Someone Told Me I Had “Early Onset Caregiving” – Do You?

Feb 6, 2024 | Caregiving, Patient Advocacy

Would you rather listen instead? Click here for the 14-minute audio recording.


This segment is about caregiving and how we found ourselves there – or here – or will.

The thing I want to express most of all to you today is that: Hope lives here. In caregiving. Hope found me, and it is my job to spread it around.

Where are you relative to caregiving right now?

 Are you IN caregiving? I respect you.  

Are you a professional in caregiving? I respect you. 

Are you thinking about a career in patient advocacy or another service-oriented field? I respect you. 

Might you be exhausted or overwhelmed, perhaps in need of support? I respect you.

To you and to many, I wish to say, “Hope is found here, in caregiving”

And it is not just Hope coming from a caregiver. Sometimes it is Hope coming TO a caregiver. No matter how you may be IN it, as a personal caregiver, a professional, or if you care for the care recipient – Hope is nearby and available.

Hoo boy, did I experience a whole lotta Hope recently at an annual event. I was so pumped up on the way home that I grabbed my phone just to record my feelings and observations, and that was the impetus for today’s segment.

You see, I had just visited a Caregivers Conference, one that I had attended and for which I had previously volunteered for several years. It was the first time I had returned to the city where I had lived previously. It was an event that always held a whole lotta Hope under one roof and with hundreds of folks feeling it. And I wanted some of that vibe. I wanted immersion, to be in and with. To soak it up and to share it also.

For those of you who may never have attended a caregiver conference, let me describe the scene. Picture with me now, if you will: a huge conference center with an event in full swing. 

The day’s events and activities include a luncheon with the keynote speaker, entertainment, and breakout sessions for education. Even if you just sat there and did not talk to anyone, you could receive a dose of Hope. Everyone was dishing. The entire conference center was abuzz.

You could travel through a Grand Exhibition Hall to view or interact with resource personnel, providers whose hearts are in the right place, there to help folks know that there are solutions at hand. Here, under this roof, was Solution: the people to help you Build Your Team, extending real Hope to you. It’s stunning to witness, I tell you.

The night before, at a reception for the professionals and exhibitors, I met up with a wealth manager and guided her around the exhibition portion, which was not quite open. She herself was unaware of some of the agencies, newer professions, and their function. As we walked along, I was regaling her with their development in the industry or how that agency evolved over time, and how we had worked together on some cases. I fear that I may have been a little too enthusiastic, as I have not heard from her since. 

On the day of the event, there would be 200+ attendees and nearly as many people working the event. In the 10 years previous, I had always volunteered at registration. Here began the Hope, at reception, at greeting and guiding. Hope and anticipation to both capture and extend. I also worked as a ‘people mover’, assisting the attendees to find their breakout session rooms, or fielding questions as to how to find a particular vendor or resource. Some would pause to tell me their needs and a bit of their story. I would shuttle them right over to the solution, be it a lecturer, provider, industry, or someone who would know if I did not. I missed doing that more than I had realized. 

With all that Hope instilled in me, the four-hour drive home seemed to be a breeze. I laughed that I was likely getting better gas mileage, as I was clearly “on the wings” of Hope, on a high from the fellowship. An hour or so into the journey, I settled into my own thoughts. I began to reflect on My Why.

I thought about how I came into my own caregiving experience, my ‘Early Onset Caregiving’. Mine began as my own parents advanced in age and needed more help. I helped as a daughter and family member. That was one way. The duties, those changing roles (when “parent becomes the child” as they say) had effects on all of us and upended our heretofore family dynamic. 

We had our challenges, our wins, losses, and debacles. Somehow Hope stayed with us even when we had little. I thank the folks from many walks of life who delivered doses of Hope or were the example that all this was doable.

Along the way, I made a career change, and unknowingly, I entered professional caregiving. No one could have told me I would end up where I am today.

Somewhere along the line I heard the phrase “Out of the problem and into the solution”, and I decided to make it my own. My own to say and my own way of life. I would dedicate my time to bringing Hope and solution. It felt right. It fit.

It seems I got hooked on that ‘providing solution and installing some Hope’ when I began to work at an EAP (Employee Assistance Program, a specialty benefits organization). I was your Call Center Rep, under a headset and seated in cubicle-land. While there I was moved onto some special teams like Eldercare and Legal, assisting callers to locate resources in their area. I “triaged’ and placed cases with providers local to the caller. I found myself to be a conduit – from Problem into Solution. It felt good, it fit.

I worked there during my parents’ aging and passing. Let me say I will be forever grateful for the place called Workplace Options in Raleigh NC, as they participated in my development and supported my work and life journey also. Perhaps I was a little, er, too verbose about what my family was encountering in healthcare and eldercare (and housing and insurance and support) and how I was creating solution. Other people began to bring their loved ones’ challenges to me for help and guidance.

“You should hang out your shingle,” they said. (No, I could never, I thought). Those comments persisted. and I began to get signs and messages in real life and spiritual life (you know, in the “There are no coincidences” department). I could no longer deny that this was indeed a calling. That “I could never” turned into a “maybe I could” that turned into an “I will”. Now, for 11 years, it has been an “I did”. It feels good. It fits.

In 2013 I founded a patient advocacy agency called NAVIGATE NC. I worked inside my agency as it grew, as did my mission mantra to lead folks “Out of the problem and into the solution.”

Some of those solutions were in the form of patient advocacy services and enabling an agency that could serve first Raleigh, NC, and then more regionally. Other solutions included designing and teaching coursework in higher education. I sat on panels for community outreach and educational purposes. I sat at kitchen tables, steering difficult conversations. I expo’d at shows and conferences, and volunteered, too.

I loved it all, but do you know what I loved the most? Bringing Hope. Just a little bit of Hope, beginning with that initial conversation with a patient or caregiver. My Early Onset Caregiving was in a different state of onset.

Inside my Complimentary Consultations (which are still offered today) I found that I could install even a kernel of Hope. Many people have shared with me in our conversations that they felt better, even after just a few minutes of talking together. That is Hope personified (not Nancy-fied, I was merely the vessel).

This kind of stuff is a magnet for me.

I have found that ‘triage’ is my jam! From confusion to containment and clarity, followed by a dose of Hope, even the preliminary call could result in some next steps or direction. All were delivered rather early in the conversation, giving the caller a reason to continue. Things seemed more clear, valid, and to be a right path. That is what I’m good at. That is where I want to live.

I respect those seeking. I serve those seeking. I want to be right there at that intersection, the first friendly voice on the phone that shines a light on a path and allows you to be heard. I live in Solution, and I want you to join me.

I’ve realized two things from all this ruminating. First, I indeed had Early Onset Caregiving. (In – deed, didja get that?). At first, I was placed into that environment, and there were choices as to my level of response. I was involved (like it or not), and I chose to stay there. Someone gave me Hope, no, so many people gave me Hope, and that helped shape me into someone who does that, too.

Secondly, through all this, I found my place, my jam, my fit, and my beam in serving caregivers. I became a Patient Advocate and founded an agency and worked in it for over 10 years. Then I elevated my speaking and teaching, and not just for patients and loved ones. I also teach and coach healthcare entrepreneurs on how to further extend their Solutions with Hope.

Where are you now in your caregiving? Whether you are IN caregiving, a professional caregiver, thinking about a career in patient advocacy, or another service-oriented position, I respect you. If you are among the exhausted or overwhelmed and may be in need of support, I respect you, and Hope is waiting for you all.

Let me be your conduit. Patient or professional, let me guide you further into your Solution with Hope.

Hope is the real deal.  I will ask you to spend some time thinking about Hope today. Think about how you have been given Hope in your life. Perhaps you have had occasion to share Hope with someone else. 

Think also about how you will share Hope the next time your brother needs it. Hope is the real deal for us caregivers.

Take Good Care,


Nancy Ruffner is a patient advocate, consultant, and coach who with the benefit of Hope leads patients and professionals alike “Out of the problem and into the solution.” Complimentary Consultations toward engagement are available here.