Updated November 30, 2014.

Do you have a friend who is taking care of a partner with cancer, a chronically sick child, or an ailing parent? Almost all adults will be involved in family caregiving at some point in life and as many as 1 in 4 Americans will be part of a sandwich generation caregivers' dilemma: how to take care of an aging parent while caring for young children at the same time.

It can be hard to know exactly how to reach out to your friend around the holidays, but as someone who has been there, here are some quick tips:

Don't say "is there anything I can do to help."

We've covered this extensively other places but basically if you ask someone if there is anything you can do, it puts the proverbial ball in their court, a court that is already full of a...bunch of other balls? A bunch of other players? A mean referee? The metaphor breaks down at that point but the solution is easy: instead of offering help, offer specific help.

To this offer specific offer of help add the words "this offer does not expire"

One of the harder things about team caregiving is juggling offers of help. While too much help is a great problem to have, it can be very comforting to have back-up assistance for when other members of the team have less availability. People tend to think of reaching out around the winter holidays but once January 1 rolls around, everyone is thinking about going back to work and to the gym. So if you can, suggest specific ways you can help and then be okay with your help not being needed at that moment.

Don't get hurt about it, because this is not about you.

Okay, I take that back. You can get hurt about it, but vent to someone else (not your caregiving friend) and then come back and offer help again.  Because again. Not about you.

Don't demand specific self-care activities

As an outsider, you might feel that you are seeing your friend spiral downward and that caregiving is taking a huge emotional and physical toll. Yup. That's pretty much in the nature of family caregiving! It's not that your friend is particularly bad at self care, most long term caregiving situations have some impact on the caregiver's mental and physical health.

Any good friend is going to be concerned. But if you think the "you really need to take care of yourself" lecture is new to anyone who has been a caregiver more than five minutes you are sadly sadly mistaken.

Lectures don't help and may alienate your friend who needs all the support they can garner right now. Instead…

Support self-care activities

Although lectures don't work, supporting your friend in self care might help. Bring them nutritious lunches individually frozen so they have healthy food to eat at work. Offer to drive them to support group meetings or arrange (with everyone's okay) for someone to stay with their loved one while they have an afternoon to take in a movie. Buy a gift certificate for a massage therapist that can come to their home.

Don't stop inviting your friends to celebrations

Your friend isn't going to be as available, but when they are, they will still need you and might want to socialize as well. You can add the caveat "I know you might not be able to come, but we always love it when you can join us" to make it clear you understand the situation, but still miss them when they aren't around. Better yet, find a way to move a smaller version of the event to their home or make it more convenient for them to attend.