More than 65 million Americans are caregivers for someone who is elderly, disabled or chronically ill. If you’re a caregiver, you may be dreading all the “extras” of the upcoming holiday season. Thanksgiving through New Years is a time of stress, high expectations, extra chores and too much spending for many of us.

Follow these pre-planning tips to avoid a holiday meltdown:

Take care of yourself

Several studies on long-term caregiving show how important it is for caregivers to take care of their own physical and mental health. Quite often, among older couples, the caregiver becomes seriously ill or dies before the patient. It is essential to take care of yourself if you wish to continue being a caregiver.

Always make time to eat healthy, get regular exercise and get enough sleep. Be sure your doctor know you are a caregiver. Worries about the holidays can creep in, perhaps unnoticed, and overwhelm your thinking. Your body can respond in several ways to worry but stress is the most common result. Unrelieved stress can make high blood pressure worse, cause sleeplessness, stomach upset, depression, chest pains and make you more susceptible to infections.

Caregivers often fail to recognize or acknowledge the mental and physical exhaustion with which they live. Watch for these signs of caregiver stress:

  • Feeling tired most of the time
  • Feeling overwhelmed and irritable
  • Sleeping too much or too little
  • Gaining or losing a lot of weight
  • Losing interest in formerly enjoyable activities

Take a break from caregiving

Getting regular breaks – called respite care – from the day-to-day responsibilities and pressures of caregiving is crucial to maintain your own health and productivity. It helps you continue to be an effective caregiver over the long term.

Don’t isolate yourself with negative thoughts like, “I’m the only one who can do this” or “I don’t want to bother the family – they’re so busy.” Caregiving is not martyrdom. It should be a family responsibility. Give your family the chance to give the gift of caregiving, too.

Plan ahead

Take some time to think and talk about how you, and the person you care for, want to spend this holiday season. Include how you want to spend your time, energy and money. If your loved one has dementia or Alzheimer’s disease, you may need to let go of some holiday traditions and create new traditions that reflect current interests and abilities.

Your holiday plan should be based on your loved one’s ability to cope with confusion, a change of routine or different environment. Adapt and simplify the patient’s favorite holiday foods, family traditions and plan ability-appropriate activities.

In some family situations, it may be easier to celebrate the holidays away from home – in a neutral location or at the home of a family member.

Overspending for holiday gifts, decorations, parties or travel can create stress and financial insecurity. Make a budget and commit to sticking to it. List what you can afford to spend on each category: gifts, charity contributions, decorations, parties and travel. Don’t forget wrapping, postage and shipping costs; higher utility bills if you have guests or lots of outside decorations; cleaning costs if you entertain; or meals out with friends. Don’t feel guilty for saying “no” to items or events you cannot afford. Financial security in January can be a most welcome gift.

Maintain a flexible routine

Daily routines should remain as consistent as possible during the holidays. A routine will increase the patient’s sense of security and help maintain abilities. If your loved one cannot participate in holiday activities as he or she once did, plan their involvement by playing to their strengths. Only accept the invitations you know you can handle. When holiday plans don’t happen as planned, always have a back-up plan.

Have a plan to reduce noise, confusion or stress. You might assign a family member to redirect them for a while to a quieter area. Make travel simple and manageable. Avoid busy places such as large cities, noisy restaurants and large groups of people.

Most people can still find joy in what their five senses experience. Let them hear familiar holiday songs, see public decoration displays and taste traditional foods.

Watch for signs of stress, depression

Taking care of a loved one can be very rewarding, but also highly stressful. It can extract a great toll on caregivers’ physical and mental health. Caregivers who don’t reduce their stress often experience poor health. Frequently they become unable to continue caregiving or even die before the patient.

Feelings of sadness, a longing for the way things used to be, or frustration with all that needs to be done can get the best of you. The key to keeping your mental balance during the holidays lies within you. Your attitude about the holidays can make or break this time of year for you. Stop negative thoughts before they take hold. Affirming statements open the door to a holiday season of hope and joy.

Focus on your strengths and know your limits. No one is a perfect caregiver. Do the best you can with the time, strength and resources you have. Never give in to guilt. In the long run, it doesn’t matter if you eat leftovers three days in a row or your house is not in perfect order.

The holidays often coincide with a spell of the winter “blahs,” seasonal affective disorder (SAD), or “cabin fever.” These conditions cause very real symptoms for many people, including irritability, depression, anxiety, helplessness or low energy. You may magnify little problems: a “clank” in the furnace and you imagine it’s doing to blow up; a “burp” in the garbage disposal and you fear the pipes are freezing. These conditions can be caused by a combination of less light (which alters our body’s circadian rhythm), holiday stress, too much or too little contact with others, altered routines, bad weather, and worries over money or your loved one’s condition.

Be sure to stay connected with the outside world if the weather deteriorates. Reaching out to others helps you from dwelling on yourself and your problems. Have something to look forward to; hope and anticipation are important to our mental health. Stay physically active because it helps combat depression and anxiety. Try walking at shopping malls or visit community centers that offer indoor exercise opportunities.

Ask for help.

Many caregivers make the mistake of thinking they have to do everything themselves. This dangerous mistake can cause caregiver “burn-out” or illness, often leaving the patient without a caregiver.

Think of all the times people have offered to help but you did not follow up. Resolve to delegate some of your routine caregiving chores during the holidays or ask for help with the extra holiday tasks.

Make a list of what has to be done and delegate to family, friends or to a paid caregiver or respite service. Hold regular family meetings or group phone chats to discuss treatments, tasks you need to delegate and other plans. Follow up with written agreements and a calendar of tasks that volunteers have agreed to perform.

There are many ways to help, even from a distance. Long-distance caregivers can provide financial help, locate local resources and services for the patient, spend time at your home to provide you respite time, cook meals for your freezer or provide transportation.

Build a support system. Start with family, close friends and neighbors. Identify the strengths of each person and match them with (or ask them to accept) a specific task that fills a gap in your caregiving responsibilities.

Your job may be another source of help. If you work for a large company, they must offer up to 12 weeks of unpaid leave for employees to care for a sick family member, including parents. Check with your human resources department about working “flex” hours to accommodate caregiving duties.

Work smarter, not harder by taking advantage of technology tools such as timers, smart phone apps, online medicine reminders. Consider a personal emergency response system (PERS). Worn like a necklace or watch, these devices connect to your phone system, and summon an emergency responder in case your loved one falls or has another emergency. Install sensors that sound when a door is opened. If you’re low-tech, use a big calendar for appointments, sticky notes and large pill-organizer boxes.

Consider a support group

Regularly meeting with other caregivers can be a unique source of support, encouragement, validation and advice. Only another caregiver can really understand the pressures, joys and frustrations you face.

These groups often include intensely helpful people who can provide realistic solutions to your most frustrating problems. It’s also a good way to meet new friends.

Support can come from other sources. An honest discussion with your loved one’s doctor might provide some perspective on the expected course of the illness or condition. A frank discussion with a minister or counselor can also be helpful. Consider having a pet visit on a regular basis or as a permanent pet, if appropriate. Pets can work miracles in helping make a person more alert, happier and more social.

Handle criticism constructively

Holiday visits from family members can sometimes bring questions about your caregiving or criticism of your efforts. Your first impulse may be to tell them to mind their own business. That’s not the best response.

It may help you to understand why visitors seem to be second-guessing your efforts. If they also love the person, then caregiving is a vital concern and their questions may be valid ones. You may have protected them from the more difficult aspects and caregiving and they don’t fully realize the enormous demands on your time. Your loved one may be having a “good” day and the visitors don’t realize the person’s deficits that you see on a “bad” day. They may not fully appreciate the isolation of full-time caregiving and the grief you feel about your loved one’s physical or mental losses. Criticism can also come from feelings of guilt for not helping you more. You may be overreacting to family and friends’ queries because you are exhausted, depressed or feeling trapped by your 24/7 responsibilities.

While family is together over the holidays, share your feelings and caregiving experiences with them. Describe the changes you’ve had to adjust to in every aspect of your life. Offer them several opportunities to become part of the caregiving team.

Prepare the patient

To minimize stress, prepare your loved one for holiday visits by showing photos of family members who are dropping by. Use stick-on name tags for visitors and place cards at the dining table. Try to limit visitors to manageable numbers so they aren’t overwhelming. Have a quiet area where the person can go if things get too hectic.

Be aware of safety issues with wires, lights, decorations, candles and fireplaces. Avoid decorations that can be mistaken for something edible. Be watchful for the possibility of wandering during visitors’ coming and going. Dementia patients should always wear some kind of identification.

At this special time of the year, never forget that your devotion as caregiver is the greatest gift you can give. It truly symbolizes this season of thankfulness and love. The gift of caregiving is unmatched by anything you can give or receive. If you know a caregiver, your gift of extra help with caregiving responsibilities during the holiday season is always most appreciated.

Resources for Caregivers:

Area Agencies on Aging (AAA) – a one-stop place to locate all types of services to help older adults, regardless of income or need. There are eight non-profit AAAs in Arkansas. Call 1-800-677-1116 to find your local AAA.

ElderCare Locator – a free service of the Administration on Aging that helps long-distance caregivers find resources in the patient’s area. Visit eldercare.gov and enter the ZIP code (or town) of the person who needs services, or call 1-800-677-1116.

Family Care Navigator lists health and disability programs and resources by state. Call 1-800-455-8106 or visit caregiver.org and select Family Care Navigator, then select Caregiving Information and Services.

Benefitscheckup.org is a free, confidential online site that helps older adults find programs that may pay for medications, healthcare, utilities and other essential services and get the application process started.

Choices in Living Resource Center, a free service from the Arkansas Division of Aging and Adult Services, has trained specialists who can provide assistance and information about long-term care options, services and supports. Call 1-866-801-3435 or visit ARChoices.

Respite care is available at adult daycare centers, short-stay nursing homes or assisted living facilities. It’s also available in-home from volunteers or paid sitters. Friends and family are great sources of respite care. Access to Respite Care and Help (ARCH) can identify local respite providers. Call 1-800-473-1727 or visit archrespite.org

Veterans Caregiver Support helps caregivers of veterans of all ages. Call the support line at 1-855-260-3274.

Alzheimer’s Arkansas at 501-224-0021 or the Alzheimer’s Association, Arkansas Chapter at 1-800-272-3900, can provide information to help care for a person with dementia or memory problems.