Q: 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 1,000 miles away. I feel so guilty I can’t be there. How can I help her and show my appreciation?

A: Ohhh, how I wish I’d had a caring sister like you!

First, realize that family caregivers often endure prolonged stress that can compromise their physical and mental health. An infamous study in the Journal of the American Medical Association found that senior caregivers who experienced care-related mental or emotional strain have a 63 percent higher mortality risk than senior non-caregivers. Everyone’s focus may be on Mom right now, but your sister’s well-being should be a priority as well.

Make sure she is taking good care of herself and gets her yearly physical, mammogram, lab tests, etc. If she says she doesn’t have time to exercise, help her buy a treadmill or some other fitness equipment for the house. If she says she hasn’t had time to get out to buy her vitamins, take care of that for her. Basically, do everything you can to help keep your sister physically and mentally healthy. This is important not only because you love her but also because your life will change dramatically if she develops her own health issues or god forbid passes away. You, your sister and your mother will all face the consequences.

Tell her directly how much you appreciate what she is doing. Having been in the caregiving position myself, I enjoyed receiving supportive cards, letters and emails from friends and family that touched my heart. Don’t assume she knows you are grateful. Be sure to send thanks frequently. Caregivers often get so stressed that they forget anyone cares about what they are going through.

I appreciated phone calls from people who were not only concerned about my parents, but also sincerely interested in how I was coping. Offers to come visit us meant a great deal to me. 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 more convenient for her busy schedule. 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, share and ask for her opinion or guidance on things so she feels included, important and helpful in your life.

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And be sure to send little gifts often, as they really do add some excitement to dark days. Gifts make caregivers feel special, showing that someone has gone to the trouble to cheer them up. Maybe you can bake her some favorite family recipes 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 find other respite arrangements for Mom so your sister can actually take time away from caregiving and use the gifts you give. Many caregivers are so overwhelmed by the hassle and expense of arranging back-up care that they avoid self-care altogether. Take on the responsibility of arranging respite care so your sister can just focus on herself.

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

Lastly, you can take a lot of pressure and possible resentment off your sister if you openly discuss your mother’s possessions and the logistics of dealing with her estate. You might want to say something like, “I know Mom’s will splits everything between us 50/50, but I want you to know that you should get her home and whatever possessions you want after she’s passed. You’ve certainly earned them.” When the time comes, offer physical help with sorting Mom’s belongings at your sister’s pace. Grief can be overwhelming. Take the opportunity to find closure together as your sister’s caregiving journey ends.