This post was written by Virginia A. Simpson, Ph.D., FT.

I’d been my mother’s caretaker for six years when one day I had the image of myself as a juggler. As I observed the juggled balls dropping to the floor and melting like Dali’s clocks, I recognized burnout had overshadowed my ability to balance Mom’s increasing health needs—such things as making sure she took her daily pills or saving her life in the middle of the night when her oxygen ceased working— and my work life as the Executive & Program Director of a nonprofit for grieving children and their families.

As an expert in death, dying and bereavement, I had taught countless individuals to recognize signs of burnout and yet, when it came to myself, I failed to notice the obvious. I was focused on being the good daughter and determined to meet my mother’s needs at all costs. Unfortunately, this attitude began to undermine and erode my ability to care for my mother, handle my job, and take care of myself. By the time I recognized the signs I was already in full burnout. I was depressed, anxious, exhausted, and felt as though I were trapped with the only way out being either my death or my mother’s. My body and spirit felt were collapsing and I didn’t know if I could survive much longer.

So what is burnout? When we experience significant stress over an extended period, our body fills with chemicals, becomes overwhelmed, and physical and psychological systems begin to collapse. Burnout is insidious and progressive, and since it does not occur all at once, we may not realize it is occurring and instead continue to expect more of ourselves. Because I focused entirely on meeting my mother’s needs and the requirements of my work, I never stopped to consider what my exhaustion, moods, and not always pleasant attitude meant.

Don’t let this happen to you. See the list below to assess your level of burnout and then follow the Seven Steps.

13 Signs of Caregiver Burnout

1. Depression
2. Flat, detached emotions
3. Extreme exhaustion – being tired all the time
4. Changes in appetite – eating a lot or too little
5. Change in sleep patterns – trouble falling or staying asleep
6. Progressive loss of humor
7. Inability to focus
8. Anxiety or feeling on edge
9. Hyper-vigilance (being on high alert)
10. Resentment
11. Anger – short-tempered
12. Negative attitude
13. Guilt

Below are suggestions for avoiding burnout by setting realistic boundaries around taking care of yourself as well as expectations for you can – and cannot – do for the person you love.

1. Be sure and get enough rest.
2. Reduce the expectations you have for yourself. It’s difficult enough to be a caregiver and exponentially more so when you are holding down a job in addition to caregiving.
3. Reach out to others for help. Join a support group. Contact your local office on aging or a gerontologist to find out how you can get respite. They may be able to provide someone who will come to your home and watch over your loved one while you get away for a few days or a few hours.
4. If your loved one has a terminal illness, contact your local hospice. Don’t wait for your doctor to tell you it’s time. I started the conversation and got my mother into hospice by asking.
5. Make sure to take time for yourself. Do something you love. Go see a movie, attend a concert, eat at a favorite restaurant, or hike your favorite trail. If nothing appeals to you right now, create a written list of things you loved doing before you were a caretaker to remind yourself of the activities you used to enjoy—then pick one or more and give yourself permission to do them.
6. Take care of yourself physically, emotionally and spiritually. Exercise and good eating habits, including cutting out or eliminating alcohol and sugar, will go a long way towards keeping your body healthy and your emotions balanced.
7. Change your self-talk. When we’re caretaking someone who depends on us, it becomes all too easy to unwittingly establish unrealistically high expectations of ourselves. If you find yourself being critical or feeling guilty, stop and change those thoughts to something more positive and useful. Speak to yourself with the same level of kindness and understanding you would offer to a friend who was going through a difficult time. For example, you can say something like: “It’s harder being a caretaker than I realized. I may not be perfect but I’m doing the best I can under these difficult circumstances, and that’s all anyone can ask of themselves.”

The only way I was able to get myself out of burnout was to recognize I needed to make changes. The first was to turn the nonprofit I founded and ran over to another organization and work as a consultant. I also moved my mother into a small residential home where she had a private room and received full-time skilled care. As a result of these difficult decisions, the last two months with my mother became a time of shared stories, laughter, and love.

Virginia A. Simpson, Ph.D., FT, is a bereavement care specialist and Executive Counseling Director for hundreds of funeral homes throughout the United States and Canada.  She is also founder of The Mourning Star Center for grieving children and their families and author of the memoir The Space Between: A Memoir of Mother-Daughter Love At The End of Life. (She Writes Press, April 2016)