I had been giving pieces of what became To Survive Caregiving in conferences all over the city, all over the country, while I was taking care of my mother. But when she died, I threw all of that away. It was not real. Once she passed, I really was able to sit with all the feelings, all the information, and I just started everything all over. To Survive Caregiving is in five sections. The first section is the crisis in caregiving. Why is this like this? I always say that today's caregiving, we talk about the sandwich generation, where people are sandwiched between the care of adults and children, but the twenty-first century caregiver sandwich is a multi-decker club.

This is the first time in American history that people are taking care of parents, grandparents, great-grandparents, in-laws, other older adults, children, grandchildren, and increasingly, great-grandchildren, all at the same time. So there's a crisis in caregiving today. The second one is, you can meet the challenge. You can do this. It has to be possible. I'm sitting here after doing it ten years. I survived, so can you. And it gives information about how to get information from clinicians, how to get help from your family, or get them to leave you alone if they are toxic.

There's another section which is the costs of caregiving, and that talks about your physical, financial, emotional, and spiritual dangers if you don't get help to survive caregiving. The fourth section is, how do you manage caregiving when your heart is bleeding?

And that's, what if they didn't take ca- good care of you, and you're invested, or you've agreed to do this? 'Cause it is a choice. You are not anybody's legal guardian. It is a choice. There has to be a choice, 'cause your brothers and sisters have chosen not to do it, right? So you made a choice, and that gives you power. What do you do after caregiving? I had a caregiver who cooked dinner for her family, went downstairs to her mother's apartment, and she was sleeping in her mother's bed for a year after her mother passed, because she couldn't get past it. So what do you do to have a life after caregiving?

It also talks about the nursing home decision, because most of us promise never, and the spirit of that promise is that you would always give the best care, and sometimes that doesn't mean doing it yourself. And sometimes, when people go into nursing facilities and pass quickly, it may be that the caregiver was so tired or so overwhelmed that they may not have been getting the care they needed in the beginning and ended up a little sicker. So when I prescribed the level of care with a family, I always said, "What would have to be happening for you to say you couldn't do this anymore?" And that's to draw a line, so that they, when they get to the line, maybe they can recruit more resources and do it a little more.

But for most families, the line was back there, and they were already overstretched. So the fifth one is from advocacy to activism, and as you're a caregiver, your head is down.

You don't have time to do it, but once the season of caregiving has passed, nobody knows what a caregiver needs more than a caregiver, and the legislators need to hear that. And so the fifth section talks about how to be an activist for caregiving. First of all, it explains why there are no geriatricians, and what you need to do to find somebody who actually knows how to care for somebody with chronic illness. But also, these are the questions for your legislators. I had a home health agency actually take legislators on visits to see what people are living with. So that activism is important, because there's nobody who knows caregiving better than caregivers.