Boundaries Webinar Q&A: Part 3

During my recent webinar on boundaries I was asked a very good question.

As a care taker for a loved one, it is difficult to watch them make choices that cause more problems (pain, symptoms that cause problems, etc). But I will always be the care taker no matter what - even though poor choices makes my job harder. I can't figure out how to set a boundary about this. How can I not feel frustrated at the consequences of poor choices?

Many of us have probably faced similar scenarios, so though I'm using this question as a prompt, my suggestions are directed at all of us, not just the lovely person who submitted the question. :-)

Previously we have talked about giving up trying to control things which we cannot control, and how to powerfully control the things we can – ourselves – to help give us the results we want to have.

I've been trying to get across the idea that since we can't actually control the choices other people make, that basing our feelings on what other people decide to do is not the strongest strategy to ensure our own self care.

But, and this is a big but, this doesn't mean that we have to stop caring about other people and what they do.

It doesn't mean we can't have an opinion on which choice we would like them to make.

And it doesn't mean we have to just let everyone around us do whatever they want without there being any consequences when they are around us.

The good news about this is that no matter what others decide to do, we can always protect ourselves with a judicious use of boundaries.

Remember, boundaries are something we create for ourselves to protect ourselves from the actions of others. They are not something we create to control the behavior of others for our own gain. If you do X, then I will do Y.

If our patient wants to engage in behavior that is detrimental to his health, that is not a boundary violation for us. If he wants to ignore everything we say, that is not a boundary violation for us.

But if they want to make you endorse or ignore or approve of their behavior, that could be.

    - If you ask me to bring you a beer with your Xanax, then I am going to decline to do that.

    - If you stay in bed all day and refuse to do your physical therapy (which is your right to do), then I am going to tell you all about pressure ulcers and drop foot (which as your caretaker is my right to do).

    - If you start eating a box of Oreos while I am giving you an insulin shot, then I am going to speak to you about the importance of proper diet and blood sugar control.

This doesn't mean you are going to grab the cookies out of his hand and yell and scream and try to force him to comply with the recommended diet. It doesn't mean you have to be mad, or resentful, or in fact feel anything that you don't want to feel because you are not going to delegate your feelings to his behavior and choices.

But while he is an adult and gets to do what he wants to do, you are also an adult and can do what you want to do. You can make requests, you can tell him what you think, and you can ask him to see things your way.

You don't want to expect or demand that he change his behavior, because that immediately puts him in charge of you as you wait to see if he will acquiesce or not.

But as a nurse you can educate self-destructive behavior when you see it, calmly and rationally and with compassion, rather than feeling like you have to do it in anger or judgement or frustration.

The strategy of taking responsibility for ourselves, while allowing others to be fully responsible for themselves isn't always the easy way, but it is powerful because it keeps everyone focused on outcomes they can actually control.

So this is the time to ask yourself a lot of questions. When it comes to your patient, what really is important to you? Is your goal to drag him into health by any means necessary? Or is it to enjoy the time you spend with him, regardless of his health status?

These newsletters have been a little longer than usual, but I hope you've found them helpful.


P.S. If you have other questions/issues/situations you'd like me to respond to, just reply to this email and let me know.