The Best Caregivers Quotes

You see, sometimes in life, the best thing for all that ails you has fur and four legs.

It is at this moment that I realize the best thing I ever did in my life was to marry this woman. She is willing to give up her life for her child. I know most parents would do the same. But how many mothers would give up everything that they love, everything that they will ever be able to do in the future for the “possibility and not the guarantee” of getting their child better. Now reduce the odds of success to less than 1%. How many mothers are still standing? She is.

Intensive mothering is the ultimate female Olympics: We are all in powerful competition with each other, in constant danger of being trumped by the mom down the street, or in the magazine we're reading. The competition isn't just over who's a good mother--it's over who's the best. We compete with each other; we compete with ourselves. The best mothers always put their kids' needs before their own, period. The best mothers are the main caregivers. For the best mothers, their kids are the center of the universe. The best mothers always smile. They always understand. They are never tired. They never lose their temper. They never say, "Go to the neighbor's house and play while Mommy has a beer." Their love for their children is boundless, unflagging, flawless, total. Mothers today cannot just respond to their kids' needs, they must predict them--and with the telepathic accuracy of Houdini. They must memorize verbatim the books of all the child-care experts and know which approaches are developmentally appropriate at different ages. They are supposed to treat their two-year-olds with "respect." If mothers screw up and fail to do this on any given day, they should apologize to their kids, because any misstep leads to permanent psychological and/or physical damage. Anyone who questions whether this is the best and the necessary way to raise kids is an insensitive, ignorant brute. This is just common sense, right?

I’m in a caregiver's relationship with my body, a perpetual internal gauging of wellness. My spine is Hogarth’s thermometer. I ascend and descend its rungs a hundred times a day, reading the mercury level. The same dis-ease speaks many languages. If you block one mouth, another will speak. The symptoms represent differently, and as I get older, my translation changes. The prescription changes. Must be vigilant. Must be my best nurse.

But no matter how carefully we schedule our days, master our emotions, and try to wring our best life now from our better selves, we cannot solve the problem of finitude. We will always want more. We need more. We are carrying the weight of caregiving and addiction, chronic pain and uncertain diagnosis, struggling teenagers and kids with learning disabilities, mental illness and abusive relationships.

...above all, let your focus be on remaining a full person. Take time for yourself. Nurture your own needs. Please do not think of it as 'doing it all'. Our culture celebrates the idea of women who are able to 'do it all' but does not question the premise of that praise. I have no interest in the debate about women doing it all because it is a debate that assumes that caregiving and domestic work are singularly female domains, and idea that I strongly reject. Domestic work and caregiving should be gender-neutral, and we should be asking not whether a woman can 'do it all' but how best to support parents in their dual duties at work and at home.

The better looking you are the harder your life, under one condition: You're of above average intelligence. It's those unintelligent attractive people who have it best.

An exhausted parent can’t provide the best care, although occasionally, we have all had to do so.

Many caregivers share that they often feel alone, isolated, and unappreciated. Mindfulness can offer renewed hope for finding support and value for your role as a caregiver…It is an approach that everyone can use. It can help slow you down some so you can make the best possible decisions for your care recipient. It also helps bring more balance and ease while navigating the caregiving journey.

I want that person you knew to return. But the truth is, this may be the best we achieve. Today, having her here and comfortable and not agitated…that may be as good as we get. Are you okay with that?

Whoa! The idea that your partner is really a composite of your parents can be a bit upsetting at first. Though we love our parents, most of us got over (consciously) wanting to marry them when we turned five or six. Then, when we hit our teenage years, all we wanted was our freedom. But the fact is, we’re unconsciously drawn to that special someone with the best and worst character traits of all of our caregivers combined. We call this our “Imago”—the template of positive and negative qualities of your primary caregivers.

I hope he can make it through this first night in an empty house, which is always the worst. If my clients are afraid of dying, then my clients’ caregivers fear being alone. There is something bleak and barren about a world that is missing the person who knows you best.

Physicians, nurses, and other caregivers often do not know the costs associated with their treatment protocols. And administrators rarely collaborate with them to develop outcome and cost measurements that would facilitate benchmarking and best-practice-sharing opportunities.

He was having one of those lucid moments that make you, as a loved one of an Alzheimer's victim, forget for a minute or two that this is all really happening. You can forget about the disease and its toll and confusion and suddenly engage with the same person with whom you conversed profoundly for so many years, until it all started to go haywire. In that moment I wanted to know what I think so many Alzheimer's caregivers crave to understand: Do you know what has become of you? Can you, so lucid now, see how you act when you are not like you are now? Does it make you sad? Does it make you ashamed? The reprieve right there at the red light was momentary, even illusory. But there for the taking, right in front of me--so obvious that I almost panicked over what to talk about. Do we discuss his beloved baseball? His beloved grandchildren? Me--how I'm doing, how much I miss him? No. As much out of curiosity as concern, I wanted to talk about him. "Dad," I said, "you are losing your mind. You know that. How does that make you feel? How are you doing with that?" "I'm doing the best I can with what God has given me," he said.

sacred pathways Naturalist — finds God in nature Ascetic — is drawn to disciplines Traditionalist — loves historical liturgies Activist — comes alive spiritually in a great cause Caregiver — meets God in serving Sensate — senses God through five senses Enthusiast — loves to grow through people Contemplative — is drawn to solitary reflection and prayer Intellectual — loves God by learning (For more information on these categories, read

While women suffer from our relative lack of power in the world and often resent it, certain dimensions of this powerlessness may seem abstract and remote. We know, for example, that we rarely get to make the laws or direct the major financial institutions. But Wall Street and the U.S. Congress seem very far away. The power a woman feels in herself to heal and sustain, on the other hand--"the power of love"--is, once again, concrete and very near: It is like a field of force emanating from within herself, a great river flowing outward from her very person. Thus, a complex and contradictory female subjectivity is constructed within the relations of caregiving. Here, as elsewhere, women are affirmed in some way and diminished in others, this within the unity of a single act. The woman who provides a man with largely unreciprocated emotional sustenance accords him status and pays him homage; she agrees to the unspoken proposition that his doings are important enough to deserve substantially more attention than her own. But even as the man's supremacy in the relationship is tacitly assumed by both parties to the transaction, the man reveals himself to his caregiver as vulnerable and insecure. And while she may well be ethically and epistemically disempowered by the care she gives, this caregiving affords her a feeling that a mighty power resides within her being. The situation of those men in the hierarchy of gender who avail themselves of female tenderness is not thereby altered: Their superordinate position is neither abandoned, nor their male privilege relinquished. The vulnerability these men exhibit is not a prelude in any way to their loss of male privilege or to an elevation in the status of women. Similarly, the feeling that one's love is a mighty force for the good in the life of the beloved doesn't make it so, as Milena Jesenka found, to her sorrow. The feeling of out-flowing personal power so characteristic of the caregiving woman is quite different from the having of any actual power in the world. There is no doubt that this sense of personal efficacy provides some compensation for the extra-domestic power women are typically denied: If one cannot be a king oneself, being a confidante of kings may be the next best thing. But just as we make a bad bargain in accepting an occasional Valentine in lieu of the sustained attention we deserve, we are ill advised to settle for a mere feeling of power, however heady and intoxicating it may be, in place of the effective power we have every right to exercise in the world.

But no matter how carefully we schedule our days, master our emotions, and try to wring our best life now from our better selves, we cannot solve the problem of finitude. We will always want more. We need more. We are carrying the weight of caregiving and addiction, chronic pain and uncertain diagnosis, struggling teenagers and kids with learning disabilities, mental illness and abusive relationships. A grandmother has been sheltering without a visitor for months, and a friend's business closed its doors. Doctors, nurses, and frontline workers are acting as levees, feeling each surge of the disease crash against them. My former students, now serving as pastors and chaplains, are in hospitals giving last rites in hazmat suits. They volunteer to be the last person to hold his hand. To smooth her hair. The truth if the pandemic is the truth of all suffering: that it is unjustly distributed. Who bears the brunt? The homeless and the prisoners. The elderly and the children. The sick and the uninsured. Immigrants and people needing social services. People of color and LGBTQ people. The burdens of ordinary evils— descriminations, brutality, predatory lending, illegal evictions, and medical exploitation— roll back on the vulnerable like a heavy stone. All of us struggle against the constraints places on our bodies, our commitments, our ambitions, and our resources, even as we're saddled with inflated expectations of invincibility. This is the strange cruelty of suffering in America, its insistence that everything is still possible.

Diabetes is a disease that separates warriors from the rest. There are no days off from it. At best it is manageable; at worst it’s the greatest weight and discouragement that can be felt. A person with diabetes is born with a special purpose. As someone who has walked this path, I see all the mothers, fathers, caregivers and those who struggle with the disease. I understand your pain and desire to give you hope. This bond connects us and serves as a support for those days I lose hope as well. You will never do it alone.

PLACEMENT The Physical Transference of Care and Saying Good-bye "A toddler cannot participate in a discussion of the transition process or be expected o understand a verbal explanation. [They benefit] tremendously by experiencing the physical transference of care, and by witnessing the former caregiver's permission and support for [their new guardians] to assume their role. The toddler pays careful attention to the former caregiver's face and voice, listening and watching as [they talk] to [their new guardians] and invites the [guardians'] assumption of the caregiver's role. The attached toddler is very perceptive of [their] caregiver's emotions and will pick up on nonverbal cues from that person as to how [they] should respond to [their] new family. Children who do not have he chance to exchange good-byes or to receive permission to move on are more likely to have an extended period of grieving and to sustain additional damage to their basic sense of trust and security, to their self-esteem, and to their ability to initiate and sustain strong relationships as they grow up. The younger the child, the more important it is that there be direct contact between parents and past caregiveres. A toddler is going to feel conflicting loyalties if [they] are made to feel on some level that [they] must choose between [their] former caregiver and [their] new guardians ...

Patriarchy creates coercive background conditions for women, and thus patriarchy, not capitalism, is to blame for women’s exploitation under capitalism. Women are exploited under capitalism because they are forced by gendered expectations of women’s place into segregated spaces. In the home, gendered expectations about what women ought to do causes them to devote more time and energy to caring activities. Not only are women expected to be the main source of childcare and domestic labor in the home, they are also the psychic caregivers, coordinating social, spiritual, and emotional efforts for families. Their doing this explains the exploitation of women qua women in capitalism. The best evidence for this claim is that women in other economic systems are also exploited. For example, in the Soviet Union women were exploited for their domestic and sexual labor despite living under a noncapitalist economic system.121 I do not mean to say that there is no economic or material component to women’s condition. Women are stuck in these roles in part for material and economic reasons; they do not have enough bargaining power within heterosexual relationships generally to escape these roles. If women are able to gain an economic foothold, as is possible in an enlightened capitalism that eschews discrimination and gender segregation, then they can begin to work their way into better bargaining positions in their homes. And with better bargaining outcomes in their domestic lives, women can do better in the capitalist economy. Thus, capitalism does not provide an easy escape route, but it does point in the direction of escape from patriarchy.

I’ll say it: I am lucky enough to not have to work, in the sense that Jesse and I could change how we organize our life to live on one income. I work because I like to. I love my kids! They are amazing. But I wouldn’t be happy staying home with them. I’ve figured out that my happiness-maximizing allocation is something like eight hours of work and three hours of kids a day. It isn’t that I like my job more than my kids overall—if I had to pick, the kids would win every time. But the “marginal value” of time with my kids declines fast. In part, this is because kids are exhausting. The first hour with them is amazing, the second less good, and by hour four I’m ready for a glass of wine or, even better, some time with my research. My job doesn’t have this feature. Yes, the eighth hour is less fun than the seventh, but the highs are not as high and the lows are not as low. The physical and emotional challenges of work pale in comparison to the physical and emotional challenges of being an on-scene parent. The eighth hour at my job is better than the fifth hour with the kids on a typical day. And that is why I have a job. Because I like it. It should be okay to say this. Just like it should be okay to say that you stay home with your kids because that is what you want to do. I’m well aware that many people don’t want to be an economist for eight hours a day. We shouldn’t have to say we’re staying home for children’s optimal development, or at least, that shouldn’t be the only factor in the decision. “This is the lifestyle I prefer” or “This is what works for my family” are both okay reasons to make choices! So before you even get into reading what the evidence says is “best” for your child or thinking about the family budget, you—and your partner, or any other caregiving adults in the house—should think about what you would really like to do.

Having a TV—which gives you the ability to receive information—fails to establish any capacity for sending information in the opposite direction. And the odd one-way nature of the primary connection Americans now have to our national conversation has a profound impact on their basic attitude toward democracy itself. If you can receive but not send, what does that do to your basic feelings about the nature of your connection to American self-government? “Attachment theory” is an interesting new branch of developmental psychology that sheds light on the importance of consistent, appropriate, and responsive two-way communication—and why it is essential for an individual’s feeling empowered. First developed by John Bowlby, a British psychiatrist, in 1958, attachment theory was further developed by his protégée Mary Ainsworth and other experts studying the psychological development of infants. Although it applies to individuals, attachment theory is, in my view, a metaphor that illuminates the significance of authentic free-flowing communication in any relationship that requires trust. By using this new approach, psychologists were able to discover that every infant learns a crucial and existential lesson during the first year of life about his or her fundamental relationship to the rest of the world. An infant develops an attachment pathway based on different patterns of care and, according to this theory, learns to adopt one of three basic postures toward the universe: In the best case, the infant learns that he or she has the inherent ability to exert a powerful influence on the world and evoke consistent, appropriate responses by communicating signals of hunger or discomfort, happiness or distress. If the caregiver—more often than not the mother—responds to most signals from the infant consistently and appropriately, the infant begins to assume that he or she has inherent power to affect the world. If the primary caregiver responds inappropriately and/or inconsistently, the infant learns to assume that he or she is powerless to affect the larger world and that his or her signals have no intrinsic significance where the universe is concerned. A child who receives really erratic and inconsistent responses from a primary caregiver, even if those responses are occasionally warm and sensitive, develops “anxious resistant attachment.” This pathway creates children who feature anxiety, dependence, and easy victimization. They are easily manipulated and exploited later in life. In the worst case, infants who receive no emotional response from the person or persons responsible for them are at high risk of learning a deep existential rage that makes them prone to violence and antisocial behavior as they grow up. Chronic unresponsiveness leads to what is called “anxious avoidance attachment,” a life pattern that features unquenchable anger, frustration, and aggressive, violent behavior.

Everyone knows what earthly success looks like - money, objects, acclaim. But only a special few understand true success, found inside us, attainable only by those fearless enough to follow their heart to become the best at what they care about most.

We need to be much more vigilant and aware of the risks inherent in touting the importance of family involvement and family care. Too easily, those calls can be reinterpreted to mean that the only care worth supporting is that provided by relatives, inadvertently demonizing and pathologizing the use of paid attendants. This is not to say that family members who provide attendant care for their disabled relatives should not themselves be compensated for their work; indeed, I support consumer-directed attendant services that allow disabled people to hire their own attendants, including family members. But, as Laura Hershey explains, seeing attendant care as something best provided by a family member too easily perpetuates the idea that disability is a private problem concerning the family that has no place in the public sphere. This attitude, in turn, leads to the continued devaluation of caregiving; abysmal wages and working conditions are justified on the basis that family members—almost always women—would be doing this work anyway and therefore any compensation, no matter how meager, is sufficient.

But once we take into account the detailed picture - poor quality wage work (low pay, lack of control over schedules, high stress); regular & persistent care gaps; children's happiness & well-being; the intensity of school work & the huge importance accorded to school examinations - we see more clearly why many women in low-income circumstances decide against employment. Their children, like children from higher-income households, need reliable, trustworthy caregivers. They, like parents with more means, have aspirations for children & want them to be the best they can be.

Once, after Briar tried zucchini for the first time, Emira stood in front of her high chair and asked the toddler if she liked it. Briar chewed with her mouth open and looked all over the room as she articulated her response. "Mira? how, how...because--how do you know when you like it? Who says when you like it?" Emira was fairly certain that the caregiver-approved answer was something like, You'll figure it out, or, It'll make sense when you're older. But Emira wiped the toddler's chin and said, "That's a really good question. We should ask your mom." She honestly meant it. Emira wished that someone would tell her what she like doing best.

While in the hospital or a skilled nursing facility your care recipient is not at her strongest, physically or cognitively; therefore, looking out for her best interests is more critical during these times.

If a boy escaped the fire with the basket, or if a girl fled the flames with the bow, then the tribe would know the child’s true nature, and the child would be honored for being a perfect and unique balance of male and female, neither one nor the other, but something more—a third gender, one thought to possess two spirits instead of one. The child, it was believed, would grow to be the tribe’s best protector, teacher, healer, provider, and caregiver. The child would forever be respected and revered.” Gran’s hands fell into her lap. “But that was long ago.

In fact I have found that the best way to revitalize many stalled service-excellence initiatives in hospitals is to make this shift in emphasis from the caregiver’s service to the patient’s experience.

I anticipate diagnostic AI will exceed all but the best doctors in the next twenty years. This trend will be felt first in fields like radiology, where computer-vision algorithms are already more accurate than good radiologists for certain types of MRI and CT scans. In the story “Contactless Love,” we see that by 2041 radiologists’ jobs will be mostly taken over by AI. Alongside radiology, we will also see AI excel in pathology and diagnostic ophthalmology. Diagnostic AI for general practitioners will emerge later, one disease at a time, gradually covering all diagnoses. Because human lives are at stake, AI will first serve as a tool within doctors’ disposal or will be deployed only in situations where a human doctor is unavailable. But over time, when trained on more data, AI will become so good that most doctors will be routinely rubber-stamping AI diagnoses, while the human doctors themselves are transformed into something akin to compassionate caregivers and medical communicators.

We came to understand that this was the primary way in which Gloria’s foster caregivers had managed her when she was young; getting candy was the closest Gloria got to being loved. Our brains develop as a reflection of the world we grow up with. You love others the way you’ve been loved. Gloria was merely showing love to her daughter the best way she knew. The caseworker continued, “She knows that she is not supposed to do that. This child is prediabetic. This is abusive.” “No,” I said. “It’s sugar-free candy.” Clearly, this caseworker, new to Tilly and likely dealing with sixty other cases, had not read the most recent reports.

Attachment theory can too easily segue into mother-blaming, so I want you to understand that this lack of a sense of safety doesn't have to be the caregiver's (read 'mother's') fault; a parent and a baby are two different people, and sometimes, with the best will in the world, two people can be a bad fit for each other. Misrecognition is very often mutual.

When we make a conscious effort to be our best selves and to set aside our differences, we encourage our loved ones to do the same. The reward is lasting, loving relationships.

Your caregiver can only give of themselves so much, so support them too! Show them your gratitude often and remember that National Caregivers Day is the Third Friday in February!

Experience is not the best teacher. An examined experience is the best teacher because it enables you to deduce how you can correct your mistakes in the present, and how you can live better in the future.

As Sullivan and colleagues wrote, “attachment [by such an infant] to the caretaker has evolved to ensure that the infant forms a bond to that caregiver regardless of the quality of care received.” Any kind of mother in a storm. If this applies to humans, it helps explain why individuals abused as kids are as adults prone toward relationships in which they are abused by their partner. Why is it that about 33 percent of adults who were abused as children become abusers themselves? Again, useful psychological insights abound, built around identification with the abuser and rationalizing away the terror: “I love my kids, but I smack them around when they need it. My father did that to me, so he could have loved me too.” But once again something biologically deeper also occurs—infant monkeys abused by their mothers are more likely to become abusive mothers.

As with all mammals and many other animals, it was simply the natural order of things that the innate attachment drive itself bonded the young with caregivers — adults of the same species — until maturity. That is nature's way of ensuring the survival of the young into healthy adulthood. It is the context in which the young are fully enabled to realize their genetic potential and in which their instincts are best given full and vigorous expression. In our society, that natural order has been subverted. From an early age, we thrust our children into many situations and interactions that encourage peer orientation. Unwittingly, we promote the very phenomenon that, in the long term, erodes the only sound basis of healthy development: children's attachment to the adults responsible for their nurturing. Placing our young in a position where their attachment and orienting instincts are directed toward peers is an aberration.

In his best-selling 1928 parenting guide, Psychological Care of Infant and Child, Watson holds forth on how to raise a child “who loses himself in work and play, who quickly learns to overcome the small difficulties in his environment . . . and who finally enters manhood so bulwarked with stable work and emotional habits that no adversity can quite overwhelm him.” Here’s Watson’s advice: “Never hug and kiss them. Never let them sit in your lap. If you must, kiss them once on the forehead when they say good night. Shake hands with them in the morning. Give them a pat on the head if they have made an extraordinarily good job of a difficult task.” Watson further recommends letting children cope with problems on their own “almost from the moment of birth,” rotating different caregivers to prevent unhealthy attachment to any one adult, and otherwise avoiding the coddling affection that prevents a child from “conquering the world.

An informed parent or caregiver becomes empowered, and empowerment can lead to the best care for our children.

Caring for someone who is physically or cognitively frail is physically and emotionally exhausting. Caregivers often feel isolated and are at high risk for depression, anxiety, and physical illness. This

A good working relationship with the doctor and health care team of the person being cared for is probably the single most important thing that caregivers need.

Kosmochem Private Limited is engaged in import and distribution of hospital consumables and home healthcare products for over 20 years. Kosmochem Home Healthcare, a division of the Company serves end-consumers by offering a wide range of quality home healthcare products for home use designed for convenience of users and care-givers and to support independent living. Our range of products help in management of Incontinence (involuntary loss of urine), Rehabilitation, Toileting, Blood Pressure monitoring, Diabetes, Obesity and Weight control. We put our best efforts to provide our customers with quality products by carefully selecting premium brands across the globe. Our experience in healthcare industry combined with quality control enables us to provide comfort, security and satisfaction to our customers.

Do you know what was discovered through the Adult Attachment Interview (AAI; PESI, 2012) as the best predictor of a child’s level of attachment security with their caregiver? The answer may surprise you. The biggest predictor was how the adults were able to make sense of their own lives. It turns out that it wasn’t what had happened to the adults but how the adults gave meaning to what they had been through that allowed them to tell a coherent and cohesive story of their pasts and how these experiences helped shape them into who they became. The adults who were securely attached themselves shared both positive and negative aspects of the events in their lives and how these influenced their developments and life journeys (Siegel, 1999).

The Lonely, Deprived Child The most popular theory is one we often encounter in the treatment room. It’s the story of a child who grew up feeling conditionally loved based on performance. His parents may have expected him to be the best, instilling that to be anything short of perfect is to be flawed, inadequate, and unlovable. He may have been taught that love is tentative and contingent, or that his emotional needs would be met if he achieved greatness. His parents may have sought pride and attention through his achievements, implying a less-than-perfect performance would devastate them. This scenario may be complicated by different treatment from each parent. These children are often criticized by one parent while doted on, overprotected, or used as a surrogate spouse by the other. They may comply with their parents’ demands and expectations to receive attention and dodge criticism and shame. In response to this profound emotional deprivation, manipulation, and stifling of the precious and vulnerable little self, the child develops an attitude of I will need no one, No one is to be trusted, I will take care of myself, or I’ll show you. He was not loved for being himself, and was neither guided nor encouraged in the discovery of his true inclinations. He was not made to feel completely safe and unquestionably cherished by a caregiver. He was not shown how to walk in someone else’s shoes—how to feel the inner emotional life of another person. There was no role model for empathy and attunement. He was left with shame and a sense of defectiveness, both from the direct criticism and from the withholding of emotional nourishment and, often, physical affection. He was made to feel there was something wrong with him, as if wanting comfort, attention, and understanding were weaknesses. In defense, he mustered up whatever safeguards he could to extinguish the pain.

To be the best—and most patient—caregiver possible, you need the right approach. It starts, as I explained in chapter 1, with recognizing that Alzheimer’s is an enemy you cannot defeat. It continues, as I told you in chapter 3, with protecting your own health.

Humans are adaptable precisely because they’re unfinished; the baby responds to her environment by “building” a brain that will best help her to flourish in that environment. If she has optimal conditions—physical nourishment, warm arms to carry and soothe her, a responsive caregiver who engages with her—she’ll build a brain that’s geared for prompt self-soothing, happy moods, and intimate connection. If the environment doesn’t offer her what she needs, or it seems dangerous—for instance, loud noises without accompanying reassurance—the brain she builds may be hypervigilant and distrustful, primed for fight-or-flight and competition for scarce resources.

So, if you’re not focused on behaviors—rewarding the ones you like and punishing the ones you don’t like—how will your child’s behavior improve? By focusing instead on the expectations your child is having difficulty meeting. I’ll be referring to those unmet expectations as unsolved problems and, in this book, you’re going to learn how to solve them. Solving problems is a task ill-suited to time-outs, stickers, berating, lecturing, ignoring, taking away privileges, sending a child to his room, spanking, and a lot of other things caregivers do with the best of intentions. Once a problem is solved, it doesn’t cause concerning behavior anymore.

I had several reasons for writing this book. First and foremost was to tell the story of Donna’s courageous battle against triple-negative breast cancer. Moreover, I felt writing would help me deal with my profound grief following the loss of my wife, soul mate and best friend. Furthermore, I sought to increase awareness about this form of breast cancer. Triple-negative breast cancer affects less than 20 percent of all breast cancer patients. Triple-negative breast cancer is more aggressive and difficult to treat than other forms of breast cancer. Triple-negative breast cancer is also more likely to spread beyond the breast and be fatal within five years. It is my hope that this book will be helpful for caregivers who find themselves looking after a loved one who is fighting this terrible disease! When Donna was diagnosed, I had no idea what that entailed or what I needed to do to support her. I learned on the fly, made mistakes along the way, and witnessed how vital a caregiver’s support can be.

One way to give labor more power is to make it easier to organize workers by passing labor law reform bills—the perennial campaign promises of Democratic candidates that go perennially unfulfilled. Another is to direct large-scale government investments into key national sectors—clean energy, manufacturing, education, and caregiving—to create jobs, stimulate innovation, and raise the pay and status of workers. And a third is to form new institutions for worker power that are better suited to a postindustrial economy, as Michael Lind argues in The New Class War: labor representation on corporate boards, collective bargaining by sector rather than company, and wage boards that set minimum terms for low-wage industries like fast food.

The best tool in any crisis is a calm mind armed with simple first aid knowledge.

Caregivers who anticipate ongoing contact after placement may be better able to relinquish their role than caregivers who anticipate that "good-bye" will be forever." ... "Former caregivers may experience grief and guilt because they are incapable of providing permanent adequate care, or they may feel anger and resentment if they had wanted but were not allowed to continue parenting the child. Even the birth parent(s) who voluntarily terminates guardianship may experience considerable ambivalence by the time of placement. Birth or foster parents who are struggling with their own needs may have difficulty meeting [the childs'] needs during the transition period and at the time of placement. In cases such as these, it is important to have sensitive professionals available to help the former caregivers identify and express their feelings about the separation and support the toddler's transition.

During the early stages of grief, the toddler typically protests and displays overt signs of despair. A number of parents reported that their newly adopted toddlers cried inconsolably. Sad crying is very different from crying associated with rage or terror. When grieving, the child’s body is typically limp or curled into a fetal position, and there are a lot of tears. Anger and/or fear, on the other hand, are indicated by a stiff, tense body, protruding blood vessels, perhaps few tears, and a high-pitched cry. Not surprisingly, the children who had no preparation or transition help displayed especially intense grieving behaviors. Sabrina, adopted at 16 months from long-term foster care, often awoke sobbing and calling out to her former caregiver for months following her placement. Fortunately, even though she had not been prepared for a change in placement, her parents used post-placement transition strategies and supported her grieving process, so instead of emotionally detaching, Sabrina began transferring attachment

Supporting the grieving process The grief associated with a toddler’s separation from caregivers with whom he has had a strong attachment is unavoidable. To try to deny or avoid displays of grief is magical thinking on the part of adults. Acknowledging and supporting their child’s grief is one of the first acts of love adoptive parents can give their new son or daughter. The more directly involved toddlers are in the preparation and transition process, the less confused they will be about what is happening to them and the less they will rely on magical thinking to explain the loss of former caregivers. The more concrete the transition and placement processes are, the more toddlers will be able to process what is happening, and the less they will be fearful. Talking to toddlers during the preparation for and adjustment to a change in placement is intended to support grieving by confronting their magical thinking and assuring them that they are not responsible for the loss. Toddlers need to be told who will take care of them and be assured that someone will be with them at all times during the transition. Other messages that support the toddler’s grieving include: “It was not your fault that you moved. You didn’t do anything bad. It’s OK for you to cry and be mad. I’ll be right here to take care of you.

Providing structure and predictability Toddlers are reassured by familiar routines, regardless of their nature. When the environment prior to placement is a healthy one, the use of transition objects that link the former caregiver’s style and schedule to the present provides the sense of structure that is important to the toddler’s developing sense of security in her new home. A consistent schedule is also important to the child who is experiencing separation anxiety. Parents should be absolutely reliable about returning when expected. It is important to help children anticipate their schedules by talking through the day’s routine. Because toddlers cannot tell time, use concrete, regularly scheduled events to help them mark time such as mealtimes or the timing of a favorite television program such as Sesame Street. Parents should make every effort to delay making additional major life changes following a toddler adoption such as moving to a new home, adding another family member, divorce, or marriage until new routines are firm and secure.

Post-placement Honoring the role of the former caregiver(s) Some toddlers transition directly from a birth family to their adoptive family, while others transition from interim care to their permanent home. If a relationship has formed between a child’s caregiver and the child, regardless of whether that person is a birth relative or not, it is essential to continue to acknowledge the importance of that person in the child’s life.

Fortunately, attachment to new parents is not dependent totally on a child either not having or losing strong feelings toward her early caregivers or birth family. On the contrary, a strong attachment to her former caregiver will help her attach to her adoptive parents.

When a child has enjoyed a healthy relationship with a former caregiver, post-placement visits, when possible, can serve a variety of purposes. Post-placement visits not only provide tangible evidence of the continuing existence of previous caregivers, they also provide another way to transfer attachment gradually. In cases where personal visits are not possible, phone calls and pictures reassure a child of a former caregiver’s continuing presence and love.

those toddlers who had experienced the fewest disrupted placements and changes in caregiver during their first year(s) of life tended to adjust to their new families with the least difficulty.

A secure attachment to a former caregiver was another similarity found among children who had little difficulty adjusting and attaching to their new adoptive families.

Even after moving to her new home, Sharon frequently talked to her foster mom on the telephone. In both of these cases, the parents took care to try to follow routines that were familiar to their children, and to talk with them daily about their former caregivers.

Lifebooks typically contain pictures of the child from as young an age as are available, pictures of important people such as birth parents and other caregivers, copies of important letters and documents that marked different phases of the adoption process, and memorabilia associated with his life transitions.

Post-placement visits While the conventional wisdom “out of sight, out of mind” may be true for some things, adoptive parents are wise to rethink this saying as they help their toddler make the transition to her new family. Without contacts to assure them that their former caregiver still exists, toddlers may expend unnecessary energy worrying, wondering, and fantasizing about former caregivers rather than directing their energy toward attaching to new parents. Worse yet, some may resist attachment because they may assume these new caregivers will simply disappear one day, too.

The toddler who has experienced healthy symbiosis with a previous caregiver and has moved into differentiation (recognizing himself as a separate being) needs to transfer the trust or bond to the new caregiver(s). If he is in the early stage of differentiation, he will probably experience intense separation anxiety. It is thus extremely important that the transition strategies discussed in Chapter 4 be implemented if at all possible to ease the transfer. The previous caregiver must give the child permission to transfer his trust and love. It is important to allow the expected and entirely normal grief process to occur and support it without abandoning the child to his grief.

It is important for the former caregiver to display honest emotions about the pending separation. If an attachment has formed, it is natural for both the child and caregiver to grieve their separation. This is no time for adults to try to be strong for the child's sake. A child's self-esteem is enhanced by tangible evidence that [they] were cared for and that [their] former caregiver will miss [them] but wishes [them] well. When adults express their feelings appropriately, it gives children permission to do so as well. Carefully planned and executed pre-placement transition strategies should assist former caregivers in adjusting their role and placing their confidence in the ability of the new [guardians] to provide a safe, secure, and nuturing environment for the toddler they have loved and cared for.

This particular form of relationship is best represented by the mother-child relationship. In our research into this particular relationship, we found out how important it can be for the child's future development. Many scientists and therapists consider the mother-child relationship to be the working model for all subsequent relationships that the child will develop. A stable and healthy love affair with the primary caregiver appears to be associated with a high probability of healthy relationships, while a weak love affair with the mother or primary caregiver appears to be associated with numerous emotional and behavioral problems later in life.

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