It is often difficult to ask for help. The most important time to ask for help, and often the most complicated time, is when you are a caregiver. It is normal to feel like you need to do everything yourself; as a society we place a high value on the unrealistic goal of doing it all alone. However, asking for help is not a sign of weakness or failure; it is instead an act of wisdom. After all, you’re not going to be your best as a caregiver when you end up tired, feeling resentful, hurt, and used.

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Adult children are the most common caregivers of the elderly. Caregivers whose childhood included domestic violence or emotional abuse face additional challenges in caring for elderly parents. Being in a role beyond their limits can be stressful for adults abused as children and can also put the senior at risk of neglect or outright abuse. An honest appraisal of the potential caregiver’s strengths and vulnerabilities can help prevent problems for everyone.

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Caregiver “meltdown” results when caregivers don’t get the help they need and begin to suffer from depression and stress. Finding help will allow you to take care of yourself and your needs, and will prevent meltdown. Taking care of yourself also helps the person you care for because you will be a more patient and effective caregiver.

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Depression could be called “the illness with many faces.” Consider these examples:

• An 83-year-old gentleman becomes very agitated, pacing back and forth and snapping at anyone who approaches him. He repeatedly talks about the end of the world and the doom of the human race. Although he says he feels tired, sleep seems to elude him, and his pacing continues into the early morning hours. His weight has dropped rapidly.
• Martha, a 78-year-old retired teacher, has slowly started to withdraw from her friends. The clubs and hobbies she once enjoyed no longer hold her attention; rather, she sits in her rocking chair, staring blankly out the window. Although not seeming particularly sad, she does not express pleasure or curiosity. It’s easy to forget her presence, as she seldom verbalizes any needs.
• When Sam’s wife died three years ago, he was very calm. Her caretaker during a long, lingering illness, this 90-year-old minister seemed prepared for her death. However, with no apparent precipitant, Sam has now begun crying many times a day, sometimes sobbing in despair. He has difficulty articulating what is wrong and seems unable to control his tears.
• Clara is 72 and feels she is near death. She describes a vast number of physical problems, all vague and variable. Her bedside table is covered with medications and medical paraphernalia. Because of long hours of bedrest and snacking, her weight has ballooned. Clara’s primary physician, frustrated, avoids her calls. Yet Clara’s obsession with her health only seems to grow.

These cases seem quite different but are all faces of geriatric depression, an illness that affects quality of life and may lead to premature death in older adults. How do we, as caregivers, recognize the signs of depression? Even more importantly, how can we assist in its treatment?

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Shock, disbelief, despair, anger, depression, and relief are some of the reactions you can expect to feel when someone important to you dies or even when a relationship ends. The extent and duration of grief can vary greatly depending on the nature of the relationship and the circumstances that ended the relationship, such as death, divorce, or breaking up. The severity of the grief felt by survivors can vary depending on how close they were to the deceased and whether they perceive that the death occurred prematurely. For example, a child who provided constant care to an ailing parent is likely to feel more intense grief than a more distant relative who did not participate in the day-to-day care.

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