What We Pass On: “Good People Put Others First”

You learned this one early, and you learned it as praise for somebody else. A neighbor sat with a dying woman for three weeks, or an aunt took in her sister’s children, and the adults said it about her while you were in the room. It is usually a compliment, and a compliment asks nothing of you, so there was no reason to hold it up to the light. And by now you have probably said it yourself, about somebody, while a daughter or a granddaughter listened.

This is a good sentence because most of the care that has ever been given in this country was given by people who believed it, and it is holding families together as we speak.

But I want you to look at one word in the sentence. First.

Who Is First and Who Is Last

First is an ordering. If somebody is first, somebody else is last, and the sentence never says who. It leaves that to be settled quietly by whoever is listening, and most of the women I know settled it the same way.

AARP and the National Alliance for Caregiving published Caregiving in the US 2025 in July of last year. Sixty-three million American adults are providing ongoing care to someone with a medical condition or a disability, close to a quarter of all adults, and that is a 45 percent increase in 10 years. They average 27 hours a week. About a quarter of them give 40 hours or more, which is a full-time job. Thirty percent have been at it for five years or longer.

The finding I want to show you is in a different part of that survey. It asked caregivers whether they had felt they had a choice about taking the role on. Fifty-six percent said they had not. Among those who felt they had no choice, 42 percent said caregiving gave them a sense of purpose or meaning in life. Among those who felt they had chosen it, 62 percent said so.

The work is the same work. The difference is whether the person doing it experienced it as hers to decide, and that difference alone moves the answer 20 points.

You Know Your Story

A sentence you learned at eight is capable of making a decision for you at 68. The call comes about your mother, or the diagnosis comes for your husband, or your son turns out to be unable to manage his own affairs, and something in you settles it before you have finished hearing the sentence. Good people put others first. You are a good person so everything after that is logistics.

The Strain of Caregiving – Real or Not?

We have inherited another story about caregiving: that putting others first will take years off your life. In 1999 a study in JAMA followed older married couples and found that spouses who were caring for a disabled husband or wife and who also reported strain were 63 percent more likely to die within the next four years. That number traveled. Caregiver organizations put it on their websites, it appeared in a federal report on aging, and at least two sites stated that caregiving can cost a caregiver as much as 10 years of life.

In 2015, three researchers went back through the evidence in The Gerontologist. David Roth, Lisa Fredman and William Haley found that the 63 percent applied only to spouse caregivers who reported strain. Spouse caregivers who reported no strain died at about the same rate as spouses of healthy partners, and 44 percent of the caregivers in that original study reported no strain at all. Put the two groups back together and the effect is no longer statistically significant.

Five later-population-based studies, one of them covering more than a million people, found caregivers as a group outliving comparable people who were not caregiving.

The authors are careful about why, and so am I. Healthier people may be more likely to take on caregiving and to stay with it, which would explain part of the gap. What they establish is narrower: a finding about a small group was repeated until it became a general claim about everyone.

The people repeating that number were advocating for caregivers and wanted help for them. It arrived with the authority of an actual study, and it frightened many women who were already tired.

Putting Someone First…

What the sentence costs is harder to see and I have no figures for that. Think of a woman who is the first call for four people. There is nobody whose first call she is, because she never asked anyone to be, and asking would have made her a person who put herself first.

I have spent the past year going back through the advice or phrases I was handed and asking what each one is claiming when you slow it down. Some of them hold. This one mostly holds, and it has one piece missing.

You are the person saying it now. Somewhere a daughter or a granddaughter is going to hear you say it about somebody, admiringly, the way you first heard it. She will take it in whole, the way you did, and it will not occur to her to examine a compliment either.

So hand her the missing part with it. Good people put others first, and they count themselves among the people who deserve care.

…Must Be a Conscious Decision

She may still choose, sometimes, to put everyone ahead of herself. Love asks that of us. But sacrifice chosen is different from sacrifice required as proof that you are good. The survey suggests that having chosen it is part of what makes it mean anything.

That is the difference between what was done to you and what you are about to pass on. You get to decide what goes in the sentence. She only gets to decide what to do with the sentence you hand her.

Let’s Have a Conversation:

What sentences that destroy self-care have you heard? Have you embraced them – willingly or not? Are you a caregiver by choice – or by requirement?