A few general guidelines can help keep caregivers from burning out. (Consider asking each of your caregivers to read this document. Alternatively, print a copy for each one.)

Try to get information about the patient's disease, situation and treatments.

Information will help you feel prepared as a caregiver.

• Consider going with the patient to doctor appointments rather than learning about the medical situation second hand from the patient. If you go, you will also have the opportunity to ask questions. 
• If you cannot go to a meeting with the doctor in person, ask the patient to record the appointments. Recorders are not expensive. The patient's cell phone may even be able to record the conversation.

Do not expect to be a perfect caregiver.

We are all human and have our own needs. Be reasonable in what you expect from yourself.

Don't be surprised if you feel overwhelmed at times. Living with a life changing health condition can be like a wild roller coaster without visible tracks. If you feel stressed out, don't blame yourself or the patient. Caregiving takes more time and energy than most people realize.

Think about the patient's individual needs and characteristics

We're all different. Perhaps a patient who has been the family leader doesn't know how to ask for help. 

Keep in mind that caregiving is a process that takes time to learn.

Learning the patient's needs and how to fill them while also taking care of your own life takes time. It often also takes trial and error.

Do not try to go it alone. Ask other family members and friends to do their share. If people offer help, take it.

Ask directly for the help you need. Your needs may not be obvious to other people.

If people offer help, let them know what would be useful for them to do. Give them practical ideas.

Consider calling a family conference where you can all discuss your and the patient's needs. It may help to practice what you want to say with a close friend before the meeting.

NOTE: Sitting in waiting rooms in hospitals can be particularly lonely. If it is for you, ask for someone to accompany you.

Keep hands-on moments for yourself.

A study authored by Michael J. Poulin, Ph.D. suggests that providing help with physical tasks such as feeding or bathing can improve your (the caregiver's) sense of well being. Passive pursuits such as sitting nearby "just in case" is more draining. When people offer to give you a break, consider asking them to take care of your loved one when he or she is resting or asleep.

Take care of your physical and emotional needs

If you aren't well physically and emotionally, you will have difficulty taking care of someone else. 

Don't let being a caregiver take over your entire life. Work toward a balance between relaxation, recreation, time for yourself and doing the things you need to do. 

If you think of caregiving as a marathon instead of a sprint, you'll recognize the need to pace yourself and to get or keep yourself in the best physical and mental shape you can. Exercise, Eat right. Get rest. 

Keep in mind whatever got you through the tough times before. Use those techniques now.

Don't let your medical care lapse because of the patient's medical expenses. If you don't have you health, you cannot help. For instance, if paying for your medications becomes a problem, see How To Save Money When Buying Or Using Drugs and Drugs: If You Cannot Afford Them

Keep the lines of communication open between yourself and the patient

Communicate as openly as possible.

Communication is essential for you to know the patient's needs, and his or her reaction to what you are doing or not doing.

It is also important for the patient to know what you are feeling. Expressing your thoughts can bring a new imtimacy to the relationship.

Release your emotions

A caregiver who is highly distressed has a negative effect on the well-being of the patient, as well as yourself.

An easy way to relieve distress is to share your emotions.

• Before sharing your emotions with the patient, ask the patient for permission. 
• Share your emotions with other people as well. Even talking with a stranger who is a good listener can be helpful.

Consider getting things out of your system by writing, or creating art. You don't have to be an artist. The form of the art doesn't matter.

If necessary, professional help is available.

Get support for yourself

• You are not alone.
• One way to get support is to make contact with another caregiver
  • Contact with another caregiver provides another means of releasing emotions. Other caregivers going through a similar situation understand your situation better than most people.
  • You can find other people in a similar situation through the nonprofit organization that relates to your specific disease, or through caregiver web sites such as www.StrengthForCaring.com . 
  • You can also find other caregivers through support groups. See the next paragraph.
• Consider joining a support group of caregivers. The contact can be formally through a support group or a self help group, informally one-on-one, or both. 
  • Support groups are an easy place to find emotional support - plus they are a great source of practical information for both the caregiver and patient. 
  • In addition to face-to-face caregiver support groups, there are also caregiver support groups that meet via telephone or the internet.
  • Many support groups for patients also accept caregivers.
  • To find support groups for caregivers or to make contact with a similarly situated caregiver, see:
    • Well Spouse Foundation, www.wellspouse.org  tel: 800.838.0879
    • Today's Caregiver, www.caregiver.com  Tel.: 800.829.2734
    • National disease specific non-profit organizations such as Cancer Care, www.cancercare.org (look in the section: Caregiver Resources). 
  • The documents in "To Learn More" describe the many advantages of joining a support group.If you try one and don't like it, you can always stop going.

Take a break

Even the strongest caregivers need an occasional break. 

• Schedule regular breaks if you can - daily if possible. Even a slow walk around the block where you can change your focus can be a break.
• The patient's insurance may cover the cost of someone to help while you take a break. Insurance companies refer to the break as  "respite care."  

Keep up relationships with family and friends

If you don't keep up relationships, you, the caregiver, will become isolated and more likely to burn out. 

Stay interested in what is happening in your friends' lives and what is happening to them. It may take concentrated effort, especially to sympathize with problems they are having which seem petty to you compared to a potentially life and death situation and difficulty dealing with a health condition or side effects or financial problems caused by medical expense. Keep in mind that their problems are just as real to them.

Don't be surprised if people only ask how the patient is and forget to ask about you. It doesn't mean that they don't care about you. It is likely instead that they think you are okay. They won't know any different unless you tell them.

Get help with emotional distress

Caregivers can suffer from depression, anxiety or emotional distress. For tips about dealing with each of these difficulties, see the documents in "To Learn More."  (The information applies to both caregivers and patients).

Take particular care at holiday time

Holidays can feel like a seasonal crisis on top of a physical crisis.

Think about ways to keep the patient involved in the holidays. 

• Be flexible and creative.
• Keep it simple.
• Ask for help if needed.
• Hold on to your sense of humor

In case it helps, click here for information that helps patients avoid depression during the holidays.

Think about what is most important to the patient. For example: a food, a particular color, a candle, a picture, seeing a person who is not nearby. Keep in mind that you can use technology. For instance, with Skype the patient can see and hear someone who is far away (or across town.)  What action would be best to get a feeling across?

Books that may help

For additional practical advice, see:

• Self-Care for Caregivers:A Twelve Step Approach by Pat Samples, Diane Larsen, Marvin Larsen (Hazelden Publishing 2000)
• Caregiving: A Step-By-Step Resource For Caring For The Person With Cancer At Home, by Peter S. Houts and Julia A. Bucher (American Cancer Society, 2000). 

If the above tips don't work, and you need help:

Get it. If you cannot afford help from a mental health professional, you can probably get it from your religious organization or a local non-profit organization that specializes in the patient's disease.

NOTE: If you have additional tips to share, please click here.

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