceman; please help make sure this story doesn't end in needless tragedy! Marley's gotten a lot of support...but he still needs our help.
If you can, please do leave a comment. I am trying to answer all, and I am failing, but please know this - I read and treasure each one.
Below are my recent releases on Kindle -please excuse their presence in the body of the blog. I haven't the energy to get them up as 'buttons' in the sidebar. You can click on the covers to go to the Amazon links.