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The Heart of Caregiving

Tammie Pough, LMSW

It is a privilege to be working in the behavioral health profession and being able to help those in need. As both a provider and a caregiver, I understand the challenges taking care of another individual and the struggle to make care decisions. Last year, my family and I were faced with the decision to place my father in a skilled nursing facility for short-term rehab after an illness.

Not everyone is emotionally or physically ready to take on the responsibility of being a caregiver. It takes a team effort and you must plan ahead. Having worked in a local hospital as a medical social worker for almost 10 years certainly helped make the process a little easier. Yes, it was hard to make the final decision to have him placed into a skilled nursing facility, but it was the best decision. My mother would have been his primary caregiver, had little experience, and was in no way ready emotionally or physically.

After several weeks in skilled rehab, we had to decide to either bring him back home, or have him remain at the facility. Bringing him home would mean being financially responsible for his 20 percent co-pay as well as his physical care: he was non-ambulatory, peg-tube feeding, Foley Cath, and had a colostomy. He was barely meeting goals for physical therapy. My family and I met with the multidisciplinary team and decided to take him home.

Looking back, what I learned most from this experience is that you must acknowledge when you need help, accept it, and not feel guilty. You must set healthy boundaries and know when you need to take a break or rest.

As a caregiver, it is very important to incorporate self-care into your daily regimen. It is easy to get so wrapped around the needs of the person being cared for, and not care for yourself.

Self-care can be as simple as reading a book, listening to a podcast, physical exercise, eating healthier meals, taking a warm bath or shower, calling a friend for a lunch date, listening to music, praying, or meditation. It is also important to tap into community resources such as caregiver support groups, counselors and therapists, your local church, and other services.

Without a strong support system it can become easy for caregivers to develop compassion fatigue, which includes being physically and mentally exhausted when caring for those who are sick. In my case, it was extremely exhausting to work full-time, take care of my own household and help with my parents’ household, while making sure my dad had his bed baths and colostomy care, and taking care of his wounds. I’d return after work, to administer medications and other needs, as well as to be there emotionally for my mother.

Even when family members are available to assist, caregivers can feel alone and can become sad, angry, frustrated, tired, and unmotivated. It is easy to become depressed. The one thing that helped me most was my faith, but my self-care also included visiting a therapist and joining a local gym. As a caregiver, I needed to recognize my emotional and physical needs. These outlets helped me to start feeling better and gave me a boost in my energy levels. I surrounded myself with positive energy, which lifted me up and encouraged me.

Through this whole process I also learned, that it is very helpful to start early having conversations with family about living wills and health care power of attorney. My father passed away after three months of being home and just one week of being placed under hospice care services. It was not an easy process, but my father wanted to be home and we were able to grant his wishes because we knew what he wanted.

It is helpful to decide who will be the best advocate for the family to talk with the physicians, social workers, and other professionals to make the process easier when needed. Invest in long-term care insurances if it is in your budget.

It was hard for me to let my dad go; to wonder if God even heard my prayers. But then I was reminded he did – but also heard my father’s. My father was tired; he was ready to go.

More and more families are faced with having to take care of their elderly parents. You have to have the heart for it, and learn how to cope. However, having a heart for it does not always mean that you are equipped to do the work. It is so important to remember; you must learn to take care of yourself first because you cannot pour from an empty cup.



Tammie Pough is a licensed master social worker who works as a behavioral health consultant at the HopeHealth Medical Plaza in Florence. She has a passion for loving everyone and is inspired to make a difference in others’ lives through her work.



HopeHealth educates its patients on the importance of having a health care home. As a primary care facility, HopeHealth’s medical team works to prevent and detect illness and the early onset of disease, provide routine physical examinations and promote overall healthy lifestyles.

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