Caring for the Caregiver

In Oregon, Nicki makes weekly phone calls to her sister Rebecca, who has Alzheimer's. Rebecca lives 3,000 miles away in New York City.

Stephanie and Doug share a New Jersey home with Stephanie's frail mother. They give her round-the-clock aid.

And Ruth, who lives in Maryland, does the food shopping and cooking for her neighbor Scott, 93.

These people have one thing in common: They're family caregivers.

"Family caregiving is the fastest-growing unpaid and often unacknowledged occupation in this country," says Lorraine Sailor, operations coordinator at Children of Aging Parents, a nonprofit charitable organization based in Levittown, Pa.

A recent survey by the National Family Caregivers Association (NFCA) found more than 54 million people give care each year. About 56 percent are women, according to the survey.

Caregivers come in all shapes and sizes. They can be adult children, spouses, siblings, friends, or neighbors, who help with daily activities such as bathing, feeding, and clothing. The caregiver may be the only person who can take a loved one to doctors' appointments. The long-distance caregiver may call weekly, help with expenses, or support the main caregiver.

More than one relative helps out in some families, but most caregivers go it alone. The NFCA survey found three out of four caregivers don't get consistent family help.

"Caregiving can be a truly rewarding experience," says NFCA co-founder and President Suzanne Mintz. It can be a time to heal old wounds, end conflicts, and improve relationships. It can be a chance to serve a loved one.

But caregiving also can be demanding and time-consuming. It may even raise your risk of stress-related disorders.

"Many of us believe in honoring our parents and take our marriage vows seriously," Ms. Mintz says. "But the work of caregiving goes well beyond what we can do. Asking for help is a sign of your love and caring, not of weakness and shame. It is much more than a one-person job."

How to Succeed

These tips are drawn from professional, government, and charitable groups: the American Society on Aging, the Federal Administration on Aging, the Family Caregiver Alliance, Children of Aging Parents, and the National Family Caregivers Association.

Don't Go It Alone

• Ask others for help. Start with family and friends. Keep less engaged family members informed. Set up a family conference, seek suggestions, and talk about disagreements.
• Ask families with similar problems how they handled them.
• Involve the person you're caring for. If possible, help the person take responsibility and join in decisions.
• Learn about your loved one's condition. Find specialists for information and guidance.
• Tap local, state, and national resources. They can offer help with transportation, nutrition, or day care. 

Watch for Problems

Mental and physical signs of caregiver stress: 

• A lot of anger or fear
• A tendency to overreact
• Feeling depressed, isolated, or overburdened
• Thoughts of guilt, shame, or inadequacy
• Taking on more than you can handle
• Headaches
• Digestive upsets
• Weight loss or gain
• Trouble sleeping
• Fatigue
• Illness 

Take Time Out

Be good to yourself. Take time away from caregiving and don't neglect your personal and professional needs: 

• Get lots of rest and exercise
• Enjoy relaxing music
• Eat nutritious meals
• Visit with friends and plan leisure activities
• Do deep breathing
• Read a magazine
• Don't abuse alcohol or drugs, or overeat
• Keep a sense of humor
• Write your feelings in a journal
• Do spiritual meditation
• Set limits on what you can and cannot do
• Realize you're doing the best you can
• Join a support group
• Use community resources for help 

Get Help

It's OK not to have all the answers. Seek help when you need it most: 

• Call a support hotline. Just having someone listen may help.
• Speak with a counselor. A professional can help you understand your situation.
• Talk with your religious adviser.
• Attend a support group. Groups can explain your loved one's condition, ease tension, and provide a sense of what's important. 

General Assistance

• AARP: Advocacy group with publications on aging, including recent legislation.
• Children of Aging Parents: Information on caregiving and referrals to support groups, care managers, and other resources.
• Family Caregiver Alliance: Covers medical, social, public policy, and caregiving issues linked to brain impairments.
• National Council on Aging: Information and advocacy.
• National Family Caregivers Association: Dedicated to aiding caregivers through education, research, and support.
• National Institute on Aging: Conducts and supports research, training, and information on aging.
• Well Spouse Foundation: Offers support to people caring for a sick spouse who need emotional care themselves.
• Religious organizations often provide additional assistance. 

Specific Ailments

• Alcoholics Anonymous: Fellowship and self-help group.
• Alzheimer's Association
• American Cancer Society
• American Heart Association
• National Parkinson Foundation
• National Stroke Association