Caring for a seriously ill family member can lend a tinge of blue to the holidays. It may be sadness that cherished family rituals are no longer possible. Or worry that this year will be the last for your loved one. Here are some ways to handle these common stressors.

- It doesn’t have to be “all or nothing.” Even if some family customs are no longer realistic, embrace what’s still possible. And let go of the guilt-laden “shoulds.”

- Keep it simple. Perhaps you still gather at Mom and Dad’s, but order a precooked, take-out meal. Or have everyone contribute to the meal. Try to capture the essence in a way that no one person shoulders a big burden.

- Focus on the most meaningful activities. Your energy and your loved one’s energy are limited! Pick one ritual that truly gives you that holiday lift and consider any others an “extra gift” of the season.

Acknowledge the “anticipatory grief.” You’re not crazy if pulling out your holiday sweater brings on a bout of tears.

- A holiday can sharpen awareness of life’s impermanence. You may feel grief about the losses you have already experienced. And grief as you realize your loved one may not be with you next year. These feelings are normal. If possible, share them with someone who understands.

- Celebrate your loved one’s presence. Trying to “make this holiday the best” may distract you from spending quality time with your relative. Instead, take the opportunity to cherish what you have now, and revel together in shared memories of holidays past.

Maintain your normal self-care routines. In this season of extra stress, it’s especially important to get enough sleep, eat sensibly, and exercise regularly.

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As we face the possibility that we are in the last chapter of our lives, our priorities suddenly change. Life’s details may fade to the background, and we may find ourselves looking at its deeper meanings. Old conflicts pale in importance, and the desire to resolve difficulties with family relationships often comes to the fore. Serious illness presents an opportunity to evaluate one’s life. People often reflect upon their accomplishments and even humbly acknowledge their regrets. When facing a serious illness, we commonly think about what remains undone and focus on addressing those issues one day at a time.

Luis is a 68-year-old man who has advanced diabetes. His kidneys are starting to fail. When he is honest with himself, he realizes that the dialysis is only a temporary solution. Although he was religious in his youth, he has not been to church in many decades. As he concedes that his illness is quite serious, spirituality is becoming more important to him. He spends quite a bit of time seeking his own interpretation of the meaning of life.

As the days and weeks pass, Luis goes back and forth between periods of hope and periods of letting go. Both he and his family are grieving, yet they have also become aware of the gifts his illness has revealed. For instance, Luis has been able to mend some of the rifts in his relationships and has resolved a long-time family conflict with his daughter that separated them for more than 15 years.

Although they are uncomfortable thinking about his death, his family caregivers know it is inevitable and are doing their best to make him comfortable. Still, it is extremely difficult to watch someone you care about gradually decline, with little hope of getting better. His children are also concerned about their mother. They hope that when the time comes, they will be able to band together and support her, and each other, in their mourning.

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