April 10, 2025
By Yona Lunsky
As we wrap up our final session in our six-part series on brain health and aging for family caregivers, and prepare to launch our parallel program for older adults with developmental disabilities, I’ve been reflecting on what we’ve been teaching and what I’ve been learning along the way.
Courses like these are full of information, resources, and sage advice from clinicians, scientists, and peers. But there is one potential risk: sometimes all of that can feel like just one more thing to do. And when everything doesn’t get done, it can feel like yet another failure.
That’s the last thing we want to teach. The message we want to share is: you matter, what you do matters, and if you don’t do anything at all—if that’s what you need—that’s okay too. But do we share this enough?
This message runs through much of what we cover in the course. But are we as prescriptive as we could be? Speaking of prescriptions, we teach about the health problems that can emerge with age, the role of medications in addressing these problems, the importance of medication monitoring, and the consequences of having too many prescriptions.
We also explore social prescribing: the idea that healthcare professionals can “prescribe” or connect people with non-clinical supports and community resources to meet their needs, such as reducing loneliness, increasing connection, and stimulating both the brain and body. Meeting these needs is just as important as a typical prescription (you can read more about social prescribing here).
But what we hadn’t talked about, until a recent planning meeting, was the additional need for “no prescriptions”. One of the parent teachers shared how hard it is to keep adding to an already overwhelming to-do list, and how sometimes, it’s simply too much. It might be helpful to receive a prescription: clear guidance or medical advice that gives permission to say no.
That comment sparked a deeper conversation. We started talking about how sometimes we just have to say no. It sounds so easy—just say no—but it’s incredibly difficult. At our worst moments we might not even be able to say anything at all, which may be our body’s way of saying “no” for us. So what if we planned for it and practiced saying no, like this:
• No, not right now. • No, I can’t. I am really sorry but I need to rest. • No, I won’t be there and I really need your help. • No, I’ve already taken on too much. Can we work together to find an alternative?
Of course, it’s not like in the movies. Saying no doesn’t magically fix everything. Things can still go wrong. But what we often fail to recognize is that things can also go wrong when we keep saying yes. We can burn out or hit a crisis point. And we might send the message that, even though it’s too much, we will do it anyway because we believe (and perhaps others believe) that we’re the only ones who can.
When we continually say yes, we don’t leave room to explore other possibilities. In our conversations this week, we reminded ourselves that it’s okay to ask others to step in. It might not be the same and it might not be perfect, but that’s okay.
And if there really is no one else to help? That’s an emergency waiting to happen. We can keep saying yes and wait for a crisis to hit. Or, we can say “no,” or “no, but...” before that happens, and find a way to get support. If saying no feels impossible, it’s important to share that with someone: a doctor, a family member or friend, a spiritual leader, a caregiver organization, or even the 9-8-8 crisis hotline.
Importantly, “no” prescriptions aren’t just useful for caregivers; they’re also important for paid care providers and people with disabilities.
Our recent study on the mental health of care providers in the developmental sector found that many are feeling maxed out and doing more than they can manage, without knowing how to get help. Part of what they need is the ability to say, “No,” and to say, “I need help. This is too much.”