One of the most popular discussion threads here, on, is called, "The Caregiver…How are YOU doing today?"

Created by Jam, one of our most active members, this discussion has entertained thousands of comments about one of caregiving's most troubling paradoxes: Does anyone ever really ask you how you're holding up as you try to take care of your elderly loved one?

And no, the casual acquaintance, who, upon asking, expects no further response beyond a rote, "Fine, thank you," wrapped in a falsely bright smile, doesn't count.

Far from making a caregiver feel connected to and supported by those around them, this exchange can be terribly isolating.

Most caregivers are rarely asked how they are doing by someone who is willing to hear the truthful answer. Even when someone really does want to know, unless they are a fellow caregiver, how could they possibly understand your pain and frustration?

The "Fine, thank you," mentality can even become so ingrained that a caregiver may stop asking themselves how they are doing.

Ceasing to have an honest inner dialogue can intensify a caregiver's feelings of isolation, putting them at great risk for burnout.

Cara Levine, Assistant Administrator of the Workmen's Circle MultiCare Center, a senior care facility in New York, says that most caregivers don't even realize they're burning out because they are so focused on caring for their loved one that they forget to check up on their own wellbeing.

According to Levine, the most effective way to avoid caregiver burnout is to start being honest—How ARE you doing today, really?

Know your needs

Caregivers are often counseled to make sure they take care of themselves. But for many, the statement: "If you don't take care of yourself, you won't be around to take care of them," is as unhelpful as it is true.

Research indicates that as many as 13% of caregivers die before their care recipients do. While the causes of death vary, the chronic stress associated with caregiving has been cited as a contributor to this statistic.

But, when your whole life revolves around caring for someone else, how do you begin to make yourself a priority?

Levine says that caregivers should start by taking stock of their situation, seeking specific sources of stress and how to neutralize them.

She says that caregivers should ask themselves certain questions in order to begin developing a care plan for themselves:

  1. How am I feeling today?
  2. What is it about my situation that is making me feel this way?
  3. What things are causing most of my stress?
  4. What things are stressful, but manageable?

Once you've discovered where your stress is coming from, you can figure out a plan of attack by asking yourself these questions:

  1. Knowing that I can only control myself and my outlook, what steps can I take to manage my stress levels?
  2. What do I have to do to get some time for myself?
  3. If I had the time what would I want to do with it? What do I enjoy doing?

"Everyone needs an outlet," Levine says, "the trick is to figure out what works best for you."

Whether you find solace in the synagogue, or enjoy basking in the bathtub, you need to find the time to do things that make you feel good.

For her part, Levine makes sure that she periodically takes some time away from the nursing home, where she works, to go see a silly movie. "Being a caregiver, sometimes you just need to get away and laugh," she says.

"Well, since you asked…"

Once you figure out what you need—remember to ask for it.

According to Levine, one of the hardest things for caregivers to do is to make their needs known and ask for help. "Sometimes you have to be willing to accept help," she declares.

People in your life who know that you're caring for an elderly loved one probably want to help, but they can't be expected to guess what you need—you need to be honest and tell them.

It can be something as simple as asking your neighbor to take care of your lawn while they're out mowing their own, or asking the handyman down the street to take a look at your leaking gutters.

Levine also laments that many caregivers seem determined to withhold the truth about how they are feeling from their loved ones, when, in some cases, expressing your emotions in a calm, productive way may help to make them more aware of how their behavior is affecting you.

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(There's one caveat to this; if your loved one suffers from dementia, or is otherwise cognitively impaired, you're probably better off not telling them how you feel—sharing your feelings with a person who won't be able to understand or modify their behavior isn't productive.)

A caregiver obviously can't share all of their feelings with their neighbor or their loved one, so Levine says that support groups are a great way to connect, share, and vent with other caregivers.

Whether they're online or in-person, Levine feels that, in addition to a sense of community, support groups can help caregivers accept and gain a better level of understanding about their situation.

And you can be completely truthful without fear of judgment—after all, these men and women know exactly how you feel.

To tell (and accept) the truth

As a caregiver, you can't go it alone—and no one, who cares about you, expects you to.

The key is to be able to honestly identify your needs and accept the fact that you will have to rely on others to help you.

"When they recognize that they may have an issue or a problem, the intelligent person needs to know when to seek help," says Levine.

There will always be people who expect you to be "fine" no matter what you're going through.

But, the more honest you are—with yourself, as well as with the other people in your life—the more people you'll find who really do want to know how the caregiver is doing today.