Author: Pat

Do you have “choice paralysis?”

Too many choices, too many decisions, too much overwhelm, and decision fatigue all contribute to you feeling and being stuck. Do you feel as if you are “just surviving” every day? That stinks, doesn’t it? But, what to do and how to get started moving forward again?

November 30, 2022

Sometimes, the issue is that we do not know what to do first. Not only that, but we stress over what is the most important thing to do first. We are afraid to be wrong and so, we do nothing. I think the acronym F.A.I.L. is appropriate here, it is your First Attempt In Learning. Yes, you are learning what works and what does not work. Failure is an event and never a person.

We like certainty. We want to know that we have made the “right” decision. Our brains do not like uncertainty, it makes them work overtime to feel safe. Our brains get hijacked by our emotions and we cannot think logically. Stop overloading your brain.

Do you feel like you have to “shop around” and keep all your options open before making a decision? Two or three would be ideal, but we have to go to 10 places and keep comparing. How many of us get too obsessed or too anxious? You know who you are and you are nodding your head in agreement.

How much energy are these decisions taking? Is it really worth that much stress, anxiety, or energy-wasting? Have you ever thought about when this choice overload happens? It usually happens when we don’t have enough good information or knowledge in the area of need. Use your good resources. Set your limit to three of those resources. Find a knowledgeable person and have them provide you with your best two or three options for your needs. (That would be a plug for my services, in case you didn’t catch it.)

What does feeling stuck look like?

  • You have been searching for something that interests you and you find it. Then you look at all the steps it takes to do it and talk yourself out of doing it.
  • You keep thinking about what could be better or different all the time. You may even be future-oriented. You get into the “when I get this, I will be happy” or “when this happens, I will be happy.”  The problem is that you are here, right now in the present and this is where your focus for happiness would be best served.
  • You really want something – for yourself – a new relationship, a better job, a new house, to get in better shape, etc. – However, before you start, you lose your motivation. Maybe, you do get started and then you lose your motivation.
  • You have a feeling that something isn’t right in your life, even if you can’t put your finger on it.

Motivation is red hot for a while, but then it burns out and all you have are a bunch of ashes. What now? For one, the realization that motivation is never enough to achieve a goal. It takes commitment to the process. Doing it even though you don’t feel like it is another realization. Be consistent. Continue after a break.

Maybe you feel trapped as a family caregiver. You don’t mind helping, but now you feel like you never get out. It is a difficult adjustment. Be careful, resentments can build up before you know it. You feel like you are missing out. You feel trapped by doing the same tasks over and over.

Consider this, challenges are matters of perspectives and our own attitudes.

Is there some middle ground that you and your care receiver can agree to? Challenge your on “stinking thinking.” It could be your perspective and attitude that are the problems.

Some ideas to help you not feel trapped:

  • Only you can change the things in your life that you are unhappy about.
  • Live a healthier life by moving (walking/running) and eating better.
  • Be consistent, motivation alone is not enough.
  • Accept uncertainty. We can make good decisions, but we cannot choose the outcome.
  • Reconnect with your personal values.
  • What can you do, right now, that will be helpful?
  • Be the hero of your story and not the victim. Stop saying, “I don’t want …”
  • Stop focusing on the things that are causing you to suffer. Focus on whatever fills you up.
  • You may not have good options, so choose the option that you will regret the least.
  • See if you are in the “all or nothing” thinking. It can be a “both/and.”
  • Write down some “I could …” statements.
  • Write down three different things you are grateful for every day.
  • Be proactive rather than reactive. You will have more control and less stress.

Pat

Do you have cyberchrondia?

Most of us have used Dr. Google for signs and symptoms that we have experienced. It is a good tool if you use credible sources AND you know how to differentiate things. Too often, many of us do not know how to discern relevant information from non-relevant information. You get too focused on what is happening and the cause. What you have determined as the cause may be happenstance. It just happened to occur and has nothing to do with what is happening.

November 16, 2022

I think that it is great that we can research information. We need to be careful and use credible websites that have good information. You must do your due diligence on what sources are good, credible, and have up-to-date information. If you are going to research medical information, you deserve to find and use the best available. This is also where it is a good idea to know your biases and find out what your unknown biases are. It makes a big difference in how you search for things.

You can go down a rabbit hole in a New York minute and still have NO good information. You will have information, but it probably will not be good information. What is your purpose for searching for this particular information? Is it to prove what you think is going on or are you open and curious about what might be happening?

It is great to have your signs and symptoms written down. It is great to have a diary of what has been going on, what you have been eating, what physical activity you have been doing, and what is your general mood. For those of you thinking, that is too much to do. Then why are you searching for information online? Are you familiar with the term “GIGO?” Garbage in, garbage out. Think about that.

You don’t have a clear picture of what you need to search for. Why do you think there are millions of pieces of information for you to look at? Why do you think there are multiple possibilities when you use symptom checkers? You have lasered in on one thing and you are dismissing other possibilities because you are not taking the time to assess your whole body, all of your current diagnoses, and the medications you already take.

Look, our bodies are fearfully and wonderfully made. We have our own set of “normal for us,” kinds of things. You may have only one diagnosis, but someone else may have four different diagnoses. The totality of you matters, you have to step back and look at the whole picture.

I want you to be well-read and up-to-date on what is going on with your body. Find the best resources. Work with your doctors. It is great to discuss different possibilities. We know a lot of times it will be the process of elimination. Use major hospitals, such as the Cleveland Clinic, Mayo Clinic, Or Johns Hopkins. Use PubMed. Use the CDC. Use NIH. Use the (dot)Org sites for diagnoses.

Questions to ask when evaluating a website:

  1. Who runs the site?
  2. What is the purpose of the site? To inform people? To sell products? To promote the opinions of a person or a group?
  3. Who pays for the site? Is it ads? Do they clearly look like ads or “neutral” health information? Is it a business?
  4. Is the health information fair and balanced or biased towards a “claim or cure?”
  5. Where does the information come from? Do they cite and post references?
  6. Is the information up to date? Things change fast in the medical world.

I think it is better to use your time and energy to keep a health journal and talk regularly with your primary care doctor. Together you and your doctor will figure out the next steps and if you need to see a specialist. Too often folks either overestimate their symptoms and end up taking the wrong medication or doing the wrong self-treatment. For others, you underestimate your symptoms and do nothing or waste time waiting while the condition worsens.  I have recently learned a couple of new terms, “health anxiety,” and “cyberchrondia.”

Health anxiety refers to the excessive worry that “something” is wrong or you are fearful of a missed diagnosis or a misdiagnosis. The key word is “excessive.” Are you adding unnecessary worrying or anxiety to your life? If that is all you are fixated on, then I say, YES. Let’s try some balance here. Start researching things you can do, right now to improve your health no matter what else is going on. Eating for nutrition, doing physical activity every day, and drinking your water every day. Focus on what you can change to make a more positive impact on your health.

Questions about a sore throat or if someone has slighted you used to come and go in your mind. You let it go. It was just a passing thought. If anything seemed serious, you would go get it checked out. But now, you have a computer at your fingertips and you have to know. Because you can. Statistically improbable, but you latch on to it. Down the rabbit hole, you go, and you are finding more and more of the awful things it could be. Never mind that none of the sites you are now looking at are “good” sites. Your mind goes to the worst possible thing. That is what it does automatically, we have to stop it and get back to balance. You may be looking for reassurance that you are not going to die or you are going to be okay…but that is not what you are finding. You are finding the doom and gloom scenarios. It is a freaking algorithm people. Once you click on a link, you are given many more links with that same type of information.

According to Psychology Today, there are 5 tell-tale signs that you are a cyberchondriac.

  1. You check online for symptom information from up to 1 to 3 hours per day. On average, people high in illness anxiety spent a little over 2 hours a day as a high point during the past month on their worst day. In contrast, people low in illness anxiety spent less than an hour, or 1 hour at the most on their very worst days.
  2. You fear having several different diseases: Those high in illness anxiety feared having nearly 5 diseases compared to their low illness anxiety counterparts, who feared having less than 2. How many diseases do you think you might have?
  3. On your worst day, you’ve checked 3 to 4 times a day: People high in illness anxiety not only spend more time but also take more opportunities to search online for information on their symptoms. Those low in illness anxiety check perhaps once a day, if that, even when they’re feeling the sickest.
  4. Looking online to get symptom information makes you feel more anxious: If those high in illness anxiety are trying to reassure themselves, their online probing is only making them worse. During and after their checking sessions, they report far higher anxiety than individuals scoring low on the illness anxiety scale.
  5. Your health is actually medically stable: Although people high in illness anxiety had a higher self-reported disability, their health hasn’t undergone major changes. They were actually less likely to have an unstable medical illness than were those low in illness anxiety.

If these 5 qualities apply to you, The Doherty-Torstrick team propose that your best way to handle your anxiety is to stop checking. 

Susan Krauss Whitbourne 2016

Tips for when you go down a rabbit hole and have a cyberchrondiac attack.

  1. Remember it is not all you. Sometimes your brain hijacks you.
  2. Talk about your fears with your primary care doctor. Maybe you are searching and searching for things to go wrong because of a prior catastrophe. Waiting for the “other shoe to drop,” as they say. The reality is that you are afraid something might sneak up on you again.
  3. Check in with your body, learn to meditate, and feel your feelings. You don’t have to act on them, but you must recognize them.
  4. Question why you are believing this way. What is the evidence? Is it true? Is it helpful?
  5. Don’t beat yourself up. The stress is coming from somewhere, let’s try to identify that and work on that.
  6. Sometimes, you just have to breathe deeply for 5 minutes and move on to something else.
  7. Set a time limit on your search – 20 minutes

Pat

Secrets that folks over 65 try to hide…

If they still have their partner, the partner will try to help and cover for them. When they are tag-teaming it is more difficult to figure out what is going on. It isn’t always intentional, but it can be intentional. To be fair, it may have happened slowly and they are taking care of each other the best way they know how to help. Observe to see if the spouse is finishing tasks for them, finishing sentences for them, or making excuses for some type of behavior.

November 9, 2022

No one likes to admit that they may need help. We are all very independent and quite stubborn. Most of us fear losing our mental faculties more than we fear losing physical capabilities. I understand that. Too often, people feel that they are “getting dementia” or “Alzheimer’s disease,” but that may not be the issue at all. Which is why it is important to go through a diagnostic workup. It could be fixable, such as better nutrition and hydration. It may even be a type of depression.

  1. Falls
  2. Pain
  3. Dizziness
  4. Financial difficulties
  5. Short on money
  6. Buying a lot of “stuff”
  7. Gambling
  8. Drinking more alcohol
  9. Prescription drug misuse or abuse
  10. Illegal medication misuse or abuse
  11. Binging on sweets
  12. Financial abuse – from a family member, a friend, or a caregiver
  13. Elder abuse or Neglect – from family, friends, neighbors, or caregivers
  14. Automobile accidents
  15. Driving Infractions or Getting a Ticket for something
  16. Hiding bruises – either from falls or abuse
  17. Eating a lot of take-out
  18. Changes in the way they dress
  19. Closing the doors to rooms – to keep junk hidden, the messiness, or the dirtiness
  20. Limiting driving to short trips and not far from home
  21. Poor personal hygiene – from not changing clothes to not bathing nor brushing teeth
  22. Unopened mail

A few behaviors that may mean they are trying to hide information:

  1. They discourage visitors. It may get to the point of them not letting anyone inside their home. It starts as, “We will meet you at the restaurant.” “The house is such a mess, let’s do it another time.” They may even say that they know “you are busy with your job.”
  2. Hiding mistakes – driving, spending, buying,
  3. They make a lot of excuses for their forgetfulness or their behaviors
  4. Changes in activity – you are looking for changes in their normal routines
  5. Speaking for their spouse

Why might they do some of these things? “Denial (De Nile) isn’t just a river in Egypt.

  1. Denial – If you don’t acknowledge it or talk about it, then it doesn’t exist and nothing is wrong.
  2. Pride – They can’t admit that they can’t do a lot of things necessary to live on their own. We all are an independent and prideful bunch.
  3. Embarrassment – maybe they become self-conscious or ashamed of what they can no longer do. Especially if it has to do with personal hygiene. Embarrassment rears its ugly head when they have some financial difficulties. They cannot afford food, medication, and getting repairs done to the house. It may or may not be any fault of their own.
  4. Fear – of losing their independence
  5. Depression – chronic health conditions seem to cause a rise in depression. Depression is not always the ‘woe is me” stuff.

Depression is not a normal part of aging. It may mimic dementia.

Signs and Symptoms of Depression in folks 65 years and older:

  1. Memory impairment
  2. Trouble retrieving some words
  3. Takes longer to process information and deliver an answer
  4. Depressed mood
  5. They no longer have pleasure or want to do the things they used to enjoy
  6. Noticeable weight loss or weight gain
  7. Sleeping too much or too little
  8. Feeling fatigued
  9. They experience feelings of worthlessness
  10. Having excessive or inappropriate feelings of guilt
  11. Recurrent thoughts of death or suicide
  12. Feel confused
  13. Struggle to pay attention
  14. Be grumpy or irritable
  15. More aches and pains
  16. Move more slowly
  17. Crying spells
  18. Apathy –  lack of interest or concern

We always want to rule out the things that can be ruled out. What if it is a lack of nutrition, dehydration, loneliness, or isolation? Those are fixable and doable. If it is depression some medications can help. Shoot, even running has been shown to help mild to moderate depression. Once we know what it is, it really is much easier to handle.

Pat

What Caregivers Do Need from You

Caregivers need to hear that they are appreciated. They need practical help that almost anyone can help if they are willing to put forth some time and effort. You have said, “If there is anything you need, let me know.” Did you mean it? I am going to tell you what they need and want.

There are really helpful things you can do and say to caregivers or helpers. Last week we talked about what not to do and say. This week we move towards helpful things to do and say.

November 2, 2022

This time we are going to be talking about what you can say and do to help your friend or loved one who is a caregiver. Did you really mean it when you said, “Let me know what I can do to help you?” If you mean what you say and say what you mean then this article is for you. If you do not mean what you say then you can stop reading now. We are going to get into the practical and doable things.

What caregivers and helpers want and need to hear.

  1. Recognition and Understanding – Recognize that what they are doing matters and is helpful. Try putting yourself in their shoes, and be understanding when they are stressed and need to vent. Be understanding that they are exhausted and need a break from both thinking and doing. A short visit to shoot the breeze or watch a movie. Find a distraction when they cannot leave their caree (care receiver).
  2. Time to recharge – Offer to stay or sit with the care receiver for two to four hours so they can go and do whatever they want to do. Are you willing to do this once a week, once every two weeks, or once a month? What day and time? Be specific.
  3. Provide respite care – This could happen a couple of ways. Find a facility that allows for respite care and find a company that provides in-home care so the primary caregiver can get away. Cost is usually the main factor. How many friends, family or church members can donate money to provide this much-needed service? Imagine what a week away would mean to them.
  4. Take them out to eat and to a movie. If you can, pay for the in-home care or find someone to sit with the caree for three or four hours. Most of the time, it really is just being there in case the caree needs something. It is not like you would be asked to do anything medical.
  5. Emotional support – They may need to vent. They may need to talk about what is going on with their caree. They may need to talk about something else.
  6. Feel heard and understood – Acknowledge how hard this may be for them. Understand that they have bad days and feel anger, hate and rage.
  7. Send flowers
  8. Offer to be the communication person – keeps others updated or put info on a website like Caring Bridge
  9. Send a thinking of you text and state – no need to respond
  10. Coordinate the offers of help and support
  11. An email with a joke or two
  12. Remind them they are loved and cared about
  13. Say, “I will be keeping you in my thoughts and prayers, every day and sending you good vibes.”
  14. Share “remember when” stories about your relationship
  15. Share funny stories that you have witnessed
  16. Laughter provides many great benefits – watch a funny video
  17. Say, “I love you.”
  18. Offer to sit with their mom or dad so they can go out with their spouse and kids.
  19. Ask, “How can I be a good sounding board for you?”

What caregivers would like you to do and how to effectively help them.

Yes, it would be great if the caregiver had a list of things to be done and errands to run, but most have not had the time to do one. Maybe you are the one to make the list and place it on the refrigerator so folks can sign-up.

  1. Never offer to do anything that you do not want to do. The look on your face and being told no is more than the caregiver can handle. They will shut down.
  2. Ask, “When is the best time to come for a visit and how can we help during the visit?”
  3. I am coming over on Saturday from 2 to 5 to stay (with your loved one) so you can take a break. Be specific.
  4. Give a Visa/MasterCard gift card of $50 – $100 and say, “Enjoy.”
  5. Pick up a meal from their favorite restaurant and deliver it.
  6. Make a meal and deliver it – use throw-away containers
  7. Make a few freezer meals and take them over.
  8. Set up a meal train to provide meals anywhere from 3 to 7 days a week (ask about likes/dislikes)
  9. Make phone calls and do research for them – if asked
  10. Donations to help cover lost work and medical expenses
  11. Offer to coordinate medical bills, EOB’s and medical claims. Only if you know how.
  12. Give a gift certificate to a spa/massage
  13. Mow the yard (either the caregiver’s yard or the care receiver’s yard or both)
  14. Do laundry – Pick it up and bring it back
  15. Help clean the house – vacuum, dust, sweep, mop, wash dishes, change the sheets, clean the shower/tub and toilet, wipe down surfaces – nobody expects you to deep clean
  16. Clean the gutter
  17. Take their car in for an oil change
  18. Run the errands – grocery shop, pick up Rx’s
  19. Sit with the care receiver so the caregiver can run errands
  20. Take the care receiver to the doctor’s appointment
  21. Deliver a care basket – good snacks, a book to read(nothing about caregiving allowed), favorite lotion and skin care things, gift cards, blanket, neck pillow, board game, cards, Mani-Pedi gift certificate, etc.
  22. Wash and vacuum the car
  23. Rake leaves
  24. Shovel snow
  25. Clean out the refrigerator
  26. Change the air filter
  27. Shred old documents
  28. Help clean out a closet or room
  29. Clean out the garage
  30. Replace light bulbs
  31. Walk the dog
  32. Clean out the litter box
  33. Take animals to the vet
  34. Take animals to the groomer
  35. Wash the outside windows
  36. Clean the oven

Think about the things that you do at your own home. The caregiver needs those things done either that their own home or the care receiver’s home. Find 2 or 3 things that you don’t mind doing and do them. Do the things that you don’t mind doing. Do not do things that you hate doing. For example, I don’t mind doing laundry, taking the cars in for service or cleaning, or running errands. I hate washing the outside window and cleaning the oven and I won’t do them. Other folks have different likes and dislikes. So, what I hate doing, someone else doesn’t mind doing.

Be specific about what you will do and when you will do it. Ask, if that is okay with them and if not, be flexible. Clear communication is important. Do not assume.

It is not a requirement to help out financially. If you can, that would be great but not a necessity. Your time, efforts, and help will mean more. So there is no misunderstanding, be upfront about what you can and cannot or will and will not do. It is perfectly fine to state that you can’t help with the financial expenses, but you can run errands and pick up things that have either been paid for or they can send you with some form of payment.

Most caregivers don’t assume you will pay for things, but they may simply forget to give you a way to pay. Just remind them that you need a check or card.

Pat

What Caregivers Do NOT Need from Others

You may mean well. You may even mean what you say, but you are hurting them rather than helping them. Will you be open to learning how to better support someone who is helping a loved one? It will require some effort and thinking on your part.

October 26, 2022

I have said some things in the wrong way. I really meant to help, to be supportive and available. What went on in my own mind, did not play out well for someone I was trying to help. I had to realize that I was looking at their situation through my own ways of caregiving and what I would have liked help with.

If you truly want to be a help to your friends or family members that are caregivers, you have to buck up and take the time to learn what they need and want help with. No, that does not mean rapid-fire questions. A lot of the time, they do not know what they need or want because they are in hell and too stressed out to think.

What do you do? How about you learn what they don’t need and don’t need to hear?

  1. Judgement – Don’t second guess them or their choices. You don’t know their family dynamics and you are not in their shoes.
  2. Horror stories – They don’t need or want to hear about all the messed up crap that happens in nursing homes or what happened to “so-and-so.” Just shut up, there is no good that can come from that.
  3. Don’t ask what they need – Granted, this is difficult as you may want to help, but you don’t know what to do. Give them the gift of your time. You know the things that need to be done at your own home. Mowing, cleaning the house, laundry, running errands, grocery shopping, and making dinner.
  4. Don’t make more work for them – Don’t just show up, don’t call and say. “the gang is coming over to visit you.” They will feel the need to clean up and get the place cleaned up.
  5. Don’t ignore them – Maybe they can’t attend functions much anymore, but you can keep including them. Update them and let them know that you are thinking of them.

Now we will move on to, “What NOT to say…”

  1. “If you ever need a break, call me.” – What the hell. They do need a break and they don’t have time to go take a shower, much less call you.
  2. “You have to take care of yourself, too.” – Do you really think that they don’t know that? You are adding more stress and guilt, so unless you are offering to sit with their caree (care receiver) so they can take care of themselves, shut up.
  3. “You look tired.” – They are tired.
  4. “I don’t know how you do it.” – They have no choice.
  5. “God doesn’t give you more than you can handle.” – That statement is wrong on so many levels.
  6. “You will get your reward in heaven,” – You have just discouraged them more.
  7. Why do you keep going to visit them, they won’t remember it anyway.” – Their loved one still deserves love and care. They may not remember your name or who you are to them, but they sense and know that you are someone that loves them and cares for them.
  8. “You should put them in a home.” – You don’t get to decide what is best for them and their loved ones. Pretty much, anything that has a “should” or “would” in it ….keep it to yourself.
  9. “I could never do what you do.” – You don’t know what you will or won’t do until you are in your own situation. All relationships are different. All families are different.
  10. “I wish there was something I could do to help.” – Bullshit, you would do something if you wanted to. We will get into the things you can do and say next week.
  11. “You should get some help.” – Do you really think that they haven’t thought of that? Maybe, they can’t due to finances. Maybe, they have hired folks that do not show up.
  12. “How are you doing?” in front of the caree (care receiver) – Really? Do you want them to vent right in front of their loved one?
  13. “You need to find some time to relax.” – I am sure they would love to, but when and how?
  14. “Don’t feel guilty about …” – Feeling guilt is a part of caregiving.
  15. “Everything happens for a reason.” – No, it doesn’t. Stuff happens and we have to deal with it.
  16. “I know just how you feel.” – No you don’t. You may have had a caregiver type of experience, but it is not the exact same. Situations are not exactly the same, people are not exactly the same, and needs are not exactly the same.
  17. “What doesn’t kill you, makes you stronger.” – Do you think this hardship is making them stronger? That is foolish.
  18. “At least it’s not cancer.” – At least it’s not…statements cause more pain to the caregiver.
  19. “Just think positive thoughts.” – Way to go, you have just increased the feelings of guilt and pressure they put on themselves.
  20. “Your mom (dad) used to be a great person.” – Don’t talk about their loved one in the past tense. It is hard enough to watch a loved one decline, without being reminded of what has already been lost.

Think before you speak. Practice what you will say. Say it out loud. How does it sound? Is it uplifting or helpful? How might it be taken by someone who is stressed out and exhausted?

If you find yourself using any of the following, don’t do it. “I think,” “You should,” “I would,” “You could,”

Shut up. I get it, I want to help and fix things too, but some things are not meant to be fixed by you. That is a hard lesson, but a helpful lesson on being fully present and letting them vent. You just sit there and be the listener.

Next week we will talk about what to say and do to help a caregiver.

Pat

It’s just something you do.

Men often feel unprepared when their role in the family changes. Even if, they played a significant part in child raising (changing diapers, bathing, reading to them, holding them when they cry, etc.), they do not know how to help an adult that needs help with ADLs (activities of daily living).  It is just something that you do. You may have seen your mom or dad help their parents or each other when needed. The word “caregiver” never entered your mind. Maybe, “caregiver” is a negative word these days.

October 19, 2022

Ruck up – “man up” for a difficult situation

I like that phrase. It doesn’t matter if you are a man or a woman, the sentiment is “handle it.” You can handle it and you will need help. Everything may be okay for a year or so, but, eventually, you will need help. Learn to delegate. You will still have plenty to do.

I did not identify as a caregiver because I was not doing hands-on care. I was helping out. I was doing what needed to be done. Along with working full-time and dealing with my own home and life with kids.  I was scheduling, and I was seeing to her needs. I ran errands, took her to doctor appointments, cleaned the house, mowed the yard, and did the laundry.

I did not want to be seen as a caregiver. Maybe it was because I did not want to admit to myself the reality of the situation. If I did, then it would be real. I did not want to be seen as a caregiver because it made me feel weak. I wanted to “fix it,” but I couldn’t. I didn’t want to be a caregiver because it meant I had to give up some things that I wanted to do. I didn’t want to give up my life and free time. If I admitted that I was a caregiver, I would have to make changes in my life.

I did not realize that I had choices, opportunities, and helpers willing to help. I could have boundaries and provide good care. I could take care of my own needs and my family’s needs as well as care for my mom and my dad, who was the primary caregiver.

My dad never identified as a caregiver. This was his wife and he was going to keep her at home and do what needed to be done. He learned a lot. He learned how to cook a little, clean the house, do the laundry, pay the bills, make doctor appointments, etc.

He never talked about how he felt. It didn’t matter, he had a job to do and it was going to get done. A few years later, a few mini-strokes later, a personality change and a decline in physical health all began to take their toll. Mama was not rational and daddy did not know what to do or how to handle it. He finally told me that he did not know how much more he could take. Long story short, we got her the help she needed (when daddy stopped fighting us) and things improved immensely.

He stayed in the CCU (critical care unit) area for families from the first visit until the last visit. He got to visit 10 minutes about every 4 hours. I couldn’t get him to leave, even when I was there. He finally agreed to stay with me at my house (which was 20 minutes away versus an hour from where he lived). Mama was there for about a week. She did not make it.

He took early retirement and did what needed to be done for his family. He loved her and had responsibilities as a man and husband. My brother and I saw his example of how you take care of your family. Was he perfect? No. Is that a requirement? No. Did he love her? Yes. Did he do the best he could? Yes. Was he a good caregiver? Yes.

My brother and I saw as we were growing up that you help your family in whatever way that you can. You jump in and do what is needed. We didn’t think anything about it, we just did it. That is the way a lot of us were raised.

That is great, but nobody really talked about the stress and emotions that you deal with while helping. Times were different when I was growing up only about 50% of the females or moms worked outside of the home. It is much higher than that today. Men are more hands-on with child rearing too. Good thing, too. 45% of caregivers are now men. They need different things than women caregivers. Hell, one thing is that they need to identify as “caregivers.”

Men approach caregiving responsibilities differently from the way women do. Men focus on tasks and practical things that need to be done. Not so much on the nurturing tasks such as bathing, toileting, or dressing them. They can do them, but they need some training. Men are problem solvers and they tend to hire help to do some of the responsibilities that they either cannot do or do not want to do.

How frustrated might you be if you had never changed the sheets or cooked a meal? Yes, you can learn but you can also hire that stuff out.

The strong silent types are those that will have major health issues sooner rather than later. Sadness is a part of all caregiving. Things that are lost deserve to be grieved. You may even hear men say, “What good does talking about it do?” It keeps crap from getting bottled up and further stressing you out. I get it, being stoic is about self-preservation. You can’t deal with the sadness, anger, and anxiety so you push it all down. It will eventually all come up and out.

You are often unprepared and usually overwhelmed when the need hits. Why is identifying as a caregiver a good thing? It opens you up to possibilities of help and care. It also helps your primary care doctor know what to look out for in your own health needs.

Can you be a man and be a caregiver too? I think you can. Some men may feel it makes them look weak. That is not true. A caregiver has to be strong both physically and mentally. It is a very hard job. Strength under control is how I look at it. You have the physical strength when you need it, but you can be kind, nurturing, and loving too. To me, that is a protector. Another good thing about men as caregivers is that they are more vocal advocates for their loved one.

Guys, you may feel that you are failing if you aren’t able to “fix-it.” You are not a failure. Sometimes, things cannot be fixed. You have to be strong enough to let things “be as they are.” That sucks and it hurts. It doesn’t mean that we do not have hope or work toward goals, but we can accept things just as they are, right now. I can accept reality but I never give up.

You will feel alone. You will feel resentment. You will begin the grieving process before they are gone. It is your job to take care of your own physical and emotional needs. If you don’t then you will not be an effective caregiver for very long. Then what?

Place your to-do chores list on the refrigerator and leave a place for names of who will do the chore. People usually ask what you need or what you need to be done. Of course, you can’t think of a thing when they ask…

This way they can check the list on the refrigerator and pick what they can help with. Yes, you can put a time frame or day on the chore that needs to be done. Put everything that someone else could do on your list and see what you get.

Examples

  • Dinner Monday
  • Dinner Tuesday
  • Dinner Thursday
  • Laundry Wednesday (take home and bring back)
  • Clean the bathrooms
  • Mow the yard
  • Clean the gutters
  • Change the sheets Friday
  • Vacuum, Sweep, Mop
  • Sit with her from X to Y on Friday
  • Take her to the beauty parlor on ______ at _____

Getting help is not a sign of weakness, it is a strategy for being successful.

Pat

Burnout stage or Nervous breakdown stage?

What does that really mean? It isn’t used as a medical term or a diagnosis, but we all seem to know what it means. It means a mental health crisis. It means an emotional health crisis. It is also known as a breakdown of your mental health.

It happens when you have intense physical and emotional stress, with difficulty coping and you are not able to function effectively or normally anymore. You feel like you are losing control. The stress that you are under may have you feeling anxiety, fear, worry, stuck, overwhelmed, and/or nervous.  You are at the point where you can no longer function in life.

October 12, 2022

Everyone is different and everyone will have different stressors and reactions to those stressors. This is way past burnout.

A few things to watch out for:

  • You call in sick for a day or two (sometimes, longer).
  • You miss appointments.
  • You avoid or back out of social engagements.
  • You have trouble with healthy eating, exercising regularly, sleep, and your personal hygiene starts slipping.
  • You withdraw from people and don’t want to leave your home.
  • You lose interest in things that used to bring you joy.
  • Panic attacks.
  • PTSD flashbacks

We all have our own “set point” for a breakdown. Losses are a huge part, especially if they are stacked one on top of another. For example, a death, a divorce, losing your house, a terminal illness, being a caregiver, losing your job, family turmoil, severe financial strain, a chronic medical condition (a worsening chronic medical condition), inability to relax, continued loss of sleep, work stress, school stress, etc.

As you can see, a lot of things can pile on. Step away, take a timeout! Get a talk therapy appointment, ASAP. You are no longer able to get out of this situation on your own.   Breathe, just deep breathe for 5 minutes.

You will have to make adjustments and learn better-coping skills. You will have to learn to say, “No.” You will have to take care of yourself physically and mentally before you can help anyone else. Yes, you can recover.

Burnout is more common. My wish for all of us is that we take better care of ourselves BEFORE we get to this stage. The same stressors apply, they may not be as intense or as long, but they could be.

Burnout is usually defined as chronic stress related to poor life and work practices, that produce exhaustion (physically, mentally, and emotionally). You are overloaded and overwhelmed. When a person is overloaded and overwhelmed with negative emotions and feelings rear their ugly heads. We have hostility, anger, and frustrations and we don’t seem to be able to cope or handle these negative emotions.

Extreme burnout will lead to a mental health crisis.

This article from Medical News Today, explains burnout very well.

Some causes of caregiver burnout include:

  • Emotional demands: A caregiver can feel emotionally drained, especially if they are aware that the person they are looking after will not get better despite their efforts. For example, this could happen if a person is caring for someone in palliative care.
  • Conflicting demands: These are the additional demands a person has outside of their caregiving role, such as looking after children, going to a job, and making time for their partner.
  • Ambiguous roles: Often, the role of a caregiver is all-consuming. It is easy for a person to lose sight of who they are outside of their caregiving responsibilities.
  • Workload: Some caregivers may be looking after someone with complex needs. In these instances, it is important a person seeks temporary relief and gets assistance from other carers.
  • Conflicting advice: In some cases, treatment procedures may change as research progresses. While these changes aim to give people the best care, they can cause a significant amount of disruption and stress if a caregiver has an established routine.
  • Privacy: Additional clinical support, such as nurses and other healthcare professionals, may visit a caregiver’s home throughout the week. While this can be helpful, it can also take away their privacy.

All of these factors can contribute to a caregiver feeling overwhelmed, self-critical, and drained. If they do not address these feelings, they may start experiencing serious symptoms of caregiver burnout.

Caregiver burnout symptoms 

Caregiver burnout can manifest in several ways, and some people may notice they are experiencing some symptoms more strongly than others.

Symptoms of caregiver burnout include:

  • disrupted sleep
  • persistent irritability
  • altered eating patterns
  • anxiety
  • increased alcohol consumption
  • high-stress levels
  • lack of joy
  • loneliness
  • loss of hope
  • suicidal thoughts

Additionally, symptoms can indicate what stage of caregiver burnout a person is in.

The three stages of caregiver burnout are:

  1. Frustration: A person starts feeling frustrated and disappointed that the person in their care is not getting better. They cannot accept that the person’s condition will decline regardless of how well they look after them.
  2. Isolation: After a while, a person may begin to feel lonely in their caregiving role. They may also grow tired of hearing negative opinions from family members, especially if these family members do not appreciate or recognize the time and effort caring requires. At this point, the caregiver may withdraw from friends and family.
  3. Despair: Eventually, a person may feel helpless and isolated. They can find it hard to concentrate, struggle to find joy in hobbies or interests, and avoid social interactions. The level of care they provide may also begin to drop as they spend less time on their own well-being.

Read the entire article here:  https://www.medicalnewstoday.com/articles/caregiver-burnout#symptoms

Pay attention to your signs of stress and aggravation. If you need help or think that you may need some help, give me a call and let’s have a conversation. We won’t know if I can help unless we talk to see.

Pat

865-684-8771 (leave a message, if I am unable to answer)

How to balance expectations and reality

Sometimes, reality sucks! We cannot accept reality until we go through a process. Denial will be high and it is a coping mechanism for difficult emotions. We are not talking about avoidance, which causes a whole lot of other problems. We deny the truth so we can keep things the same. We have a fear of change and the unknown.

Facing reality means that we might have to change and make choices that we do not want to make. The uncomfortable feelings rise up within us and we become stuck. The inner conflict makes us miserable. Are you in denial about something?

October 5, 2022

We can’t even get to balancing expectations versus reality until we deal with our denial.

Some clues that you may be in denial about something:

  • You wonder, “If only she (or he) would …?
  • You doubt or dismiss your feelings.
  • Hope things will improve when …
  • You begin to feel resentful.
  • You walk on eggshells, trying to avoid a blow-up or avoid talking about the problems.
  • You may be worried that you will develop dementia yourself.
  • You avoid talking about the issue.
  • You avoid thinking about the problem.
  • You promise to address the problem in the future.
  • You minimize or rationalize what is going on
  • You become numb to your feelings

Denial isn’t always a bad thing. It gives you time and space to gradually accept the change. You need time to process and figure out the next steps. It can become a problem when you continue the denial and your health unnecessarily suffers. You will have some anxiety. That is normal. It is not comfortable, but it is normal.

We might have to take an action that we do not want to take. Okay, on to expectations versus reality.

Expectations are what we think will happen. Reality is what actually happens. Our frustrations and problems arise when our expectations are not met. My perspective is not the same as your perspective. Our life experiences are not the same and we have different known and unknown biases.

What impacts our perspectives? Our energy levels and our physical strength. How attuned we are with our own bodies. Being hungry (you will not make good choices when you are hungry). Easy-to-read statements “Seem” to be truer, whether they are true or not. Feeling bad, sad or depressed makes everything seem harder. Having our family and friends (our support system) around helps make things easier.

What expectations do you have?

Common signs that you have expectations:

  • Anticipating a certain outcome.
  • Having and holding a vision in your mind of how things will play out.
  • Having a set idea of what you want or need to happen.

Idealized versions of life and what you want can set you up for disappointment. You may not even realize that you are not being realistic.

Increasing your awareness of your expectations is one way to help. If you have a “should” in your thinking, be careful. Life is not fair. Why do you think it “should” be this way? Stop making comparisons. You are unique and your situation is unique. It is okay to feel disappointed. It is okay to feel all of your feelings. Remember, that you have control over how you act and react.

Accepting “what is” and trying to make that better is a great goal to have. I know some of you are wondering what I mean. It is difficult to accept reality and “what is.” It takes hard work and practice to let things “Be, just as they are, right now.” It is hard for the “fix-it” types to adjust to not being able to fix it. We have to find our new role. We have to figure out how to help. We have to learn to accept the reality before we can figure out our options.

I don’t deny the reality of what my clients are or will be going through. It will be hard and it will be exhausting. But everyone has the right to have the best quality of life possible for them. I never give up hope. Accepting what is or what will be, does not negate hope and trying. Being fully present” in “the moment is all we have. What you can see, feel touch, smell, and taste…right now.

What if we would set compassionate expectations? We are all going to get smacked down a time or two and that hurts. Something that we tried did not work out or it was a complete disaster. Well, hell! So, try something else.

We all have a mind or soul age and physical body age. My soul age is 35, but my physical body age is 60. I listen to my body and make adjustments for activity. Now, the little imp in me is still as active as ever. I play games, aggravate people, and have fun wherever I am. I have accepted the reality that I have to make adjustments sometimes. I am okay with that. That is really the key, isn’t it? Being okay with “that.”

Consider the conflicting emotions that you sometimes feel. Could that be what is really bothering you?

  • Happy & Sad
  • Scared & Excited
  • Confident & Doubtful
  • Love & Anger
  • Grief & Joy
  • Wanting time with your partner & Alone time
  • Believe in yourself & have a fear of failure

All of us have found ourselves in these types of emotions. It is like a push/pull situation. It sure can cause a lot of procrastination too. How can you make a decision when you have competing thoughts? They don’t have to cancel each other out. They can both be true and exist simultaneously. We do not have to choose we can accept both feelings. We have talked before about getting rid of the “either/or” and finding the “both/and” to find ways to move forward.

Pat

How to decrease wandering and aggressive behaviors

Our bodies are made to move. When we sit for long periods our body hurts. Our joints and bones hurt. We simply do not feel good. Now, imagine that you have a disorder or chronic health condition that makes movement more difficult or you can’t remember to exercise. Your body still needs movement to relieve pain and relieve excess energy.

September 28, 2022

Move more, hurt less. Move more, rest better. Movement and exercise for the care receiver will make the care giver’s life easier.

Is your loved one restless? Do they wander? Are they withdrawn? Hurting? Regular exercise and movement will help decrease these issues. Do something every day. We often think about things to keep the mind busy, but we sometimes forget about the body. It takes both to make an impact on their well-being.

Those dealing with Parkinson’s disease know that movement and breathing exercises help them to maintain strength and independence longer. They seem to be more open to exercise classes and doing workouts at home. Why? Probably, because they have all of their mental faculties, it is their body that is failing them and they want to be as independent as possible.

Those dealing with a dementia, such as Alzheimer’s disease, are experiencing brain failure. They become less and less aware of what their body needs. They forget that their body needs movement and exercise. Over time, they lose the ability to reason through the many steps it takes to exercise. These folks need reminders and workout buddies to help them achieve their goals. Many times, they can mimic what they see.

What they can do safely is of great importance. As with any exercise routine, a physician needs to be consulted. Maybe, a visit to physical therapy and/or occupational therapy is a good idea. PT’s and OT’s can help with an exercise program that can be done at home. Any exercise needs to be done appropriately. Form matters. Consistency matters. Never giving up matters.

Rock steady boxing has great results for folks that are dealing with Parkinson’s. Deep breathing exercises and vocal exercises are important too. Walking is good for everyone. Being outside is good for everyone. Playing in the dirt (aka, gardening) is good for almost everyone.  So, what, if you have to modify things? Being adaptable is a plus.  

Walking, weightlifting and dancing are great exercises for folks that are dealing with any type of dementia. The body needs to work in order to get tired. If we don’t get tired, we get restless. We can’t sleep and we get a little testy. Now, imagine that your brain is failing and you can’t reason out these things. You only know how you feel at this moment in time. You have to get your “willies” out somehow. You wander, you follow people around, and you ask the same question over and over.

Don’t forget about brain use activities. They are important too. Coloring, making something, building something, and doing a puzzle are all important, too.

I know that some of you are thinking, “I just want to get X, Y, and Z done.” Let your loved one help, give them a job. Be fully present and engaged with them. It won’t take any more time and it may even take less time because you won’t have all of the interruptions.

People before things.

Help your loved one to take care of their exercise needs. Develop your routine and stick to it. Put yourself in “time-out,” when needed. Think outside of the box. Who can exercise with them for about 30 minutes every day? Total visit time would probably be 1 & ½ to 2 hours. I bet you can find other family members or friends that can do that visit.  You have to tell folks what you need help with.

Those that have requested to stay at home (age in place), for as long as it is safe for all…will need to be fit, and have some strength and endurance. When they become “dead weight,” or can no longer toilet themselves, they will have to begin the transition to assisted living and nursing homes. It is possible to keep them at home with 24/7 in-home care.

Strength and balance exercises are very important.

The health benefits of exercise include:

  • Improved mood
  • Better sleep
  • Reduced likelihood of constipation
  • Reduced wandering
  • Reduced aggressive behavior
  • Reduced risk of falls
  • Increased maintenance of motor skills
  • Improving heart health
  • Improved strength
  • Improved balance

You may start with 5 minutes a day and increase a minute or two every week.

Dancing counts. Playing golf counts. Running errands counts. Riding bicycles counts. Walking on a treadmill counts. Yoga or Tai chi counts. Vacuuming and folding laundry counts.

For the mind:

  • Do a puzzle
  • Play a board game (Connect Four, Chutes & Ladders, Checkers)
  • Read a book aloud to them
  • Play a card game
  • Reminisce (ask them about childhood, hobbies, work life)

Pat

Does behavior in a person with Alzheimer’s disease have a reason?

Why is he doing this? Why is she acting this way? We always wonder why they are acting out or being disruptive, but we don’t always think about what is really going on. What is really going on is that something is bothering them and they cannot tell you what it is. You have to put on your detective hat. I promise you that they are not doing this on purpose.

September 21, 2022

It is hard to deal with a person that cannot tell you that they are hurting, uncomfortable, or scared. They do things that don’t make any sense to us. But, remember you are in dementia land. They have less and less control over their emotions.

Aggression in dementia can become scary and abusive. Aggression can become physical. It may also come out as cursing, spitting, or being verbally abusive to the care partner or helper. The aggressive behavior is thought to be the way that the person with dementia  shows anger, fear or frustration.

Overboard reactions include screaming, shouting, making crazy accusations, and becoming agitated or very stubborn. They may also have uncontrolled laughing or crying. Possibly due to misunderstandings/miscommunications or even an underlying illness.

Change in sexual behaviors. The person with dementia no longer knows what to do with their sexual desire or how to address it appropriately. There may be a diminished interest in sex or there may be an increased interest in sex. They may remove their clothes, make sexual advances toward others, fondle themselves in public, or mistake another person for their partner.

Repetitive behaviors include asking the same question over and over and over, pacing, undoing something that you have just done, or word repeating. Give them something to do.

Wandering or leaving. Maybe they are “trying to go home,” or “they are going to work.” You may have to hide “exit cues” or “trigger items,” such as keys, shoes, jackets, purses, or hats. Try to engage with talking or reminiscing while distracting them from leaving.

Sleep disruptions. Dementia affects sleep patterns. Have the doctor rule out other possible causes. Keep them active and on a schedule during the day. They need physical exercise (walking 30 -45 minutes each day). Is the sleeping environment dark, and quiet? Is the temperature in the bedroom comfortable? Make sure they have sunlight during the day and even if they can’t go outside a lot, they can see the sunlight through the windows.

Delusions and Hallucinations: False beliefs, paranoia, and hallucinations may occur. Sometimes, the hallucinations are pleasant and sometimes they are not. Strong emotional memories from their past may recur. They will feel as though they are experiencing them in real time, all over again. If they are not bothered by the hallucination, then leave it be. If they are distressed, talk with the doctor to rule out other causes or to change/update medications. You can acknowledge their experience with a matter-of-fact tone without agreeing or disagreeing with them. You could say something like, “That is interesting.”, “I don’t see that.”, or acknowledge what they have said and move on to another topic.

I saw this article from Better Health and would like to share it with you.

https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/dementia-behaviour-changes

Sleeping problems in dementia

Problems with sleeping are common for people with dementia. Some people sleep during the day and are awake and restless at night. Some are no longer able to tell the difference between night and day, while others are simply not as active as they used to be and so need less sleep.

Problems with sleeping or late evening agitation are often a stage in dementia that eventually passes. Many people with dementia sleep more during the later stages of the illness.

Sleep problems are among the most difficult dementia symptoms for carers. Families and carers must be able to get adequate sleep themselves. Plan regular periods of rest and regular breaks for yourself, as well as for the person with dementia.

Medical causes of sleeping problems in dementia

Sleeping problems may be caused by physiological or medical causes including:

  • brain damage (caused by the dementia) that affects the ‘biological clock’ in the brain that directs our sleep patterns
  • illness such as angina, congestive heart failure, diabetes or ulcers
  • pain caused by conditions such as arthritis
  • urinary tract infections that cause a frequent need to urinate
  • leg crampsor ‘restless legs’, which can indicate a metabolic problem
  • depressionthat causes early morning wakening and an inability to get back to sleep
  • side effects of medication, such as antidepressants and diuretics
  • snoring and sleep apnoea
  • ageing that causes sleep patterns to change so that some people need more sleep and some need less.

Things you can try include:

  • Discuss with the doctor the possibility of stopping or changing diuretic medication (which makes a person urinate), because this may be contributing to the problem.
  • Arrange a medical check-up to identify and treat physical symptoms.
  • Treat pain with an analgesic (pain-relieving medication) at bedtime if the doctor agrees.
  • Discuss with the doctor whether sedatives may be contributing to the problem.
  • Ask the doctor whether an assessment for depression may be necessary.
  • Ask the doctor about possible side effects of medication.
  • In some situations, it may be necessary to consider discussing with the doctor the appropriateness of either using tranquillising medication or sleeping medication. Sleeping medication may be helpful in the short term to establish a better sleep cycle, but both types of medication can have negative effects, such as increased confusion.

Environmental causes of sleeping problems in dementia

The environment of the person with dementia can cause sleeping problems in a number of ways including:

  • The bedroom may be too hot or too cold.
  • Poor lighting may cause the person to become disoriented.
  • The person may not be able to find the bathroom.
  • Changes in the environment, such as moving to a new home or having to be hospitalised, can cause disorientation and confusion.

Things you can try include:

  • Keep the environment as consistent as possible.
  • Check whether the person is too hot or cold when they wake up, because dementia can affect the body’s internal thermostat.
  • Provide adequate lighting if shadows, glare or poor lighting are contributing to agitation and hallucinations.
  • Move the mirror in the bedroom if the person becomes confused when they do not recognise their own reflection or the reflection of others in the room.
  • Install night-lights that might help cut down on confusion at night and may help the person to find the bathroom.
  • Place a commode next to the bed if finding the bathroom is a problem.
  • Make sure the bed and bedroom are comfortable and familiar, because familiar objects may help to orient the person.
  • Avoid having daytime clothing in view at night, because this may make the person think it is time to get up.
  • Make sure that the person is getting enough exercise – try taking one or two walks each day.

Other causes of sleeping problems in dementia

Other causes of sleeping problems may include:

  • going to bed too early
  • sleeping too much during the day
  • overtiredness, causing tenseness and inability to fall asleep
  • not enough exercise, so the person does not feel tired
  • too much caffeine or alcohol
  • feeling hungry
  • agitation following an upsetting situation
  • disturbing dreams.

Managing sleeping problems with food and drink

Some suggestions include:

  • Cut down on caffeine (coffee, cola, tea, chocolate) during the day and cut them out altogether after 5 pm.
  • Cut down on alcohol and discuss the effects of alcohol and medication with the doctor.
  • If you think the person may be hungry at night, try a light snack just before bed or when they wake up during the night.
  • Herbal teas and warm milk may be helpful.

Managing sleeping problems through daily routine

Some suggestions include:

  • Try not to do any tasks in the late afternoon that may be upsetting to the person.
  • If the person refuses to go to bed, try offering alternatives such as sleeping on the sofa.
  • In some situations, it may be necessary to consider discussing the appropriateness of either using sedative medication or sleeping medication with the doctor. If the person wanders at night, consider allowing this, but check that the house is safe.
  • Try a back rub before bed or during a wakeful period.
  • Try a radio beside the bed that softly plays music.
  • Gently remind the person that it is the evening and time for sleep.

Hoarding in dementia

People with dementia may often appear driven to search for something that they believe is missing and to hoard things for safekeeping.

Some causes of hoarding behaviours include:

  • isolation – when a person with dementia is left alone or feels neglected, they may focus completely on themselves. The need to hoard is a common response
  • memories of the past – events in the present can trigger memories of the past, such as living with brothers and sisters who took their things, or living through the Depression or a war with a young family to feed
  • loss – people with dementia continually lose parts of their lives. Losing friends, family, a meaningful role in life, their income and a reliable memory can increase a person’s need to hoard
  • fear – a fear of being robbed is another common experience. The person may hide something precious, forget where it has been hidden and then blame someone for stealing it.

Managing hoarding

Things that you can do to help manage hoarding behaviour in dementia include:

  • Learn the person’s usual hiding places and check these first for missing items.
  • Provide a drawer full of odds and ends for the person to sort out, as this can satisfy the need to be busy.
  • Make sure the person can find their way about – an inability to recognise the environment may be adding to the problem of hoarding.

Repetitive behaviour in dementia

People with dementia may say or ask things repeatedly. They may also become very clinging and shadow the person caring for them, even following them to the toilet. These behaviours can be very upsetting and irritating for families and carers.

Managing repetitive behaviour

Things that you can do to help manage repetitive behaviour in dementia include:

  • If an explanation doesn’t help, distraction sometimes works. A walk, food or doing a favourite activity might help.
  • It may help to acknowledge the feeling expressed. For example, ‘What am I doing today?’ may mean that the person is feeling lost and uncertain, and a response to this feeling might help.
  • Do not remind the person that they have already asked the question.
  • Repetitive movements may be reduced by giving the person something else to do with their hands, such as a soft ball to squeeze or clothes to fold.

Wandering in dementia

Wandering is quite common among people with dementia and can be very worrying for those concerned for their safety and wellbeing. The person’s failing memory and declining ability to communicate may make it impossible for them to remember or explain the reason they wandered.

Develop an action plan for when a person with dementia wanders, such as noting the clothing they were wearing, and contacting neighbours and the police.

Reasons that a person with dementia might wander include:

  • changed environment
  • loss of memory
  • excess energy
  • searching for the past
  • expressing boredom
  • confusing night with day
  • continuing a long-held habit
  • agitation
  • discomfort or pain
  • believing they have a job to perform.

Managing wandering

Things that you can do to help manage wandering in dementia include:

  • Get a physical check-up for the person to help identify whether illness, pain or discomfort has triggered the wandering.
  • Discuss the side effects of medication with the doctor – try to avoid medication that may increase confusion, and cause drowsiness and possibly incontinence.
  • Consider the psychological causes of wandering to try to determine if the person is anxious, depressed or frightened.
  • Make sure that the person carries some form of identification that includes their current address, if travelling
  • Use identification cards available from Alzheimer’s Australia.

Sundowning in dementia

People with dementia may become more confused, restless or insecure late in the afternoon or early evening. This is known as sundowning and these behaviour changes can become worse after a move or a change in routine.

The person with dementia may become more demanding, restless, upset, suspicious, disoriented and even see, hear or believe things that aren’t real, especially at night. Attention span and concentration can become even more limited. Some people may become more impulsive, responding to their own ideas of reality, and this may place them at risk.

Visit the doctor for a check-up and a review of medication. There are a number of physical and environmental changes you can make to restrict stimulating activities to the morning and promote relaxation in the afternoon and evening.

When you are dealing with all kinds of behaviors, you will need a way to calm your own frustration. Sometimes, you need to walk away and take a few minutes to compose your own thoughts and settle down. Is what they are doing hazardous or frustrating and aggravating? Unless it is dangerous or hazardous, leave them alone.

Know your own warning signs of frustration:

  • Shortness of breath
  • Knot in the throat
  • Stomach cramps
  • Chest pains
  • Headache
  • Compulsive eating
  • Excessive alcohol consumption
  • Increased smoking
  • Lack of patience
  • Desire to strike out

If you don’t deal with your own frustrations, anger and resentment are not far behind.

Pat

Are you engaged with your loved one or are you just doing chores?

Think about it. Are you really having a conversation or are you just placating them so that you can get crap done? As the care giver or care partner are you even aware that your care receiver has needs that you can easily meet while you are handling tasks? I get it. A lot of us are task-oriented and do not want to be bothered with other things while we are doing our tasks. That would be great if our care receiver was not a human being. Take the time to talk with them.

September 14, 2022

Most of the tasks you will be doing, will not take a lot of brain power or concentration. Some tasks will, and you will need quiet time to concentrate, but not a lot of them. It does not take brain power or concentration to do laundry, wash dishes(place in or take out of dishwasher), cook something, sweep or mop, etc. You can be engaging your care receiver by talking, telling stories, or singing together. Paying bills, comparing EOB’s with medical bills and figuring things out, will take concentration and brain power. You do need quiet time for those types of things. To get that quiet time, engage your loved one before you get started. Take 10-15 minutes to be fully present with them.

Remember, they can sense your attitude and feelings towards them even if they have any type of dementia. If they have a physical disability or injury, and they need a little help, they still like to be engaged in conversation or stay up-to-date with what is going on with you, the community, and the world.

We talk a lot about dementia patients, but let’s focus on care receivers that have a physical disability, such as stroke survivors.

They need help and encouragement.

  • Encourage them to do the exercises they have been given by their physical or occupational therapists. You have to rewire the brain and movement is key.
  • Allow them to do what they can do, even if they struggle. Unless they ask for your help, let them keep working on it. Be helpful, but not overbearing.
  • You may have access to a social worker or counselor, and use them for help and resources. An occupational therapist can help with identifying home modifications that would help.
  • New stroke side effects may arise after going home. Be alert and contact their doctor.
  • Understand that sometimes, the stroke survivor may have a little setback, before they move forward again.
  • Always push past the plateau. There may be a time (3-6 months after a stroke) that “getting better” seems to level off. It may seem that way, but the brain is still healing and working. Keep on, keeping on. Changing exercises or rehab strategies may help, too.
  • There may be emotional changes after a stroke. There may also be outbursts of laughing or crying due to pseudobulbar affect.
  • Report falls to doctor
  • Don’t give up, keep striving for the best. (Independence depends on this.)

As a care giver, learn as much as you can about your care receiver’s stroke. What areas of the brain were affected? What do those areas control? What to expect physically, emotionally and mentally.

Some of the symptoms that a stroke survivor may experience:

  • Loss of control of movement &/or feeling in some parts of the body (This usually occurs on the side of the body opposite from the side of the brain affected.)
  • Changes in muscle tone on the affected side of the body
  • Involuntary muscle contractions
  • Difficulty sitting, standing or walking
  • Reduced ability to balance
  • Problems with speaking and/or understanding speech
  • Confusion and/or poor memory
  • Decreased control over bladder, bowel or both
  • Difficulty swallowing
  • Reduced control over emotions

The following is from Johns Hopkins Medicine

What are the effects of stroke?

The effects of stroke vary from person to person based on the type, severity, location, and number of strokes. The brain is very complex. Each area of the brain is responsible for a specific function or ability. When an area of the brain is damaged from a stroke, the loss of normal function of part of the body may occur. This may result in a disability.

The brain is divided into 3 main areas:

  • Cerebrum (right and left sides or hemispheres)
  • Cerebellum (top and front of the brain)
  • Brainstem (base of the brain)

Depending on which of these regions of the brain the stroke occurs, the effects may be very different.

What effects can be seen with a stroke in the cerebrum?

The cerebrum is the part of the brain that occupies the top and front portions of the skull. It controls movement and sensation, speech, thinking, reasoning, memory, vision, and emotions. The cerebrum is divided into the right and left sides, or hemispheres.

Depending on the area and side of the cerebrum affected by the stroke, any, or all, of these functions may be impaired:

  • Movement and sensation
  • Speech and language
  • Eating and swallowing
  • Vision
  • Cognitive (thinking, reasoning, judgment, and memory) ability
  • Perception and orientation to surroundings
  • Self-care ability
  • Bowel and bladder control
  • Emotional control
  • Sexual ability

In addition to these general effects, some specific impairments may occur when a particular area of the cerebrum is damaged.

suffered a life-threatening stroke that left half her face paralyzed, a devastating loss for a talented

Effects of a right hemisphere stroke in the cerebrum

The effects of a right hemisphere stroke may include:

  • Left-sided weakness or paralysis and sensory impairment
  • Denial of paralysis or impairment and reduced insight into the problems created by the stroke (this is called “left neglect”)
  • Visual problems, including an inability to see the left visual field of each eye
  • Spatial problems with depth perception or directions, such as up or down and front or back
  • Inability to localize or recognize body parts
  • Inability to understand maps and find objects, such as clothing or toiletry items
  • Memory problems
  • Behavioral changes, such as lack of concern about situations, impulsivity, inappropriateness, and depression

Effects of a left hemisphere stroke in the cerebrum

The effects of a left hemisphere stroke may include:

  • Right-sided weakness or paralysis and sensory impairment
  • Problems with speech and understanding language (aphasia)
  • Visual problems, including the inability to see the right visual field of each eye
  • Impaired ability to do math or to organize, reason, and analyze items
  • Behavioral changes, such as depression, cautiousness, and hesitancy
  • Impaired ability to read, write, and learn new information
  • Memory problems

What effects can be seen with a stroke in the cerebellum?

The cerebellum is located beneath and behind the cerebrum towards the back of the skull. It receives sensory information from the body through the spinal cord. It helps coordinate muscle action and control, fine movement, coordination, and balance.

Although strokes are less common in the cerebellum area, the effects can be severe. Four common effects of strokes in the cerebellum include:

  • Inability to walk and problems with coordination and balance (ataxia)
  • Dizziness
  • Headache
  • Nausea and vomiting

What effects can be seen with a stroke in the brainstem?

The brainstem is located at the base of the brain right above the spinal cord. Many of the body’s vital “life-support” functions such as heartbeat, blood pressure, and breathing are controlled by the brainstem. It also helps control the main nerves involved with eye movement, hearing, speech, chewing, and swallowing. Some common effects of a stroke in the brainstem include problems with:

  • Breathing and heart functions
  • Body temperature control
  • Balance and coordination
  • Weakness or paralysis
  • Chewing, swallowing and speaking
  • Vision
  • Coma

Unfortunately, death is possible with brainstem strokes.

Over time, it may be harder for the stroke survivor to stay motivated during recovery. The two main contributors to this are apathy and depression. Apathy is a loss of motivation, concern, interest, and emotional response after a stroke. Feeling sad after a major life event that turns your world upside down is normal, depression seems to affect 30-50 percent of stroke survivors. Signs of depression include feelings of hopelessness and sadness that do not go away.

Help stroke survivors to stay motivated.

Set relevant and achievable goals

Address the emotional challenges and get help with medications and talk therapy

Help the stroke survivor understand about their stroke, the changes, the rehab, the plateau, etc.

Have a consistent routine, do it no matter how you feel about it

Find what motivates them

When motivation fails, discipline takes over – just do it

Pat

Why does your own health take a hit when you are a caregiver?

We have seen the studies. We have experienced a decline in our own health all the while ignoring our own health needs. We know that we need to take care of ourselves so that we can take care of our loved ones. We know that caregivers can often wind up in worse physical shape than those they are caring for. Still, we do nothing for ourselves. Why?

September 7, 2022

We are stubborn people. We all  believe that we can handle “this.” We must handle “this.” You may even hear and believe that “God doesn’t give you more than you can bear.” That is not a true statement. Go read it. 1 Cor. 10:13. God will not let you be tempted more than you can bear. He will provide a way of escape. God will give you the grace you need in every situation. His power helps us use the resources that we have and can get to handle whatever is in front of us.

Do we think that we have to suffer or put our own lives on hold to help or care for someone we love? You see, that is more of the “either/or” thinking and not the “both/and.” Get out of the “either/or” thinking mindset. Get into the “both/and” types of thinking. If you have only thought of the “either/or” possibilities, then you can learn to think of a “both/and” possibility. More on this later.

What attitudes and beliefs do you have that stand in your way?

  • Do you think you are being selfish if you put your needs first?
  • Is it frightening to think of your own needs? What is the fear about?
  • Do you have trouble asking for what you need? Do you feel inadequate if you ask for help?
  • Do you feel you have to prove that you are worthy of the care recipient’s affection? Do you do too much as a result?

Really think about the above questions. It may be time to take 30 minutes to think and talk to yourself. Writing it out helps you to get to the real issues/answers.

Here are some ways that your own mind will kick your ass.

  • I am responsible for my parent’s health.
  • If I don’t do it, no one will.
  • If I do it right, I will get the love, attention, and respect I deserve.
  • Our family always takes care of their own.
  • I promised my father I would always take care of my mother.

Your own negative self-talk will get you into trouble. Just because you think it, does not make it true or right. Circumstances may have changed and you can no longer keep your promises. Don’t hold yourself to impossible standards made in the heat of concern/passion.

Our behavior is based on our own thoughts, beliefs, attitudes, and misconceptions. Remember, your feelings can and will lie to you. You may believe something that is simply not true. Half-truths are what make up great lies. You do get to choose what you will or will not do. You do not get to choose what you can and cannot control. That is not the way life works. Yes, it sometimes is awful, frustrating, and maddening. What can you truly control? Your attitude. Your own actions. Your self-talk. Your gratitude. Your own mental and physical fitness. Your eating habits. Your sleep. Your boundaries. What you prioritize?

Things you do not have control over:

  • You can’t control other people (what they do or what they say).
  • You can’t control how other people see you.
  • You can’t control what happens to other people.
  • You can’t control your thoughts or feelings, they just are. You don’t have to act on them, though.
  • You can’t control the outcome.
  • You can’t control other people’s happiness.
  • You can’t control the past.
  • You can’t control the future.
  • You can’t control that change is inevitable.

Stop wasting your energy and time on things you cannot control. Focus on what you can control and actually make a difference.

Will you reduce your personal stress?

The problem isn’t always the problem. The problem is how we perceive the problem. The meanings we attach to the problem.

The following information is from Family Caregiver Alliance

Your level of stress is influenced by many factors, including the following:

  • Whether your caregiving is voluntary. If you feel you had no choice in taking on the responsibilities, the chances are greater that you will experience strain, distress, and resentment.
  • Your relationship with the care recipient. Sometimes people care for another with the hope of healing a relationship. If healing does not occur, you may feel regret and discouragement.
  • Your coping abilities. How you coped with stress in the past predicts how you will cope now. Identify your current coping strengths so that you can build on them.
  • Your caregiving situation. Some caregiving situations are more stressful than others. For example, caring for a person with dementia is often more stressful than caring for someone with a physical limitation.
  • Whether or not support is available.

Steps to Managing Stress

  1. Recognize warning signs early. These might include irritability, sleep problems, and forgetfulness. Know your own warning signs, and act to make changes. Don’t wait until you are overwhelmed.
  2. Identify sources of stress. Ask yourself, “What is causing stress for me?” Sources of stress might be that you have too much to do, family disagreements, feelings of inadequacy, or the inability to say no.
  3. Identify what you can and cannot change. Remember, we can only change ourselves; we cannot change another person. When you try to change things over which you have no control, you will only increase your sense of frustration. Ask yourself, “What do I have some control over? What can I change?” Even a small change can make a big difference. The challenge we face as caregivers is well expressed in the following words modified from the original Serenity Prayer (attributed to American theologian Reinhold Niebuhr):

God grant me the serenity to accept the things I cannot change,
Courage to change the things I can,
and (the) wisdom to know the difference.

  1. Take action. Taking some action to reduce stress gives us back a sense of control. Stress reducers can be simple activities like walking and other forms of exercise, gardening, meditation, or having coffee with a friend. Identify some stress reducers that work for you.

Pretty good information, huh?

Have you considered the real reasons that you do not take appropriate care of yourself?

  • You haven’t made your health a priority.
  • You don’t feel you have enough time to do all you “need” to do.
  • You feel guilty taking some time away from your loved one.
  • You don’t have the energy.
  • You have reached the burnout stage.
  • You won’t accept things as they are, right now.
  • You won’t put yourself in the mix of things to handle.

10 Health Problems Caused by Chronic Stress

  1. Weakening of the immune system, which increases vulnerability to colds and other infections
  2. Mental health disorders (e.g., anxiety, panic attacks, depression, mood swings)
  3. Cardiovascular problems (e.g., high blood pressure, elevated heart rate, high cholesterol levels, increased risk of heart attack and stroke)
  4. Metabolic disorders (e.g., metabolic syndrome, insulin resistance, diabetes, obesity)
  5. Gastrointestinal issues (e.g., ulcers, vomiting, diarrhea, constipation, heartburn, chronic bowel disorders)
  6. Muscle tension and pain (e.g., backaches, neck pain, jaw pain, tension headaches, migraines)
  7. Sleep problems (e.g., insomnia, stress dreams, sleep deprivation)
  8. Chronic fatigue syndrome
  9. Respiratory problems (e.g., shortness of breath, rapid breathing, exacerbation of existing lung diseases like asthma and chronic obstructive pulmonary disease)
  10. Worsening of skin conditions (e.g., eczema, psoriasis, acne, rosacea, hives)

Which of these have you noticed in your own life? As you can see, you have to decide if your health is worth taking care of so that you feel better and are able to be the caregiver your loved one needs. Prevention is much easier than fixing a problem after it has happened. You do deserve to be happy and healthy. You do deserve to provide better care and get your life back. My services can help you achieve your goals.

Pat

What are the two things that, usually, trigger a need to move a loved one into an assisted living facility?

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.

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!

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.

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.)

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.

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:

  1. 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.
  2. Heat the bathroom with a heater.
  3. Deep breathe and get yourself in the right frame of mind to help them.
  4. 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.
  5. 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. **
  6. You may drape a towel over their lap and shoulders to maintain dignity.
  7. Allow them to wash on their own. You only help if they can’t get everything washed.
  8. Wash the hair and condition it, first (always rinse well).
  9. 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.
  10. Drape a terry cloth robe around them (it helps in the drying process).
  11. Try to pat dry and not rub vigorously (again, you want them to do everything they can do).
  12. 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.
  13. 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.
  14. 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.
  15. 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?

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

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 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.

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.

  • 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).

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.

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.

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

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

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.

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.

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.

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.

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.

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. 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.

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.

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.

Pat