The Silent Strain , Why Caregivers Say They're "Fine" When They're Not

Post 1: Series: Caregiving and Communication: Lessons from the Heart

I heard this story from a caregiver and built a series of posts on  caregiving. I hope you enjoy it and maybe  even learn from it. I know I learned a lot when putting the series together. After I retired, my husband’s health began to decline. Slowly at first, just little things. But before long, I had taken on the role of caregiver. What began as support with daily routines evolved into around-the-clock care over the last three and a half years of his life.

I didn’t plan for this. Few of us do. But like so many others, I did what needed to be done. And like so many women, who make up nearly 60% of all eldercare providers, I kept saying, “I’m fine.”

Even when I wasn’t.

The Unseen Majority

According to the 2023 U.S. Bureau of Labor Statistics, more than two-thirds of eldercare providers are spouses or unmarried partners. Caregiving is often invisible and unpaid. It happens in kitchens, bedrooms, and hospital waiting rooms. And more often than not, it's women, wives, daughters, sisters, carrying the load.

Cultural expectations play a role. Many women internalize the belief that caregiving is simply what women do. Women may feel selfish or guilty for acknowledging the toll it takes. And so, they push through.

They put off doctor's appointments. They skip exercise. They put everyone else first. The stress becomes background noise, persistent, but unspoken.

The Moment I Broke

Even though I had worked my entire career in education, I didn’t apply what I knew to my own caregiving experience. When my husband had a major heart attack and came home from the hospital, we both needed help, he declined. And I didn’t push. He was relying entirely on me.

I had worked so hard to appear strong and competent that he didn’t know I was unraveling inside.

A few months later, our daughter called. She was coming to visit with her young children. I suggested paying for a motel during their stay, hoping to reduce the pressure on both of us. My husband got upset. He took it as a rejection.

That’s when I snapped. “I can’t handle one more thing! I can’t take care of one more person. Don’t you understand?” The words came out sharper than I intended, but they were true.

I had reached my breaking point, but I had also kept him in the dark about how hard it had become. In trying to protect him, I’d isolated myself.

The Performance We Both Gave

When our daughter arrived, my husband put on a show. He was cheerful, engaged, bigger than life. It struck me then that he was managing something too. He wanted to be remembered as he had been strong, proud, full of life.

We were both playing roles. And we were both afraid.

He didn’t want to show weakness. I didn’t want to seem overwhelmed. In the silence between us was so much unsaid, gratitude, grief, love, and fear.

What I Wish I Had Said

Looking back, I wish I had sat down with him and said:
“I’m thankful I can be here for you. I know this isn’t easy for either of us. But I need us to figure out, together, how to make this work in a way that protects both of us. I can’t do this alone.”

I believe he would have listened. I believe he would have helped.

We never had that conversation. But I share this now in the hope that other caregivers will.

The Health Toll of Saying “I’m Fine”

Caregivers are at significantly higher risk for conditions like heart disease, depression, stroke, and diabetes. We often ignore early warning signs in ourselves while advocating for our loved ones.

Why? Because we’re afraid to admit that caregiving is hard. Afraid to seem weak. Afraid of judgment.

As Emma Nadler wrote on Next Avenue, “Many caregivers feel pressure to act as if they are fine, even when they are not.”

And that pressure is dangerous.

Three Years Later: Healthier, But Changed

My husband passed three years ago. I am healthier now, with far less stress. I’ve had time to reflect.

I am thankful that I could care for him. I would do it again in a heartbeat. But I wish I had taken better care of myself in the process.

I learned a hard lesson about communication and caregiving.

I hope what I’ve learned helps you.

Key Takeaways for Caregivers:

• Your health matters. If you're not okay, your ability to provide care suffers too.
• Silence helps no one. Talk to your partner, your family, and your healthcare team.
• There is strength in vulnerability. Saying “I’m struggling” takes courage, but it opens the door to support.
• Don’t wait for a breakdown. Check in with yourself and ask: What do I need today?

What If You Can't Say "I'm Struggling"?

For many caregivers, especially those who’ve always been seen as the strong one in the family, asking for help feels like failure. Pride, fear, or even love can keep us silent. If this sounds like you, here are a few gentle ways to begin:

Start small. You don’t have to bare your soul. Try saying, “This week has been hard,” or “I’m feeling stretched thin.” These phrases open the door without making you feel overexposed.

Use “I statements.” “I’m overwhelmed” feels less confrontational than “No one is helping me.” The goal is to express, not blame.

Write it down. If speaking feels too emotional, consider writing a short note, email, or even a text to a trusted person. “I’ve been carrying a lot lately. I think I need some support.”

Talk to someone outside your circle. A caregiver support group, counselor, or family doctor can be a safe starting point. They can listen, guide, and often help you figure out your next step.

Practice saying yes. If someone offers help, try saying yes, even if it’s just once. Accepting help can feel uncomfortable at first, but it gets easier with time.

Remember, asking for help doesn’t make you weak. It makes you wise. And it might give someone else the opportunity to show up in a meaningful way.

In the next post, we’ll explore the hidden health risks of caregiving, and how you can begin to protect your wellbeing without stepping away from the person you love.