"When will this misery be over?"

My mother uttered these words on a day when the aches and pains of old age were especially intense. Mentally I knew the answer,but I said, "I'm sorry you're uncomfortable."

As I prepared to go, my mother said, "Don't leave me," so I sat and waited until she nodded off before exiting the room. Alone in my car, the tears slid down my face, and I realized that even though my mother is still alive, I'm already grieving her death.

Caregiver grief is a complicated puzzle of sorrow, guilt, and longing for the day when you can move forward with your life, no longer bound in a state of limbo to the next health crisis or cognitive issue.

Caregiver grief differs from the grief of someone who has had a sudden loss in that the caregiving process involves anticipatory grief. A caregiver watches her loved one lose abilities and vital life functions. When Dad can no longer walk unaided, grieving occurs for the little girl who no longer sees her big strong daddy standing beside her, ready to catch her if she falls. Those grief moments come weeks, months, or even years before death occurs. In some ways, it makes the actual death easier; in other ways, harder. The ease comes when the caregiver realizes the loved one was ready to leave the body that no longer supported the vital spirit within.

A caregiver works hard to improve quality of life, and regular bouts of grief steal energy from the caregiver, making the day-to-day journey feel more of a struggle than perhaps it actually is.There are days when there is no concrete reason for the exhaustion and sorrow you feel, but the emotional aspects of caregiving sap strength like a heavy load on a hot day.

Here are some things to remember about caregiver grief:

· It's real. Pretending you aren't grieving accomplishes nothing. Acknowledge the sorrow you feel and express it with tears, by writing in a journal, or talking to a trusted friend or family members.

· We all grieve differently. Grief doesn't always follow a predictable path and the thing that precipitates waves of grief may seem inconsequential. Don't try to pattern your grief after someone else's.

· You don't have to be strong. You don't get any awards for being an emotional stoic during the caregiving process. In fact, you will be healthier physically and emotionally if you allow grief to come when it chooses.

· Maintain some normalcy.While it's good to grieve, it's also easy to fall into a morbid mindset that overwhelms all your thoughts and keeps you from doing anything else. You forget what real life if like. A caregiver who has not nurtured at least some of her own life and identity while caring for others will suffer feelings of displacement for a much longer time and may experience a true identity crisis once the caregiving season is over.

· Believe and hope for the future. An especially difficult caregiving day ended with a late afternoon cloud burst. Wind bent the trees. The heavens opened and pelted the ground with huge raindrops. As I drove across town, a multi-colored swath painted the dripping sky. A rainbow: God's promise to never destroy the earth again with a flood. Hope swelled within me. On that day, the rainbow was God's personal promise to me that the storms of caregiving will not destroy me and there will be a bright tomorrow.