Your friend Liz is visiting from out of town. You have been telling her for months about your new favorite

restaurant so you are excited to bring her there. When you arrive at the restaurant, the owner Kim greets

and seats you. Then Kim brings you menus and water. After you and Liz settle into your seats, Kim

returns to take your order. Kim then heads back toward the kitchen to prepare your food. After a few

minutes, Liz visits the restaurant’s restroom. When she returns she whispers that she saw Kim

replenishing the paper towels in the bathroom. While you are a little surprised to hear this, Liz seems

completely startled. Liz remarks, “I have never seen the owner of a restaurant do everything. I doubt

this place will be open for much longer.”

This restaurant is clearly not well-managed and Liz is right—if the owner Kim is doing absolutely

everything, there are going to be mistakes. Kim is also likely headed for burnout.

A similar scenario occurs frequently in caregiving for a sick or disabled loved one. One person—the

primary caregiver—often tries to do it all. Just as it is dysfunctional for all duties in a restaurant to be

handled by one person, it is also a mistake for caregivers to be the only person involved in caregiving.

Think of caregiving as a voyage. In order for the voyage to be as smooth as possible, you need a

captain, first mate and lots of dockhands.

The captain of the caregiving ship is the primary caregiver. This person is the main person coordinating,

planning, and/or providing care for someone who is ill or disabled. A primary caregiver may live with

the loved one or may simply be the key person handling things from some distance (from a single mile

to thousands of miles). Seldom are there multiple primary caregivers; it does happen, but very rarely.

Perhaps two sisters live close to their father and truly split the duties equally. But even then, in almost

all cases one does a little more and is the true primary caregiver. As boaters will tell you, there can only

be one captain, and it is mostly the same in caregiving situations.

A secondary caregiver is a person invested in the older loved one’s care but who is not able or willing

to be on the front lines as often or as closely. While the primary caregiver is the captain of the ship, the

secondary caregiver is the first mate. The secondary caregivers may perform some of the direct

caregiving duties (take the sick person to the doctor) but additionally, they may provide support to the

primary caregiver (bring dinner for her).

Tertiary caregivers provide support to the primary caregiver only. A tertiary caregiver is similar to the

dockhand at the marina. Any captain will tell you that docking can be stressful, even under decent weather conditions. When there is a dockhand at the marina, it is much easier for the captain to dock the boat. While

tertiary caregivers do not have much direct contact or impact on the older loved one, they can have a

significant impact on the primary caregivers. For example a tertiary caregiver might babysit the primary

caregiver’s kids so the primary caregiver can visit the loved one in the hospital.

Could the captain of the ship do it alone? Yes, but most boat captains will tell you that they are much more confident on their voyage when they have a solid crew they can rely on. Just like Kim’s restaurant would

benefit from staff and the captain wants a crew, you don’t want to be a lone caregiver.