Caretaking can be difficult, and almost always falls to family members, writes Sophia A. Nelson.

Editor’s Note: Sophia A. Nelson is a writer, consultant and attorney. Her latest book is “Be the One You Need: 21 Life Lessons I Learned Taking Care of Everyone but Me.” The views expressed in this commentary are her own. View more opinion on CNN.

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It is widely understood that Covid, as well as other serious illnesses, can have a profound long term impact on the mental and emotional well-being of the people who become sick. It’s all too easy however to forget another group for whom illness can also take a significant toll.

Friends and family members sometimes spend hours each day caring for aging or infirm loved ones. That’s more the case than ever as the population ages and as the number of available professional health workers dwindles.

Sophia A. Nelson

It raises the inevitable question: Who is taking care of the caregivers?

Nothing can fully prepare one for a parent who becomes sick or disabled. My own mother suffered the onset a few years back of debilitating vertigo. Her chronic health problems were exacerbated last month when she fell ill with Covid-19. She had to isolate in her room while she was infectious and because she lives with me, I had to limit my outside interactions as well.

My mom and I were able to get through these past few years with a lot of love and support from friends – hers and mine, a circle of women that has proven to be one of life’s greatest gifts. But make no mistake, caretaking is a difficult journey that almost always falls hardest on family members.

The isolation of my mom’s illness and the additional demands on my time as her primary caregiver were challenging: I had to get to the pharmacy to pick up her medications, check her temperature and blood pressure at regular intervals, feed her throughout the day and attend telehealth appointments with her to monitor her recovery. Most days, I was also running up and down stairs, washing dishes, cooking and cleaning – all while working at my business as many as 10 hours each day.

It was exhausting. And it probably shouldn’t have come as a surprise when I eventually got sick too and took to my bed. I have a childhood autoimmune illness that kicks in when I’m not getting enough rest and I was simply run down after not managing my extreme stress and not doing enough to nourish my mind, body and soul.

Research has found that more than half of US adults are caregivers to their elders, often at great physical, mental and emotional cost. Caregiving is defined as providing help with health care, usually through making appointments, talking with doctors and handling insurance issues. That’s tens of millions of Americans every day assisting loved ones every day with home cleaning, yard work, grocery shopping, meal preparation, banking and bill paying, among other needed tasks.

A dire national shortage of home health care workers and nursing home staff has only made the pressure on friends and relatives of those who are ailing and elderly more acute. In fact, a University of Michigan National Poll on Healthy Aging found late last year that 54% of Americans 50 and older are considered to be caregivers because of the help they provide to one or more people 65 and older. And the vast majority of caregivers – 94% – are not paid for the work they provide.

Although I was financially in a position to provide for my mom’s care, physically and emotionally, it was a lot. Caretaking can be grueling. If you’re the caregiver to a loved one, you must be intentional about making time for rest and recovery. Here are a few things you can do to start preparing for the day when you might become the primary caregiver for someone you love.

First, you must get a caregiving plan in place for your aging parents, siblings or special needs children. You’ll need one for yourself as well. This is not negotiable. You either devise a plan now or you will likely end up having to pay out of pocket later.

I am fortunate to be an attorney with a good estate plan in place. It only takes one illness. Caring for a family member who may not have long-term care or short-term care insurance or disability insurance, can drain your own savings and disrupt your own retirement plans. A recent AARP study found that many adults in their 40s, 50s and 60s are helping their parents financially.

If your parents haven’t saved up a tidy sum to finance their care during their golden years, siblings should plan to share in the care-taking responsibilities and costs – each according to his or her means. Don’t try to push an undue share of the responsibility on the eldest sibling, or the only daughter or the adult child who happens to live closest. No sibling should get a pass. These are your parents too! They raised you and you need to do your part. To sit back and do less than your fair share will only cause more resentment and fractures in your family.

Make sure that you understand the ins and outs of Medicare, Medicaid and long-term care ERISA laws and benefits, how to apply for them, what they cover and what they do not. Medicare, of course, is the federal government’s health management program for seniors over age 65. Medicaid is for people who have no financial resources and are totally dependent upon the government resources for care.

And by ERISA, I mean The Employee Retirement Income Security Act of 1974 (ERISA), a federal law that sets minimum standards for most voluntarily established retirement and health plans in private industry to provide protection for individuals in these plans.

Taking care of an aging adult can be difficult to manage alone. Look into in-home care services that offer meal prep and medicine drop. Assemble a list of trusted individuals who can watch your loved one if you must travel or take some time away.

Finally, even the most stalwart caregivers among us could use some tender, loving care. As you devise your plan to care for your loved one, make sure you factor in what your strategy will be to care for you. You must set healthy boundaries financially, emotionally and physically.

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    Swapping roles with our parents is not easy – and that’s what we’re doing when we take on responsibilities for their care. Dealing with an aging and unwell parent’s mood swings, their depression, stubbornness – and sometimes their frustration and anger at being unwell – can be a challenge.

    Now is the time to start preparing mentally and emotionally for what that involves, by starting first with the plan I mentioned, then by making sure you build in self-care boundaries for you. Make sure you refill your cup each day that you take care of someone else. And always, always bear in mind that when the health of your parents or spouse begins to fail, your own health is at risk as well.