Milk Thistle For The Brain, Bones, & More

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“Thistle Do Nicely”

Milk thistle is a popular supplement; it comes from the milk thistle plant (Silybum marianum), commonly just called thistles. There are other kinds of thistle too, but these are one of the most common.

So, what does it do?

Liver health

Milk thistle enjoys popular use to support liver health; the liver is a remarkably self-regenerative organ if given the chance, but sometimes it can use a helping hand.

See for example: How To Undo Liver Damage

As for milk thistle’s beneficence, it is very well established:

Brain health

For this one the science is less well-established, as studies so far have been on non-human animals, or have been in vitro studies.

Nevertheless, the results so far are promising, and the mechanism of action seems to be a combination of reducing oxidative stress and neuroinflammation, as well as suppressing amyloid β-protein (Aβ) fibril formation, in other words, reducing amyloid plaques.

General overview: A Mini Review on the Chemistry and Neuroprotective Effects of Silymarin

All about the plaques, but these are non-human animal studies:

Against diabetes

Milk thistle improves insulin sensitivity, and reduces fasting blood sugar levels and HbA1c levels. The research so far is mostly in type 2 diabetes, however (at least, so far as we could find). For example:

Silymarin in Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Studies we could find for T1D were very far from translatable to human usefulness, for example, “we poisoned these rats with streptozotocin then gave them megadoses of silymarin (10–15 times the dose usually recommended for humans) and found very small benefits to the lenses of their eyes” (source).

Against osteoporosis

In this case, milk thistle’s estrogenic effects may be of merit to those at risk of menopause-induced osteoporosis:

Antiosteoclastic activity of milk thistle extract after ovariectomy to suppress estrogen deficiency-induced osteoporosis

If you’d like a quick primer about such things as what antiosteoclastic activity is, here’s a quick recap:

Which Osteoporosis Medication, If Any, Is Right For You?

Is it safe?

It is “Generally Recognized As Safe”, and even when taken at high doses for long periods, side effects are very rare.

Contraindications include if you’re pregnant, nursing, or allergic.

Potential reasons for caution (but not necessarily contraindication) include if you’re diabetic (its blood-sugar lowering effects will decrease the risk of hyperglycemia while increasing the risk of hypoglycemia), or have a condition that could be exacerbated by its estrogenic effects—including if you are on HRT, because it’s an estrogen receptor agonist in some ways (for example those bone benefits we mentioned before) but an estrogen antagonist in others (for example, in the uterus, if you have one, or in nearby flat muscles, if you don’t).

As ever, speak with your doctor/pharmacist to be sure.

Want to try it?

We don’t sell it, but here for your convenience is an example product on Amazon

Enjoy!

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  • Science of HIIT – by Ingrid Clay

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    We previously reviewed another book in this series, Science of Yoga. This one’s about HIIT: High Intensity Interval Training!

    We’ve written about HIIT before too, but our article doesn’t have the same amount of room as a book, so…

    This one lays out 90 key HIIT exercises that you can do at home without special equipment. By “without special equipment”, we mean: there are a few exercises that use dumbbells, but if you don’t want to get/use dumbbells, you can improvize (e.g. with water bottles as weights) or skip those. All the rest require just your body!

    The illustrations are clear and the explanations excellent. The book also dives into (as the title promises) the science of HIIT, and why it works the way it does to give results that can’t be achieved with other forms of exercise.

    Bottom line: if you’ve been wanting to do HIIT but have not yet found a way of doing it that suits your lifestyle, this book gives many excellent options.

    Click here to check out Science of HIIT, and level-up yours!

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  • Reversing Alzheimer’s – by Dr. Heather Sandison

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    The title here is bold, isn’t it? But, if the studies so far are anything to go by, she is, indeed, reversing Alzheimer’s. By this we mean: her Alzheimer’s patients have enjoyed a measurable reversal of the symptoms of cognitive decline (this is not something that usually happens).

    The science here is actually new, and/but references are given aplenty, including Dr. Sandison’s own research and others—there’s a bibliography of several hundred papers, which we love to see.

    Dr. Sandison’s approach is of course multivector, but is far more lifestyle medicine than pills, with diet in particular playing a critical role. Indeed, it’s worth mentioning that she is a naturopathic doctor (not an MD), so that is her focus—though she’s had a lot of MDs looking in on her work too, as you may see in the book. She has found best results in a diet low in carbs, high in healthy fats—and it bears emphasizing, healthy ones. Many other factors are also built in, but this is a book review, not a book summary.

    Nor does the book look at diet in isolation; other aspects of lifestyle are also taken into account, as well as various medical pathways, and how to draw up a personalized plan to deal with those.

    The book is written with the general assumption that the reader is someone with increased Alzheimer’s risk wishing to reduce that risk, or the relative of someone with Alzheimer’s disease already. However, the information within is beneficial to all.

    The style is on the hard end of pop-science; it’s written for the lay reader, but will (appropriately enough) require active engagement to read effectively.

    Bottom line: if Alzheimer’s is something that affects or is likely to affect you (directly, or per a loved one), then this is a very good book to have read

    Click here top check out Reversing Alzheimer’s, and learn how to do it!

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  • The Core Program: – by Peggy Brill

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    The author, a specialist women’s physiotherapist, has produced not only an exercise program, but also an explanation of various body-related matters can be easily neglected—but also, with the right knowledge and a small daily commitment of practice, easily addressed.

    Thus, thus subtitular claim of “15 minutes a day that can change your life” is referring to a daily 15-minute exercise session, that’s very Pilates-like in its functional strength and mobility focus with little or no equipment, without actually being Pilates.

    After some introductory chapters discussing the things we need to know in order to implement the program with full understanding, she gets into the program itself, which consists of three progressive parts:

    1. a foundation to get going
    2. an intermediate level to get things truly into good shape, and
    3. an advanced level for if one wants to take things further.

    She also provides extra advice on maintaining what one gained, taking the program forwards for life.

    The program is optimized for women, but there’s nothing truly exclusive to women here, just, occasional “this affects women more” things to include.

    The style is a little dated (the book being published in 2003), but this does not meaningfully affect the content, as the information itself is timeless.

    Bottom line: if you’d like to get into good condition without overcomplicating things and without needing a lot of resources, this book is quite a comprehensive course!

    Click here to check out The Core Program, and get into shape sustainably!

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  • He Thinks His Wife Died in an Understaffed Hospital. Now He’s Trying to Change the Industry.

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    For the past year, police Detective Tim Lillard has spent most of his waking hours unofficially investigating his wife’s death.

    The question has never been exactly how Ann Picha-Lillard died on Nov. 19, 2022: She succumbed to respiratory failure after an infection put too much strain on her weakened lungs. She was 65.

    For Tim Lillard, the question has been why.

    Lillard had been in the hospital with his wife every day for a month. Nurses in the intensive care unit had told him they were short-staffed, and were constantly rushing from one patient to the next.

    Lillard tried to pitch in where he could: brushing Ann’s shoulder-length blonde hair or flagging down help when her tracheostomy tube gurgled — a sign of possible respiratory distress.

    So the day he walked into the ICU and saw staff members huddled in Ann’s room, he knew it was serious. He called the couple’s adult children: “It’s Mom,” he told them. “Come now.”

    All he could do then was sit on Ann’s bed and hold her hand, watching as staff members performed chest compressions, desperately trying to save her life.

    A minute ticked by. Then another. Lillard’s not sure how long the CPR continued — long enough for the couple’s son to arrive and take a seat on the other side of Ann’s bed, holding her other hand.

    Finally, the intensive care doctor called it and the team stopped CPR. Time of death: 12:37 p.m.

    Lillard didn’t know what to do in a world without Ann. They had been married almost 25 years. “We were best friends,” he said.

    Just days before her death, nurses had told Lillard that Ann could be discharged to a rehabilitation center as soon as the end of the week. Then, suddenly, she was gone. Lillard didn’t understand what had happened.

    Lillard said he now believes that overwhelmed, understaffed nurses hadn’t been able to respond in time as Ann’s condition deteriorated. And he has made it his mission to fight for change, joining some nursing unions in a push for mandatory ratios that would limit the number of patients in a nurse’s care. “I without a doubt believe 100% Ann would still be here today if they had staffing levels, mandatory staffing levels, especially in ICU,” Lillard said.

    Last year, Oregon became the second state after California to pass hospital-wide nurse ratios that limit the number of patients in a nurse’s care. Michigan, Maine, and Pennsylvania are now weighing similar legislation.

    But supporters of mandatory ratios are going up against a powerful hospital industry spending millions of dollars to kill those efforts. And hospitals and health systems say any staffing ratio regulations, however well-intentioned, would only put patients in greater danger.

    Putting Patients at Risk

    By next year, the United States could have as many as 450,000 fewer nurses than it needs, according to one estimate. The hospital industry blames covid-19 burnout, an aging workforce, a large patient population, and an insufficient pipeline of new nurses entering the field.

    But nursing unions say that’s not the full story. There are now 4.7 million registered nurses in the country, more than ever before.

    The problem, the unions say, is a hospital industry that’s been intentionally understaffing their units for years in order to cut costs and bolster profits. The unions say there isn’t a shortage of nurses but a shortage of nurses willing to work in those conditions.

    The nurse staffing crisis is now affecting patient care. The number of Michigan nurses who say they know of a patient who has died because of understaffing has nearly doubled in recent years, according to a Michigan Nurses Association survey last year.

    Just months before Ann Picha-Lillard’s death, nurses and doctors at the health system where she died had asked the Michigan attorney general to investigate staffing cuts they believed were leading to dangerous conditions, including patient deaths, according to The Detroit News.

    But Lillard didn’t know any of that when he drove his wife to the hospital in October 2022. She had been feeling short of breath for a few weeks after she and Lillard had mild covid infections. They were both vaccinated, but Ann was immunocompromised. She suffered from rheumatoid arthritis, a condition that had also caused scarring in her lungs.

    To be safe, doctors at DMC Huron Valley-Sinai Hospital wanted to keep Ann for observation. After a few days in the facility, she developed pneumonia. Doctors told the couple that Ann needed to be intubated. Ann was terrified but Lillard begged her to listen to the doctors. Tearfully, she agreed.

    With Ann on a ventilator in the ICU, it seemed clear to Lillard that nurses were understaffed and overwhelmed. One nurse told him they had been especially short-staffed lately, Lillard said.

    “The alarms would go off for the medications, they’d come into the room, shut off the alarm when they get low, run to the medication room, come back, set them down, go to the next room, shut off alarms,” Lillard recalled. “And that was going on all the time.”

    Lillard felt bad for the nurses, he said. “But obviously, also for my wife. That’s why I tried doing as much as I could when I was there. I would comb her hair, clean her, just keep an eye on things. But I had no idea what was really going on.”

    Finally, Ann’s health seemed to be stabilizing. A nurse told Lillard they’d be able to discharge Ann, possibly by the end of that week.

    By Nov. 17, Ann was no longer sedated and she cried when she saw Lillard and her daughter. Still unable to speak, she tried to mouth words to her husband “but we couldn’t understand what she was saying,” Lillard said.

    The next day, Lillard went home feeling hopeful, counting down the days until Ann could leave the hospital.

    Less than 24 hours later, Ann died.

    Lillard couldn’t wrap his head around how things went downhill so fast. Ann’s underlying lung condition, the infection, and her weakened state could have proved fatal in the best of circumstances. But Lillard wanted to understand how Ann had gone from nearly discharged to dying, seemingly overnight.

    He turned his dining room table into a makeshift office and started with what he knew. The day Ann died, he remembered her medical team telling him that her heart rate had spiked and she had developed another infection the night before. Lillard said he interviewed two DMC Huron Valley-Sinai nurse administrators, and had his own doctor look through Ann’s charts and test results from the hospital. “Everybody kept telling me: sepsis, sepsis, sepsis,” he said.

    Sepsis is when an infection triggers an extreme reaction in the body that can cause rapid organ failure. It’s one of the leading causes of death in U.S. hospitals. Some experts say up to 80% of sepsis deaths are preventable, while others say the percentage is far lower.

    Lives can be saved when sepsis is caught and treated fast, which requires careful attention to small changes in vital signs. One study found that for every additional patient a nurse had to care for, the mortality rate from sepsis increased by 12%.

    Lillard became convinced that had there been more nurses working in the ICU, someone could have caught what was happening to Ann.

    “They just didn’t have the time,” he said.

    DMC Huron Valley-Sinai’s director of communications and media relations, Brian Taylor, declined a request for comment about the 2022 staffing complaint to the Michigan attorney general.

    Following the Money

    When Lillard asked the hospital for copies of Ann’s medical records, DMC Huron Valley-Sinai told him he’d have to request them from its parent company in Texas.

    Like so many hospitals in recent years, the Lillards’ local health system had been absorbed by a series of other corporations. In 2011, the Detroit Medical Center health system was bought for $1.5 billion by Vanguard Health Systems, which was backed by the private equity company Blackstone Group.

    Two years after that, in 2013, Vanguard itself was acquired by Tenet Healthcare, a for-profit company based in Dallas that, according to its website, operates 480 ambulatory surgery centers and surgical hospitals, 52 hospitals, and approximately 160 additional outpatient centers.

    As health care executives face increasing pressure from investors, nursing unions say hospitals have been intentionally understaffing nurses to reduce labor costs and increase revenue. Also, insurance reimbursements incentivize keeping nurse staffing levels low. “Hospitals are not directly reimbursed for nursing services in the same way that a physician bills for their services,” said Karen Lasater, an associate professor of nursing in the Center for Health Outcomes and Policy Research at the University of Pennsylvania. “And because hospitals don’t perceive nursing as a service line, but rather a cost center, they think about nursing as: How can we reduce this to the lowest denominator possible?” she said.

    Lasater is a proponent of mandatory nurse ratios. “The nursing shortage is not a pipeline problem, but a leaky bucket problem,” she said. “And the solutions to this crisis need to address the root cause of the issue, which is why nurses are saying they’re leaving employment. And it’s rooted in unsafe staffing. It’s not safe for the patients, but it’s also not safe for nurses.”

    A Battle Between Hospitals and Unions

    In November, almost one year after Ann’s death, Lillard told a room of lawmakers at the Michigan State Capitol that he believes the Safe Patient Care Act could save lives. The health policy committee in the Michigan House was holding a hearing on the proposed act, which would limit the amount of mandatory overtime a nurse can be forced to work, and require hospitals to make their staffing levels available to the public.

    Most significantly, the bills would require hospitals to have mandatory, minimum nurse-to-patient ratios. For example: one nurse for every patient in the ICU; one for every three patients in the emergency room; a nurse for triage; and one nurse for every four postpartum birthing patients and well-baby care.

    Efforts to pass mandatory ratio laws failed in Washington and Minnesota last year after facing opposition from the hospital industry. In Minnesota, the Minnesota Nurses Association accused the Mayo Clinic of using “blackmail tactics”: Mayo had told lawmakers it would pull billions of dollars in investment from the state if mandatory ratio legislation passed. Soon afterward, lawmakers removed nurse ratios from the legislation.

    While Lillard waited for his turn to speak to Michigan lawmakers about the Safe Patient Care Act in November, members of the Michigan Nurses Association, which says it represents some 13,000 nurses, told lawmakers that its units were dangerously understaffed. They said critical care nurses were sometimes caring for up to 11 patients at a time.

    “Last year I coded someone in an ICU for 10 minutes, all alone, because there was no one to help me,” said the nurses association president and registered nurse Jamie Brown, reading from another nurse’s letter.

    “I have been left as the only specially trained nurse to take care of eight babies on the unit: eight fragile newborns,” said Carolyn Clemens, a registered nurse from the Grand Blanc area of Michigan.

    Nikia Parker said she has left full-time emergency room nursing, a job she believes is her calling. After her friend died in the hospital where she worked, she was left wondering whether understaffing may have contributed to his death.

    “If the Safe Patient Care Act passed, and we have ratios, I’m one of those nurses who would return to the bedside full time,” Parker told lawmakers. “And so many of my co-workers who have left would join me.”

    But not all nurses agree that mandatory ratios are a good idea. 

    While the American Nurses Association supports enforceable ratios as an “essential approach,” that organization’s Michigan chapter does not, saying there may not be enough nurses in the state to satisfy the requirements of the Safe Patient Care Act.

    For some lawmakers, the risk of collateral damage seems too high. State Rep. Graham Filler said he worries that mandating ratios could backfire.

    “We’re going to severely hamper health care in the state of Michigan. I’m talking closed wards because you can’t meet the ratio in a bill. The inability for a hospital to treat an emergent patient. So it feels kind of to me like a gamble we’re taking,” said Filler, a Republican.

    Michigan hospitals are already struggling to fill some 8,400 open positions, according to the Michigan Health & Hospital Association. That association says that complying with the Safe Patient Care Act would require hiring 13,000 nurses.

    Every major health system in the state signed a letter opposing mandatory ratios, saying it would force them to close as many as 5,100 beds.

    Lillard watched the debate play out in the hearing. “That’s a scare tactic, in my opinion, where the hospitals say we’re going to have to start closing stuff down,” he said.

    He doesn’t think legislation on mandatory ratios — which are still awaiting a vote in the Michigan House’s health policy committee — are a “magic bullet” for such a complex, national problem. But he believes they could help.

    “The only way these hospitals and the administrations are gonna make any changes, and even start moving towards making it better, is if they’re forced to,” Lillard said.

    Seated in the center of the hearing room in Lansing, next to a framed photo of Ann, Lillard’s hands shook as he recounted those final minutes in the ICU.

    “Please take action so that no other person or other family endures this loss,” he said. “You can make a difference in saving lives.”

    Grief is one thing, Lillard said, but it’s another thing to be haunted by doubts, to worry that your loved one’s care was compromised before they ever walked through the hospital doors. What he wants most, he said, is to prevent any other family from having to wonder, “What if?”

    This article is from a partnership that includes Michigan Public, NPR, and KFF Health News.

    KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

    USE OUR CONTENT

    This story can be republished for free (details).

    KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

    Subscribe to KFF Health News’ free Morning Briefing.

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  • The Sweet Truth About Glycine

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    Make Your Collagen Work Better

    This is Dr. James Nicolantonio. He’s a doctor of pharmacy, and a research scientist. He has a passion for evidence-based nutrition, and has written numerous books on the subject.

    Controversy! Dr. DiNicolatonio’s work has included cardiovascular research, in which field he has made the case for increasing (rather than decreasing) the recommended amount of salt in our diet. This, of course, goes very much against the popular status quo.

    We haven’t reviewed that research so we won’t comment on it here, but we thought it worth a mention as a point of interest. We’ll investigate his claims in that regard another time, though!

    Today, however, we’ll be looking at his incisive, yet not controversial, work pertaining to collagen and glycine.

    A quick recap on collagen

    We’ve written about collagen before, and its importance for maintaining… Well, pretty much most of our body, really, buta deficiency in collagen can particularly weaken bones and joints.

    On a more surface level, collagen’s also important for healthy elastic skin, and many people take it for that reason alone,

    Since collagen is found only in animals, even collagen supplements are animal-based (often marine collagen or bovine collagen). However, if we don’t want to consume those, we can (like most animals) synthesize it ourselves from the relevant amino acids, which we can get from plants (and also laboratories, in some cases).

    You can read our previous article about this, here:

    We Are Such Stuff As Fish Are Made Of

    What does he want us to know about collagen?

    We’ll save time and space here: first, he’d like us to know the same as what we said in our article above

    However, there is also more:

    Let’s assume that your body has collagen to process. You either consumed it, or your body has synthesized it. We’ll skip describing the many steps of collagen synthesis, fascinating as that is, and get to the point:

    When our body weaves together collagen fibrils out of the (triple-helical) collagen molecules…

    • the cross-linking of the collagen requires lysyl oxidase
    • the lysyl oxidase (which we make inside us) deanimates some other amino acids yielding aldehydes that allow the stable cross-links important for the high tensile strength of collagen, but to do that, it requires copper
    • in order to use the copper it needs to be in its reduced cuprous form and that requires vitamin C
    • but moving it around the body requires vitamin A

    So in other words: if you are taking (or synthesizing) collagen, you also need copper and vitamins A and C.

    However! Just to make things harder, if you take copper and vitamin C together, it’ll reduce the copper too soon in the wrong place.

    Dr. DiNicolantonio therefore advises taking vitamin C after copper, with a 75 minutes gap between them.

    What does he want us to know about glycine?

    Glycine is one of the amino acids that makes up collagen. Specifically, it makes up every third amino acid in collagen, and even more specifically, it’s also the rate-limiting factor in the formation of glutathione, which is a potent endogenous (i.e., we make it inside us) antioxidant that works hard to fight inflammation inside the body.

    What this means: if your joints are prone to inflammation, being glycine-deficient means a double-whammy of woe.

    As well as being one of the amino acids most key to collagen production, glycine has another collagen-related role:

    First, the problem: as we age, glycated collagen accumulates in the skin and cartilage (that’s bad; there is supposed to be collagen there, but not glycated).

    More on glycation and what it is and why it is so bad:

    Are You Eating Advanced Glycation End-Products? The Trouble Of The AGEs

    Now, the solution: glycine suppresses advanced glycation end products, including the glycation of collagen.

    See for example:

    Glycine Suppresses AGE/RAGE Signaling Pathway and Subsequent Oxidative Stress by Restoring Glo1 Function

    With these three important functions of glycine in mind…

    Dr. DiNicolantonio therefore advises getting glycine at a dose of 100mg/kg/day. So, if you’re the same size as this rather medium-sized writer, that means 7.2g/day.

    Where can I get it?

    Glycine is found in many foods, including gelatin for those who eat that, eggs for the vegetarians, and spinach for vegans.

    However, if you’d like to simply take it as a supplement, here’s an example product on Amazon

    (the above product is not clear whether it’s animal-derived or not, so if that’s important to you, shop around. This writer got some locally that is certified vegan, but is in Europe rather than N. America, which won’t help most of our subscribers)

    Note: pure glycine is a white crystalline powder that has the same sweetness as glucose. Indeed, that is how it got its name, from the Greek “γλυκύς”, pronounced /ɡly.kýs/, meaning “sweet”. Yes, same etymology as glucose.

    So don’t worry that you’ve been conned if you order it and think “this is sugar!”; it just looks and tastes the same.

    That does mean you should buy from a reputable source though, as a con would be very easy!

    this does also mean that if you like a little sugar/sweetener in your tea or coffee, glycine can be used as a healthy substitute.

    If you don’t like sweet tastes, then, condolences. This writer pours two espresso coffees (love this decaffeinated coffee that actually tastes good), puts the glycine in the first, and then uses the second to get rid of the sweet taste of the first. So that’s one way to do it.

    Enjoy (if you can!)

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  • How To Avoid Carer Burnout (Without Dropping Care)

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    How To Avoid Carer Burnout

    Sometimes in life we find ourselves in a caregiving role.

    Maybe we chose it. For example, by becoming a professional carer, or even just by being a parent.

    Oftentimes we didn’t. Sometimes because our own parents now need care from us, or because a partner becomes disabled.

    Philosophical note: an argument could be made for that latter also having been a pre-emptive choice; we probably at some point said words to the effect of “in sickness and in health”, hopefully with free will, and hopefully meant it. And of course, sometimes we enter into a relationship with someone who is already disabled.

    But, we are not a philosophy publication, and will henceforth keep to the practicalities.

    First: are you the right person?

    Sometimes, a caregiving role might fall upon you unasked-for, and it’s worth considering whether you are really up for it. Are you in a position to be that caregiver? Do you want to be that caregiver?

    It may be that you do, and would actively fight off anyone or anything that tried to stop you. If so, great, now you only need to make sure that you are actually in a position to provide the care in question.

    It may be that you do want to, but your circumstances don’t allow you to do as good a job of it as you’d like, or it means you have to drop other responsibilities, or you need extra help. We’ll cover these things later.

    It may be that you don’t want to, but you feel obliged, or “have to”. If that’s the case, it will be better for everyone if you acknowledge that, and find someone else to do it. Nobody wants to feel a burden, and nobody wants someone providing care to be resentful of that. The result of such is two people being miserable; that’s not good for anyone. Better to give the job to someone who actually wants to (a professional, if necessary).

    So, be honest (first with yourself, then with whoever may be necessary) about your own preferences and situation, and take steps to ensure you’re only in a caregiving role that you have the means and the will to provide.

    Second: are you out of your depth?

    Some people have had a life that’s prepared them for being a carer. Maybe they worked in the caring profession, maybe they have always been the family caregiver for one reason or another.

    Yet, even if that describes you… Sometimes someone’s care needs may be beyond your abilities. After all, not all care needs are equal, and someone’s condition can (and more often than not, will) deteriorate.

    So, learn. Learn about the person’s condition(s), medications, medical equipment, etc. If you can, take courses and such. The more you invest in your own development in this regard, the more easily you will handle the care, and the less it will take out of you.

    And, don’t be afraid to ask for help. Maybe the person knows their condition better than you, and certainly there’s a good chance they know their care needs best. And certainly, there are always professionals that can be contacted to ask for advice.

    Sometimes, a team effort may be required, and there’s no shame in that either. Whether it means enlisting help from family/friends or professionals, sometimes “many hands make light work”.

    Check out: Caregiver Action Network: Organizations Near Me

    A very good resource-hub for help, advice, & community

    Third: put your own oxygen mask on first

    Like the advice to put on one’s own oxygen mask first before helping others (in the event of a cabin depressurization in an airplane), the rationale is the same here. You can’t help others if you are running on empty yourself.

    As a carer, sometimes you may have to put someone else’s needs above yours, both in general and in the moment. But, you do have needs too, and cannot neglect them (for long).

    One sleepless night looking after someone else is… a small sacrifice for a loved one, perhaps. But several in a row starts to become unsustainable.

    Sometimes it will be necessary to do the best you can, and accept that you cannot do everything all the time.

    There’s a saying amongst engineers that applies here too: “if you don’t schedule time for maintenance, your equipment will schedule it for you”.

    In other words: if you don’t give your body rest, your body will break down and oblige you to rest. Please be aware this goes for mental effort too; your brain is just another organ.

    So, plan ahead, schedule breaks, find someone to take over, set up your cared-for-person with the resources to care for themself as well as possible (do this anyway, of course—independence is generally good so far as it’s possible), and make the time/effort to get you what you need for you. Sleep, distraction, a change of scenery, whatever it may be.

    Lastly: what if it’s you?

    If you’re reading this and you’re the person who has the higher care needs, then firstly:all strength to you. You have the hardest job here; let’s not forget that.

    About that independence: well-intentioned people may forget that, so don’t be afraid to remind them when “I would prefer to do that myself”. Maintaining independence is generally good for the health, even if sometimes it is more work for all concerned than someone else doing it for you. The goal, after all, is your wellbeing, so this shouldn’t be cast aside lightly.

    On the flipside: you don’t have to be strong all the time; nobody should.

    Being disabled can also be quite isolating (this is probably not a revelation to you), so if you can find community with other people with the same or similar condition(s), even if it’s just online, that can go a very, very long way to making things easier. Both practically, in terms of sharing tips, and psychologically, in terms of just not feeling alone.

    See also: How To Beat Loneliness & Isolation

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