I am my fiance's caregiver and feel he doesn't appreciate me. How do I cope?

Question: I am my fiance's caregiver and feel he doesn't appreciate me. How do I cope?

My fiance was diagnosed with cancer 6 months ago and I have been by his side through every surgery and treatment cycle. At home, I am his primary caregiver. I cook for him, make sure he takes all of his medications, call the doctor when side effects become overwhelming, and clean up after him when the side effects affect him the most (vomiting, diarrhea, etc.). Aside from being his caregiver, I also hold a full-time job. I have exhausted all of my sick days and vacation time caring for my fiance.

Lately, I have felt that he no longer appreciates how much I do for him. He gets angry easily and I feel I am the object of his displaced anger and frustration. It feels like nothing I do is good enough for him. For example, he gets so upset if his food is too hot or too cold or if I have taken too long to help him out of the shower. It's almost as if he is no longer the same person I met five years ago.

I feel like I am beginning to resent him. I have very little time to myself and feel trapped. I can't leave him because it would be terrible to leave someone with cancer and I am hoping he will return to normal as he gets better. I feel so guilty! How do I cope with these feelings?

Answer: Cancer doesn't just affect the person diagnosed; it also emotionally affects loved ones, especially those who also serve as caregivers. Caring for a person with cancer can be an emotionally taxing role. Each day is different -- some bring unforeseen challenges, while other days proceed without skipping a beat. The ups and downs are like an emotional roller coaster and the instability and unpredictability can cause emotional stress, much like you are experiencing.

Feelings of Resentment

Resentment can be a completely appropriate reaction considering your life has completely been changed and you were suddenly and involuntarily placed in a caregiver role. You have sacrificed a lot in the relationship, as caregivers often do. You should know that harboring feelings of resentment are often the result of caregiver burnout -- the mild to severe emotional and physical exhaustion experienced by caregivers. It's a common occurrence, especially for those who get little or no respite care while they care for their loved one. Signs that you may be experiencing caregiver burnout include:

• changes in sleep patterns
  
• changes in appetite
  
• withdrawing from friends and family
  
• physical and mental exhaustion

It's important to also note that caregivers can also experience depression. The symptoms of depression are similar to caregiver burnout. If you do experience the symptoms of caregiver burnout, it's prudent to see a health care provider who can determine if you are suffering from depression or just under extreme stress related to caregiving.

Coping with Feelings of Being Undervalued

As feelings of resentment can be common with caregivers, emotional detachment can be a coping mechanism for people with cancer. Your caregiving efforts surely have not gone unnoticed and he may be feeling guilty about the sacrifices you have had to make to care for him. Emotionally detaching himself can be a defense mechanism, but it does not justify his behavior. Of course, this is just a theory based on my experiences with patients and their caregivers, but is definitely worth investigating, perhaps through professional couples counseling.

When someone in a relationship suffers from cancer, couples counseling can be extremely helpful. You can discuss your feelings and concerns in an environment that promotes healthy discussion. A trained mental health counselor or psychologist can help you effectively sift through your feelings and moderate communication between you and your fiance. If you do not have access to a mental health care provider, consider seeking help from a member of the clergy or other trusted professional to assist you.

Taking Care of You

For you to take care of someone else, you have to take care of you first! You must find the resources that will aloow you to take some time for yourself, even if it's just taking a short walk or having an entire day to yourself every once in a while. We all need time to recharge our batteries, caregivers included. By seeing a counselor and taking time for yourself, caregiving may be less stressful and increase the communication between you and your fiance.