Frustration may result from the helplessness of being unable to change the course of their relative’s illness, personality differences, having to contend with annoying behaviours such as repetitive questioning or being unable to reason with their cognitively impaired relative.

Anxiety and fear stem from safety concerns, such as the possibility of falls or, if the relative has dementia, household accidents, wandering away from home or physical aggression towards others and from concerns about what the future holds.

Caregivers can suffer from loneliness because of social isolation, feeling no one understands what they are going through, having to do things alone that they used to do with their relative and being unable to relate to their relative in the usual ways.

Sadness may arise because their relative is gradually losing his or her abilities and perhaps also personality, joint plans for the future must go unrealized and the caregiver can’t imagine life without the relative.

A caregiver can be angry that their relative is ill or disabled, he or she is overly dependent, he or she refuses mobility aids or other recommended equipment or he or she refuses community support services.

Feelings of anger may be directed towards the care receiver — especially if his or her lifestyle may have contributed to the health condition, towards family members, health care providers or God, or they may be generalized. Caregivers may also be angry at themselves for taking on the caregiving role or not being more assertive with their relative, family members or health care professionals.

While a certain degree of stress is inevitable, when left unchecked it can lead to burnout. Physical warning signs include fatigue, memory problems, sleep difficulties, significant weight loss or gain, frequent illness and development of chronic health problems.

Some emotional red flags are frequent crying, frequent irritation as a result of small annoyances, difficulty controlling one’s temper, feeling overwhelmed, feeling inadequate and feeling hopeless. In severe cases, burnout can lead to abuse of the care receiver. This signals the need for immediate help.

For caregivers, I would like to share some strategies (from personal and professional experience) to help keep stress manageable.

Look after your health: eat nutritious meals, get adequate rest, exercise and schedule regular medical check-ups.

Find something relaxing you can do to give yourself a break every day — perhaps quietly enjoying a cup of tea, reading something uplifting or writing in a journal.

Stay connected to your friends, your parish community and other supportive groups.

Accept the reality of the illness. Focus on your relative’s remaining abilities and the things you can still do together.

Acknowledge your relative’s right to make decisions you disagree with.

Let go of past grievances. Seek counselling if necessary to help you move forward in your relationship with your relative.

Don’t promise your relative you will never place him or her in long-term care, because you don’t know what the future holds.

Take things one day at a time. Recognize that there will be good days and bad days, and be especially good to yourself on the bad ones.

Join a community caregiver support group or an Internet group if it’s hard to get out.

Acknowledge that you can’t do it alone. Accept offers of help.