Migraine and Caregiving: Here’s What I Do

I’m a planner, which comes in handy when dealing with migraine disease. I can plan around eating schedules, sleeping routines, weather conditions, and trigger exposure in social environments, at least to some degree. I know what pitfalls look like, and I’ve learned how to avoid them whenever possible. Keep a granola bar in my purse in case lunch is late, be prepared with medication when a storm front is coming through, and wear a face mask to avoid cigarette smoke, that sort of thing. I’d say I set my alarm for the same time every day, but I have an orange tabby who’s set for 5:30 a.m., so that’s covered.

Even a planner can’t plan for everything. It never occurred to me that I would need to combine being a caregiver with migraine management. I knew I would be taking care of my parents as they aged because I love them and it’s the right thing to do. I just hadn’t thought about how I might have to deal with a migraine episode at the same time. It seems obvious now.

Most of the time, it’s simple. I take my triptan medicine as soon as I think a migraine episode is happening and I go on with my day, which could mean taking Mom to a doctor’s appointment, grocery shopping, going out to lunch, or driving 20 minutes to visit Dad’s grave. Mom’s cognitive decline has complicated matters.

Early in our parent/child role reversal relationship, if I needed to reschedule an outing with her because of a migraine episode, I’d call and tell her what was happening and what I needed to do to take care of myself. Usually, I take medicine and lie down for an hour or two, and I’m good to go. I might be a little sluggish for a few hours, but not bad enough to interfere with plans, and I was free to talk to Mom about it. Things are different now because Mom is different now.

I can’t tell her when I have a migraine anymore. She’s always been a worrier, but with cognitive decline, her worrying becomes extreme and she builds worst-case scenarios in her head. She’s concerned I’ll have a stroke or brain aneurysm or something. I’m not even sure what she imagines. If any episode begins while I’m with her and she sees me take medicine, she immediately believes she has caused my migraine and starts apologizing. Sometimes it goes as far as sobbing. I’ve got to say, this aspect of migraine management took me by surprise.

So, what do I do? I keep my illness to myself, which is the opposite of what I typically advise migraine warriors to do. I usually tell you to talk about migraines, don’t apologize for having a disease, and take advantage of every opportunity to educate as many people as possible about the illness. Don’t be quiet about standing up for yourself. In this case, I keep quiet. You can’t reason with cognitive decline. You just can’t.

I take her to doctor's appointments even if I don’t feel well. For other outings, instead of driving us somewhere, which I shouldn’t do while having a migraine, I suggest a fun, low-key day at home playing cards, reminiscing through photo albums, or fixing lunch together. If an episode strikes while I’m with her, I take my medicine when she leaves the room.

Migraine management has always involved doing what I need to do. Avoiding triggers, missing out on activities, following the rules my illness dictates, that sort of thing. We migraine warriors know how to adapt. That has turned out to be a handy skill to have when dealing with caregiving for someone with cognitive decline. 

Originally published at WebMD.com on 2/10/25.