When Patricia Hoolihan of Minneapolis stepped up to care for her aging parents, she knew the task would be meaningful — and challenging. With no road map, she sought out books to guide her. Not able to find one that addressed "the particular challenges" of her experiences, she wrote her own. "Hands and Heart Together: Daily Meditations for Caregivers," offers uplifting messages and practical tips, and it comes at a crucial time. More than 53 million Americans are now caregivers, according to AARP, up 10 million from 2015. As that role expands (Hoolihan was one of several caregivers for her grandchildren during the pandemic), she shares her thoughts on sacrifice, loss, growth and the joy of hugging.

Q: You began your caregiving book in August of 2019, when we simply didn't grasp the enormity of what was coming. How did that timing impact your deadline of June 1, 2020, when the perils were clear?

A: In those spring months of 2020, I found myself needing to write about caregiving during COVID because it was happening all around me. I wrote 11 meditations that deal specifically with COVID, but in those early months it was hard to discern how long COVID would be around. If I had known how tenacious this virus time would be, I would have written more.

Q: I feel like COVID put caregiving on steroids in that, suddenly, everyone was a caregiver for someone — children, parents, spouses. Can you speak to how the definition of caregiver has shifted and expanded?

A: I have used that same phrase: Caregiving on steroids. It has been all around us, the need for it, the way caregiving is the one and only thing that softens the hardness of physical and mental pain of COVID and everything else. The definition of caregiver has expanded as people take care of each other in so many ways and at all ages. Think of all the cultural resources that were cut off for much of this past year: schools, workplaces, the ability to gather with loved ones for something as simple as birthday parties. Everyone was reeling. We all needed to care for each other in this new world.

Q: Are some people better suited to caregiving than others?

A: There is no prescribed personality trait required. Some people are more comfortable stepping into this role than others. But I have known people who felt ill-equipped in terms of personality, who had difficult relationships with the one they are caring for, and yet were able to caregive with compassion. It takes awareness and effort but many such people learn a lot about themselves in the process.

Q: You speak of loneliness as an inevitable byproduct of caregiving. But we've just survived a year of tremendous loneliness for most of us, caregiving or not. Is it a good thing that we all experienced that?

A: I don't think I would ever call it a good thing what happened to all of us this year, but the enforced level of solitude or retreat-like life does have things to teach us. For one thing, it was like a collective break from the patterns of busyness most of us live by. I do think this is good for the soul. Loneliness might teach us how to listen more deeply to the sorrows of the world, to the huge varieties of music in our world, how to look to the natural world for solace over and over again. Loneliness can both deepen an inner strength and also make us so aware of our need for human connection.

Q: Why do you feel it's important that caregivers ask, "What kind of human being do I want to be?"

A: It is the only way to live an intentional life. Caregiving takes one away from all the usual rewards in life: money, prestige, proof of productivity/worth. It will drain you some days, it will keep calling you back, it is not for the faint of heart. If we don't have the clarity about what kind of human being we want to be, it is easy to fall into resentment or to land in bitterness around the question of, "Why me?"

Q: You write of the importance of listening and paying attention. What might that looks like?

A: I sometimes think of caregiving as a creative art: when does this loved one need a distraction? When does he or she simply need to be listened to? When does showing up with flowers and a special treat make a world of difference? What resources could help us both?

Q: We need to talk about loss. The past year forced us to endure so many agonizing, unexpected losses. How do we make sense of those losses and forgive ourselves if saving a loved one was not possible?

A: Loss is a huge part of caregiving and, yes, it has been palpable this past year. I think it is so important to give loss some space. Too often, we hurry by it, understandably so, as it's not an easy emotion to feel or process. But it doesn't go away and it does wait for us. Some days, when I just felt tired, it helped to pause and realize that what I was truly feeling was sadness. Writing is an incredible tool for giving loss its due and writing is accessible to everyone. More than once, I have written a letter to a loved one no longer here and that has helped. Regret is part of life but it can be talked about, written about and in these ways one can come to terms with regret.

Q: As vaccines promise a slow return to normalcy, what aspects of caregiving do you hope we retain?

A: I hope we retain a sense of the importance of caregiving. It is kindness and care that has helped so many of us get through this traumatic year. I hope that as we reclaim the pleasure of being together, of hugging each other, we continue to cherish that ability as the gift that it is.