my bosses want to know how I’ll improve my performance … but I’m sleep deprived with a chronically ill child

by Ask a Manager on March 5, 2013

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A reader writes:

My two-year-old son has a chronic illness that requires weekly therapy, weight checks, and regular doctor visits. Not to mention the day to day toll of caring for him; we have to stay on our toes and respond to his body cues for his complicated care. The worst episodes happen at night and we live on less than 5-6 hours broken sleep a night. I am a litigation paralegal for a plaintiff firm (no billable requirement). My firm has been very understanding and allows me to take the time I need, etc.

I admit to being distracted and not performing at my best. Nothing major like blowing a deadline, but little things like not keeping up on filing, projects taking longer than they should, etc. Two mistakes last week (not getting a letter out as requested and forgetting about a phone call) caused the partners to call a meeting to address their concerns. They took it further than I think was necessary and told me I wasn’t invested, didn’t care and they don’t trust me. I admitted to them I am distracted and overwhelmed by my son’s care. But I certainly do care about my job. I am ashamed that I have lost their trust.

They want another meeting wherein I acknowledge my shortcomings and my plan to turn things around. I’m not sure what they need. I can’t cure my son (there is no cure). My plan is to acknowledge again that I’ve been distracted, overwhelmed and sleep deprived. Apologize and say we are trying to make major changes on the home front to give me relief. I also am talking to my doctor about medication for anxiety. Should I mention that? I don’t want to lose my job. In better times, I really like my job and right now, I can’t afford to lose it. What else can I say that lets them know I am going to do my best to improve?

I’m so sorry you’re struggling with this.

Here’s where your bosses are coming from: While it sounds like they’ve been understanding about your situation in the past, they also rely on you to get your job done, and to get it done in certain ways (i.e., at a certain speed, with a certain attention to detail, and so forth). If you’re not meeting the bar they need, they’re going to get worried — because they need that stuff handled.

What they’re looking for you now are signals that you received their message and that you’re taking it seriously and will be actively working to remedy the issues they raised. They’re looking to make sure that you’re not blowing off their concerns or minimizing them, and that you have both a commitment to tackle those issues and a realistic plan for doing that.

So, for instance, you might say something like this when you meet: “I appreciate you raising your concerns with me last week. I’m mortified that it was necessary. I heard you loud and clear, and I’m going to be working on some changes to address the issues you raised. To be honest, the situation at home has been interfering with my sleep and causing me a lot of stress. We’re going to make some major changes at home to give me some relief there, and I think that will help significantly. I’m also going to redouble my efforts to be vigilant about staying on top of things here. If there’s anything specific you’d like me to do in addition to this, I’m very open to hearing it, but I want to assure you that I take your concerns seriously and I’m going to be working hard to perform at the level you need from me.”

There’s no mention here of talking to your doctor about anxiety medication, because that’s more information than they need. They just need to know that you’re addressing this stuff in some credible way, and the wording above (or something similar) should accomplish that.

You might also check back in with them in, say, a month or so, because revisiting it shows that you did indeed take it seriously, that you care about how you’re doing, and that you’re not just hoping they’ll forget there was an issue. You could say at that point that you’ve been working to make changes, that the results have been ___, and that you want to check with them to see if they have continuing concerns or whether there’s anything else you should be doing. So few people take this step when they’ve been admonished, and it will reflect well on you if you do it … because it conveys, “I’m able to maturely discuss these issues without hiding from them, and I’m as interested in things working smoothly as you are.”

I hope this helps. Good luck, both with the job and at home!

{ 75 comments… read them below or add one }

Laura March 5, 2013 at 1:09 pm

I don’t know your specific situation, but anxiety medication doesn’t sound like a solution (although it may help). Something that would DEFINITELY help is sleep. You need sleep, and it looks like your job will depend on you getting more sleep and being more relaxed and alert.

Perhaps looking into some live-in or part time help may be necessary.

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Rana March 5, 2013 at 5:11 pm

+1

This sounds like a situation where hiring a home health aide or arranging for hospice care would be worth checking out.

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twentymilehike March 5, 2013 at 6:42 pm

hospice care

Eek! Isn’t hospice for when your dying? Do you mean respite? … or am I thinking of hospice incorrectly?

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Jamie March 5, 2013 at 7:01 pm

Hospice is for the terminally or incurably ill. However, as a service we weren’t able to get it for our mom until her prognosis was < 6 months – which was the rule for her insurance.

I don't know, the home health aides were great for the practical stuff…but when she was hurting I still got up to be with her, I can't even imagine how much stronger that impulse would be with my toddler. She could have a team of the best doctors in the world living in her house and still may not get a decent nights sleep as long as her son is sick and scared.

I would take advantage of all the help you can get for the mission critical but easier hand offs. The house, meals, etc..and respite is a godsend…that will allow the OP to save her energies for her son and her job.

I have to say I think this post has affected me more than any other. My kids are all ducking me now because I've hugging them since I got home.

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Rana March 5, 2013 at 9:04 pm

I’d been under the impression that hospice included care for the seriously ill, not just the ill and dying. If that’s not so, I take that part back!

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Elaine March 7, 2013 at 3:50 pm

Not that this is nearly the same, but what my husband and I had to do with our baby who is NOT a good sleeper (even occasionally in toddler hood), is that we would switch off nights. For instance, we have a pullout bed in the basement. One of us was “on duty” for the night, the other slept. We’d rotated. It helped, at least a little. If it’s a small apt, or whatever, perhaps a good friend would let one of you stay periodically, just to sleep in and be refreshed. Good luck!

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JL March 5, 2013 at 1:16 pm

I’m so, so sorry that you’re facing such a difficult situation.
Is there someone who could provide help with the care for your son? It could be a family member, or perhaps even a childcare professional who has experience with your son’s illness. It doesn’t have to be full-time or on a daily basis; even just one or two days a week may help improve the quality of your sleep and thus your concentration and performance at work.

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Jamie March 5, 2013 at 1:33 pm

I am really sorry for what your family is going through.

I know when I’m sleep deprived and stressed my short term memory for tasks is the first thing to go. I would devise a system by which you’re not relying on your memory – but you have alerts and reminders, lists, to keep things from slipping through the cracks.

Heck – even when things are fine for me I wouldn’t be able to function without Outlook reminders. There is no shame in using organizational tools.

I would also explore unconventional sleep scenarios. Of course you have to care for your son, if he needs you that comes first, but maybe you your husband could alternate doing dinner some nights while the other goes to bed early. Maybe you can alternate nights getting up with him?

I can’t imagine how stressful it must be to juggle the care for your son and your commitment to a job you need. Is it possible to take intermittent FMLA while you get the new support structures in place at home?

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AB March 5, 2013 at 3:05 pm

This. I wouldn’t rely on my memory even when I had a good night of sleep, let alone with little rest, heh.

“Jane, can you please send this letter to Tom this afternoon?”

“Sure boss!” — immediately adds a note to Remember the Milk, as “due today”.

(Do check rememberthemilk.com – it’s a free app that lets you quickly add reminders and alerts — you just put “today” or “tomorrow” in the “Due:” field, and the tool automatically replaces it with the correct date.)

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Anlyn March 5, 2013 at 3:32 pm

Ooh, I’ve been looking for an app like that. All I could find were calendars, which didn’t work for what I wanted. Thanks for the recommendation!

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Anonymous March 6, 2013 at 2:59 pm

If you google GTD or “getting things done”, you will find tons of apps like this. There are even lists of “10 best task management apps”.

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Jenna March 5, 2013 at 7:12 pm

Thank you so much for this! I am using an Excel spreadsheet but need something better. Going to try this out tomorrow.

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danr March 5, 2013 at 10:23 pm

And, if you don’t want to use an app, get a small notebook (get one with more pages than you’ll need for a year) and write down everything that you need to do. If something is due at a certain time, carry a note forward, with the due date. Write down the normal stuff that you need to do too. It helps to jog the memory.
I did this when I was buried in stuff at work and kept missing deadlines. It worked…. and drove my boss nuts until he saw the difference. He was the type who *could* remember everything.

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Jessa March 6, 2013 at 12:47 am

I readily admit to going old school. I have one of those flat desk blotter calendars and a few coloured pens. Easy for scribbling down what’s due when and you can physically look at it. But notebooks work. And Remember the Milk is great.

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Jen M. March 7, 2013 at 5:03 pm

This is exactly how I do my hand written to-do list. My blotter is blank, and I list out my tasks each day. That way, it’s right in my face, all the time. Simple and amazing!

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Jen M. March 7, 2013 at 5:03 pm

I was going to suggest lists, reminders, etc. too.

When I ran into similar trouble at work (entirely different reasons), I started keeping both a hand written to-do list and setting up reminders in Outlook for various things. I also use my phone’s task function, now that I have a smart phone. It helps a lot.

I really hope, OP, that you can pull together the help you’re working on, not just for the sake of your job, but for the sake of your health. If you’re not healthy, you can’t be there for your son.

I’m really sorry for all of the difficulty your family is facing, especially your little one. :(

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Malissa March 5, 2013 at 1:35 pm

Sleep will help you with the anxiety. You say “we” when talking about caring for your son. I’m hoping that another adult is involved in the care taking as well. If this is the case have you tried having one person sleep in a different area of the house so that they don’t get disturbed by the night time activities? Then you could switch off every other night. This way at least every other day you’ll be fully rested.

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Anonymous March 5, 2013 at 1:42 pm

My heart goes out to the OP. That’s a very stressful situation.

I’m wondering if a simple task list application would help. I really like astrid.com. I use it both at home and work. On the web and on my android devices. (There’s an iOS version, too, but I can’t vouch for it.)

Organization is not one of my natural traits. I’m more of a big picture person. On the other hand, I want to be dependable even if my memory of minor tasks is not.

Even on days I’m scatter brained due to other stresses, I make sure I don’t miss anything important.

Sounds to me like the OP’s managers are looking for how to address the issue of missing items at work. As much as they may sympathize, talking about lack of sleep and the stress of child care are just excuses, and they don’t address how the problems (missed letter, forgotten phone call) won’t be recurring issues.

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Esra March 5, 2013 at 2:21 pm

I’d like to second Astrid. Like Jamie above, as soon as I get really stressed, my task memory completely fails and I begin to live and die by my to-do list. Putting tasks into an app or Outlook etc also takes some pressure off you because you aren’t constantly worrying about what you might be forgetting.

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Anonymous March 5, 2013 at 3:57 pm

Agreed.

The issues that OP listed both had to do with her forgetting to do something. While it won’t solve the bigger issues OP is facing, having a good to-do list that can be accessed anywhere, anytime (both to note things down and to review what you need to do) may help. David Allen’s “Getting Things Done” offers extremely valuable advice on prioritizing and tracking to-do’s.

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Joey March 5, 2013 at 1:49 pm

I’d just like to point out that ultimately you will have to stay on top of things to keep your job. Just making the attempt (trying) to stay on top of things will only buy you time. Too many people believe the attempt to improve is what matters. Ultimately its the results that matter-not how hard you tried.

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Anon March 5, 2013 at 1:49 pm

OP, this sounds like a super stressful situation. You have my sympathies. One thing that might help is to think of work as your safe haven – it is the time when you are supposed to let go of your worries about your child. Take advantage of that! Do some little things that make you feel comfortable – buy some of your favorite teas or other treats to have at the office, bring in a cute mug. This might not work for you, but when I’ve been having difficult times in my life, unplugging from all of that at work has been huge help for myself both professionally and personally!

Best of luck.

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Barbra - OP March 5, 2013 at 2:02 pm

I’m the original poster. Thanks for all of your suggestions. I look forward to reading more. I do have a husband that helps out a lot. But I am in charge of coordinating our son’s care between providers and dealing with health insurance (whole ‘nother issue). We were alternating every other wake-up (a wake up can consist of a vomit episode, feeding pump malfunction, or comforting our son’s pain). My doctor recommended we alternate every other night instead so that we both get a full nights sleep sometimes. We’ve been doing this about four days and I think it’s helping. We live 2500 miles from both families and thus have no outside help. I am so very embarrassed it took a meeting from my partners to realize I had such a problem dealing with everything – it made me realize I’m not handling anything very well. We are planning to fly out a family member to help for a week or two which should help jump start our energy. I am also being much more diligent about checking my lists and I’ve even set timers on outlook to go off reminding me of what I’m supposed to be doing.

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fposte March 5, 2013 at 2:09 pm

It sounds like you’re moving forward very effectively here (and I’m so glad to hear you switched to every other night–every other wakeup sounds absolutely exhausting!). I also think it sounds like the organization alerted you at a good time, rather than waiting until they were really unhappy; that’s a good sign that they value you and your work, and they’re likely to respond very positively to your having made such significant changes.

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fposte March 5, 2013 at 2:13 pm

Additionally–if you can find a way to get some outside help, I still think that’ll help the stress a lot. Even occasional respites–a swap with parents in the same boat, maybe?–can be a big help.

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Anlyn March 5, 2013 at 3:35 pm

I echo this. When you’re rested, and a little bit back on track, check out support groups in your area, or look on the Internet. You’d be amazed at how rejuvenating it can be knowing there are others who have dealt with the same thing you are going through, and may be able to offer advice and assistance.

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Mimi March 5, 2013 at 4:15 pm

I second this – are there any respite care organizations in the area? I know the doc is trying to help, but suggesting that you and your spouse trade sleeping “every other night” isn’t much of a long-term solution.

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Jean March 5, 2013 at 11:14 pm

Third this. Support groups are invaluable because they connect you with fellow travelers. It’s amazing how much energy gets freed up once you eliminate the need to explain every last detail of your situation before getting to “today was a hard day and I need a hug!”

Sometimes congregations are incredibly helpful in these situations…and sometimes they are not. It’s hard to predict. Not pushing religion, just brainstorming for other connections since you said you’re far from immediate family.

Take care of yourself. With some of the immediate day-to-day stress relieved at home, you should have a few more crumbs of energy for refocusing on, and reclaiming mastery of, your job.

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Jean March 5, 2013 at 11:15 pm

P.S. Sending good wishes in your direction.

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ExceptionToTheRule March 5, 2013 at 2:13 pm

I can’t imagine the stress you’re under and can do nothing but echo the suggestions to use reminder tools as an organizational lifeline and to definitely follow up with your partners periodically. Good luck with everything.

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COT March 5, 2013 at 2:18 pm

Don’t be embarrassed–you have a lot on your plate and it’s easy to be focused on your child’s wellness to the point that you’re not quite aware of your work performance. There’s no reason to linger on the shame; all you can do is move forward on a positive note.

It sounds like you’re making some changes that will help and I’m sure your partners will see the fruits of those soon.

I’m guessing you’ve already done this, but take advantage of any support groups (local, online, at your hospital, etc.). They can offer great ideas, resources, and strength from other people who have been in your shoes. Take advantage of every form of assistance and support available to you, because it sounds like it’s time to bring in some non-family care.

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Jamie March 5, 2013 at 2:21 pm

I am so very embarrassed it took a meeting from my partners to realize I had such a problem dealing with everything – it made me realize I’m not handling anything very well.

Your son is getting the care he needs and you are addressing the concerns of your employer in a professional way.

I think you are handling things better than many would in your shoes.

You’re human. We all get a little off course sometimes, with far lesser reasons than you have, and we self-correct and get back on track. Have as much compassion and kindness for yourself as you would anyone else going through this – impossible standards of perfection where no ball is ever dropped aren’t doable for anyone. You picked the ball up and are getting it back in the air – that’s the important thing.

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GonnaBAWriterNGetOut March 6, 2013 at 8:47 am

+10000!
So very true, Jamie and I’m so glad you said it so much better than I could have. This comment broke my heart for the OP. We all have lives outside of what we do for a living and sometimes, it’s harder to cope with those lives than others but we just gotta do the best we can and keep pushing. At the same time, finding our compassion for ourselves and remembering we only supposed to be human can go a long way helping us get where we want to be. Very best of luck, OP and take good care of you!

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The IT Manager March 5, 2013 at 2:26 pm

Sounds like you’re on top of it now. I’d mention these things specifically to your bosses – this is your plan to turn your work performance around. You have my sympathy, but Joey (above) makes a good point that wanting to do better isn’t doing better so I think specifics help. You have a good plan to get more sleep which will hopefully mean performing to acceptable levels.

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Eric March 5, 2013 at 4:15 pm

This post sounds like the perfect reply to give to the partners.

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Min March 6, 2013 at 12:30 pm

+1

You’ve expressed both the aknowledgement of the problem and your plan to correct it very well here. I think you are handling an extremely difficult situation with as much grace as humanly possible. As Jamie said upthread, please be compassionate to yourself.

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Steve G March 5, 2013 at 10:10 pm

Barbara – God bless you you are dealing with something I wouldn’t be able to handle. After 4 of 5 days of sleep deprivation I always get sick. I would say reevaluate where you live – go move closer to family so they can help, but I am not sure they would provide substantial coverage. It sounds like you need to focus on working so you can hire overnight help, at least a few nights per week.

And how is the kid by the way? I would be a wreck having to do this. What about a trip to Lourdes or Medjugorje? ALOT of people have been healed there from seemingly incurable illnesses.

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Crosspatch March 5, 2013 at 11:08 pm

This is just such an inappropriate suggestion.

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Anonymous March 5, 2013 at 11:27 pm

See if the Arc is in your area. It is a great resource.

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KimmieSue March 5, 2013 at 2:21 pm

OP – I’m terribly sorry that your family is experiencing this and wish the best for your son. Don’t forget to take care of yourself also. Being a caregiver to a special needs person is very taxing. We don’t raise enough awareness about the toll these situations take on the caregivers. Please reach out to others in your community. Here is a link from a simple google search.

http://caregivers.supportgroups.com/

Hang in there and take time for yourself. Add a daily walk or weekly massage to that list! Remember, you can’t do it all. You might also seriously consider working part time? Not sure if that is feasible with your family finances but it might help with the balancing act that you are facing.

My sincere best wishes to you!

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KellyK March 5, 2013 at 2:32 pm

Alternating nights sounds like a really good idea. For me personally, I’d rather get 5 hours one night and eight the next than six or seven, full of interruptions, for two nights in a row. Since sleep deprivation is cumulative, that should be a big help.

Are naps an option at any point? If you and your husband are both home in the evening, maybe you can trade off and get an hour or two nap.

If there are things you can do right before work or on your lunch break to help you feel more awake and alert, that would be a good idea. (Taking a walk, listening to upbeat music, that kind of thing.)

I would avoid upping your caffeine intake unless you really have to, because it can screw with your sleep cycle even more, and create a vicious cycle, especially if you become dependent on it. *Especially* with anxiety, because caffeine can contribute to anxiety. But, by the same token, if there’s a day where you’ve had four hours’ sleep and are dead on your feet, and drinking a ton of coffee is the only thing between you and more career-imperiling slip-ups, it might be a good trade-off.

Keeping lists that you check regularly and reminder timers is also a good idea. Do you have access to Outlook away from work? I frequently have things occur to me about work while I’m in the shower or driving home, so it might be good to be able to update your to-do list right when you think of something.

I would also take a really hard look at all the stuff you’re doing outside of work and taking care of your son. Both to make sure that you *are* taking time for yourself to recoup and relax, and to make sure you’re not spending more time on something than the benefit it gives you. For example, if you spend an hour making dinner every night and that’s stressful, maybe look at simpler meals or a couple take-out nights a week. (On the other hand, if cooking is fun and relaxing, or your son’s illness comes with major dietary concerns, you might want to spend *more* time cooking.) Or, if you’re crashing in front of the TV for an hour and not really enjoying it, would it be better to sleep during that time, or read?

Similarly, if there are household tasks that you can afford to outsource or quit doing, that might free up time for rest or other more important activities. That could be anything from having someone come clean once a month to paying a neighbor kid to mow the yard and weed the garden.

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Jennifer March 5, 2013 at 2:50 pm

I don’t have too much experience with this, but I want to wish the OP best of luck with both the work and home situations!

And also, if I may, I’d love to point out how interesting it is to have such a similar question posted quickly after the in-the-red-from-sick-leave post. The attitude of the OP on this one seems miles apart from that of the first, and thus the answers are wildly different as well. I think this is a great example of how the attitude one takes when approaching problems (or life in general) can greatly affect the outcome and people’s perceptions. We could all learn from this.

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Ask a Manager March 5, 2013 at 3:25 pm

That’s a great point.

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AdAgencyChick March 5, 2013 at 3:51 pm

+100!

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Anna March 5, 2013 at 2:50 pm

Do you have a spare bedroom that you might be able to use to get an au pair or some other sort of live-in, part-time help? You don’t sound like you need a full-time babysitter, but it might be really good to have one more adult in the house who can take things over for you, even just one or two nights per week. And if you could offer housing and other amenities, it might not cost too much to get a college student or an exchange student into your household to relieve a little of the pressure.

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B March 5, 2013 at 3:01 pm

To echo this…perhaps a nursing student or resident would be able to help. Even if it is not to comfort your son, they could help with the feeding and cleaning up. That could go a bit of a ways to helping relieve some of your stress and maybe cut 30 minutes off of the nighttime routine.

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Emma G. March 5, 2013 at 3:03 pm

I’m sorry that you and your family are facing this. The other suggestions are all good, but (since I am also a litigation paralegal) I think you should also take a long, hard look at your employer’s expectations. Before caring for your son became an issue, did you have any problems keeping up? Were you always rushing to meet deadlines? Has the staff been downsized, and are you expected to pick up the slack? There is always the possibility that they are simply expecting too much of you, your personal circumstances aside. I know that my workload has shifted drastically in the past few years, and I hear the same story from friends at other firms.

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Barbra - OP March 5, 2013 at 3:13 pm

This is another part of the puzzle, albeit I did not think it worth mentioning because it is part of my job expectations. My firm recently lost a major case at trial that had been worked on for years. Coincidentally, an assistant coworker is leaving and they don’t want to replace her. They have carved up her job to other positions, with mine receiving the bulk of her duties. I am currently in training for these new duties. That has added to my work stress. I am afraid that if I can’t handle these new duties, they will let me go. And I feared that before I knew they weren’t happy with me.

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Elle March 5, 2013 at 3:43 pm

Litigation is a funny thing. Law is often a slave to external deadlines and is ALWAYS last minute. Don’t be afraid – once the dust has settled – to leave to find another job which is less deadline focused.

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Anon March 5, 2013 at 3:50 pm

Some other folks pointed this out, but in addition to all the good advice here, I would seriously consider finding a less stressful position. I know you probably need to work, but you and your child should be your first priority. I feel bad that you have to worry about this and your child too. I think you can work and do things at home, but not all jobs are conducive to doing both well. Good luck.

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BeenThere March 5, 2013 at 3:54 pm

You have a ton on your plate. It sounds like you have a great attitude and are willing to work hard at all of your life’s realities and demands. Have you looked into whether or not your insurance will cover a night nurse some nights of the week? Sites like sittercity.com and care.com sometimes have night sitters available too- even if it was just one night a week- that way you and hubby could both be rested at the same time. how great would that be? Best of luck.

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Runon March 5, 2013 at 4:20 pm

Something that might be useful especially as a part of a plan is to dedicate some time each week to planning. For me it is usually about 11 on Mondays (cause there is always a monday morning crisis). I actually schedule the time on my outlook so no one else books me for that time and then create a plan, what needs to be done, what is outstanding, what is waiting for others. And then things that are crucial not only get added to a task list but time actually scheduled on the calendar for them so that time is blocked off and you get the little ping, time to work on that letter now.
Something else that might be beneficial is if you have items that require concentration talk to them about using an office or a conference room for those tasks. Being able to be uninterrupted can create a serious skyrocket in your performance for certain tasks. Heck even using a lunch room at 3 pm when others aren’t in there can help. You may need a laptop or something to be able to work this but I definitely recommend it. One of the first things to go with sleep deprivation is task switching ability. You are working on something, someone comes by and asks a really quick question, you take 30 seconds to answer it but now it can take you several minutes to get back to where you were. So being able to not have those even quick questions that require you to task change will make a big difference.

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Runon March 5, 2013 at 4:21 pm

Holy text batman. TLDR: Schedule time. Work uninterrupted.

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Anonymous March 5, 2013 at 11:33 pm

Too bad clients can’t see that I’m in the field or working a tight deadline when they call me.

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LCL March 5, 2013 at 4:27 pm

And when you have your second meeting, explain what is involved in your child’s care, the medical and logistics aspects.
People develop compassion fatigue when they keep hearing that a special needs child is the reason for whatever workplace issues. Once it is explained to people what those needs are, they are usually a lot more understanding.

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Anon March 5, 2013 at 4:34 pm

This. I think many people immediately put up “privacy fences” with things like this. I think your manager needs to know what is going on. When I have been forthcoming with things going on at home, things have gone smoothly. When I have kept things to myself, for whatever reason, I had more explaining to do later – and usually folks asked, “Why didn’t you tell me before???”

When you tell your manager specifically what is going on, you and he/she can work together to develop an effective plan to get the work done. And then everyone is happy.

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Ask a Manager March 5, 2013 at 4:38 pm

I’d be somewhat cautious about sharing too many details, or at least cautious in how you do it. It’s good for your manager to understand what you’re dealing with, but you don’t want to come across as if you expect them to lower the job expectations for you as a result — because that could make them fear that you’re on very different pages about expectations. Sharing so they have context, yes — but I wouldn’t do that expecting them to adjust the job requirements.

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Barbra - OP March 5, 2013 at 5:03 pm

I agree with this. My partners need a certain level/speed/quality of output and it doesn’t really matter why I am having difficulty. They shouldn’t have to lower their expectations of me – I am glad they have been understanding of the appointments but they shouldn’t have to accept below par work. They already know he has a chronic illness and requires lots of appointments. They don’t know about the sleep deprivation or the constant monitoring that my son requires. I will explain that I have been dealing with sleep deprivation and have a plan to change that but I don’t think they need to know that my son can throw up 2-4 times every night. (unrelated note – you don’t want gastroparesis – it sucks)

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Anonymous March 5, 2013 at 7:24 pm

You wrote:

“My partners need a certain level/speed/quality of output and it doesn’t really matter why I am having difficulty. They shouldn’t have to lower their expectations of me – I am glad they have been understanding of the appointments but they shouldn’t have to accept below par work.”

Oh, if only everyone had this kind of attitude.

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Rachel in Minneapolis March 5, 2013 at 4:42 pm

We have friends in a similar situation, with a child who needs round the clock care. They have been able to afford some caregiver shifts, split up the rest, but they have really mobilized their friends to help. Since neither family is close by, we all chip in what we can.

They have a shared care calendar (like on Google calendar, but connected to Caring Bridge) and you can sign up to make meals, babysit for 2 hours, take an overnight shift or whatever. Their son is 3 years old and I think they get about 1-2 nights a week of volunteer help from various friends. I like it because I can help out and schedule a time when it works for me.

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Victoria Nonprofit March 5, 2013 at 5:20 pm

That sounds like a terrific system.

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No name for this March 5, 2013 at 4:53 pm

Barbra, my heart goes to you. I’ve had a rough patch myself some time ago (my teenage son had depression with suicidal episodes, so I was always on high alert). When I was about to collapse I learned from a life coach several simple mind techniques to alleviate anxiety (mine was about to turn into full-fledged depression) and get better rest. One trick stayed with me: when I need a good rest in a short time span I put my headphones on with soothing, trance-enabling music, enter a shallow trance and then slip into sleep. I amost always seem to get up refreshed as if I had slept a lot more than what I actually did. If this kind of thing seems helpful, perhaps you’d like to have a talk to someone knowledgeable.

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Lulula March 5, 2013 at 5:28 pm

Not much to add other than +1′s to all the great suggestions above, and my sympathy: it sounds like an incredibly difficult situation to deal with, and the fact that you’ve been able to keep it together on the face of things is impressive in itself. I suffer from a lot of fatigue-related/causing issues, and it really does impact so much of one’s ability to function, as well as emotional state!

I had the same reaction as a couple of people above, that you also seem to be in a high-stress position. While I’m the first to say that waging a job search can certainly be yet another resource-drag, perhaps just starting to consider potential alternatives (even less hectic paralegal fields) might be helpful for the long term.

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AMG March 5, 2013 at 5:42 pm

Prayers to you, OP. I hope you are able to find some solutions that help. Please keep us posted.

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Anonymous March 5, 2013 at 6:06 pm

My son is special needs, and although he doesn’t require the same intense level of care that your son does, I still can empathize with the challenges of having to perform to extremely high expectations when your attention is being pulled in so many directions.

I started using OneNote to keep track of projects and keep a running todo list. It’s helped me not forget things I’m supposed to do and to quickly move from task to task. Since I started using it, I notice that I’m not forgetting as much.

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girlreading March 5, 2013 at 6:59 pm

Do you have the financial means to hire some kind of night nurse or nanny? This way he/she can deal with your son while you get some sleep. I’m sure you worried this person won’t be able to care for your son properly, I totally understand, this is you child you love dearly and want only the best for him, but part of that means you have to either be at your best for you job to keep your job or leave your job if you’re financially able. If it’s feasible, maybe you or your spouse could work only part time so you have more time to devote to your child or find work in your field, but perhaps not as a lawyer.

I also like fposte’s idea about finding others in your situation (your doctor may be able to point you to some support groups). Someone may be able to suggest reliable caregivers or see how others have dealt with these issues.

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Elizabeth March 5, 2013 at 8:01 pm

I think Alison’s advice is spot on.

Remember the importance of self-care as you take care of your son. I hope you have some social and practical support to rely on.

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Adele March 5, 2013 at 10:26 pm

As far as nursing care goes, if it’s not covered by insurance to have a full-time night nurse, you might (if it’s financially feasible) arrange for one out of pocket for one or two nights a week, so that both you and your husband can get some quality sleep, and have a little time together, as well. This would be all the more important if either of you drives to work, since sleep-deprived driving is seriously unsafe! It would be terrible for either of you to end up in an accident.

In addition to all the other great suggestions about caregiving options, perhaps you could also look into something like Task Rabbit, to outsource the more mundane things like grocery shopping or picking up the dry cleaning? Even though those things are small, they add up time-wise and can add additional stress and aggravation, particularly if your life is already filled with difficult logistics. You could even outsource meal planning or someone to help you keep track of appointments.

I also think it might be helpful to meet with a social worker or patient advocate or something similar, to hash out a longer-term strategy for caregiving for your son and “caregiver care” for you and your husband. Oftentimes they know about resources that could potentially help your situation that you might not find out about otherwise.

I do think it’s rough when a condition is chronic, because sympathy in a person’s community seems to run dry, often when a caregiver/family member needs it the most.

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Anonymous March 5, 2013 at 11:29 pm

Is the Op able to negotiate flexible work hours? Perhaps coming in later or even working 1-2 days per week at home? Some companies even offer full benefits if you maintain a minimum number of hours per week ( for example going from 40 hr work week to 32 hour work week) While it does mean less income, if you still have benefits that counts for a lot. good luck!

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Just Breathe March 6, 2013 at 9:48 am

Once you get back on track and regain the trust of the firm, perhaps–if the time is right–you could you ask the firm about reducing your work-schedule and salary slightly? Working a slightly reduced schedule even an hour or hour and a half less each day, may help you to jump into your work day with greater clarity.

Good luck and remember to take care of yourself too!

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perrik March 6, 2013 at 10:26 am

My current work projects have been related to caregiving, so I’ve become familiar with some of the resources out there. OP, head over to the National Alliance for Caregivers (http://www.caregiving.org) and the Family Caregiver Alliance (http://www.caregiver.org) for tons of information and resources.

Most caregiving resources assume that the care recipient is an older adult (usually a parent) who lives in a separate residence. NAC’s research arm has begun to study other caregiver populations who have concerns different from the “typical” caregiver. Here’s their 2009 report on the caregivers of special needs children: http://www.caregiving.org/data/Report_Caregivers_of_Children_11-12-09.pdf

Please look into respite care! It’s such a valuable but underutilized tool for taking care of yourself so you can better take care of your child. If your child is a regular outpatient at a hospital, you could talk with the social work department there to learn about local respite options. Social workers are an awesome resource.

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Barbra - OP March 6, 2013 at 7:27 pm

I had the meeting today. It went better than I expected. They had no intention of firing me. They just wanted to share their concerns about their work getting done correctly and in a timely manner. They were actually more worried about my well being than the work. I talked to them about the points that Alison mentioned above, and some of the specific things I plan to do to get back on track. They want more open communication, regular check in meetings and for me to take care of myself. It was good. Thanks everybody for your suggestions and well wishes.

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Ask a Manager March 6, 2013 at 7:30 pm

I’m so glad it went well! Thank you for updating us, and please keep us posted!

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kryzstoff March 7, 2013 at 1:01 am

I would talk to them about taking some parental / carer leave, if you are able, or better yet, discuss reducing your working week eg. from 5 down to 4 days, to better focus yourself (on work) and get some much needed R&R and quality time to help your child.

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Human May 5, 2013 at 9:47 am

Wow. The advice given is realistic to the cold, materialistic world we live in, but my God, who except an orphan with no pets has no outside obligations. The partners behavior is bullying. The woman is sleep deprived, caring for a disabled child and MADE TWO mistakes. Truth is, she needs a new job (work at home) that fits her- they will force her out and seem to be using this technique to avoid paying unemployment. And in reality she did nothing wrong, unless being a compassionate human being is wrong.

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