My single sister has been caring for our mother full-time for 6 years, while I am happily married with 3 children, running a successful business and living 1000 miles away. I feel so guilty I can’t be there. How can I help and show my appreciation?

Jacqueline Marcell

Ohhh, how I wish I’d had a caring sister like you! First, realize that caregivers in a prolonged stressful situation have a 63% higher death rate than their peers of the same age—so your sister’s health is in jeopardy and needs to be the priority.

Make sure she gets her yearly physical, mammogram, tests, and that she is taking good care of herself. If she says she doesn’t have time to exercise, buy a treadmill for the house. If she says she hasn’t had time to get out to buy her vitamins, take care of that for her. If you know she is depressed, encourage her to discuss an anti-depressant with her doctor. Basically, do everything to keep your sister healthy, not only because you love her but because if she goes down, your life will change dramatically and you will have to go be there.

Having been in the caregiving position myself, what I appreciated was receiving heartfelt loving cards, letters and emails from friends and family that touched my heart. Be sure to send them often, as caregivers often get so stressed, they can forget that anyone cares about what they are going through.

I also appreciated phone calls from people not only concerned about my parents, but who sincerely showed interest in how I was coping and offered to come visit us. You might ask your sister if she’d appreciate a call from you daily. If she says, “Oh no, that’s not necessary,” ask how often she’d prefer and if there are times that are better. Then be sure to follow her wishes and listen closely for mentions of things you can do for her.

Be careful not to talk too much about your happy marriage, brag about your kids or business, or make your sister feel jealous of your situation. Instead, ask for her opinion or guidance on things, even if you don’t really need it--so she feels important and helpful in your life.

And be sure to send little gifts often, as they really do add some excitement to dark days. Gifts make caregivers feel special knowing that someone has gone to the trouble to cheer them up. Maybe you can bake some family favorites or send meaningful family photos with sweet notes about fun past events.

Gift certificates make great gifts--especially those for pampering like a manicure, massage or spa treatment. Be sure to mention that you will arrange and pay for a professional caregiver or Auntie Alice to come in and sit with Mom so she can go.

Also, discreetly contact other family members and friends and ask them to do these ideas as well, so your sister never has to endure days on end without someone letting her know they care and appreciate what she is doing.

And, you can take a lot of pressure and possible resentment off your sister if you discuss your mother’s possessions and who will get what after she passes away. You might want to say something like, “You know, I know Mom’s will splits everything between us 50/50, but I want you to know that I want you to have her home and whatever possessions you want—you’ve certainly earned them.”

Jacqueline Marcell is the author “Elder Rage” and host of the radio talk show “Coping With Caregiving.” You can learn more about Jacqueline and find information about her book at www.ElderRage.com.