Exhaustion is more than just being tired. It's being tired for weeks, being tired for months.

The people around you can't help but notice if you've become exhausted, or if you're rapidly -- and steadily -- approaching exhaustion. It's not unusual for them to comment on it.

The typical response from the exhausted caregiver is to deny it. Why? Because if you admit the problem, you may be expected to somehow change your behavior. To do something about it. Change seems impossible. And you don't want to do anything that would jeopardize your role as caregiver. You really want to continue to be there for your loved one.

At the same time, exhaustion can bring on a sense of helplessness. A sense of hopelessness. The seemingly awful thought that "I wish all this were over."

The symptoms of exhaustion aren't hard to spot. They would include:

--a feeling of extreme fatigue (even when you do get the chance to sleep, it isn't a restful sleep);

--becoming more emotional, for example, you get angry more quickly and are less patient which increases the risk of abuse and you feel a deep sadness which may lead to depression;

--arguing more with your parent, your spouse, your children, your siblings;

--a change in your eating habits (eating all the time or not eating enough);

--a haggard appearance;

--showing poor judgment;

--having trouble remembering things;

--constantly feeling overloaded and stressed;

--feeling in danger of "crashing," having a fear of breaking down and then not being able to care for your parent, or yourself.

What can you do, especially at a time when you feel you're already doing way too much? These are some suggestions:

--Take a small step back and realize being exhausted isn't good for you personally or for you as a caregiver. An exhausted caregiver can't be a good caregiver. Also, your loved one may be able to see your exhaustion and worry about what he or she is doing to you.

--Give yourself a tiny break. A minute or two. Go into the bathroom, shut the door and wash your face with cool water. Or walk out onto the porch by yourself and take a few deep breaths. Taking a day off may seem impossible, but you can take a one-minute break. And you can build on that. More breaks, longer breaks. It takes time to go from exhausted to well. Start planning what you'll do. Something to look forward to. Take ten minutes while Dad is watching the news; take fifteen while Mom is napping.

--Get help. If you have a sibling who lives a distance, this would be a good time to ask him or her to come back home for a week or two and give you a break. Not that you would go away on a vacation, just be able to take some time off for your front-line caregiver role. (This is assuming your parent isn't critically ill, just heavily dependent on you. This is the time to take a break. You'll want to be with Mom or Dad when his or her condition does become critical.)

--Also, look into respite care. Even a few hours once a week can help a lot.

--Try to get some exercise. A daily walk around the block will make a difference.

--Remember, it's better -- and easier -- to prevent exhaustion than to reach that point and have to come back from it. You're not being selfish if you take breaks, get some exercise, eat right, get your sleep, and ask for help.

--Consider joining a caregivers' support group. Many caregivers find it extremely beneficial. In some cases care for your parent is offered while you attend the group.

--Admit the best way to be a good caregiver, to be good to your parent, is to be good to yourself. If you continue to take care of yourself, you can continue to provide the first-rate, loving, compassionate care you want your loved one to have.