Too many choices, too many decisions, too much overwhelm, and decision fatigue all contribute to you feeling and being stuck. Do you feel as if you are “just surviving” every day? That stinks, doesn’t it? But, what to do and how to get started moving forward again?
November 30, 2022
Sometimes, the issue is that we do not know what to do first. Not only that, but we stress over what is the most important thing to do first. We are afraid to be wrong and so, we do nothing. I think the acronym F.A.I.L. is appropriate here, it is your First Attempt In Learning. Yes, you are learning what works and what does not work. Failure is an event and never a person.
We like certainty. We want to know that we have made the “right” decision. Our brains do not like uncertainty, it makes them work overtime to feel safe. Our brains get hijacked by our emotions and we cannot think logically. Stop overloading your brain.
Do you feel like you have to “shop around” and keep all your options open before making a decision? Two or three would be ideal, but we have to go to 10 places and keep comparing. How many of us get too obsessed or too anxious? You know who you are and you are nodding your head in agreement.
How much energy are these decisions taking? Is it really worth that much stress, anxiety, or energy-wasting? Have you ever thought about when this choice overload happens? It usually happens when we don’t have enough good information or knowledge in the area of need. Use your good resources. Set your limit to three of those resources. Find a knowledgeable person and have them provide you with your best two or three options for your needs. (That would be a plug for my services, in case you didn’t catch it.)
What does feeling stuck look like?
You have been searching for something that interests you and you find it. Then you look at all the steps it takes to do it and talk yourself out of doing it.
You keep thinking about what could be better or different all the time. You may even be future-oriented. You get into the “when I get this, I will be happy” or “when this happens, I will be happy.” The problem is that you are here, right now in the present and this is where your focus for happiness would be best served.
You really want something – for yourself – a new relationship, a better job, a new house, to get in better shape, etc. – However, before you start, you lose your motivation. Maybe, you do get started and then you lose your motivation.
You have a feeling that something isn’t right in your life, even if you can’t put your finger on it.
Motivation is red hot for a while, but then it burns out and all you have are a bunch of ashes. What now? For one, the realization that motivation is never enough to achieve a goal. It takes commitment to the process. Doing it even though you don’t feel like it is another realization. Be consistent. Continue after a break.
Maybe you feel trapped as a family caregiver. You don’t mind helping, but now you feel like you never get out. It is a difficult adjustment. Be careful, resentments can build up before you know it. You feel like you are missing out. You feel trapped by doing the same tasks over and over.
Consider this, challenges are matters of perspectives and our own attitudes.
Is there some middle ground that you and your care receiver can agree to? Challenge your on “stinking thinking.” It could be your perspective and attitude that are the problems.
Some ideas to help you not feel trapped:
Only you can change the things in your life that you are unhappy about.
Live a healthier life by moving (walking/running) and eating better.
Be consistent, motivation alone is not enough.
Accept uncertainty. We can make good decisions, but we cannot choose the outcome.
Reconnect with your personal values.
What can you do, right now, that will be helpful?
Be the hero of your story and not the victim. Stop saying, “I don’t want …”
Stop focusing on the things that are causing you to suffer. Focus on whatever fills you up.
You may not have good options, so choose the option that you will regret the least.
See if you are in the “all or nothing” thinking. It can be a “both/and.”
Write down some “I could …” statements.
Write down three different things you are grateful for every day.
Be proactive rather than reactive. You will have more control and less stress.
If they still have their partner, the partner will try to help and cover for them. When they are tag-teaming it is more difficult to figure out what is going on. It isn’t always intentional, but it can be intentional. To be fair, it may have happened slowly and they are taking care of each other the best way they know how to help. Observe to see if the spouse is finishing tasks for them, finishing sentences for them, or making excuses for some type of behavior.
November 9, 2022
No one likes to admit that they may need help. We are all very independent and quite stubborn. Most of us fear losing our mental faculties more than we fear losing physical capabilities. I understand that. Too often, people feel that they are “getting dementia” or “Alzheimer’s disease,” but that may not be the issue at all. Which is why it is important to go through a diagnostic workup. It could be fixable, such as better nutrition and hydration. It may even be a type of depression.
Short on money
Buying a lot of “stuff”
Drinking more alcohol
Prescription drug misuse or abuse
Illegal medication misuse or abuse
Binging on sweets
Financial abuse – from a family member, a friend, or a caregiver
Elder abuse or Neglect – from family, friends, neighbors, or caregivers
Driving Infractions or Getting a Ticket for something
Hiding bruises – either from falls or abuse
Eating a lot of take-out
Changes in the way they dress
Closing the doors to rooms – to keep junk hidden, the messiness, or the dirtiness
Limiting driving to short trips and not far from home
Poor personal hygiene – from not changing clothes to not bathing nor brushing teeth
A few behaviors that may mean they are trying to hide information:
They discourage visitors. It may get to the point of them not letting anyone inside their home. It starts as, “We will meet you at the restaurant.” “The house is such a mess, let’s do it another time.” They may even say that they know “you are busy with your job.”
Hiding mistakes – driving, spending, buying,
They make a lot of excuses for their forgetfulness or their behaviors
Changes in activity – you are looking for changes in their normal routines
Speaking for their spouse
Why might they do some of these things? “Denial (De Nile) isn’t just a river in Egypt.
Denial – If you don’t acknowledge it or talk about it, then it doesn’t exist and nothing is wrong.
Pride – They can’t admit that they can’t do a lot of things necessary to live on their own. We all are an independent and prideful bunch.
Embarrassment – maybe they become self-conscious or ashamed of what they can no longer do. Especially if it has to do with personal hygiene. Embarrassment rears its ugly head when they have some financial difficulties. They cannot afford food, medication, and getting repairs done to the house. It may or may not be any fault of their own.
Fear – of losing their independence
Depression – chronic health conditions seem to cause a rise in depression. Depression is not always the ‘woe is me” stuff.
Depression is not a normal part of aging. It may mimic dementia.
Signs and Symptoms of Depression in folks 65 years and older:
Trouble retrieving some words
Takes longer to process information and deliver an answer
They no longer have pleasure or want to do the things they used to enjoy
Noticeable weight loss or weight gain
Sleeping too much or too little
They experience feelings of worthlessness
Having excessive or inappropriate feelings of guilt
Recurrent thoughts of death or suicide
Struggle to pay attention
Be grumpy or irritable
More aches and pains
Move more slowly
Apathy – lack of interest or concern
We always want to rule out the things that can be ruled out. What if it is a lack of nutrition, dehydration, loneliness, or isolation? Those are fixable and doable. If it is depression some medications can help. Shoot, even running has been shown to help mild to moderate depression. Once we know what it is, it really is much easier to handle.
Caregivers need to hear that they are appreciated. They need practical help that almost anyone can help if they are willing to put forth some time and effort. You have said, “If there is anything you need, let me know.” Did you mean it? I am going to tell you what they need and want.
There are really helpful things you can do and say to caregivers or helpers. Last week we talked about what not to do and say. This week we move towards helpful things to do and say.
November 2, 2022
This time we are going to be talking about what you can say and do to help your friend or loved one who is a caregiver. Did you really mean it when you said, “Let me know what I can do to help you?” If you mean what you say and say what you mean then this article is for you. If you do not mean what you say then you can stop reading now. We are going to get into the practical and doable things.
What caregivers and helpers want and need to hear.
Recognition and Understanding – Recognize that what they are doing matters and is helpful. Try putting yourself in their shoes, and be understanding when they are stressed and need to vent. Be understanding that they are exhausted and need a break from both thinking and doing. A short visit to shoot the breeze or watch a movie. Find a distraction when they cannot leave their caree (care receiver).
Time to recharge – Offer to stay or sit with the care receiver for two to four hours so they can go and do whatever they want to do. Are you willing to do this once a week, once every two weeks, or once a month? What day and time? Be specific.
Provide respite care – This could happen a couple of ways. Find a facility that allows for respite care and find a company that provides in-home care so the primary caregiver can get away. Cost is usually the main factor. How many friends, family or church members can donate money to provide this much-needed service? Imagine what a week away would mean to them.
Take them out to eat and to a movie. If you can, pay for the in-home care or find someone to sit with the caree for three or four hours. Most of the time, it really is just being there in case the caree needs something. It is not like you would be asked to do anything medical.
Emotional support – They may need to vent. They may need to talk about what is going on with their caree. They may need to talk about something else.
Feel heard and understood – Acknowledge how hard this may be for them. Understand that they have bad days and feel anger, hate and rage.
Offer to be the communication person – keeps others updated or put info on a website like Caring Bridge
Send a thinking of you text and state – no need to respond
Coordinate the offers of help and support
An email with a joke or two
Remind them they are loved and cared about
Say, “I will be keeping you in my thoughts and prayers, every day and sending you good vibes.”
Share “remember when” stories about your relationship
Share funny stories that you have witnessed
Laughter provides many great benefits – watch a funny video
Say, “I love you.”
Offer to sit with their mom or dad so they can go out with their spouse and kids.
Ask, “How can I be a good sounding board for you?”
What caregivers would like you to do and how to effectively help them.
Yes, it would be great if the caregiver had a list of things to be done and errands to run, but most have not had the time to do one. Maybe you are the one to make the list and place it on the refrigerator so folks can sign-up.
Never offer to do anything that you do not want to do. The look on your face and being told no is more than the caregiver can handle. They will shut down.
Ask, “When is the best time to come for a visit and how can we help during the visit?”
I am coming over on Saturday from 2 to 5 to stay (with your loved one) so you can take a break. Be specific.
Give a Visa/MasterCard gift card of $50 – $100 and say, “Enjoy.”
Pick up a meal from their favorite restaurant and deliver it.
Make a meal and deliver it – use throw-away containers
Make a few freezer meals and take them over.
Set up a meal train to provide meals anywhere from 3 to 7 days a week (ask about likes/dislikes)
Make phone calls and do research for them – if asked
Donations to help cover lost work and medical expenses
Offer to coordinate medical bills, EOB’s and medical claims. Only if you know how.
Give a gift certificate to a spa/massage
Mow the yard (either the caregiver’s yard or the care receiver’s yard or both)
Do laundry – Pick it up and bring it back
Help clean the house – vacuum, dust, sweep, mop, wash dishes, change the sheets, clean the shower/tub and toilet, wipe down surfaces – nobody expects you to deep clean
Clean the gutter
Take their car in for an oil change
Run the errands – grocery shop, pick up Rx’s
Sit with the care receiver so the caregiver can run errands
Take the care receiver to the doctor’s appointment
Deliver a care basket – good snacks, a book to read(nothing about caregiving allowed), favorite lotion and skin care things, gift cards, blanket, neck pillow, board game, cards, Mani-Pedi gift certificate, etc.
Wash and vacuum the car
Clean out the refrigerator
Change the air filter
Shred old documents
Help clean out a closet or room
Clean out the garage
Replace light bulbs
Walk the dog
Clean out the litter box
Take animals to the vet
Take animals to the groomer
Wash the outside windows
Clean the oven
Think about the things that you do at your own home. The caregiver needs those things done either that their own home or the care receiver’s home. Find 2 or 3 things that you don’t mind doing and do them. Do the things that you don’t mind doing. Do not do things that you hate doing. For example, I don’t mind doing laundry, taking the cars in for service or cleaning, or running errands. I hate washing the outside window and cleaning the oven and I won’t do them. Other folks have different likes and dislikes. So, what I hate doing, someone else doesn’t mind doing.
Be specific about what you will do and when you will do it. Ask, if that is okay with them and if not, be flexible. Clear communication is important. Do not assume.
It is not a requirement to help out financially. If you can, that would be great but not a necessity. Your time, efforts, and help will mean more. So there is no misunderstanding, be upfront about what you can and cannot or will and will not do. It is perfectly fine to state that you can’t help with the financial expenses, but you can run errands and pick up things that have either been paid for or they can send you with some form of payment.
Most caregivers don’t assume you will pay for things, but they may simply forget to give you a way to pay. Just remind them that you need a check or card.
You may mean well. You may even mean what you say, but you are hurting them rather than helping them. Will you be open to learning how to better support someone who is helping a loved one? It will require some effort and thinking on your part.
October 26, 2022
I have said some things in the wrong way. I really meant to help, to be supportive and available. What went on in my own mind, did not play out well for someone I was trying to help. I had to realize that I was looking at their situation through my own ways of caregiving and what I would have liked help with.
If you truly want to be a help to your friends or family members that are caregivers, you have to buck up and take the time to learn what they need and want help with. No, that does not mean rapid-fire questions. A lot of the time, they do not know what they need or want because they are in hell and too stressed out to think.
What do you do? How about you learn what they don’t need and don’t need to hear?
Judgement – Don’t second guess them or their choices. You don’t know their family dynamics and you are not in their shoes.
Horror stories – They don’t need or want to hear about all the messed up crap that happens in nursing homes or what happened to “so-and-so.” Just shut up, there is no good that can come from that.
Don’t ask what they need – Granted, this is difficult as you may want to help, but you don’t know what to do. Give them the gift of your time. You know the things that need to be done at your own home. Mowing, cleaning the house, laundry, running errands, grocery shopping, and making dinner.
Don’t make more work for them – Don’t just show up, don’t call and say. “the gang is coming over to visit you.” They will feel the need to clean up and get the place cleaned up.
Don’t ignore them – Maybe they can’t attend functions much anymore, but you can keep including them. Update them and let them know that you are thinking of them.
Now we will move on to, “What NOT to say…”
“If you ever need a break, call me.” – What the hell. They do need a break and they don’t have time to go take a shower, much less call you.
“You have to take care of yourself, too.” – Do you really think that they don’t know that? You are adding more stress and guilt, so unless you are offering to sit with their caree (care receiver) so they can take care of themselves, shut up.
“You look tired.” – They are tired.
“I don’t know how you do it.” – They have no choice.
“God doesn’t give you more than you can handle.” – That statement is wrong on so many levels.
“You will get your reward in heaven,” – You have just discouraged them more.
Why do you keep going to visit them, they won’t remember it anyway.” – Their loved one still deserves love and care. They may not remember your name or who you are to them, but they sense and know that you are someone that loves them and cares for them.
“You should put them in a home.” – You don’t get to decide what is best for them and their loved ones. Pretty much, anything that has a “should” or “would” in it ….keep it to yourself.
“I could never do what you do.” – You don’t know what you will or won’t do until you are in your own situation. All relationships are different. All families are different.
“I wish there was something I could do to help.” – Bullshit, you would do something if you wanted to. We will get into the things you can do and say next week.
“You should get some help.” – Do you really think that they haven’t thought of that? Maybe, they can’t due to finances. Maybe, they have hired folks that do not show up.
“How are you doing?” in front of the caree (care receiver) – Really? Do you want them to vent right in front of their loved one?
“You need to find some time to relax.” – I am sure they would love to, but when and how?
“Don’t feel guilty about …” – Feeling guilt is a part of caregiving.
“Everything happens for a reason.” – No, it doesn’t. Stuff happens and we have to deal with it.
“I know just how you feel.” – No you don’t. You may have had a caregiver type of experience, but it is not the exact same. Situations are not exactly the same, people are not exactly the same, and needs are not exactly the same.
“What doesn’t kill you, makes you stronger.” – Do you think this hardship is making them stronger? That is foolish.
“At least it’s not cancer.” – At least it’s not…statements cause more pain to the caregiver.
“Just think positive thoughts.” – Way to go, you have just increased the feelings of guilt and pressure they put on themselves.
“Your mom (dad) used to be a great person.” – Don’t talk about their loved one in the past tense. It is hard enough to watch a loved one decline, without being reminded of what has already been lost.
Think before you speak. Practice what you will say. Say it out loud. How does it sound? Is it uplifting or helpful? How might it be taken by someone who is stressed out and exhausted?
If you find yourself using any of the following, don’t do it. “I think,” “You should,” “I would,” “You could,”
Shut up. I get it, I want to help and fix things too, but some things are not meant to be fixed by you. That is a hard lesson, but a helpful lesson on being fully present and letting them vent. You just sit there and be the listener.
Next week we will talk about what to say and do to help a caregiver.
What does that really mean? It isn’t used as a medical term or a diagnosis, but we all seem to know what it means. It means a mental health crisis. It means an emotional health crisis. It is also known as a breakdown of your mental health.
It happens when you have intense physical and emotional stress, with difficulty coping and you are not able to function effectively or normally anymore. You feel like you are losing control. The stress that you are under may have you feeling anxiety, fear, worry, stuck, overwhelmed, and/or nervous. You are at the point where you can no longer function in life.
October 12, 2022
Everyone is different and everyone will have different stressors and reactions to those stressors. This is way past burnout.
A few things to watch out for:
You call in sick for a day or two (sometimes, longer).
You miss appointments.
You avoid or back out of social engagements.
You have trouble with healthy eating, exercising regularly, sleep, and your personal hygiene starts slipping.
You withdraw from people and don’t want to leave your home.
You lose interest in things that used to bring you joy.
We all have our own “set point” for a breakdown. Losses are a huge part, especially if they are stacked one on top of another. For example, a death, a divorce, losing your house, a terminal illness, being a caregiver, losing your job, family turmoil, severe financial strain, a chronic medical condition (a worsening chronic medical condition), inability to relax, continued loss of sleep, work stress, school stress, etc.
As you can see, a lot of things can pile on. Step away, take a timeout! Get a talk therapy appointment, ASAP. You are no longer able to get out of this situation on your own. Breathe, just deep breathe for 5 minutes.
You will have to make adjustments and learn better-coping skills. You will have to learn to say, “No.” You will have to take care of yourself physically and mentally before you can help anyone else. Yes, you can recover.
Burnout is more common. My wish for all of us is that we take better care of ourselves BEFORE we get to this stage. The same stressors apply, they may not be as intense or as long, but they could be.
Burnout is usually defined as chronic stress related to poor life and work practices, that produce exhaustion (physically, mentally, and emotionally). You are overloaded and overwhelmed. When a person is overloaded and overwhelmed with negative emotions and feelings rear their ugly heads. We have hostility, anger, and frustrations and we don’t seem to be able to cope or handle these negative emotions.
Extreme burnout will lead to a mental health crisis.
This article from Medical News Today, explains burnout very well.
Emotional demands: A caregiver can feel emotionally drained, especially if they are aware that the person they are looking after will not get better despite their efforts. For example, this could happen if a person is caring for someone in palliative care.
Conflicting demands: These are the additional demands a person has outside of their caregiving role, such as looking after children, going to a job, and making time for their partner.
Ambiguous roles: Often, the role of a caregiver is all-consuming. It is easy for a person to lose sight of who they are outside of their caregiving responsibilities.
Workload: Some caregivers may be looking after someone with complex needs. In these instances, it is important a person seeks temporary relief and gets assistance from other carers.
Conflicting advice: In some cases, treatment procedures may change as research progresses. While these changes aim to give people the best care, they can cause a significant amount of disruption and stress if a caregiver has an established routine.
Privacy: Additional clinical support, such as nurses and other healthcare professionals, may visit a caregiver’s home throughout the week. While this can be helpful, it can also take away their privacy.
All of these factors can contribute to a caregiver feeling overwhelmed, self-critical, and drained. If they do not address these feelings, they may start experiencing serious symptoms of caregiver burnout.
Additionally, symptoms can indicate what stage of caregiver burnout a person is in.
The three stages of caregiver burnout are:
Frustration: A person starts feeling frustrated and disappointed that the person in their care is not getting better. They cannot accept that the person’s condition will decline regardless of how well they look after them.
Isolation: After a while, a person may begin to feel lonely in their caregiving role. They may also grow tired of hearing negative opinions from family members, especially if these family members do not appreciate or recognize the time and effort caring requires. At this point, the caregiver may withdraw from friends and family.
Despair: Eventually, a person may feel helpless and isolated. They can find it hard to concentrate, struggle to find joy in hobbies or interests, and avoid social interactions. The level of care they provide may also begin to drop as they spend less time on their own well-being.
Pay attention to your signs of stress and aggravation. If you need help or think that you may need some help, give me a call and let’s have a conversation. We won’t know if I can help unless we talk to see.
865-684-8771 (leave a message, if I am unable to answer)
Sometimes, reality sucks! We cannot accept reality until we go through a process. Denial will be high and it is a coping mechanism for difficult emotions. We are not talking about avoidance, which causes a whole lot of other problems. We deny the truth so we can keep things the same. We have a fear of change and the unknown.
Facing reality means that we might have to change and make choices that we do not want to make. The uncomfortable feelings rise up within us and we become stuck. The inner conflict makes us miserable. Are you in denial about something?
October 5, 2022
We can’t even get to balancing expectations versus reality until we deal with our denial.
Some clues that you may be in denial about something:
You wonder, “If only she (or he) would …?
You doubt or dismiss your feelings.
Hope things will improve when …
You begin to feel resentful.
You walk on eggshells, trying to avoid a blow-up or avoid talking about the problems.
You may be worried that you will develop dementia yourself.
You avoid talking about the issue.
You avoid thinking about the problem.
You promise to address the problem in the future.
You minimize or rationalize what is going on
You become numb to your feelings
Denial isn’t always a bad thing. It gives you time and space to gradually accept the change. You need time to process and figure out the next steps. It can become a problem when you continue the denial and your health unnecessarily suffers. You will have some anxiety. That is normal. It is not comfortable, but it is normal.
We might have to take an action that we do not want to take. Okay, on to expectations versus reality.
Expectations are what we think will happen. Reality is what actually happens. Our frustrations and problems arise when our expectations are not met. My perspective is not the same as your perspective. Our life experiences are not the same and we have different known and unknown biases.
What impacts our perspectives? Our energy levels and our physical strength. How attuned we are with our own bodies. Being hungry (you will not make good choices when you are hungry). Easy-to-read statements “Seem” to be truer, whether they are true or not. Feeling bad, sad or depressed makes everything seem harder. Having our family and friends (our support system) around helps make things easier.
What expectations do you have?
Common signs that you have expectations:
Anticipating a certain outcome.
Having and holding a vision in your mind of how things will play out.
Having a set idea of what you want or need to happen.
Idealized versions of life and what you want can set you up for disappointment. You may not even realize that you are not being realistic.
Increasing your awareness of your expectations is one way to help. If you have a “should” in your thinking, be careful. Life is not fair. Why do you think it “should” be this way? Stop making comparisons. You are unique and your situation is unique. It is okay to feel disappointed. It is okay to feel all of your feelings. Remember, that you have control over how you act and react.
Accepting “what is” and trying to make that better is a great goal to have. I know some of you are wondering what I mean. It is difficult to accept reality and “what is.” It takes hard work and practice to let things “Be, just as they are, right now.” It is hard for the “fix-it” types to adjust to not being able to fix it. We have to find our new role. We have to figure out how to help. We have to learn to accept the reality before we can figure out our options.
I don’t deny the reality of what my clients are or will be going through. It will be hard and it will be exhausting. But everyone has the right to have the best quality of life possible for them. I never give up hope. Accepting what is or what will be, does not negate hope and trying. Being fully present” in “the moment is all we have. What you can see, feel touch, smell, and taste…right now.
What if we would set compassionate expectations? We are all going to get smacked down a time or two and that hurts. Something that we tried did not work out or it was a complete disaster. Well, hell! So, try something else.
We all have a mind or soul age and physical body age. My soul age is 35, but my physical body age is 60. I listen to my body and make adjustments for activity. Now, the little imp in me is still as active as ever. I play games, aggravate people, and have fun wherever I am. I have accepted the reality that I have to make adjustments sometimes. I am okay with that. That is really the key, isn’t it? Being okay with “that.”
Consider the conflicting emotions that you sometimes feel. Could that be what is really bothering you?
Happy & Sad
Scared & Excited
Confident & Doubtful
Love & Anger
Grief & Joy
Wanting time with your partner & Alone time
Believe in yourself & have a fear of failure
All of us have found ourselves in these types of emotions. It is like a push/pull situation. It sure can cause a lot of procrastination too. How can you make a decision when you have competing thoughts? They don’t have to cancel each other out. They can both be true and exist simultaneously. We do not have to choose we can accept both feelings. We have talked before about getting rid of the “either/or” and finding the “both/and” to find ways to move forward.
Our bodies are made to move. When we sit for long periods our body hurts. Our joints and bones hurt. We simply do not feel good. Now, imagine that you have a disorder or chronic health condition that makes movement more difficult or you can’t remember to exercise. Your body still needs movement to relieve pain and relieve excess energy.
September 28, 2022
Move more, hurt less. Move more, rest better. Movement and exercise for the care receiver will make the care giver’s life easier.
Is your loved one restless? Do they wander? Are they withdrawn? Hurting? Regular exercise and movement will help decrease these issues. Do something every day. We often think about things to keep the mind busy, but we sometimes forget about the body. It takes both to make an impact on their well-being.
Those dealing with Parkinson’s disease know that movement and breathing exercises help them to maintain strength and independence longer. They seem to be more open to exercise classes and doing workouts at home. Why? Probably, because they have all of their mental faculties, it is their body that is failing them and they want to be as independent as possible.
Those dealing with a dementia, such as Alzheimer’s disease, are experiencing brain failure. They become less and less aware of what their body needs. They forget that their body needs movement and exercise. Over time, they lose the ability to reason through the many steps it takes to exercise. These folks need reminders and workout buddies to help them achieve their goals. Many times, they can mimic what they see.
What they can do safely is of great importance. As with any exercise routine, a physician needs to be consulted. Maybe, a visit to physical therapy and/or occupational therapy is a good idea. PT’s and OT’s can help with an exercise program that can be done at home. Any exercise needs to be done appropriately. Form matters. Consistency matters. Never giving up matters.
Rock steady boxing has great results for folks that are dealing with Parkinson’s. Deep breathing exercises and vocal exercises are important too. Walking is good for everyone. Being outside is good for everyone. Playing in the dirt (aka, gardening) is good for almost everyone. So, what, if you have to modify things? Being adaptable is a plus.
Walking, weightlifting and dancing are great exercises for folks that are dealing with any type of dementia. The body needs to work in order to get tired. If we don’t get tired, we get restless. We can’t sleep and we get a little testy. Now, imagine that your brain is failing and you can’t reason out these things. You only know how you feel at this moment in time. You have to get your “willies” out somehow. You wander, you follow people around, and you ask the same question over and over.
Don’t forget about brain use activities. They are important too. Coloring, making something, building something, and doing a puzzle are all important, too.
I know that some of you are thinking, “I just want to get X, Y, and Z done.” Let your loved one help, give them a job. Be fully present and engaged with them. It won’t take any more time and it may even take less time because you won’t have all of the interruptions.
People before things.
Help your loved one to take care of their exercise needs. Develop your routine and stick to it. Put yourself in “time-out,” when needed. Think outside of the box. Who can exercise with them for about 30 minutes every day? Total visit time would probably be 1 & ½ to 2 hours. I bet you can find other family members or friends that can do that visit. You have to tell folks what you need help with.
Those that have requested to stay at home (age in place), for as long as it is safe for all…will need to be fit, and have some strength and endurance. When they become “dead weight,” or can no longer toilet themselves, they will have to begin the transition to assisted living and nursing homes. It is possible to keep them at home with 24/7 in-home care.
Strength and balance exercises are very important.
The health benefits of exercise include:
Reduced likelihood of constipation
Reduced aggressive behavior
Reduced risk of falls
Increased maintenance of motor skills
Improving heart health
You may start with 5 minutes a day and increase a minute or two every week.
Dancing counts. Playing golf counts. Running errands counts. Riding bicycles counts. Walking on a treadmill counts. Yoga or Tai chi counts. Vacuuming and folding laundry counts.
For the mind:
Do a puzzle
Play a board game (Connect Four, Chutes & Ladders, Checkers)
Read a book aloud to them
Play a card game
Reminisce (ask them about childhood, hobbies, work life)
Why is he doing this? Why is she acting this way? We always wonder why they are acting out or being disruptive, but we don’t always think about what is really going on. What is really going on is that something is bothering them and they cannot tell you what it is. You have to put on your detective hat. I promise you that they are not doing this on purpose.
September 21, 2022
It is hard to deal with a person that cannot tell you that they are hurting, uncomfortable, or scared. They do things that don’t make any sense to us. But, remember you are in dementia land. They have less and less control over their emotions.
Aggression in dementia can become scary and abusive. Aggression can become physical. It may also come out as cursing, spitting, or being verbally abusive to the care partner or helper. The aggressive behavior is thought to be the way that the person with dementia shows anger, fear or frustration.
Overboard reactions include screaming, shouting, making crazy accusations, and becoming agitated or very stubborn. They may also have uncontrolled laughing or crying. Possibly due to misunderstandings/miscommunications or even an underlying illness.
Change in sexual behaviors. The person with dementia no longer knows what to do with their sexual desire or how to address it appropriately. There may be a diminished interest in sex or there may be an increased interest in sex. They may remove their clothes, make sexual advances toward others, fondle themselves in public, or mistake another person for their partner.
Repetitive behaviors include asking the same question over and over and over, pacing, undoing something that you have just done, or word repeating. Give them something to do.
Wandering or leaving. Maybe they are “trying to go home,” or “they are going to work.” You may have to hide “exit cues” or “trigger items,” such as keys, shoes, jackets, purses, or hats. Try to engage with talking or reminiscing while distracting them from leaving.
Sleep disruptions. Dementia affects sleep patterns. Have the doctor rule out other possible causes. Keep them active and on a schedule during the day. They need physical exercise (walking 30 -45 minutes each day). Is the sleeping environment dark, and quiet? Is the temperature in the bedroom comfortable? Make sure they have sunlight during the day and even if they can’t go outside a lot, they can see the sunlight through the windows.
Delusions and Hallucinations: False beliefs, paranoia, and hallucinations may occur. Sometimes, the hallucinations are pleasant and sometimes they are not. Strong emotional memories from their past may recur. They will feel as though they are experiencing them in real time, all over again. If they are not bothered by the hallucination, then leave it be. If they are distressed, talk with the doctor to rule out other causes or to change/update medications. You can acknowledge their experience with a matter-of-fact tone without agreeing or disagreeing with them. You could say something like, “That is interesting.”, “I don’t see that.”, or acknowledge what they have said and move on to another topic.
I saw this article from Better Health and would like to share it with you.
Sleeping problems in dementia
Problems with sleeping are common for people with dementia. Some people sleep during the day and are awake and restless at night. Some are no longer able to tell the difference between night and day, while others are simply not as active as they used to be and so need less sleep.
Problems with sleeping or late evening agitation are often a stage in dementia that eventually passes. Many people with dementia sleep more during the later stages of the illness.
Sleep problems are among the most difficult dementia symptoms for carers. Families and carers must be able to get adequate sleep themselves. Plan regular periods of rest and regular breaks for yourself, as well as for the person with dementia.
Medical causes of sleeping problems in dementia
Sleeping problems may be caused by physiological or medical causes including:
brain damage (caused by the dementia) that affects the ‘biological clock’ in the brain that directs our sleep patterns
illness such as angina, congestive heart failure, diabetes or ulcers
pain caused by conditions such as arthritis
urinary tract infections that cause a frequent need to urinate
leg crampsor ‘restless legs’, which can indicate a metabolic problem
depressionthat causes early morning wakening and an inability to get back to sleep
side effects of medication, such as antidepressants and diuretics
snoring and sleep apnoea
ageing that causes sleep patterns to change so that some people need more sleep and some need less.
Things you can try include:
Discuss with the doctor the possibility of stopping or changing diuretic medication (which makes a person urinate), because this may be contributing to the problem.
Arrange a medical check-up to identify and treat physical symptoms.
Treat pain with an analgesic (pain-relieving medication) at bedtime if the doctor agrees.
Discuss with the doctor whether sedatives may be contributing to the problem.
Ask the doctor whether an assessment for depression may be necessary.
Ask the doctor about possible side effects of medication.
In some situations, it may be necessary to consider discussing with the doctor the appropriateness of either using tranquillising medication or sleeping medication. Sleeping medication may be helpful in the short term to establish a better sleep cycle, but both types of medication can have negative effects, such as increased confusion.
Environmental causes of sleeping problems in dementia
The environment of the person with dementia can cause sleeping problems in a number of ways including:
The bedroom may be too hot or too cold.
Poor lighting may cause the person to become disoriented.
The person may not be able to find the bathroom.
Changes in the environment, such as moving to a new home or having to be hospitalised, can cause disorientation and confusion.
Things you can try include:
Keep the environment as consistent as possible.
Check whether the person is too hot or cold when they wake up, because dementia can affect the body’s internal thermostat.
Provide adequate lighting if shadows, glare or poor lighting are contributing to agitation and hallucinations.
Move the mirror in the bedroom if the person becomes confused when they do not recognise their own reflection or the reflection of others in the room.
Install night-lights that might help cut down on confusion at night and may help the person to find the bathroom.
Place a commode next to the bed if finding the bathroom is a problem.
Make sure the bed and bedroom are comfortable and familiar, because familiar objects may help to orient the person.
Avoid having daytime clothing in view at night, because this may make the person think it is time to get up.
Make sure that the person is getting enough exercise – try taking one or two walks each day.
Other causes of sleeping problems in dementia
Other causes of sleeping problems may include:
going to bed too early
sleeping too much during the day
overtiredness, causing tenseness and inability to fall asleep
not enough exercise, so the person does not feel tired
too much caffeine or alcohol
agitation following an upsetting situation
Managing sleeping problems with food and drink
Some suggestions include:
Cut down on caffeine (coffee, cola, tea, chocolate) during the day and cut them out altogether after 5 pm.
Cut down on alcohol and discuss the effects of alcohol and medication with the doctor.
If you think the person may be hungry at night, try a light snack just before bed or when they wake up during the night.
Herbal teas and warm milk may be helpful.
Managing sleeping problems through daily routine
Some suggestions include:
Try not to do any tasks in the late afternoon that may be upsetting to the person.
If the person refuses to go to bed, try offering alternatives such as sleeping on the sofa.
In some situations, it may be necessary to consider discussing the appropriateness of either using sedative medication or sleeping medication with the doctor. If the person wanders at night, consider allowing this, but check that the house is safe.
Try a back rub before bed or during a wakeful period.
Try a radio beside the bed that softly plays music.
Gently remind the person that it is the evening and time for sleep.
Hoarding in dementia
People with dementia may often appear driven to search for something that they believe is missing and to hoard things for safekeeping.
Some causes of hoarding behaviours include:
isolation – when a person with dementia is left alone or feels neglected, they may focus completely on themselves. The need to hoard is a common response
memories of the past – events in the present can trigger memories of the past, such as living with brothers and sisters who took their things, or living through the Depression or a war with a young family to feed
loss – people with dementia continually lose parts of their lives. Losing friends, family, a meaningful role in life, their income and a reliable memory can increase a person’s need to hoard
fear – a fear of being robbed is another common experience. The person may hide something precious, forget where it has been hidden and then blame someone for stealing it.
Things that you can do to help manage hoarding behaviour in dementia include:
Learn the person’s usual hiding places and check these first for missing items.
Provide a drawer full of odds and ends for the person to sort out, as this can satisfy the need to be busy.
Make sure the person can find their way about – an inability to recognise the environment may be adding to the problem of hoarding.
Repetitive behaviour in dementia
People with dementia may say or ask things repeatedly. They may also become very clinging and shadow the person caring for them, even following them to the toilet. These behaviours can be very upsetting and irritating for families and carers.
Managing repetitive behaviour
Things that you can do to help manage repetitive behaviour in dementia include:
If an explanation doesn’t help, distraction sometimes works. A walk, food or doing a favourite activity might help.
It may help to acknowledge the feeling expressed. For example, ‘What am I doing today?’ may mean that the person is feeling lost and uncertain, and a response to this feeling might help.
Do not remind the person that they have already asked the question.
Repetitive movements may be reduced by giving the person something else to do with their hands, such as a soft ball to squeeze or clothes to fold.
Wandering in dementia
Wandering is quite common among people with dementia and can be very worrying for those concerned for their safety and wellbeing. The person’s failing memory and declining ability to communicate may make it impossible for them to remember or explain the reason they wandered.
Develop an action plan for when a person with dementia wanders, such as noting the clothing they were wearing, and contacting neighbours and the police.
Reasons that a person with dementia might wander include:
loss of memory
searching for the past
confusing night with day
continuing a long-held habit
discomfort or pain
believing they have a job to perform.
Things that you can do to help manage wandering in dementia include:
Get a physical check-up for the person to help identify whether illness, pain or discomfort has triggered the wandering.
Discuss the side effects of medication with the doctor – try to avoid medication that may increase confusion, and cause drowsiness and possibly incontinence.
Consider the psychological causes of wandering to try to determine if the person is anxious, depressed or frightened.
Make sure that the person carries some form of identification that includes their current address, if travelling
Use identification cards available from Alzheimer’s Australia.
Sundowning in dementia
People with dementia may become more confused, restless or insecure late in the afternoon or early evening. This is known as sundowning and these behaviour changes can become worse after a move or a change in routine.
The person with dementia may become more demanding, restless, upset, suspicious, disoriented and even see, hear or believe things that aren’t real, especially at night. Attention span and concentration can become even more limited. Some people may become more impulsive, responding to their own ideas of reality, and this may place them at risk.
Visit the doctor for a check-up and a review of medication. There are a number of physical and environmental changes you can make to restrict stimulating activities to the morning and promote relaxation in the afternoon and evening.
When you are dealing with all kinds of behaviors, you will need a way to calm your own frustration. Sometimes, you need to walk away and take a few minutes to compose your own thoughts and settle down. Is what they are doing hazardous or frustrating and aggravating? Unless it is dangerous or hazardous, leave them alone.
Know your own warning signs of frustration:
Shortness of breath
Knot in the throat
Excessive alcohol consumption
Lack of patience
Desire to strike out
If you don’t deal with your own frustrations, anger and resentment are not far behind.
We have seen the studies. We have experienced a decline in our own health all the while ignoring our own health needs. We know that we need to take care of ourselves so that we can take care of our loved ones. We know that caregivers can often wind up in worse physical shape than those they are caring for. Still, we do nothing for ourselves. Why?
September 7, 2022
We are stubborn people. We all believe that we can handle “this.” We must handle “this.” You may even hear and believe that “God doesn’t give you more than you can bear.” That is not a true statement. Go read it. 1 Cor. 10:13. God will not let you be tempted more than you can bear. He will provide a way of escape. God will give you the grace you need in every situation. His power helps us use the resources that we have and can get to handle whatever is in front of us.
Do we think that we have to suffer or put our own lives on hold to help or care for someone we love? You see, that is more of the “either/or” thinking and not the “both/and.” Get out of the “either/or” thinking mindset. Get into the “both/and” types of thinking. If you have only thought of the “either/or” possibilities, then you can learn to think of a “both/and” possibility. More on this later.
What attitudes and beliefs do you have that stand in your way?
Do you think you are being selfish if you put your needs first?
Is it frightening to think of your own needs? What is the fear about?
Do you have trouble asking for what you need? Do you feel inadequate if you ask for help?
Do you feel you have to prove that you are worthy of the care recipient’s affection? Do you do too much as a result?
Really think about the above questions. It may be time to take 30 minutes to think and talk to yourself. Writing it out helps you to get to the real issues/answers.
Here are some ways that your own mind will kick your ass.
I am responsible for my parent’s health.
If I don’t do it, no one will.
If I do it right, I will get the love, attention, and respect I deserve.
Our family always takes care of their own.
I promised my father I would always take care of my mother.
Your own negative self-talk will get you into trouble. Just because you think it, does not make it true or right. Circumstances may have changed and you can no longer keep your promises. Don’t hold yourself to impossible standards made in the heat of concern/passion.
Our behavior is based on our own thoughts, beliefs, attitudes, and misconceptions. Remember, your feelings can and will lie to you. You may believe something that is simply not true. Half-truths are what make up great lies. You do get to choose what you will or will not do. You do not get to choose what you can and cannot control. That is not the way life works. Yes, it sometimes is awful, frustrating, and maddening. What can you truly control? Your attitude. Your own actions. Your self-talk. Your gratitude. Your own mental and physical fitness. Your eating habits. Your sleep. Your boundaries. What you prioritize?
Things you do not have control over:
You can’t control other people (what they do or what they say).
You can’t control how other people see you.
You can’t control what happens to other people.
You can’t control your thoughts or feelings, they just are. You don’t have to act on them, though.
You can’t control the outcome.
You can’t control other people’s happiness.
You can’t control the past.
You can’t control the future.
You can’t control that change is inevitable.
Stop wasting your energy and time on things you cannot control. Focus on what you can control and actually make a difference.
Will you reduce your personal stress?
The problem isn’t always the problem. The problem is how we perceive the problem. The meanings we attach to the problem.
The following information is from Family Caregiver Alliance
Your level of stress is influenced by many factors, including the following:
Whether your caregiving is voluntary. If you feel you had no choice in taking on the responsibilities, the chances are greater that you will experience strain, distress, and resentment.
Your relationship with the care recipient. Sometimes people care for another with the hope of healing a relationship. If healing does not occur, you may feel regret and discouragement.
Your coping abilities. How you coped with stress in the past predicts how you will cope now. Identify your current coping strengths so that you can build on them.
Your caregiving situation. Some caregiving situations are more stressful than others. For example, caring for a person with dementia is often more stressful than caring for someone with a physical limitation.
Whether or not support is available.
Steps to Managing Stress
Recognize warning signs early. These might include irritability, sleep problems, and forgetfulness. Know your own warning signs, and act to make changes. Don’t wait until you are overwhelmed.
Identify sources of stress. Ask yourself, “What is causing stress for me?” Sources of stress might be that you have too much to do, family disagreements, feelings of inadequacy, or the inability to say no.
Identify what you can and cannot change. Remember, we can only change ourselves; we cannot change another person. When you try to change things over which you have no control, you will only increase your sense of frustration. Ask yourself, “What do I have some control over? What can I change?” Even a small change can make a big difference. The challenge we face as caregivers is well expressed in the following words modified from the original Serenity Prayer (attributed to American theologian Reinhold Niebuhr):
“God grant me the serenity to accept the things I cannot change, Courage to change the things I can, and (the) wisdom to know the difference.”
Take action. Taking some action to reduce stress gives us back a sense of control. Stress reducers can be simple activities like walking and other forms of exercise, gardening, meditation, or having coffee with a friend. Identify some stress reducers that work for you.
Pretty good information, huh?
Have you considered the real reasons that you do not take appropriate care of yourself?
You haven’t made your health a priority.
You don’t feel you have enough time to do all you “need” to do.
You feel guilty taking some time away from your loved one.
You don’t have the energy.
You have reached the burnout stage.
You won’t accept things as they are, right now.
You won’t put yourself in the mix of things to handle.
10 Health Problems Caused by Chronic Stress
Weakening of the immune system, which increases vulnerability to colds and other infections
Mental health disorders (e.g., anxiety, panic attacks, depression, mood swings)
Cardiovascular problems (e.g., high blood pressure, elevated heart rate, high cholesterol levels, increased risk of heart attack and stroke)
Respiratory problems (e.g., shortness of breath, rapid breathing, exacerbation of existing lung diseases like asthma and chronic obstructive pulmonary disease)
Worsening of skin conditions (e.g., eczema, psoriasis, acne, rosacea, hives)
Which of these have you noticed in your own life? As you can see, you have to decide if your health is worth taking care of so that you feel better and are able to be the caregiver your loved one needs. Prevention is much easier than fixing a problem after it has happened. You do deserve to be happy and healthy. You do deserve to provide better care and get your life back. My services can help you achieve your goals.
I know, it is usually more than two things, but, these two, in particular, seem to ramp up the need for 24/7 in-home care or transitioning to an assisted living facility. Toileting and Bathing. Some helpers/caregivers can help a spouse or partner with toileting and bathing duties with no problem, but when it comes to an aging parent, they can’t seem to handle those areas. Some are willing to learn how to do these things safely and some are not going to do them at all. Still, others will do it in an emergency situation, but not all the time. Whatever you choose is the right decision for you.
August 31, 2022
Emotions, feelings, physical strength, and preparedness are all important factors in helping someone to toilet or bathe. Embarrassment, Stress, Rebellion, Stubbornness, Shame, and whatever else shows up will have to be dealt with respectfully. Everybody will feel embarrassed.
We all want to do our private business by ourselves. Imagine, that you have had surgery on your right shoulder and your left arm is hooked up to an IV bag on a pole. Now, imagine that you have to go to the bathroom badly and it is not to pee. Can you wait on a nurse? No. A side note, it is so much easier to let someone, you don’t know, who is trained in helping a patient poop and then clean their bottom, help you than it is to let a partner, spouse, or loved one help you. I was so embarrassed to have someone that I knew and loved to wipe my bottom. It was an awful feeling. The person doing the wiping was great and it did not seem to bother her as she said, “I’ve cleaned my kids’ butts, no big deal.”
Pooping is a normal bodily function. Peeing is a normal bodily function. Why did I wig out over having to go? Because I could not take care of my needs at the time. I was vulnerable. I was embarrassed. I needed help. I am the one that helps others, I don’t need help. Although, I am not sure that I could wipe someone’s bottom that I love or care about on a regular basis. I probably could in an emergency, but not all the time. I guess we really don’t know what we will or won’t do until we are put in the situation. I have learned to never say never. Some of you are thinking, “Well, if you did it once, then you can do it again and again.” Probably, but I don’t want to!
It takes time, effort, and physical strength to help a loved one toilet and bathe. It takes someone that knows how to do these things appropriately and safely. It takes someone that is patient and kind throughout the entire process. Will both of you get over the embarrassment? If you can, then all the better to help your loved one be as independent as possible. Realizing that some help with toileting and bathing will help your loved one stay at home longer.
Grab bars are a must for the toilet and shower/bath. A raised toilet seat will help too. Non-slip decals need to be placed in the tub. Brighter light is a plus. Some bathrooms need to be heated with a ceramic floor heater or an oil-filled radiator heater. Be sure whatever you get, is appropriate and safe for a bathroom.
Schedule regular bathroom breaks every 2 – 4 hours. Give them time to get there. Pack your patience and a loving demeanor along with a loving tone. Give them directions and let them know what you are doing.
The toilet seat is right behind you. Squat down slowly to sit.
I am going to help you stand up now. Scoot your butt forward.
Lean forward and put your hands on my forearms when you are ready. Then ask them to raise/stand up. (Do not pull on their arms or legs. Hold on to the trunk of their body or their hips.)
If it is the opposite gender from you, learn to wipe properly. For example, an adult son, helping his mom toilet needs to know that to wipe a female, you wipe from the front to the back. So, put on your gloves and wipe from the vagina towards the rectum. This keeps fecal matter from getting into the vaginal opening and the urinary tract. Use wet wipes for cleaning and throw them in the trash can. Keep the private areas clean to lessen the chance of a UTI.
If the person you are helping has a dementia, remember that they can sense emotions so keep calm and carry on. Do not make a big deal out of anything. Do not mention clothes or the mess. Sing a song and carry on. They are going to have an accident.
Either they cannot make it to the toilet on time or they have no awareness that they need to “go,” The unawareness may be due to a dementia. It may also be that they have no warning from their brain signals that they have to “go.” They do not feel the urge. Sometimes, they feel the urge too late and can’t make it on time. Shit happens, literally. Use the adult undergarments. Don’t call them diapers. Absorbent underwear with pads under the bottom sheet in the pelvic area may help protect the mattress. If urinary or bowel incontinence is an issue at night, go ahead and place two bottom sheets on the bed with pads in the appropriate place. Keep the mattress dry. That way, you can strip off the top layer, get them cleaned up, and back into bed without too much fuss.
You may also try using an absorbent menstrual pad under the absorbent underwear to catch excess urine.
If they have a poop incident at night, you may have to strip them, get them in the shower, and wash them. Place some Vicks Vapo Rub under your nose to block some of the smell. Lotion them and redress them. If they are calm, then back to bed, and if not, go to the kitchen for a little snack or treat. Rinse the poopy clothes in the toilet to get as much fecal material off as you can. The same goes for the sheets and blankets. Launder in the washing machine. Sing a song and soldier on. The calmer you are the calmer they will be. If they do not have a dementia, the calmer you are the less stressed they will be. It is okay, it was an accident.
Learn their habits. When do they normally poop? After breakfast? After the second cup of coffee? After dinner? When do they usually pee? Another useful tidbit … wear easy-on and easy-off clothes. Help them to maintain their privacy and dignity as much as possible. Dignity is based on people’s feelings, emotions, and perceptions & other peoples’ reactions to them. Watch your tone of voice. Do not use words of any kind that associate with a “baby-state.”
Close the door when they are in the bathroom. Give them privacy (if it is safe).
Cover the top of their lap with a towel.
Give them extra time to sit. Bodies need to relax to pee and poop.
Knock before opening a door.
Turn your head away when they are pulling their pants up or down.
Do not discuss their business with others.
Do not restrict their fluid intake because of incontinence. You may slow it down after dinner, but never stop them from drinking. You need to encourage drinking throughout the day.
Let’s move on to showering.
Showering or bathing 3 times a week may be sufficient. You can use wet wipes for underarms, privates, feet, and rolls (where skin touches skin) on the other days. Lotion is good for their body and so is a face moisturizer. Clean clothes and underwear every day. Teeth brushed twice every day and flossed once a day.
Gather all supplies you will need (shower chair or bench, body soap/wash, pouf with a handle, 3 washcloths, shampoo, conditioner, shaving cream/gel, razor, 3 towels, robe, body lotion, etc.) Some use a barber’s cape to cover them.
Heat the bathroom with a heater.
Deep breathe and get yourself in the right frame of mind to help them.
Follow them in and help them toilet and undress. While they are on the toilet, start the shower and check the temperature before putting them in. A hand-held shower head is very useful. Warmer than lukewarm water, but not hot.
Have them use the grab bars and guide them to the shower seat. ** Note: if you know that you will be the one washing the private parts and bottom …Latex gloves on, have 2 washcloths ready, and use one for their front and one for their backside. Rinse well and then have them sit. **
You may drape a towel over their lap and shoulders to maintain dignity.
Allow them to wash on their own. You only help if they can’t get everything washed.
Wash the hair and condition it, first (always rinse well).
Wash the body from face down. Start with the face, neck, and ears. Then proceed to the shoulders, back, right arm, and left arm. Front of body, under breasts, right leg, right foot, and toes, left leg, foot and toes, Be gentle when lifting limbs. You may have to ask them to lean forward or to the side. Have them clean their bottom and private parts, if at all possible. This is easier while they are standing. Decide what works best for them, private parts first or last.
Drape a terry cloth robe around them (it helps in the drying process).
Try to pat dry and not rub vigorously (again, you want them to do everything they can do).
Look at the skin for any red or cracked places. If there are some, contact their primary care doctor. You may need to use a skin protectant like Calmoseptine.
Lotion everywhere, except between the toes. Make sure between the toes are completely dry. Make sure the genitals, perineal area, and bottom areas are dry as well.
Ask them about their normal routine for shaving. Some men shave in the shower and some shave after their shower at the sink. Ask the ladies if they want to shave, as some may no longer shave or even need to shave their legs. Ask them about shaving their underarms too.
Ask them if they prefer the morning, evening, or afternoon for a bath/shower.
When you need to help them wash body parts:
If you need to help them wash, use latex gloves (this barrier may make them and you feel more comfortable).
Use a clean washcloth for the genitals area and another clean washcloth for the anal area
For females, clean from front to back. Washing the inner thighs, labia groin and perineum.
dry the skin folds and skin underneath the breast.
Apply face moisturizer
Get them dressed in clean clothes and comfortable for a little rest afterward. They will be tired. Give them their favorite drink or snack.
For males, clean the tip and shaft of the penis and the scrotum & perineal area. For uncircumcised men, pull back the foreskin, wash, rinse and place the skin back into position.
Wash the anal area (where the poop comes out). Use a clean area of the washcloth with every pass.
Be quick, gentle, and efficient. Rinse well.
Always have clean sheets once a week after a bath. The little things do matter.
Yes, you will have a load of laundry to do after bath time. Accept it.
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
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.
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.
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
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
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.
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
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
Help/Monitoring physical therapy exercises at home
Checking blood sugar (how and when)
Checking blood pressure
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.
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.
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.
How caregiving is like working out, rest days are important.
April 13, 2022
Why is it okay to take a rest day or two from working out but, it is not okay to take a rest day from care giving or helping your loved one? Think about that. We have the research and the information about listening to our bodies. That rest days are just as important as workout days. That if you cannot mentally concentrate on a lifting day, you are better off skipping that workout. If you push through your chances of injury are greatly increased. Then what? You got it… you will have to take four to six weeks off to heal.
Helping out a loved one is the same kind of thing. Sometimes it is mentally exhausting and sometimes it is physically exhausting. You know that you need a break, but will you take a break? Will you push through? For how long? At what cost to you and your own health?
These are things that all of us need to think about. The problem is that we don’t think about these things. We just jump in and do. That is great, if it is for a short time. The problems arise after we have been helping for a longer period of time. Three to six months is what I consider a longer period of time. At about 18 to 24 months burnout has begun, if you have not gotten help or taken time outs.
I get it. It is hard when you are in the big middle of things to think about what would be best for all involved. You get in to survival mode and you just do. Some of us don’t want to think about what would be best for us and for out loved one. Thinking is hard and it takes a lot of energy when you are learning new things or doing new things. Remember, you only have about three hours of focused energy per day to use. When are your good hours? When are you able to concentrate and work on detailed projects the best? The rest of the day, you can do the things that do not take as much mental energy or focus.
Developing habits are good for us. They decrease the expenditure of mental energy. Basically, when we have habits, we do them and we do not have to waste any mental energy or focus to think about the “who, what, when, where, why” things. We just do. We have already learned. Some folks call it discipline and others call it a routine.
As with most of us, the most aggravating thing is trying to figure out where to go for dinner. How much time and energy is wasted on this simple act? We ask each other, “Where would you like to go?” The reply is usually, “I don’t care, where do you want to go?” Yes, you know what is coming next. “How about the Roadhouse, you ask?” Wait for it …. The reply is … “I don’t want to go there.” Here comes the hard part … do you say this or just think it? “Obviously, you do care. So, where do you want to go?” The back and forth continues, until finally a place is chosen. How do you feel after this discussion? Tired? A little miffed? Wondering why it is a chore to pick a place to eat? Sometimes, you can give them three options and they still do not like any of them. But, they don’t have any options to give you. Why is that? Sorry about that, I digressed.
How does the rest of your evening go? If both of you can let it go, the evening will probably be okay. If one or both of you do not let it go, then chances are you will not be having pleasant conversation the rest of the evening.
I wonder how much better and easier it would be if one of us said, from the beginning, “I would like to go to the Roadhouse, do you want to go?” The other person can say yes or offer another suggestion. Then the suggestion could be taken or not and they can go or stay at home. Shoot, one person gets to pick this time and next time the other person gets to pick.
We are trying to get a consensus, but sometimes that is not possible. The same thing happens when you are a helper or care giver. You may or may not get a consensus. A “good enough” decision has to be made. NOT perfect. Progress, not perfection is what we are after.
If you do not have habits or routine, try this for two weeks and see how you do and how you feel. Plan your breakfast every day. It does not matter if you eat at home or go and pick something up. Figure out what it will be the night before. Pick out your clothes and shoes the night before. Stick to this routine for two weeks.
Hopefully, you will find that having a routine frees your mental energy for other things. What day or days do you clean the house? Do laundry? Change the sheets? Workout? Run or walk? Schedule them like an appointment, until they become a habit. When they become a habit, the less focused mental energy you will use and will have that energy to do other things. Learning to manage your energy is much more efficient than managing time.
What happens when things do not go smoothly? What happens when things do not go our way? Stress levels rise.
February 23, 2022
Think about the turmoil in your life. The things that are stressing you out. The things that you are just uncertain about or confused about what to do next. Some of you need to take a few deep breaths right now.
Breathe in deeply through your nose for a count of 5 and exhale through pursed lips of a count of 6. Do this 5 times. Now, you can settle down and focus. You realize that “it” is not happening, right now and you are okay. Why would I want you to be able to focus? Why would I want you to realize that you are okay?
Because things run together. They get intertwined and become a big mess with you in the middle of the situation. You cannot think straight when you are in the big middle of a mess. Most of us do not like messes. We like it when things go smoothly and we especially like it when things go our way.
What happens when things do not go smoothly? What happens when things do not go our way? Stress levels rise. Reactions take priority over a plan. WTF, gets said multiple times. Dammit and shit are said a lot too. You may or may not say them out loud, but you sure are thinking them. It is okay, it can be a stress reliever and give you enough time for your thinking brain to catch up to your reacting brain. I know, friggin’ amygdala.
We have heard the phrase, what we resist, persists. Carl Jung is apparently the one who first stated this principle. Resistance is what stops us from getting things done. We use excuses, justifications, procrastination, perfectionism and even the voice in our head that is telling us that we aren’t good enough or we don’t have enough time. It also tells us other things, but you get the idea. Sometimes, you have to tell that inner critic to shut up.
We have resistance because we are afraid of something. We have resistance because we need to make some kind of change. We do not like change. It is hard and it takes energy to change. Resistance will always rear its ugly head when there is something that will need our energy and attention. We would be better if we learned to “let go” or let things be, just as they are. No judgement allowed. The goal is accepting things, just as they are, right now. If you keep resisting, then all of your focus and energy is going to something that you do not want.
Learn to refocus your energy and focus on what you DO want. You don’t give up. You won’t give up. It is not in your nature. Persistence is a good thing, especially if you are a helper or care giver.
Recognize your resistance triggers and when they will show up. Be curious about them. We all have them. The question becomes, will we give up or will we move forward? Visualize the success in your mind. Set your personal goals. That is all you have control over, anyway. Decide how you will act during a tough time. Maybe, you will need to take 5 – 10 minutes to gather your thoughts and figure out the next best step. No, not the whole plan. Just the next step.
When you find yourself in the middle of a crap storm, look around, take inventory. Is anyone in mortal danger? Is any one about to die? If not, then you have time to take a few minutes to see how best to proceed. I know you want the pain to stop. We all do. That is part of the resistance, we do not like change or the unknown it takes energy and time.
Some signs you may be in a resistant mode:
You are too busy
You are impatient
You forget things
You are not organized
You feel stuck or paralyzed
You are very impatient
You can’t or won’t make a decision
You find a reason Not to act
You complain a lot
You become defensive
You look for limitations and barriers
You avoid people or change
Antidotes to resistance:
Acceptance of how things are, right now
Observe and acknowledge how you are feeling
Let go of blame or judgement
Move – walk, run, work out, hike
Take the next step forward
You may have to start with accepting that you are not ready to accept what is. We resist because we don’t want to deal with “it.” We are fearful of the outcome. We may know intellectually what the outcome may be, but we are not emotionally ready for the outcome. It won’t go away. Get comfortable with being uncomfortable. Feeling out of control is another trigger.
Find the lesson. There is always a lesson that we are supposed to learn. A lesson about ourselves. A lesson about our loved ones. A lesson about trust. We do have a choice. We can choose acceptance and move forward. It won’t be easy, but you can do it. Acceptance never means giving up. It means finding new ways to have the best quality of life possible for you and your loved ones.
I am more of a “see where we are and what needs to be done,” kind of care giver. I don’t deny the facts, but I sure won’t give up either. We can no longer do it this way, so what about trying the other way? Focus on your realistic goals and options. You only have so much energy every day, don’t waste it on things that are not changeable or cannot be changed.
You don’t have to be okay with the “thing” that you are accepting. It doesn’t even mean that you feel good or peaceful about it. It requires courage to face the reality of “what is, right now.” Maybe, the word acknowledging is better than acceptance in some situations. It is okay to hate it and not know what to do. Use a person to be your sounding board so you can work through scenarios. Ask for input or suggestions, realizing that you get to choose to use that information or not.
Are you ready to make some kind of change?
Identify your “want” in the change (not the should)
Give yourself time to prepare for change
Visualize your life during the change and after the change
Prepare for set-backs and moving forward again
Be kind to yourself and acknowledge all of your victories (both large and small)
Create an action plan (Empowering Health Options does this, too)
Hands-on caregiver – you are physically there and you help with their daily needs (i.e., dressing, bathing, toileting, brushing their teeth, meal preparation and feeding).
Companion care – they can do most things on their own and you are there to provide company, keep them engaged with conversation (emotional support) and make some meals as well as medication reminders and light housekeeping. Maybe, take them to an appointment or on errands.
Long-distance caregiving – you probably live an hour or more away, you may be helping with money management, and you may be in charge of making appointments, finding in-home care assistance, and planning for emergencies.
Accidental caregiver – Oh crap, I did not see this coming, right now. I know that I have to help, but I am not sure what I am good at? I will muddle through.
Reluctant caregiver – you may find yourself responsible for someone who has abused you in the past or that you do not get along with. This one is very difficult and it may be best to find help immediately and place yourself in the long-distance caregiving camp.
A Swoop-in, create havoc and swoop on out caregiver – these folks need an ass whipping. They come in every once-in-a-while, state and do whatever they feel like, without regards to the care receiver or the other care givers and get things stirred up and then they leave. Most likely, these folks are just waiting for the care receiver to die so they will not have to be bothered.
Provider of support to the caregiver – Physically and emotionally help the caregiver to excel at being a caregiver. You help the caregiver with the chores or things that need to be taken care of at their house or the house of the care receiver. (Laundry, house cleaning, cooking a meal or two, mowing the lawn, cleaning the gutters, running errands, etc.)
Some of you have never identified as a caregiver, it is just something that you do. You are helping your mom. You are helping your dad. You are helping your wife. You are helping your husband. You have never viewed it as caregiving, they need help and I will help them. It is that simple.
You never even give it a second thought. That is what family does for each other. I get it, I have been there too. It is what good friends do for each other too. While we don’t identify with the word “caregiver,” that is what we are. A lot of us are the Lone Ranger. We are fine, for a while. We can manage our lives, our jobs, our homes and all of our loved one’s stuff, for a while. Usually, it is about 18 months in and we are stressed out, frustrated, tired and overwhelmed. We look up one day, and wonder how we got here? It happened so slowly and it wasn’t too bad or too hard. But, now, it takes a lot more time and effort to help our loved one.
Our love for them has not changed. Our goals for them have not changed. Our goals for ourselves have not changed. What has changed is our own health. We are tired and we just cannot get rested. Our eating habits are worse, we have gained weight and those stress headaches and lower back pain keep us off of our game. Work is work. It hasn’t slowed down and I am expected to perform at my best every day. I can’t concentrate as well as I used to. I find myself worrying more about my loved one and I can’t remember the last time I had some free time.
What would help you the most in the next three months?
Do you need an easy to use, fill-in-the-blank essential information binder?
The three things it will do for you –
Decrease your stress level
Empower you to be more in control, to make better decisions
Information will be easily accessed when needed
What is included in this Stress Buster, Time Saver, Information Binder:
Banking Information (including retirement information)
Bills – list of and when due
Doctors and other Health care providers list
HIPAA release form
Home information (home, vehicles, rental property)
Income to be received (from Social Security, Retirement, Renters, etc.)
Legal Documents needed
Medical bills and EOB’s (explanation of benefits, with tips and info)
Medical history (incl. diagnoses, surgeries, devices used, etc.)
Medicare and Medicare Advantage Plan (how to check on EOB or MSN for coverages and benefits)
Medications (list of medications, administration check-off list, incl. over-the-counter medications0
Online accounts (User names, Passwords, Answers to security questions)
Tasks to be done sheets
Available as a Binder Kit (with pages in sheet protectors, highlighters, ink pens and a mechanical pencil)
As a downloadable, fillable PDF file for Single use or Family Use
Use this link for more information and to Order product.
The next thing that may help you or your loved one is to KNOW whether the medications you are taking are working for you, against you or doing nothing for you. It is a genetic test for medications. You do it once and use the information for the rest of your life. It is a cheek swab. Have your own doctor, physician’s assistant or nurse practitioner order the test (they may use a prescription pad), get it to me and we will get you started.
For more information and a list of medications that have a genetic impact, click on this link
Option 1 is for an overview and is available to all.
Options 2 and 3 are researched, doable plans of action using best practices and your individual needs as guidelines. You will be heard and understood. These require a conversation and acceptance as they are customized and detailed.
** I won’t waste my time or your money, if these options are not for you. **
Options 2 and 3 are customized for the individual with researching, troubleshooting and support plans for the individual and the family.
The difference in Option 2 and Option 3 – Option 3 includes follow-up for three months instead of one month. With Option 3, updating the support plan is included. I am your guide and will help you to keep moving forward.
My goal with Option 2 or Option 3 is to help you have an understanding of your options, what you may be facing in the future and how to be as prepared as possible. To have the information that you will need to make decisions and choose the best options for you and your family.
Who do you know that could benefit from any of these products or services?
I need your help to get the word out about these products and services. I want to help those that need these things. If I can make their journey less stressful, that is what I want to do. Please pass along this information to those you know. Thank you for your time and effort.
All products and services are available throughout the U.S.