Because We Care
Practical tips for family caregivers

Reducing the stress of procrastination

Many of us have the habit of procrastination. We stall rather than move forward decisively. Ultimately, of course, decisions are made and things get done. But we tend to heap on self-criticism about having put things off.

All that self-criticism is in fact misguided. Recent research indicates that berating oneself actually seems to promote procrastination! It turns out that putting things off isn’t rooted in laziness or bad time management. Rather, it stems from fear of failure or fear of others’ judgment of our performance. A Princeton study suggests that “self-compassion” may be a more fruitful path to getting things done.

If you find yourself procrastinating, try this approach to feeling better (and doing more!):

• Check your self-talk. Instead of commanding yourself to “just get on with it,” listen consciously to your inner voice. You might discover thoughts such as, “I have to call health insurance about Mom’s bill! But I always feel so dumb when I talk with them.” Or, “Dad’s bedroom is a mess. I should clean it, but Sis will just find something wrong with what I’ve done.”
• Put it in perspective. You’re not unwilling to do the task, you just don’t want to end up feeling stupid or inadequate. That’s not “bad,” that’s just human and understandable!
• Give yourself realistic, gentle support. Acknowledge that anxiety and fear of criticism are the culprits. Rewrite your internal script more positively. For example, “It’s perfectly okay to have questions about Mom’s bill. It doesn’t mean I’m dumb. Insurance bills are complicated. It’s the company’s job to explain the statement if it isn’t clear.” Or, “It doesn’t feel good when Sis says those things. I need to take a deep breath and let it go. Just because we do things differently doesn’t mean that I don’t do a good enough job.”

The treatment phase of cancer

The treatment phase is a time of intense activity. Initially, you may feel relief and hope after the waiting and uncertainty of the diagnosis phase. Something is finally happening! But treatment also takes a lot of your time and energy.

This phase requires making arrangements for

• transporting your loved one to/from treatment. This may be a one-time event, in the case of surgery. Or your relative may have appointments several times a week. Or even daily.
• supporting your relative through side effects. Ongoing side effects, such as nausea, fatigue, bleeding, and infections, may require that someone be with your family member daily, possibly 24/7.
• handling your loved one’s nonmedical needs. Bill paying, housework, shopping, and meal preparation may be more than your relative can manage.

Treatment often takes weeks, and sometimes months, so pace yourself. It is hard to imagine how much your relative’s treatment will demand of you physically and emotionally. Experience shows it’s typically too much for one person alone.

Plus you have the demands of your own life responsibilities. If you work or have other family obligations, you will need to find ways to reduce your load. Ask your employer about Family Medical Leave.

Family, friends, and neighbors are likely to rally early on. But it’s natural for their assistance to taper off over time. Be proactive and ask them to commit to ongoing help. Lotsa Helping Hands or CaringBridge are free online services that can help you coordinate schedules.

If you are the primary caregiver, block out time for keeping your strength up. The fatigue of this phase may cause you and others to wonder if it’s even worth continuing. Set aside time for good sleep, good meals, physical activity, and periods away from the focus on cancer and caregiving. It’s not selfish. It’s essential. If you burn out, who will carry on when the going gets rough?

What if you are paid to care for a relative?

Getting paid to help Mom or Dad may be extremely helpful. However, you need to clarify your tax status. You will owe income taxes on that money. But who should pay the Social Security and Medicare taxes? Does your relative owe taxes as an employer?

Here are some common family scenarios to kick-start your thinking. As always, consult with a tax preparation professional. He or she can determine exactly what is needed for your situation.

If your family is paying you, the IRS considers you a household employee. This is true regardless if you

• work full-time or part-time caring for your relative;
• are paid daily, weekly, or by the job; or
• are paid by your parent, another family member, or from a family trust.

If your relative paid you more than $1,900 in 2015, he or she must deduct and send in Social Security taxes and Medicare taxes for you. Income taxes will likely need to be deducted and sent in for you as well. Like any employer, your family member should give you a W-2 to submit with your tax return. In addition, your relative must pay the employer’s portion of Social Security and Medicare taxes. He or she may also owe federal unemployment tax. There may be other state or local taxes that are to be paid by employers.

If you are being paid through an insurance policy or Medicaid, you are not an employee. You will receive a 1099-MISC form and will need to report this as “other income” on your 1040. You will need to pay your own state and federal income taxes. None will be deducted. No Social Security or Medicare taxes will be paid for you either. Unless you have a business providing care services to others, however, you will not owe money for Social Security or Medicare taxes.