We come to the work of caregiving without any training on how to be an advocate for our loved one or how to care for ourselves while we do this.

Because caregiving is sacred work, it requires a connection to our self, our loved one, our families and friends, the health care community, our Higher Power, and the universe. Many of us don't understand this need or know how to expand our world in the midst of a medical crisis. Whether you are a seasoned or beginning caregiver, it's easy to set aside your own needs for another. But when we do this, no one wins.

Caregivers, by the very nature of their work, tend to be isolated and uncertain about whether they are "doing the right thing" for their loved one. Additionally, while adults have many models about how not to do something, we receive little or no guidance about what right looks like.

While I was a successful advocate for my husband during his protracted illness and hospitalization, I was an unsuccessful caregiver. It was only after five years of solo caregiving that I took stock of my own health and discovered 100 extra pounds on my body in all the wrong places, high blood pressure that was not being controlled by three medications, extremely high triglycerides, and metabolic syndrome, a precursor to diabetes.

To address these urgent health issues, I had to remove myself from any caregiving and focus solely on myself—the result of which was a divorce. While I am much healthier today, in retrospect I know that my failure to attend to my own issues is very common among caregivers.

Today my ex-husband and I are renegotiating our relationship as we finally acknowledge that we are no longer the people who entered the hospital almost seven years ago. How were we different?

• Bill was physically debilitated and mentally impaired. He expected full recovery in spite of being told otherwise. In other words, my husband survived; the man I married didn't.
  
• I had terrible PTSD, jumped at any and every sound, and was so hypervigilent that there was no humor left in me. And, truth be told, I was used to being totally in charge.
  

Bill's illness created his differences. I created mine. How did we get there?

While Bill was hospitalized, I had nursing help to care for him. He was monitored 24/7, and someone else cared for our home. When I brought him home, there was no help and I asked for none. I thought I could do it all. No machines monitored him; I did. I heard him begin a seizure when he fell off the bed. I knew he was running a fever when I thought to check it.

I took care of house, pets, and finances (including $1.75 million in medical expenses); scheduled and transported him to copious medical appointments; managed prodigious amounts of complex medications; modified the house to accommodate his disability; carried his wheelchair everywhere; pushed him up the steps; and required him to accept accommodations such as a gait belt that he didn't believe he needed. His resistance to this accommodation resulted in Bill's falling and breaking his feet three times.

Unless family members approach caregiving with a commitment to care for their own health first, they will become unhealthy caregivers and, potentially, in the case of marriage, a soon-to-be-ex-family member. I went from loving wife to mother to jailer. While my intentions may have been laudable, my actions were based on fear that he would die on my watch. Clearly there was a little ego in my actions, as well.

Mary Robinson Reynolds, a spiritual coach, named my failure this way: "If a chick is helped out of its shell, it will die. If a butterfly is helped out of its cocoon, it will die. The gift, or the service, you can provide to humanity is to let the struggle take place, as with your own struggle to not overdo or over-give for people. Miracles happen when people get so in touch with their desires that they start asking for what they want. When they do this, they start sending new vibrations out. Miracles happen when we decide it's OK to not struggle or suffer any more. There is nothing valiant about suffering."

And I suffered because I did not ask for what I wanted. I did not ask for help. I struggled with boundaries—where Bill ended and I began. Today I know that what I experienced is normal and I have forgiven myself for my failure to cope.

If you have any doubt about the "normalcy" of my failure to cope, remember:

• Nobody is superman or superwoman. We all have feet of clay and need help when we move into situations that are so far outside our experience base.
  
• Organizations exist to help you sort through these issues. Check out www.hospitalstayhandbook.com for a list.
  
• Caregiving statistics repeatedly predict the pattern I experienced, with the same outcome: death of relationship or disability or death of the care provider.
  

If you take apart the word "stress," from which caregivers surely suffer, there are answers for us all:

S Support system: friends, family, healthy people
T Talk: self-talk, talk with others
R Rest, relaxation: practice deep breathing and visualization
E Exercise: do something physical to relieve tension
S Self-care
S Stay in the present: avoid "what if" worries

These suggestions are just the beginning. There are many more things you can and should do for yourself. Be kind to yourself. Stop judging the inadequacy of your efforts. You are not failing your charge, just yourself.

Roderick MacIver, artist and founder of Heron Dance, says the following. I agree.

"We each have a spiritual current that runs through our lives—a river. Connected to that current, our work, our life, has power. … When you turn your back on the current of your life, you are on your own. You are coming at life believing that you are strong enough, powerful enough, on your own. … Being in touch with the spiritual current means first being able to listen to oneself, being in sync with oneself. Work of the spirit requires strength of spirit." (Heron Dance, Issue 13, 1996).

And strength of spirit requires a connection to our self. Check in with that strong face staring back at you in the mirror.