Author: Pat

What is your stress sweet spot?

Posted on July 28, 2022 by - #alzherimers, #caregiver, #caregivers, stress

Why do we need some stress in our lives? We need stress in our lives to get things done and to keep us safe. With too little stress, we get bored. With too much stress, we have anxiety and porer health. 

If you went to your vacation happy place and stayed, what would happen? I can imagine your minds going into overdrive with all of the thoughts, smiles, and dreams. Come back to reality and let’s think this through.

July 27, 2022

Vacation Time and Break Time

We all enjoy a break. We all enjoy getting away. Decompression time, rest time, fun time, and alone time are all necessary for us. That one or two weeks at a time for us not to worry or deal with the day-to-day issues is awesome. I know that I think about staying on vacation forever. If I did what could happen? I could lose my job. I couldn’t afford to live year-round at the same spot where I vacation. Well, hell. What would I do in three or four months? Be bored because I didn’t have anything to do? Probably. Everybody else has to work and I don’t have anyone to play with. I am pretty good by myself, but I do want people around sometimes.

If I lived there full-time, it wouldn’t be special anymore. It would eventually, be the same old same old. A bored Pat, is not a good Pat. What about you?

Good Stress

We need some good stress. It motivates us to do something. Use your stress for good. Think about athletes. They have goals, training, and resting. They are pushing their bodies to do more than what is normal. Bigger, better, stronger, and faster are their goals.

Good stress vs bad stress. Yes, there is such a thing. Good stress is usually short-term, excites you and motivates you. You feel excited and your heart rate increases, but there is no fear or threat. Even with acute stress the body needs time to get rid of all the cortisol & other hormones to calm down. If your body does not have some down time to deal with the acute stress, it becomes as bad as bad stress.

Good stress:

    • It feels doable.

    • We know the stress is only temporary.

When good stress  becomes bad:

    1. It feels like all the time and you see no end in sight.

    1. You can’t control it.

    1. It takes up all of your time.

    1. You don’t see the long-term benefit.

    1. It comes into direct conflict with one of your life values or priorities.

Bad Stress Will Wear You Out

 Bad stress or distress wears you out. You do feel fear. You do feel like a threat is near. You may feel confused. You cannot concentrate very well. Some anxiety pops up. Bad stress can be short-term, but it can also be long-term. The long-term or chronic type of stress is the one that leads to negative health consequences.

Bad stress:

    • It no longer feels doable.

    • The stress is not temporary.

Could your stress be harmful?

You make mistakes on things that are routine for you.

You are spending a lot of time & energy on little things.

You feel stuck or paralyzed.

You don’t ask for help and you begin to isolate yourself

You are not eating well.

You are not working out or exercising.

You are not sleeping very well.

.

Is it possible to turn bad stress into something good?

    1. Look for the potential benefits or positives in the situation.

    1. Recognize and use your strengths to their full potential.

    1. Identify the resources that you have at hand.

    1. Collaborate with others.

    1. Learn something new.

    1. Have a positive perspective.

    1. Sometimes, you just have to be positive.

When things feel out of control or awful, do what is best for your own mind and body. When you do these types of things, you allow your brain and mind to destress so that you can handle the issues better.

    1. Good and restful sleep.

    1. Eat for nutritional health.

    1. Do something physical.

    1. Meet with your social support system.

    1. Quiet your inner critic.

Athletes often redirect stress into anticipation, excitement, and motivation, rather than allowing themselves to get into anxiety and fear of the situations. We can do this in our everyday lives, too. The sweet spot is where you are using the stress for good. You will never get rid of all stress nor should you. You can lessen it and you can navigate it!

Pat

How your attitude affects your problem solving skills

Posted on July 20, 2022 by - #caregiver, #caregivers, Emotions, making decisions

When you are frustrated, upset, or angry, you cannot problem-solve very well.

Guess what part of your brain is hijacking your normally calm, cool and collected self? The friggin’ amygdala is at it again. Fight, flight, freeze or fawn stuff. Those are the only options that we see when our amygdala is activated.

July 20, 2022

Friggin’ Amygdala and the Problem-solving Process

We know that the amygdala hijacks our abilities to make good decisions and lowers our ability to problem-solve because we cannot think about our true options. What about our attitudes? I am having a little trouble explaining attitude, so bear with me here. We each have assessments or judgments about “attitude object” We use words to describe what we like or do not like. Examples include, Like, prefer, love, do not like, hate, can’t stand, etc. We make these statements in relation to ourselves. “I like _____.” “I hate ____.” Attitudes are really evaluations that we make based on what is important to us. Our experiences are different and so our attitudes may be different too.

Attitudes are shaped by feelings and emotions. And another tidbit, emotion is sometimes the driving force behind our attitudes and behaviors.

There will be some things that you feel very strongly about. There will also be things that you don’t feel strongly about.

Structure of Attitudes

Attitude’s structure can be described in terms of three components.

    • Affective component: this involves a person’s feelings/emotions about the attitude object. For example: “I am scared of spiders”.

    • Behavioral (or conative) component: the way the attitude we have influences on how we act or behave. For example: “I will avoid spiders and scream if I see one”.

    • Cognitive component: this involves a person’s belief/knowledge about an attitude object. For example: “I believe spiders are dangerous”.

This model is known as the ABC model of attitudes.

Does a negative attitude affect problem-solving skills?

A negative attitude towards a problem makes it worse. When you think negatively, it only magnifies and deepens the emotional weight of “said problem.” You not only see the problem as a problem, you see it as an enemy or an attack on you. You can become overwhelmed and paralyzed. You know what comes next, don’t you? The downward spiral. Which makes the attitude and the problem much worse?

I like the Fish! Philosophy and want to share a little with you.

The FISH Philosophy to help problem solve

The FISH! Philosophy doesn’t promote “correct” or “approved” attitudes over others. Every situation is unique. But it is important to mindfully Choose Your Attitude. You may not control what happens to you, but you do get to decide how you respond to it.

Making a conscious choice isn’t easy, especially when a situation hijacks your emotions and drives you to react the same way you have hundreds of times before. It takes practice to take control of your response, instead of letting it control you.

Here are four tips to help you take charge and Choose Your Attitude:

1. Be aware of your inner voice
External events may trigger your feelings, but only after they go through an internal filter called your inner voice. Your inner voice starts talking to you as soon as you wake up, issuing opinions about everything you see, hear, touch, smell and feel.

Your inner voice is rarely a neutral observer. It judges each experience through the likes and dislikes you have accumulated over a lifetime. It looks for evidence that you are right and the other person is wrong. It exaggerates how bad the situation is or imagines how it might go off track. Sometimes it puts other people down. Often it puts you down, questioning your talents and capabilities.

If you want to choose your attitude, not just react, you must challenge your inner voice. Catch it in the moment, then take a step back. Instead of just accepting what it is telling you, observe it as a neutral onlooker.

Just becoming aware that it is a voice, and what it is saying is one of several possible interpretations, helps you decide how much to believe it—and the best way to respond. 

2. What’s your goal?
To mindfully choose how you respond to what life throws at you, you need a plan. Decide who you want to “be” today. Keep your goal top of mind. Select a few words that describe your intentions, such as “patient”, “open” or “helpful”. Focus on living those qualities.

Moment-to-moment awareness is key. Ask yourself throughout the day, “What is my attitude now? Is it helping me to be as effective as I can be? Is it helping the people who depend on me?”

Think ahead: What people or situations are likely to test your attitude today? What might push your buttons? Rehearse how you will respond. Reaffirm your goal and stay focused on the response that helps you achieve it.

Consider the long-term consequences of your reactions. Say a member of your team makes a bad mistake or you have a disagreement with them. Is the momentary satisfaction of tearing into them worth damaging your relationship? Disagreements and problems come and go, but your relationships are not so easily replaced.

3. Adopt a “growth” attitude
Your attitudes are shaped by how you see others—and by how you see yourself.

People with a “fixed” attitude see their abilities as set and established. They know what they’re good at and view what they’re not good at as talents they don’t have the capacity to improve (“I could never learn that!” or “I wasn’t born with a brain for that!”).

People with a fixed mindset see tasks requiring them to step outside their comfort zones as threats. Confident in what they already excel at, they fear mistakes that might threaten their identity. They only pay attention to feedback and information that confirms their beliefs.

People with a growth mindset believe they can always improve their skills. It doesn’t mean you can do anything, like play in the NBA or be an opera star. It means you never know what more is possible for you and do not limit yourself before you try. It means seeing mistakes as a chance to learn and stretch yourself.

Studies show people with growth attitudes are more engaged and empowered. They handle change more successfully. They’re more flexible and open to seeing new solutions. In workplaces that support a growth attitude, people collaborate more and feel safe to try new approaches.

4. Challenge your assumptions
It’s natural to assume the worst about other people’s motives and capabilities, especially if we don’t agree or connect positively with them. Believing they offer little of value to us, we usually try to avoid them—which doesn’t do much for team collaboration and camaraderie.

If you have a coworker or employee you think has a bad attitude or lack of motivation, move past your assumptions. Reach out. Find out why—not with accusations but with caring questions. You may learn they are dealing with a trying situation at home or work stresses you didn’t know about. Knowing this will help you respond to them more productively.

Treat them with a little kindness and encouragement and you may see a different side of them. Learn their perspective. Find out what they do well and seek their input. People tend to respond to you based on how you treat them. If not, you have chosen an attitude you can be proud of.

Back to problem-solving.

If you don’t see a problem as a disaster, you are more likely to be calm and think about your options. Are you open to looking at the problem as an opportunity? We like opportunities. Our brains like opportunities. Our brains like to brainstorm. Finding any and all possible solutions to our dilemma. Now, not everything thing will be a winner, but the whittling down comes a little later in the process.

Improve problem-solving skills

Would you like to be a more effective problem-solver? Then invite positivity into your environment. Positive attitudes increase creativity and problem-solving skills. A positive attitude also increases productivity.

    • Some ways to create a positive attitude:

    • Write down three things you are grateful for each day (not the same 3 things, either)

    • Take breaks during your day

    • Tell a few jokes, or watch a funny animal video

    • Think about the ways to have a great morning and do them

    • Don’t spread gossip, don’t listen to gossip

    • Look forward to something outside of work

    • Practice meditation, walk, work-out

    • Have some “you time”- unwind, destress, play

    • Listen to music, watch a funny TV show, read an uplifting or funny book

    • Hang-out with positive people

    • Be open to possibilities

    • Stop the “stinking thinking”

    • Sit with your feelings and acknowledge them

    • Recharge your batteries

    • Stop complaining

    • Assume responsibility, choose your response

    • Laugh

Pat

Caregivers: Do You Know Your Limitations?

Posted on July 13, 2022 by - #alzheimers, #caregiver, #caregivers, #dementia, Caregiver Information

“A man’s got to know his limitations,” Dirty Harry in Magnum Force

I really like that quote. We all need to know our limitations or the scope of our knowledge base. I get it, most of us push past our limitations before we realize what we are doing. Can we get better at finding our limitations before we blow past them? Let’s explore a little and see…

Do you know your limitations or do you just keep on pushing? You know when you keep pushing your limits, the stress piles up or you leave collateral damage in your wake.

July 13, 2022

As a caregiver or helper, you are tasked with many different challenges every day and some will push you past your limits. Most of us know our limitations. However, we do not always heed the warning signs that we are getting close to them. A few folks do not know their limits and get into trouble before they realize, “Oops, I messed up.”

Other words for limitations include – Constraint, Control, Obstruction, Impediment, or Qualification

Realizing and Recognizing Your Limits Can Actually Benefit You

What if realizing and accepting your limits could benefit you? What if knowing your limits and your boundaries allow you to take care of yourself in body, mind, and spirit? Learning what to give and share as well as knowing what you need from your relationships Boundaries are important too.

Knowing your limits can help you to assess the areas that you can improve on. Knowing your limits also allows you to use your strengths. Another way to look at knowing your limits is to prevent burnout and decrease your stress.

Definitaion of Stress

When I think about stress, I always remember the line – “Stress: the confusion created when one’s mind overrides the body’s desire to choke the living shit out of some asshole who desperately needs it.” It always makes me smile.

I get it. We can learn new skills when we hit our limitations. Usually, that is true. It is not always true though. There are times when we have hit our limitations and we need to stop. Accepting our limitations is not the same thing as accepting failure. That is probably the crux of everything anyway, the fear of failure.

You may have all the information, but do you know how to apply that information?

No matter how well we manage our time, we only have 24 hours in a day to get things done. We are limited by what we can and cannot control. We do not have endless abilities or endless knowledge about everything. We are good at what we do. We are experts at our jobs. But, that does not translate into expertise at everything. For example, I am good at what I do with research, finding solutions, and preparing plans of action with guidance and support. Now, I have a plumbing problem at home. I am smart and I can figure a lot of things out. I can research info online and handle it. WRONG! I can have all of the information in the world, but if I don’t know how to apply that information, I am stuck, frustrated, and angry. Guess who might bear the brunt of my frustration and anger? Yep, family and friends.

Knowing and being able to do it or handle it are two different things. Find the expert you need. Save yourself a lot of stress, frustration, and anger. Stop beating your head against the wall.

Which of these responses do you recognize in your own life when dealing with frustration?

    • Anger – an angry person often reacts without thinking

    • Giving up – you quit everything and you no longer care about the goal (this is not the same thing as deciding to give up on an unreachable goal)

    • Loss of confidence – you might take a hit to your self-esteem too by giving up

    • Stress – too much stress breaks our bodies down (irritability, anger, anxiety, fatigue, headaches, depression, low back pain, stomach pains, migraines, ulcers, etc.)

    • Depression – continued stress or anxiety that causes brain chemical changes

    • Abuse and misuse – drugs, alcohol, food, shopping

    • Anxiety, Fear, Sadness, Guilt, or Shame are other responses to frustration.

I know that we have chased a few rabbits today. A lot of things are interconnected. I want you to know your limitations. I want you to prevent excess stress and burnout. Continued stress leads to burnout. You will begin to feel empty and numb. You don’t just numb the negative feelings; you numb the good ones too. Your “get up and go” has “got up and went.” You no longer have the motivation you once had. You are tired. Sometimes, you feel hopeless or stuck.

If you have thought or said, “I know that it will never get better,” you could very well be at the burnout stage.

Signs of Caregiver Burnout

    • Feeling anxious

    • Feeling irritable

    • Feeling stressed

    • Feeling resentment

    • You are neglecting your own health

    • You are missing out on important events

    • You are not eating properly

    • You are not exercising

    • Your finances are taking a hit

    • You feel lonely

    • Increased alcohol consumption

    • Overreacting

    • Impatience

Setting limits will actually help you to achieve your goals. Limit your goals to 4 or 5 per year. You cannot do everything. Pick ones that mean the most to you and focus on them. Limit your tasks to 3 per day. Only do the important and necessary things. Place a time limit on your tasks. Focus on the task at hand. Stop adding stuff to your schedule and start crossing off the things that are not a priority.

Pat

Caregivers: Do you have the skills, knowledge and expertise to be a good family caregiver?

Posted on July 6, 2022 by - #alzheimers, #caregiver, #dementia, Caregiver Information

You think you can. You said you will. But, do you have the knowledge and expertise to do it safely?

Most of the time we don’t think about all the consequences before we jump in and do what we do. Maybe it isn’t really consequences, but more the techniques and training you will need for certain tasks.  Unfortunately, some caregiving tasks are not on-the-job training. They can be dangerous to your loved one and to you if not done properly.

July 6, 2022

Know your strengths and weaknesses

Find your strengths and your “not-so-good-ats” (weaknesses). Find your helpers. Have them figure out their strengths and “not-so-good-ats” too. You will have to honestly assess your abilities, your capabilities, and your training needs.

You know that there are some things that you can do, things that you can take care of and things that others will need to handle. Knowing is always better. It helps you to make a plan, make a schedule and prepare for the future.

Sure, you can fly by the seat of your pants and find yourself in a constant state of managing by crises. Talk about exhausting, frustrating and maddening, this will do it. Planning for what you can plan for makes everyone feel more safe, secure and settled. When the unexpected arises, you can handle it easier and with less stress.

Some tasks that caregivers do, provide and handle.

    • Buy groceries, cook, clean house, do laundry, provide transportation

    • Help the care receiver get dressed, take a shower, take medicine

    • Transfer someone out of bed/chair, help with physical therapy, perform medical interventions—injections, feeding tubes, wound treatment, breathing treatments

    • Arrange medical appointments, drive to the doctor, sit in during appointments, monitor medications

    • Talk with doctors, nurses, care managers, and others to understand what needs to be done

    • Spend time handling crises and arranging for assistance—especially for someone who cannot be left alone

    • Handle finances and other legal matters

    • Be a companion

    • Be a (usually) unpaid aide, on call 24/7

    • Be some emotional support

    • Be backup care and extra care when needed

    • Take care of lawn maintenance, outside house maintenance

    • Help with wheelchair usage

    • Help with oxygen usage

    • Help with CPAP machine usage

    • Help them walk with a belt to decrease fall risks

    • Help turn them and move them in bed

    • Help with hearing aid insertion and removal

    • Help with false teeth

    • Bathe them (maintaining modesty and dignity)

    • Change sheets with them in the bed

    • Pay bills

    • Housekeeping

    • Laundry

    • Help/Monitoring physical therapy exercises at home

    • Checking blood sugar (how and when)

    • Checking blood pressure

    • Checking weight

    • Handle a crisis or an emergency

    • And much more

As you can see, some of these things you can do and handle. Others may take some training. I know that there are online training courses and probably some in-person training places in some areas. You will need to search in your area for what is available.

Online Trainings Available

Tennessee Department of Health

NFSP

Meet Caregivers Caregiver Training

Caregiver Training online course

A Place for Mom trainings and videos

APFM videos and courses

These will get you started.

What about your own physical strength?

Do you have the physical strength to transfer the care receiver? Do you have the physical strength to help someone get into and out of the shower or bath that is mostly dead weight? Toileting and bathing are intimate experiences and are very tough to handle. Not everyone can or will learn do it. It can be very unnerving and very uncomfortable. Your loved one will feel the same way. Be patient and respectful. It is going to take more time than you think for bathing.

Do you know how to help with personal hygiene appropriately and safely?

Personal hygiene is probably the hardest to do. No one likes it, but it is necessary. You will have to make the decision to do it, all of the love you feel for them will not make it any easier.  You will have to use discipline to get it done. Get yourself trained. The training will help you to feel more comfortable with doing it safely. The training will help you increase your confidence. The training will help your loved one feel more safe and secure.

You are more apt to be able to help with personal hygiene if you have been properly trained. As many family members as possible need this type of training. It is a learnable skill. Focus on the positive aspects of them being clean. Think about how you feel after a bath or shower. You do feel better. You do rest better. Teeth brushed, hair combed, lotion on body with clean clothes makes everyone feel better.

Full bathing two or three times a week is good enough. Do spot cleaning on the other days. You want to keep the skin from breaking down. You want to prevent infections from happening. A daily bath for dementia patients is better because they like routine. Lotion up after the bath. You can find your routine and rhythm.

What if you have a bad back and you need to help your loved one out of a chair or from the floor. How can you do that without hurting them or yourself? Learn the techniques. How much dead weight can you lift safely? Get yourself trained.

When you can no longer do personal hygiene or lift and transfer safely, it is time to bring in home care help or begin the transitioning to assisted living/nursing home.

Pat

One of the Caregiving Tolls: Negative Emotions Caregivers Feel

Posted on June 30, 2022 by - #alzheimers, #caregiver, Emotions

You may try stuffing negative emotions down, or you may just ignore them … it will work, for a while. Then watch out! They will come out and it rarely will be in a productive way. Recognize them. Acknowledge them. The emotions you are feeling are valid.

June 29, 2022

Of course, you love them and want to help them. You think that because you love them and you want to help them, everything will be okay. It won’t. Dueling emotions and feelings will arise. It usually becomes overwhelming in a few short months.

Accepting what you feel

Be healthier. Be more on top of things. Be accepting of what and how you feel. It is okay to feel resentful sometimes. It is okay to feel lonesome. It is okay to feel angry at your loved one’s frustrating behavior. You will have some thoughts and feelings that you will feel guilty over. Sadness will creep in. You will probably start grieving for them a little while after the diagnosis.

It takes a lot of energy and effort to hold in your feelings. Stifling your feelings and emotions can cause high stress, sudden angry outbursts, unhealthy life choices, problems sleeping, increased risk of depression and hopelessness.

Give yourself permission to vent

Will you give yourself permission to say what and how you are feeling? You need a trusted person that will listen to you and not judge. You do need to vent. You may also need to tell the person that you are talking with that you just need to vent. You are not looking for solutions or suggestions. This is where support groups can help, too.

Don’t feel guilty about your feelings.

That is always easier said than done. Do you have unrealistic expectations? Do you beat yourself up over negative emotions? It is okay to get mad. For example, your loved one has made a huge mess with the meal. It is at the end of the day and you are tired because it  has been a very tough day. Now, you have to clean up the mess. You have to get your loved one cleaned up and changed.

The problem isn’t that you have negative feelings

The problem is not that you have unpleasant feelings, the problems arise when you haven’t taken care of them and you hurt yourself physically or emotionally or you hurt your care receiver physically or emotionally. You don’t bottle them up and you don’t let loose in front of your loved one. What will be your safe outlet? Take care of the mess and your loved one, then find your ways to decompress.

Suggestions:

    • Call or text with a supportive friend, family member or another caregiver

    • Go to a support group meeting

    • Cry

    • Go for a run or walk

    • Journal – let it free flow and write whatever comes up

    • Find a punching bag (a real one or a pillow) to punch, throw or scream into

    • Cleaning

    • Take a break, call in reinforcements

    • Take a hot shower or soak in a bath

    • Watch a TV show or a movie

    • Whatever is healthy and works for you

Caregiver guilt – the self-imposed “oughts’,” “shoulds,””shouldn’ts,”  and “musts.” Doing or saying what you believe is the wrong thing.

When the guilt and negative emotions rear their ugly heads

When the guilt comes, how about asking yourself what is triggering this? Perhaps an unrealistic belief about your abilities, the unrealistic “oughts,” or faults that are imagined or even unavoidable? You will feel guilty sometimes, don’t try to get rid of it, just accept it. Get comfortable with being uncomfortable. It is hard to accept reality sometimes.

Resentment – few people admit to being or feeling resentment, but it happens quite a lot. It is part of the duality. You love them and want the best for them, but you do feel resentment. Your life got hijacked by this new responsibility. You may be feeling resentment because of feeling slighted by others. Maybe your brothers and sisters do not help? Resentment really shows up when your own life is way out of balance. Yet, another reason to take care of yourself.

Anger – being mad for reasons that are both direct (unfair criticism, a loved one that is not cooperating, too many problems that day) and indirect (you are tired from working full-time, helping your loved one, and the lack of sleep, frustration over the lack of control, disappointment,) Chronic anger and hostility has been linked to high blood pressure, heart attacks, heart disease, stomach problems, headaches and low back pain.

Learn to express your anger in healthy ways when you are a family caregiver

Learn to express your anger in healthy ways. When you blow up or explode, what do you leave in your wake? Who do you hurt? Learn to self-soothe, take a time out, find a constructive way to express your anger. It will take work and practice, but it can be done and you will feel much better and so will your anger targets. Count to five. Take 10 deep breaths. Let your more rational mind catch up to your reactive reptilian mind.

Worry – Worry seems to be good intentions run amok. Our brains need something to focus on or to be engaged with. How many of you are good at ruminating? I know that I can be very good at ruminating. It does nothing but keep me stuck. It is a time waster. It is an energy deplete. It does not change anything. You can “what-if” yourself to death.

Set a timer for 5 minutes and allow worry. When the timer goes off, you then look at the possible solutions to what you have been worrying about. What will be productive? What can make a difference? Who do I need to call?

Loneliness – Caregivers are lonely. Friends step back. Co-workers step back. Some family members step back. You need your peeps. You need them to be present in your life. Go out for lunch or dinner every week or two. Have an afternoon tea and dessert. Take a couple of hours to catch up, laugh, watch a movie, exercise. If you find that your loved ones or friends have stepped back, it may be because they do not want to add to your burdens or they don’t know what to do or how to help you. Be direct and upfront with them. Tell them that you want them to ask you to do things. Tell them that you do want to go out. Tell them to text you or call you and if you can’t talk then that you will contact them later.

Grief – When someone deals with a long-term illness, the grieving process can start soon after diagnosis. Definitely, when the loved one begins to decline. Anticipatory grief is what it is called. I didn’t know it at the time, but that is what happened with  me. You are grieving that your loved one is losing their abilities to be the independent person they once were. You are grieving the loss of their abilities that will come.

Defensiveness – It is okay to bristle at some things that people say. Try not to have a knee-jerk reaction to everything that has been said. If you are having a strong reaction to what the other person is saying. Sit with it a minute and figure out why you are feeling defensive. Realize that being overly defensive makes you closed-minded. The kind of person that can’t see the forest for the trees. Most of the time, people are trying to help. Not everyone, but, most are trying to help. The only thing that I will ask you to do is to listen to the suggestion(s) and give them some thought. You get to decide what is best for you and your loved one.

Find support. Find humor where you can. We need to laugh. Even using inappropriate humor is a coping mechanism. Don’t feel guilty about laughing or finding humor in the stressful times. The absurdity of things will make you shake your head. You are not laughing at your loved one. We all know how serious these chronic health conditions are, but we also know there is stupid shit that happens too, and it is funny.

Emotional Acceptance – It has happened, you have an emotional pain. 

Try this exercise when you feel safe.

    1. Identify the emotion

    1. Close your eyes and put the emotion 5 feet in front of you (you want to look at it)

    1. Give your emotion a size, shape and color – watch it and recognize it for what it is

    1. Let that emotion return back inside of you

    1. Reflect on what you noticed. Did you notice any change in the emotion when you got some distance from it?

Will you be willing to accept and experience the negative emotion? By accepting the emotion, you are accepting the truth of your situation. You don’t have to expend your energy in trying to deny what is happening. You can focus on solutions. When you accept the emotion, you can be curious about it. Why is it arising? What is it trying to tell you? What tools in your emotional toolbox will help you navigate this emotion and diffuse it? Negative emotions are not fun, and accepting them will not kill you. If you want to lose the destructive power of negative emotions, accept and acknowledge them.

Acceptance is acknowledging the moment as it is, right now. No judgement.

Pat

Maybe, you aren’t cut out to be a caregiver.

Posted on June 22, 2022 by - #alzheimers, #caregiver, #caregivers, #dementia

Or at least, you are not cut out to be a hands-on caregiver. Maybe, you are more of the management type who makes sure that things are handled and done. Maybe, you are the visiting regularly and running errands type. Maybe, you are the do everything but the personal hygiene type. Then again, maybe you are not the caregiving type at all. Not everyone is cut out to be a primary caregiver. 

June 22, 2022

4 Common signs that you are not cut out for caregiving.

    1. You are not patient.

    1. You do not have the time.

    1. You are finding excuses not to do it.

    1. You cannot do the kind of care required.

There may be times that you have to jump in and do the caregiving due to a sudden illness, surgery, or injury. You suck it up and handle it, for a short period of time. Short period of time is the key. Now that the immediate “danger” is over, it is time to reassess the situation and the needs.

You cannot always sustain a high level of care as a caregiver

What you can do in an emergency, usually cannot be sustained over a long period of time, to me, a long period of time is anything over a month. You get worn down, everything else in your life has been put on hold. You can’t put everything on hold for very long. Relationships, jobs, careers, kids, friends, other commitments require your attention. Our lives are in flux and we do pay more attention to our jobs at times and other times we pay more attention to family and friends. Forget balance, there is no such thing. Just be fair and disciplined with your energy and time. No one likes leftovers all the time.

Every family has its own dynamics and history. Sometimes it is functional and good. Sometimes it is very dysfunctional and bad. There may be estrangement. There may have been verbal abuse, physical abuse or sexual abuse. You get to decide what you will and will not do. You may hear stupid crap from outsiders who have no clue about your experiences, if you distance yourself from your family. You do not answer to them. You do not have to acknowledge what they have said or explain any thing to them. 

Yeah, I know, we chased a couple of rabbits. We always get back on track, eventually.

It may depend on your loved ones specific needs

Depending on the needs of your loved one, you may or may not be able to be a good caregiver. What happens if they need to be lifted, transferred or dressed and you have no training in how to do that appropriately? If you don’t do it safely, you can hurt yourself , them or both of you. What if they need toileting help or other personal care help? Talk about caregiver stress…

Even if you have a good relationship, caregiving may not be right for you. Maybe conflicts have started to rear their ugly head. It would be better for everyone if there was some separation and other solutions found. Sometimes the caregiver’s own physical or emotional health prevents them from being someone else’s caregiver. Experiencing caregiver stress is a given, but we sure don’t want you to get to caregiver burnout. 

Maybe, their needs have increased

The care receiver’s needs have increased and now you find that you cannot provide the care needed. Learn to say, “No.” Have the conversation and look for alternative solutions. You will feel guilt, give your heart time to catch up with your head (what you know). Just as the word “caregiving” means different things to different people. The word, “no” means different things too.

It may mean that I can not do all that I have been doing, but, I can do _____________________. Maybe, “no” means that you are tired physically and mentally. Maybe, “no” means that we need to re-evaluate the situation and change some things.

Time to set bourndaris as a family caregiver

Caregivers will benefit from learning to set boundaries and also to express their feelings. Ideally, you will learn these things before you are an asshole to everyone else. Use “I” statements. “I” feel, “I” can, “I” cannot, “I” can no longer, etc. Thou shalt not use “You ought to,” “You should,” “You need to,” types of statements. You will be starting a fight. Get rid of the “shoulda, woulda, coulda’s. They are not helpful. They keep you stuck when you need to move forward.

Yes, caregivers often have guilt

Let’s talk more about guilt. We will all experience it. Not all guilt is bad, so pay attention to what it is trying to tell you. Is it calling to your attention that you wanted to do something, but then you didn’t? You can fix that by changing your own behavior. For example, if you were going to cook two meals and take them over, but didn’t…you can decide what to cook and when to take over with some follow through. Boom! It’s done. IF you are feeling guilty because you cannot change the unchangeable, then hold on a minute. You are not that powerful. You aren’t even responsible for other people’s feelings. Remember, thoughts are just thoughts until you put action to them. Granted, sometimes you need to let the thoughts go. Getting rid of the “shoulds” in your head will certainly help to stop the guilt cycle.

Are you feeling guilty because?

    • You aren’t spending enough time with your mom?

    • You aren’t spending enough time with your spouse and kids?

    • You aren’t taking care of yourself?

    • You aren’t focused at work due to your caregiving to-do lists?

    • You forgot  to do something that your dad needed you to do?

    • You let your mom  stay in her own home too long?

    • You moved your mom into assisted living?

    • You resent the time caregiving takes?

    • You think your life would be easier if they died?

Acknowledge that you feel guilty and then move on. Guilt won’t kill you but it will keep you stuck.

Most of the time, your feelings as a caregiver are completely normal.

    • It is normal to feel frustrated, in general.

    • It is normal to feel frustrated with the time it take your loved one to do anything.

    • It is normal to feel anger at times.

    • It is normal to want all of this to be over.

    • It is normal to hate yourself for feeling certain ways.

    • It is normal to silently scream in your head.

    • It is normal to enjoy aspects of your time together.

    • It is normal to wonder  if your marriage will make it through this.

    • It is normal to hate missing your kids’ games.

    • It is normal for you to be numb and not feel anything, just handle it.

    • It is normal to feel guilty when you take some “me” time.

    • It is normal for you to want to throat punch the next person that tells you that you should take care of yourself.

    • It is normal for you to want to run away.

    • It is normal for you to miss your job.

    • And, a bunch of other things.

Setting boundaris will keep caregivers and care receivers safe

Do you have boundaries? Boundaries keep us safe. They are our non-negotiables. Our individual or family values that we use to guide our choices. Find yours. A boundary is something that you must have or something that you cannot tolerate. It is going to get touchy here – sometimes we get our non-negotiables confused with important needs.

Examples of non-negotiables:

    • Your physical, mental and emotional well-being – What will you do to protect them?
        • What won’t you do to protect them?

    • That you speak to yourself in a kind manner.

    • A healthy relationship with yourself – Eating nutritious food, walking, running, working out, reading for pleasure

    • Keeping your word to yourself and others

    • Your core  values – honesty, love, joy, happiness, reliability, respect, openness, trust, accountability, etc.

    • I will be kind to myself, when I make mistakes

    • Having fun

    • Resting/Sleeping

Find your most important values

So, what are your governing values  as a person and a caregiver? The principles that you live your life by? The things you will and will not tolerate? Find 3 or 4 that are valuable to you and how you want to live your life. They will make it easier for you to answer questions. They will make it easier to say “yes or no.” Another name for non-negotiables for me is deal-breakers.

No one is perfect. We will all mess up, from time to time. 

Pat

What does your temperament and your traits have to do with caregiving/helping loved ones?

Posted on June 15, 2022 by - #alzheimers, #caregiver, #caregivers, #dementia, traits

Think about it, some folks can take on caregiving chores and still be happy and others are absolutely miserable. They both have frustrations. They are both exhausted. Both of them are doing the best that they can.

June 15, 2022

Are you a caregiver?

Some of you don’t know that you are a caregiver. You think you are helping them out. It could be your mom or dad. It may be your husband, wife or significant other. We are resistant to be caregivers much less be called a caregiver. We really do not want that responsibility, do we?

Maybe that is just me, but I suspect that others out there feel the same way as I do. When my mom needed help, I did not consider myself a caregiver. She just needed help and we helped her. Daddy was the primary caregiver, I tried to support both of them, in ways that I could. With daddy, it was about listening to what he was going through. The frustration, the anger and the not knowing what to do. With mama, it was about listening to her anger, frustration and the irrational thoughts. Mama did not need personal hygiene care, she could take care of that herself, with modifications to the house.

It gets hard to be a caregiver, my own experience

To hear my daddy, say that he did not know how much more he could take, was hard. To hear my mama, say that she was going to divorce my daddy, was hard. To be summoned down to the house (an hour away), many times, was hard. I was working 12 hour shifts at the pharmacy and had three boys at home. Our stress was mental and emotional, not so much physical. It took about four months to get things back to “normal.”

I was dealing with a dad that did not believe in mental health treatment such as talk therapy and that medications might help. I had a mom that had changed both physically and mentally due to MS and mini-strokes. WTF. Now, dammit, this was my area of expertise and my own daddy is not listening to me. I finally convinced them to go to the neurologist and let the neurologist see what could be done. I worked behind the scenes with a message to the neurologist. My mom got the meds she needed and a couple of talk therapy visits. Things went much smoother after that.

It was good to hear from my dad that my mom was back to her usual fun self. It was good to hear my mom laugh again and be the jokester that she was. She cheated at the Rook card game; you know. We always had to make her stand up and turn out her pockets for that damn rook card.

I wasn’t the primary caregiver, but I was still stressed out

During all of this, I was tired and frustrated. I wasn’t angry. I wasn’t miserable. I didn’t hate every minute of help that I provided my parents. I didn’t hate that I was missing things with my boys. Disappointed, sure, but I was needed elsewhere sometimes. If your family needs help, you help them.

Other folks are angry. Sometimes, they are resentful and miserable for “having” to help. Maybe, the difference is in how you look at it or feel about your loved one? Feeling like you must help instead of wanting to help may be the key, I don’t know. Did you accept your role as a helper or caregiver out of love or obligation? Most of us have had no training and very few skills in this arena. It is on-the-job training or more likely, flying by the seat of your pants. If you are providing personal hygiene care or you are having to physically move or transfer your loved one, you do need training in how to do it appropriately and safely.

Personality Traits of a Happy Caregiver

    • Patience – especially with questions, angry outbursts, length of time to do things

    • Compassion – understanding what the other person is dealing with

    • Empathy – understanding the feelings that others may be feeling or thinking

    • Humor – finding something to laugh about in these difficult situations. We know how serious things are, but we need to laugh. Not at the person, but at the situation or other things.

    • Present – be in the here and now, focusing on what they can do

    • Detail Oriented – good management skills

    • Able to Accept Help – a good caregiver lines up a team to help out

    • Able to Set Boundaries – know your own limits and say “no” when needed

    • Flexible – able to cooperate with others

    • Assertive Advocate – getting the answers needed, making sure their loved one has what they need; being firm but not being an asshole (at first)

    • Creative – some days things will work and other days you have to find something else that works

    • Good Communicator – learn to communicate with your loved one in the way that they can communicate, especially if they are non-verbal now

Which ones of the above do you need to work on?

How many of these skills do you have? Be honest. There will probably be a few that are not in your wheelhouse. That is okay, are you willing to learn? Are there some skills that you know you don’t have and are not good at? That is okay too. It is great to know what you are good at and great to know what you suck at. Use your strengths to your loved one’s advantage. Others will have different strengths to help. We can all improve.

Know this: You are perfect as you are… but you can always be better. We all have the struggle or tension between self-acceptance and self-improvement. We have talked about this before. It is progress over perfection.

Are you smart enough to know when you don’t know? Do you know how to find good and trusted information? Do you know when you are out of your area of expertise and need to hire that expertise?

Self-confidence in your caregiving abilities comes with time and patience with yourself. It comes with learning new ideas and ways to help. You may have to silence your inner critic. Your negative thoughts are not always right. They are only thoughts, so challenge them.

Confidence in your abilities is good. Over-confidence is bad. The goal is appropriate confidence. Focus on the effort. Keep learning new things. Listen to what others have to say.

A reluctant or sad caregiver has feelings of unfairness or irritation. You may even feel resentment. Resentment at the care receiver or resentment at the others who don’t or won’t help. Not everyone is cut out to be a caregiver.

Pat

Can you work with your siblings to provide care for your mom?

Posted on June 9, 2022 by - #alzheimers, #caregiver, #caregivers

I have seen both ends of the spectrum. I have seen the complete breakdown and fights between siblings trying to help their mom. I have also  seen the absolute success of siblings working together to take care of their dad.

Why can one family make it work and another family implode?

June 8, 2022

You know people that can put the “fun” in dysfunction. It can be amusing when the stakes are low. What happens when the stakes are high and everyone needs to do their part? It’s not so funny then. It is downright hard and very stressful.

Family dynamics, sibling relationships, parent-child relationships, rivalries, blended families, issues from the past, issues from the present, etc. Relationships can be complicated. Relationships can be messy. There may not be a relationship anymore.

First, you need to decide if you want to help your mom or dad. No judgement here, I have heard the stories of how you were treated as a child by your mom. I have heard the stories of what you endured as a child and how you worked hard to get out of that situation. No one is required to help or provide assistance to their mom or dad. It was usually one or two of the kids that had to endure the hell. The other children were spared. This is also where you and your siblings will disagree about what happened in the past. We can only speak about our own experiences and perceptions.

The first time that I heard of people being mistreated or abused when they were kids, it was hard for me to imagine. I had no reference point for that. My brother and I knew that we were loved and wanted. We got spanked, but we were never abused. You don’t know what someone else has been through. It is always hidden and it is never talked about. Why was it so hard for me to imagine? Because, I could not imagine my mama or daddy doing to me what other parents did to their kids. After hearing about others being slapped, locked in their room or being starved, you start to realize that not everyone grew up like you did.

For some of these kids, they did not admit it to themselves until they were in their 30’s or 40’s and it is not easy for them to talk about. I get why some folks cannot or will not help to take care of their parents either from a distance or hands-on care. Your own safety and mental health needs are absolutely of paramount importance.

The other things that we need to look at are the siblings that do not want to help because they don’t want to help. They have no real reason other than it will affect their own lives. Tough toenails, sometimes you have to do things that you don’t really want to do. It is called being an adult. Don’t misunderstand me, I am not saying that you have to do the hands-on care, but you do need to be involved in seeing to their care. See, right there, I used my own feelings and my own background with my own family to make a generalized statement about caring for a loved one. I apologize to you for that. I don’t know your experiences and I respect your decisions.

 For this article, I am assuming that you have siblings and you do want to help your mom or dad. You do love them and you do care, you may not know where to start or what to do first. Safety is of paramount importance. Are they safe? Are they in a safe environment? Do they have nutritious food and are they eating? What about drinking their water every day? Taking their meds appropriately? Showering/Bathing and keeping up with their personal hygiene? Are they putting on clean clothes or are they wearing the same thing every day? What are their limitations? Are they physical limitations, mental limitations or a combination of both?

It seems as though there is always a primary caregiver and then supporting caregivers. All of you may be hands-on helpers or a combination of hands-on and have in-home help. Being a caregiver or helper is hard. It is demanding, frustrating and tiring. Not everyone is good at being a hands-on caregiver. But, they can be great at other things.

Communi-friggin-cation is the key. You have to talk to each other. You have to work out a schedule. You have to figure out what your strengths are and what you are willing to do and what you are not comfortable doing. Maybe, you are good at doing most everything but personal hygiene tasks. Maybe personal hygiene tasks are okay with you, but you hate cooking and doing the laundry. Maybe your mom or dad needs help getting up out of bed or a chair. Do you know how to help them safely? You probably need training in how to lift and transfer them safely.

What happens when one sibling see things differently than another sibling with regards to where the parent is exactly “at” in their disease progression? De-Nile (denial) ain’t just a river in Egypt. When you cannot agree, it is time for a frank discussion with a social worker, their physician or me. Why would I say to meet with someone rather than tell you to roughshod over your sibling? Remember, your parent may tell one sibling one thing and something different to another. It is usually not malicious. They are trying to keep up appearances that they are okay.

A neutral third party can be objective, so that you and your siblings have a better understanding of where your loved one is, right now and also, what is to come. It is hard. We call it the practice of medicine, because there are no absolutes. We make the best decisions that we can with the information that we have right now. As the status or information changes we will make adjustments.

Some of you are thinking, but my sister is a looney tune. Others are thinking, my brother is the baby of the family and is no help at all. Other complaints include –  My sister is a know-it-all and a martyr. My brother lives out of state and thinks everything is fine. All my sister/brother wants is for them to die and get their money. My sister and I don’t get along. You may even hear, “I can’t bear to see mom/dad like that.” There is some kind of hurt or conflict in the sibling relationships.

If you love your mom or dad and want the best for them, then do what is best for them. Keep that your main goal and focus. You have compartmentalized before; you can do it again. You will get distracted and you will harp on your sibling(s). When you start griping and yelling about what “they are doing or not doing,” maybe it is time to refocus on the goal.

Have the roundtable discussion. Keep the main thing the main thing. Decide who will do what and by when. Calendar it. Place the calendar on Google Docs so everyone knows what is happening. Include your triggers for when it is time to bring in paid help. Of course, you need to figure out how and who is going to pay for it. Ideally, it will be from your loved one’s money or a long-term care insurance policy, but that is not always an option. Can the siblings pitch in money to help? Some can and some cannot. Be upfront about what you can and cannot contribute financially and time wise. You can make a plan when you know who and what you have to work with. You are looking for progress, not perfection.

Clues That You Are Acting out of Emotional Needs or Fighting Old Battles

  • Your level of emotion is out of proportion to the specific thing being discussed right now. For example: getting into a heated argument about which of you should go to the doctor with Dad next week.
  • You or your siblings criticize the way you think another person is being, for example: selfish, bossy, uncaring, irresponsible, or worse.
  • You feel that none of your siblings understands what Mom needs the way you do and you are the only one who can do certain things.
  • You or your siblings generalize a discussion, saying, for example, “You always do this!”
  • You or your siblings criticize the way one another feels, for example, “You don’t care anything about Mom.”

Here, I stole this from Family Caregiver Alliance.

Tips for Winning More Support from Your Siblings

  1. Try to accept your siblings—and your parents—as they really are, not who you wish they were. Families are complicated and never perfect. There are no “shoulds” about how people feel. They are not bad people or bad children if they don’t feel the same as you do. If you can accept this, you are likelier to get more support from them, or, at least, less conflict.
     
  2. Do not over-simplify. It’s easy to assume that you are completely right and your siblings are all wrong—or lazy, irresponsible, uncaring, etc. Each person has a different relationship with your parent, and each person’s outlook is bound to be different.
     
  3. Ask yourself what you really want from your siblings. Before you can ask for what you want, you need to figure this out, and that’s not always as simple as it seems. First of all, ask yourself whether you really, deep down, want help. Many caregivers say they do but actually discourage help. So, think hard. Do you want them to do certain tasks regularly? Do you want them to give you time off once in a while? Or do you feel you have everything under control but you’d like them to contribute money for services or respite?
     
  4. Or—and this is a big one for many caregivers—do you really not want them to do anything but you’d like more emotional support? Many caregivers feel lonely, isolated, and unappreciated. If you’d like your siblings to check in on you more, ask them to call once a week. And tell them it would really help if they would say “thanks” or tell you you’re doing a good job. They are more likely to do this if you don’t criticize them for what they are not doing.
    • Ask for help clearly and effectively.
    • Asking is the first step. You might ask for help by saying: “Can you stay with Mom every Thursday? I have to get the shopping done for the week and it gives me some time to myself.” Don’t fall into the common trap of thinking, “I shouldn’t have to ask.” Your siblings may assume that you have everything covered so they don’t recognize the added responsibilities and “burden.” They are involved with their own lives and struggles and not so attuned to yours that they can read your mind. Also, if you’re not exactly sure what you want from them, you may be giving them mixed messages.
    • Ask directly and be specific. Many caregivers hint or complain or send magazine articles about the hardships of eldercare. But these strategies do not work well.
    • Ask for what’s realistic. People get more when they don’t ask for the impossible. So, consider the relationship your sibling has with Mom or Dad and ask for what that person can really give. If your sister can’t spend ten minutes with Mom without screaming at her, don’t ask her to spend time; ask for something that’s easier for her, like doing paperwork or bringing groceries.
       
  5. Watch how you ask for help—and steer clear of the cycle of guilt and anger.
    • Avoid making your siblings feel guilty. Yes, really. Guilt makes people uncomfortable and defensive. They might get angry, minimize or criticize what you are doing, or avoid you. That is likely to make you angry, and then you will try harder to make them feel guilty. They will attack back or withdraw even more. And round and round you go.
    • Sometimes your siblings will criticize you because they are genuinely concerned about your parents. Try to listen to these concerns without judgment and consider whether it is useful feedback. At the same time, be bold by asking for appreciation for all that you are doing—and remember to say thanks back when someone is helpful.
    • Be careful of your tone and language when you request something. It’s not always easy to hear the way we sound to others. You might think you are asking for help in a nice way, but if you’re angry, that’s the tone your siblings will hear. And they’re likely to react in unhelpful ways.
       
  6. Get help from a professional outside the family. Families have long, complicated histories, and during this very emotional passage, it is often hard to communicate with each other without overreacting, misinterpreting, or fighting old battles. Even the healthiest families can sometimes use the help of an objective professional. People like family therapists, social workers, geriatric care managers, physicians, or clergy can help siblings establish what is real about a parent’s health and needs in order to help distribute responsibilities more equitably. In family meetings, they can help you stay focused on the topic at hand and help you avoid bringing up old arguments.
     
  7. Steer clear of power struggles over your parent’s assignment of legal powers. Whether or not you have been given your parents legal powers over finances or health, you need to remember that it is your parent who has made these decisions. If you have your Mom’s or Dad’s power of attorney, be sure to keep detailed records and send your siblings statements about how you have spent Mom’s money. This may seem like a lot of extra work, but record keeping is required by law, and being open will reduce distrust or distortion—and lawsuits. If a sibling has been given legal power, try to accept your parent’s decision and don’t take it as a personal attack on you. Do your best to work with the sibling who has the authority by presenting expenses and bills in black and white. If the sibling who has the purse strings doesn’t cooperate, then bring in a professional to explain your parent’s needs and to mediate. If you are concerned about manipulation, a changed will, or undue influence, contact your local Adult Protective Services.
     
  8. Don’t let inheritance disputes tear your family apart. If you feel wronged by the way your parents have divided their money and property, it’s natural to be upset, especially when you are grieving. You may feel that you deserve more because you have cared for your parents. If that’s what you feel, you need to discuss this with your parents while they are alive and can make these decisions. If you suspect foul play by another sibling, then this is the time to consult an attorney or Adult Protective Services.

Yet, research shows that most parents feel a need to leave their estates equally as a sign of their equal love for all their children. When they divide things unequally, it’s often because they are worried that a particular child will be in greater need. Whatever their reasons, remember that it was your parents, not your siblings, who decided this. Think hard before you take your anger or disappointment out on your siblings. They are what remains of your original family, and for most people, this relationship becomes more important after parents die.

The above 8 steps are from Family Caregiver Alliance

Will you agree to operate as a team for the best quality of life possible for your mom/dad? Teams set clear goals and responsibilities for team members. Everyone has a skillset, use the best person for the job. Set weekly calls with an agenda that has 3 things on it. Never more than 3. Focus on the here and now. NEVER start a statement with “you.” Use, “I feel, about a situation. Your bothers and sisters may have different ideas about the care needed. That is good. Talk about it and see if better options arise.

Be fair about the division of responsibilities. When you get off track, go back and focus on your goals for your mom or dad. You did write them down, didn’t you?

Shameless plug – I help families figure out where they are, what they will need in the future, develop an action plan to move forward and guide them.

Pat

Signs of a Bad Caregiver

Posted on June 2, 2022 by - #alzherimers, #caregiver, #caregivers

Hired helpers are not the only ones to watch out for… family caregivers or helpers may be a bad caregiver too. They may not only be bad caregivers; they could be dangerous too.

June 1, 2022

If your loved one is not comfortable around the hired caregiver or the family caregiver, it may be that their personalities don’t mesh. Nothing good or bad is going on, just a mis-match. Sometimes, it is much more than that.

Do they have the skills needed to provide quality care?

The caregiver may be well-meaning, but they do not have the experience or skills necessary to do the job right. This is more common in family members as caregivers and in hiring a private caregiver. Get references and check them out.

For example, you have a loved one that weighs 240 lbs. and the caregiver weighs 150 lbs. If your loved one needs help getting out of bed, bathing, transferring to a chair, and they cannot help themselves, what will happen? Dead weight is very heavy. If the caregiver has not had any training in lifting, transferring or bathing this type of person, what do you think is going to happen? Falls. Back pain and pulled muscles for the caregiver. Injury to your loved one. You can’t just pull someone up by their arm. Not to mention the dignity and respect issues. They are not a toddler and they deserve compassion, dignity and respect.

Look, they may be a bad caregiver. They may be a wonderful person, but they are not a good caregiver. They may be a good caregiver for someone else, but not for your loved one.

You have hired someone to help your loved one and to help out around the house with light housekeeping and cooking. You were specific on what you want/need and it has been agreed to by all parties, right? If not, fix that immediately. Never assume. Clarity cuts down on the aggravation. Create a task list.

Is your loved one out and about in the house or are they in their room “hiding?” Of course, they will need time to get used to their new caregiver, but it should not take a long time. Some folks are not used to have other people in their houses, especially people they do not know. Heck, some of them don’t want people they do know in their houses. Observe to see if it is a familiarity thing or a scared thing.

Specific Signs of Neglect or Elder Abuse

If your loved one is constantly complaining you have to determine if it is because they are frustrated that they are no longer able to do the things they used to do in their own home or is it more? You may have to ask questions along with observing how they are acting and what they are saying. If they don’t like the way the caregiver cooks, well, that is a complaint and can be fixed. If they are saying things like “they just sit there all day,” “they don’t talk to me or anything,” or “they talk to me like I am stupid,” those things may indicate poor treatment by a caregiver.

You see a bruise on the inside of their bicep area. Increased falls. Burns, cuts, scrapes or welts. Pressure ulcers or bed sores. Broken bones. These are all indicators of abuse and neglect. If the explanation does not make sense, trust your get and get them away from your loved one.

From a long-distance

You are a long-distance daughter and you call to talk to your mom. The caregiver always makes some kind of excuse as to why they can’t talk, right now. Is the caregiver always in the room when you call and talk to them or in the same room when you go for a visit? This is a controlling behavior by the caregiver and is not appropriate.

Do they care/love their caregiver too much? Watch out for money being given to the caregiver. Watch out for too much closeness, too fast. It is perfectly fine for them to get along and to care for one another, but it still must be a professional relationship.

Your loved one seems to have declined physically (weaker, more tired) or emotionally (not their normal talkative self). There could be a medical reason. Weight loss or malnutrition are other indicators of inadequate care. It may not be abuse, some caregivers are over their heads with dementia patients, for example.

I would like to make the difference between a bad caregiver and an abusive caregiver. A caregiver can be a bad caregiver and not be abusive towards the care recipient. The caregiver has not been adequately trained for the care recipient. They don’t understand all that goes in to providing care or help to a person with limited mobility, a dementia or a traumatic brain injury. An abusive caregiver does harm to the care recipient or allows harm to impact the care recipient.

If you are suspicious, get the caregiver away from your loved one. At the very least put-up cameras or nanny cams to see what is going on in your absence. If you get a “feeling” or you know that something is not right, trust that instinct. Do not reason it away. You don’t have to know why you know; you just know.

FYI

SIGNS AND SYMPTOMS OF SPECIFIC TYPES OF ABUSE

Physical abuse Unexplained signs of injury such as bruises, welts, or scars, especially if they appear symmetrically on two side of the body Broken bones, sprains, or dislocations Report of drug overdose or apparent failure to take medication regularly (a prescription has more remaining than it should) Broken eyeglasses or frames Signs of being restrained, such as rope marks on wrists Caregiver’s refusal to allow you to see the elder alone
Emotional abuse In addition to the general signs above, indications of emotional elder abuse include Threatening, belittling, or controlling caregiver behavior that you witness Behavior from the elder that mimics dementia, such as rocking, sucking, or mumbling to oneself
Sexual abuse Bruises around breasts or genitals Unexplained venereal disease or genital infections Unexplained vaginal or anal bleeding Torn, stained, or bloody underclothing
Neglect by caregivers or self-neglect Unusual weight loss, malnutrition, dehydration Untreated physical problems, such as bed sores Unsanitary living conditions: dirt, bugs, soiled bedding and clothes Being left dirty or unbathed Unsuitable clothing or covering for the weather Unsafe living conditions (no heat or running water; faulty electrical wiring, other fire hazards) Desertion of the elder at a public place
Financial exploitation Significant withdrawals from the elder’s accounts Sudden changes in the elder’s financial condition Items or cash missing from the senior’s household Suspicious changes in wills, power of attorney, titles, and policies Addition of names to the senior’s signature card Unpaid bills or lack of medical care, although the elder has enough money to pay for them Financial activity the senior couldn’t have done, such as an ATM withdrawal when the account holder is bedridden Unnecessary services, goods, or subscriptions
  Duplicate billings for the same medical service or device Evidence of overmedication or undermedication Evidence of inadequate care when bills are paid in full Problems with the care facility:
– Poorly trained, poorly paid, or insufficient staff
– Crowding
– Inadequate responses to questions about care

Pat

Signs it is Time to Hire an In-home Caregiver

Posted on May 25, 2022 by - #alzheimers, in-home care

A Wednesday, like any other Wednesday, you go for a visit to your mom’s house for a mid-week visit and to take her a few groceries and you need to pee before you leave. You go to the hall bathroom, turn on the light and the toilet does not look like it has been cleaned in a month. There is a ring around the bowl, dirt on the floor, the countertops are visible soiled and there is soap scum and mineral deposits in the sink.

You know what happens next, don’t you? You start reasoning things away. “Oh, she must not clean this bathroom every week, since she does not use it.” “She must not feel good or she may be tired.” “She is missing a lot of dirt, dust and grime, we probably need to get her to the eye doctor.”

May 25, 2022

Observe the home conditions

All of those things may be true. But, there could be other reasons. Do you ask about the hall bathroom or do you just observe, make a mental note to check on it next week? Are you brave enough to check out the master bedroom and bathroom?

What do you see in the kitchen? What do the countertops look like? Is the sink full of dirty dishes or are the dirty dishes placed into the dishwasher – but not washed? What does the refrigerator look like? Expired food? Old leftovers, that are growing mold.

How many excuses do you hear? “Oh, I’ll get to it this weekend.” I was sick last week.” “It looks good, to me.” “I’ll do it later.”

Maybe, they are just getting older and they need a little help with the cleaning. Arthritis is a bitch. Low back pain can have you down and out. Look for clutter or things not put away. Look for clothes in a pile or basket, clean, but not folded. Look for garbage not taken out regularly. What does the house smell like?

Can you determine if there are physical limitations that make house cleaning hard, if not impossible now? Hire a housekeeper or clean it for them.

Check-in again 6 months later

Let’s go 6 months to a year or so down the road. You begin to notice other things …

    • They wear the same outfit multiple days in a row.

    • Their hygiene is noticeably in need of attention.

    • They are telling you they can’t find important items or you notice they are regularly missing must-haves like glasses, hearing aids, etc.

    • They are missing trash day, and trash is accumulating at the house.

    • They are not opening their mail and may have overdue bills.

    • They seem more quiet or lonely.

    • They have unruly hair

    • They look scruffier, more so than usual

    • They have lost or gained weight (due to frozen meals or junk food)

    • Unexplained bruises (usually due to falling)

    • They are forgetting appointments

    • They are forgetting words or repeating themselves

    • They have a personality change

When you notice some of the things listed above, it is time for an assessment and a plan of action for in-home care. They will not usually volunteer any information. They will, however, deny any problems exist. They may or may not realize they are forgetting things. When they do become aware that things are not “right,” or that they really are forgetting things, watch out. They can get really uptight and angry. The goal is not to set off the dynamite, it is to diffuse it.

ADLs (Activities of Daily Living) 

You may hear the phrase Activities of Daily (ADL’s) living, which are self-care tasks that can no longer be performed or are very hard for them to do now.

    • Get into/out of bed or chair

    • Toilet hygiene

    • Bathing or Showering

    • Getting Dressed

    • Personal hygiene

    • Eating

    • Walking / Climbing Stairs

    • Safety /emergency responses

IADLs (Instrumental Activities of Daily Living)

Another phrase is Instrumental Activities of Daily Living (IADL’s). These are the activities related to living independently by themselves.

    • Shopping/ Getting Groceries

    • Transportation (Driving/Public)

    • Preparing meals

    • Managing Medication

    • Using Phone/Technology

    • Cleaning / Maintaining home

    • Running Errands / Appointments

    • Managing Finances

dADLs (Domestic Activities of Daily Living)

A less common phrase is Activity Assistance or Domestic Activities of Daily Living (dADL’s). A person is no longer physically able to do ____.

    • Companionship/Socialization

    • Mental exercise

    • Hobbies requiring dexterity or fine motor skill

    • Care of others

    • Care of pets

    • Activities in the community

    • Lite exercise

    • Exertive exercise

Sometimes, it gets to the point that your loved one needs 24/7 care or a skilled nursing facility.

SIgns it is time for an in-home caregiver 24/7

10 Signs your loved one needs 24/7 care.

    1. Frequent falls or compromised balance

    1. Confusion between day and nighttime 

    1. Difficulty eating or drinking without assistance

    1. Fainting or confusion due to dehydration

    1. Wandering from home or getting lost

    1. An increase in bathroom accidents

    1. Sleepwalking or wandering during the night

    1. After surgery, a hospitalization, or stay in a rehab facility

    1. Bedbound and/or developing bedsores

    1. Family caregivers are suffering sleep deprivation or have chronic stress that interferes with their own health, wellness, and quality of life

What Care Needs are Needed?

What type of in-home care would be best for your loved one and you?

    • Companionship – they are fairly independent but they are isolated or lonely

    • Help with ADL’s

    • Help with IADL’s

    • Mobility assistance – getting in and out of chairs or bed; toilet sitting and rising

    • Memory or Cognitive decline/impairments

    • Personal care

    • Preparing meals

    • Pet care

    • Taking them to Dr. appts, visit friends or family

    • Light housekeeping

Let’s go ahead and get in the housekeeping arena. What is light housekeeping? Light housekeeping is a task that the care giver does to help provide better care for the client. NOT the entire family!

What IS and IS NOT Light housekeeping

Light housekeeping duties DO include:

    • Clearing away dishes after meals

    • Preparing/cooking meals

    • Drawing baths and setting out towels

    • Hang up towels and washcloths to dry or place in laundry

    • Cleaning sink, bath tub and toilet after use

    • Wiping down spills and sanitizing surfaces

    • Spot mopping

    • Changing bed linens

    • Dusting off surfaces

    • Tending to house plants

    • Taking out trash

    • Pet care – feeding, a walk and general cleanup

    • Cleaning up clutter

    • Sweeping and vacuuming floors

    • Organizing closets and drawers

Light housekeeping duties DO NOT include:

    • Moving furniture

    • Washing windows

    • Scrubbing carpets and floors

    • Shoveling snow

    • Mowing the grass

    • Raking leaves

    • Scrubbing shower or tub

The caregivers do not bring supplies with them. They are not housekeepers. They are people helpers and companions.

It is a good idea to write down what your loved one needs and wants. Write down what the family wants, too. Look at the lists. Do you need an in-home caregiver or do you need a housekeeper? Some of you need an in-home caregiver, but you want to use them as an in-home caregiver AND a housekeeper or a maid. That is NOT going to happen. So, to prevent any misunderstandings, anger or frustration, everyone needs to be clear on what will and will not be done. Never assume, always ask and write it down. There are a few caregivers that want to sit around and play on their phone or watch TV. That is not a caregiver. It isn’t a companion either. Whoever is there to help your loved one needs to be engaging with them and helping them. 

Pat

When is overthinking bad?

Posted on May 18, 2022 by - #caregiver, #caregivers, Decision criteria, Overthinking

Calling all perfectionists and overachievers …

If you have a tendency to ruminate, excessively worry, second guess your decisions or even struggle to make decisions, you may be an overthinker. I would even bet that you have some OCD tendencies. The quirky kind, not the disabling kind.

May 18, 2022

Paralysis, Rumination, Overthinking

My overthinking tendency is rumination. Sometimes, I recognize it and sometimes, I don’t. Yes, I have the quirky OCD tendencies. My paper money has to be in a certain order and turned all the same way. My shoes have to be placed next to each other and in the correct L/R order. Not just kicked off in any old way. I have to eat an even number of cookies. Enough about me. What are your tendencies? Are you able to recognize them? Can you recognize your triggers? Do you know what your analysis paralysis is? Do you know what you overthink? 

When does overthinking cause problems?

When does overthinking cause problems? When it paralyzes you from taking action? When it keeps you stuck? When you realize that you have spent hours on a problem/issue with nothing to show for it? Have you noticed that your mind will always come up with another “worry question?” There will always be another “what if,” or “if this, then that.”

Our brains go in to analysis mode, which is good. However, it is not good to stay there. At some point we do have to make a decision and move forward. One of the problems with overthinking is that we stay in the analysis mode even to the point of becoming paralyzed. You have heard the phrase, “analysis paralysis.” It most commonly happens when we have too much information or we “feel” that we do not have enough good information to make a decision. We want to make the best decision possible. That is always my main objective and I am sure it is yours too. What we don’t realize is that we keep looking for the answers that we cannot know until we make a decision. The real reason we keep searching, is because we must not fail. We cannot fail, it is too important. We get afraid when we have important decisions to make. 

I get it. I want to know all of the possible scenarios and the possible outcomes too. But, that is not the way the world works. Look at it this way, if you are in a competition, whether it is sports, band, game night, or whatever, you can play a perfect, errorless game and still lose. You did your best and you did not make any errors, but you still lost. We cannot know every outcome. 

Stop overthinking and use 3 trusted resources

Use three trusted resources and allow appropriate time for research, reflection and choosing. I wish that I could tell you it was two hours, but maybe you need more or less time. Realize that your choice will not be perfect, but strive for “good enough, for now.” You can always make adjustments later. Maybe the best thing for you is two hours of research, discovering three possible options and then you take a day or two to think about those options (or you need to meet with others to flesh it out). Then it is time to make a decision.

Your brain(thoughts) will fight you. It will throw up all the “what ifs, buts, worst outcomes.” You can quiet it down. You can still make a decision. You can move forward. Mindfulness meditation really will help you calm your mind. 

Sometimes, thoughts are just thoughts

Your thoughts are just that, thoughts. They are not reality. In fact, they may be lies. Learn to challenge your thoughts. Sometimes, you will have to throw the bullshit flag on your thoughts. We all want to control situations, outcomes and consequences. We are not that powerful. The reality is that we can make the best decision possible with the information that we have, at this moment in time. We cannot choose the consequences. We cannot choose the outcome. It sucks. We beat ourselves up too much for things we have absolutely no control over.

Is it possible to stop overthinking?

Find your pattern of overthinking. What moments or situations cause you to go in to the overthinking mode? Note – write them down when you find yourself in an overthinking situation

You will find your pattern. Then when you are aware of it, that is when you are able to notice your triggers and will then be able to work on your strategy or plans of action. For example, you will give yourself, two hours of research from trusted resources. You will develop two or three options. You give yourself time to think about the positives and possibilities of the options. (1 to 2 days) Our brains go to the worst-case scenario, so be prepared for that. Understand that the probability of that worst-case scenario will probably NOT happen. Of course, it could, but really how likely is it? Make a decision and implement the steps to move forward. Set a time for evaluation (2 weeks – 2 months). Make updates or changes, if needed. Re-evaluate in 2 weeks to 2 months, etc.

You do not have to believe everything that your thoughts are telling you. What is the evidence in this situation? What are the logical and reasonable possibilities? If a thought is not logical, reasonable or helpful, then tell it so. I know that this sounds crazy, but you do need to talk to yourself out loud or at the very least write down the conversation. Do not have the conversation in your head. It will just keep going around and around.

Talk with a trusted friend. They may be able to see things that you can’t. They may have a different perspective than you and can see other options or possibilities. They can also give you a kick in the butt, when you need it.

Do some kind of physical activity

Walk, run, work out, do something physical. You need to burn off that cortisol energy. It will help your brain too.

If you find yourself overthinking in most situations, you may need to do some talk therapy. Talk therapy is a great tool, to help you see patterns, and how to make adjustments to move forward. Overthinking causes a great deal of stress and if you do not deal with stress, it can cause anxiety, depression, fatigue, headaches, stomach problems, etc.

How can you tell if you are overthinking?

When you find yourself focusing on the problem, you are probably overthinking.

The goal is to get in to the problem-solving or solution finding mode of thinking.

If you find yourself ruminating about the past or worrying about the future you are probably in the overthinking mode. If you are dwelling on how bad you feel or you are thinking about all the things that you have no control over, you are probably overthinking. Overthinking does nothing to prevent or to solve problems. Irrational fears often lead to overthinking.

Manage your energy, you only have about 4 hours of focused energy per day.

You only have so much energy every day anyway, so why not use it for solution finding or problem-solving rather than ruminating or staying stuck on the problem. Practice quicker decision making. Start with dinner choices or dessert choices. Read your options and decide in 3-2-1- choice. This is the biggie, choose where to go for dinner. If you need to, have 3 choices, then pick. You can do this.

Sometimes, you just have to declare it DONE!

Pat

Is it a psychiatric illness, psychosis, or a drug-induced problem?

Posted on May 12, 2022 by - #alzheimers, #caregiver, #caregivers, #dementia, overmedication

First, what is psychosis? Psychosis is a term used to describe when a person interprets or perceives reality in a different way than those around them. Psychosis may be a symptom of mental illness, but that is not always the case. Nobody knows exactly what causes psychosis.

May 11, 2022

Observations

Typical story of a psychosis

Suzi visited her mom, Val Thursday after work. Suzi checks in on her about twice a week. Val is 70, active with high cholesterol, high blood pressure. arthritis, and mild depression. Val takes her medication regularly and as directed. Suzi notices that her mom is not quite herself. Val cannot follow the conversation and does not seem to be able to concentrate.

The first thing Suzi thinks is, an UTI. Possible dehydration. They go to the Dr., but the urine test comes back clean. No infection and her electrolytes are all in the normal range. Hmm. Now what? Nobody seems to know what to do next, but wait and see.

It is now a week later and Val is not better and in fact she is a little worse. She cannot remember if she has taken her meds or not. She is unsure of what has happened over the last three days. Suzi is getting more and more concerned. This is not normal and her mom has never been this way before. Suzi wonders if her mom is developing dementia, Alzheimer’s disease or mild cognitive impairment.

In this particular case, her physician looked at her medications and had a consult with her pharmacist. They determined that most likely it was her blood pressure medication and/or her arthritis medication. Outside chance it could be anti-depressant med, but not likely. They began a withdrawal of HBP medication and started a different one. Val was some better, but not back to normal. It was not her arthritis medication; it was her anti-depressant medication. She was slowly weaned off of that and they did a wait-and-see approach to see if she needed to be on an anti-depressant anymore. Her mind cleared and she was back to her normal self.

Too often, we fail to look for signs and symptoms of drug-induced psychosis

While this case was a success, many more are not. No one thinks to check the medications. Why? Well, their thought processes go along these lines – She has been on these meds for three years or more. It came on suddenly, it must be a UTI or dehydration or she does indeed have the beginnings of mild cognitive impairment or a dementia.

Medications are not without risks and problems over time. As we age, our metabolization and kidney function decrease. We cannot clear meds as quickly or as easily as we once did. You know when your loved one is “not right.” You may not know what it is, but you know that something is wrong. Push for answers, never accept it is “just old age,” dementia, or other assumptions. Blood tests and urine tests need to be done. Medications need to be checked. Hydration and nutrition need to be addressed. We want to rule out any fixable problems.

Psychosis can be:

    • Due to stressful life experiences or trauma

    • Part of a neurological condition such as dementia. Alzheimer’s disease, or Parkinson’s disease

    • Triggered due to a brain injury

    • Medication side effects

    • Effects of illicit or illegal drugs such as marijuana or cannabis

    • Effects of alcohol withdrawal

    • Triggered by menopause

    • Triggered during times of severe stress or anxiety

As you can see, it is not black and white. Many things can trigger a psychosis. By the way, marijuana is not the gateway drug to addiction. Trauma is the gateway to addiction. The self-medication, whether it is alcohol, marijuana, cocaine, hydrocodone, heroin, etc., becomes the problem due to another problem. We have to deal with the primary problems first! Yeah, I know, we chased a rabbit there.

We don’t think about medications as causing a psychosis or a psychotic episode, but they sure can. Too often, we assume that it is a mental health issue. Maybe it is, but, we need to find out and rule out other fixable causes.

Understand that some classes of drugs can cause psychosis.

Classes of meds that may cause psychosis:

    • Muscle relaxants

    • Antihistamines

    • Antidepressants

    • Cardiovascular medications

    • Antihypertensive medications

    • Analgesics

    • Anticonvulsants

    • Antiparkinsonian medications

    • Chemotherapy agents

    • Corticosteroids

    • Stimulants

From the list above, you can see that the possibility is real that the psychosis is from a medication and not mental illness. Alcohol abuse or misuse is another inducer of psychosis.

Drug-induced psychosis usually only lasts until the medication/drug has cleared the body. Depending on the drug, the metabolization and clearing may take from 1 day to several weeks (if it is from a stimulant medication).

A healthcare professional needs to be contacted. They can decide where the safest place to “come-off” the medication will be. Drugs can affect different people in different ways. What causes a psychotic episode in one person may not cause a psychotic episode in another person. Genetics plays a part. Life experiences play a part. Pre-disposition to mental illness plays a part. Remember, mental health disorders can cause substance use or misuse on its own. The mental health disorder can be exacerbated or intensified by medication use, abuse or misuse, but it is not caused by the meds.

We should note that schizophrenia is not caused by drug use, abuse or mis-use. It may trigger schizophrenia symptoms in those people susceptible to schizophrenia.

Common signs and symptoms of psychosis includes:

Hallucinations – when you see, hear, feel or taste things that other people don’t

    • Hearing voices or sounds that others don’t

    • Seeing things that others do not see

    • Tasting things when you haven’t had or eaten anything

    • Feeling someone touching you who is not there

    • Smelling things which other people cannot smell

Delusions – unusual beliefs that other people in your “community” do not share, even though they feel real to you

You may worry:

    • That you are being followed by secret agents or members of the public

    • People are out to get you or to kill you (may be strangers or people that you know)

    • That a chip has been implanted in your brain to monitor your thoughts

    • That your food or water is being poisoned

    • That you are a powerful person or God

Cognitive impairments – these relate to mental action (learning, remembering, functioning)

    • Problems concentrating

    • Memory problems

    • Difficulties understanding new information

    • Having a difficult time making decisions

Alcohol, amphetamines, phencyclidine (PCP), cocaine, and hallucinogens are among the most common causes of drug-induced psychosis. Symptoms of drug psychosis include:

    • Hallucinations. A person might see, smell, or hear things that aren’t there.

    • Delusions. A person may adopt demonstrably false beliefs, such as that a demon is pursuing them.

    • Dangerous behavior. A person might attempt to fly, harm themselves because a voice told them to do so, or become a danger to others. Some people who experience psychosis become aggressive.

    • Disconnection from other people or from reality. A person may appear catatonic or totally withdrawn.

Drug-related psychosis is distinct from other forms of psychosis in a few ways:

    • It appears while under the influence of or withdrawing from a drug.

    • It comes on suddenly.

    • It is typically more intense than other forms of psychosis.

Illicit/Illegal Drugs that most commonly cause substance-induced psychosis:

Methamphetamine

Cocaine

Marijuana

LSY

Peyote

Mushrooms

Ketamine (this is a Rx drug, but is used illicitly)

PCP

Ecstasy

This overview is so that you know and understand that medications can cause psychotic episodes. What signs and symptoms to look for? Contact your healthcare provider for withdrawal and monitoring needs.

Pat

Medication Overload – Another Drug Problem

Posted on May 4, 2022 by - overmedication, problems, too many meds

Too much medication, too many medications (polypharmacy), overprescribing, inappropriate prescribing, & the body’s decline in metabolization and excretion. Whew! It is a lot, isn’t it?

May 4, 2022

Medications will not fix everything. Medications are not without risks. Over-the-counter medications are not always safe. Vitamins, supplements, herbs, or essential oils are not without risks and they are not always safe either.

What I look for is medication overload

I am on the lookout for unnecessary medications, potentially inappropriate use of medications., or multiple medications used for the same thing. I look for appropriate medication usage and benefits vs risks treatment regimens. Just because a medication may help, does not mean it should be used because the risks or side effects will be worse than the treatment. Treatment may be indicated, but it will not be beneficial. A medication may no longer be necessary. Medication is not necessary at all.

We have to get over this, “a pill for every ill,” kind of thinking. Let’s be honest, a lot of folks want “my rights” or “my choices,” but they do not want the responsibilities that come along with those things. It is each of our responsibilities to take care of our bodies, as best we can. Eating better, drinking our water, doing physical activity, taking care of our mental health, and even sleeping well. Progress over perfection. Be consistent. Then if you need meds, take only what you need in the lowest amount you need.

Medication overload isn’t really talked about very much. When 750 people aged 65+ are admitted to the hospital Every Day, due to medication problems … that is significant. Not all of these folks survive. 7,000 people die every year due to preventable adverse drug events. It is unknown how many dies, due to worsening of their current diagnoses.

If you are 65+ and take 5 or more prescription medications, you are at risk of an adverse drug event.

Possible side effects of overmedication include:

    • Mental health concerns

    • Addiction

    • Substance misuse or abuse disorders

    • Drug reactions that are dangerous

    • Adverse side effects

    • Increase in physical health problems

Common signs of overmedication in seniors include:

    • Fatigue and energy depletion

    • Pressure in the abdomen

    • Aches and pains in the body

    • Problems with balance and motor skills

    • Fatalities and falls

    • Rashes and flushing of the skin on a regular basis

    • Weight gain or loss that is not clarified

    • Mood swings are frequent, and there is a lack of personal hygiene.

    • Concentration problems

    • Impairment of memory

    • Confusion or cloudiness of mind

    • Delayed decision-making

    • Inability to think rationally

    • Psychosis, hallucinations, and delusions

    • Symptoms of withdrawal when not using

How can we decrease or eliminate medication overload in the older adult?

Take time to discuss medications during office visits. Find out what is still necessary and needed. Find out what can be stopped or tapered off. Work with your physician. Discuss the benefits vs harm and what are the alternatives. You doctor will probably be thrilled that you want to decrease the number of medications that you are taking.

Be open to the possibility that your medications are hurting you rather than helping you. Maybe, you feel so bad, not because of your diagnoses, but because of some of your medications. Your goal is to reduce medication overload. Could you be on a potentially inappropriate or harmful medication for you? One or more medications that you are taking may cause you to feel bad or may even cause a hospitalization. 

You are the one inside your body and you are the expert on how you feel and how you are really doing. Consider, just consider, that taking less medication (in number or dosage) may benefit you. 

Pat

Manage Your Energy, Not Your Time and Recharge Your Tired Brain

Posted on April 27, 2022 by - #caregiver, #caregivers, time management

Promises of a better life, an easier life, if you will only use the XYZ method of time management. You are convinced that if you knew and could master the trick of managing your time to be more and more productive, your life will be better.

April 27, 20222

How many phrases pull you in to the “That would make my life better and easier?” Probably, quite a few. Why? Because, we are dealing with crap that is standing in our way of our lives being better and easier.

We see the ads, we see the promises, and we even search for solutions. Of course, we are leery, we have either bought or done things before that did not work for us. Still, we search. Why? Because, we want better. Something is out there to help us; it just has to be.

We have thought about time management wrong

What if we have thought about time all wrong? Maybe, we have only been managing deadlines, this whole time? Use a planner, they say. Planners and date books are great for solid meeting times, appointments or deadlines. There are list makers and there are fly-by-the-seat-of-your-pants kinds of people. I am a list-maker, but I have learned to leave space for spontaneous goings-on. Changes, reschedules, opportunities, missed out times, it is all good. Time marches on no matter what we do or don’t do. Our energy on the other hand, is finite. It does run out. We do need to rest and recharge.

Doing a mental versus physical activity and the energy levels each takes

When doing a physical activity that does not require a lot of focused attention to detail, we get tired. We rest, get cleaned up and we are ready to go again. When doing mental activities that take a lot of focused attention to detail, we have about three hours a day before that energy is zapped. Sorry, but a short rest and shower will not fix this energy depletion. The brain must rest, from processing information. Daydreaming is a nice way to rest the brain. Letting your thoughts wander is great too.

What can you do to rest and recharge your brain?

    1. Go for a walk

    1. Take a nap between 10 minutes up to an hour

    1. Take a shower, leisurely

    1. Play sports

    1. Stretch

    1. Go outside

    1. Journal

    1. Color or Draw

    1. Watch animals play

    1. Listen to music

Find what works for you. If you know that you will be having to process a lot of information, learn when you perform at your best. You may already know that you can only be detail oriented for an hour and a half at a time. Great, you have two of those blocks per day.

How to stay focused during your workday

Depending on how detail oriented I need to be or how much research that I need to do, I know that I have about three hours a day for that intensity. After that, I will need to do other tasks that do not take as much effort and energy. My best times are usually from 11:30 am – 1:30 pm and from 2 pm – 4:00 pm. If I have reading and research to do, I protect that time frame so that I will be at my best to work on my clients needs.  I check email once in the morning and once in the late afternoon. I scan the news in the morning and late afternoon. I check Twitter and facebook mid-day and late afternoon. I have this routine and I don’t waste any brain energy trying to figure out what I am going to do or not do next. Routines and habits help you conserve brain energy.

Chasing rabbits and wasting time

We can all go down rabbit holes at any time. We learn to catch ourselves doing that, course correct and go forward. Mindless scrolling, is a rabbit hole. If you are having trouble with that, set a timer for 10 minutes. Do something else. Read. Journal. Chores. Plan for the next day. Walk. Daydream.

Learning to calm yourself benefits your brain too. When you focus on the problem or issue, you get stuck because you cannot think about it in any other way. By taking a break, getting away, playing or being fully present in the moment, you can rest and let your brain work in the background. Who knows, it may come up with a brilliant new way to look at the situation or find even better options.

New perspectives. New ways to think about brain energy. New ways to plan your day. Give them a try for two weeks and see how you are doing. Make adjustments, you may be surprised at how much better you feel and how much easier your tasks become. You get to do your most intense work when it is best for you, your brain and your body.

Pat

Conflicting thoughts and how to decide what is best for you.

Posted on April 20, 2022 by - #caregiver, #caregivers

Conflicts inside our mind

We all have them, the mixed feeling or conflicting thoughts. What does it do to us? How do they make us feel? They stress us out. They make us tired both emotionally and physically. We stay paralyzed because we don’t want to make a wrong decision. It hurts us worse to make a wrong decision than it does to make a potentially right decision.

April 20, 2022

Internal conflicting thoughts is the experience of having opposing psychological beliefs, desires, impulses or feelings.

A few examples:

    1. You feel frustrated and angry at the health care system (doctors, hospitals, insurance companies) but, yet, you need them.

    1. You are disappointed in the lack of communication but you are unsure how to fix it.

    1. You are not sure that your loved one has the financial resources that they will need to have the best care possible for them, yet, you are not sure how much, if any, you can contribute.

    1. To be an advocate, you need good, science-based information that works for you and your needs.

    1. The frustration of unmet clinical concerns (diagnoses, treatment plans, home needs).

    1. Our inner child emerges and is ready for battle.

    1. Our compassion and losing the ability to be compassionate.

    1. Our Ego gets bruised and then we act out instead of seeking to find the best solution.

    1. Conflict with yourself – taking care of yourself along with taking care of your loved one.

    1. Unresolved family issues rear their ugly head.

    1. And many more…

What is causing this inner agitation? Ruminating thoughts? Troubling thoughts? Feeling like the thoughts are in control? You experience this out of control feeling and you just keep spinning your wheels. There is an element of fear. In fact, the “fear” of something is always at hand.

Relieve the stress and the conflicting emotions will disapper

When your mind is relieved of the stress, those feelings of conflict and turmoil will disappear. Our minds want to be in a state of calm. We like it when things are copasetic. So, how do we get there?

Your thoughts are not always true. Identify what thoughts are causing the distress. Do you have competing or conflicting thoughts? Get your paper and pen out. Write the competing thoughts down. Under them, write down the good points about each of them. We are looking for win/win ideas. Now you have to change hats to be the mediator. As a mediator you are looking for the best options for RIGHT NOW. There will be give and take. Get rid of the “either – or” mindset, look for a “both – and” mindset.

Your Want vs Reality

Have you figured out that the biggest problem is between your WANT and REALITY? Yes, it sucks, but more times than not that is what the conflict is about. Does that mean we give up? Of course not. Making things the best they can be under the parameters that we have is our goal. Rarely, do we have a perfect reality anyway so we know that we can course correct and move forward. We are made for challenges. Take the limits off of your thinking. Let’s try and see.

You are the one in control of your thoughts and your feelings. No one else. That is powerful. That is an “in control of me” empowering feeling. You have to be the one to learn how to handle your strong emotions and feelings. Drill down deep, what are they trying to tell you? Yes, they do have a message. They are ALWAYS trying to keep you safe. They will always raise a ruckus. It is your job to listen, step back and figure out what is real and what is not real. Are you safe, right now? Is this an old trigger? Is this a pattern? I know we just chased a squirrel here.

Back on task.

What does the evidence say to you?

What does the logic say to you?

Reasoning

Reasoning is a powerful tool for the mind. To be able to reason well, we need correct and true information. Three trusted sources is sufficient for you to make a well-reasoned decision. A trusted source is NOT ‘they said and I heard.”

Remember, we buy with emotion and justify with logic. Sometimes, we keep looking for sources to help us justify the way that we want. We keep searching until we find what we WANT it to be.

Be careful about how you are searching for information. Do you want the facts or do you want the biased information that will support what you want? When you know the facts and your options, you will actually feel much better about your decision. You will know that you have done everything possible to get the best information available at the time to help you make a decision. It doesn’t mean that it will be easy. It doesn’t mean that you won’t wonder? It doesn’t mean that you won’t make a mistake. We are human, we will probably always wonder. But those are just thoughts. They are not reality. The reality is that you did the best you could with the best information that you had at the time. Very few decisions are final. Oops, that did not work as well for us, so, you make adjustments and move forward. Progress over perfection.

Write these things down and answer them:

I am concerned about ____________________________________________________

I am afraid that _____________________________________________is going to happen.

Write down all the possible outcomes that you are thinking about.

Make 3 columns – Thoughts that reinforce Negative outcomes, Thoughts that make the situation stay the same, Thoughts that are Growth/Goal oriented realistic outcomes

Try to focus on the thoughts that are growth/goal oriented realistic outcomes. These thoughts are the motivators to help you take action.

Consider what you really want. What are your life values?

We want balance between our head and our hearts. When it is out of balance we have inner conflict. You are having trouble or confusion between accepting and aligning your belief with what is being presented to you. Accept the duality. Sometimes, you need to be still and breathe, just deep breathe. Allow your thoughts to calm down so you can think more rationally. Think about your life values and the principles that you live your life with. Decisions are hard. If you have no good decision, then which decisio

Pat