I remember, many years back, watching an old variety talk show on afternoon television. It was probably Merv Griffin or Mike Douglas, as I recall flipping channels back and forth between the two after school on weekday afternoons. One of the acts featured a man who balanced a dozen or more porcelain plates on long sticks, keeping them all spinning in perfect unison so that none of them ever slowed enough to drop to the ground and break. He would scurry from one stick to the other, adjusting the orbit of the plate just so, never allowing the rhythm to be interrupted, or the plates to slow and fall. I remember feeling oddly anxious as I watched, constantly sensing the stress of the performance, knowing that it would only take a momentary distraction to send the entire arrangement tumbling to the floor.

I see this same dynamic in the lives of caregivers that I know. Dedicated and perfectly organized, they are experts at keeping a dozen or more elements in perfect, unified motion. They multitask and prioritize long lists of duties and obligations, scheduling their lives down the minute and filling every moment with clockwork efficiency. But like the plate spinner, it only takes one misstep to send the entire operation crashing down around them.

I used this metaphor at a support group meeting for caregivers a few weeks back, to illustrate how easy it can be to lose control when you begin taking on more and more responsibility. The trick, I said, is to never get so many plates spinning that you don’t have time to occasionally take a break. As I was sharing my observations with the group, I could not help but notice that Shirley, one of the women in the group, was wiping away tears and nodding her head in quiet agreement.

Shirley lives with her developmentally challenged son, Adam and her husband, Dave, who has recently been diagnosed with early onset Alzheimer’s disease. She operates a small business, and moves through life with a seemingly effortless grace, always smiling and barely pausing to take even a good, deep breath. The people around her marvel at her energy and unflappability. I have often wondered, though, how much stress was simmering below that lovely, polished exterior.

After the meeting, I looked for a private moment to speak with her and make sure she was alright.

“I’ve never heard such a perfect description of the way I feel about my life,” she said. “I feel as though I am scampering from one thing to the next, constantly in motion, always thinking one obligation ahead, and acutely aware of how close I am to the entire operation coming apart. Sometimes I imagine it all falling down around me, and I wonder how we would recover if it did.”

I listened to her talk about how exhausting it can be to carry so much responsibility.

“It’s all on my shoulders,” she said. “Everything. The household, the business. Dave used to take on most of Adam’s appointments and commitments, but it’s no longer safe for him to drive. He wants to help, and he doesn’t understand that he is impaired, so not only do I have to take on the things he used to deal with, I now have to negotiate the choppy waters of keeping him from taking on things he’s no longer capable of handling, while protecting his feelings and his dignity.” The tears began to flow. “Some days I feel like it’s all teetering on the edge and I’m the only one holding it in place.” We took a few minutes

We took a few minutes to talk about strategies for getting some much-needed relief. “There is only one of you,” I said, “and trying to be all things to all people is setting you up for disaster.” We discussed who she might have in her life who could take on some of the stuff that doesn’t specifically need her to sign off on. “Delegating even a little may relieve enough of the pressure to keep you from feeling overwhelmed,” I said. “If you have friends or family who have offered to help, it’s important to let them. I know you are accustomed to taking charge and handling things, but your life has become significantly more complicated. You can’t sustain a lifestyle where you are constantly putting out fires.”

Shirley agreed, but she knows that changing won’t be easy. “I’ve never been comfortable asking for help,” she said. Still, she realizes she’s reaching a breaking point. I encouraged her to consider applying for respite services through the Area Agency on Aging. She wasn’t familiar with the program, but I explained that the Agency provides vouchers that will allow her to hire someone to care for Dave so that she could take a little time for herself. At first she balked, worried that Dave would never agree to spending time with “a sitter.” But after a little encouragement she agreed to think it over.

Last week she stopped me after the support group meeting to tell me how things were going. She said she had used respite vouchers to help pay travel expenses for her stepson to come and spend some time with his dad and Adam over the weekend. He didn’t want to be paid, but the vouchers helped defray the cost of gas when he made the six-hour drive from his home just outside of Dallas. The guys were delighted to spend some time together, and Shirley got a reprieve from her chaotic schedule.

The time away has helped her gain perspective, and she’s learning that she can’t do everything on her own. “It’s still a bit of a balancing act,” she said, “but I try to remember to focus on one thing at a time, and I ask for help when I need it. There are no extra points for achieving emotional exhaustion.”

She’s right of course. There is a fine line between “your best” and “your tipping point.” If you can find that delicate balance, you just might be able to keep all those plates in the air.