Alzheimer's caregiving is a tough, tough job. The physical demands and the emotional strains are exhausting. Before you know it, you've drifted away from your family and friends — at a time when you need them the most.

Not only can this be harmful to your physical and mental health, but it also can affect the quality of the care you provide. Caregiver burnout is one of the main reasons people with Alzheimer's are placed in nursing homes.

Being the primary caregiver for a person with any chronic illness is stressful. But Alzheimer's is one of the most stressful illnesses a caregiver can face.

The physical demands increase as the disease progresses. Your loved one needs more and more help with everyday tasks such as eating, bathing and toileting. The emotional toll increases steadily as you watch his or her personality slip away. And dementia-related behaviors can strain the coping skills of even the most patient of caregivers.

Many caregivers try to do everything themselves, which may be possible for a few months. But Alzheimer's is a path that leads only downward. And the journey can take years to complete.

The sustained stress of caring for a person with Alzheimer's can affect your health dramatically. Your immune system becomes less strong, so you are more likely to get sick and stay sick longer. Depression is the most common health problem in caregivers.

Despite these risks, family caregivers typically take care of everyone else's health better than their own. They usually sleep poorly, exercise rarely and eat less-nourishing foods. They won't stay in bed when they're ill, and they won't go to the doctor.

One way to reduce individual caregiver stress is to spread it out over more people. Some caregivers may be resistant to this idea, worrying that they may be seen as inadequate or selfish if they ask for help. Others may fear their requests will be rejected.

While it's true that some people may not be able to assist you, remember that most of your friends and family do want to help but simply don't know how.

The next time someone says, "Let me know what I can do to help," offer a couple of concrete suggestions. Perhaps a neighbor could do some yardwork or pick up your groceries. A relative could sort bills or fill out insurance papers. Friends might read a book to your loved one or take him or her for a short walk.

If you feel awkward asking for help, these tips might help:

• Consider abilities and interests. If a friend enjoys cooking, ask him or her to help with meal preparation. A friend who likes to drive might be able to serve as transportation to doctor appointments.
• Prepare a list. Let the helper choose from a variety of things that need to be done. That way, the task may be more suited to his or her interests and time constraints.
• Timing is important. A person who is tired or stressed might automatically refuse a request for help. That doesn't mean he or she wouldn't say yes at another time.

If you can't get enough help from your friends and relatives, there are agencies that provide personnel to watch your loved one for several hours at a time, either in your home or at a senior center. Counseling services and support groups also can help you cope with your caregiving duties.

You may have to be your loved one's primary caregiver for more than a decade. Think of the process as more of a marathon than a sprint. Marshal your resources and find every bit of assistance available, to conserve your strength for this exhausting journey. In the long run, you'll be helping your loved one as well as yourself.