Stages of Careving,  by Nancy B. Miller, Ph.D., MSW

Caregivers experience four clearly defined stages as they travel the caregiving path. These stages can be understood as "developmental tasks" in adapting to the role of caregiver. These stages may occur at the same time, or in any order, and may "recycle" themselves during the course of a caregiving relationship.

Surviving. Surviving is what you do to keep going when you are feeling completely helpless. Surviving consists of coping: doing what has to be done and expending one's energy to just get by.

Searching. This is a time of acting, of moving forward from a reactive state of surviving. It is the beginning of a sense of control over emotions and your life; the awakening of a source of energy; a time for asking questions about the goals, values, and priorities of your own life. Outer Searching asks, "What's wrong? Can it be fixed?" Inner Searching asks, "Why? Why him or her? Why me? Why us? What does this mean for me and for our lives?" Searching also involves seeking answers and interventions related to the illness or condition.

Settling In. This stage is seeing the world for what it is and seeing yourself for who you are. It is moving beyond the intense emotions of surviving, feeling less of the sense of urgency of searching, and gaining a greater sense of control and balance in your daily life. Settling In is a
time of relative equilibrium: you may not ever "forget" the reality your precarious time, but it can become a time of deepening, and more precious, moments in the relationship.

Separating. This final stage is a normal and necessary process in parent-child relationships. In a caregiving relationship, "letting go" by the caregiver may be especially difficult, with the caregiver unwilling, or unable, to experience any small separations, such as letting others help out in the caregiving and getting needed respite. However, it is necessary to avoid caregiver fatigue, and to allow the needy family member to retain or attain some level of independence. 

The four stages are part of a normal process of adaptation. By understanding how they work, caregivers can better predict their emotions and reactions, and not think they are somehow "failing" when they feel a sudden rush of uncomfortable feelings. The stages help us see how we grow through the crises and hard times of our lives. The struggles and challenges of caregiving present great sorrows
at times, but also opportunities for personal growth and competence.

Nancy B. Miller, Ph.D., MSW, author of Nobody's Perfect: Living and Growing with Children Who
Have Special Needs. Paul Brookes Publishers, 1994. 

© 1998 National Family Caregivers Association

Reprinted with permission of the National Family Caregivers Association, Kensington, MD, the nations only organisation for all family caregivers. 1-800-896-3650; www.nfcacares.org

SEE ALSO:

1. Ten Tips For Family Caregivers 
2. Coping With Caregiver Grief by Suzanne Mintz
3. Caregiver Grief: Dealing with Ongoing Loss by Pat Kaufman
4. Stages of Careving, by Nancy B. Miller, Ph.D., MSW

The main link for these articles can be found here.