More five million Americans suffer from Alzheimer's disease or another form of dementia and over 70 percent of those individuals are cared for in their homes by a spouse or other family member. Stress, anxiety and burnout are never far from the doorsteps of these caregivers as they often juggle the responsibilities of providing daily care with the added demands of working, maintaining a household, or raising children. The holiday season can intensify these daily burdens, but too often caregivers don't know how to ask for help and friends and family members aren't sure of how to lend a hand.

"Caregivers will say 'no' when offered help because they worry it will reflect poorly on them or because they 'don't want to bother' others. And some caregivers get so attached to their role that just can't let go," said Nancy Alterman, a licensed clinical social worker with the New Jersey Institute for Successful Aging at the UMDNJ-School of Osteopathic Medicine. "The holiday season is a great time to put some gentle but persistent pressure on those caregivers you know who could probably use a little help."

If you know a family member or close friend who is a caregiver, Alterman offers the following suggestions to help ease that person's burden.

Be sensitive about visiting by calling ahead to schedule a time that is convenient. But if the caregiver routinely declines offers of a visit, you may need to just show up...with special foods or an easy activity like a puzzle. Avoid bringing a crowd, but visiting with at least one other person gives the caregiver a chance to go out with a friend, knowing that another trusted person is there for the patient's needs.

Instead of asking, "What can I do?" offer to grocery shop, go to the post office, do laundry or cook a meal that you can bring over.

Be a good listener. Whether in person or by phone, sometimes just having a contact to the outside world is all the caregiver needs to help cope with that day's burden.

Be alert for signs of caregiver stress, such as denial, social withdrawal, sleeplessness or lack of concentration.

Offer to spend the night so the caregiver can get some rest. Lack of sleep can quickly lead to a deteriorating situation or a health crisis. Make sure the caregiver and the patient are discussing any sleep issues with their primary care physician.

Research adult medical day services in your community and share that information with the caregiver. These medically supervised programs can actually help extend the time that the patient can remain at home.

"If you are a caregiver, be prepared for the added demands of the holiday season and remember that you are not a failure if you accept an offer to help," Alterman said. "You can help family and friends help you by being prepared with some specific suggestions when they ask, such as appropriate gifts for your loved one or a task you routinely do."

Alterman also recommends that caregivers ask family or friends for the gift of time, either watching over the patient so that the caregiver can get away for a few hours or helping to arrange in-home care.

"If you can, ask a close relative or friend to stay with your loved one for a few days while you take a mini-vacation. A quick trip to the seashore or the mountains can help rejuvenate you for the days ahead."