Drastic Changes: When a Host Parent Gets Sick

by cv harquail on October 16, 2011

Two difficult challenges have hit my friends this past month. Last week a friend’s BIL slipped off a ladder, and is now in an intensive care unit coping with serious head trauma. His recovery will be long, difficult and uncertain. 201110161502.jpg

Earlier in the month, a friend’s sister was diagnosed with cancer, for the third time. She has no idea what the specifics will be, but her prognosis is grim.

As it happens, both of these families have live-in childcare. One has an exchange student, the other has an au pair. In both cases, the caregivers have to face a very different physical and emotional situation than they originally signed up for.

When there is a serious and dramatic change in a host family’s situation, both the family and their au pair need to find ways to adjust to the new reality. We’ve already discussed situations like surprise host mom pregnancies, divorce, lost jobs, abrupt moves, and the serious illness of a host child.

All of these changes upset the delicate balance of the au pair and host family’s ‘psychological contract‘. A situation that was perfect for a family (or an au pair) changes on a dime, but we are still locked into our commitment to each other.

We generally assume that, as thoughtful host parents, we can find a way to talk with our au pairs and renegotiate what to expect of each other. But what about when the abrupt change happens to you? What if you, yourself, are having a hard time handling the situation?

How can you even begin to think of helping your au pair — not to mention your kids, your friends, your partner, your family — get adjusted to what’s coming?

Making things more difficult is that when the change happens so abruptly that we are unable to plan ahead or take time to change. We may have so little understanding of what to expect that we might simply be unable to predict, or to plan. Then what?

Both families above are blessed with large and strong networks of friends, and getting lots of help and support.

If we could offer them some suggestions about addressing the situation with their caregiver, what would we recommend?

Share your thoughts, below.



See also:
When Your Au Pair Breaks Your Psychological Contract
Having another baby? How to tell your au pair

When your personal, private challenges affect your Au Pair relationship
— emotional challenges of one host parent
How can we prepare our Au Pair for significant disruption? — serious change & challenge for host child

Image: Hopeful Morning from Dead Air


Taking a Computer Lunch October 17, 2011 at 7:55 am

While I know it doesn’t work for everyone, being up front and open about what is happening has always worked best for me. Any time a family member is sick there is tension in the air, and an AP may worry that it is something she has done.

I would recommend talking to her at night after the kids have gone to bed and saying “X is sick. We’re going to be going through a tough time, and we’re going to need you to be strong and go the extra mile for us.” Before you have this conversation, try to think through how your au pair’s schedule will change. If you or your spouse needs surgery, then you’ll want her to work the full 10-hour day on that day (and you may need extra coverage from other family members – a parent, a sibling or even a good friend). If the sick parent was in charge of taking the children to dance lessons or soccer games, then consider scheduling the AP to be there to watch or root for the children. Ask her to pick up some of the household tasks that person did if they are recovering from surgery – or in the case of chemo, on the days they are especially sick. If you are going to need to block out potential vacation days, then warn your AP as far in advance as possible. “I know your friend may be planning some trips, and I’m going to ask you not to take time off this week while X is recovering from surgery [or these weeks while x recovers from chemo].” In addition, warn your LCC that changes are afoot in your family and that you’ve already had a conversation with your AP. Ask her to call your AP and chat with her about the conversation – if she’s been an LCC for a few years then she will have had experience in assisting APs in surviving a family crisis.

In my experience, most APs enjoy being needed and rise to the occasion of helping the family get through a crisis. Remember that they are young, and may not have experience in knowing how to express their feelings well in English, so don’t hold them accountable for not saying “I’m sorry to hear that.” Remember their deeds and don’t worry about their words.

While most of my experience is in the hospitalization of a child, I will say having a conversation preparing the AP for changes in the family goes a long way into having the outcome you desire. When my special needs child was hospitalized, my AP assumed that she would have almost no work to do (as 90% of her time was spent caring for that child), because we had the luxury of sitting her down a month in advance, she was able to understand that she was very needed and that her use of vacation time that month would not be an option because we needed her to be there for our healthy child. We were able to establish expectations for the recovery period and she exceeded them, in part, I think, because she felt included and needed.

German Au-Pair October 17, 2011 at 10:38 am

I agree with TACL. Being upfront would be what I would wish for.
In case of serious, long term conditions like cancer I might add the option for an out for the au pair. I’d say, that you’d understand if she felt she couldn’t deal with it and wnated to rematch.
Most girls I know wouldn’t just bail on their family but just saying that demonstrates that you care for her feelings and know that this might be a little overwhelming for her.

I’d share as much information about the condition and treatments with her as you feel comfortable with. Knowing what exactly is going on helps to feel needed and understand how and why you are needed.
In case of chemo I would tell her, how you feel (e.g. if this an extra bad day) and not expect her to just know. I imagine that it’sa relief if you don’t have to tiptoe around the situtation, watching you hostparent the whole time to not make anything wrong.
Knowing that they will actually be upfront with you and directly tell and ask you things would be really relaxing for me.

Calif Mom October 17, 2011 at 11:53 am

The following brain dump is a bit disheveled, for which I apologize. I think it’s got some ideas worth sharing, though, even if they aren’t well organized. You will understand why better after you read through it! :-)

Our family’s crisis evolved into a chronic condition, so I have perspectives on two phases of this issue. Or, to be more precise, I have vague impressions of the acute phase after I was involved in a car accident, and will jot down what I do know about that, and will ask my hub what he did. I suffered what would later be labeled a mild TBI, and I don’t remember those early days much at all.

What I do know is that the thing I was most grateful for during those longs days and weeks and months (besides my amazing husband who leaves no medical question unresearched, and the parents of kids in my daughter’s new school who brought dinners over) was telling everyone who would listen how extremely grateful I was that we had a terrific au pair at the time. She didn’t hesitate to step up and be even more reliable and rock-solid for us all. She took a tremendous burden off my recovery because I didn’t need to worry about the kids. She was a person of great equanimity, which is just what we needed at the time. She kept them on schedule, with clean clothes, cookies snitched, homework done, playdates made, and plenty of playing around and silliness, and then pitched in with dish washing after dinner. Her thoughtfulness freed my hub to focus on schlepping me around to various doctor appointments and occasionally even being able to work himself and keep his own career on track. I will always hold her in a special place in my heart for stepping up because while I still don’t know what exactly she was doing, I knew my kids were being cared for by someone they loved and trusted. That allowed me to rest without worry. Guilt, yes, because I still hate scaring my kids so much by being such a mess, but at least I was not worrying about their needs being met. I was completely out of work for 4 months, gradually returning, but with a schedule with tons of doc appts. (I’ve been back to full time for two years, working outside the home.)

My hub advises giving the au pair updates after the kids go to bed whenever you have new information. Maybe after a significant doc appointment, or if you get a different estimate of how long the acute phase will be, what to expect. Share, share, share! Even if you just don’t know, telling the au pair “The docs just don’t know, but are telling us it could be xyz” is better than not saying anything because you don’t know anything more solid than that. He also let the counselor know what was going on so that she could reach out to the au pair.

And yes, bring in family as needed. Yes, let parents of kids’ friends from school bring over dinners. And don’t keep the kids in the dark, either. Age-appropriate information is always better than what they are imagining. They fear the worst, always. They need reassurance.

Today–almost 4 years later–I still have to manage my “invisible” needs when it comes to our au pair. When I have extra stress, my symptoms worsen. Work stress absolutely affects my energy reserves and hence stress at home and hence our au pair’s world, too. I apologize frequently. But it is what it is.

Being open about it all is crucial. I tell au pairs about the situation during matching process so they aren’t surprised, but it remains difficult. Invisible differences are tough to understand, and it takes an au pair with empathy to be able to handle this in a host parent. I could easily see an au pair interpret my flakiness as deliberate or just plain lame. Yes, sometimes I am lame. If you can’t forgive me that, then don’t be my au pair. I don’t LOOK or SOUND like I have big issues. I am a really good masker. But masking takes a toll in energy. Things will slip.

Or, if I power through a difficult situation– for example, having a conversation while I am making dinner– I pay a heavy toll later with a headache or just plain exhaustion. An au pair who lacks empathy may well think I’m an airhead, but I will NOT remember whatever it is she asked me to do at that time. Just cooking more than one dish at a time takes tremendous focus. My kids, my hub, my au pair, they don’t really understand that if the radio is playing in the living room it makes whatever household tasks I”m working on that much harder to do. It’s been 4 years, and they wonder why it is still so hard for me. It sounds like a cop-out, but many tasks for me are like running in the deep soft sand at the beach, instead of the harder–packed sand by the water’s edge. My family and au pair have had to learn that that’s just the way it is, whether they understand it or not. Sometimes the set of “traits” that I carry around now makes me a really crabby mom. Luckily, I still have a sense of humor! And I’m really good at the hand-eye stations at the science museum that none of them can do at all (because they are designed for people with normal visual processing). Ha! Take that, Science Center! ;-)

Since I still have some, uh, quirks (though believe me, no one would be happier to send them packing than I am, since right after the accident I was told I would be out of work for a couple weeks, and that most people recover just fine) is to be completely open about it. I tell our au pairs that I will forget everything they tell me out loud, that they MUST email me with requests, that they MUST pester me or write notes or do whatever it takes if I forget to do something for them. That I NEED them to nag me, that I am not offended by it. And that they are in charge of the logistics of playdates. So a good part of the success in this situation — once you are in a chronic phase — is to choose au pairs who can really take charge and who have a good sense of humor. Empathy, humor, adventurous spirits. That’s what will work best (at least for us) in dealing with chronic gaps in the host mom.

And if they like to make cookies, so much the better!

In an acute phase, where the disaster/emergency is unfolding rapidly, your best response is sharing information as available, trying to anticipate as much as you can while still focusing on getting through the day-to-day. Get the ball rolling to bring in reserves if needed. Accept help from all quarters. Let people grocery shop for you or go to the dry cleaners.

And know that this may well be a turning point. If you have a so-so au pair, this could well be too much for her. Be sure you do as much as you can as a host to prevent that decline.

Culturally, this is very hard for some au pairs. They don’t want to be a burden so they let things slide. Or they are from a culture which makes asking for money taboo. I address this out loud, early and often. I also do work very hard to put their needs high on my list. I put an alarm on my iphone so I remember to write paychecks (I do wish our credit union would do auto deposits). And I have asked au pairs to use email during the day for things they need me to do when I can focus. I can take time at lunch to research college needs, for example, but there is no way I can do that when I come home from work. So I guess I throw some of the burden back on the au pairs. I advise them on how to manage me and tell them that they will need to do so. That’s not a bad lesson to learn in one’s 20’s.

So I think some of this is setting expectations and setting up tools so the au pair knows the best ways and the best times to ask you certain things. Email is always the way to handle “business” type stuff, like days she wants to take off in the future, calendar items, research items, etc. If we need to talk more about it, we will talk about it after dinner and kids are in bed one evening.

How I compensate for this lack of memory and occasional flakiness is by sending her links to things and coupons and random nice thoughts at other times of day. If I get a groupon that she might like, I will email it to her right then. If I am at work and remember how nice it was of her that she unloaded the dishwasher before I was even awake that morning, I will send a quick email. I will text her for things like making sure her plane landed and she hooked up with her friends on vacation okay. I try to let her know we are thinking of her needs and appreciate her, even if I forget stuff all the time. I try hard to balance out the really annoying things about being our au pair with some positives about being our au pair. We really do appreciate her, and we try to show it on a regular basis. There are plenty of posts here on the blog about how to do that. Bottom line is that it’s never good to take people for granted, and during times of crisis it’s easy to do, so guard against that.

These are good lessons, right? I mean, life is bumpy. There is no perfect. Adapting — your attitidues, your systems, your priorities — is key to finding whatever your new way ends up looking like. Seeking support is really good. Whatever kind of support fits your situation and is offered, grab hold of it. Don’t shut down or shut people out, even when you really just want to protect your family. If a doc suggests PT or OT, take advantage of it. If you end up changing your work situation, so be it. You are showing your kids and your au pair how to get through life happily. There’s no best way to do that. Being vulnerable is uncomfortable, but people are generous and really want to help. Au pairs, too. :-)

German Au-Pair October 18, 2011 at 12:30 am

Wow, thanks for the great insight and respect for dealing with you situation -or better: help your au pair deal with the situation like that!
I really like that you emphasized the importance about being clear and honest.
From a different but in some ways similiar experience I know, that being left in the dark is the worst thing, that can happen to you. You know something’s going on but you only know a little bit and not the whole story and that makes you feel confused and also leaves you wondering how to react all the time. Extremely stressfull.
I would want my hostfamily to tell me what the problem is and how they want me to deal with it. That’s how it is the easiest for everyone.

Calif Mom October 19, 2011 at 1:13 am

We do tend to want to know everything right away when facing a medical difficulty. The problem is that 1) unless you happen to already be a medical specialist in the right area for your family’s particular problem, there is going to be a steep learning curve. Any spare time that the hosts have–at least, if they are anything like my husband and I — are going to be spent on Medline (the online free database of published scientific papers that the National Institutes of Health’s National Library of Medicine makes available) reading about your illness, sifting through endless data, looking for needles in haystacks and/or writing up lists of questions. So it’s easy to slip into the “we’ll tell our au pair when we know what we are really dealing with — we don’t want to upset her unnecessarily”. Having worked in healthcare for many moons, I’ll just say that there is never perfect knowledge. Better to bring your au pair in from the start, at least as much as you can or as much as feels right. Intuition plays no small part.

We have always been honest with our kids, and that has carried over into how we work with our au pairs, too. Most things are less scary if you can name them. Even when the names are terrifying. There are a couple big issues in dealing with a parent’s illness: the first is the fear, and then the uncertainty of how it will affect the au pair’s schedule and workload. And then how the illness will affect the kids and the host parents themselves; will this ripple around and about the family (YES! It will) and then how can you help your au pair both be a part of the solutions within the family and also “wall off” parts of her life so she can still have a great time during her au pair year. It’s about fairness and balance, just like how you manage most other au pair/host family issues. It’s just that the issues of fairness and balance are made more intense by the illness. (Just like everything else being more intense when you are dealing with big illness.) I think if you can bear all that in mind, besides being a stellar person in general, you will benefit from the positive downstream effects within your family and with an au pair who sticks around–and everyone will be the better off for it.

Best wishes to all who are dealing with these huge upheavals.

Rosa December 27, 2011 at 11:27 pm

You’ve really helped me undsetarnd the issues. Thanks.

Calif Mom October 17, 2011 at 12:02 pm

CV, I wish nothing but the best for your friend’s relative who is in ICU. Prayers and good thoughts and appreciations are being sent. Recovery from something like that is an absolute roller coaster for the family. Crossing fingers and sending prayers. carpe diem.

PA AP mom October 17, 2011 at 5:40 pm

I am going through the same situation right now. I am being worked up for a potentially fatal, progressive mitochondrial disorder. I was in the hospital for 6 days recently.

I struggled with how much information to give our AP and worried how she would take it. DH and I decided that the best way was to be honest and open without piling on too much info at one time.

Our AP has been awesome and said she wants to stick around for her entire year. It’s been great having that extra support during this very difficult time.

Calif Mom October 19, 2011 at 12:52 am

PA AP mom,

Thinking of you and hoping for all the best… take care!

Should be working October 19, 2011 at 12:19 pm

PA AP mom, good thoughts coming your way from here, all best wishes too.

Jeana October 18, 2011 at 7:52 am

California Mom, I understood totally, everything you shared. I experienced two concussions within three months, thankfully before I became a parent. You really helped people understand what it is like to have an injury to the brain. I hope you continue to see improvements as time passes. Even ten and eleven years past my injury it was clear to me that I was making progress.

My younger daughter had seven surgeries during the time that we had four aupairs. I explained prior to matching that my daughter had been born with a cleft lip and cleft palate, and would be having surgical procedures during their time with us. Some required hospitalizations for several days and some were same day procedures. I communicated that I would need the aupair to keep life normal for my older daughter, while I cared for my younger daughter in her recovery. Our aupairs stepped up to the challenge and were very helpful.

We also had family members that had unexpected hospitalizations. I shared specific information with them so they would understand the need for me to away from home. I was so thankful that life continued for my children, despite the challenges that the adults may have been facing. Our aupairs kept us afloat many days!

NE mom October 18, 2011 at 6:46 pm

PA AP mom – I hope you receive good news soon; my thoughts are with you and your family.

Taking a Computer Lunch October 19, 2011 at 7:32 am

I would like to add, that based on my own experience, children become quite anxious whenever any close family member is sick, whether it be a sibling, a parent, a grandparent or even a cousin or friend they adore. My son became extremely aware of his own mortality after seeing his sister on life support, although the most severe symptoms did not manifest until after she had begun the road to recovery and it was clear that she would not only live, but thrive. It takes extra patience when parents and APs may have it least, to deal with children’s anxiety, but it is essential for them to grow up secure in their world.

Before bringing children into the hospital room for the first time, it is helpful to show them photographs and ask them if they notice anything different – that way seeing a parent in a hospital gown in bed or in a chair won’t be a huge shock. In addition, when children say they need to leave the room, it’s not an insult – they’re overwhelmed, so best to bring your AP along to take them to the lobby, the cafeteria or gift shop if you’re having a big family visit and don’t want to leave yourself.

Finally, when my son was 4 and his father was hospitalized after a burst appendix, I purchased a stuffed animal for him and told him that it’s Daddy was sick, and wanted him to talk to him about what it was like. He carried that toy around for weeks afterwards.

So, in addition to warning your AP about changes in household and childcare duties, also warn her to anticipate changes in your children – and that they may very well need a sympathetic ear, a shoulder to cry on, or extra hugs and cuddles.

Should be working October 19, 2011 at 12:18 pm

Great tips here as well for when Mommy has another baby and the older sibling visits!

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