“Putting the needs of everyone else before your own may solve an immediate stress; however, in the long-term, it can lead to increased anxiety, frustration, overwhelming feelings, resentment, depression, burnout, and even illness. Whether you think of yourself as a caregiver or not, these are all signs of caregiver stress.”

Modern families come in many styles. Primary caregivers may be parents or spouses or adult children, and they might be other relatives (kinship providers), friends, or neighbors. “Care recipient” is a term for anyone who requires assistance for daily living. “Caregiver” refers to anyone who provides regular assistance to a child or adult with chronic or disabling conditions.

Time apart can boost well-being for all: While caregivers temporarily shift their focus to self-care, care recipients have time to meet new people and explore new interests.

Finding an appropriate respite service and organizing payment can feel challenging. This article offers guidance to simplify the steps.

Check standards and safety measures

When researching a respite agency, caregivers can check whether the agency meets standards and follows appropriate safety measures.

Lifespan Respite Washington provides a checklist with questions to think about. Here are a few examples:

• How are the workers chosen and trained?
• Can the respite worker give medicine or help with medical tasks?
• If the provider will be driving the care recipient, do they have a valid driver’s license? Is the company insured to have their workers do that?
• How are emergencies and problems handled?

Registered, publicly funded respite providers need to meet certain standards and qualifications, including background checks and training. The public agency that pays for the service is responsible to track and share information about those procedures and quality measures. If respite is paid for by private medical or long-term care insurance, providers must meet the insurance company’s standards. Caregivers can ask an insurance company representative to explain the standards and how the insurance company makes sure the standards are followed.

Another helpful resource: the ARCH National Respite Network and Resource Center provides a free, downloadable 17-page guidebook, ABCs of Respite: A Consumer Guide for Family Caregivers. ARCH stands for Access to Respite Care and Help.

Respite includes a broad range of services. Some organizations offer short-term, overnight stays in their facilities and some offer daytime services. Some respite services are delivered in the home, like:

• personal hygiene care
• meal preparation
• light housekeeping
• companionship, activities, or supervision

Community Living Connections (CLC) has an online tool to help caregivers figure out what type of help they may want or need.

Washington’s Pathways to Respite booklet includes “fill-in-the-blanks” tools to help define needs, like these examples:

“I would like to take a break, but I am concerned that___________” and “If I had some time to myself, I would _____________.”

Pathways to Respite was developed by Informing Families, a resource of the Washington State Developmental Disabilities Council, in partnership with the Washington State Developmental Disabilities Administration, Aging & Long-Term Support Administration, and PAVE, which administers Lifespan Respite WA.

If a family will pay directly for respite services, they can find respite providers online. Here are some ideas to start a search:

• “Adult Day Services Washington State”
• “After-school programs children with special health care needs Washington State”
• “In-home care agencies near me”

Another way to find a respite provider is to connect to a website managed by SEIU 775:  The Service Employees International Union is for independent service providers who have a collective bargaining agreement with Washington state’s Department of Social and Health Services (DSHS). This is one way to find an independent respite worker (usually for in-home care) that meets WA State qualifications for the work.

Care.com is a private, online service connecting respite or personal care workers with potential care recipients and their families. Families are on their own to follow up on an individual worker’s qualifications, references, and background, although some listings will show someone has passed a background check.

If a care recipient is eligible for respite through private medical insurance, the insurance company will list approved providers or caregivers may call their insurance company representative.

Publicly funded respite programs also have lists of registered providers. Family caregivers who have respite funding through Medicaid or the Developmental Disabilities Community Services (DDCS) can use CarinaCare.com, an online tool to connect individuals with providers. A Who’s Who page describes the provider’s qualifications.

Lifespan Respite WA provides information about how to apply for a voucher. Vouchers are “mini-grants” for unpaid caregivers supporting a family member, friend or neighbor who has a special need or condition. The vouchers, up to $1,000 per qualifying household, can be used with any of the registered Lifespan Respite Providers listed on their website.

To qualify, the caregiver or care recipient can not be enrolled in a Medicaid respite or personal care program through DDCS (formerly DDA). (Exceptions are made for people on a waiting list and not scheduled to get respite services within 30 days of applying for a Lifespan voucher.) Additionally, a caregiver must:

• Not be paid to care for the care recipient
• Give 40 or more hours a week of care
• Not get respite from any other program
• Live in Washington State
• Can’t afford to pay privately for respite care

In Washington State, eligibility for free or low-cost respite services may depend on a person’s circumstances or the category of disability.

• Seniors and Adults with Disabilities
  • Seniors 65 and older who meet functional and financial eligibility can get a variety of services through Department of Social and Health Services Home and Community Services Administration (HCSA).
  • Unpaid caregivers of adults 55 and older who meet functional and financial eligibility can get respite care and other needed support services like caregiver education, support groups, housework and errands and other services.
  • The easiest way to learn about services and eligibility is to contact the county or regional Area Agency on Aging, which administers many of HCSA’s services. They are also listed at Washington’s Community Living Connections/waclc.org.

• People with Developmental Disabilities (All Ages) and Children with Disabilities
  • Children and adults with developmental disabilities who meet eligibility criteria for Developmental Disabilities Community Services (DDCS) might get respite, personal care, assistive technology, community engagement support, and other services provided through Home and Community-Based Services and Community First Choice (CFC).
  • Children with disabilities who are not DDA eligible may still get CFC through DDA.

• Learn about enrollment for DDCS services and the application process.
• Review the Washington Waiver Factsheet, which describes Medicaid waiver programs and who may qualify.
• Locations are listed on the website of Washington’s Community Living Connections/waclc.org.

Respite care is available for foster parents licensed by the Division of Licensed Resources (DLR), a Tribal agency, or a Child Placing Agency (CPA). Unlicensed relative caregivers or those determined to be “suitable person placements” also can get respite, as can caregivers assigned by the Department of Children, Youth, and Families (DCYF) or a Washington Tribe. 

Child Specific Respite (CSR) is linked directly to the medical, behavioral, or special needs of an individual child. CSR authorizes respite relief to families providing care to a child placed by DCYF on a case-by-case basis, consistent with the written service plan for the child.

Veteran’s families may qualify for respite through the Program of Comprehensive Assistance for Family Caregivers (PCAFC), operated by the United States Department of Veterans Affairs. PCAFC offers up to 30 hours of respite: Program options, eligibility and the application process are described in a downloadable booklet published Oct. 1, 2020.

Active-duty military and Activated Reserve or National Guard family caregivers may be eligible for respite care through TRICARE, the military healthcare system. Here are resources for military family caregivers:

• Respite care for primary caregivers of service members injured in the line of duty can be found on the TRICARE website.
• Extended Care Health Option (ECHO) can be a respite resource for caregivers of non-military family members.
• Some installations have respite funding available when the care recipient is enrolled in the Exceptional Family Member Program.
• Coast Guard family caregivers have the Special Needs Program which may offer respite or funding for respite:
• Coast Guard Mutual Assistance has Respite Care Grants available for eligible Coast Guard clients who have responsibility 24 hours per day to care for an ill or disabled family member who lives in the same household.

Whether your family is newly stationed in Washington or returning after time away, we welcome you! Moving to a new state is a big change, and it can be confusing when programs and services are called different names than they were in your last location. We’re here to help you learn how Washington’s education and medical systems work, so you can find the right support for your child. 

This video shares key facts to help you get started in Washington with a child who has exceptional needs. 

The State Education Agency (SEA) is the Office of Superintendent of Public Instruction (OSPI). Local Education Agencies (LEAs) are organized as 295 Districts that operate independently and include a school board governance structure. School boards are responsible to follow the Open Public Meetings Act. There are nine Educational Service Districts (ESDs) that partner with OSPI to provide services for school districts and communities and to help OSPI implement legislatively-supported education initiatives. 

Charter schools, as public schools, have the same responsibilities as all public and non-public entities when serving students with disabilities. This includes developing and implementing Individualized Education Programs (IEPs) or Section 504 Plans for eligible students.  

Washington has adopted the Interstate Compact on Educational Opportunity for Military Children (commonly known as “MIC3”), which addresses certain school transition issues for military children consistently, from State to State. Each Member State has a MIC3 State Commissioner to oversee compliance and coordinate with other commissioners as needed. Parents of military-connected children may contact their School Liaison or MIC3 State Commissioner directly for support with Compact-related issues. PAVE has prepared a MIC3 Step-by-Step Checklist to Resolve Issues with the Interstate Compact. 

Washington’s Purple Star Award Program recognizes school districts that go above and beyond to support military families. Districts with this award provide a webpage with resources, have a trained staff member to help, and make sure teachers understand school transition rules under the Interstate Compact. Families can look for the Purple Star designation when choosing schools—it’s a sign the district is committed to welcoming military-connected students. To see which districts have the award, visit OSPI’s Purple Star page. 

Washington’s compulsory attendance law requires that children begin attending school full-time at the age of 8 and continue attending regularly until the age of 18 (RCW 28A.225.010). A child must have turned 5 years old by August 31 to enroll in kindergarten, and 6 years old to enroll in first grade. Military-connected children who are covered by the provisions of MIC3 may continue kindergarten or first grade, despite the school’s age requirement, if they were already enrolled and attending at the sending school in their previous state. This PAVE article explains how MIC3 supports children in military families with enrollment-related issues. 

Washington has multiple Pathways to Graduation and requires a High School and Beyond Plan (a career and college exploration experience that students begin in seventh grade) for all students. Under MIC3, schools must place military children in courses and programs based on placement and assessments performed by the sending school. Schools and districts may waive course requirements for placement and/or graduation of military-connected children, if a child has met the sending school’s requirements for grade advancement, placement, or graduation. Learn more about how MIC3 protects academic progress toward graduation in this PAVE article. 

Families concerned about a child’s development can call the Family Health Hotline at 1-800-322-2588, with support in multiple languages, or complete a free developmental screening online at ParentHelp123. The Department of Children, Youth and Families (DCYF) administers the state early intervention services (EIS) program, called Early Services for Infants and Toddlers (ESIT). After evaluating a child for eligibility and developing a family-focused plan, ESIT provides services to help infants and toddlers with disabilities or delays to learn and catch up in their development. Planning for the child’s transition out of ESIT by their third birthday includes coordination with the local school district to evaluate the child for school-aged services and supports. PAVE’s toolkit for family caregivers of infants and toddlers, From Birth to Three, outlines the educational rights of children and families in early intervention services. 

The Early Childhood Education and Assistance Program (ECEAP) is Washington’s no-cost prekindergarten program, aimed at preparing 3- and 4-year-old children from families facing more significant challenges for success in school and life. Families with children aged 3 or 4 by August 31st may be eligible for ECEAP. Children are eligible for ECEAP and Head Start based on their age and family income. Up to 10 percent of ECEAP and Head Start children can be from families above the income limit if they have certain developmental factors or environmental factors such as homelessness, family violence, chemical dependency, foster care, or incarcerated parents. PAVE’s 3-5 Transition Toolkit includes more information and resources to support families of children with disabilities in this age range. 

Every student with a disability is protected from discrimination under Section 504 of the Rehabilitation Act of 1973, including each student with a 504 Plan and each student with an Individualized Education Program (IEP). OSPI provides fact sheets about Section 504 in multiple languages that describe the evaluation process and state requirements. Parents may contact the Section 504/Civil Rights compliance officer assigned to their student’s school district. 

Washington Administrative Code (WAC), implements the provisions of the Individuals with Disabilities Education Act (IDEA) in WAC Chapter 392-172A. Parents’ rights and responsibilities in special education, known as procedural safeguards, are described in a short handbook available for download in multiple languages on OSPI’s website. 

A child’s right to a timely evaluation and the school district’s responsibility to seek out and serve students with disabilities, referred to as Child Find, is described on OSPI’s website. A school district has 25 school days to respond to a referral/request for special education evaluation. Once a parent/caregiver signs consent to evaluate, the district has 35 school days to complete the evaluation. A parent can request an evaluation any time there are concerns about whether services match the student’s present levels of performance and support needs. PTI provides a sample letter for requesting evaluation. 

Areas of evaluation are associated with 14 eligibility categories. Developmental Delay is a category for children ages 0-9 years old. The category of Emotional/Behavior Disability is unique to Washington – it is known as Emotional Disturbance under IDEA. Washington law requires that schools screen children in kindergarten through second grade for signs of dyslexia and to provide reading support for those who need it. 

School districts must write and implement an IEP within 30 calendar days after eligibility is determined. Decisions about the provision of special education services are made by an IEP team, which includes parents and specific required staff members (WAC 392-172A-03095). 

For a student with an IEP, there must be a transition plan in place by the beginning of the year in which they turn 16 years of age, unless the IEP deems it appropriate to begin earlier. Students “age out” of special education when they graduate from high school with a diploma or at the end of the school year in which they turn 21 years of age. If the student’s birthday is after August 31 of the current school year, they may continue special education until the end of that school year.  

In 2019, the Washington State Legislature provided students with multiple pathways to graduation by passing House Bill (HB) 1599. PAVE provides an on-demand webinar on this topic: Life After High School: A Two-Part Training to Help Families and Young People Get Ready. 

OSPI offers both informal and formal dispute resolution processes. IEP facilitation is available at no cost through Sound Options Group as a voluntary and informal process where a neutral facilitator helps parents and schools resolve special education concerns collaboratively. Washington State Governor’s Office of the Education Ombuds (OEO) acts as a neutral guide to help parents and schools resolve disagreements about special education services, without providing legal advice or advocacy. OSPI provides three formal special education dispute resolution processes: mediation, special education community complaint, and due process hearing. 

In addition to educational resources, families often need healthcare support. Washington offers options that work alongside TRICARE benefits to meet your child’s needs. 

Washington’s Medicaid, which includes the Children’s Health Insurance Program (CHiP), is called Apple Health. Applications are managed through the Health Care Authority (HCA), which oversees various Managed Care Organizations (MCOs) to provide health plan options. Open enrollment for Medicaid and Medicare starts on November 1^st, 2025 and ends on January 15^th, 2026. This is the annual opportunity to sign up, renew, or change coverage to best suit your family’s situation. Washington Health Plan Finder has step-by-step instructions for applying and navigators to help with the application process. Help is available for those who are having trouble navigating the health insurance landscape.  

Eligible dependents of military families can benefit from both TRICARE and Medicaid. When a military family member is dually enrolled in TRICARE and Medicaid, TRICARE is the primary payee and Medicaid covers remaining costs. When a service member leaves the military and TRICARE benefits change, Medicaid can provide services similar to those of TRICARE Extended Care Health Option (ECHO).  

TRICARE allows beneficiaries to make changes to their health coverage when a Qualifying Life Event (QLE) occurs, such as a move to a new city, region, or zip code. When a QLE happens, you generally have 90 days from the date of the move to update your enrollment. 

In addition to QLEs, TRICARE offers an annual open season for making changes to health coverage. Open season starts on the second Monday in November and ends on the second Monday in December each year. Any changes made during this period take effect January 1 of the following year. During open season, families can: 

• Stay in their current plan – no action required. 

• Enroll in a new plan. 

• Switch between plans. 

• Change enrollment type from individual to family coverage, or vice versa. 

PAVE provides more information about TRICARE’s basic plans, ECHO, and the Autism Care Demonstration in the TRICARE’s Big Three on-demand module. For this and more personalized learning at your own pace, check out our PAVE Learning Library.  

PAVE offers downloadable toolkits filled with fact sheets, worksheets, sample letters, and practical tips to guide you through every stage of your child’s education and care. These resources are designed to make complex systems easier to understand and navigate. 

Celebrate your military child all year long with social stories, activities, and tools that help families stay connected and ease transitions. The PAVE article, Purple Up! Celebrating the Month of the Military Child, includes free downloads in the top five languages spoken in military households. 

Want to know what makes a military family “exceptional”? Explore PAVE’s two-part series on the Exceptional Family Member Program (EFMP) to learn how enrollment works and what supports are available to help your family thrive. 

STOMP (Specialized Training of Military Parents) workshops and webinars offer military families the opportunity to access valuable information and resources while fostering connections and knowledge-sharing to create a collaborative environment that strengthens partnerships between families and professionals. STOMP events are free to military-connected families from all branches of services, including all service statuses and all installations worldwide. 

Need personalized help? Military families can access one-on-one support, training, information, and resources through PAVE’s Get Support request form — wherever the military takes you! 

Raising children requires patience, creativity, problem-solving skills and infinite energy. Think about that last word—energy. A car doesn’t keep going if it runs out of gas, right? The same is true for parents and other caregivers. If we don’t refill our tanks regularly we cannot keep going. We humans refuel with self-care, which is a broad term to describe any activity or strategy that gives us a boost.

Self-care is not selfish! Without ways to refresh, we cannot maintain our jobs, manage our homes, or take care of people who need us to keep showing up. Because the demands of caring for someone with a disability or complex medical condition can require even more energy, refueling through self-care is especially critical for caregivers.

Before you read anymore, try this simple self-care tool called Two Feet, One Breath. Doctors use this one in between seeing patients.

Download this infographic, Two Feet 1 Breath:
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Two Feet, One Breath can become part of every transition in your day: when you get out of bed or the car, before you start a task, after you finish something, or any time you go into a different space or prepare to talk with someone. This simple practice highlights how self-care can become integrated into your day.

Although a day at the spa might be an excellent idea, self-care doesn’t have to be fancy or expensive to have a big impact!

Almost everyone knows or cares for someone with special needs. According to the Centers for Disease Control (CDC), at least 28% of the American population experiences a disability. The result is widespread compassion fatigue, which is a way to talk about burnout from giving more than you get.

Below are some ways to use self-care to avoid burnout!

Building a support network with others who share similar life experiences can be incredibly valuable. When you’re going through a challenging or unique situation—like parenting a child with special needs or managing a family health issue—it can feel isolating. These connections offer emotional validation and a sense of understanding that can be hard to find elsewhere—you don’t have to explain everything because others simply get it. Research shows that social support can significantly reduce stress, anxiety, and depression, enhancing overall well-being and resilience. Beyond emotional comfort, support networks empower individuals by helping them build confidence, understand their rights, and even engage in advocacy efforts that benefit their families and communities.

Here are some communities and resources to help you get connected:

Parent-to-Parent Connections
The Parent-to-Parent network can help by matching parents with similar interests or by providing regular events and group meetings.

Support for Families of Youth Who Are Blind or Low Vision

Washington State Department of Services for the Blind (DSB) offers resources and support for families. You can also hear directly from youth about their experiences in the PAVE story: My story: The Benefits of Working with Agencies like the Washington State Department of Services for the Blind.

Support for Families of Youth Who Are Deaf or Hard of Hearing
Washington Hands and Voices offers opportunities for caregivers of youth who are Deaf or Hard of Hearing (DHH) to connect, share experiences, and find community.

Resources for Families Navigating Behavioral Health Challenges
Several family-serving organizations provide support, education, and advocacy for caregivers of children and youth with behavioral health conditions: 

• Family, Youth, and System Partner Round Table (FYSPRT). Regional groups are a hub for family networking and emotional support. Some have groups for young people.
• Washington State Community Connectors (WSCC). WSCC sponsors an annual family training weekend, manages a Substance Use Disorder (SUD) Family Navigator training, and offers ways for families to share their experiences and support one another.
• COPE (Center of Parent Excellence) offers support group meetings and direct help from lead parent support specialists as part of a statewide program called A Common Voice.
• Dads Move ​works to strengthen the father’s role in raising children with behavioral health needs through education, peer support and advocacy.
• Healthy Minds Healthy Futures is an informal network on Facebook.

PAVE provides a comprehensive toolkit for families navigating behavioral health systems, including guidance on crisis response, medical care, education, and family support networks.

The body uses sleep to recover, heal, and process stress. If anxiety or intrusive thinking consistently interrupts sleep, self-care starts with some sleeping preparations:

• Turn off screens after 7 pm, or use a blue-light filter
• Pre-load sleepy music or a calming meditation onto your phone or tablet
• Finish the evening with an herbal tea, such as chamomile
• Check out PAVE’s video: Body Sensing Meditation for Help with Sleep
• For more ideas, visit SleepFoundation.org

Moving releases feel-good chemicals into the body, improves mood, and reduces the body’s stress response. Walk or hike, practice yoga, swim, wrestle with the kids, chop wood, work in the yard, or start a spontaneous living-room dance party.

The Mayo Clinic has this to say about exercise:

• It pumps up endorphins. Physical activity may help bump up the production of your brain’s feel-good neurotransmitters, called endorphins. Although this function is often referred to as a runner’s high, any aerobic activity, such as a rousing game of tennis or a nature hike, can contribute to this same feeling.
• It reduces the negative effects of stress. Exercise can provide stress relief for your body while imitating effects of stress, such as the flight or fight response, and helping your body and its systems practice working together through those effects. This can also lead to positive effects in your body—including your cardiovascular, digestive and immune systems—by helping protect your body from harmful effects of stress.
• It’s meditation in motion. After a fast-paced game of racquetball, a long walk or run, or several laps in the pool, you may often find that you’ve forgotten the day’s irritations and concentrated only on your body’s movements. Exercise can also improve your sleep, which is often disrupted by stress, depression and anxiety.

Mindfulness can be as simple as the Two Feet, One Breath practice described at the top of this article. Mindfulness means paying attention or putting your full attention into something. Focusing the mind can be fun and simple and doesn’t have to be quiet, but it should be something that you find at least somewhat enjoyable that requires some concentration.  Some possibilities are working on artwork, cleaning the house or car, crafting, working on a puzzle, cooking or baking, taking a nature walk, or building something.

For more mindfulness ideas, check out PAVE’s Mindfulness Video Series. From this playlist, Get Calm by Getting Organized, explores how getting organized provides satisfaction that releases happiness chemicals and hormones.

A day can disappear into unscheduled chaos without some intentional planning. A carefully organized calendar, with realistic boundaries, can help make sure there’s breathing room.

Set personal appointments on the calendar for fun activities, dates with kids, healthcare routines, and personal “me time.” If the calendar is full, be courageous about saying no and setting boundaries. If someone needs your help, find a day and time where you might be able to say yes without compromising your self-care. Remember that self-care is how you refuel; schedule it so you won’t run out of gas!

Time management is a key part of stress management! This article, “Stress Management: Managing Your Time” from Kaiser Permanente, gives tips for managing your time well, so you can reduce the pressure of last-minute tasks and make space for the things that matter most to you.

Respite care provides temporary relief for a primary caregiver. In Washington State, a resource to find respite providers is Lifespan Respite. PAVE provides an article with more information: Respite Offers a Break for Caregivers and Those They Support.

Parents and caregivers of children with developmental disabilities can seek in-home personal care services and request a waiver for respite care from the Developmental Disabilities Administration (DDA). PAVE provides two training videos about eligibility and assessments for DDA. For more information about the application process, Informing Families provides a detailed article and video.

Download this checklist of Emotional Wellness Tips for Caregivers in:
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