At some point, most of us have been on the receiving end of a neighbor’s kindness. In turn, we do what we can for others in our communities. We stop to help wrangle the horse that jumped the fence, take a meal to the bereaved, help someone who hit a deer duct tape their bumper in place so they can get to work on time. Like tater tot casserole and sheet cake, helping is baked into the culture of country life.
Sometimes we wish we could do more. Other times, though, more would never be enough. And sometimes the merest offer of help would be enough for a neighbor to tell you to mind your own blankety blank business.
Every situation is different, so there are no easy answers about how to offer help without overstepping or how to set boundaries that work. But here are some things to keep in mind.
How immediate is the need? Neighbors may drop what they’re doing to help pull porcupine quills out of a dog’s nose or drive you to the emergency room for stitches. It’s hard to say no to needs that are truly immediate. But as anyone who has negotiated garbage removal with a teenager knows, perceptions of immediacy are highly variable. In my dad’s final years, “Whenever you have time” was meant sincerely, but I often chose to reorder tasks and address his needs asap because I knew he would be anxious until it was done. That was my choice, and he was grateful. “Thank you” certainly reinforces a desire to help better than “What took you so long?” But when frantic calls for help from a neighbor escalate, it’s time to ask a few questions.
Is this situation new? Whether it’s the result of circumstances or personality, some people live in an exhausting state of perpetual emergency. Knowing that, it’s a bit easier to avoid being swept into their drama du jour. But for others, an escalation in calls for help (big or small) may signal a change in physical health, cognition, depression, grief or economic stability. When the elderly neighbor who used to appreciate goodies from your garden now refuses those luscious tomatoes and salad greens, it might signal nothing. Then again, it may indicate difficulty with meal preparations. When a neighbor seems to be struggling with simple everyday tasks, it may be time to keep a closer eye on them. If they seem to need regular help with Activities of Daily Living (ADLs) like medications, glucose monitoring — even bathing — it’s time to face the fact that your help may be keeping them or their family from making an honest assessment of a deteriorating condition.
Is the behavior different? Most of us find our behaviors change with the different chapters of our lives. When the new baby won’t sleep, you may see headlights pulling out of the neighbors’ drive at odd hours as desperate parents try to lull that infant with a drive. That doesn’t necessarily mean they need help, any more than if you notice an elderly neighbor no longer seems to drive at night. Of course, those new parents might appreciate having a meal dropped off after a few sleepless nights (text first — a call might wake that baby). And your elderly neighbor may jump at an offer to join you at a community event some evening. But some behavioral changes may send up warning flags. My mother masked her dementia pretty well in its early stages. In time, though, neighbors began to notice changes — anxiety, loss of social filters, and paranoid delusions. Their care and concern were evident in the number of slips of paper I found with names and cell phone numbers that people had given her to call if she needed help. They didn’t know that by then she could no longer dial the phone. In elderly neighbors, the often progressive nature of conditions like cognitive impairment, alcoholism, diabetes, heart and respiratory diseases, incontinence, and chronic pain can cause profound changes in behaviors.
Crisis response. Most of us can weather an unexpected crisis, especially with the help of good neighbors. But crises that come in waves or clusters may require more than a neighborly helping hand. The responsible thing to do is make contingency plans. Who will manage meds and meals for the frail spouse if their caregiver has a heart attack? The wait for an ambulance may be lengthy in some rural areas, but it’s still not quite enough time to make and implement that kind of plan. Expecting a neighbor to step into the caregiver role with no preparation for who knows how long? That’s almost a recipe for giving the neighbor a heart attack, too.
Setting boundaries. It’s hard to set new boundaries after an emergency transforms a friend whose once-a-week visit into an accidental surrogate caregiver with no authority to speak on what appropriate care might entail. That’s true whether you’re a neighbor or a near or distant family member. And we want to assure those we care about that they can call on us in need. But that assurance might need to come with some conditions. So if you say, “Call me any time” you might want to add that you need to know things like:
- Names and contact information for family members or close friends who would expect to be called in a crisis.
- Who holds Power of Attorney for Health Care?
- How to gain access to the home if the occupant can’t be reached after a given length of time, and how long that is.
- Where to find important information like insurance cards, medications, allergies, and primary care physician. (No one wants to rummage through a neighbor’s things to find all that in an emergency.)
Tough love. Asking for that type of information may seem akin to inviting mission creep unless you are prepared to deliver some tough love. “I know you don’t want to ‘bother’ your daughter but this situation is making me very anxious.” Or “I’m afraid we will both fall if I help you do that, so I think we need to call an ambulance / your daughter / a home care service.” Or, “I can see how your caregiver role could become overwhelming, so let’s discuss some available respite care options so you can make a plan you can share with me — just in case.”
Telling tales. A neighbor’s commitment to caring for a spouse and/or living independently may lead to situations that concern you deeply. You may notice things the family doesn’t, and vice versa. Offering your observations may make you feel like a busybody. Them asking you may feel like violating the code of silence about family matters. It’s tough to know what to say, and to whom and when. But we’ve all seen people sugarcoat situations for loved ones who are then blindsided by the inevitable crisis. Often they truly believe the situation is temporary and will get better, or they’re just too tired and overwhelmed to do anything beyond get through the day. They may not thank you for telling their kids you seem to be struggling. The kids might not, either. And you may not fully understand the family dynamics involved. But sometimes you have to take the risk and open a channel of communication with whoever might need to know what you are seeing: “I don’t want to overstep, but I’m noticing some things and want to be sure you have my number if you have questions or concerns, too.”
Strong social networks are a blessing in rural areas where services and resources for neighbors in need can be distant or otherwise difficult to access. But sometimes the helpers need help, too. Here are some people and organizations a caring neighbor might find useful:
- Local clergy
- County or tribal health department
- Alzheimer’s Association
- Rural Health Information Hub
Donna Kallner writes from rural northern Wisconsin. She says, “When I was a teenager my mom told the neighbors to call if they ever saw me doing something she should know about. Forty years later, I said the same thing to her neighbors when I gave them my contact information. She wasn’t happy about it but couldn’t really argue the point.”