Good luck, Tina.

"Hi, this is Tina, new to the forum," she writes on the Alzheimer's message boards. "My mom (93 years old) was diagnosed with Alzheimer's over two years ago and I manage everything: financial, legal, medical, physical therapy, home care, emergencies. I don't provide the care myself so am not there on a day-to-day basis, but I have been highly involved for the whole time."

Tina goes on to explain that she lives 40 miles away. And that mom is no longer ambulatory, doesn't communicate coherently, still eats is very well cared for and safe.

"We have had several crises & ER visits over the past 5 months," Tina says, "and I am exhausted...and I get very upset each time she has a crisis and this is on top of the general exhaustion from managing the details of her life and dealing with the loss of my mom. People say, 'Take care of yourself.' But that seems like one more thing that I have to do! I'd like to get a bit of distance so I don't get so upset. Do you think that is possible? I feel pretty funny, wanting to distance myself from my mom. But I am worried about my level of tiredness. Help please!"

Everybody needs respite, Tina. Regular breaks. You've got to try to work those in to your schedule. So you can recuperate. That will make you a better manager and care-giver. If you wear yourself out, you won't be good to anyone. Not even to yourself. Before you know it you'll be the one in need of care. I was a 24/7 care-giver for a while. And wore myself out. I didn't handle it well. When I cutback to 8-10 hours daily, and got daily respite, it worked wonders. I was a much better care-giver. I benefitted. And so did my patient. If you are spread thin and become tired and worn out, you've got to find a solution. Or, as you put it, you have to find some distance. One way or another. Good luck, Tina. --Jim Broede