As I do in many caregiver consultations like this one, I laid out the four relationships that have the biggest impact on caregiver coping:

1. the caregiver's relationships (good or bad) with the care recipient;

2. the caregiver's relationships with members of his or her immediate family;

3. the caregiver's relationships with extended-family members and community/church members;

4. the caregiver's relationships with health care and social-service professionals.

A caregiver can increase his or resilience, I told the daughter, by drawing upon the goodwill of all these relationships. She and her mother had always gotten along well, the daughter reported, and she trusted the physicians and other professionals they were working with. She also explained she had a loving family, with little past or present conflict. But, consistent with her reluctance to accept help, she had held off asking immediate or extended-family members to assist her in caring for her mother. "Think about tapping those relationships," I urged her. "That sort of caregiver support is crucial."

The daughter left my office that day with several new coping strategies. I gave her the option of making another appointment but didn't hear from her for another two months, when she called to talk further about how best to handle her caregiving stress. At this time, she meets with me periodically to brainstorm means of bolstering herself psychologically through this period of caregiving. I feel less like her psychotherapist than her coach, suggesting strategies and cheering her on.

Note: Not every mental-health professional is knowledgeable about caregiving. Among those who are, not all provide consultations. Your local Area Agency on Aging may be able to provide referrals to psychotherapists who do caregiver consultations in your community. For AAA contact information, visit eldercare.gov.

Barry J. Jacobs is a member of the AARP Caregiving Advisory Panel. If you have a caregiving question, submit your query to the panel of experts.

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