“If you’re depressed, tired or sick, your caregiving is likely to suffer,” counsels John Schall, CEO of Caregiver Action Network, in Washington D.C., and a former family caregiver.  “For the sake of your loved one, take care of yourself.”

The AARP estimates that some 34 million family caregivers provide for someone that is ill or disabled in the U.S. According to the National Alliance for Caregiving, in Bethesda, Maryland, caregivers generally struggle with finding time for themselves, managing emotional and physical stress and balancing work and family responsibilities.

Experts suggest that the following seven steps can help people enjoy a healthier, less stressful and more conscious approach to care giving—and receiving.

Reframe Care

When Lori La Bey’s mom was diagnosed with dementia, the daughter initially felt she was the only family member that could help her. But gradually, the Minneapolis-based international caregiver advocate and founder of AlzheimersSpeaks.com learned to welcome help from others. “Being perfect gets in the way of true connections,” she observes.

Although La Bey began her caregiving out of love, the volume of related tasks soon sparked stress. That’s when she taught herself to slow down and reframe her outlook: Before going into her mom’s room, folding her laundry, scheduling healthcare practitioners and delivering dinner, La Bey paused to consciously ask: “Is Mom safe, happy and pain-free?” Centering on those three questions reminded her that she was doing this work out of love.

Psychotherapist Diana Denholm, Ph.D., of West Palm Beach, Florida, heightened her own consciousness by learning to see caregiving as collaborative effort. Denholm, author of The Caregiving Wife's Handbook: Caring for Your Seriously Ill Husband, Caring for Yourself (CaregivingWife.com), sought to keep her husband as engaged and active as possible.

When she had difficult issues to discuss, she’d make a “talking date” with him, offering choices by saying, “I’d love to chat with you. Would Tuesday before dinner or Thursday after breakfast work for you?” Beforehand, she’d select a comfortable room and clear her mind by meditating, napping or mindfully sipping herbal tea. The conversations would cover anything from how to work with their health professionals to plans for his end of life ceremony. They agreed on strategies and worked together as a team.

Redefine Assistance

I’ll carry your luggage for you, Dad, since you’re not feeling well… LaBey still remembers her father’s downturned mouth as she tugged the suitcase out of his hands. “I was trying to be helpful, but instead I took away his dignity and power,” she later realized. “If I had packed his bag lighter, he could have carried it like always.” When are we helping and when are we doing too much?

“Put yourself in the sick person’s shoes. Avoid doing something the person can do for himself,” agrees Denholm. Controlling behavior changes the dynamics of the relationship and can put the caregiver in a parental role. She recommends a holistic brainstorming exercise in which the caregiver writes answers to such questions as: What am I frustrated about? What really annoys me? Why am I angry with myself?

The results offer a window to understanding our own feelings. “Feeling anger could mean we’re acting co-dependently and taking on too many responsibilities,” Denholm says. “The caregiver’s job isn’t to save the patient, but merely to support him or her in necessary ways.”

Ask for Help

“I don’t want to be a burden,” and “We’re afraid of losing our privacy,” and  “I’m the only one who can take care of him; no one else can do it right,” are common concerns. “These self-limiting beliefs prevent people from reaching out for help,” says family caregiver and life coach Yosaif August, founder of Yes To Life Coaching (YesToLifeCoaching.com), in Philadelphia, Pennsylvania, and author of Coaching for Caregivers: How to Reach Out Before You Burn Out. 

August quotes a recent Johns Hopkins study that reported caregivers might improve their health “… when caregiving is done willingly, at manageable levels and with individuals who are capable of expressing gratitude.” Accepting assistance makes caregiving more manageable.

August understands how overwhelming the experience can be and advises caregivers to ask themselves: “What do I need help with right now?” Keep answers specific, such as, “I need someone to prepare dinner tomorrow night, mow the lawn and pick up our vitamins.”

August also suggests creating a family Declaration of Interdependence, a personal statement documenting how the family prefers to be helped, along with the attitudes and behaviors they find especially supportive. Encourage family and friends to ask these two questions: “Are you open to advice?” and “Is this a good time to talk about your spouse’s condition?” Make much-needed breaks sacrosanct from such discussions.

Nurture through Nourishment

Make a list of favorite ways to relax and renew during short respites, such as reading, listening to music, stepping outside, sipping coffee with friends or taking a hot shower, and refer to it often.

More than 50 percent of caregivers surveyed in a 21st-century study spearheaded by the National Alliance for Caregiving reported, “I don’t have time to take care of myself.” That can translate to a lack of exercise, an unhealthy diet and little or no respite.

“If you aren’t healthy and strong, you can’t properly care for anyone else,” says Liana Werner-Gray, New York City natural lifestyle consultant and author of The Earth Diet (TheEarthDiet.org). To begin the day, she advises drinking one cup of warm water with juice from half a lemon, explaining that stress produces acid and lemon water metabolizes as alkalinity and helps keep the body’s pH balanced.

For healthy snacks, Werner-Gray recommends easy and nutrition-rich choices like fresh fruits, green smoothies, organic nut butters and a trail mix of raw nuts, seeds and dried fruits. Save time with the smoothies by making a large batch and freezing portions to enjoy later. A basic recipe might include two handfuls of greens, such as spinach and kale, a banana and other fruits, almond milk or purified water and maybe adding flaxseed, cinnamon or goji berries. When appropriate, share the same health-boosting foods with the loved one.

Victoria Moran, of New York City, is the director of the Main Street Vegan Academy and author of a dozen books on health and well-being including Main Street Vegan and Living a Charmed Life. She offers such conscious eating tips as eating full meals of “real” food instead of snacks; selecting beautiful foods; and ritualizing indulgences, such as laying out a spot of high-quality dark chocolate and tea using good china while listening to classical music.

Stand for Exercise

Even though caregivers may feel they don’t have time to spare, Dr. Jordan D. Metzl, author of The Exercise Cure, says it’s vital to incorporate physical activity. He recommends starting by walking 30 minutes a day for one month. If necessary, it can be done in 10-minute increments.

According to a study by Mayo Clinic Physician James Levine, Ph.D., in Scottsdale, Arizona, “Sitting is the new smoking.” Researchers have linked sitting for long periods of time with a number of health concerns that include obesity, metabolic syndrome and increased risks of death from cardiovascular disease and cancer. The solution is to move more and sit less—walk while on the phone and stand up while reading. Meztl suggests a stretch break every 20 minutes. Three of his “commandments” for fitness are having fun, setting goals and minimizing sitting.

“Schedule exercise and respite breaks and make them as inviolate as a doctor’s visit,” advises Schall.

Commune with Spirit

August suggests establishing a twofold consciousness-raising ritual to welcome and appreciate life. Begin each day by showing gratitude to being alive and end it focused on forgiveness and gratitude. “When you cultivate gratitude, you notice more things to be grateful for,” says August.

La Bey concurs, and writes down at least five things she is grateful for every day. She mentally replays time with her mom and appreciates the little moments and signs of hope, like “the twinkle in Mom’s eye or the way she held hands and smiled.” This puts her in an upbeat frame of mind when she drifts off to sleep. She also writes out her intention for the day, envisioning positive outcomes. She might affirm: “I am going to have a grace-filled day. Things will go smoothly.”

Denholm centers herself by petting her cats. Some caregivers chant or practice meditation or mindful breathing, while others might take a walk, shop or sit quietly in a church.

Notice Blessings

La Bey discovered that her journey as a caregiver also dramatically enhanced her own life. “Mom taught me so much,” she relates. “I learned compassion and unconditional love on multiple levels. I learned to live in gratitude, instead of loss.”

August notes, “Even in the tough times, I experienced an engaged, poignant and rich connection with my parents.”

For Denholm, treasured gifts included strengthening her communication with her husband and working as a team.

“Allowing yourself to reach out for assistance and make time for respite will deeply enrich your caregiving experience,” concludes Schall.

Deborah Shouse is the author of Love in the Land of Dementia: Finding Hope in the Caregiver’s Journey. Follow her blog at DeborahShouseWrites.wordpress.com.

Extending a Hands to Caregivers

If your caregiving friends can’t articulate what they need, try these lovely offerings.

• Send a cheerful card.
• Gift a plant.
• Weed the garden.
• Cook a meal.
• Schedule a walk together.
• Sit with a loved one for several hours so they can run errands.
• Volunteer to get their car washed.
• Take them to a movie or out to dinner.
• Buy a gift certificate to use online.
• Treat them to a massage.

Online Help for Caregivers

• AlzheimersSpeaks.com - Radio show, blogs, free webinars and resource directory
• CaregiverAction.org - Advocacy, peer support and other practical information
• CarePages.com - Free patient blogs connect friends and family
• CaringBridge.org - Share views and receive support
• LotsaHelpingHands.org - Coordinates ways to address specific needs by those rallying to help
• ShareTheCare.org - Join in organizing a healing team and/or support system
• TheCaregiverSpace.org - Free social network to share experiences, find critical resources, cope with stress and learn to fulfill the role most effectively
• CaregivingWife.com - Helps caregivers solve problems, learn survival tips and improve the caregiving relationship