The first rule of rescue is “save yourself first.” That is, don’t let your rescue efforts land you in so much trouble that you yourself need to be rescued. It’s a rule that can be applied to many situations in life, including one that growing numbers of Americans face nowadays: serving as a caregiver to aging parents or other family members.

Caregiving can extract a huge toll on caregivers – emotional, financial, physical, and social. Most advice on the subject focuses on the needs of the persons being cared for. In contrast, To Survive Caregiving (Infinity Publishing, 168 pp., 2007) is mainly a guide for caregivers on how to take care of themselves – so that they don’t wind up needing to be rescued. To judge by the many stories in the book, the latter happens all too often.

The subtitle of the book is A Daughter’s Experience, A Doctor’s Advice on Finding Hope, Help, and Health. The author, Cheryl E. Woodson, M.D., is a geriatrician with years of professional experience caring for older adults, who also spent 10 years caring for her mother, who had Alzheimer’s disease. Like many caregivers, Dr. Woodson struggled to keep a balance in the rest of her life during this period, trying to maintain a professional career and raise her own young children while tending to the needs of parent who lived hundreds of miles away.

The best advice in the book: Don’t go it alone. Get help from family and friends. Don’t rule out assisted living, day care, respite care, and nursing homes. Have a geriatrician review the older person’s situation. The tendency in many families is for one person to step in and try to do it all. Many caregivers are reluctant to reach out, and Woodson’s book message is that this is a mistake, one that can end in disaster for the caregiver, the cared-for, or both.

There are ten chapters: The Crisis in Caregiving, Get Help From Professionals; Get Help From Family and Friends; Protect the Primary Resource – Hey That’s YOU!; When Eldercare Puts Other Relationships at Risk; When The Doctor Says It’s Not Safe For Your Loved One To….; The Nursing Home Decision; End of Life Care; We Deal With Grief; and The Failure of Public Policy.

There is also a useful reference guide with the names, websites, and phone numbers of caregiver resources and support.

The book includes many stories about real caregivers. They are often depressing (“Mrs. F suffered a stroke that affected her memory and partially paralyzed one leg…Daughter V took so much time off from work to care for her that she lost her job...), but they do shine a light on the very real problems that caregivers face. And the point of Woodson’s book is that even though these situations are often unavoidably difficult, there are things caregivers can do to help them make better decisions, give better care, and protect their own health and finances.

The final chapter, The Failure of Public Policy, is excellent. Any caregiver will eventually wonder why the health care system seems so poorly equipped to address the needs of the chronically ill and their families. It was never designed to do this (when Medicare was designed in the 1960s, there was little chronic illness.) The demographics have changed enormously, but the system has lagged behind. We need more geriatricians, but the financial incentives drive medical students into other, more lucrative specialties. She also discusses the “myth” of assisted-living facilities: These have proliferated in recent years, but they are ill-equipped to provide the level of care people expect them to.

The list price of the book is $18.95 (but it is available at a discount from amazon.com). Given the huge toll that caregiving can take, financial and otherwise, it is worthwhile investment for anyone providing such care.

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