‘Tis the Season: Let’s have some F.U.D.G.E.

Nov 13, 2023 | Patient Advocacy, Aging Successfully

Would you rather listen instead? Click here for the 14-minute audio recording.


I find that the emotions of healthcare, caregiving and aging can be digested “with or without” nuts.


Chocolate fudge and a candy cane.Does ‘F.U.D.G.E.’ get your attention? Does it draw your attention when spelled in CAPS and with periods? It did mine when I first encountered the term.

The first time I read about F.U.D.G.E. was when as a newer Patient Advocate, I was reading the work of Trisha Torrey, founder and then director of the Alliance of Professional Health Advocates. F.U.D.G.E. caught my eye and demanded my attention. I am glad my curiosity had me investigate because the term adeptly outlines a swarmy, complex state of mind.


F.U.D.G.E. means Fear, Uncertainty, Doubt, Guilt and Exhaustion.

F.U.D.G.E. stands for Fear, Uncertainty, Doubt, Guilt and Exhaustion. If you have been anywhere near the issues of healthcare navigation, caregiving, planning for successful aging, then you likely have been exposed to some of these “ingredients.” Sometimes a combination. 

I have posted in greater detail about each one of these ingredients in greater detail (find them here) and right now, we’re gonna have some  F.U.D.G.E. together. In fact, I’ve bought a sampler.

And because some people like their fudge with nuts, I can always wax poetic about situations or people who seemed like it (nuts), or perhaps you may end up thinking I am. Your call. 🙂

Here is the Overview of F.U.D.G.E., a sampler prepared just for you.



The F in F.U.D.G.E.  stands for FEAR  

Fear is behind more than we realize as we live out our lives or plan our futures. Whether or not we feel its presence or its grip, FEAR is a huge component when you are inside a healthcare encounter. Or when a caregiver or when the care recipient thinks: 

What will happen to the person I’m in charge of?
What’s this diagnosis, and what does it mean (to me or to my loved ones)?
What is going to happen (and happen to me)? 

It may not be anything you can put your finger on or consciously think about, but there may seem a sort of subtle presence lurking.

Then there is absolute FEAR which is more like “Is  Doris going to survive this procedure?” or “I fear for my life, or his life.” Fear is behind more than we realize. In elder care, well care, or caregiving, FEAR is there in the backseat. We witness it in the form of

Reticence – (Senior living communities are not right for me. (Or) No need for a doctor, I feel fine.
Complaining – Quit fussing over me! (Or) You are so busy with work that you never call me anymore. Can’t find a companion to accompany me to the colonoscopy, I will skip it.
Discord – Mom’s fine, Jackie, you are imagining things. I see zero need for having a family planning discussion.
Sabotage – even self-sabotage – It took me all month, but no one saw that it took me longer to pull off my holiday cookie gathering.  I blew my budget.  (Can one live on cookies, I wonder?).

FEAR is lurking. You can bet on it. In fact, for the rest of the word F.U.D.G.E., it is quite likely that FEAR is woven in every part of it.



UNCERTAINTY is the “U” in F.U.D.G.E. I must ask: is there anyone among us who’s not felt any uncertainty about healthcare or caregiving? Dealing with change, change that naturally arrives with aging?

How’s this going to go?
Do I know all I need to know?
(Or) I’m pretty sure I don’t know all I need to know. 

UNCERTAINTY occurs when there are too many factors to consider, not well understood, or balls are in the air, or whatever is UP in the air! We don’t know how the other factors are going to impact our concern. We’re dealing with humans here, so then there’s that part of any UNCERTAIN-ty. 

When we are caregiving, whether the caregiver or the care recipient, whether you are aging or solo-aging, whether you are attempting to navigate a healthcare system that’s not showing signs of getting any easier – it is easy to see and feel the UNCERTAINTY. After all, we are all moving targets with distinct personalities and we can, without trying to, contribute to volatility.

This F.U.D.G.E. stuff builds.



The D in F.U.D.G.E. is for DOUBT. Once again, who among us has ever sailed through life (or healthcare, or caregiving, or aging) without a side helping of DOUBT?  

Is this right, or is this wrong?
I’m not sure if my capability or the other party’s capability.
Will this all come together, or will it unravel? 

There are lots of shapes and sizes of the Doubt-FUDGE (would you like a small piece? Oh, do take two, they’re small).

Somebody may be doubting you, or me, or themselves. Not full belief and less-than-full trust is DOUBT. And FEAR is here with us also. Fear + Doubt  (What will happen? Am I ready for this? I am not sure this is gonna work).



GUILT, the unhappy lookback. I’d bet we all have some things we regret or certainly would have done differently that have been part of caregiving or receiving. Maybe in our healthcare encounters – who of us has not left the doctor’s office and realized we either did not get an answer to a question we’d meant to ask or left lacking because we did not sufficiently ask for clarity on the matter? 

The ‘unhappy lookback’ and sometimes the eternal lookback. Have you ever encountered someone who was eaten up inside with GUILT, and you could tell it? Or perhaps it is evidenced in another way, that GUILT when folks delve too far into assuaging it with poor choices. They may enter into other diseases or addictions under the influence of GUILT. GUILT is sticky. The binder in FUDGE. Then DOUBT inserts itself. We don’t have to do a thing to find ourselves with it.

It happened on my watch.
He or she made me promise not to, and now it’s happening.
Did I do all I could do? Am I doing all I can do?
How do I weigh their wishes against safety and maybe an outcome?



How fitting that the “E” is for EXHAUSTION and is at the end of the F.U.D.G.E. –word. After all the angst we have covered here, I am tired just thinking about it all. EXHAUSTION is both a sum total and a result. It is also a danger zone. EXHAUSTION is easily recognized, and it is easily understood. EXHAUSTION is expected or anticipated. and is a result of courses of events that we cannot well control. 

Guess who’s in the backseat? Your friends Fear, Uncertainty, Doubt, and Guilt are all there. In fact, they likely backseat-drove you here to EXHAUSTION. 

Did I do (or am I doing) all that I can do? > I can do more, I must do more.
I cannot let others see that I am not on top of my game or that I need help.
Me? Self-care? HOW DARE I?

EXHAUSTION may also be a result of denying self-care, which I talked about in an earlier blog, Me, Self Care? HOW DARE I? You may think of EXHAUSTION as a kind of waning, slowing down, or even a forced stop -kind of thing, but EXHAUSTION can fool us. It can be self-sustaining. It can create further exhaustion as we try not to let others see (Pride is often a pathway into EXHAUSTION). Or when we do not ask for help or allow people to help. There’s pride in EXHAUSTION in a weird way. We are exhausted because we haven’t let others know or see. Often and all too late, we realize that we have not allowed for self-care, such as rest and proper nutrition, to fuel the furnace. We have not been or stopped being good to ourselves. We have been blinded by and in our EXHAUSTION.


Problem now defined; I invite you to join me in the solution.

Those who know me know I prefer to shift to solution. I will always bring it. Ha! The F.U.DG.E. antidote (or antacid)!

Knowing what we know about human nature and our frailties, foibles, and tendencies means we can work within them to find solution. This Patient Advocate likes to live in The Solution, so on your behalf, I have already been batting around approaches and ideas such as

How to combat – Ha! How to stop yourself from eating too much F.U.D.G.E. – It’s a sick feeling, isn’t it.
Mitigate – You see it, here comes the plate… You can decide to say No or discuss the ingredients with another.
Reduce – you can limit your exposure to FUDGE by not going to where you know it will be or merely.
Improve – sometimes, we can learn to say No (this time, next time, or sooner). Or we can decrease an ingredient when we next prepare it. Eat one less piece, and begin control.
Seek – we can ask for other recipes or variations (How did you make your F.U.D.G.E?). Did you know that every time you share a problem, it will lose some of its power over you? (nugget!).
Accept help – or simply allow yourself to be seen candidly. That can be progress.
Work a plan – give some thought and conversation about how you are going to handle things when you know that F.U.D.G.E. will be there or when it shows up.
Give yourself permission – to live it, work each and every ingredient of F.U.D.G.E. to the best of your ability. Let others see, and suggest sharing the load (but pass the plate, y’all, keep it moving)

It is very likely that we all have some F.U.D.G.E in our futures. It may be with nuts. or it may threaten to drive us nuts. We can learn to manage our intake.

Have you ever been F.U.D.G.E.’d?Had too much at times? I help people who are navigating healthcare, who are caregiving or who are the care recipient, who wish to age or solo age, successfully – by managing their F.U.D.G.E. intake. Contact me if you’d like to know more.


Contact me, let’s see what your F.U.D.G.E. is made of. The emotions of healthcare, caregiving or aging can be “with, or without nuts”. We can empty the plate, wash it and put it away! Schedule a Complimentary Consultation here.  919.928.4428 www.nancyruffner.com