Burnout, guilt, and the caregiver's own health: what is normal, what is not, and what to do this week

It is not just you

The Family Caregiver Alliance's conservative estimate is that 20 percent of family caregivers have depression, twice the rate of everyone else, and the National Institute on Aging notes that caregivers get fewer checkups and have more sleep problems and chronic conditions than people who are not caregiving. None of that is weakness. It is what happens when one person carries a load built for several.

Signs you are past tired

The Alzheimer's Association lists ten symptoms of caregiver stress; these are the ones families most often miss in themselves.

• Anger at the person you care for, then guilt about the anger.
• Pulling away from friends and things you used to enjoy.
• Sleep that does not refresh, or lying awake running the list.
• Trouble concentrating, or forgetting your own appointments.
• Getting sick more often, headaches, or pain that will not settle.
• Denial: telling yourself the illness is not as bad as the doctor says.
• Feeling hopeless, or that nothing you do matters.
• Drinking more, or leaning on pills to sleep.

About the guilt

Guilt shows up whether you move a parent or keep them home, whether you visit every day or once a week, whether you lose your temper once or never. It usually means you care and you are exhausted, not that you did something wrong. Two things help: say the guilty thought out loud to someone who has done this, and ask what a friend would say if they told you the same thing. If guilt turns into feeling that you are a bad person or that things would be better without you, that is depression talking, and it is treatable. Tell your own doctor.

This week

• Name it to one person. Out loud. "I am not okay."
• Hand off one specific job, not a general plea for help: Tuesday rides, the pharmacy runs, the insurance calls. People say yes to specifics.
• Book your own doctor visit, the one you have been putting off, and say you are a caregiver.
• Put one hour on the calendar that is yours, and treat it like a medical appointment.
• Call NY Connects, 1-800-342-9871, and ask what caregiver support and respite the county has. It is free and they know.
• Turn on quiet hours in CarePair so nothing pings you at midnight.

This month

• Try a support group, in person or online. The Alzheimer's Association, the county Office for the Aging, and many hospitals run them. One meeting tells you if it fits.
• Arrange a real break: a day program, an aide two mornings a week, or a respite stay. Our respite article has the doors.
• Have the family meeting. Our siblings article has the agenda.
• Ask your doctor about counseling. Many insurance plans cover it, and telehealth makes it easier to fit in.
• If you are working, ask about family leave. New York has paid family leave for caring for a seriously ill family member; your employer or the state can explain the rules.

If it is an emergency

If you are thinking about harming yourself or feel you cannot go on, call or text 988, the Suicide and Crisis Lifeline, at any hour. If you are afraid you might hurt the person you care for, put space between you and call 988 or 911. Asking for help in that moment is the strongest thing a caregiver can do.

People who get it

• Alzheimer's Association 24/7 Helpline, 1-800-272-3900, for any dementia and any hour.
• Family Caregiver Alliance: plain fact sheets on stress, depression, and family dynamics.
• AARP caregiving: guides, an online caregiver community, and state resource guides.
• Your county Office for the Aging: caregiver counseling, support groups, and respite funding.