Joanne Roe has a full plate. The single mother of a 12-year-old daughter works full-time as a nurse’s aide at a medical center in Philipsburg, Montana, while taking online classes toward a nursing degree. But it was caretaking duties for her 65-year-old mother with lung disease that brought Roe to a much-needed retreat.
“Being a caregiver, it's very hard to ask for help, because you're so used to doing everything that you just do it,” Roe said.
Roe and a group of fellow caregivers gathered in Philipsburg, a small town equidistant between Missoula and Helena, and recharged.
The Montana State University Extension started the Montana Caregiver Respite Retreat Program in 2021 to help the state’s 214,000 caregivers learn how to take care of themselves. It’s easier said than done, especially for those accustomed to providing round-the-clock care. To alleviate barriers, the free state-funded program offers $100 gift cards.
“It's hard to market it because people don't know what the word respite is,” said Daniel Koltz, a gerontology specialist at MSU and the program’s director. “So we try to use ‘take a break.’ It's hard for them to envision what this would be.”
What some consider an everyday task, Roe thinks of as a luxury. Up at 4:30 a.m. most days and studying well into the evening, her version of self-care is sleep and hot showers – neither of which she has much time for.
“Just got to make it work,” Roe said. “The extra time I do have is pretty much for my mom and my daughter and school.”
Roe and 10 other caregivers got to “take a break” at the November retreat. They made scent jars with essential oils, painted affirmations on rocks, got neck massages and assembled a custom trail mix, through modules designed to relax and engage the senses.
Peyton Vining, caregiver program manager, broke the ice by cracking jokes and casually discussing self-care. Participants told Vining they enjoy going on walks, doing yoga and using deep-breathing techniques. She stressed that self-care encompasses a range of things, even something as small as taking the time to wash your hands thoroughly.
Vining pulls out a copious selection of scented essential oils. Roe, sitting toward the back of the room, adds eucalyptus to a glass jar smaller than a golf ball. She hopes it can ease her anxiety over work and school. Vining next pulls out heated electric neck massagers, which Roe uses regularly as a way to wind down. Even Vining puts one on. The group takes a moment of silence to enjoy the massage.
For Roe, the retreat was a breath of fresh air. She said it was the first time anyone had wanted to take care of her. By the end, she asked herself, “Wow, why didn’t I do this earlier?”
As of 2025, Koltz says, more than 1,585 unpaid family caregivers have taken part in the retreats across the state, which are funded through grants from the Montana Department of Public Health and Human Services Montana Lifespan Respite Coalition. The one-day retreats return to the same towns annually, and try to add two to four new cities to the list each year.
Retreats focus on educating caregivers about how to take care of themselves and why that’s important. In addition, caregivers are eligible for a free food program that brings boxes of nutritious food to their doors. Through partnerships with local organizations, the meal program erases the daily burden of meal preparation for caregivers.
About 30 miles southeast of Philipsburg, nearly three dozen caregivers gathered the next day for a retreat in Anaconda. Before the start, the room was lively with chatter as participants reconnected or got to know each other.
Off to the side, Lydia Janosko huddled with a fellow caregiver whose experience was similar to hers, their conversation ending with Janosko dabbing at tears. For the past three years, she’s cared for her 93-year-old mother at least 30 hours per week, while also working full time as the director of a nonprofit. Janosko is struggling to accept the progressive loss of her mother to dementia.
“It’s just watching her brain shrinking and not recognizing things or people or understanding what's going on,” Janosko said. “But then she'll be fine the next day.”
Between work and caregiving, Janosko finds solace in physical activities such as yoga and morning walks. Time to herself is precious.
“I am grateful for every moment,” Janosko said.
At lunchtime, caregivers mingle over sandwiches, and the room sounds like it’s full of old friends, as people chat and share their stories. At the heart of the retreat is the premise that having carefree moments, socializing and reserving time for oneself reduces stress and anxiety, helps to avoid burnout and promotes well-being.
The National Alliance for Caregiving reports that only 13% of caregivers seek the respite they need. One reason is that they feel there is no one to whom they can entrust the care of a loved one. Roe says, “It feels very strange” to ask for help. “It’s not normal.”
Some attendees bring the people they are caring for to the retreats. John Jeffs, for example, brought his wife of 30 years, Cheri, who struggles with severe PTSD. Cheri calls him at least four times a day, and sometimes he has to leave work to comfort her.
“If something's going wrong, then I can tell him,” Cheri said. “I can call him whenever I need to.”
John says he struggles to have patience while caregiving. But the retreat has helped him learn the importance of self-care. Recently, he picked up a hobby by buying a 3D printer.
While travel is the number one barrier for caregivers in rural Montana to participate in retreats, Vining said the second is finding somebody to fill in as a caregiver during the retreat.
The stigma around mental health also prevents caregivers from taking advantage of resources. Across the country, respite is underreported, said Angie Perone, director of the University of California, Berkeley, Center for Advanced Study of Aging Services.
“There's this complex issue of ‘I shouldn't be seeking this because I should do this out of the goodness of my heart, or this is a family obligation, or this is a cultural norm,’” Perone said.
A study by Penn State researchers published in Aging & Mental Health in 2018 found that research on respite efficacy is limited and difficult to obtain, even though caring for a family member is “an all-consuming enterprise that engulfs caregivers’ daily life.”
In Montana, the stigma may be more acute. “They talk around here about pulling myself up by my bootstraps,” Koltz said. “The cowboy mentality is, ‘We're just going to power through no matter what, so I don't really need to talk about my feelings. I don't need to talk about my mental health, my well-being.’”
Koltz starts the afternoon module in Anaconda with a rock-painting activity, asking participants to hold and describe the rocks. They shift them around in their hands. They describe them as solid, unique and sturdy. Just like caregivers, Koltz points out.
They write words of affirmation on their rocks – faith, patience, perseverance, compassion, gratitude – and keep them as a reminder of their strength.
Throughout the day, Koltz shared bits of his story. Talking helps him process his own caregiving experience with his father, who died a couple of months before the retreats.
“The more I talk about it, the easier it is for me to let my dad go,” Koltz said. “Not forget him, but let him go.”
Koltz had helped care for his mother, disabled by an infection in her hip since he was a kid. Following his mother’s death at 74 years old, Koltz’s father had a stroke and became ill. For the next two years, his father was able to live independently, with caretaking help from Koltz.
“It's more than just a job for me,” Koltz said. “I'm going to share what I know to help other people who are like me.”
At the end of the day, everyone made trail mix, and Koltz explained how each ingredient is part of the trail of caregiving. Nuts are strong in protein, used to sustain strength and endurance. Raisins are sweet, relating to laughter, joy and anything that quickly revitalizes like taking a walk or going shopping. And finally, candy, which represents something to look forward to.
He told caregivers to think big and set goals. Maybe it's scheduling a weekend away, enrolling in a class or learning a new instrument.
Caregivers went home with information about the food box program and about resources they can tap if they start to feel burned out.
Koltz uses a scale from the World Health Organization to measure retreat effectiveness.
“The well-being is through the roof by the time they leave,” he said.
But after a while, people come down from that high and might forget to implement the self-care they learned. That’s why the retreat returns annually, and why many caregivers sign up again.
Hope Muñoz a writer with the Investigative Reporting Program at the University of California, Berkeley, Graduate School of Journalism. She reported this article through a grant from The SCAN Foundation.