Month: August 2022

What are the two things that, usually, trigger a need to move a loved one into an assisted living facility (especially a person with a dementia or Alzheimer’s disease)?

I know, it is usually more than two things, but, these two, in particular, seem to ramp up the need for 24/7 in-home care or transitioning to an assisted living facility. Toileting and Bathing. Some helpers/caregivers can help a spouse or partner with toileting and bathing duties with no problem, but when it comes to an aging parent, they can’t seem to handle those areas. Some are willing to learn how to do these things safely and some are not going to do them at all. Still, others will do it in an emergency situation, but not all the time. Whatever you choose is the right decision for you. August 31, 2022 Emotions, feelings, physical strength, and preparedness are all important factors in helping someone to toilet or bathe. Embarrassment, Stress, Rebellion, Stubbornness, Shame, and whatever else shows up will have to be dealt with respectfully. Everybody will feel embarrassed.

Helping Your Loved One with Privacy and Personal Hygiene

We all want to do our private business by ourselves. Imagine, that you have had surgery on your right shoulder and your left arm is hooked up to an IV bag on a pole. Now, imagine that you have to go to the bathroom badly and it is not to pee. Can you wait on a nurse? No. A side note, it is so much easier to let someone, you don’t know, who is trained in helping a patient poop and then clean their bottom, help you than it is to let a partner, spouse, or loved one help you. I was so embarrassed to have someone that I knew and loved to wipe my bottom. It was an awful feeling. The person doing the wiping was great and it did not seem to bother her as she said, “I’ve cleaned my kids’ butts, no big deal.” Pooping is a normal bodily function. Peeing is a normal bodily function. Why did I wig out over having to go? Because I could not take care of my needs at the time. I was vulnerable. I was embarrassed. I needed help. I am the one that helps others, I don’t need help. Although, I am not sure that I could wipe someone’s bottom that I love or care about on a regular basis. I probably could in an emergency, but not all the time. I guess we really don’t know what we will or won’t do until we are put in the situation. I have learned to never say never. Some of you are thinking, “Well, if you did it once, then you can do it again and again.” Probably, but I don’t want to!

You better be strong and patient

It takes time, effort, and physical strength to help a loved one toilet and bathe. It takes someone that knows how to do these things appropriately and safely. It takes someone that is patient and kind throughout the entire process. Will both of you get over the embarrassment? If you can, then all the better to help your loved one be as independent as possible. Realizing that some help with toileting and bathing will help your loved one stay at home longer.

Safety needs for older folks and memory care folks

Grab bars are a must for the toilet and shower/bath. A raised toilet seat will help too. Non-slip decals need to be placed in the tub. Brighter light is a plus. Some bathrooms need to be heated with a ceramic floor heater or an oil-filled radiator heater. Be sure whatever you get, is appropriate and safe for a bathroom. Schedule regular bathroom breaks every 2 – 4 hours. Give them time to get there. Pack your patience and a loving demeanor along with a loving tone. Give them directions and let them know what you are doing.
    • The toilet seat is right behind you. Squat down slowly to sit.
    • I am going to help you stand up now. Scoot your butt forward.
    • Lean forward and put your hands on my forearms when you are ready. Then ask them to raise/stand up. (Do not pull on their arms or legs. Hold on to the trunk of their body or their hips.)

Learn to wipe properly

If it is the opposite gender from you, learn to wipe properly. For example, an adult son, helping his mom toilet needs to know that to wipe a female, you wipe from the front to the back. So, put on your gloves and wipe from the vagina towards the rectum. This keeps fecal matter from getting into the vaginal opening and the urinary tract. Use wet wipes for cleaning and throw them in the trash can. Keep the private areas clean to lessen the chance of a UTI. If the person you are helping has a dementia, remember that they can sense emotions so keep calm and carry on. Do not make a big deal out of anything. Do not mention clothes or the mess. Sing a song and carry on. They are going to have an accident.

Nighttime Accidents:

Either they cannot make it to the toilet on time or they have no awareness that they need to “go,” The unawareness may be due to a dementia. It may also be that they have no warning from their brain signals that they have to “go.” They do not feel the urge. Sometimes, they feel the urge too late and can’t make it on time. Shit happens,  literally. Use the adult undergarments. Don’t call them diapers. Absorbent underwear with pads under the bottom sheet in the pelvic area may help protect the mattress. If urinary or bowel incontinence is an issue at night, go ahead and place two bottom sheets on the bed with pads in the appropriate place. Keep the mattress dry. That way, you can strip off the top layer, get them cleaned up, and back into bed without too much fuss. You may also try using an absorbent menstrual pad under the absorbent underwear to catch excess urine. If they have a poop incident at night, you may have to strip them, get them in the shower, and wash them. Place some Vicks Vapo Rub under your nose to block some of the smell.  Lotion them and redress them. If they are calm, then back to bed, and if not, go to the kitchen for a little snack or treat. Rinse the poopy clothes in the toilet to get as much fecal material off as you can. The same goes for the sheets and blankets. Launder in the washing machine. Sing a song and soldier on. The calmer you are the calmer they will be. If they do not have a dementia, the calmer you are the less stressed they will be. It is okay, it was an accident.

Do’s and Don’ts

Learn their habits. When do they normally poop? After breakfast? After the second cup of coffee? After dinner? When do they usually pee? Another useful tidbit … wear easy-on and easy-off clothes. Help them to maintain their privacy and dignity as much as possible. Dignity is based on people’s feelings, emotions, and perceptions & other peoples’ reactions to them. Watch your tone of voice. Do not use words of any kind that associate with a “baby-state.”
    • Close the door when they are in the bathroom. Give them privacy (if it is safe).
    • Cover the top of their lap with a towel.
    • Give them extra time to sit. Bodies need to relax to pee and poop.
    • Knock before opening a door.
    • Turn your head away when they are pulling their pants up or down.
    • Do not discuss their business with others.
    • Do not restrict their fluid intake because of incontinence. You may slow it down after dinner, but never stop them from drinking. You need to encourage drinking throughout the day.

Let’s move on to showering.

Showering or bathing 3 times a week may be sufficient. You can use wet wipes for underarms, privates, feet, and rolls (where skin touches skin) on the other days. Lotion is good for their body and so is a face moisturizer. Clean clothes and underwear every day. Teeth brushed twice every day and flossed once a day.

Shower day:

    • Gather all supplies you will need (shower chair or bench, body soap/wash, pouf with a handle, 3 washcloths, shampoo, conditioner, shaving cream/gel, razor, 3 towels,  robe, body lotion, etc.) Some use a barber’s cape to cover them.
    • Heat the bathroom with a heater.
    • Deep breathe and get yourself in the right frame of mind to help them.
    • Follow them in and help them toilet and undress. While they are on the toilet, start the shower and check the temperature before putting them in. A hand-held shower head is very useful. Warmer than lukewarm water, but not hot.
    • Have them use the grab bars and guide them to the shower seat. ** Note: if you know that you will be the one washing the private parts and bottom …Latex gloves on, have 2 washcloths ready, and use one for their front and one for their backside. Rinse well and then have them sit. **
    • You may drape a towel over their lap and shoulders to maintain dignity.
    • Allow them to wash on their own. You only help if they can’t get everything washed.
    • Wash the hair and condition it, first (always rinse well).
    • Wash the body from face down. Start with the face, neck, and ears. Then proceed to the shoulders, back, right arm, and left arm. Front of body, under breasts, right leg, right foot, and toes, left leg, foot and toes, Be gentle when lifting limbs. You may have to ask them to lean forward or to the side. Have them clean their bottom and private parts, if at all possible. This is easier while they are standing. Decide what works best for them, private parts first or last.
    • Drape a terry cloth robe around them (it helps in the drying process).
    • Try to pat dry and not rub vigorously (again, you want them to do everything they can do).
    • Look at the skin for any red or cracked places. If there are some, contact their primary care doctor. You may need to use a skin protectant like Calmoseptine.
    • Lotion everywhere, except between the toes. Make sure between the toes are completely dry. Make sure the genitals, perineal area, and bottom areas are dry as well.
    • Ask them about their normal routine for shaving. Some men shave in the shower and some shave after their shower at the sink. Ask the ladies if they want to shave, as some may no longer shave or even need to shave their legs. Ask them about shaving their underarms too.
    • Ask them if they prefer the morning, evening, or afternoon for a bath/shower.

When you need to help them wash body parts:

    • If you need to help them wash, use latex gloves (this barrier may make them and you feel more comfortable).
    • Use a clean washcloth for the genitals area and another clean washcloth for the anal area
    • For females, clean from front to back. Washing the inner thighs, labia groin and perineum.
    • dry the skin folds and skin underneath the breast.
    • Apply face moisturizer
    • Apply lotion.
    • Apply deodorant.
    • Brush teeth.
    • Get them dressed in clean clothes and comfortable for a little rest afterward. They will be tired. Give them their favorite drink or snack.
    • For males, clean the tip and shaft of the penis and the scrotum & perineal area. For uncircumcised men, pull back the foreskin, wash, rinse and place the skin back into position.
    • Wash the anal area (where the poop comes out). Use a clean area of the washcloth with every pass.
    • Be quick, gentle, and efficient. Rinse well.
Always have clean sheets once a week after a bath. The little things do matter. Yes, you will have a load of laundry to do after bath time. Accept it. Pat

Why does running errands and doing chores feel like a giant overwhelming task when you are a caregiver?

Because you aren’t sure what to buy, what to cook or what chores to do. You haven’t let yourself relax enough to think. Believe it or not, some people like doing errands and chores. For them, it is like getting on top of things. They like to be organized and prepared. Some of these organized and prepared people are also control freaks. I said, some of them. Let’s take a look at why other folks hate running errands. The chores thing is called adulting. August 24, 2022

Chores contribute to caregiver burnout

Let’s knock out chores first. I don’t personally know anyone that likes doing chores. I like the end result of a clean house and well-kept yard, but I don’t like to do them. That being said, I don’t hate doing them either. It is more of a matter of fact. The house needs to be cleaned, the yard needs to be mowed, the laundry needs to be done, the bills have to be paid, the car has to have an oil change, dinner has to be made and the dishes cleaned, etc. If you have to do it anyway, then do a great job. Be proud of your work. I have heard about folks that will do a half-assed job, so they don’t have to do it again. I say, make them do it again and again until they get it right. They will learn to do it correctly the first time or they can keep doing it until they get it right. They will learn that doing it right the first time is easier and quicker. If you have children, remember when they tried to half-ass clean? Hopefully, you made them keep doing it until they got it right. After they had to do it three times before they could go play, they learned to do it right the first time. Everyone, just do your chores! Take pride in the end result. Then, go out and play or enjoy the rest of your day. Check your attitude because little ones (and big ones) are watching you. Teamwork makes the dream work.

Men’s and Women’s Brains ARE Wired Differently

Men’s brains are wired differently than women’s brains. Women can multitask and men do one thing at a time. Men compartmentalize into boxes and nothing spills over into the boxes. Don’t ask a male child 3 questions. You will only get 1 answer. Men are task-oriented (one task at a time). Women can plan a list of things to do, put it in route order, and get it done while planning dinner. I asked my youngest son what he was thinking one day. Guess what he said? “Nothing.” Now, I cannot believe this. I am thinking “stuff” all of the time. However, I saw a scientist explain this very thing. At first, I called bullshit, but then did some research. Turns out males can think about “nothing.” Females cannot think about “nothing.” Everything is connected (somehow) to everything in a female’s brain. Women tend to “care” and men tend to “not care.” The above paragraph is in general. We all have male and female tendencies. The goal for us is to realize the deficits that we have and improve on them. Women can focus on the one task before them and only that. Men can learn to think ahead, make lists and plan dinner.

What a man will do, for example

If you ask a man to watch the kids, that is all he will do. He will do nothing, except watch the kids. When a woman watches the kids, she does the laundry, cleans the kitchen, and does a quick pick-up. If you want a man to do the little things, you have to give him a list, in the order that you want it done, and place the word “Tasks” on top of the list. Be specific and time-oriented or you will get “I’ll handle it. Or I’ll get to it.” It will then be on their timetable and not yours. This article has taken a turn that I had not intended, but here we are. Nothing is 100%, there are a few men that can multi-task and there are a few women that compartmentalize. Learn how to communicate with your significant other, they do not think like you. Assuming gets everyone into trouble. If you think or say, “why can’t he…” or “why can’t she…” then you are not communicating effectively.

I saw these things on Parenting. See if you can relate in your role as a caregiver

    • Women see the big picture.
    • Men have tunnel vision.
    • Women tend to talk more than men.
    • Men tend to condense their feelings and say a few words.
    • Women revisit memories more and tend to ruminate more.
    • Men tend to think about issues briefly, analyze quickly and move on to something unrelated.
    • Women can identify emotions quicker and are more tuned in to emotions.
    • Men tend to rely on facts and logic.
    • Women are more empathetic and tend to brood.
    • Men tend to turn to problem-solving mode.
    • Women have better memory power than men.
    • Men don’t pay a lot of attention to details (other than sports crap). Men have to make an effort to remember.
    • Women need a combination of things to get aroused.
    • Men need visuals to get aroused.
    • Women are better at learning languages.
    • Men are better with numbers (sports crap, again).

Manage your time better to help decrease caregiver stress

Managing your time better may help you to hate running errands and chores a lot less. Don’t jam-pack your schedule. Allow for “what-if time”. Find what works best for you. It may be a pick one day of the week to do the errands. It may be that you pick one room a day to clean. What if you could use errand day to reconnect with someone? Have someone go with you, a kid, a friend, or even your spouse. Be grateful that you can run errands. Not everyone has the money to run errands. Not everyone can physically go and do the errands.

Maybe, don’t do chores on the weekend?

If you feel like your Saturday is another complete workday, maybe you would be better off doing a little during the week. Don’t make yourself miserable. Prioritize and focus. Stop wasting your mental energy. Batch the things that can be batched. Delegate what can be delegated. Be flexible.

When you hate doing a particular chore

Couples fight about chores and cleaning almost as much as they fight about what to do with money. Destress your house. Never assume who will do what at the house. Talk it out and decide who will do what and how often. Develop a partnership in running the household. If you both hate and I mean hate,  not dislike a chore then you have to alternate it. Switch it up occasionally, to make sure it is still fair. Reevaluate and change when needed. If you have kids, teach them early and make sure they do a good job. Teamwork makes the dream work. More free time, coming up. Pat

Managing Multiple Appts

Caregivers: How to manage multiple appointments

Sometimes, we are so stressed that we give up more of our power than we need to around scheduling. Sometimes, we are thrust in to a role without our prior permission. Other times, it is assumed that we will do X,Y or Z at A, B and C time and there is no way that we can make that work with our schedule. Talk about stress levels rising. August 17, 2022

Get Legal Stuff in order for Caregiver

Before you are thrust in a role, have the tough conversations. Discuss who will be POA (power of attorney) for healthcare and for financial matters. It may or may not be the same person. It is much better to have these tough conversations with everyone who is to be involved, present at the meeting. No excuses, be there in-person, via telephone call or a Zoom meeting. Family caregiver supporters need this information. Decide who will be the point person or the one with the overall knowledge of what is going on and what will need to happen. Next, we need volunteers to take loved one(s) to doctor appointments, therapy appointments, pharmacy pick-ups, grocery shopping, cleaning the house, barbershop appointments and hair dresser appointments.

Which family caregiver will do certain appts or emergency appts?

During an unexpected crisis or emergency, whoever is available or can take off, will have to step up and handle the appointment. Any time there is to be an initial appointment, you will probably have to take what you can get. After that, you can set the appointment day and time that works best for the patient and the companion or the driver. Decide what days and time are best for you to help your loved one. Maybe, you have one or two days during the week that are easier for you to take off work, come in late or leave early. Treatment Tuesdays, Wednesday Errands, Hair Thursdays, or Manic Mondays (get everything done on this day) are some examples. Caregiver support = helping caregivers with the care recipient.

Have a day for appointments and try for first appt.

Get the first appointment of the day, the appointment right after doctor’s lunch or the last appointment of the day. These are the most on-time appointments. Overall, most doctors are scheduling better and wait times are in the 20-minute range, if there is a wait time. Yes, your time is valuable and as you respect the doctor’s time by getting there 15 minutes early to check-in and update your information, if needed, your time needs to be respected as well. I hear your voices in my head. The, “I had to wait 45 minutes passed the appointment time.” I get it , I have done it before too. I no longer do that. I give them 15 minutes and then I am back up at registration, checking out the situation. Oftentimes, you get back to a room at your scheduled time and then you have to wait for the doctor to come in. There is no easy solution with this type of situation. It could have been that two or three previous patients needed more time than what they were scheduled for. It could have been that the doctor got interrupted by an insurance company call. Before you get all pissed, give them the benefit of the doubt. There may come a time when you need more time with them and someone else will have to wait. You need a care team to provide care for your loved one.

Be prepared for your appointment

My appointments go smoothly because I am prepared. I get there 10 minutes early and check-in with insurance card and ID. Sign or fill out paperwork, if needed and I am ready to go. The assistant comes out and does the preliminary stuff. Takes down the notes for today’s visit and then I wait for my doctor. When he comes in, I have my list of medications out and ready. I have a list of meds that needs to be refilled ready to hand him. At the bottom of my list, are the  3 things that I want to talk about or have checked. If I am sick, I write down my symptoms in bullet points, how long it has been going on and what I have done or tried at home. By the time he has read this, we are ready to discuss treatment options or next steps. He may have a few questions that need to be answered. I answer, he checks out what needs to be checked out, orders what lab tests needed and electronically sends off prescriptions to be filled at my pharmacy. We discuss whether a follow-up is needed and I am out the door.

Want respect? Give respect.

It is great to like your doctor and I hope that you do. Any good relationship is a mix of give and take. Do you want more respect, attention and help from your doctor? Then be prepared for your visit. They no longer have the time to shoot the breeze, they just don’t. I believe that they want to do a good job and help you. Remember, this is a business relationship. The business is your personal health. It is important and we all need a doctor that we can work with for our best quality of life.

On your sheet of paper list, the following:

    • Name
    • Date of birth
    • Current Medications, Why taking, Who prescribed it?
    • Current over-the-counter (OTC) medications, herbal supplements, vitamins, etc.
    • Chief complaint – what brought you to the doctor today?
    • Signs & Symptoms you are having
    • How long has this been going on?
    • What have you tried or taken to help?
    • What refills you need?
If you think your medications are not working or helping, state that and why you think that. If you are having problems or unbearable side effects of your medications, tell your doctor. If you haven’t been taking your medications, tell your doctor. What is the reason? Be honest.

Write out your questions

Write out your questions. I know that you think that you will remember, but you won’t. You will talk about everything else and then your appointment time will be over. Stay focused on why you are there for that visit. There is such a thing as an extended visit, and maybe you need to ask for one of those for next time. If you have your all of your information and questions written down and ready, you may be surprised that you do have time left over. Doctors like bullet points or statements of facts. Save the story for later, if you have time. Find out how the doctors like to be contacted. Email, leave a message, make an appointment, etc.

When mistakes happen

Mistakes happen. Things get dropped or missed. Yes, it is frustrating and sometimes maddening. Take a chill pill, your amygdala just hijacked your emotions. Breathe and let the cortisol dump dissipate a little before you make phone calls and yell. Whatever has been dropped or missed has been dropped or missed. Move to next steps and when. Never ever assume that the doctor’s office will call you about test results. You make the call and leave a message that you are waiting on results and have not received them yet. Sometimes, you may be told that the office will call you, if anything is wrong. They may mean to, but crap happens. It is your health so you be responsible for calling them. Have you ever sent an email to someone and waited on a reply. But, you got no reply and now it is a week later. You are mad or disappointed. You either write another email or forget the whole thing. Guess what? They may have never received your first email. It may be in their Spam folder or something screwy may have happened and they did not get it at all. Give them a call and ask. Don’t assume your texts are going through either. Follow-up with a call. Strange things happen all the time. Set and keep your follow-up appointments. If you are dealing with chronic health conditions, you may have multiple doctors and will need regular check-ups. Usually, 3 or 4 times a year. These follow-ups are not punishments. They are to keep you healthy and on track to have the best quality of life possible. For follow-ups, you pick your days and time. Maybe Tuesdays are best for doctor appointments. Tell the scheduler, what day you want and what time will work for you and they can search for openings. See your dentist twice a year too. It isn’t just about your teeth and gums; it is also about heart health. If you have a fear, they have gas. Get better at describing how you feel and what is going on with you.

Be specific in your descriptions

Focus on how your life is being affected by what is going on. Be specific. Don’t say, I get tired easily. Tell what you are specifically doing. For example, I am having trouble drying my hair with a blow dryer, I feel weak and tired. My back hurts, here (point it out) and describe the pain (achy with movement, dull pain all the time, sharp pain when I do this.) and what makes it feel better and what makes it worse. Which of the following would be better information? My right knee hurts. OR …My right knee feels like it is giving out and it aches in the evening. In your mind, you know that your knee hurts and you know what you have done and tried. You also know what has worked and what has not worked. You are also concerned that it will give away and you may fall. Your doctor does not know all of this and they cannot read your mind. You have the clues that they need to help make an accurate diagnosis or treatment plan. Maybe, you are having trouble climbing stairs or going down stairs. Describe the trouble and how your knee feels.

Use a metaphor or simile  to describe what is going on. Be descriptive.

    • My legs feel like I am carrying 20-pound weights on each leg as I walk.
    • My stomach is in knots.
    • This pain feels like I am being stabbed.
    • I have jackhammers in my head.
    • My neck feels like rocks grinding together with bits and pieces chipping off.
    • I am itching so badly, that I wish I could dig my fingernails in and  pull out the affected area.
    • I feel like barbed wire is wrapped around my foot.
    • My headache is on one side and it is continuous with occasional lightning bolt zaps.
    • My stomach feels empty and gnawing about an hour after I eat.
Rarely, but it does happen, you have to say… “ I am not right. This is what I have observed and felt.” You may not have any concrete signs or symptoms, but you know that your body is not right. Be observant about your body and how it feels, be observant about your thoughts and what you are thinking. Things to help you write out your notes for your appointment:

Questions to ask yourself about your symptoms:

    • What exactly are my symptoms?
    • Are the symptoms constant? If not, when do I experience them?
    • Does anything I do make the symptoms better? Or worse?
    • Do the symptoms affect my daily activities? Which ones? How?
Go through the story in your mind and pick out the relevant information, remember, doctors like bullet points. Just because your doctor can’t make a diagnosis does not mean that there is nothing wrong with you. In too many cases missed diagnoses happen. Be persistent about what is going on. Get a second or third opinion. Missed diagnosis, also called delayed diagnosis or failure to diagnose, means that the medical professional did not realize a medical condition that a patient presented with signs and symptoms of. This may be because the doctor did not recognize a constellation of symptoms that should have prompted them to test for a certain condition, or because symptoms that might indicate a serious condition are also associated with a number of other, minor health issues. Misdiagnosis means that a person with one medical condition was diagnosed by a doctor with another condition that they do not have. In the best-case scenario, a misdiagnosis results in a little frustration and the waste of some time and money. In the worst-case scenario, the treatment for the wrong condition could further sicken or kill the patient, or delay diagnosis of the true condition until it is too late for it to be successfully treated.

Common missed diagnoses  and misdiagnoses in women:

    • Heart attack
    • Heart disease
    • Autoimmune diseases (there are about 100 of these and too often the symptoms are not specific enough and you may be labeled a chronic complainer)
    • Endometriosis
    • Polycystic ovary syndrome
    • Sleep apnea
    • Breast cancer
    • Ovarian cancer
    • Lupus
    • ADD (attention deficit disorder) & ADHD (attention deficit and hyperactivity disorder)
    • Stroke
    • Fibromyalgia
    • Chronic fatigue syndrome
    • Multiple sclerosis

Common missed diagnoses and misdiagnoses of men:

    • Depression
    • Fibromyalgia
    • Lung cancer
    • Colon cancer
    • Parkinson’s disease
    • Pulmonary embolism
    • Multiple sclerosis
    • Lyme disease
    • Migraines
    • Lupus
    • Obsessive compulsive disorder
Be diligent regarding your own health. You are not crazy and you are not a hypochondriac (well, most of you aren’t). Be as factual as you can be and understand that you have the clues. Get your symptoms across to your healthcare provider. Have the care recipeint be as involved as possible with all appointments. Pat

Family Caregivers: How to Manage Medications

Why is managing your own or a loved one’s medications important? Because to get the maximum benefit, you need to know so much more than just when to take them. Medication management is one of the best ways to help your loved one maintain their health and slow the decline. August 10, 2022 So often you hear about the adverse reactions, the terrible side effects, and the meds not working, but what about the successes?  Actually, getting better and feeling better. What is your part and responsibility in that area? Have you ever thought that you had a part in that? You do. If there are multiple family caregivers that will be administering meds, you do need a chart to keep track of meds and when given.

Medications Won’t Fix Everything

Medications are not going to fix everything; you will have to do your part. Medications have risks. Medications may have side effects, cause adverse reactions or not work at all for you. Only take what you need to take. What if we treated our health like a project we wanted to do? With ideas, goals, and successes. Those things along with medications would help you to have the best quality of life possible.

Questions to ask about medications

    • Why has this medication been prescribed?
    • How does this medication work in the body?
    • What are the most common side effects?
    • Are there any serious or rare side effects that I should be aware of?
    • Will this medicine interact with others that I am taking now?
    • When will this medication begin to work?
    • What should I do if I miss a dose? What if I  accidentally take more than prescribed?
    • Should I take this medication with food or water?
    • Are there other drugs, vitamins or supplements that I should avoid while taking this medicine?
    • Are there activities that I should avoid while taking this medication?
    • Are there any foods that interact with this medication?
    • Is it safe to drink alcohol while on this medication?
    • How long will I  have to take this medicine?
    • Do you have written information about this medicine that I can take home with me?

Tools you can use to manage and organize your medications

    • Weekly pill box – best for taking your medications all at once
    • AM/PM Weekly pill box – best for those that have morning meds and evening meds
    • Four times a day weekly pill box – best for those that have to take meds multiple times per day
    • Automatic pill dispenser – has a clock timer and can be set to dispense only at certain times & it is locked
    • Reminder Apps – best if you keep your phone with you all the time and need a reminder
    • Pre-packaged meds from your pharmacy – can be customed packaged
    • Pre-packaged meds from online pharmacy – see each site for rules/regulations

Keep a Current Medications List

Medication List – Keep it current, update it after every change in medication Get an Index card, you can use paper, but you will be mad when it gets wet and rips or tears. This is the minimum information that you need,  Drug name and strength, How you take it? (times per day), Why you are taking it?, Prescriber name Fold it up and keep it in your wallet.

Medication Managment Needs

Take your medications as prescribed. If you are having problems, contact your prescriber. Maybe your dose has not had time to work. Maybe you are underdosed? Maybe, you are overdosed? Talk with your doctor. Start Low and Go Slow is a good motto when beginning new medications. It may have to be increased to get to the maximum dose and maximum benefit. Take medications correctly. If you are using multiple mouth inhalers, you need to learn the proper order and the proper timing of each inhaler.

Why are you taking this?

Know if you are taking a medication “off-label.” Off-label means that a medication has been prescribed for a use other than its intended use. For example, Seroquel® (quetiapine) or Risperdal® (risperidone). These two medications are intended to be used as antipsychotics. Most of the time they are used for behavioral problems or sleep.

Our bodies change

Changes in our bodies as we age also contribute to how we metabolize and excrete medications.. As we get older, what we took in our 40’s may be too much for us in our 50’s+. **Note**  Any symptom in someone 60+ years and older should be considered a medication side effect until proven otherwise. **Note** Determine your goals for treatment. Your personal goals. Your medication goals. What if we all treated our health like a work project? One we actually wanted to do. We could use the SMART goals. Goal – A statement that describes in broad terms what you will learn from a particular treatment. It is a behavioral outcome statement.

Use SMART Goals

Specific – Be crystal clear on your goal. Not, I want to lose 20 pounds over the next year. I will lose 0.4 of a pound each week by decreasing my food intake and increasing my exercise output to equal 1,400 calories. Not, I want to feel better. Be specific, what will you do for yourself to feel better? Measurable – Track the small tasks within each goal, especially for long-term goals. For example, track the calories you consume and track the calories that you burn in a normal week. You have set your goal to lose 20 pounds in 1 year. Whatever your normal week numbers are, you can decide to decrease your calorie intake by 200 calories per day or you can burn 200 calories per day in exercise or a combination of both. You cannot outwork a bad diet. Attainable – Set goals that are challenging, even difficult at times, but within your reach. Relevant – Decide what is most important to you in your life and work. What qualities or changes do you most desire? It has to be something that you want to do. You may not want to do the “tasks,” but you really want the result so you will do the tasks. If you say to yourself, “ I should” or “I need”  or “ So and So wants me to” then just stop. You will not be successful. When you can get to, “I want” or “I would like to” statements then you can be successful. Timed – Every goal has to have a timeline to keep you on track and progressing toward success. A goal without the parameters of the SMART goals is just wishing.  Your willpower will give out, and all you will have is your discipline.

Use this template to practice your goal setting.

SMART Goal
Initial Goal Write your goal here.
S Specific Your goal should be well defined, detailed and clear.
M Measurable Is your goal measurable? You should be able to tell when you reach your goal.
A Achievable Can you reach the goal, taking into account your available time, skills, and financial status?
R Realistic Is your goal realistically achievable within the given time frame and with the available resources?
T Timely Set a start and finish date for your goal.
  Start Date: ___________________Finish Date_____________________
SMART Goal Revise your goal based on the answers to the questions above.

Action Plan

What steps do you need to take to get you to your goal?

Action Items Expected Completion Date Actual Completion Date

Potential Obstacles and Solutions

Potential Obstacles Potential Solutions
Pat

Pondering: When you think about “thinking about” making a decision

It happens one of two ways. One, you see or hear something that triggers the thought. Two, an incident happens and you know that you will have to deal with it sooner or later. You will hear yourself say, “I need to check on “this thing.” Sometimes, it will be, I am going to have to make a decision on “this thing,” and I need to start thinking about it. August 3, 2022

We ponder a lot, but are we stalling?

We think about thinking about stuff all the time. It isn’t high up on our priority, but we know that we will have to deal with “it” soon. Soon, as in, it’s coming. Oh well, we don’t have a timeline/deadline yet, so I guess I can think about thinking about it later. The “it” may be an oil change. The “it” may be a medical issue. The “it” may be a work project. We do this pre-contemplation for a lot of things in our lives. How do we prioritize? What can we do to make the prioritization process easier? Surprisingly, we need inspiration. A moment of clarity about new possibilities and options. Do you want to reach your goals? Your inspiration helps in your journey to reach your desired goals.

Which of these words for inspiration helps you to see your capabilities?

Creativity                    Inventiveness                          Ingenuity                                 Imagination Originality                   Individuality                           Artistry                                    Revelation Brainwave                   Brainstorm                              The “Aha” moment                 Genius Insight                         Vision                                      Incentive                                 Motivation

Find Your Top 3 Goals or Decisions to be Made

Now, that you have identified some of your capabilities you would be best served to find your top three goals. Hang with me here. You need your top goals to figure out what is important to you and to help guide the direction that you will be going. Laser focus is much better than the shotgun approach. Why? To maximize your energy levels. Remember, you only have so much focused energy per day. The other way that it helps is so you can decide what really does need to be done, what can wait, and what can be discarded (things you don’t need to do or you don’t need to do yourself). What if you could focus on the things that you can control? You cannot control your feelings or thoughts. But, you can be curious about them and accept them as they are with no judgment of good or bad. You can control how you react and act. Be present, right now. The present situation is what you can work on. You cannot change anything about the past. There will be challenges and obstacles and sometimes, you will need some help.

You can control time and effort, but not the outcome

You can control how much time and effort you put into a problem, relationship, or work issue, but you cannot control the outcome. We all hate that part. Have your “can do attitude” ready for the things you can control. Back to prioritizing. You know that we chase a few rabbits. Urgency and importance are the key factors in prioritizing. The Eisenhower box is a great tool to use. Are you able to recognize what needs to be accomplished? Do you comprehend the task? Do you know why you should do it? Feelings and emotions will probably arise about prior experiences or things we have lived before. Prior choices, prior consequences, prior successes, etc. What systems do you have in place for yourself to help you succeed? Routines, habits, scheduling, flexibility, rearranging ever-changing priorities, allowing for adequate amounts of time, etc. Patience and persistence will pay off while learning this new skill of prioritizing and planning. You will mess up and you will feel frustrated, but you will progress. Practice kindness to yourself, not beating yourself up. Just get back on track and try again. We are not looking for perfection we are looking for progress. Celebrate your efforts. That is what builds resilience.

What are some barriers to prioritizing?

    • Not making time to prioritize.
    • Not seeing the “big picture.”
    • Getting distracted by time wasters or the little things.
    • Not delegating what can be delegated.
    • Refusing to adapt when you get new or better information.
Learning your core values also helps in prioritizing and making decisions. Pat