As an Alzheimer's care-giver, you may feel as if you're riding a roller coaster, never sure of what the next curve may bring. It's incredibly stressful; yet it can also be rewarding. Rocked by this dizzying mix of emotions, you walk a tightrope, balancing your own needs against those of your loved one. Learning to recognize and defuse stress can make it easier to keep your balance. Focusing on the rewards from your efforts also helps. Care-giving can become so demanding and all-consuming that it makes caregivers vulnerable to problems of their own.

Care-givers generally talk about their feelings of satisfaction in making good on a commitment and in paying back their loved ones... and they also often realize that they are stronger than they ever thought they could be. At the same time it is important that a care-giver does not try to deny the grief that they may feel and working through their grief is part of the growth a person can experience.

Research has shown that caregivers themselves often are at increased risk for depression and illness, especially if they do not receive adequate support.

* As they witness the slow decline of their loved one into a helpless, anonymous person, they feel the loss of the person they used to know and hence can become depressed.

* When they realize that they cannot change or stop the progression of the illness, they begin to feel frustrated which often makes them irritable, angry or distressed. Caregivers suffer more from these feelings than patients, who often have little awareness of their lost capacities.

* The care-giver is left with a person who cannot remember and does not recognize them. The care-giver may lose a sense of who they are, because their loved one is no longer able to validate their shared experiences.

* The increasing demands of care can drain the care-giver of energy for engaging in familiar activities and social commitments. At the same time, the care-giver's life is more and more intertwined with that of the patient. The result can be more frustration, depression, and exhaustion. At times the care-giver may begin wishing that the elder would die, not only to end the patient's miserable state of life, but also to end the care-giving.

* Stress, lack of rest, depression and grief all take their toll on the care-giver's mind and body. Besides, the demands of care-giving can make it hard to maintain good health habits.

Common signs of care-giver stress are depression, frequent crying, a decrease in energy, sleeping too little or too much, unintended weight gain or loss and increased irritability and anger.

Suggestions for care-givers

• When you're stressed, remember to take special care of yourself. Eat healthy food, get enough sleep, stay in touch with friends and schedule times when you can take regular breaks.

• Maybe a friend can spend time with your loved one, read a book aloud or watch a movie together, while you get out of the house now and then.

• Try and find a support group (people who have an Alzheimer's patient at home) where you can share your feelings and concerns. Members of support groups often have helpful ideas or know of useful resources based on their own experiences. Online support groups make it possible for care-givers to receive support without having to leave home.

• You could also ask your doctor if you have any questions about Alzheimer's disease. Find out what treatment might work best to alleviate symptoms or address behaviour problems.

• Spend some time to see if you can develop a routine that could makes things go more smoothly. If there are times during the day when the person with Alzheimer's disease is less confused or more cooperative, plan your routine to make the most of those moments. Keep in mind that the way the person functions may change from day to day, so try to be flexible and adapt your routine as needed.

• Begin to plan for the future by putting financial and legal documents in order, investigate long-term care options, and determine what services are covered by health insurance.

• You could also consider using adult day care or respite services to ease the day-to-day demands of care-giving. These services allow you to have a break while knowing that your loved one is being well cared for.

Remember, watching a loved one travel through the stages of Alzheimer's disease is heartbreaking and caring for them during this time is one of the hardest jobs imaginable. It requires an abundance of physical and emotional energy. Accepting help and taking care of yourself are crucial to success.