Mental Health Insights for Healthcare workers and other Caregivers

In today's episode of MaryLayo Talks, I’m with guest, Professor Dale Larson, to discuss the mental health of caregivers, who are also known or include care workers, carers and healthcare workers. Professor Larson shares about experiences nurses, doctors, therapists, social workers, and others such as the clergy can often struggle with in their role to help others, e.g., burnout, trauma, Covid, showing compassion and grief, and how they too can be helped.

Questions included:

• How prevalent is burnout among first line healthcare workers?
• What are the unique challenges healthcare workers face that impacts their mental health?
• What are the signs that a caregiver is facing burnout?
• Tell me about your book ‘The Helper's Journey’?
• What key things could a caregiver do to stay well and protect themselves?
• What advice would you give to a caregiver that is struggling?
• Bible verses about caring for others, being cared for and offloading burdens.

Take a moment to delve into what may be 'beyond the smile' - listen in to the conversation.

Guest details:

Professor Dale Larson is an award winning author and clinical psychologist. He is the J. Thomas and Kathleen L. McCarthy Professor of Counseling Psychology at Santa Clara University, a Fellow in three Divisions of the American Psychological Association (Counseling, Health, and Humanistic Psychology) and Member of the International Work Group on Death, Dying, and Bereavement.

Professor Larson is author of the book "The Helper's Journey - empathy, Compassion, and the Challenge of Caring".

Guest's website

Related resources: Check out Episode 1: Running on Empty & Episode 15: All Work, No Play also.

MaryLayo's spiritual wellbeing tips: Matthew 25:40, Psalm 23:1-4 & 1 Peter 5:7.

Connect with MaryLayo:

LinkedIn

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For help in dealing with mental health related matters, please seek specialist advice and support if needed.

1

Marylayo: Welcome to Marylayo Talks, a podcast

that discusses mental health and spiritual

2

well being.

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Before we jump in, there may be episodes that

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are particularly sensitive for some listeners.

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And if that applies, then I hope.

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Marylayo: You'll be able to join me whenever.

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Marylayo: You feel ready and able.

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Today's episode is on caregivers, and I'm with

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guest professor Dale Larson.

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Professor Larson is professor of counseling

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psychology at Santa Clara University in

Silicon Valley.

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He's also an award winning author, a national

expert on grief, burnout and resilience.

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So I asked him about the challenges that

healthcare workers and other caregivers

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experience and how they can stay well

mentally.

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Let's join in the conversation.

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Marylayo: How prevalent is burnout among first

line healthcare workers?

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How prevalent is it?

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Professor Larson: It's very prevalent.

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World Health Organization has now recognized

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it as a phenomenon of great importance.

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In a recent interview, the president of the

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National Academy of Medicine said that before

COVID about 40%, maybe up to 50% of doctors

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and nurses were reporting burnout, distress

and anxiety.

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Since COVID the figures have risen to 70% to

90%.

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Now, it's hard to get exact figures on this,

but a high percentage of health professionals,

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and I think helping professionals in general

experience significant amounts of burnout.

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And this is a real issue for us in today's

world because we need helping professionals

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who are not burned out to help everyone who is

suffering.

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Marylayo: Exactly.

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So what are the unique challenges then, like

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psychosocial risk factors?

What are the challenges that caregivers

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encounter that actually impacts their mental

health?

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Professor Larson: Well, doing this kind of

work asks a lot of us.

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It asks us to be present to suffering.

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It asks us to be pretty vulnerable because we

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are human beings doing this work.

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There are extreme demands that are placed on

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helping professionals.

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I'm thinking mainly doctors, nurses, social

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workers, clergy who are working with people in

oncology hospice and general medicine.

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And there's so many difficult experiences that

people have doing this work.

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There was a survey of end of life

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are your major stressors?

And they reported two things which I found

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very interesting.

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Number one was they thought overwork too many

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demands.

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Number one, stressor, which is not surprising

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in COVID, things were absolutely outrageous.

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And just recently there was a report in the

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United States of 100,000 nurses leaving the

profession.

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So that's a pretty good sign.

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Wow, burnout.

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But their number two stressor, which I found

really intriguing because of my own background

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and interest, is that they said we don't have

time to grieve.

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So those professionals working with dying

patients, or with everyday patients who become

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ill and die, they found the lack of

opportunity to grieve.

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So that's why we have more emphasis now on how

do we address that need, how can we provide

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opportunities for people to talk about their

experiences as caregivers in these situations?

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We have Schwartz rounds in healthcare.

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We have various efforts to kind of build in

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opportunities to talk about our experiences.

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If you're working in a high mortality

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saturation environment, how do you take time

as a team or as an individual to grieve the

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loss of this patient for whom you were in a

very intimate relationship?

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Marylayo: So let's take it maybe back a little

bit in the sense of what are the signs that a

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caregiver, whether they're professional or

even voluntary caregiver because they're

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caring for a loved one, what are the signs

that they are actually facing burnout?

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Professor Larson: Well, burnout there are

three things in addition to burnout.

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We have secondary traumatization and we have

moral distress.

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So let me talk about burnout, secondary

traumatization and moral distress.

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So burnout, first of all, it's hard to

recognize in oneself.

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So there are studies showing that people don't

recognize burnout in themselves, but their

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colleagues do recognize it in them.

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And it's really dramatic kind of finding.

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But how do we recognize it?

Well, burnout has three major characteristics.

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The first is demoralization, and that is that

inner experience of I'm not doing well at

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doing good.

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I'm kind of beating myself up.

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I'm not feeling good about myself, feel

helpless.

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It's like a learned helplessness experiment

that Martin Seligman did with the rats.

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You just can't do what you want to do.

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So the highly motivated person is more likely

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to experience this because they're most

frustrated when they can't make a difference

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in their work.

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The second characteristic is a little bit of a

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distancing that one experiences.

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You develop a kind of cynicism, oh, I have the

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cancer in room 238, and you start to find a

way to keep yourself emotionally distant

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because you're burned out.

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It's like a bright flame is more likely to

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burn out.

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That's the idealism burnout relationship.

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And you start to pull back and not be caring.

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And then you really dislike yourself.

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Because I got into this work as a physician,

as a social worker, as a clergy member, as a

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nurse, as a psychotherapist, because I'm a

caring person, and now I'm not caring.

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So that is a downward spiral.

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The final characteristic, which is almost a

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defining characteristic, burnout, is

exhaustion.

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Emotional, physical, psychological exhaustion.

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It's not because you're doing more physically,

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it's that it's emotionally demanding.

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So this is what burnout looks like from the

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inside.

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Then you have vicarious or secondary

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traumatization that you experience because

you're talking to people who are traumatized.

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If you're talking to someone whose child has

died, they're traumatized.

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And this trauma can be transmitted to you.

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And that's where empathy is challenging,

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because empathy is a double edged sword.

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It's the thing that makes you a little bit

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more vulnerable, but also can make you a great

helper.

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And you have to find a way to be an emotional

relationship emotionally balanced in order to

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do this work without burning out.

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I call that the challenge of caring.

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And then we have moral distress.

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So in COVID, we had so many examples of this

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where people were triaging.

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When you have to make a decision about who to

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attend to in an emergency room, who to give

this life support to, some very difficult

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decisions were being made.

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And in general, when we feel like we're not

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doing enough, or our organization is not

providing the kind of care we want, or our

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team isn't doing very well with our patients,

that leads to moral distress, and that can

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lead to what I call helper secrets.

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All these experiences, this trifecta

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troubling, trifecta burnout, secondary

traumatization and moral distress can lead to

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people concealing their experience.

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Because I don't want others to know that I'm

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burned out.

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You're looking over at the other professional

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across the table and you say, they're doing so

well.

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They seem like they're in control and managing

this so well, and yet I'm feeling terrible.

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And that's what leads to many people leaving

the field.

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And undoubtedly those 100,000 nurses, many of

them were feeling the same thing.

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It's just not right for me.

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But if they had gotten the support they needed

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in those difficult moments, if they had an

organization in which they felt like their

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mission division process was in alignment with

the mission division process of their

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organization team and they got the support

they needed, I don't think they'd be burning

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out.

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Marylayo: Very true.

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So I want to come on to your book.

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You've written a book called The Helper's

Journey empathy, Compassion, and the Challenge

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of Caring, and that was written for

caregivers, and it won a Book of the Year

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award from the American Journal of Nursing.

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Can you tell me about that?

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Professor Larson: Yeah, it goes from the

inside out, if you will.

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It begins with the inner experiences, like

some of those we're talking about, what's our

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mission in the work?

How did we get here in the first place?

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Call those emission moments when we discover,

well, this is why I'm here.

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We don't have them every day necessarily, but

we learn from them.

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Well, this is what really brought me in.

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This is what can keep me in.

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This is what can nourish me and make me

realize why I'm here in the first place.

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And then talk about stress management, because

we need to find a way to manage our stress.

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We need to find a way to be emotionally

involved without burning out.

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We need to learn about self care and

reappraisal of stressful situations and

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mindfulness and self compassion.

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So I write about all these new ideas that we

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have in psychology, a lot of them coming from

positive psychology.

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And that's kind of exciting because to realize

we can do something about our stress is very

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important to realize the fact we can make a

difference.

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Resilience is not a trait, really.

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It's an outcome.

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We can affect that outcome.

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Maya Angelo said, you cannot control all the

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events that happen to you, but you can decide

not to be reduced by them.

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Albert Vander was sitting in this office with

me that I'm in right now, and he's the person

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who developed the idea of self efficacy, I

think one of the foremost psychologists of the

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20th century.

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And I said, what would you tell all the

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doctors, nurses, therapists who are struggling

out there?

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He'd say, don't let them wear you down.

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And he quoted this.

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It's not really Latin, but illegitima known

carborundum, which means essentially, don't

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let the B-A-S-T-A-R wear you down.

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So it's important to realize we can do

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something about it.

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Then I talk about self concealment, and that's

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a big research area.

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Now, my scale has been used in 15 countries

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and there are 220 studies now looking at the

tendency to self conceal and how that causes

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us problems, especially as helping

professionals, and leads to helper secrets.

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I write about helper secrets, which is another

thing I focused on a lot in my career.

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All these troubling experiences we have that

we don't disclose to others, but then can kind

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of corrode from within.

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Then I go to the interpersonal realm and look

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at, well, how can we communicate more

effectively?

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How can we develop a person centered

relationship?

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What makes that work?

What's at the heart of that to put our

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compassion to work and with the patients we're

caring for?

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And then team issues.

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So focus on what makes for a healthy team.

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What do we know about team functioning and how

can we get our mission division process

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working within the team and increase

effectiveness and the compassion that we're

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providing in our care?

And then finally, I end with a bigger

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statement about compassion in the world and

how do all these ideas relate to what's

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happening in our society and in the world?

Largely looking at all the developments that

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have happened recently and how we can take

some of the ideas from psychology and put them

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to work and creating a more compassionate

society.

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It was an exciting thing to write.

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I was really glad that it got recognition.

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Marylayo: It certainly sounds comprehensive in

terms of what it covers.

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You mentioned healthcare workers, how they

need to find that balance in terms of still

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being emotionally involved, but without

getting burnt out.

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And when you were talking about that, it

brought a picture to my mind.

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And so when my mum passed away, for example,

who broke the news was a nurse in the

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hospital.

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So I was in the hospital with a nurse and it

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was obvious that she'd been crying and she was

in the room with me.

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And I had to tease out of her what happened

because maybe she'd been sent there to keep me

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company or to hold the fall until the doctor

came to share the news.

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And so it was basically when the nurse shared

the news, I knew because of her reaction,

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because she'd been crying and because she

dared not even look me in the face.

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And I felt she was very emotionally involved

and it had upset her.

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However, when the doctor came to share the

news, it was all very mechanical, very

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factual.

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And so there was a big difference between

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those two healthcare workers and basically how

they expressed themselves or how involved they

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were when it came to empathy and being

attached.

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Yeah.

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And there's a part of me that actually really

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valued or appreciated the nurse because she

cared.

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It was my mom.

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She cared and it bothered her.

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Just oh, it concerned her and it showed in

terms of how she was.

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So back to the point that you raised about

being emotionally involved.

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How can a healthcare worker be emotionally

involved and protect themselves?

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They're there to care.

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And if something traumatic has happened, it

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can impact them.

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So how can they remain healthy?

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Professor Larson: Yeah. Mary Loud this is

really a great illustration.

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Your personal experience really illustrates so

many things.

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So how can we do that?

First of all, people don't care what you know

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till they know that you care.

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The nurse with tears is an interesting

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example.

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And then the doctor coming in and being more

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just rational.

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And it's highly likely that the nurse had a

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much deeper relationship with your mom.

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Nurses are on the front lines.

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They're caring for patients day to day.

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Your mother was obviously special to her in

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some way and she had real feelings.

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And this is something that the idea that we

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know that helping professionals when they

report, especially end of life professionals,

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say that the number one stressor is

overworked.

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The number two stressor is no time to grieve.

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So that nurse was grieving there.

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Now the question is, okay, how can she do that

in a way that she's not feeling shame and that

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she's able to still be helpful to you?

I have a metaphor that been used a lot by

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people over the years because I think it just

makes sense in a way, the helper's pit, that

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we don't want to fall into the helper's pit as

helpers because we don't want to identify with

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the losses of people we're caring for.

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And we have to find a way to keep our

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emotional balance.

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So when Mary Leo walks in the room, I'm able

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to communicate with her.

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And you saw the grief that she was

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experiencing.

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It was for you.

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It meant something that's special.

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She was caring for my mother, and that's

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beautiful.

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I've asked, like, one time I was lecturing to

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5000 oncology nurses all at once.

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And I said, how many of you have had a tear in

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your eye when you're working with patients?

Every single person in the room raised their

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hand.

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Everyone.

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I couldn't see maybe every single but it was

the whole yeah, it seemed like I said, for how

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many of you?

Did the patient or family member run out of

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the room saying, my nurse is having a feeling

I can't deal with it.

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No one raised their hand.

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We are human beings working with other human

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beings.

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But the trick is we don't want to fall into

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the helper's pit and then have all the focus

shift to ourselves.

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That's self focused, and that's not helpful to

the people we're caring for.

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We have to maintain that empathic

relationship.

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So she had to also be there for you, and

that's key.

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So we've got to find a way to be emotionally

involved.

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And I've devoted a lot of my career to trying

to understand this experience I write about

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extensively.

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How can we be emotionally involved?

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How can we nurture our compassion and find a

way to express that without burning out and to

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help people live with hope in a world in which

loss is inescapable?

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That's kind of the challenge of caring.

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That is the challenge, caring.

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So I think we need technical expertise and we

need relational expertise from our caregivers.

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And that's across the board, whether it's

psychotherapist, a social worker, nurse,

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doctor, chiropractor, whoever it is, we need

both and to have really truly compassionate,

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person centered care.

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Marylayo: And Dale, a lot of what you've

mentioned or certainly touched on and

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referenced from your book was just about like,

teamwork and even having that space for

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grieving, for professionals.

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So I see that there are a lot of challenges

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for the healthcare sector when it comes to

ensuring that the healthcare worker is able to

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get back to being well or staying well

mentally, because a lot of those issues could

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be systematic or cultural within the

organization.

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So, yes, they may try, but the fact of in

terms of the number of hours that they're

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doing or maybe the scheduling or what they're

encountering in terms of patients and it's

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probably not a response you're able to give

because it's going to be so detailed.

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And it's probably in your book that are there

ways you can share?

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What the key things someone would be able to

protect themselves?

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Professor Larson: Well, first, one of the key

findings in the burnout field, chris Manslack

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at Berkeley had this understanding of burnout,

which is, it's not bad apples, it's bad kegs

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that the apples are in.

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It's the system we're in.

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I don't think those 100,000 nurses who left

the field recently left because there was

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something wrong with them.

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We couldn't have predicted them leaving the

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field by giving them a personality measure

before they entered the field.

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We could predict them leaving the field by

looking at the organizations they're in and

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the lack of support that they've received.

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Healthcare has become brutal in so many ways

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in terms of not providing enough support for

healthcare workers.

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And that's a reality.

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And we are struggling, at least here in the

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United States, I'm sure true in England as

well.

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I have spent quite a bit of time in England at

the various hospice programs at St.

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Christopher's Lecturing, and I know that these

are universal kinds of situations.

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But in our system, which is very often for

profit and driven by bottom line.

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Bottom line is not taking care of our health

professionals.

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So the bottom line is making more money.

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And we've seen that with hospice care becoming

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more and more for profit here in the United

States, it's coming a little bit of an issue.

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Not that all for profit organizations are bad

or all non profit good, but whenever your

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mission is to make more money versus you're

making more money to fulfill your mission, you

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have problems because you think, well, should

we provide this extra service for our patients

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or the community?

No, we're not going to do that because that

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would cost us money.

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We don't have to do it.

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I'm not an expert on all that, but I just have

my observations.

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But I do have expert knowledge about the

stressors that health professionals and

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caregivers generally are dealing with.

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And we need to provide for family caregivers

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as well.

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In the United States, we're trying to get some

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mobilization of a national policies that would

be supporting family caregivers.

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We would provide tens of billions of dollars

of support for their loved ones.

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I mean 50 just huge numbers of people

supporting their loved ones who have

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Alzheimer's and different infirmities.

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So we need to do more to support those who are

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helping us with our conditions, our

situations, our suffering.

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And I hope that the future holds more promise

in that regard.

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Marylayo: Sure. Like you mentioned about COVID

how that made a significant increase in terms

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of healthcare workers leaving the profession

pre COVID and post COVID, there's that

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significant difference.

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So actually, are there any specific signs that

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as a caregiver it shows that it's because

they've been traumatized by COVID?

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Is there anything in particular that shows

that it's because of that traumatic period?

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Professor Larson: Well, actually we have now a

psychologist.

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We always develop measures.

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So the first thing we do is we say can we

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measure this?

And then we try to develop a scale.

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There's actually a COVID Stress Syndrome

Scale.

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And here are the items fear of Contamination.

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So think about people who are really high on

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these items.

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I'm really afraid of being contaminated.

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This is true in general.

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I mean, COVID has not gone away and it's still

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a reality in our lives and will be, it seems,

forever.

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I have an acronym that people will find

humorous probably Scared situational

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coronavirus Activated Relational Disorder.

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But it's this fear that we have when you're

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encountering anybody who's new in your life,

have they tested?

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This is a little barrier between us and

others.

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So I call it scared but fear of contamination.

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Worry about finances because you're worried

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about losing money.

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These are the items from the scale xenophobic

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fear that foreigners are spreading the virus.

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Traumatic stress symptoms associated with

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direct or vicarious traumatic exposure.

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Compulsive checking and reassurance seeking

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profound and pervasive experiences of grief,

loss and trauma are I think really reshaping

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how we live, die and grieve now in the future.

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And this COVID stress syndrome, not sure what

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that'll look like when it's administered to

tens of thousands of people if it is.

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But some of those elements we can all relate

to.

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I think this COVID has affected us all.

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It's changed our relationships.

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I know I'm always thinking am I safe?

It's really taken away a sense of security.

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I never thought about going into a crowded

room as any kind of threatening situation.

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I'm going to a conference soon where I'll be

with hundreds of people.

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I don't know how comfortable I feel standing

at the boot know with a bunch of people I

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don't know they tested.

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So this is the kind of anxiety that I know

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people go oh no, I'm not worried about that

anymore.

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But I don't know.

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In my own life I've had six friends all

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actually coming back from Europe on long term

flights who've developed COVID and a couple of

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them have long COVID now so it's not gone

away.

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Marylayo: So those items that you mentioned in

the scale, if there's an increase in them then

400

there's a chance that it's because the

individual has been traumatized by COVID.

401

So how could they then cope with that or deal

with that, address it effectively?

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Professor Larson: Well I think we have to have

exposure whenever we have any kind of anxiety

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issue.

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So I think it is good that we find ways to

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begin segwaying back to normal but we're in a

new normal, but segwaying to this new normal

406

reality that we're in.

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So I think exposure is good to find safe

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contexts where you can be without a mask.

409

Most people now I know on airlines are not

410

wearing masks so there's a way that that's

really good.

411

There's another way that it's a little bit

brazen because I know people listening might

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be saying oh my gosh, he's so stuck in this

COVID fear.

413

It's a reality still and it's something we

have to pay attention to but we don't want to

414

be overwhelmed by it, we don't want to be

panic stricken, we don't want to score super

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high on the COVID stress syndrome.

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We have to find a way to adjust.

417

So it's going to be part of our future that we

find a way to be overcoming these anxieties.

418

And I think we do that through exposure

principle in psychotherapy.

419

So we find ways to reappraise, we check out

the realities of how prevalent is the COVID

420

right now?

Right now, what's going on in my area and

421

what's going on generally and I think then we

find a way through this.

422

Marylayo: And specifically talking about those

caregivers that focus on end of life, there

423

will be some that are in positions of

harboring secrets.

424

So it could be for example, the load is on one

particular caregiver rather than others in the

425

family and there could be resentment that's

felt by that caregiver.

426

It could be self doubt, maybe in terms of the

fact that they feel that they haven't given

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perhaps the level of quality care that they

could have, or maybe they've made a mistake.

428

So perhaps there's some secrets that the

caregiver may be harboring when in an end of

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life support scenario, what can they do to

help themselves?

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Professor Larson: Well, I think you've

outlined some really important ones.

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The resentment.

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What about me?

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Is one of the categories.

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When I do research on helper secrets or

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caregiver secrets, it's a very common one.

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What about me?

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I'm caring for others.

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Also feeling these self doubts, like I'm not

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good enough or I'm not caring enough.

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So it can go both ways.

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And it's very important to recognize these,

which I term helper secrets.

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And you get stuck in the fallacy of

uniqueness.

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The belief that I alone am having trouble with

this.

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And there are some secrets that we possess,

there are other secrets that possess us.

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So some of these can really drive you out of

the helping professions if you're not sharing

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them with others, if you're not normalizing

those experiences, you're not finding a way to

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share them with somebody and also to get

feedback from others who are experiencing the

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same kinds of things.

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So I think the key thing they can do, any of

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us can do with these kinds of inner

experiences where they get kind of stuck in

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our echo chamber and we end up feeling bad

about ourselves and we have shame because, oh

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my gosh, nobody else would feel this way.

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The fallacy of uniqueness.

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It's me.

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I'm unique.

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It's my failure.

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It's something about who I am.

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No, it's about the situation.

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It's about this environment that I'm in, these

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demands that are placed on me, this lack of

support, et cetera.

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And so they need to find a way.

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I think your question is what can they do?

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They can find a way to explore these inner

experiences, to have self compassion.

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I'll Let Kristen Neff has written extensively

about this, but what Carl Rogers also wrote

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about and taught about beautifully, as one of

my teachers and inspirations, how to accept

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ourselves.

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When we can accept ourselves, we can change.

468

We have to accept these inner experiences.

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Listen, to know burnout is in general, it's a

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badge of honor.

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You don't burn out unless you're on fire.

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So one of the idealistic people are more

likely to burn out because they're on fire.

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They want to make a difference.

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And when I can't make a difference, I feel so

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frustrated.

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Actually.

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We found that high commitment nurses are

really not bothered by the stupid things that

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other people are bothered by.

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Like the paper is not in the right place, et

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cetera.

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It doesn't really bother them.

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But it's when the quality of care is

compromised that they really are suffering.

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So that's an important point, I think.

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So we have to realize that it's not just me,

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it's not all about me, it's situation I'm in.

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And then when we get that new perspective,

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we've got to see what we can do to change that

situation in this organization or in our

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personal lives, helping lives.

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We have to find a way to find balance

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emotionally in the moment.

491

We have to find a way to take care of

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ourselves and set limits and do things for

ourselves outside of our helping work.

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Like how about vacations?

And about taking time for yourself to do

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things that are nourishing.

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And increasing that self compassion and

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increasing your ability to have the resources

that you need when you are going into these

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helping contexts so that you can really give

what is demanded of you.

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And there's a lot that's asked of you that

these helping situations ask a lot of us.

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They ask us to be present suffering.

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They ask us to be vulnerable.

501

They ask us to be teammates with people.

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When we're used to being Lone Rangers solo

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kind of helpers.

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Now I've got to work on a team and work

505

interdependently.

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There are a lot of issues that I've talked

507

about and written about about these things

that are so central in helping.

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Marylayo: And lastly, there may be someone

listening who is a caregiver that's

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struggling.

510

Would you like to share anything with them

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directly?

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Professor Larson: Well, first I'd like to

thank you for your work and I really hope that

513

that is experienced is really taken in because

I've dedicated my life to supporting people

514

like you.

515

I have a tiny clinical practice, but most of

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my work has been researching and trying to

understand what's going on here.

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And how can the things that we're learning in

psychology help you do what you're doing?

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What matters to you?

I would say take time to understand how you

519

got here.

520

What matters to you?

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What is your mission in the work?

One of the things we know now is that

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compassion could be one of the best buffers

for stress.

523

I know that sounds not right because we think,

oh no, the more compassionate person is more

524

likely to burnout.

525

No, actually compassion balanced emotional

526

involvement.

527

And compassion is an antidote to burnout.

528

Empathy is an antidote to shame.

529

Compassion is an antidote to stress because it

530

enlivens you and you find a deeper sense of

happiness.

531

There's a term that is very old.

532

It's a Greek term, eudemonia.

533

And eudemonia is a deeper kind of happiness.

534

It comes when we live our lives with our

535

values and the meanings that really matter to

us.

536

Activated Actuated and I would like you just

to reflect on that, on your helping journey,

537

that what you're doing has meaning.

538

It's going to reverberate far into the future

539

long after you're gone and I'm gone.

540

In the families that follow, the patients

541

you're caring for, they will be sharing this

goodness that you're sharing with them.

542

And then.

543

Those children will share it with the next

544

generation.

545

So all this goes on far into the future.

546

And so feel that for yourself and also

recognize, hey, this situation is challenging.

547

It's not all about me.

548

It's not my failure.

549

It's that I have to find a way to navigate a

difficult world of helping, but one that is

550

deeply meaningful and can have so much

significance and such a legacy for you and

551

your life.

552

So thank you for your work from the bottom of

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my heart.

554

Marylayo: Well, Professor Dale Larson, thank

you for those words of encouragement to

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caregivers, particularly those that may be

struggling.

556

Thanks for joining me on Mary lyre Talks.

557

And for those that are listening, stay well

558

and hope you join me next time.

559

Being a caregiver can be overwhelming at.

560

Marylayo: Times, so here are a few spiritual

wellness tips you can meditate on.

561

The first is Matthew, chapter 25, verse 40,

which reads, and the king will answer them.

562

Marylayo: Don't you know when you cared for.

563

Marylayo: One of the least of these, my little

ones, my true brothers and sisters, you

564

demonstrated love for me.

565

Another is Psalm 23, verses one to four, which

566

reads the Lord is my shepherd, I shall lack

nothing.

567

Marylayo: He makes me lie down in green

pastures.

568

Marylayo: He leads me beside still waters.

569

He restores my soul.

570

He guides me in paths of righteousness for his

name's sake.

571

Marylayo: Even though I walk through the

valley.

572

Marylayo: Of the shadow of death, I will fear

no evil, for you are with me.

573

Your rod and your staff, they comfort me.

574

We'll end with first Peter, chapter five,

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verse seven, which reads give all your worries

and cares to God, for he cares about you.

576

Thank you for listening.

577

Marylayo: Do follow and join me again.

578

Marylayo: Next time on Marylayo Talks Beyond

the Smile.