Medication and appointments now control their time and energy. They have to adjust from being independent to being somewhat dependent on others. Then there is the financial stress and the frustration of bills mounting up and trying to navigate the often confusing realm of health care insurance. They may feel guilty because their illness has changed their lives and strapped them financially. Anger and weariness are constant companions. Beneath the anger are the feelings of unfairness and powerlessness. Where does that anger go? Either they bottle it up and feel depressed, or unload it on their caregiver. They become what some call "the prosecutor." They may feel like the caregiver is not doing enough for them. It is a situational anger.

It is also
helpful to remember:
all feelings are acceptable,
but all behavior is not.

The caregiver can become the prosecutor as well. They can have a lot of the same feelings as the ill person- feeling overwhelmed and unappreciated, like they never have time for themselves, and that they're always exhausted. Being tired most of the time leaves them with little patience. They may feel isolated and alone because they believe they're not getting enough support or understanding from family and friends. All this leaves them angry, so they take their anger out on their partner. They do this knowing that their loved one did not sign up for this disease. They find themselves feeling guilty over the anger clashes. It is a stressful and tiring time for both the caregiver and the patient.

When your patients are going through a serious illness, it can be helpful to talk with them about coping mechanisms to help them deal with the emotions they're feeling. If they and their caretaker can disengage and recognize that what they are feeling is situational anger, that could save the relationship. Breathing exercises, taking a walk, or calling an uninvolved friend are all good disengaging tactics. It is also helpful to remember: all feelings are acceptable, but all behavior is not.

Another way to help them reduce the sense of isolation is by encouraging them to find a support group. Within a group, patients and caretakers can find friendship as well as empathy and understanding that is hard to find among people who haven't shared their situation.