"If you want to observe people who are truly attuned to their needs, watch babies and toddlers. They fall asleep when they're tired, even in the middle of the living room floor during a party. They wake up when they're rested. They cry when it hurts and stop when the pain abates. They eat when they're hungry and stop when they're full.

"This unhindered responsiveness to the needs of their bodies begins to change when we start teaching them how to delay, overlook, and ignore their body's signals. We potty-train them, put them down for naps because we're tired, and push food at them when they clearly don't want it. They start to learn to react to convenience and other people's expectations rather than to their own needs.

"By the time we mature, we're experts at denial. An alarm clock jars us awake in the morning. We're rushed, so we skip breakfast. Caffeine, not protein, is the fuel we expect to start our engines. We eat large, rich dinners late in the evening. Bedtime comes only after the chores are done or the TV movie of the week is over — often too late for an adequate amount of sleep before the alarm clock jars us awake again and the cycle repeats.

"When someone we care for is sick, we need to recognize the illness as a stress on the body — an extra burden, a battleground. Throughout this battle the body keeps talking: I am weak, don't push me to do things. Let me rest awhile to try to get some strength back. All of my energy is being spent trying to fight this illness and its assault on my body. Let me rest often.

"Think of energy as if it were a modest savings account in the bank. Every demand on our energy is a withdrawal. Deposits of energy are rare and small — usually the result of resting. If we continue to make withdrawals without making deposits, the account will be depleted quickly. So it makes sense for the sick person to spend his or her small amount of energy wisely. This includes resting before important company comes to visit, using a wheelchair to get from the car to the doctor's office instead of walking, and alternating activities with periods of rest. 'Pushing past the pain' may work when you're training for the Olympics, but not when you're seriously ill.

"Listening to the body is enormously important for the patient, and it's important for the caregiver as well. Caregivers can easily overlook their own needs. Providing care for someone who is seriously ill is often exhausting and stressful. It can easily make you weak and ill. Stress does that.

"Don't be afraid to change the message on the phone to say something like 'We unplug the phone when we're resting. Please leave a message and we'll get back to you later.' Sleep when the patient sleeps. Caregivers often ignore the early warning signs of their own illnesses because they're exhausted and totally focused on the person for whom they care. People at the end of life often tell me how anxious and guilt-ridden they are when they see their caregiver falling apart.

"All too often I have seen two ambulances arriving at the house of a patient — one for the patient and one for the caregiver. I often say to the families and friends doing the heroic work of caring for the dying, 'I only allow one patient per address.' They laugh — but they get it."