There are many herbal approaches to supporting Shen depending on the imbalance affecting it:

  • Nourish the Shen through Heart Qi, Blood, or Yin tonics: fu shen, zizyphus, biota, asparagus root, reishi, rhodiola, hawthorn
  • Astringe the Shen: schisandra, cornus
  • Clear Heart Heat or Fire: scute, coptis
  • Sedate the Heart and settle the Shen: dragon bone, oyster shell, magnetite
  • Open the Heart orifices: borneol, musk, acorus
  • Transform Damp and calm the Heart: fu ling, atractylodes (bai zhu), cinnamon twig, akebia

Generally, herbs that nourish the Shen are employed when the Shen is low. These include such herbs as zizyphus seeds, biota seeds, polygala, longan berries, hawthorn berries, albizzia, rhodiola (hong jing tian), reishi (ling zhi), polygala, wild asparagus root (tian men dong), ginseng (ren shen), fu ling cortex, schisandra (wu wei zi), oyster shell and dragon bone. 

Albizzia [Albizzia julibrissin; he huan pi (bark); he huan hua (flower)]:

Having a neutral energy, the mimosa tree is known as the "happiness bark," although the flowerheads may also be used. The bark calms the Spirit and is specifically used for depression, bad temper, insomnia and palpitations due to anger and anxiety, irritability and poor memory due to Stagnant Liver Qi, pain and swelling due to trauma, abscesses, carbuncles, furuncles and similar swellings. The flowerheads are used for insomnia and palpitations due to anger and anxiety, fullness of the chest, poor memory, and irritability due to Stagnant Liver Qi.

American Ginseng (­­­­­­­­­­­­­­­­­­Panax quinquefolium; xi yang shen):

This root is a Yin tonic which quiets metabolism. The Chinese widely use American ginseng because its cooling demulcent energy tonifies Yin while simultaneously strengthening Qi (this is quite different than Panax ginseng, which is a warming Qi tonic). Thus, American ginseng is used for chronic, afternoon or low-grade fevers and irritability and thirst after a fever, since Yin (fluids) becomes depleted from fevers (heat evaporating moisture). It also treats irritability, thirst and night sweats due to general Yin Deficiency, all accompanied by weakness, deficiency and debility. American ginseng is also great for nourishing the Lungs to treat loss of voice, wheezing and coughing up of blood. As such, it is valuable for wasting conditions such as AIDS and pulmonary tuberculosis. Western herbalists use American ginseng as an adaptogen to counteract the effects of stress and to increase endurance.

Asparagus(­­­­­­­­­­­­­­Asparagus cochinchinensis; tian men dong; Sanskrit: shatavari):

Asparagus tuber is a Yin or nutritive tonic. The Chinese believe that this herb engenders love and compassion, so Chinese pharmacists routinely set aside some of the sweetest roots for their personal use. Typically used for dry mouth, thick blood-streaked mucus, dry cough, tuberculosis, mouth sores, low-grade afternoon fever, constipation due to Dryness, and thirst. Because it nourishes the Yin of the Heart, it supports Shen in those with Yin Deficiency.

Biota (Platycladius orientalis; Thujae orientalis; bai zi ren)

More commonly called Platycladi seeds now, biota seeds nourish Heart Blood and Yin, treating insomnia, forgetfulness, palpitations, anxiety, night terrors in children, and night sweats. They are sweet and neutral with a gentle nature that harmonizes and so they nourish the Heart and Spirit. They are especially good for those who are exhausted with sensations of heat and weakness in the lover back and knees. As well, biota seeds moisten the intestines, helping alleviate dry constipation. 

Codonopsis (Codonopsis pilosulae; dang shen):

Codonopsis is called "poor man’s ginseng" because it is very similar to, although milder acting, than ginseng. As a Qi tonic, it increases vital energy, strengthens digestion and assimilation and is given in all diseases associated with weakness. Having more Qi means feeling better in general, which boosts the Shen.

Ginseng (Panax ginseng; ren shen):

Korean red ginseng and Chinese white ginseng tonify the Qi in all Deficiency diseases. It is used for palpitations with anxiety, insomnia, forgetfulness, or restlessness and excellent for convalescence, debility and weakness in old age, debility, weakness, tiredness.

Hawthorn Berries (Crataegus oxycantha, C. pinnatifida; C. spp; shan zha):

Although hawthorn berries (and leaves and flowers) are primarily known in the West as a cardiac tonic, these berries also nourish Heart Blood. treating both emotionally and physically induced heart issues including high and low blood pressure, rapid or arrhythmic heartbeat, tachycardia, inflammation of the heart muscle, angina pectoris, arteriosclerosis, enlarged heart, heart strain and valvular heart diseases. This incredible herb stimulates circulation and moves Stagnant Blood, regulates blood flow, blood pressure and heart rate, dilates coronary vessels, brings more blood to the heart, reduces cholesterol and blood lipids, strengthens the heart muscle, and helps maintain a healthy heart, arteries and veins. I have seen it stabilize irregular heartbeat and eliminate palpitations many times. Although the Chinese are aware of its Blood-moving and heart protective properties, they primarily use the berries to move food congestion, particularly due to meats or greasy foods. Hawthorn also stimulates appetite and eases abdominal distention, gas, bloating, and pain. Interestingly, many people go to the emergency room with heart pains believing they are having a heart attack when really this is caused by Food Stagnation. Hawthorn helps here!

Precautions: Hawthorn may potentiate the effects of cardiac glycosides, such as digitalis; caution in Spleen/Stomach Deficiency without food stagnation; acid regurgitation.

Jujube Dates (Zizyphus sativa; da zao)

The delicious large red fruit tonify both Qi and Blood, treating poor digestion, weakness, low energy, nervous exhaustion, insomnia, diarrhea from Coldness and poor appetite, digestion and memory. Nourishing to the Spirit, they calm and stabilize emotions when feeling irritable, sad or crying for no reason. They are added like licorice to sweeten and harmonize other herbs in a formula. After cooking the dates in a tea or soup, eat them for their full medicinal value (remove pits first). They help weight gain and help malnourished children thrive.

Longan Berries (Euphoria longan; long yan rou):

These delicious berries quickly tonify Heart Blood (like no other herb I know), alleviating palpitations, anxiety, forgetfulness and insomnia, particularly due to overwork or from excessive thinking, studying, reading or talking (all of which use a lot of Heart Blood and blood sugar in the brain – these berries are high in glucose and sucrose, which quickly replenish blood sugar). As such, they wonderfully nourish the Shen.

Polygala (Polygala tenuifolia; yuan zhi)

Polygala especially works by establishing harmonious communication between the Heart and Kidneys. Warming and bitter, it should not be used for those with any Heat signs. Polygala calms the Spirit and quiets the Heart, treating restlessness, anxiety, disorientation, excessive brooding or pent-up emotions. As well, it expels phlegm, helping to clear any phlegm blocking the Heart orifices that causes emotional or mental disorientation, spasms or seizures. As well, polygala treats coughs.

Reishi (Ganoderma lucidum; ling zhi):

Although it is classified as a Qi tonic, reishi (the Japanese name) means "spirit plant." Reishi mushroom, once a rare and secret fungus revered by the ancient Taoists, was considered to be the elixir of life, even said to restore it, because of its amazing tonifying properties. No wonder it has been treasured more than gold! Calming and revitalizing at the same time, reishi increases inner stamina and strength. It tonifies Blood along with Qi and is a bone marrow tonic. Among many other medicinal uses, it specifically nourishes the Spirit, treating anxiety, insomnia, nervousness, arrhythmia, and palpitations.

Salvia (Salvia miltiorrhiza; dan shen):

Red sage root moves blood circulation and is one of the premier herbs for most heart conditions, including moving the blood, breaking up congestion and clots, and regulating cholesterol and triglycerides. Because it is a cooling herb that moves Blood (most Blood-movers are warming), it is extremely useful for a wide variety of Blood Stasis complaints in those with Excess Heat (such as inflammation) as well as those with Deficient Yin.

Precautions: Use caution in pregnancy; when there is no Blood Stasis; in patients who are taking anticoagulant medications, such as Warfarin, unless under direction of a qualified health care practitioner.

Schisandra (Schisandra chinensis; wu wei zi):

Schisandra astringes the Spirit which helps to anchor it. Among its many uses, it assists the Shen by treating nerve weakness (neurasthenia, meaning weakness, fatigue and pallor), forgetfulness, insomnia, and dream-disturbed sleep. As a tonic astringent, schisandra strengthens tissues, eliminates secretions and retains energy, Essence and leakages (good for all of you exhausted folks in physical and mental "burnout"). Schisandra is a mild adaptogen that regulates various body functions, and increases the body's ability to handle stress.

Zizyphus seeds (Zizyphus spinosae; suan zao ren):

Because zizyphus seeds clear Liver and Heart Heat, they help calm the mind and emotions, treating insomnia, irritability, palpitations, anxiety, nervous exhaustion, amnesia and poor memory. They also reduce spontaneous sweating or night sweats.

Oyster Shell (Ostrea concha; mu li)

A "heavy" mineral, oyster shell’s astringency "anchors" the Spirit. It settles and calms the Spirit, treating palpitations, anxiety, insomnia and restlessness. As well, it "pulls down" floating Yang that leads to dizziness, tinnitus, headaches, flushed face, insomnia and irritability. It also treats continuous sweating, spontaneous sweating, night sweats, nocturnal emissions, and vaginal discharge.

Dragon Bone (fossilized bones of various animals; long gu)

Like oyster shell, dragon bone anchors the Shen, calming restlessness, palpitations with anxiety, and insomnia. It also treats floating Yang with irritability, restlessness, dizziness, vertigo, and a bad temper. Its astringent nature stops leakage such as spontaneous sweating, nocturnal emissions, night sweats, and vaginal discharge. Both oyster shell and dragon bone are often combined in formulas.

Do you love life? Do you enjoy people? Are you enthusiastic about what you do? Do you wake up excited for your new day? Do your eyes sparkle? Are you playful? Then you've got Shen.

If you currently don’t feel eager, excited, or joyful but you normally do, then this is natural. We all can swing into periodic contemplative, confused or unhappy states, for living in the world of polarity means we experience both ups and down. But if you feel a lack of will, dullness in life, have no sheen to your face, or spring to your step, then you lack Shen.

Shen reflects the entire physical, emotional, mental, and spiritual health of your body. It includes the capacity to think and act coherently and appropriately, your personality’s magnetic force and the joy to live life. It is distinguished by the sparkle in your eyes, an overall vivaciousness and a will to live. Housed in the Heart, Shen is your enthusiasm, charisma, and innate vitality. Spiritually, it is the dynamic faith, vitality and force of your personality that is able to surmount obstacles and make things happen.

There are no disharmonies of Shen in and of itself, yet because it is connected with the Heart, Deficient Heart Qi or Blood can weaken it. This appears as a lack of joy or enthusiasm in life, dull eyes, dislike of talking, muddled thinking, forgetfulness, insomnia, lack of vitality, depression, unhappiness, confused speech, or excessive dreaming. Heart Fire or Phlegm misting the Heart orifices can also impair Shen, causing irrational behavior, incoherent speech, hysteria, delirium, unconsciousness, inappropriate responses to people or the environment, or violent madness.

However, if you’ve got any physical imbalance, then you won’t physically feel in top form and when you don’t feel good, your emotions and thoughts decline. If this continues, ultimately your Shen is affected, too. Because of this, it’s easy to understand why Shen, along with Jing (essence) and Qi (life force), is considered one of the three treasures in Chinese medicine, for it is integral to our health and well-being.

Whether or not you "got Shen," you can bring back more joy and enthusiasm through several ways. Even one little thing can make a difference. Give your physical heart what it needs and this will automatically brighten your Shen.

So go for it: get Shen!

  • Change your posture: Shifting posture immediately changes how you feel. Turn the corners of your mouth up or genuinely smile, even if you don’t feel like it. You’ll instantly feel somewhat better. Now get out of your chair and stretch or go for a walk. Altering your facial expression or body stance immediately changes how you feel.
  • Laugh: Laughter is the sound of the Heart, the seat of joy and Shen in your body. Put on a funny movie or TV show. Laugh at a past memory, or good joke. Go see comedians. Make up your own jokes as if you were a comic. View life as a sit-com. Lighten up!
  • Be like an angel: "Angels can fly because they take themselves lightly."[1] Take yourself and your situation less seriously. When you lighten up, it in turn elevates your mood, then your energy, and thus the cascade continues until you feel better and better.
  • Daily attention: Do something you love every day, even if for just ½ an hour, or if you can, create a block of time. Schedule in moments of gratitude. Get sufficient sleep and rest as these alone can greatly improve mood and Shen.
  • Address emotional and spiritual issues: Find whatever helps you to appropriately express and release any stuffed, suppressed or repressed emotions. Try counseling, prayer, journal writing, meditation, movement, laughter, or play. Change jobs. Take holidays, which can even just be weekly hours set aside to do what you love.
  • Cultivate your heart’s virtues: These include laughter, open-heartedness, joy, compassion, beauty, pursuing your heart’s passions and desires, and following a spiritual path. Nourishing the virtues of your heart enhances your Shen. 
  • Take herbs: Interestingly, there are several herbs with "Shen" as part of their names (which may well point to the various imbalances that can disturb the Shen – this is my idea and not yet researched!). Historically, the five main Shen herbs are ren shen (Panax ginseng), dan shen (Salvia miltiorrhizae), xuan shen (Scrophularia ningpoensis), ku shen (Sophora flavescentis) and sha shen (bei sha shen is Glehnia, while nan sha shen is Adenophora). Check the following out and see which are best for your physical needs: dang shen (Codonopsis pilosulae), fu shen (Poria cocos), ren shen (Panax ginseng), dang shen (codonopsis), hai shen (Stichopus japonicus), xi yang shen (American ginseng, Panax quinquefolius), and tai zi shen (Pseudostellaria heterophyllae).

In the next installment of this blog, we will explore some of the above mentioned herbs and others for the treatment of Shen disharmony.

[1] G.K. Chesterton; from the chapter entitled "The Eternal Revolution," in the book, Orthodoxy.

herbpeaceIn Part I of this series I began the discussion about using of herbs to care for the caregiver. As a reminder, many herbs support your body-mind complex to assist in stressful times. They can increase immunity, help sleep, calm the mind and emotions, and treat issues such as anxiety, depression and disturbed Shen, all of which can easily arise during stressful caretaking situations.


As a reminder, Shen reflects the entire physical, emotional, mental and spiritual health of the body. It includes the capacity to think and act coherently and appropriately, the personality’s magnetic force or charisma, enthusiasm, innate vitality, and the joy to live life. It is distinguished by the sparkle in the eyes, an overall vivaciousness, and a will to live. As well, it’s the dynamic verve that enables us to surmount obstacles and make things happen.

According to traditional Chinese medicine (TCM), Shen is "’housed" in the Heart, so physical heart issues can affect one’s Shen and vice versa. There are no disharmonies of Shen in and of itself, yet because of its connection with the Heart, Deficient Heart Qi or Blood can weaken Shen. This appears as a lack of joy or enthusiasm in life, dull eyes, dislike of talking, muddled thinking, forgetfulness, insomnia, lack of vitality, depression, unhappiness, confused speech, or excessive dreaming. Extreme Shen disharmony results in irrational behavior, incoherent speech, hysteria, delirium, inappropriate responses to people or the environment, violent madness, or unconsciousness.

Herbs that nourish the Heart Blood also nourish Shen. However, the true remedy for Shen problems is addressing emotional and spiritual issues through counseling, prayer, affirmation, meditation, play, changing jobs, taking holidays, and whatever else is needed to nourish the Spirit and Heart.


Disrupted sleep can lead to Shen disorders. To treat chronic insomnia or sleep issues, most herbs must be taken during the day as well as at night and for several days before they’ll work. Stronger sedative herbs, however, should only be taken a couple of hours before and right at bedtime and avoided for daytime use; they are not for short naps but for longer, restful sleep. Others are simple relaxants and may be used during the day to ease the effects of stress.

When to use each herbal category

For quick and easy reference, I’ve created a chart of herbs in specific categories so you can easily choose which is best for your needs. Here are the symptoms and treatment of each category:

Anxiety: Symptoms includepalpitations, sweating, dizziness, shortness of breath, insomnia, tremors, twitches, and muscle spasms. Other symptoms may accompany these such as digestive upset, frequent urination, diarrhea, headaches and fatigue.

Hysteria: This is a state of mental disorder characterized by emotional excitability, emotional outbreaks, disturbances of sensory and motor functions, and intense agitation, anxiety, or excitement.


Calmatives: These nourish the heart and calm the spirit (Shen). They are useful for nervous disorders, stress, relaxation, and simple sleep problems. They are better for weaker individuals and less acute conditions.

Nervines & Sedatives: Nervines nourish the nervous system, calming the nerves and relieving muscle spasms, nervousness, anxiety, insomnia, emotional instability, pain, cramps, spasm, tremors and epilepsy. Sedatives are stronger than calmatives. They are used to alleviate nervousness, palpitations, insomnia, and irritability.

Strong sedatives: Generally minerals, these herbs have tranquilizing effects that weigh down and calm the mind to treat palpitations, insomnia, anxiety, Shen disorder, nervousness, irritability, fright and hysteria. They are typically used for more short-term acute conditions, as over time they can injure the digestion.

Regulate heart: These herbs regulate the heart function and should be used in appropriate doses.

Increase immunity: Herbs that increase immunity tend to be adaptogens that enhance endurance, energy and strength so the body handles stress better.


Herbs for the Caregiver









Kava kava


Pungent, bitter

Liver, Kidney

Spasm, insomnia, anxiety


Lemon balm


Sour, slightly pungent 

Lungs, Liver 

Nervousness, hysteria, anxiety, insomnia, melancholy, depression, gas, cramps


Passion flower



Heart, Liver 

Anxiety, nervous tension, hysteria, insomnia 


California poppy



Liver, Heart 

Nervous tension, anxiety, insomnia 


Zizyphus seeds (suan zao ren – very safe for the weak and elderly) 


Sweet, sour

Heart, Spleen, Liver, Gallbladder

Insomnia, irritability, palpitations, anxiety, spontaneous sweating, nervous exhaustion


Mimosa flower & bark (Albizzia – he huan pi; "the happiness tree")  



Lung, heart, Kidney

Insomnia, bad temper, insomnia, depression, irritability, poor memory caused by emotional constraint


Biota (Thuja, cedar tree seed – bai zi ren) 



Heart, Liver, Kidney, Large Intestine

Nervousness, anxiety, palpitations, insomnia; especially with anemia/Blood deficiency


Polygonum stem (ye jiao teng) 


Sweet, slightly bitter

Heart, Liver

Calms the Shen; insomnia, irritability, dream-disturbed sleep especially due to weakness





Slightly pungent

Liver, Stomach, Lungs

Nervousness, headache, stomach upset, anxiety, cramps, spasms 





Slightly pungent

Lung, Liver







Nervousness, irritability, insomnia from Heat, worry, exhaustion




Bitter, pungent

Liver, Heart

Cramps, spasms, insomnia, nervous conditions from Cold





Heart, Liver

Anxiety, nervous tension, hysteria, insomnia





Liver, Heart

Hypertension, stress, worry,


Dragon bone (long gu) 


Sweet, astrin-gent

Heart, Liver, Kidney

Insomnia, epilepsy, night sweats, spontaneous perspiration, irritability, dizziness, short temper


Oyster shell (mu li) 

Slightly cold

Salty, Astrin-gent

Liver, Kidney

Restless Shen, palpitations, insomnia, vertigo, dizziness, convulsion, spasm, epilepsy, spontaneous perspiration, night sweats


Pearl (zhen zhu – use finely granulated powder) 


Sweet, salty

Heart, Liver

Epilepsy, convulsions, hypertension, excessive anger with blurred vision


Amber (hu po – use crushed resin) 



Heart, Liver, Urinary Bladder

Epilepsy, insomnia, anxiety, forgetfulness, palpitations, seizures from disturbed Shen, coronary heart disease


Black haw




Nervous complaints, convulsions, hysteria, spasms


Night blooming cereus



Heart, Kidney

Palpitations, anxiety, tachycardia, angina, carditis, pericarditis, arrhythmia, valvular disease, all cardiopulmonary diseases, mental derangement




Sour, sweet

Heart, Stomach, Liver, Spleen

Cardiotonic, arrhythmia, heart failure, heart diseases, digestive ailments, angina, hypertension




Astrin-gent, pungent

Heart, Kidney

Heart diseases, angina,

Tachycardia, arrhythmias; poor cardiac muscle and pumping function



Slightly warm


Lungs, Spleen

Boosts immunity, building resistance to colds, flu




Sweet, pungent

Kidneys, adrenals, Spleen

Increases energy, vitality, endurance



Slightly warm

Sweet, slightly bitter

Lungs, Heart, Spleen Liver, Kidney

Calms the spirit, increases energy, immunity and endurance; anti-stress





  • There are several herbal formulas available that combine California poppy, hops and passionflower often with valerian or skullcap. Use for sleep, stress and nervousness.
  • Planetary Formulas Stress Free: I’ve seen people take up to 20 tablets of this a day without putting them to sleep but handling their stress beautifully. It contains zizyphus (suan zao ren), skullcap, hops, wood betony, valerian, American ginseng (xi yang shen), hawthorn, ginger, licorice, chamomile, black cohosh and eleuthero.
  • Planetary Formulas Calm Child: Contrary to its name, this formula is also great for adults. Containing chamomile, jujube dates, hawthorn, catnip, lemon balm, longan pepper, licorice, amla, magnesium, calcium and gotu kola, it aids sleep and reduces stress, hyperactivity, and nervousness.


The following may be found as patent medicines in pill form from Mayway online, either in the Plum Flower of Min Shan brands:

  • An Mien Pian: This is especially good for anxiety, disturbed Shen, insomnia, restlessness, palpitations, vivid dreaming, depression and panic attacks particularly from Heat. As well, it transforms Phlegm and relieves food stagnation, which can often cause heart symptoms such as pain and stuffiness in the chest. Use caution with anemia, Yin and/or Blood Deficiency. This formula contains zizyphus (suan zao ren), polygala (yuan zhi), poria (fu ling), gardenia fruit (zhi zi), massa fermenta (shen qu), and licorice (gan cao).
  • Calm Spirit Teapills: This formula that contains polygonum stem (ye jiao ten), triticum (wheat – fu xiao mai), jujube dates (da zao), poria (fu ling), lilium (lily bulb – bai he), licorice (gan cao) and albizzia (he huan pi) treats disturbed Shen due to deficiency and excessive worrying. I’ve found it to be especially effective in manic/hysterical disorders as well as a gentle sedative.
  • Suan Zao Ren Wan: Containing zizyphus (suan zao ren), ligusticum (chuan xiong), poria (fu ling), anemarrhena (zhi mu), and licorice (gan cao), it treats restlessness, insomnia, palpitations, night sweats, anxiety and vivid dreaming.
  • An Shen Bu Xin Wan: A stronger calm spirit sedative formula, it contains mother-of-pearl (margarite – zhan zhu mu), polygonum stem (ye jiao ten), ligustrum (nu zhen zi), salvia (dan shen), eclipta (han lian cao), cuscuta (tu su zi), albizzia (he huan pi), rehmannia (di huang), schisandra (wu wei zi), and acorus (she chang pu). This formula calms Shen, settles the heart and treats insomnia, vivid dreaming palpitations, dizziness or restlessness with anxiety, possible chest pain or oppression, mania, nightmares and hallucinations. Use caution with poor digestion.

easychairNow that you know how to be and find a hospital advocate, what about the advocate herself? How does she get her much-needed support? Being a caregiver can be a staggering job and consume your mental, physical and emotional energy. Yet there are many ways that you can be supported at this time. This not only applies to hospital advocates, but all caregivers as well.

Herbalists are caregivers, too. In fact, there are many ways to give care: emergency care as I just did with my mom in the hospital, care for someone who is dying, elder care, child care, handicap care, Alzheimer’s/dementia care, and of course everything in between.

Caregivers: Earth Element Types

There’s a distinct caregiver personality archetype. This is someone who tends to nourish, give and do for others, often regardless of whether it’s needed or wanted. In traditional Chinese medicine (TCM), this is called an Earth Element type.

We are currently in the Earth Element "time of year," the two-and-a-half month period when its energy should flourish and thrive. This means that caregivers may find themselves with an especially strong drive to give and care for others, even to the point of over-giving, or they may find that even though they want to give, it’s more difficult or tiring now than usual.

Caregivers need support and help themselves because as one reader of my recent blog said, "Disordered Shen is catching!" Being an advocate can be intense to say the least, so it’s not unusual for caregivers to become exhausted, ill, or even develop symptoms of Shen disorder – insomnia, anxiety and agitation. Caregivers are notorious for giving to everyone but themselves, and this is what leads to their illness and decline.

Regardless of whether you are a caregiver professional, caregiver archetype, in a position where you normally give care, or your care is needed now, the situation is the same: you must also care for yourself in order to stay strong so you can continue to give.

So how does the advocate or caregiver get cared for, too?

The key is – GET HELP!

If you are not taken care of, you will not be able to care for others. The same goes for the person taking care of you – if they aren’t cared for, they can’t give you the care you need. So it’s essential that the caregiver gets good rest, food, water, exercise, and help as needed. No excuses here! No buts or what ifs, and I especially mean that for those of you who give and give and give at the expense of your own needs or health.  You know who you are!

There’s no guilt that can be inferred or adopted here because if you do not take care of yourself, then you are not truly serving the one you are caring for. You are also setting up a future need of care for yourself from others – and this often appears in the form of cancer for you folks. Plus, if you don’t get help, your patient will suffer as a result and your need for care will take from them. So whether you avail yourself of help from family members, friends, neighbors, or outside help, take the self-care train and get on board!


About Getting Help

  • Write down your needs: Often writing down all your specific needs makes it more obvious what type of help you seek. You may actually require several different types of help such as medical, sitters, personal care, shoppers, financial planning, and so forth. List all of these along with their detailed points.
  • Make people aware: Often, people don’t know you need help but think you have it covered. If you are acting like Superman or Wonder Woman, people will think you don’t need help. That’s the fast track to a breakdown or burnout. Others may want to help, but they don’t know what to do so it’s necessary that you ask for the help you need.
  • Be specific: When you ask for help, or others offer help, provide definitive times, days and tasks. Give advance notice. If someone can sit with the person to give you a break, offer suggestions as to what they can do together.
  • Accept what is offered: Allow others to help as they can and as they offer, even if it’s just one time or a small task. Be grateful for the small things, as they do add up.
  • Share the help wealth: Don’t overburden a few people with many jobs but include many people with simple duties.
  • Don’t make demands: Make requests for what you’d ideally like to have happen and then graciously accept what does happen.
  • Be respectful: If people say no to your request, respect that. Find out what they can do and accept their limitations.
  • Get creative: If one thing doesn’t work, try another. Use your imagination. For instance, try new approaches for those who can’t read such as giving the person an iPod with recorded books. This not only provides them enjoyment, but gives you a break, too.
  • Financial Help: There are many resources available for obtaining the needed finances to care for your patient. Consider trade, Medicare, Medicaid, long-term health insurance, federal and state government agencies, volunteer programs, church groups and family members.
  • Outside help: There are many resources available where you can obtain outside help. Often the patient’s doctor sets these up, so put in your request. Consider social workers, home health care, skilled nursing, nursing homes, home health aids, personal care aids (for dressing, bathing, eating, changing beds, laundry and light chores), foster homes, boarding homes and hospice. Know that hospice is also for palliative care, not just terminal conditions, plus it offers more than home health care and covers more expenses, too. As well, be sure to check available local programs to see what they offer and how they might meet your needs.
  • Ideas for help: Keep your requests reasonable, specific and timely. Consider sharing telephone calls, staying in close touch, doing research for you, talking to the doctors or practitioners, driving, grocery shopping, picking up medications, bringing meals or other needed items, providing a listening ear, giving you breaks, walking or exercising with you, and taking on the job of finding the help you need.

Care for the Caregiver – Things You Can Do to Help Yourself

  • Eat well: Keep your diet simple. Emphasize protein, vegetables and fruits as appropriate for your body’s needs. Eat three good meals a day with perhaps one or two snacks. Keeping your blood sugar balanced increases your energy, stamina and immunity. It also helps you sleep better. When you are stressed, the body has less tolerance for internal stressors. Challenging foods such as sugar, caffeine and alcohol create internal stress and so often cause health symptoms during stressful times (including menopause) when they seemingly don’t otherwise. Foods that cause liver congestion are also less tolerated during stress. These include fried and fatty foods, alcohol, caffeine and other stimulants (maté, chocolate), cheese, nuts and nut butters, chips of all kinds, and excessive intake of turkey. 
  • Get sleep: Grab what sleep you can including naps. Post "do not disturb" signs and take them down when you may be disturbed. Sleep when the patient does. Most hospital rooms have a recliner or couch for visitors, so take advantage of it.
  • Exercise frequently: Even if you can only take 5-10 minutes off at a time, exercise as possible. Include frequent stretching and take the stairs.
  • Feed your spirit: Engage in meditation, prayer, spiritual contemplation, reading, and other activities that juice your spirit, even if just for five minutes at a time.
  • Delegate tasks: You don’t have to do it all. Truly. Determine what is key for you to do and get help with the rest.
  • Set priorities: You don’t have to do everything right now. Really. Set goals and solve problems one at a time. Pace yourself! 
  • Talk with others: Share your experiences, feelings, ideas and thoughts with others. Talk with more caregivers. Seek counseling if needed. Avoid isolation!
  • Maintain humor: Laughter and humor can lighten many a difficult situation and improve everyone’s energy.
  • Plan ahead: Bring food, water, snacks, blankets, layered clothing, music, books, drawing or writing materials, a journal, and other items to care for all your needs. Look to the next day or two and plan accordingly.
  • Take frequent breaks: It’s essential that you "get away" from the caretaking situation. If you can’t get blocks of time off, take frequent short breaks. Do what you can and be creative about it. Walk, take the stairs, go outside, call a friend, read a book – you get the idea.
  • Be informed: The more you know about the person’s condition and needs, the better prepared you will be and the less stressed as a result. Ask for help in researching proposed medications, procedures, the patient’s condition, local resources and so forth. 
  • Have back up: I know I keep harping on the get help part, but at the very least have others bring you good quality food and water, guard the door to protect everyone’s sleep, and bring requested items.
  • Emotionally release: Appropriately express and release your emotions so they don’t build up inside. Long-term suppressed emotions stagnate your energy and blood, leading to a myriad of health issues over time. Thinking about how you feel doesn’t work because it keeps you locked in mental and emotional loops that only intensify your feelings. Instead, write them down or talk with a friend or professional. 
  • Self-nurture: You know best what you need so take care of yourself. If you require specific types of food, regular exercise, or certain hours of sleep, be sure you maintain them however you can. 
  • Treat yourself: Include in your self-care plan periodic treats that nurture you. Avoid food teats as these usually make you feel worse in the long run. Instead, buy something for yourself, watch the sunrise/sunset, get take-away food, or listen to favorite music or sports.
  • Be gentle with yourself: It doesn’t help anyone to beat yourself up for forgetting or not doing something in time. Know you are under extreme stress and allow for how this affects you. Do what you reasonably can first and then seek help for the rest as you work toward the larger tasks.
  • Let go: Your normal life may well be on hold so let go of expectations, deadlines, extra duties and so on.
  • Thisis your service: Know that being a caregiver IS your service. THIS is your service, your gift and focus. Like raising a child, your patient takes precedence over everything else, except your own physical needs. Realize the gift you are giving IS your work in the worldat this moment in time. Surrender to this and know it is a gift for you as much as it is for your patient. 
  • Take herbs: Herbs are powerful. While most are gentle, they also support your body-mind complex to assist in stressful times. Herbs can increase immunity, help sleep, calm the mind and emotions, and treat issues such as anxiety, depression and disturbed Shen, all of which can easily arise during stressful caretaking situations. Herbs are also easy to find and take. Look for them in health food, herb shops or alternative markets. Even mainstream drug stores and groceries now carry common herbs. Take them as needed in the simplest forms possible – tablet, capsules or tinctures.


There is so much that can be said on the subject of caregiving that entire books have been written on it. One great book, although written for Alzheimer’s and dementia, is actually quite useful for any person needing long-term or end-of-life care. I highly recommend it: The 36-Hour Day by Nancy L. Mace and Peter V. Rabins, (Johns Hopkins University Press, 5th edition 2012).

I hope this never happens to you, but it’s usually inevitable that one day either you or a loved one may end up in the hospital. This is most typical when caring for elderly parents, as happened to me in the last couple of years, yet you never know when you’ll end up there, too. And what we all need when in a hospital is an informed advocate. This can make the difference between life and death, as I just experienced.

My recent foray into the hospital scene when my mother became ill taught me this lesson. Generally, most practitioners there truly have each patient’s best interests at heart. They care, they love their work and they want to do the best job they can. Despite this, I have found the hospital system to be fractured; in spite of all the individual efforts made to save lives and heal people, it can actually cause the opposite: decline and death.

The major reason I see for this occurrence is at the very basis of western medicine itself: specialty-ism. In the medical world of microscopically dismantling the human body to discover how it works and to develop medicines for its diseased parts, the whole person is lost. The same arises in hospitals where there’s a specialist doctor for each system of the body who effectively helps that organ’s functions, but who also misses the rest of the body and personhood as a whole. This is great in terms of expertise, but if you are the patient, it could mean your healing process is not necessarily served, and even more so, it may make you worse.

For example, you may undergo a separate blood draw for each doctor, sometimes occurring every two hours and despite the fact that you might be anemic to begin with. Or you may have one doctor prescribe a medication that another doctor already knows doesn’t work or causes side effects, but that little detail didn’t make it into the records or the records weren’t read thoroughly enough, or the new doctor on duty decides to try that medication because it’s useful from his experience but in not knowing the patient, promotes side effects because it was inappropriate for that person in the first place.

This fractured system occurs within medical groups, too. The admitting doctor may belong to a larger association of doctors in the same specialty that shares hospital rounds on different days. A patient may see one’s personal doctor anywhere from every one to four days, but in extended stays, most likely will see a different doctor each day.

And every time there’s a different doctor, nurse, or technician, he/she has to fully read and understand the records and get to know the patient’s history all over again. That means the patient needs to catch them up so they aren’t experimented on, which if one is in the hospital in the first place can be quite trying and exhausting for any patient. And what doctor really has the time to fully catch up on all those new patients’ histories anyway? Plus, they may know the condition they are treating, but not the person in whom they are treating that condition!

Besides the lack of one person who oversees the entire case or patient for consistency, the best possible care, and to prevent wrongful experiments (yes, there are often "hospitalists" assigned to do this, but often they are the attending physician – the original admitting doctor – and neither will be present or available 24/7 let alone maybe four days in a row), there is one other aspect to hospitals that promotes decay rather than health: lack of sleep and rest.

Hospitals are NOT restful places; quite the contrary. Nurses, doctors, technicians and more have legal obligations and must regularly obtain stats, perform tests, and monitor or treat their patients. This includes in the middle of the night. It’s common for a person to be wakened every two to three hours regardless of the time of day as everyone performs his/her necessary duties. Doctors and nurses will attest to this. One doctor actually told my mom, "That hospital bed will suck the life out of you."

Being in my mother’s recent hospital room felt to me like a revolving door to Grand Central Station. During the day someone showed up almost every 20 minutes! That sounds like great care, right? In one sense maybe but it was also extremely disruptive. The people who appeared day and night included:

  • Various doctors
  • Various nurses
  • Nurse’s aids
  • Charge nurse
  • Physical therapists
  • Other therapists such as breathing therapists
  • People who clean the room
  • People who stock the room with new supplies
  • Chaplain and his/her team
  • People who deliver the meals
  • People who pick up the meals
  • People who take you for tests
  • People who bring you back from tests

quietpleasesingDuring my mom’s most recent hospital stay, she was disturbed every night as well by a stream of people who poked, prodded and tested her until she was wide awake 24/7 for four days. As can be predicted after such treatment, she steadily declined until it disturbed her Shen[1]. At that point, the hospital sent in a psychiatrist to treat her!

That’s when I discovered that there’s actually a hospital diagnosis called "IC psychosis," usually experienced by one patient out of every three after five days in IC (intensive care) units. This condition results in a cluster of serious psychiatric symptoms caused by the loss of normal anchoring that arises from repeated interruptions, continuously lighted rooms and loss of night and day cycles. As a consequence, patients become agitated, severely disoriented in time and space, paranoid, delirious and possibly hallucinogenic, all signs of Shen disturbance!

And what is one great factor in restoring Shen? Sleep!

In the hospital where I most recently spent time, there was a photo on the walls along all the corridors. Several practitioners stand in it, all with fingers to their lips, indicating travelers to "Shhhh" their way along. Indeed, most of the corridors were quiet (except when equipment was shuffled along several times daily), but inside the room itself, it wasn’t quiet at all. I mean even the chef, who had recently been hired and wanted to provide the best possible food every patient would like, stopped by twice because my mom wasn’t eating the meals!

This is good-hearted and well meaning indeed, BUT it sure is disruptive to the healing process. Sleep is, after all, the Great Healer, and this is one medicine definitely missing from hospitals.

All of this is to say that until the hospital scene changes, it’s important to have an advocate lined up to help you or your loved one heal AND it’s key to be an advocate for others. In general, an advocate is someone who:

  • Gives support
  • Speaks on the patient’s behalf
  • Promotes the patient’s best interests
  • Helps get the patient’s needs met

Stay tuned for Part II to learn many of the important roles of an advocate can fulfill along with information on Living Wills and DNR’s ("do not resuscitate" legal orders).

If you know anyone who might benefit from reading this blog, either now or in the future, please share it! And don't forget to leave your comments below.

[1] Shen reflects the entire physical, emotional, mental and spiritual health of the body. It includes the capacity to think and act coherently and appropriately, the personality’s magnetic force and the joy to live life. It is distinguished by the sparkle in the eyes, an overall vivaciousness and a will to live. Housed in the Heart, Shen is our enthusiasm, innate vitality and charisma. Spiritually, it is the dynamic faith, vitality and force of our personalities that are able to surmount obstacles and make things happen.

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