Managing Caregiver Expectations: Recovery

Most people choose the role of family caregiver with little or no knowledge of what they’re getting into. Stroke is a sudden occurrence that requires many decisions to be made very quickly.

Lori Ramos Cavallo, Denver, Colorado

Most people choose the role of family caregiver with little or no knowledge of what they’re getting into. Stroke is a sudden occurrence that requires many decisions to be made very quickly. Often loved ones come home relying on their caregivers to have the answers about their care and recovery. This is challenging and adds stress to a life-changing role that was taken on without warning. I have found journaling very helpful and wanted to share tips about recovery via journaling, in a series of articles on managing expectations about recovery.

About two and a half years after becoming a caregiver to my mom, who survived a stroke, I realized I had built up resentment towards family, friends and even my mom for not meeting my expectations — expectations I hadn’t consciously realized I’d set. I noticed that I had begun a slow, steady path towards depression. I wasn’t sleeping, had difficulty concentrating and was getting headaches several times a week. I knew I needed to do something for myself, to continue to care for my mom and help her recover.

Counseling led me to therapeutic writing. I use my journal to manage the stress and emotions that can come from caregiving. With the right tools, a journal can be both a safe confidant and a way to manage expectations.

Let’s begin slowly with a 5-minute exercise. Find a quiet place where you will be undisturbed for several minutes. I found a good time for me was when Mom went to bed or while she was watching her favorite show.

Below are three partial sentences; pick one to begin the process and write for 5 minutes, setting a timer. When it goes off, finish your sentence and put down your pen. Read what you wrote and then write for 2 to 3 minutes more, beginning with “I am surprised by…” or “I didn’t realize that….” This is a very telling part of the process. We will use this “a-ha” moment in the next exercise.

Here are your sentence starters:


Don’t forget to add the 2-3 minute follow-up mentioned above.

After the journal exercise, what did you learn about your feelings concerning recovery? Are there ways you can adapt your expectations to be more in line with your loved one’s current stage of recovery and how fast it’s moving?

The next exercise is designed to help you identify new ways to think about the recovery process. Look back at your two minute follow-up and find the a-ha. Write a description of what the process might look like considering your a-ha realization. My a-ha moment was recognizing that I had expected my mom to be back to normal in a year. A year after her stroke, when she had not met my expectation, I had no idea how to continue. After writing about how to allow recovery to take as long as it needed, I was in a better place not to be disappointed because it was slow going.

I hope these exercises can help you in your journey. I look forward to sharing more techniques about managing expectations around family and friends in the next article.

Tips for using a journal:

  • Find the type of book you prefer to use; for example, a spiral notebook or a journal with bound pages.
  • Get a pen that is comfortable to use. -
  • Never edit yourself, misspelled words can hold a key.
  • Always set a time limit. The limit will depend upon the technique (from 5 to 30 minutes).
  • MOST important: When your time is up, put down your pen. Read what you wrote, then write for two more minutes - beginning with: "I am surprised by..." or I-didn't realize that...." This is where the real - a-ha moment will happen. I recommend that you use this awareness to write the next day, and keep writing until you feel you have resolved your topic or issue before you move to the next one.

About the author...

Lori Ramos Cavallo became a caregiver at age 43 when her mother, Lupe, had an ischemic stroke in July 2001 at the age of 75.

At the time, Lori was living in Denver and her mother was in California. Lupe’s husband, Lori’s stepfather, was too ill to become Lupe’s caregiver, so Lori moved to California in order to take on that job. Because of the level of commitment, which she likens to joining the military, caregiving became her whole life. After Lupe’s husband died in 2003, Lori moved her mother to Denver and took care of her until Lupe’s death in July 2009.

Continuing the military analogy, she wrote in her blog: “I too am left with the wounds from combat against the effects of a ‘brain attack’ that took my mom’s independence. Most family caregivers like me are left with both mental and physical scars from our time of service. I have begun my journey back into the ‘civilian population,’ and I am reaching out to other caregivers through my website My hope is to heal my battle scars by teaching others the successful strategies I learned during my tour of duty.”

This information is provided as a resource to our readers. These tips, products or resources have not been reviewed or endorsed by the American Stroke Association.

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