More than 20 million Americans are now hitched to a routine as relentless as tending to a newborn. Caregivers experience interrupted sleep, restricted liberty and emotional strain. New research indicates that caregiving can lead to negative health effects, including depression, a weakened immune system, even premature death. Common sense dictates that caregivers should give themselves regular breaks, but often, motivated by a mix of love, guilt, loyalty and tenacity, they don't do what's good for them. Here, some guidelines to avoid total burnout.

Ask for help. Caregivers are often overprotective of their loved ones and refuse to allow other people to provide relief. "Carry around a list," says Bonnie Lawrence of the Family Caregiver Alliance, so when friends and family ask, "How can I help?" you can respond with specific requests: mow the lawn, go to the grocery store, pick up a prescription. Don't be shy about asking a friend to sit with your mother for an hour just to give you time to make dinner. Enlist a social worker to help you navigate the confusing array of long-term-care options. To find local assistance, see or call the Eldercare Locator at 800-677-1116.

Get support. Caregiver-support groups and online bulletin boards can help answer questions and relieve social isolation. AOL offers a live "Caregivers Corner" chat--an especially good resource for people who wake at odd hours or can't leave home. Ask your local chapter of the Alzheimer's Association (800-272-3900 or to pair you up with another caregiver for social outings with your charges. For bulletin boards and support-group information, call or e-mail the Family Caregiver Alliance (800-445-8106; Check out chat groups and message boards on

Change your habits. Instead of getting frustrated, adapt. "You have to have a new definition of what's normal," says AARP's Elinor Ginzler. "If they're sleeping from 2 until 4 in the afternoon, you should nap then, too." Play games the ailing person used to enjoy--backgammon, bridge--but with no winning or losing. If getting dressed provokes issues of pride or power struggles, replace zipper- and button-close pants with elastic or Velcro waistbands. For more ideas, see

Take a break. Find opportunities to give yourself time off. If there's one 30-minute TV show that holds Dad's attention, use that time to sit alone on the porch. Take advantage of adult day-care centers or adult day health centers (which provide medical supervision) to catch dinner and a movie with friends. Hire respite care--professionals who come to your home so you can leave for a few hours. In San Francisco, the Family Caregiver Alliance holds a weekend camp for people with Alzheimer's. The patients enjoy scheduled activities, and you'll get to relax, knowing they're receiving one-on-one care. Contact Eldercare for adult day-care and adult day-health-center referrals, or Family Caregiver Alliance for respite-care and weekend-camp information.

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