Many caregivers watch their loved ones suffer a long, slow decline that will eventually end in death. During this time, we are grieving every loss that our loved ones endure. At the same time, we struggle with mixed emotions about the release from suffering that their death will bring. You may wonder why you secretly want your elderly parent to die, while knowing how deeply you will miss their presence in your life once they are gone.

The whole process is nearly too much to bear. Yet often, rather than acknowledge this grief, we stuff our emotions down and simply get on with life.

What are better, healthier ways to handle grief?

That's the question I put to Margo Rose who has been a fitness trainer for over 15 years and specializes in practical ways to manage loss, stress or disappointment. She's the creator of BodyAwareGrieving.com and the author of "Body Aware Grieving, A Fitness Trainer's Guide to Caring for Your Health During Sad Times."

"Sleep is one of the best medical ‘treatments' possible, especially for grief and shock," Rose says. "It is very common for people to want to sleep much more than they are used to while going through an upsetting time. This natural tendency is generally worth giving in to without pressuring yourself.

"Another typical response to stress can be the opposite experience, that of difficulty sleeping well or getting to sleep. Being sleep deprived can reduce the function of all our senses, especially thinking clearly and being able to stabilize our moods. To improve the quality of your sleep, make sure to stay well hydrated during the day, reduce or eliminate caffeine products past noon, and keep your sleep environment as peaceful and dark as possible.

"For traumatic and confusing events, you may want and need a long time to comprehend what has happened," Rose continued. "My father had been blessed with excellent health his whole life, until he was diagnosed with cancer at age 70. This may not make sense, but I had still not adjusted to the concept that he could even become sick, and it soon came time for me to realize that he had actually died.

"One of the few relaxing moments before, during or after his funeral was when I told myself, ‘It is okay. I do not need to try and understand or accept this all right now. My father will be dead for the rest of my life and I have that long, if necessary, to adjust to the changes that are taking place right now.'"

Rose is emphatic that we sometimes need to ask for help. "It is possible to be independent and strong, while still accepting, and even asking for, help from the people around you or online," she says. "It can often take an event like a severe injury or illness to realize that literally no one can take excellent care of themselves in all circumstances.

"Physical limitations are easier to see, but the same is true with emotional and mental troubles. Instead of using energy to fight the fact that you need assistance, it can be more efficient to start figuring out which forms of support most appeal to you and serve the current situation."

An interesting point to me was Rose's statement that under extreme levels of stress it is common to see aspects of yourself or the people around you that are unfamiliar. "People can behave in surprising ways during troubled times that can be either very uplifting or upsetting," Rose says. "Perhaps a person you thought was dependable pulls away when you most need them. It is also very possible for someone new or unexpected to step forward in a very caring and supportive manner."

Finances can contribute to stress, and financial issues are often present during our caregiving years and during or after a loved one dies. "When money is tight, couples can either pull together or become torn apart," Rose says. "Siblings who lose a parent may cooperate skillfully or start to fight about inheritances. One's own responses and abilities may be a surprise during an emergency. Sage advice is to expect the unexpected from yourself and others."

Rose's next point hit close to home for me. I've called it "working my way back."

Since my dad went through ten years of severe dementia before he died, I had to emotionally process many things before I could start moving back through time to remember how he was before that devastating surgery destroyed his brain. The trek back was painful but rewarding. I used the same process in accepting my mom's long illness and death.

"Salvaging beautiful memories from a painful transition may take a while," Rose says."It can be a matter of waiting long enough so that raw and often conflicting emotions can simmer down. Eventually though, most forms of loss can be referred to later in more loving ways."

The last important fact that Rose mentioned to me was that it still can be surprising when our loved ones actually die. After thinking about my own experiences, I had to agree. Strange as it may seem, the actual death still comes as shock. We know that something irreversible has happened that will change our lives forever.

"Caregivers can spend months or years handling the challenges of caring for a loved one who is ailing," Rose says. "That quiet moment when they are really gone can still be quite shocking. Especially if that person has survived many potentially fatal health problems before, it can be hard to get used to them being gone."

Hospice also cares for the caregiver

Since one of the many services provided by hospice is caring for the caregiver, I reached out to Hospice of the Red River Valley for their advice on how caregivers can take steps to help themselves through the grief of long-term caregiving and the death of their loved one.

Wendy Tabor-Buth, Bereavement Manager for Hospice of the Red River Valley, offered these suggestions from their booklet "The Importance of Self-Care During Grief."

  1. Accept your feelings: Feelings are neither right nor wrong, they just are. Sadness, loneliness, fear, confusion, anger—these are among the many feelings you may experience, and they are completely normal. Emotions are often raw early in the grief process, but it is important to express them. Ignoring your feelings is an unhealthy coping mechanism , and attempting to stifle feelings usually leads to an emotional outburst at an inconvenient time.
  2. Be patient with yourself: Grief is an intensely personal process. Accept that it follows no magic formula or time frame. It will take as long as it takes. Think of the care you would extend to a friend in the same situation of loss, and allow yourself that same grace. Be careful not to take on responsibilities beyond what is realistic. It is better to allow for some flexibility in your obligations during this time.
  3. Pay attention to physical needs: It can be very easy to neglect your physical needs while grieving. However, this is a time when taking good care of yourself is crucial. As difficult as it may seem, making every effort to get adequate sleep, eat nutritionally balanced meals, and fit in regular exercise and intentional relaxation can do wonders.
  4. Accept the help of others: Understand that grief is hard work. It requires a great deal of energy and can be exhausting. Even though we place a high value on self-sufficiency, it is important to ask for, and accept, help from those close to you.

Thanks to Margo and Wendy for their helpful tips. I'm deeply grateful, as always, to the many people who are prepared to offer help to caregivers.