Author: Pat

Can you have a difficult conversation and be respectful?

Posted on March 15, 2023 by - #alzheimers, #caregiver, #caregivers, #dementia, #parkinsons, difficult conversations, hard conversations

Sometimes, having a difficult conversation and being respectful don’t always go together. You can have a difficult conversation, but you can’t seem to reign in your emotions or you can talk about things that don’t really matter and be respectful. Think about it. How do you feel when you know a difficult decision must be made and you are facing a difficult conversation? Your heart begins to race, tension builds up in your body, and you are irritable. The conversation hasn’t even happened yet and you are all torn up. 

You are on edge and ready for a fight. You don’t want to have this difficult conversation, but you’re facing it all the same.   However, this is all in your mind. Nothing has happened, yet. Why do you feel this way? Past experience? Your racing thoughts are running amok and you are experiencing a stress response. You aren’t sure that a difficult conversation can be any other way than adversarial. Maybe, you don’t feel safe because you can’t predict the outcome. 

March 15, 2023

First, let’s figure out what your style of communicating is when you are stressed. Yes, you handle things differently when you are at peace with yourself and your surroundings. Stress impacts our ability to communicate. What toll are your relationships taking when you are not at your best?

Self-awareness plays a vital role in this arena. Are you aware of how you are feeling and why you feel that way? Are you aware of when it is not a good time to have a difficult decision because you are not in the best frame of mind? Did you know that it is your responsibility to get your shit together and then have the hard talks?

When you are self-aware and emotionally healthy:

·       You can intentionally respond to a situation. You think about the situation and act accordingly.

·       You are more open to others’ ideas and inputs. You are looking for the best solutions.

·       You are actually listening to understand and not just to respond.

·       You are empathetic to the other person.

·       You allow yourself to be curious about how the other person thinks and are open to changing your own mind.

·       You will allow yourself to seek out support from others.

·       You are willing to be understanding, supportive and fair.

·       You have the ability to be patient during the discussion process.

When you are not emotionally healthy or self-aware:

·       You tend to react to what the other person says and emotions escalate.

·       You will be more critical of anything the other person is saying.

·       You may even shut down and withdraw from the discussion.

·       You tend to personalize the comments and do some projecting of how you feel onto the other person.

·       You tend to be more judgmental and closed-minded.

·       You will do things on your own and not seek out help or guidance from others.

·       You will use manipulation, and verbal attacks to dominate the discussion.

·       You are impatient and that will lead to you becoming pushy and interrupting.

When we are tired, we can slide into the not-emotionally healthy or self-aware category. What is usually a small annoyance can become a mega monster deal to us and we react accordingly. Notice that I said, react. We are not being rational or acting in the best manner. Our brains have been hijacked by the amygdala (stressors and cortisol dump) and we are off on a tear. What we sometimes forget is that there are people whom we love and care deeply for on the receiving end of those rants and raves.

So, what can we do to be in the best frame of mind when we need to have difficult conversations?

·       Rest and get good sleep.

·       Do something physical each day for 15-30 minutes.

·       Write down 3 things that you are grateful for every day. Different things.

·       Be aware of what your inner critic is saying to you. Is it true or correct? If not, then you have to get verbal with the inner critic and tell it to shut up. Your inner critic needs a new job but that is another discussion.

·       You may not be able to rid yourself of stress, but you can manage your stress. Hopefully, you will do that in constructive ways.

We can all benefit from learning how to become better communicators. Take a course, do a seminar, or look up good articles online.

Our scenario:

Let’s look at the driving issue that seems to pop up. Here is the situation. Your dad needs to stop driving. He no longer has quick enough reflexes. His arthritis and neck issues are worse. Maybe there is some dementia that is now becoming an issue. You have noticed dings in the car on the sides and in the rear. The reasons could be physical, mental, or both.

You know that this is going to be difficult and it could get ugly. Hence, the stress response. You also know that this very difficult conversation has to happen soon because you are truly concerned for their safety and the safety of others.

Now that you have the scenario, what is the best approach for you to use when this discussion has to happen and you want to be helpful, loving, and respectful?

Family dynamics will play a part in this. It is best for the person who will have more sway with them to do the talking. This is not a guarantee, but it will help. Keep the main thing the main thing. Don’t get off-topic and into the weeds. Know what your “main thing” is. Next, you will need to state the “why’s.”

The main thing – stop driving

Why’s –         

§  Cognitive decline (dementia, Alzheimer’s disease, or other impairment)

§  Problems with mobility or coordination

§  Vision problems

§  Hearing loss

§  Sleep disorder

§  Seizures

§  Inability to turn their head and neck very far

All right, you have your main thing and your “why’s.” Now you need to prepare for the emotions that will come from you and them. This is where you discuss and listen with respect. That means no name-calling, no cussing, no threatening, no bulldozing over their concerns or pushback. 

They are going to push back. They are going to fight you on this. The best way to prepare for this is to listen to what their concerns are and understand what they are trying to say. I guarantee you that there are many things not being said and that is the real problem. Understand the other person’s point of view. Keep the conversation going as long as it is productive and emotions don’t send it off the rails.

What is not being said is, “I don’t want to give up my independence.” 

                                          “I want to go and do as I please.”

                                          “I don’t want to bother you or be a burden.”

                                          “I don’t want you judging me for where I go or what I do.”

                                          “I am your dad, you are not my dad.”

                                          “I will not be told what I can and cannot do.”

Take the time to understand things from their point of view. Imagine yourself being in the same situation because you’re going to be in the same situation one day so put yourself in their shoes.

You can keep stating the facts. You can even talk about the concerns you have for their safety, their passenger’s safety, or someone else’s safety. All of that is great and necessary. You have not addressed their concerns and wants. How will you handle that? You have to listen to the other person’s perspective.

You have to meet their needs and help them with what concerns them about not driving. Who will take them to the store, to the mall, to breakfast or lunch with friends? Who will take them to play golf, bowl, or to a ball game? Can they use a driving service such as a Taxi,  Uber, or Lyft? Will you set up the drive to and from for them? Who will pay?

Whew! You may or may not have a resolution, yet. You may have to table this discussion until a later date. You may, in fact, have to have this discussion multiple times before a resolution is reached. Unless they have a cognitive impairment, you may never get them to stop driving. Their doctor may have more sway than you and that is fine to use the doctor if needed. You can’t make someone do or not do anything. They get to make the decision, even if it is a bad decision. 

The purpose of this exercise was to show you an example of a difficult discussion and some things to think about before jumping in. To show you that you can prepare, you can listen for understanding and provide alternative solutions to meet their needs.

You are in control and in charge of your own emotions, feelings, and how to act and react. You are not in control of any other person’s actions or reactions.

A few tips:

·       Use “I” statements. Do not use any sentence that starts with ”you.” It makes people defensive.

·       Do not be sarcastic.

·       Do not use the words, “always” or “never”

·       Look at them in the eye.

·       Do not interrupt them. Let them say what they need to say.

·       Stick to their abilities and not their age.

·       Remember to value the relationship.

·       Be solutions-oriented. Ask them to be solutions-oriented.

·       Watch your tone.

·       Remember to deep breathe.

·       It is okay to disagree. Maybe a neutral person needs to do an evaluation of driving skills.

·       Have them drive you around.

·       Maybe, they can drive short distances in the mornings or early afternoons (avoid rush hours).

·       Know when to start or not start the conversation. Is this the best time to have this discussion? What else is going on? The time may never be perfect, but you need to find the best time possible.

·       Remember your purpose in having this difficult decision. You want them and others to be safe.

With any difficult discussion, emotions run high. Do what you can do to be prepared. Maintain your composure and learn to listen for understanding.

What disrespect looks like and sounds like

·       Disrespectful people do not care about the other person’s feelings.

·       People stop talking when you enter a room.

·       They do not accept responsibility when both of you share some of the blame.

·       They continuously interrupt you.

·       Angry or rude outbursts

·       Bullying

·       Shaming you

·       Arrogant behavior

·       Sarcasm or Taunting

·       Sighing, Making faces, Eye rolling

·       The silent treatment

·       Dismissing ideas without listening to them

You can become a more effective communicator. You can have difficult discussions with less stress. You can do all these things. You can learn better communication strategies. You know what you want to accomplish. Are you also willing to agree to disagree and improve the situation? 

Pat

What happens to your body when springtime seasonal allergies start?

Posted on March 8, 2023 by - Seasonal Allergies

While we may not be finished with Winter weather, Springtime weather is peeking through, and with that comes a host of spring allergy issues for those of us sensitive to those allergens. The aggravating headaches will not go away and have you wondering if it is a stress-type headache, a beginning migraine, or because you are stuffed up. It could be any or all of these allergy symptoms at the same time. Dang allergy season. 

Your eyes may feel like sandpaper or they are burning and itching so bad that you want to scratch them out. You try not to rub them, but sometimes the need for relief wins. Your nose is stuffed up, on both sides and it is hard to breathe. Don’t forget about the other sinus cavities that can be congested. We have 4 pairs. These allergy symptoms may trigger all kinds of allergic reactions. 

Scratchy or sore throat from the drainage. Sneezing and coughing to clear mucus from the irritated pathways. The mucus is clear in allergies. If you have mucus that is yellow or green colored, that usually points to a cold. Some folks even develop hives. What is causing this misery and how long will it last? The most common culprits are tree pollen, grass pollen, mold, and dust mites. 

March 7, 2023

Don’t forget about the body aches and tiredness that may happen. Did you know that they could be caused by an allergen?  A slight temperature increase may also happen in some folks. Not a fever, but a degree or two increase. Just enough to make you feel bad and tired.

 Seasonal allergies are caused by the immune system that has been overloaded and is now overreacting to some “stimulus.” The stimulus in seasonal allergies may come from a variety of sources. Check your local area for the pollen count. You may also use the American Academy of Allergy Asthma & Immunology website:  

https://pollen.aaaai.org/#/

Trees in East Tennessee that may trigger seasonal allergies:

·       Oak

·       Hickory

·       Birch

·       Maple

·       Cedar

·       Walnut

Grasses in East Tennessee that may trigger seasonal allergies:

·       Bermuda

·       Bent

·       Timothy

·       Sweet Vernal grass

Pollen in East Tennessee that may trigger seasonal allergies:

·       Ragweed

·       Wormwood

Common Molds that trigger an allergy: 

·       Alternaria

·       Aspergillus

·       Cladosporium

·       Penicillium

Mildew is also a type of mold that may trigger an allergic reaction. 

If you ever feel like your throat is closing off, go to your doctor or allergist. I understand it may close off for a few seconds when an allergen is near, but if it continues longer than a few seconds or seems to get worse go to your doctor. If you have asthma or COPD you must treat the allergy so you can have better control over asthma or COPD. 

Immune Response Diagram

A trigger causes a histamine release and an immune response.

Look at all that. It is a good thing that our bodies know what to do, isn’t it?

Oops! I almost forgot about the 4 pairs of sinus cavities:

Frontal sinuses – Just above each eye

Maxillary sinuses – Sit behind the cheekbones

Sphenoid sinuses – behind the eyes and way back, near the optic nerves & pituitary gland

Ethmoid sinuses – separated into the front, middle and rear groups (about 6 -12 tiny air sacs) they are behind the nose

Pain locations:

·       Side of nose

·       Temple area

·       Eyes

·       Jaw

·       Teeth

·       Back, Neck, or Joint pain – due to inflammation

·       Muscle aches – due to inflammation

·       Headache

Treatments to help alleviate symptoms that allergy triggers cause: 

Home

1.     When you come inside for the day, take a bath or shower to get rid of the pollen on your body and hair. Change your clothes.

2.     Stay well hydrated.

3.     Clean and dust your house regularly to get rid of pollen and dust mites

4.     Use a HEPA filter/HEPA Air Purifier to help get rid of dander, dust, and such.

5.     Change sheets weekly (best sheet materials include – bamboo, cotton, Tencel, or silk) 

6.     Use air conditioning in your house and car (recirculated air)

7.     Do not hang clothes outside to dry

Reducing your exposure to your allergy trigger: 

1.     Stay inside on dry, windy days.

2.     Avoid lawn mowing or pulling weeds.

3.     Wear a face mask when outdoors.

4.     Close doors and windows at night or when pollen counts are high. They are high in the early morning, too.

5.     Avoid outdoor activity in the early morning, when pollen counts are highest.

Over-the-counter allergy medications

1.     Antihistamines – (there are both sedating (sleep-causing) and non-sedating antihistamines)

These meds help with itchy watery eyes, drainage, and skin itching

These meds do not increase your blood pressure

2.     Decongestants – help with nasal congestion.  These meds can cause you to feel jittery or wired and may keep you awake.  Decongestants are meds that will increase your blood pressure.  Decongestants are not recommended for people with heart disease, high blood pressure, thyroid disease, diabetes, or in men with enlarged prostates or with difficulty urinating.

3.     Steroid Nasal Sprays – to decrease swelling and congestion

4.     Cromolyn Sodium nasal spray – helps with sneezing, runny nose, or itching – Prevents mast cells from releasing substances in the immune response cascade.

5.     Decongestant nasal sprays should only be used for 2 days and not more than 3 days or you will probably develop rebound congestion due to the nasal spray. I do not recommend these types of sprays because they can cause more problems than they are worth. Place a little Vick’s vapo-rub under your nose, if needed.

Rinsing your sinuses

1.     Using normal saline nasal spray or  rinse to clear the nose, moisten nasal passages

2.     Using at-home products – Neti pot or other nasal irrigation devices to clear out sinuses. Be careful – you must take care of your devices and clean them as directed. Let them air dry as directed. NEVER use tap water! You must use distilled or sterile water in these irrigation devices. If you are using salt or saline in your device always check to be sure that it is USP-grade sodium chloride and sodium bicarbonate, 99.99% NON-iodized salt, or pharmaceutical grade. Clean your irrigation device as directed by manufacturer instructions.

Tap water is not adequately treated or filtered to be used in medical devices or in nasal irrigation products. Using tap water in these devices may cause serious and even deadly infections.

Alternative treatments

1.     Things like Spirulina, Butterbur, or other herbal remedies may help, but they have not been verified or proven to help with an allergy. 

2.     Acupuncture or Acupressure may help, but has not been proven to help.

 Multi-use over-the-counter products

Don’t buy them. Take only what you need when you need it. A lot of those types of products contain acetaminophen (Tylenol®) and you can find yourself taking way too much. The only multi-use over-the-counter product I recommend is Robitussin-DM® (dextromethorphan and guaifenesin).

Pat

Could it be an adverse reaction to a medication?

Posted on March 2, 2023 by - #alzheimers, #caregiver, #caregivers, #dementia, #parkinsons, #parkinsonsdisease, Caregiver Information

It is springtime, and you are excited to be outside and doing your thing. Whether it is cleaning up, planting, prepping, or mulching. It is great to be outside, even if you are just enjoying the weather. Time to go inside, get cleaned up, and ready for dinner. All of a sudden, you start itching and you notice a rash on your forearm. Do you think about an adverse drug reaction? Do you think about a drug reaction? 

March 1, 2023

You assume that it must be poison ivy or some other weed irritation. Over the next couple of days, the itching is still making you crazy and you are beginning to feel miserable and aggravated. You begin taking over-the-counter Benadryl or some other antihistamine. Two weeks later, it is better, but it is still there.

What is the cause? Yes, it could be poison ivy mixed up in the mulch you spread. Yes, it could be some other weed or, who knows what? It could also be one or more of your medications. Most of us don’t relate itching and redness to a drug reaction. Especially, if we have been taking our meds for a few months. 

Adverse drug reactions are not side effects. An adverse drug reaction is always negative and may cause harm to you. A side effect is a secondary effect of a medication, which could be harmful, beneficial, or neutral. Usual side effects are where you see a lot of off-label use of medications.

A drug allergy is a serious matter. Technically, it is an adverse drug reaction. In a drug allergy, your body recognizes “it” as a foreign and dangerous substance. The body then activates the immune system to fight it off. You may see rashes, hives, itching, wheezing or other breathing problems, and inflammation. In severe cases, you may see anaphylaxis, which is life-threatening. True allergic reactions happen in about 10% of adverse reactions.

The time frame is different for a drug allergy and an adverse reaction (usually). In a drug allergy situation, the immune system evens occur within minutes to a few hours after exposure. Rarely, does it occur after 24 hours of exposure.

An adverse drug reaction can occur anytime after exposure to the medication. Where it gets confusing or better yet, forget about it when it happens weeks or months after you begin taking the medication. Some adverse drug reactions can be due to the drug itself or an interaction with another drug.

Symptoms of an adverse drug reaction vary by medication, but common ones include:

·       Digestive system bleeding

·       Heartburn

·       Fatigue

·       Sleepiness

·       Nausea/Diarrhea

·       Lightheadedness

·       Dizziness

·       Constipation

·       Skin rashes

Adverse drug reactions aren’t caught a lot of times. Most of the time the physician sees the complaints as “another problem.” Guess what you get? Yep, another prescription. It takes time and effort to figure out what is going on and what may be causing the problem. This is where you can use someone, like me to help figure things out.

We didn’t discuss intolerance, but it is a possibility too. You cannot tolerate a certain medication or the side effects that may occur. Usually, this has to do with metabolism and your body’s ability to use the medication.

Drugs that most commonly cause Adverse Drug Events that lead to a hospital visit:

·       Antibiotics

·       Anticoagulants (blood thinners)

·       Insulin

·       Opioid pain meds

·       Benzodiazepines

·       Renin-angiotensin drugs (blood pressure meds) Ex. ACE Inhibitors, ARB’s (Angiotensin Receptor Blockers, ARA’s (Aldosterone-receptor antagonists)

·       Lipid modifying agents

·       Urological medications (ex. Urinary incontinence meds)

Drug reactions to medications happen more than we realize. Strange symptoms may occur such as unexplained drowsiness may be a symptom. The dosage prescribed may be too much for you. Remember, allergic reactions occur fairly quickly after the medication has been administered. Anaphylaxis reactions may occur immediately or within half an hour of administration. Anaphylaxis is a life-threatening reaction. You may see these terms, adverse drug reaction, drug reactions, adverse reaction, allergic reaction, or adverse event and they are almost always talking about an unintended adverse drug reaction. Anyone taking a drug can have reactions to medicines even if they have taken the drug before and had no problems. 

You know your body and how it feels. Don’t dismiss things that are happening for more than three or four days. You may not know what it is, but you know that you are “not right.” Yes, it could be the side effects of a drug or it could be a possible adverse drug reaction. Your response to a drug may be different from another person on the same drug. You may know folks that feel this way and maybe they could benefit from my services. Let’s have a chat and see. I don’t know if I can help them or not until we talk and it is free.

Leave a message if I am unable to answer.

Pat 865-684-8771

Learning to accept help is hard.

Posted on February 23, 2023 by - #alzherimers, #caregiver, #caregivers, Alzheimer's, Caregiver, Husband caregivers

I have started this freaking blog, three times. I can’t seem to get going with it. Why? Because my mind is racing and I don’t want to deal with the emotional “stuff” that I am going to have to deal with. How can I tell you to learn to accept help when I have had trouble accepting help? Maybe, I can use some of my experiences so you don’t have to be as stressed as I was.

Our own thoughts, feelings, and stressors keep us from accepting help much less asking for help. Look at us in our Superman power pose. We can handle all. We can do all. And we truly can until the needs of our loved one takes up so much time and energy that we have nothing left to give. This happens about 18 months to two years in the helping process.

February 22, 2023

When I can help someone, I do. I don’t think a thing about helping them nor do I keep track or a “tab”, if you will. I am sure there are many people out there that are the same way. Just as I am sure that there are people that do keep score. Find the people who do not keep score and are willing and able to help each other out when needed.

We can’t do it all. We do need help. We need a written list. It doesn’t have to be things for your loved one, it can be things for you or the house. Things that others can do for you to help ease the stress. What would help you? It is often hard to think about what would help us when we are put on the spot with an offer of help.

Too often we think all the help needs to be for our loved one or we should not ask for help because we are the caregiver. Nope, wrong again. What could someone do for you to free up time for you to get your paying job done? What could someone do for you so that you can spend more quality time with your loved one? I want you to think and consider all of the things that do not require you personally to handle. There are quite a few, aren’t there? Write them down on a piece of paper and place them on the refrigerator. Think of it as delegating certain tasks so that you can be fresh, rested, and in a better frame of mind to help your loved one. Let’s face it, if you don’t take care of your health and your needs too, you will become ill and you can be in worse physical health than the person you are caring for…then who will take care of your loved one?

Let them pick what they want to do from your list. Most of us have things that we can do and will do and we also have things we hate to do. Don’t expect someone to do something that they hate doing. Since you aren’t making them or expecting them to do something that they hate…you don’t have to feel guilty about asking for some help.

Our own personal barriers get in the way of asking for help or accepting help. Most of the time it is the negative head trash talk that gets in our way.

Examples of barriers that caregivers have in accepting or asking for help:

  • Do you feel selfish if you take care of your own wants and needs?
  • Do you feel like a failure if you have to ask for help?
  • Do you feel that you have to prove something? (being worthy, loving, caring)
  • Do you feel responsible? Are you truly responsible or is that a false narrative?
  • Do you find yourself saying, “If I don’t do it, no one else will do it?”
  • Do you find yourself saying,” family takes care of family?”
  • Do you keep hearing the promise that you made, playing over and over in your mind?
  • Do you have the inability to let go of control?
  • Do you have guilt over leaving your loved one for a short time?
  • Do you have trouble feeling that no one else can “do it right?”

Reframe the way that you view things. Look for solutions to the problems. The problems are things that get in your way of sleep, rest, physical activity, alone time, and being in the best frame of mind and shape that you can be in to provide the best care for your loved one.

What are some solutions that will remedy these things? One of the best things to remember is to use “I” statements. As in, “I need…” “I want …” Do not say, “You need to…” No hinting allowed. No one can read your mind.

If someone asks you what they can do, don’t even think that you are a burden. You aren’t. You are important to them and they want to help you. Don’t rob someone of a blessing when they want to do something to help.

Caregiving is hard. Caregiving is a burden. Don’t misunderstand…the person is not a burden. I want you to be able to recognize that caregiver burnout is real and it can happen to anyone. You do need help and you do need to rest.

Admit what you cannot do. Admit what you can no longer do. The struggle is the fight inside your own mind. When you accept things that you cannot do, you allow your brain to look for other solutions.

Pat

Who is messing with your routine?

Posted on February 16, 2023 by - Alzheimer's, Caregiver, Husband caregivers, Parkinnson's disease

How do you feel when someone messes with your routine? Aggravated, pissed off, out of sorts, or off your game for the rest of the day. Very few folks can let it roll off their backs and move on without any negative feelings.

We are all creatures of our own habits. From what we do first thing in the morning to how we get dressed. Our habits are so ingrained in us that we don’t have to waste our precious brain energy to think about what to do. We just “do.” Everything goes off without a hitch, UNTIL…

February 15, 2023

We need help getting dressed and our helper does things the way that they do them for themselves. Unfortunately, it is not how we do things for ourselves. Talk about trouble and aggravation and a few dammits are thrown in for good measure. We may be dressed but we are all out of sorts and are not happy.

Try this and you will see what I mean. Stand up and relax with your arms by your side. Cross your arms over your chest. Look down and see which arm is on top. Left over Right or Right over Left. Now, relax them back down to your sides and do it the opposite way. Some of you can’t do it without a struggle. Some of you can do it but it sure feels strange.

Put on your jacket the “normal” way for you. Left arm in first or Right arm in first. Take it off and put it on again using the opposite arm. How does that make you feel? Kind of out of sorts? Now you are aware of how it feels to you. Now you can imagine how it feels to your caree too. You may have wondered why they were not helping you more and it seemed to be more of a struggle than it should have been. Now, you know. You weren’t doing things the way that they have always done them for themselves. You were throwing their routine off and their brain was having to figure out what in the hell was going on and how to compensate all the while their brain is screaming inside because you are doing it wrong!

My goal is to get you to understand that we all have our own ways that feel right and good to us. It is comfortable, safe, and secure for us. When we feel comfortable, safe, and secure we are much more agreeable, and our attitude is much better. It is the little things that matter.

Some of you may be thinking, “I just want to get it done.” I understand that feeling. If you want to get it done more easily and with much less stress, then do it their way and you will be done in less time and have a better day.

I have a document named “My Way.” It is about 12 pages, and it lists things that almost all of us do each day plus some things that we like to do, watch or listen to. It will be helpful to you and your loved one to let each other know what and how you like to do “things.”

It is free for the asking. I will email it to you.

Send me an email and in the subject line type in “my way” and I will send you a copy.

Email – pat@EmpoweringHealthOptions.com

Pat

Husbands, shower your wives…literally.

Posted on February 8, 2023 by - #alzheimers, #caregiver, #caregivers, #dementia, #information, #multiplesclerosis, #parkinsons, Caregiver Information, husband caregiver

Tips on how to be more helpful when assisting your loved one to bathe or shower. Things that you need to think about when becoming a helper. Understanding your own feelings and beliefs in this personal issue. Understanding your loved one’s feelings, wants and beliefs in this most personal area.

February 8, 2023

You two have been through a lot. You are a team, usually. You are both independent and self-sufficient. Then, things change and you are no longer self-sufficient. You need help because of a stroke. You need help because of cancer. You need help because of Parkinson’s disease. You need help because of Alzheimer’s disease or other dementia. No matter the reason, your wife needs help with one of the most intimate parts of her life.

We don’t think about it much, but we each how our own ways of doing things. They are our own patterns and our own order of doing things. Most partners do not know their significant other’s daily routine. When you are the helper, you need to be aware that your loved one has their own way of doing things. They have their own schedule and order in which to do things.

Try this experiment. Each of you writes down exactly what you do from when you wake up to when you go to sleep that evening. I mean everything with the time of day noted. We won’t get into the getting dressed procedure. I know, some of you have this puzzled look on your face. We all have our preferred way of getting dressed and we have specific ways we do things. For example, I place my left arm first, whether it is my shirt or jacket. It is automatic for me; if I even try to do it with my right arm first, I can’t do it easily AND I am out of sorts mentally.

Now, the next day write down your partner’s daily routine with times noted. Do this from what you have observed or what you assume they do. You will probably get the big things right, but probably not all of the little things.

Find a time to go over the information. Make it a date night. Talk about it and see how close you are to know each other’s routine. What are the similarities? What are the differences? This is a big-picture type of exercise. We all have our own routines.

When you are the helper or caregiver, it is best for the caree (your loved one) to be as comfortable and safe as possible. In order for that to happen, you need to know their routine and their times. We automatically do things in our routine and we don’t realize that others have other routines. Doing their routine becomes doubly important when your loved one has Alzheimer’s disease or another type of dementia.

Guess what? Female anatomy is different from male anatomy. We don’t automatically know to help the other person with bathing. We don’t automatically know how to wash and clean some private areas effectively. We don’t automatically know what to lotion and what to powder. Sometimes, we don’t know what we don’t know until we get in the big middle of it. That can be very stressful.

What follows are the supplies needed and the how-to tips to help you help your wife.

Bathroom

  • Grab bars installed properly and permanently. Place one above the water turn-on area, too.
  • Non-slip grips on bottom of tub
  • Portable heater to warm up the room
  • Shower seat or shower chair for tub
  • Tub rail grab bar
  • Hand-held shower head with 5–7-foot hose length
  • Remove trip hazard rugs

Shower Supplies

  • 4 Towels
  • 2 Washcloths
  • 2 Hand towels
  • Pouf for bodywash – may have a handle
  • Bar soap – gentle or sensitive skin type for washing privates and underarms
  • Bodywash -for washing other body areas
  • Shampoo
  • Conditioner – apply on hair and immediately rinse off
  • Lotion
  • Facial moisturizer
  • Deodorant
  • Barrier cream or protectant – if needed
  • Powder or Talc – if needed
  • Gloves – nitrile seems to be the best
  • Pump supplies are easier to use
  • Cotton terry robe will help in the drying off stage, too.
  • Always have them sit on the toilet to pee first before getting into the tub. Warm water brings on the urge to pee and if it happens in the tub, no big deal move on.
  • Let the water run for 1 -2 minutes and check the temperature on the inside of your wrist before putting any water on them.
  • You may want to place a hand towel on the shower seat for warmth or comfort
  • Encourage them to wash everything that they can wash – promotes dignity and independence
  • Use a gait belt – get trained in how to use one first
  • As the helper, you need to remain calm and relaxed. It will be slower than you anticipate. If your approach is more of a loving gesture and a desire for them to feel good, it will go a lot smoother.
  • If you have the attitude of getting in, getting it done, and getting out…it is probably time to hire this job out.
  • Use the gloves – it helps to separate intimate touch from helping with a need
  • Use a hand towel over their lap to promote privacy and dignity while they are seated on the shower seat

Order of Washing -Be Gentle

  1. Wash the face and neck first and dry the face
  2. Have them place a washcloth over their eyes while you wash their hair and condition it. Ask them to tip their head back. Scalp massages feel really good.
  3. Dry the hair with a hand towel
  4. If they can, have them hold the shower handle
  5. If they can wash themselves, then you soap up the washcloth or pouf
  6. Wash their back in a circular motion all the way down to the buttocks
  7. Wash the arms and underarms next
  8. Wash the front torso and under the breasts – wash skin folds well, too
  9. Rinse them off really well
  10. Place a towel over the top half of the body and pat dry a little (helps keep them warm)
  11. Wash the legs and have them lift up one at a time or gently lift them up. If they can stand then have them stand.
  12. Wash the feet and in between the toes (while they are sitting)
  13. Tell them it is time to wash private parts. Offer them the option to wash their own private parts, even if you need to help some.
  14. Use a clean washcloth and clean the vulvar area – use a different clean area of the washcloth for each swipe
  15. Clean from clean to dirty = front (vaginal area) to back (anal area)
  16. Separate the labia with one hand and clean gently with a downward motion to the perineum area (area between vagina and anus)
  17. Separate buttocks and clean from bottom to top area
  18. Rinse very well
  19. Talking throughout the bathing process and telling them what you are doing or will be doing next seems to help everyone calm down
  20. Use a towel to pat dry and dry well
  21. Areas that need extra care to be dry – vulvar area, anal area, underboob area, all skin folds and in between toes
  22. Gently get them out of the tub. Dry them off again or place a terry cloth robe on them to help with that. They can either stand or sit on the commode (lid down and with a towel placed on the lit) while you lotion them, powder them, and put on deodorant. Dry and style the hair. ** Note, some want to dry and style their hair before applying lotion and anything else. Some brush their teeth either before getting into the shower or right after getting out and drying off. Ask what they want to do. **
  23. Apply barrier or skin protectants to areas needed (usually incontinent folks need this)
  24. Never lotion between toes (want to prevent fungal or other infections)
  25. Places to put powder or talc – underboobs (skin under the breasts, and torso area where they touch), skin folds (anywhere there is skin-on-skin contact that does not get a lot of air circulation)
  26. Do not put anything in or right around vagina (it is self-cleaning)
  27. Help them into their clean clothes
  28. They may need a nap after a bath, it is hard work

Getting clean makes all of us feel better. Change the sheets on the bed on a bath day. Some bathe every day and some bathe 2 or 3 times a week. That is fine. Find what works best for your loved one and you.

It is also fine if you hire a shower aide to come into your home to help with bathing your loved one. You will still have to do the daily cleansing needed which includes face, underarms, underboobs, skinfolds, feet, in between toes, vulva area and anal area. This is sometimes referred to as a sponge bath.

Products to Consider:

Soaps/Body Washes

CeraVe Body Wash for Dry Skin

Kiehl’s Grapefruit Bath & Shower Liquid Body Cleanser

Aveeno Restorative Skin Therapy Sulfate-Free Body Wash

Dial Clean + Gentle Body Wash, Aloe

Neutrogena Hydro Boost Fragrance-Free Hydrating Body Gel Cream

Olay Moisture Ribbons Plus

Dove Beauty Sensitive Skin Body Wash

Dove Body Wash for Dry Skin

La Roche-Posay Lipikar Wash AP+ Body & Face Wash

Lotions/Moisturizers

CeraVe Moisturizing Cream 

Cetaphil Restoring Lotion

Eucerin Daily Hydration Lotion

Vaseline® Intensive Care™ Advanced Repair

Lubriderm Daily Moisture Lotion Shea + Enriching Cocoa Butter

Gold Bond Healing Lotion

La Roche-Posay Lipikar Balm AP+ Intense Repair Moisturizing Body & Face Cream

NIVEA Essentially Enriched Body Lotion

Facial Moisturizers

CeraVe AM Facial Moisturizing Lotion

La Roche-Posay Toleriane Double Repair Face Moisturizer UV SPF 30

Aveeno Positively Radiant Daily Moisturizer SPF 30

Cetaphil Daily Facial Moisturizer SPF 35

Unscented Neutrogena Hydro Boost Water Gel Face Moisturizer with Hyaluronic Acid

Aveeno Calm and Restore Oat Gel Moisturizer Unscented

Cetaphil Gentle Clear Moisturizer

Neutrogena Oil-Free Daily Sensitive Skin Face Moisturizer

Eucerin Redness Relief Day Lotion Broad Spectrum Sunscreen

Best Body Lotions for Men

Nivea Men Maximum Hydration 3 in 1 Nourishing Lotion

Aveeno Daily Moisturizing Body Lotion

CeraVe Daily Moisturizing Lotion

Dr. Jart+ Ceramidin Body Lotion

Vaseline Intensive Care Lotion

Jack Black Cool Moisture Body Lotion

Dove Shea Butter Lotion

Men Facial Moisturizers

Neutrogena Hydro Boost Face Moisturizer

Kiehl’s Ultra Facial Moisturizing Cream with Squalane

La Roche-Posay Toleriane Ultra Soothing Repair Moisturizer

Bulldog Mens Skincare and Grooming Original Face Moisturizer

Jack Black Double-Duty Face Moisturizer SPF 20

Cetaphil Fragrance Free Daily Facial Moisturizer

Skin Care Products for Incontinence – Barriers and Protectants

BAZA Clear Skin Protectant Ointment

Sween 24 Superior Moisturizing Skin Protectant Cream

Calmoseptine Ointment

3M Cavilon Durable Barrier Cream 

Boudreaux’s Butt Paste Rash Cream, Original

Incontinence Cleansers

PeriFresh No-Rinse Perineal Cleanser

Aloe Vesta Skin Cleansing Foam

Theraworx Protect Advanced Hygiene & Barrier System

Pat

Toileting Information for husband caregivers

Posted on February 1, 2023 by - #alzheimers, #caregiver, #information, husband caregiver

Personal hygiene care is probably one of the most needed guides that no one ever talks about. It is up close and personal. Dignity is important. Good information on the differences in needs of women versus men is needed for guidance and “how-to-do.”

Let’s face it…we really only know what we need and how we do things. Someone else has no idea what you need and want. If you are helping someone of the opposite sex, some things that may be going through your mind include…

  • How do I do this hygienically?
  • Am I too rough?
  • Am I wiping the right way?
  • Am I helping with their dignity or do I just want to “get it done?”
  • I hate this part.
  • I want to do this right.
  • I want to help them, but I have no idea if I am doing it right

February 1, 2023

The anatomical differences. The personal “wants” differences. The “how I do it” types of things may be different for each of us. Personal hygiene is definitely one area where very open and honest information is communicated for understanding. Never assume that you know best. Ask how you can best help them.

These are tough conversations but they don’t have to be awful. Maybe addressing it as a clinical need will help both of you to begin the conversation. Is it time to use adult undergarments that help with urinary or bowel incontinence? If she has hemorrhoids, how to best wipe and lessen the chance of discomfort or pain? Do any cleansers or ointments need to be applied after peeing or pooping? Do they prefer to be patted dry or wiped? After pooping, do they pat dry or wipe? Do they use a wet wipe? There are so many things to discuss.

If you are used to being in each other’s space when bathing or toileting then you will have a leg up on everyone else. If you are used to being in private when you bathe or toilet, then you will have a little more “getting used to each other” in that situation. Maybe you can pee in front of each other, but pooping is a private situation for you. That is cool, make sure your loved one is seated on the toilet comfortably, and leave the room until you are called back.

Try things and see what is more comfortable for both of you. Have gloves(nitrile) easily accessible in the bathroom and wear them. Wearing gloves seems to help each other to feel more comfortable with wiping.

Items to have on hand:

  • Nitrile gloves
  • Disposable white washcloths
  • Pump sanitizer
  • Personal cleansing wipes (Be careful, some of these cause a lot of irritation.)
  • Barrier cream, if needed (Calmoseptine, A&D Ointment, Boudreaux’s Butt Paste, etc.)

Niceties or Aids to help:

  • EasyWipe Toileting Aid
  • Butt Scrubber Multi-Purpose Toilet Aid
  • Bottom Buddy Toilet Aid
  • Bottom Wiper Self Wipe Long Reach Wiper – for larger or obese people
  • Squatty potty

Cleaning with tissue paper

  1. Grab more than one sheet of soft tissue paper. 4-6 squares & roll over the hand to make a roll ( I know, some people wad toilet paper.)
  2. Wipe from front to back. You are cleaning the vulva area and not the vagina. The vagina is self-cleaning. Some people use toilet paper to pat the area dry and that is fine.
  3. Make sure the area is completely dry.
  4. Be gentle

It’s important that you wipe front to back, as wiping the opposite way — back to front — can spread bacteria.

After pooping, you will still need to wipe the vulva area as we pee when we poop.

Prepare toilet tissue as before and you will wipe from front to back from the perineal area to past the anus. Yes, you may pat the area until it is clean. Place a little pressure on the area to clean it.

Be gentle, do not wipe hard or aggressively. You may need to use a moist wipe and then pat dry.

Wiping too much or too hard will cause anal itching and that will be maddening. 2 -4 wipes should be good.

Note: The perineum is the area between the vagina and the anus.

Note: Sometimes wet wipes irritate the vulva or anal area. If it does, use warm water and a washcloth to clean the areas and then pat dry.

**Wash your hands after dealing with any bodily fluids, secretions, or stool.**

If you have wiped and still feel like you need to wipe more….it may be because of one of the following … Dr. Sameer Islam

  1. Hemorrhoids (hangs on to feces)
  2. Pelvic Floor Dysfunction (muscles are too tight)
  3. Weak Rectum Muscles (leakage & soiling issues)
  4. Foods can Weaken Muscles (Spicy foods, Greasy foods, Coffee)
  5. Wiping Wrong

Tips to fix the problems

  1. Fix your hemorrhoids
  2. Get a bidet
  3. Increase your fiber- slowly and drink your water to stay well hydrated
  4. Pelvic Floor Therapy – see a physical therapist for too tight or too loose pelvic floor
  5. Wipe correctly – front to back

Dr. Sameer Islam YouTube videos

Are you wiping correctly? https://www.youtube.com/watch?v=ItFKEtEt4q4

Pat

Feelings that a Well Spouse Has

Posted on January 25, 2023 by - #alzherimers, #caregiver, #caregivers, #parkinsonsdisease, Caregiver Information

Good relationships take work on the parts of both people involved under the best of circumstances.  What happens when one of the partners becomes seriously ill or will need help for more than six months? It may be from a stroke, cancer, traumatic brain injury, mental health/psychiatric disorders, spinal cord injuries, dementia, Alzheimer’s disease, Parkinson’s disease, etc.

What happens when relationship challenges rear their ugly head? Will you address it? Will you ignore it? Will you stuff your feelings way down deep? Will you deal with it in a healthy way? Decisions, decisions, decisions.

January 25, 2023

Challenges arise when the changes come. There will be changes. No one can tell you when they will come or what they may be. Deal with them as they come. You can stuff your feelings, but eventually, they will come out. It won’t be in a good way, either. Acceptance is hard. Accepting things as they are, right now is hard. We have to give ourselves grace for every moment.

Learning about their chronic health condition will help you to understand what is happening. Yes, I know there is usually more than one. Accurate information about what is happening and what will come will help you be more prepared to handle situations.

The challenges that cause the most aggravation are:

  1. Toileting and incontinence issues
  2. Showering/Bathing
  3. Eating out
  4. Repetitive questions
  5. Relationship strain
  6. Fatigue
  7. Guilt

Learning healthy ways to cope will help in this journey. Yes, it will be a journey. You will have good times, bad times and okay times.

Things you can do to help yourself destress:

  1. Find things you can do together
  2. Accept that you are doing your best
  3. Breathe, just deep breathe
  4. Have someone you can talk to and vent to
  5. Go for a walk/run
  6. Play a sport
  7. Meet up with friends for lunch
  8. Have a massage
  9. Tell others what you need, no one is a mind reader
  10. Keep your own doctor appointments
  11. Eat for nutritional needs
  12. Sleep and rest
  13. Learn to become more resilient (yes, you can do that)

It is okay to feel your feelings. It is okay to talk about your feelings. It is even okay to not have an answer. It is not okay to act aggressively or become verbally or physically abusive. Physical abuse includes doing things “rougher” than is necessary.

Feeling sadness, anger and frustration are normal feelings. It is how you handle those feelings that make the difference between a healthy relationship and an unhealthy or abusive relationship. Don’t bottle up your feelings, you will eventually explode.

Warning Signs that you Need Help:

  1. Your own health is in decline
  2. You find yourself anxious and irritable
  3. You are relying more on alcohol or other drugs
  4. You are becoming withdrawn
  5. Smoking or eating more
  6. Overreacting to minor nuisances
  7. You are feeling increasingly resentful
  8. You are constantly exhausted even when you are resting & sleeping
  9. You are beginning to feel helpless or hopeless
  10. Backaches, headaches, stomachaches or other physical problems

Caregiving doesn’t always have to be bad or feel like a chore. In fact, a lot of folks find themselves okay with being their spouses’ caregivers. Learn what you need to do for yourself so that you are a more resilient caregiver. Find three things that you will do each day for yourself.

Pat

How much light is needed?

Posted on January 19, 2023 by - #alzheimers, #caregiver, #caregivers

Aging eyes need twice as much light as young eyes to read and do tasks. Folks with Alzheimer’s need even more light. More contrast is needed. For older eyes, yellow backgrounds or yellow highlighted areas are easier to read. Use black ink or dark blue ink. There is a point where we have to get over “pretty” and use functional.

Have you ever wondered why folks with dementia “see things that aren’t there?” It could be shadows or a dark area in their field of vision. Have you ever wondered why a person with Alzheimer’s gets fearful and acts out for so seeming reason? It could be lighting, shadows or depth perception issues.

January 18, 2023

How do you see? Nope, not with your eyes. With your brain. Your eyes feed data to the brain and your brain computes to send back messages on what you are seeing. Now, imagine that your brain isn’t working very well and it can’t quite make out some of the data that is being sent. In fact, it is corrupted information. GIGO – garbage in, garbage out.

My brother and I were out driving one night, shooting the breeze and looking around. All of a sudden, I caught a glimpse of something on the right side of the car. It was a freaking deer. It did not hit the car, thank goodness. He saw it too, just a glimpse of something. Our eyes had taken in the data and our brains had processed what we saw. What we think we saw. We reasoned out it was probably a deer. We had no time to react, just jump because we were startled. Good thing it didn’t hit the car, because we sure didn’t have time to swerve.

Now, imagine that same scenario but now my brain has an injury or is failing. What will happen to the information that has been gathered by the eyes and sent to the brain for processing? It depends. Where the damage is in the brain and what still works will impact the quality of information and processing ability. The information sent back from the brain may have been nothing, to a bear, to a spear, to a person, or to a deer, who knows what it interpreted?

In dementia or Alzheimer’s, the brain is failing. It cannot process and interpret as it once did. It cannot give factual information. It still gives information; it just may be incorrect information. Can you see why we would hold on to what our brain is telling us? We saw “x” and our brains interpreted either, “x, y or z” and relayed that information back. I know what my brain told me and here you are trying to tell me that it isn’t real? The fight is on! Don’t be telling me what I saw was wrong, hell, I saw it. You get the gist.

You want to lessen the anxiety and agitation by using appropriate lighting throughout the home. You will need brighter lights. You will need to eliminate or decrease dark corners and shadows. Dark corners and shadows tell our brains to be wary and afraid. Use natural light as much as possible. Always cover bulbs with a shade.

Look at the hallways. Is there light bouncing or reflecting off of the floor? Minimize glare. Does the floor look dark like an abyss? Look outside, what does the area look like when the sun starts going down? Look for shadows or reflections that may be troublesome. Close the curtains when it begins to get dark outside. Shadows may be mistaken for strangers.

Use contrasting colors to help them find things. Use a red plate for their food. Use colorful bed linens so they can find their bed. Maybe it is time to place signs up with arrows for finding the toilet, bedroom, kitchen, etc. Hang a sign, with their name on it, on their bedroom door. Label the hot and cold-water handles.

A side note, sometimes you may need to cover mirrors because the person with dementia no longer recognizes their own face.

Bulbs, Watts, LED’s, CFL’s

Maybe you need 100 watts or 150 watts of bright light. Make sure the lamp can handle that amount. It is so confusing now with all of the different types of bulbs. Read on the packaging to find what you need. Ask someone that works there for help in determining what may be best for you. Some of those things are expensive. Make sure your lamp or socket is designed to hold that type of bulb and the wattage of the bulb. For example, a 32-watt compact fluorescent light (CFL) correlates to the same amount of light that a 100-watt bulb does. Then you have to deal with the height of the bulb. It will be a process.

Your goal is brighter and more consistent lighting. Getting rid of shadows and dark corners. Give it a try for a few months and see how much better their life will be and your life will be.

Pat

You want it. You need it. But, you don’t do it. WHY?

Posted on January 12, 2023 by - #alzherimers, #caregiver, #caregivers, #dementia, #information, #parkinsons

Maybe, it is because you don’t know your “why.” Your own personal “why” is what motivates you. You can say “I need to…” or “I should …” do X,Y, and Z.  Yet, it never gets done. Is it because you don’t know where to start? Is it because you are not sure what to do or what is important? Is it because you don’t really see the benefit of doing “it?”

January 11, 2023

Simon Sinek, says to always start with your “WHY?” Why is it important? How will it help you or your loved one? How will it improve your life? How will it decrease your stress? Why do you do what you do?

Would a fill-in-the-blank notebook be of benefit to you? Would a fillable pdf document be of benefit to you? For some of you, it is what you have been looking for. For others, it is something you didn’t know you needed but will be of tremendous help to you.  What is in the world could it be? My shameless plug for my Stressbuster, Time Saving Important Documents Binder.

How will it help?

It is organized by topic. The pages are protected by sheet protectors, you fill it out and have the information at your fingertips. You know how it is, you go to a new doctor and you have to fill out a complete medical history. You cannot remember everything nor can you remember dates. With the grab-and-go binder, you fill it out ONCE and use the information forever. That decreases your stress level when you are asked for medical information that you don’t recall.

Topics Included:

You also receive clean sheets to make copies. This is great for updating the records and for when you need to use medications given check-off sheets.

The complete binder kit is $249.00 and can be mailed anywhere in the contiguous 48 states for $17.00, as of this date 1/11/2023. Prices for printing and mailing may be updated as those prices increase. Yes, I am telling you to get the binder before the price increases.

PDF file for family use $129.00

PDF file for single use $69.00

Pat

What will you do to feel happier and more relaxed this coming year?

Posted on January 4, 2023 by - #caregiver, #caregivers, Caregiver Information, time management, Why it is important

With the start of a new year, most of us think about getting organized and decluttering our spaces. We know that we would feel better, be happier and have the ability to do more. We want it. But, will we invest in the time it takes to get us there? Some will and some will not. Do you see the value of taking time and putting forth the effort to make your life easier, in all areas?

January 4, 2023

What you value, you will make time for. What you value, you will do. It is that simple. It doesn’t matter if you “would like to” or if you “need to,” or even if “I have to.” None of those things matter. You get to decide what you will do or will not do. It really is a decision that you make.

Nobody likes to do the grunt work. We would all rather do the “fun” stuff, but that is not the way things work. There is an upside. What you take care of now, you won’t have to fool with later and then you get to have more fun. You can get rid of the “I should’s” or the “I need to…” kinds of things and all of the stress that comes with that.

Organization is your friend. Getting organized is a process, it does take time, but it will be worth it in the long run. Think about it, no more searching for 20 minutes and sometimes hours on end. You know where it is and you can go and get it. Being able to put your hands on the information you need is awesome. Think of all the stress you don’t have to deal with because you have your stuff in order.

Organization helps your brain to rest. Your brain needs downtime. That is another article and we will get to that later. Remember, you only have about four hours of focused brain energy every day.

Organization will boost your health. By decreasing your stress, you have already helped your health. You will rest better, sleep better, have a better outlook on life. Organization helps you to control the things that you can control. There are so many things outside of our control, do what you can to manage the things you can.

Organization helps you be healthier. You make time for meal prep. You plan food for your meal times and snacks.

Organization will help you to be more productive. Yep, it’s true. Getting your ducks in the same pond will help you perform your duties better and more easily. They don’t have to be in a row, but they do need to be in the same pond.

Organization decreases overwhelm. How would you like to know who is doing what on each day? How would you like to know what you will or won’t be doing each day? How would you like to know what is coming up so you can make better plans for your days and weeks?

Organization allows for spontaneity and unexpected problems. You know what must be done and can see what needs to be moved to a later date.  Things are going to “come up.” And stuff will “hit the fan.” Being able to make adjustments on the fly is what you need and organization helps you to do that.

When you feel things are looming over you, you feel stressed and sometimes, that paralyzes you and then you are stuck. Feeling stuck sucks. It is hard to get moving when you feel stuck. If you are already in motion, then all you have to do is readjust or reorient and keep moving forward.

 Start with two areas in your life.

  • Your work area
  • Your “To do” list
  • Your email – read it, do it, delete it, save it in a file folder, and answer it when you read it ** Do email two or three times a day only. Example – beginning of the workday, after lunch, before going home
  • Meal prep – every Sunday (or whatever day works best for you)
  • Make time for friends and family
  • Dedicate 30 minutes – 1 hour to plan your week
  • Develop a chores list and when to do them
  • Schedule your workout days and times – walking, running, lifting, bicycling, yoga, etc.
  • Journalling for 10 – 20 minutes daily
  • Reading for 10 – 30 minutes daily
  • Social media scrolling and interacting for a maximum of X amt. of minutes or hours per day and set a cutoff time every evening.
  • Declutter your home
  • Declutter your desk
  • Work from a check-off list

Be consistent! You will get there.

Maybe, you will do better with big bucket areas:

  • Work
  • Home
  • Home life
  • Bills/Finances
  • Health
  • Leisure time/Hobbies/Interests
  • Relationships
  • Personal growth
  • Education/Expanding knowledge
  • Caregiving

What does organization look like?

  • Focus on what is important
  • Identify tasks – pick only 3 things at a time
  • Delegate what you can
  • Create To-do list
  • Use a planner to keep up with the agenda
  • Use labels/Dividers
  • Set goals – use SMART system         Specific, Measurable, Achievable, Relevant, Time-bound
  • Track your progress – Are you achieving your goals in the allotted time? Would it be better to block out periods of time? Find what works best for you.
  • Limit your distractions – unnecessary phone calls, texts, emails, other people
  • Use a timer
  • Reprioritize, when necessary
  • Take a break – sometimes 5 minutes will do and sometimes you need 20 minutes
  • Deep breathe – to help you decrease your stress and to refocus
  • Be flexible – bend, don’t break
  • Do a brain dump – get it all out so you can be creative, solve problems and imagine. Write down everything you need to do, think of appointments you need to make, bills you need to pay, people you need to see, tasks you need to complete, presentations you need to prepare for and make, etc. Don’t censor yourself and don’t put them in order. The goal is to get it out.
  • Be realistic about what you can complete in a day
  • Leave space for the unexpected
  • Eat the frog – Do it first thing in the morning and get it over with. Tackle the most difficult task first.
  • Work for 25 minutes on one project with no interruptions or distractions, then take a break for 5 minutes (get up and walk around).  Keep doing this cycle until you are done or as long as you are productive.
  • Avoid re-clutter – read it, handle it, throw it away, put it away
  • Never leave trash in your car

Yes, you will mess up every now and then. It is okay, no beating yourself up. Start where you are and get back on track. The mess-ups will happen less and less. Getting more organized is to help you. It is another tool for decreasing stress and improving productivity. When you improve your productivity you are less tired both mentally and physically.

Pat

What skills training do you need, now that you are a family caregiver?

Posted on December 14, 2022 by - #alzheimers, #caregiver, #caregivers, #dementia, #parkinsons, Caregiver Information

As long as your loved one is fairly independent, all is well. The time will come when they need you to physically help them.  Getting up from a chair. Help with bathing, Help to get out of bed. Help with toileting.

Can you do it correctly and safely for both of you? Think about what can happen if you don’t know how to move and transfer someone correctly. You can wrench your back and then what? They can fall and hit their head or break a bone.

December 14, 2022

Maybe your mom can help you to move, right now. What happens when she can’t and is dead weight? Your dad is able to use safety bars to toilet and shower, right now, but what about over the next year?

Not only do you have to figure out how to help them, but you also have to figure out how to keep yourself from getting hurt while helping them. Are you really in good enough physical shape to help them? Even if you are in great physical shape, do you have the knowledge and training to do the transfers and get them up safely?

There are some online courses or videos for you to access. It would benefit you and your loved one to view the videos and take a course or two. I am sure that many are on YouTube, but be careful to find out where their expertise came from.

Educating yourself and learning new things will help you and your loved one. Be safe. Be safe for yourself. Be safe for your loved one. Learn how to put a gait belt on your loved one and how to use it appropriately. Be prepared to help them up from the floor after a fall. Do you know how to check for injuries Before moving them?

Remember these essential safety tips

DON’T

  • Bend from your waist
  • Try to pull your older adult up
  • Ask them to hold onto your shoulders or neck
  • Let them use toilet paper holders, towel bars, or other non-sturdy items to help them sit or stand

A few resources for you to check out:

Getting in and out of a car video by Teepa Snow

Resources For Seniors And Caregivers: Tips And Products

How to use a gait belt

Training Programs and Resources

Alzheimer’s Association

https://www.alz.org/help-support/resources/care-education-resources#elearning

Family Caregiver Alliance Events & Classes

https://www.caregiver.org/connecting-caregivers/events-classes/

The Veteran’s Administration

https://www.caregiver.va.gov/

The Caregiver Action Network

https://www.caregiveraction.org/resources/instructional-caregiver-videos

Generations Home Care

Family Learning Center

American Red Cross

http://www.programsforelderly.com/caregiver-family-caregiver-red-cross.php

Family Caregivers Online

Video Training for Caregivers

Invest in yourself for your loved one.

Be safe,

Pat

It looks like aging, but what if it is malnutrition?

Posted on December 8, 2022 by - #alzheimers, #caregiver, #caregivers, #information, Caregiver Information

It may be disease-related or due to other reasons that can be addressed and fixed.

December 7, 2022

You notice that your mom has lost weight. Maybe, she was a larger woman that could lose a few pounds. She tells you that she is not hungry or doesn’t have much of an appetite. She does not appear to be underweight, so you don’t think too much about it. 

A couple of weeks later, you see her again and you notice a little more weight loss. The question to ask is, “Are you meaning to lose weight?”  Unintended weight loss can become a problem. She also appears weaker and more tired.

Ask more questions such as:

  • Is your mouth sore or is it hard to chew?
  • Is it hard to swallow?
  • Do you feel like you are choking when you swallow?
  • Have you lost your appetite?
  • Does your stomach hurt?
  • Do you have swelling or are you retaining fluid?
  • Can you only eat a little bit at a time?

If yes, to any of these, a visit to the primary care physician is in order.

Try to find a physical cause. Can they get to the store? Can they cook for themselves? What are they eating? Frozen dinners, soup, cheese, and crackers? Are they drinking enough fluids?

They may be eating, but it may not be enough for their nutritional needs. There is usually an imbalance of protein, fat, carbs, and calories that the body needs every day.

It could be their medications. It could also be dementia or depression. Chronic disease also decreases appetite.

Common chronic diseases that affect (usually decrease) appetite:

  • Cancer
  • COPD
  • Dementia
  • Depression
  • Chronic kidney disease
  • Chronic liver disease
  • Heart failure
  • Underactive thyroid (hypothyroidism)
  • AIDS
  • Digestive illnesses – Irritable bowel, Crohn’s, Ulcerative colitis

Common things that may decrease appetite that is usually self-limiting or can be more easily treated at home.

  • Cold/Flu
  • Dehydration – when we don’t get enough fluids we feel sick
  • Stress
  • GERD – acid reflux
  • Sadness
  • Grief

Problems caused by malnutrition:

  • Increased risk of hospitalization.
  • Increased risk of death.
  • It weakens the immune system, making them more susceptible to “getting” an infection.
  • It causes muscle weakness and bone loss which can lead to an increase in falls and fractures.
  • It slows wound healing.
  • It decreases heart muscle mass.
  • It causes poor respiratory function.
  • It increases anxiety.
  • It increases self-neglect. (Poor hygiene, Unkempt appearance, Neglecting to clean the house, Hoarding, Not wearing suitable clothing for the weather, Messy hair, Dirty nails, Unusual odors, etc.)

**An obese person can still be malnourished.**

**It isn’t always diagnosed in a hospital setting or a physician’s office without information from the patient or family members.**

If you suspect your loved one is malnourished, you may have to be a more vocal advocate to get it checked out. It is perfectly okay for you to speak up and keep speaking up until you have been listened to and someone does a malnutrition lab workup.

A Registered Dietician (RD) can be of tremendous help.

Pat

Do you have “choice paralysis?”

Posted on December 1, 2022 by - #alzheimers, #caregiver, #caregivers, #multiplesclerosis, #parkinsons, Caregiver Information

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?

Posted on November 16, 2022 by - #alzheimers, #caregiver, #information, #parkinsonsdisease, Symptom checker

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