I Care, and I Have Limits
The Yes/And of Midlife Care. And what the research tells us about caring.
Care has never been simple—especially for women.
And in midlife, it often becomes a quiet inheritance OR disinheritance: of people, of roles, of responsibilities, of grief.
When my 82-year-old aunt Kata died last week, I didn’t just inherit grief—I inherited her husband, my uncle Stjepan, 81, who lives with dementia and insists he doesn’t need help. He won’t accept any home care (“I’m fine!”) and won’t move into a retirement home. I live in Vancouver, BC. He’s in London, Ontario.
My mother, Doris, who also has dementia, is already in long-term care, 2 hours away from there in Windsor, Ontario, and I’ve been managing her needs from across the country for 5 years.
Two weeks ago, I got an early morning call —the kind that tells you everything is about to change.
The palliative care team said my aunt was close to dying. I cancelled my clinic day, took a redeye flight, 5 hours to Toronto, drove 2 hours to London, and stayed with her for the week. She talked (and yelled) about it to be over. She wanted MAiD. She was tired and “done”. She was clear. She passed for first few assessments but ultimately didn’t qualify —when she finally said yes to some morphine, for her it quickly blurred the line between pain relief and lucidity, and the window for consent closed.
She didn’t want to tell my uncle she wanted MAiD.
They’d been together forty years. Loving. Codependent. Entwined. She was the one who held things together, administratively, financially and linguistically.
She was born in Canada to Croatian immigrants; he immigrated from there in his 30s and still struggled with fully expressing himself in English.
She wasn’t scared of dying. She was scared of what it would do to him.
Saturday she died.
Monday he forgot.
I got another early morning phone call from the palliative care ward in London. He took a taxi back, convinced she was still there. He’d already visited once, but the memory had vanished.
At the same moment, as I am on the line with social worker feeding him a sandwich and tea, his doctor was calling me—he’d missed labs and specialist appointments.
Suddenly, I wasn’t just next of kin—I was everything.
Executor. Medical contact. Power of attorney. The keeper of all the pieces.
Just yesterday, I got a call at 4 am my time that the police had been to my uncle’s house.
Stjepan had called the police saying he was looking for his missing wife.
I find out just after from my uncle that he does not know why they came, and when I start to sound alarmed but he says, “Heidi what are you so upset about? I enjoyed talking with them, they were nice people”.
I also found out for the first time that there is a 30-something-year-old woman who has discovered his vulnerabilities. She met him as he was heading back from the mailbox, looking like he was having trouble walking, she drove him home.
She was sitting at his dining room table having a coffee with him when I called. He told me she was so kind, she drove him to the bank a few days ago. I later see on-line he withdrew 2500 in cash that day. I later register to put on an alert.
When I asked to speak with her, I tell her I’m his niece and POA and found out her name was Nicole—and she was already positioning herself as his new “caregiver.” She says she has 3 kids and is visiting her mother who lives nearby. I think to myself, how does she have the time to sit with my uncle and drink instant coffee at his dark dining room with newspapers, ads, mail and opened bank statements, and disorganized bills scattered across the table?
She reprimanded me for sending a repeat grocery order via Instacart, saying she had already stocked his fridge.
Then came the red flags: she started to pummel me with questions about his medications, his car documents. She doesn’t know me….
When I paused for more than a moment and asked, “Why do you need to know?”, she said: “Heidi, it sounds like you are getting irritated. I am just a caring neighbour trying to help a heartbroken man”.
Inappropriate, urgent, and unnerving.
I called the community police officer who’d recently visited my uncle. He told me best to cut this off immediately. “He’s very vulnerable. I’ll call her,” he said. “She needs to stay away.”
Needless to say, it’s a lot. And yet—I care.
The Myth of Midlife Apathy
There’s a cultural story going around that menopausal women have stopped caring. We’re fed this image of the “I don’t give a f*ck” midlife woman, shedding people-pleasing and externally imposed responsibilities like a snakeskin. There’s much truth in that shedding but let’s not confuse boundaries with emotional disinterest.
The truth is more nuanced.
I’ve never cared more deeply in my life.
But what’s shifted is how I care. And why. The care isn’t reflexive. It’s not performance. It’s not self-abandonment masquerading as obligation. It’s intentional.
There’s a difference I’ve come to understand—one I think many of us reach in midlife, sometimes through exhaustion, sometimes through clarity:
The difference between reflexive care and intentional care.
Reflexive care is what many of us did in our earlier decades—automatic, expected, unexamined. We cared because we were supposed to. Because we didn’t yet know how to say no.
Intentional care is different. It’s chosen. It costs something—but it’s given freely, not out of performance or pressure, but out of deep alignment with who we are becoming.
That’s the kind of caregiving I’m navigating now—not easy, but real.
Not always graceful, but grounded. And I’m imagining more sustainable.
The Staging of Awakening and Caring
Here’s what I’ve seen—in myself, in my patients, in the women of Pink Zones. There’s a staging to the maturity of waking up.
Stage one: Self-abandonment.
In our earlier years, we often mistake over-functioning for love. We say yes too easily. We tolerate too much. We care so hard (about how others feel and how they think of us) that we vanish ourselves in the process.
Stage two: Boundary building.
Eventually, something cracks. We read the books (Terri Cole!). We listen to the podcasts (Re-Imagining Love!). We find the language. We start saying no. It can feel abrupt, even aggressive when the pendulum swings—but perhaps it’s necessary. We need to feel the difference between a reflexive yes and a conscious one.
Stage three: Discernment.
With time, boundaries become less about defence and more about discernment. We know what depletes us. We know what matters. Both “whats” can indeed tax us and drain us at times, we are human after all but we will ALSO carve out time to refill and restore. It might be at the very end of the day or it might be a week later, but we will not neglect ourselves indefinitely. We stop asking for permission and validation.
Stage four: Capacity.
And then, a second blossoming happens. We come full circle—not back to endlessly over-giving, but forward into right-sized care. We choose love, even when it’s hard.
We show up, not to prove our worth, but because we’ve clarified what is worthy of us.
This is where I am now. Not because I’m trying to be a heroine.
Not because I have unlimited energy (I don’t).
But because I’ve come to understand what this life is really about.
I saw that in the conversations by my aunts’ bedside, me and her and her and him. The love I witnessed between them and me for them was otherworldly and melted my heart. And that care—when offered with intention—is one of the most radical, powerful things we can give.
The palliative care nurses, doctors, and social workers who see some version of this many dozens of times weekly and yet continue to hold compassion hourly in their workday and likely at home.
I’m behind on everything—work, life, a mountain of to-dos, and the never-ending admin that comes with caring for my mum. And still, I keep coming back to this sense that this is what I’m here for: to witness these moments like when I was in London, to feel these feelings, to be fully present with the people I get to exchange presence with.
I’ve been back home for two weeks before heading to Ontario again. Most mornings have felt like a shock of too many early ringing phone calls and dense days at times a blur of putting out fires alongside clinic work. But I’m so grateful for the long hours of summer light with the sun setting at 9:20pm, which have let me slip in cold ocean swims, stretch out on warm sand after, share meals with big-hearted friends, and find comfort in small rituals: cuddling with a lover, a sauna and cold plunge, acupuncture squeezed in a break, massage therapy after work, and a pedicure at the end of a day I felt like a complete zombie. The image below is one illustration of me at days end.
I’m soaking up all the Heidicare while I can—the things that fill me up. I know I won’t have the same access to them once I head off in a few days to tend to all things Stjepan... and a generous dollop of Doris.
Gus, my mum’s boyfriend of two years, has been calling in a state of panic lately. He’s insanely smitten with her special charm and totally devoted to ensuring her well-being and happiness, but also needy and insecurely attached. Gus swears another resident—George, who sits at her dinner table—is making a move.
Doris denies it completely. “Nonsense. Gus is my sweetie,” she tells me.
When I suggest, “Well, Mum, maybe you need to reassure Gus and let him know that you’re not into George,” the normally loquacious Doris must also be channelling her inner Boundary Boss and cuts in firmly:
“He has been told!”
Anyway, this Ontario trip has a different mission entirely.
Pink Zones Reflection: What We Carry, and What We Choose
In the Pink Zones, we talk a lot about resilience, wisdom, and reimagining the feminine. And here’s what I’ve learned: Care is not the opposite of boundaries. It is what happens after boundaries—when we choose, freely, to invest our love.
The real flex of midlife isn’t detachment. It’s discernment. It’s not that we don’t care anymore. It’s that we’ve learned to care with our eyes open and hearts often broken but bigger. We have a different capacity.
So if you’re in that messy middle—where the old reflexes don’t serve you, but the new clarity still costs something—I would say this. You can care. You can have limits. You can show up when it matters—and still hold onto yourself.
That’s what mature care looks like. And that’s what the world needs more of.
Want to know more about what science says?
Read these two snapshots below!
👵🏽 Research Finding for Flourishing #1: Caregiving and Longevity in Women
A large 10-year study found that:
Women who reported being caregivers at two points in time had a 9% lower risk of all-cause mortality than non-caregivers.
This longevity benefit held true even after accounting for age, health status, depression, and optimism.
The effect was consistent across subgroups—including less frequent caregivers and those with depressive symptoms.
The takeaway: When caregiving is sustainable—not rooted in depletion but in connection—it may not only support others, but also extend the life and well-being of the caregiver herself.
As the population of women 65+ grows, understanding the *true* health impacts of care will be essential—for policy, for families, and for how we care for ourselves.
🔗 Read the Caregiving and All-Cause Mortality in Postmenopausal Women full study
🧠 Research Finding for Flourishing #2: Why Self-Compassion Matters in Midlife Care
A 2025 study of postmenopausal women (ages 50–60) found that:
menopausal symptom severity significantly impacts social well-being, but that self-compassion plays a key role in preserving a sense of social coherence and connection.
the more self-compassionate a woman is—even in the face of hot flashes, insomnia, or brain fog—the more likely she is to feel grounded and emotionally connected in her relationships.
The researchers note that fostering self-compassion can be a protective factor during this life stage, especially when social support or understanding may be lacking.
Women who were gentler with themselves stayed more connected to others—even in the midst of discomfort or change.
This mirrors what I see in practice: women who cultivate gentleness toward themselves often care for others from a fuller, steadier place.
The takeaway: Self-compassion isn’t just self-care.
It’s a *relational anchor* that helps women stay present, emotionally intact, and able to care for others without losing themselves in the process.
> 🔗 Read the full study:
Beautiful message Heidi- heartfelt and helpful!! 🙏
This is so clear and true -- resonated really deeply. Thank you