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Exhaustion

Exhaustion.  It can hit out of the blue.  You think you’re doing well and handling everything, and you have a hopeful outlook.  It’s not always physical exhaustion.  It can be mental or emotional exhaustion.  But, mental or emotional exhaustion definitely adds to the physical exhaustion.  That’s where I am this week.  I’m mentally exhausted.  I’m tired of struggling all the time.  I struggle with a busy schedule…work, managing a household, taking care of kids, being available to my husband for his dialysis or any other medical needs he has.  I struggle with worry EVERY SINGLE MONTH on how I’m going to pay everything and still be able to buy a little extra, or do something fun, or be able to pay for something my kids need or want.

Home dialysis was supposed to make things easier for “us.”  They told us the machine is the size of a suitcase, and we can take it anywhere, even on vacation.  They didn’t tell us we would need to lug 5 large bags of fluid for each day of dialysis (25 bags for a week), saline IV bags, and a gazillion medical supplies with us. They told us you do dialysis more frequently, but for less time.  We do dialysis 5 nights a week for 2 1/2 to 3 hours once he is actually hooked up and dialyzing.  It doesn’t include set-up time and clean-up time.  It ends up more like 5 hours a night.  That’s a lot.  They said he can do it on his own, but it turns out, he has to have someone here with him to help him hook up and unhook, or be here in case of an emergency.  It’s not easier at all.  It’s harder.

I’m so tired of worrying about money.  I get the summers off, but I end up a stressed out wreck because I don’t get paid when I don’t work.  I’ve been applying for other full time jobs that are year round, even though it will mean I will have to leave a job of 9 years that I love.  I considered finding something part time that I could do during the school year to supplement my income, and pick up hours in the summer to maybe enjoy them without worrying.  But, because of dialysis 5 nights a week, I don’t know how it’s possible to work part time during the school year, after work.  There just isn’t enough time in the week.

I’m tired of saying no to things that are important to my kids because I can’t afford them or I don’t have the time or ability to be both at home, and out.  People will say, “you don’t have to give them everything they ask for.”  My answer to that is that they don’t ask for much, and when they do ask, it’s very important to them, or it’s a life event that they shouldn’t have to miss.  I hate that there are times they have to miss out because I’m not available or can’t afford something.  I hate struggling to figure out where the extra money is going to come from.  I hate that I am the only one who worries about it.  It really sucks to keep disappointing your child, when you know you are struggling yourself to accept all of this.

I’m tired of having to keep it all to myself because the person that I’ve always figured this stuff out with is sick.  He’s sleepy, he’s medicated, his brain is often foggy.  And there isn’t much he can do.  He is exhausted, too.  His body is failing him, he’s in constant pain, he’s sleep deprived, he’s forgetful.  He doesn’t have a solution to any of this.  I’m tired of handling it all alone.  I have to always keep him and his illness in mind, otherwise I would be overcome by resentment and hopelessness.  I keep him in mind because he has enough to worry about.   He didn’t ask for this any more than I did.  He has it worse.  My exhaustion is nothing compared to his.

This exhaustion has come and gone many times in the last 9 years since he got sick.  We always rally, we always make it through, we always survive.  It’s a matter of plugging along and pushing through.  We have no other choice.

When Is Enough, Enough?

I walked in the door at 7:30 tonight after being out since 8:15 this morning.  My day consisted of working with kindergarteners for 7 hours, picking my daughter up from track practice, driving 40 minutes to her voice lesson and 40 minutes home, and a stop for Chinese food.  I blew off a meeting because I had to get home at a decent hour to help my husband, and I was tired.  Like almost every night, I was greeted by dishes in the sink, dirty floors, dusty pet hair covered surfaces, laundry piled on the couch, laundry in the bathroom, laundry in the laundry room.  Did I mention there was laundry?  The bathroom is a mess, even though I clean it at least once, if not twice, a week.  There is also the usual clutter of a lived-in household.

I blew off cooking dinner tonight because if I had to make a meal, we would have been eating at 9 p.m.  Did I mention I was tired?  So, take-out it was.  Again.  I was out of the house and on the go for almost 12 hours today and had no desire to cook.  As I sat and ate my Chinese food , I looked around and started criticizing myself for my obvious incompetence in running a household.  What kind of wife and mother lets her home look like this?  How dare I have this amount of laundry all over?  How dare I allow my floors to look like crap all the time?  It’s incredibly embarrassing every single time someone walks into our home.  I wonder what they must think of me.  I don’t like it when people come over.  They probably think I’m lazy.  There is no excuse to not keep up with it all. Even though I try to clean it every week, it never looks the way I like it, let alone the way guests would expect to see it.  It looks good for a day at most, and then it’s a mess again.  I don’t have time to make it look incredible, or even presentable most of the time.

I look forward to weekends, but then I spend them grocery shopping, cleaning what I can, driving kids around, and hopefully catching up on some of the sleep I inevitably missed during the week.  It’s a rare weekend that I get to do something just for the fun of it.  Sitting and reading a book can be a challenge.  I figure I don’t deserve it anyway, because I can’t even get my simple chores done.

I’ve also been trying to find a part time job to supplement my income during the school year, and be able to work in the summer when I don’t get paid from my regular job.  I can make it work.  I can work a couple of evenings, and maybe one weekend day, while holding my full time job.  I mean, it’ll take some of the stress off, right?  I can do this.  No excuses.

Meanwhile, my husband sat in his recliner.  No, he isn’t lazy.  Far from it.  He was hooked up to the dialysis machine that keeps him alive.  He does this 5 nights a week for several hours.  He can’t be alone when he is hooked up to the machine.  I have to be here with him, or another adult has to be with him, in case something happens or he needs something.  I figure that should give me the time to clean, do laundry, and cook, since I’m home anyway, right?  No excuses.  There is no excuse.  There is no reason that I shouldn’t be getting everything done every night.

These are the things I say to myself all the time.  Then tonight, as I sat here,  I heard that sound a record makes when the needle scratches it.  You know the sound, if you are old enough.  Now, I didn’t really hear that sound…it was in my head.  But I noticed the negative chatter in my head and stopped myself.  What is wrong with me?  I never stop, and yet it still isn’t good enough for me.  The house isn’t clean enough, I don’t cook enough, I don’t keep up with the laundry, I’m not giving enough time/money/attention/experiences to my kids, I’m not giving enough time/attention to my husband, I’m not making enough money, so I can’t provide enough.  I also tear myself apart because of what other people might think.  They’ll think I’m lazy, or dirty, or simply not good enough.  I make it seem like I can handle it all just fine, but I really can’t.  Why is that not okay?

Honestly, I don’t know how to fix it all.  I’m trying to accept that this is my life for now.  My house will be messy, the laundry won’t be completely done, we will eat take out more than we should, and if other people come over, they will have to tolerate the mess.  People will always judge what they haven’t lived.  I’m judging it, and I live it.  I’m just trying to get myself to the point where I can say “enough is enough,” and be okay with just doing the best I can for now.

Adjustments

It’s been almost 8 years since my husband’s disease was discovered.  It’s been a long 8 years, full of learning experiences I never thought we would ever have to endure.   I’ve learned how very possible it is to get through every day life, struggling with exhaustion, or finances, or lack of time, or situations out of our control.  I know what it’s like to continually take one step forward and two steps back.  I know what it’s like to make sure my kids have a good childhood, with interesting experiences, unique opportunities, and the chance to become the people their souls are meant to become, all while living with a fathers’ illness that invades every part of our lives.  Life has been an ongoing struggle between dealing with a sick spouse, the loneliness of losing people in our lives who can’t deal with it, grieving the loss of our dreams, and living every day life, raising kids, enjoying what we can, and just keeping on going whether it’s an easy day or a hard day.

The hardest lesson has probably been acceptance of how this disease has changed our marriage.  Eight years of spousal illness takes a rough toll on a marriage.  Both of us are dedicated to each other until the end.  There is no question of that.  We love each other and we are both loyal to each other.  But life has changed for us.  My husband sleeps all the time.  When he is awake, he has no energy, or he has energy for short amounts of time.  He is on so many medications that he is often in a zone and not really hearing what I’m saying, nor responding to me.  He is in pain almost all the time.  It never goes away completely.  For all the exhaustion he has, he never sleeps well because he can’t get comfortable.  It’s really hard to watch your husband suffer every single day.  I get tired of it all. Sometimes, I just want to get out of the house so I don’t have to look at him like that.  There are days I want to scream out of frustration…frustration that he isn’t talking to me or listening to me, frustration that he can’t do much to help me out, frustration that it will never get better.  It’ll only get worse.  We likely won’t grow old together, and get to do the things we used to talk about doing when we retired.

There have been many times that I felt alone with all these frustrations, grieving the loss of a marriage that won’t be what we had hoped.  But, he deals every day with illness.  He never feels good, he is always wiped out and exhausted, he is bored being home alone all day while we are at work or school.  He wants to be included when we go out and do things, even though he doesn’t always have the stamina to keep up, and often wants to come home early.  There are times I need to get out of the house and away from the disease, so I don’t ask him to go.  I want to go out, and not have to worry about whether he is tired or in pain and needing to leave early.  We recently had a conversation in which he told me that it makes him sad when we do things and don’t invite him.  Honestly, I hadn’t really thought about it…I needed to get out, and I figured he wouldn’t want to go because he’s sick and can hardly stay awake.  I didn’t always think about asking him.

It made me realize how important the little things are when you are in this situation.  We can’t easily do the big things any more.  I don’t remember the last time we had a date night, or went away for a weekend, or did something fun together. Now, I’m happy when we have a ten minute conversation and he is awake and paying attention.  I’m really happy when he acknowledges the things I do around the house, or the little things I do to help him out, or when he brings me a candy bar just because I know he was thinking of me.  He is happy if I go to Walmart with him, or ask him if he wants to go with us somewhere, or if we pick up sandwiches and eat lunch together.

Life with a sick spouse is all about adjustments.  If you can’t adjust to a situation, you’ll never make it.  A simple shift in the mind can make all the difference in how peaceful your life is.  We have made small changes in order to make life a little easier for each other.  There will be more challenges and crises down the road, but if we do what we can for each other along the way, even little things, those challenges will be that much easier.

Out Of The Ashes

Living in a household affected by chronic illness is challenging, stressful, frustrating, and sometimes next to impossible.  It often feels like a jail sentence from which there is no escape.  But over the past almost seven years, my family has experienced amazing acts of kindness that we may not have seen if all had been well in our world.

In October of 2010, my husband wound up in the hospital with a failing kidney.  It was decided that he needed a nephrostomy tube placed through his back and into his kidney to allow it to drain properly.  His tumor had occluded his ureter and his kidney was swollen.  It was the only thing they could do to save his kidney function on that side.  We didn’t know it at the time, but that was the turning point for his disease and we had yet to feel the full impact on our family.  Meanwhile, I had a hip resurfacing surgery scheduled for early November that year, and we decided I should keep the surgery date and get it done before he was any sicker and I couldn’t take the time to do it.  I had surgery, and a few weeks later, my hip fractured, and I had to return to surgery for a total hip replacement.  My second surgery was 10 days before Christmas, and my sick time had run out.  Neither of us had any income coming in.  With three young kids, and no income, the stress of Christmas was the highest it had ever been.

One day, a letter came in the mail, addressed to me.  I opened it and found $500 with a note saying that it was so my children could have a nice Christmas.  It was signed, “Santa.”  I felt the tension release from my shoulders immediately, and was so excited that I could buy them presents to put under the tree.  A week or so after that, we found a gift basket full of cheese, crackers, snacks, and assorted other goodies, left inside our back door.  There was no note and we had no idea who had left it for us.  We put it under the tree to save for another day.  We decided to open it a few days before Christmas.  At the bottom of the basket was a green gift box.  I opened the box and found $800 in cash.  To this day, we don’t know who left those for us.  But whoever it was, they were our Christmas angels that year, and we will be forever grateful for their kindness and generosity.  That was the most stressful two months of our lives.  Our world had completely fallen apart, and yet out of the ashes came hope, love, and incredibly kind gestures that made all the difference to us that Christmas.

Over the years since my husband got sick, we have been the recipients of numerous kindnesses from many people.  Our friend celebrated her 40th birthday, and asked all of her friends and family to donate money to help us, in lieu of gifts for herself.  Our parents have helped us out numerous times when we were in a bind.  They have paid our mortgage at times, bought us heating oil, bought us appliances when ours had broken, and my awesome uncle even gave me a car when mine had died.  Friends gave us money this past Christmas and we were able to buy heating oil and pay some bills.  My parents treated us to a Disney vacation,  have taken us on vacation to the beach in North Carolina, and my husband’s parents treated us this summer to a vacation in Vermont.  The list goes on and on.  People have made us dinners, and taken our kids to do things, and helped with projects around the house.  Every gesture of kindness has been very much appreciated and drastically reduced our stress during those tough times.

Families dealing with chronic illness tend to get caught up in the day to day stress of trying to keep their lives as normal as possible, even though their lives are anything but normal.  It helps to take a step back sometimes and look at the good that has come out of a tragic situation.  We have had friends come into our lives who have provided companionship, laughter, and time away from “the disease.”  Anonymous people have come through to help us when we needed it most.  We all have a choice to get lost in the rubble, or to stand up and see the beauty that can come from the same mess. We were dealt a crappy hand, but because of that hand, we have also been given the profound gift of friendship, love and generosity.  THAT is the true gift.

Signs

A Prayer for the Caregiver
by Bruce McIntyre

Unknown and often unnoticed, you are a hero nonetheless.
For your love, sacrificial, is God at his best.
You walk by faith in the darkness of the great unknown,
And your courage, even in weakness, gives life to your beloved.
You hold shaking hands and provide the ultimate care:
Your presence, the knowing, that you are simply there.
You rise to face the giant of disease and despair,
It is your finest hour, though you may be unaware.
You are resilient, amazing, and beauty unexcelled,
You are the caregiver and you have done well!

 

Several years ago I was on vacation in North Carolina with my husband, kids, parents and my aunt and her boyfriend.  One night after dinner we went around the table and asked each other the questions that James Lipton asks celebrities at the end of the TV show, Inside The Actor’s Studio.  The last question he asks is, “If  heaven exists, what would you like to hear God say when you arrive at the pearly gates?”  My answer to that question was that I’d like to hear the words, “You did a good job.”  I’ve always tried to do a good job, whether it was raising my kids, being productive at work, or just by being kind to everyone.  I’ve always tried to be a good person and do the right thing.

I’m not a religious person.  I’ve never had use for organized religion, but I definitely believe in God and consider myself a spiritual person.  My relationship with God is personal, and I don’t feel a need to share it with other people.  However, in my daily life when I’m struggling with a decision, or unkind feelings, or coping with stress, I frequently ask myself what God would want me to do.  Daily life with a sick spouse can be filled with stress, frustration, anger, resentment, sadness, loneliness, isolation, and exhaustion.  This is especially true when your day also includes raising children, managing a household, and working.

Over the past several months, it’s been a real struggle for me to deal with the resentment I have for my husband, our life together, and my life personally due to an illness we have no control over.  I’ve watched my husband go from a man who was always extremely energetic, busy, and on the go from morning until night, become a man who has so little energy that even the shortest tasks exhaust him.  I’ve watched him go from the life of the party to someone who stares into space, wanders around the house, and sleeps for long periods of time.  It’s extremely hard not to feel resentful when I’m running around taking care of the daily needs of three kids, myself, my husband, a household, and be responsible to go to a job.  I often feel like he is here physically, but his mind is tuned out.

I resent that everything is on my shoulders.  My plate is overflowing.  It makes me not want to do things for him.  I do it anyway.  It makes me want to run for the hills sometimes.  I daydream about what it would be like to run away from it all.  But I stay.  It makes me fantasize about life after the illness, when he’s gone someday.  That will be an awful day, but it will be liberating, too.  All of these things make me feel guilty.  It’s a daily struggle, a never ending cycle of resentment, fantasy, guilt.  We aren’t even at the point that my husband needs personal care, but I’m overwhelmed.  I had breakfast yesterday with my friend Yvonne.  She is my dear friend of 41 years.  I told her all of this and said, “I’m not even really his caregiver yet.”  Her response was, “you still have the mental stress.”  That acknowledgement was priceless for me.

I came home from breakfast and found the above poem.  I believe that sometimes God sends signs.  I believe that poem was a sign for me.  “For your love, sacrificial, is God at his best.” That line changed my entire perspective.  God works through us to help people who need it most.  It made me remember that question that I hadn’t asked myself in a while…what would God want me to do?  My husband is in need of someone to be here for him, not only to meet his physical needs, but emotional support, and to provide a home environment where it’s okay to feel lousy, and sleep, and just be sick.   When the days get rough, and the stress gets high, I will read this poem to remind myself of the good I’m doing for my husband and the example I’m setting for my children.  I’m sure there will be many days that are a challenge for me.  I’m only human.  Hopefully, there will be fewer days of resentment, and more days appreciating the time I have with my husband and making his years as comfortable as possible.

The Noose

In November of 2007, I returned to the workforce after staying home with my three kids for ten years.  My youngest child was in Kindergarten, and I needed something beyond the mommy and household stuff.  I also wanted to start contributing financially.  We had decided to sacrifice lots of things, especially money and the “extras” it can buy, so I could be home with our kids.  It was extremely important to us.  Two weeks after I returned to work, my husband’s tumor was discovered.  In addition to the toll on my husband’s health and the incredible stress it placed on the family emotionally, it began to destroy any hopes we had of financial freedom.  Over the past almost 7 years, any hope of financial freedom is gone, and has been replaced with the dream of just being able to be comfortable every month.  By comfortable, I mean that the mortgage and monthly bills are paid, we have enough food on the table, and perhaps we can do a few fun things during the month.  Our hopes of providing college educations to our children, or going on great vacations, or giving our daughters big, beautiful weddings are gone.  I don’t know if I will ever be able to retire.

We are in survival mode and have been every single month since my husband stopped working in October of 2009.  It’s a way of life for us.  It is possibly the absolute most stressful part of my life.  It’s like constantly dangling from a noose, trying to hold yourself up so you don’t suffocate. In addition to raising three kids, managing a household, and dealing with an ill husband, I work to try to make ends meet.  Medical retirement and disability payments barely cover the mortgage and food.  There have been times we considered shopping at the food bank.  We get energy assistance so our electricity doesn’t get shut off in the winter.  Our kids qualify for free or reduced lunch.  We didn’t pay our mortgage for 6 months, and still could barely make it.  We get free stuff for our household from the dump.  When we have a little extra, we do something fun so our kids don’t have to miss out all the time.  We do our best to give them things, and as a result we sacrifice what we want, or live with that much more stress.  They only get one childhood, and I refuse to make them feel “poor,” or let them feel as if they are missing out.

My husband and I have both worked since we were about 12 years old.  We both have a good work ethic, and we do what we need to do to provide for our family.  We always paid our bills, and were responsible with our money.  Then the illness took it all away.  I have sat around dinner tables where people talked about how “irresponsible” people are who “live beyond their means” or don’t “keep up with their mortgage.”  They criticize people who need help with mortgage programs, or who “live off the government.”   Comments are made by people who have no idea what it’s like to be in that situation.  People judge with no regard to the facts.  They judge people who would do anything to be healthy and provide for their family.  Living this way isn’t laziness or irresponsibility.

We commonly hear comments from friends or family members who complain about how they struggle or how upset they are over some financial stress they are having.  These same people are hiring people to clean their houses, or are taking their kids out to eat or to some fun event several times a week.  They are planning multiple vacations every year, and buying new cars.  I even had one person tell me they were a little upset that they are now making so much money that they are in a new tax bracket and no longer qualify for the child tax credit.  Their tax refund was going to be less this year.  I sat there like an asshole and gave sympathy, when what I really wanted to say was that I would literally give one of my arms to be in the next tax bracket, rather than struggling every damn day of my life.  I had just told her that we qualified for a new child tax credit because we are low income.  These same people know how hard it is for us.  Sort of.

 

There is a shame that goes along with the way we are living.  I don’t know why.  Shame implies that we have done something wrong.  We haven’t.  We’ve tried to do everything right for ourselves and for our children.  I never, ever share our true financial story with anyone.  We pretend it isn’t as bad as it is. People have some idea, but they don’t know what it’s really like.  It’s exhausting and hopeless and depressing and frustrating.  The stress leaves me teetering at the edge sometimes.  Yet, somehow, we always make it through.  We are lucky to have some family and friends who have been Godsends at times.  There are times we wouldn’t have made it without them.  The struggle is never ending, and sometimes people get tired of helping.  We don’t know if we will ever be able to repay people for what they’ve done to help us.  There is no end in sight to the struggle.  We try to pay it forward and help other people when we can.

People talk openly about the physical, emotional and psychological effects of chronic illness on themselves and their families.  But when it comes to money, people keep it to themselves.  Yet, I suspect it’s one of the most detrimental aspects of living with chronic illness for everyone involved.  It is by far the most stressful part of my life and affects my mood, stress level, health and outlook on life every single day.  The nonchalant comments from other people make it even worse.  I don’t know what the solution is, but putting it out there without shame is a good start.

Abandonment

As I’ve written about in previous blog posts, I have a chronically ill husband.  It’s not a disease that will go away.  It’s progressive and incurable at this point.  It can be manageable, but it’s also unpredictable, and some days are good days and some days are bad days.  Chronic illness affects families in many different ways.  Patients and spouses go through many emotions at different times.  An ongoing theme that I’ve noticed affects both my husband and I, and has a ripple effect on the people in our lives, is abandonment.  We abandon and we feel abandoned.  I can’t speak for my husband, but I can share what it’s like for me.  I have always kept this stuff bottled up inside me for many reasons.  I feel like I have to be strong and be able to handle everything.  But I can’t.  I don’t want people who leave me out, to know I feel abandoned because I don’t want them to feel bad.  So, I feel bad instead.  I feel guilty for having less than stellar emotions.  I don’t know why.  I’m human and entitled to be negative at times, and feel sadness, and feel upset with people.  Mostly, I don’t want other people to worry about me, or have my hard times affect their happy lives.  I know in my head that I shouldn’t feel this way, but since when does that matter?  We feel what we feel.  That is one of the reasons I write.  It’s therapeutic for me, and I think it helps other people who are going through the same thing.  Writing lets me get out my feelings without having to say them.  It’s easier for me.

One of the hardest things that I have gone through over the past 6 ½ years, is the feeling of being abandoned.  There are people who I have thought would be there for me who have not.  I don’t think it’s necessarily intentional, but nothing hurts more than people you care about becoming scarce when you are left to hold together a family affected by illness.  There have been many people who have stepped up and been great supports to us, and for that we will be forever grateful.  But there are others who have not.  My husband has told me that he feels left out of things, and he says it doesn’t bother him, but I think it does.  I know it bothers the hell out of me when I feel left out.  It happens frequently.  We aren’t sure why.  Maybe people think we can’t afford something, or he won’t be up to it, or maybe we just aren’t as fun because we can’t do everything everyone else does.  We wish people would invite us to do things and leave it up to us to decide if we can or not.  Sometimes we will be able to, and other times not.  I need to get out and keep living my life and do fun things.  He is still living and he should get out and do things, too.

Abandonment goes in both directions.  I work, take care of a household, and I’m busy with three older children who have places to go and activities to do.  I’m also looking for a better job.  Thankfully, my husband is still at a point where he doesn’t need me to be a caretaker, but there are days he doesn’t feel well and I do take care of him.  I spend a large part of my life doing for others, and there are those times when a crisis happens and suddenly there is a trip to the hospital.  Out of necessity, I abandon those things that aren’t of vital importance.  My house tends to be messy…who wants to spend a free day cleaning the stinkin house?  I do whatever amount of laundry needs to be done in order to give us clean clothes for a couple of days.  I’ve also abandoned certain dreams…buying a bigger, nicer house…spending my older years traveling with my husband…retiring, in general.  There are those times, when I don’t feel like doing anything on the weekends, so I don’t seek people out to do things with.  When you spend your weeks always doing, a day off to do nothing is a luxury.  A day to myself, doing anything I want to do is almost unheard of.   Because of this, I have done my share of abandoning some people.  One of the people that I don’t spend nearly enough time with is my Mom.  But she is the one person in my life who I know will NEVER abandon me, no matter what.  It’s not fair to her.   I am going to change that.  The irony of all of this is that I feel abandoned, and the one person who has never abandoned me is the one I leave out.  Sometimes, I just feel like I have nothing left to give.  I’m tired.  There are also times I feel like I’ve abandoned my husband, but again, sometimes I feel like I am depleted of whatever I have to give.  I have also abandoned some of the people who have stopped bothering with us.  That was hard to do, but necessary for my peace of mind.  Sometimes, you just have to let people go.

All of these feelings lead to that old cycle of guilt and resentment.  There are millions of people who are going through an illness with a family member.  We have become a caretaking society…people take care of parents with Alzheimer’s, children with autism and other disabilities, cancer patients, chronically ill family members.  It’s not an unusual thing to have someone in your life that needs to be taken care of.  Someday, YOU may need to be taken care of.  Or you may be taking care of someone.  Take a moment to reach out to someone who is going through this.  Please understand that a lot of times, the person may say no to an invitation.  Keep asking anyway, because it makes a world of difference to know that someone thought of them and took the time to at least ask.  It helps people to not feel abandoned and isolated, and that goes a long way.