GUILT: The F.U.D.G.E. Ingredient That Won’t Let Go

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Ah, F.U.D.G.E.!  I get a lot of mileage out of this concept of F.U.D.G.E. (Fear, Uncertainty, Doubt. Guilt, and Exhaustion). After all, there’s a lot of F.U.D.G.E. in healthcare, whether you are the care recipient or the caregiver. Aging, and Solo Aging can F.U.D.G.E. us up!

If you need to catch up on our ingredients (Fear, Uncertainty, and Doubt) they can be found on my website on the Blog/Media page.

Today we are folding in GUILT to the mix.

GUILT is an integral ingredient of F.U.D.G.E.; there will be no true F.U.D.G.E without the G for GUILT. You do get to decide whether to go, or add, nuts.

Of all the ingredients of F.U.D.G.E. I believe that GUILT is likely the most difficult one to untangle. GUILT is a state we find ourselves in, or a thing we are having, or are becoming.

Guilt an equal opportunity ingredient. We can have it while aging, caregiving or navigating healthcare.

How Does GUILT Make You Feel?

Consider now GUILT, and how it has made you feel. Not so good, huh (kinda like when you eat too much F.U.D.G.E.)?.

It is not easy to shed GUILT. GUILT likes to ride along with us, cause us to make poor decisions, and it can impact other aspects of our lives without our ever realizing it. GUILT can entrench itself in our lives to the point where folks seek outside intervention to rid themselves of it, or to come to terms with it.

With that kind of power, I suppose we could elevate it to the ‘main ingredient status’ in F.U.D.G.E. 

The thing I find the most disconcerting about GUILT is that when I am GUILT-y I am at that place because of something I have done or that I felt I’ve brought on. Me, myself, and I-GUILT. Knowingly or unknowingly.

There are not many options in GUILT, no substitutions. It is not spurring us to the next action, rather, I feel like it is more confining us. It is hard to find anything good about GUILT at all.

Let’s examine the GUILT we find in healthcare, navigation, caring for loved ones, and aging.

GUILT in healthcare: when you think about it, there seems to be a lot of opportunity for GUILT to both manifest and to stick around. Most of it seems to be a GUILT that is assigned. By us, to us, or to another.

Assigned GUILT produces stigma. In healthcare we see blame assigned, and shaming. Addicts and alcoholics are blamed for a seeming lack of willpower. Obese people are perceived as guilty of their own accord for lack of control. Both are medical diseases, complete with a DSM-5 code for diagnosis and treatment methodology.

GUILT goes for the jugular.

There is an emotional toll when stuck inside GUILT. Holding, bearing GUILT is tremendously difficult and life-changing.

Did I do this, did I cause this? Did that happen on my watch?

Oh my gosh, I played a part in this unknowingly. Have I caused harm?

I didn’t know, or I didn’t want to look.

Days, weeks, months, and years line up waiting for the job.

Holding on to GUILT

In the aging or caregiving arena, I do witness good and bad GUILT. In the bad (let’s call it “less than positive,” shall we?) department there may be less than positive feelings that are left unresolved. For instance, when a loved one’s end of life did not go well we may wonder if we did all we could do. We rack ourselves, we flog ourselves, many of us for years to come.

A Story now. The GUILT-iest-GUILT story I’ve heard that has stuck with me for years: Two Adult Children were cleaning out their recently deceased mother’s possessions. They were tackling the cedar chest which contained their mother’s wedding dress, old photographs, and memorabilia. They know the chest had served as their mother’s Hope Chest before her wedding, and then as storage for precious things after the rest of her life. All their lives. Opening the chest they discovered an envelope marked “Wishes.” In it was a letter from their mother who’d only recently passed, asking that she be buried in her wedding dress. The children’s hearts hit the floor. They hadn’t known, she’d not told them, and they’d never thought to ask. There was such palpable GUILT as the story was relayed, and my first thought was “Conversations never held.”  

There’s another kind of GUILT that many of us will recognize: Irrational GUILT. This comes as a result of having impossible expectations.

I should have prevented (this or that).

Because of my (this or that) things are terrible.

This was all my fault.

This is where the Shoulda-Coulda-Wouldas come out to dance. They will set up camp and make you watch their Field Day.

The problem with GUILT is that it can hitch a ride with us for years. Front seat, back seat, no matter, and it WILL try to navigate. GUILT can sense if we had unrealistic expectations; if something didn’t come true that we wanted, or something happened that we didn’t want. GUILT will dig in for a longer haul, or as long as we allow it to ride along.

Those unrealistic expectations, the real culprit, the GUILT-stigator, has had a big place in my life. You’ve heard me talk about the care of my own parents, how I and my sister thought we were the two best daughters on the planet to care for our parents as they aged and changed. I, in my employment with an employee benefits program, with eldercare resources and providers at my fingertips and lots of research skills; my sister on her job worked for the ombudsmen and was often that helpful voice on your “first call,”  responding as a veritable clearinghouse of eldercare information.

I had it in my mind, deep down, that I should and would be a most knowledgeable daughter who could prevent every bump in the road, see it coming. I would alleviate and ease all of my parent’s dis-ease. That is not at all what we encountered and I beat myself up when things went wrong.

Have you ever heard the phrase “I should all over myself”? Millions of people ‘should on themselves’ every day. Perhaps the time would be better spent coming to understand the situation and obtaining proper information to make solid decisions. I know that it took a couple of “objective third parties” to help my sister and I during our journey. All that is also a large reason why I do what I do now as a patient advocate and strategist.

But wait, there is some Good GUILT to consider. And I suppose there are some constructive ways to use GUILT. I consider some of this to be in the category “GUILT for the greater good”.

GUILT For the Greater Good?

Some elders can GUILT their adult children  into talking and planning when the kids do not wish to. As for the Adult Children – kids can employ GUILT to get the outcome they want; they’ve been doing it for decades!

Think about it. We manipulate each other all the time! If we are intentional in our GUILT-ing we may tell ourselves “It’s for all the right reasons.” I see this used in family dynamics and ploys to achieve the outcome for the greater good (or Mom’s own good, or Dad’s).

 Ask yourself, have you ever GUILT-ed anyone? I will pause here for your station identification.

GUILT for the Greater Good? Like bending a rule to get to a safe and better ending. Like assisting with the parent’s signing of a Power of Attorney designation, or enabling a visit with an attorney “when Mom’s having a good day.” It seems warranted to help to build her team and get ducks in a row if her cognition is rapidly changing.

To me, Greater Good instances are in the eyes of the beholder. Act with integrity and make sure you check your malice at the door.

On our part, it’s the malice we need to avoid. And if we harness malice as a weapon then we may become the ones assigning GUILT and blame (to distract from our own, perhaps?) Caution there.

GUILT as this week’s ingredient - Don’t forget consider if nuts may be a good addition to your F.U.D.G.E. (They, or we, can complicate things).

GUILT, the hardest ingredient to untangle. Good GUILT, Less-Than-Positive GUILT, Shoulda-Coulda-Woulda GUILT, and GUILT for Greater Good.

Only we can decide if we want to let it ride with us and for how long.

Got F.U.D.G.E.? Need help dealing with Fear, Uncertainty, Doubt, Guilt, and Exhaustion? I consult with patients, parents, adult children, and Solo Agers when planning for successful aging or navigating our complex healthcare system. Book a consultation here or while visiting nancyruffner.com.