"The big issue when you are working and caregiving is how do you manage the ongoing caregiving crises," says Denise Brown, founder and owner of caregiving.com, an online community for caregivers. "It's not one and done. It's one, OK breathe; OK, here's another one. Now what do we do?"
That volatility is a way of life for Trish Hughes Kreis, whose epileptic brother, Robert Wright, 47, moved in with her and her husband not long after the couple's children moved out. "You just don't know what's going to happen from day to day," she says. He suffers at least two seizures a day, causing him to fall on others, against walls and on floors – even knocking a toilet off its foundation once. With such unpredictability, she's given up on her initial attempt to strictly separate her caregiving duties from her work as the manager of a Sacramento, Calif. law firm. She's found support at her office as well as Brown's online community – and inspiration from her brother, whose dogged optimism she details on her blog, RobertsSister.com, where he's pictured, wearing a dimpled smile and a white helmet
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Those who succeed at caregiving "take advantage of all the help and resources they can find," says Brown, noting that technology can assist you, whether it's through a meal-planning service, video chats with someone you are caring for remotely or managing a schedule online (one is available on her site).
At Hebrew Rehabilitation Center in Boston, Mass., social services leader Robin Bromberg advises caregivers to join support groups or find an outlet for expressing and monitoring their feelings. "If you feel you need professional help, there's absolutely no shame in that," she says. "This is a natural part of aging, with children becoming caretakers, and it being emotionally very filled ... Watching your loved one age is a loss."
[Read: How to Handle Extreme Stress.]
At the same time, for all its stress, caregiving can provide both parties with purpose and comfort.
These days, Marilyn Karoly seems perfectly at home with her legs strewn easily across a blue loveseat, draped in plaid and quilted blankets, and her cross pendant matching the cluster of crosses arranged on the wall behind her. She speaks with the help of a tracheostomy tube fastened around her neck like jewelry with a pretty pink ribbon complementing her hot pink and orange ensemble.
"The hardest thing that happens to us is sometimes [the] place that gives you the greatest growth," Anne says. Ironically, caring for her mother has shown Anne, for the first time, how to ask for help for herself. "I say it's Marilyn's gift," she says.
And then, with a remark that recalled her own years of caregiving, Marilyn says, quietly: "It's one of the hardest lessons of parenting."