Category: #caregiver

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

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

July 6, 2022

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

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

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

Some tasks that caregivers do, provide and handle.

  • Buy groceries, cook, clean house, do laundry, provide transportation
  • Help the care receiver get dressed, take a shower, take medicine
  • Transfer someone out of bed/chair, help with physical therapy, perform medical interventions—injections, feeding tubes, wound treatment, breathing treatments
  • Arrange medical appointments, drive to the doctor, sit in during appointments, monitor medications
  • Talk with doctors, nurses, care managers, and others to understand what needs to be done
  • Spend time handling crises and arranging for assistance—especially for someone who cannot be left alone
  • Handle finances and other legal matters
  • Be a companion
  • Be a (usually) unpaid aide, on call 24/7
  • Be some emotional support
  • Be backup care and extra care when needed
  • Take care of lawn maintenance, outside house maintenance
  • Help with wheelchair usage
  • Help with oxygen usage
  • Help with CPAP machine usage
  • Help them walk with a belt to decrease fall risks
  • Help turn them and move them in bed
  • Help with hearing aid insertion and removal
  • Help with false teeth
  • Bathe them (maintaining modesty and dignity)
  • Change sheets with them in the bed
  • Pay bills
  • Housekeeping
  • Laundry
  • Help/Monitoring physical therapy exercises at home
  • Checking blood sugar (how and when)
  • Checking blood pressure
  • Checking weight
  • Handle a crisis or an emergency
  • And much more

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

Tennessee Department of Health

NFSP

Meet Caregivers Caregiver Training

Caregiver Training online course

A Place for Mom trainings and videos

APFM videos and courses

These will get you started.

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.

Pat

One of the tolls of caregiving … Negative Emotions

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

June 29, 2022

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

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

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

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

Don’t feel guilty about your feelings.

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

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

Suggestions:

  • Call or text with a supportive friend, family member or another caregiver
  • Go to a support group meeting
  • Cry
  • Go for a run or walk
  • Journal – let it free flow and write whatever comes up
  • Find a punching bag (a real one or a pillow) to punch, throw or scream into
  • Cleaning
  • Take a break, call in reinforcements
  • Take a hot shower or soak in a bath
  • Watch a TV show or a movie
  • Whatever is healthy and works for you

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

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

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

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

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

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

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

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

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

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

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

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

Try this exercise when you feel safe.

  1. Identify the emotion
  2. Close your eyes and put the emotion 5 feet in front of you (you want to look at it)
  3. Give your emotion a size, shape and color – watch it and recognize it for what it is
  4. Let that emotion return back inside of you
  5. Reflect on what you noticed. Did you notice any change in the emotion when you got some distance from it?

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

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

Pat

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

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

June 22, 2022

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

  1. You are not patient.
  2. You do not have the time.
  3. You are finding excuses not to do it.
  4. You cannot do the kind of care required.

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

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

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

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

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

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

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

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

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

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

Are you feeling guilty because?

  • You aren’t spending enough time with your mom?
  • You aren’t spending enough time with your spouse and kids?
  • You aren’t taking care of yourself?
  • You aren’t focused at work due to your caregiving to-do lists?
  • You forgot  to do something that your dad needed you to do?
  • You let your mom  stay in her own home too long?
  • You moved your mom into assisted living?
  • You resent the time caregiving takes?
  • You think your life would be easier if they died?

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

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

  • It is normal to feel frustrated, in general.
  • It is normal to feel frustrated with the time it take your loved one to do anything.
  • It is normal to feel anger at times.
  • It is normal to want all of this to be over.
  • It is normal to hate yourself for feeling certain ways.
  • It is normal to silently scream in your head.
  • It is normal to enjoy aspects of your time together.
  • It is normal to wonder  if your marriage will make it through this.
  • It is normal to hate missing your kids’ games.
  • It is normal for you to be numb and not feel anything, just handle it.
  • It is normal to feel guilty when you take some “me” time.
  • It is normal for you to want to throat punch the next person that tells you that you should take care of yourself.
  • It is normal for you to want to run away.
  • It is normal for you to miss your job.
  • And, a bunch of other things.

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

Examples of non-negotiables:

  • Your physical, mental and emotional well-being – What will you do to protect them?
    • What won’t you do to protect them?
  • That you speak to yourself in a kind manner.
  • A healthy relationship with yourself – Eating nutritious food, walking, running, working out, reading for pleasure
  • Keeping your word to yourself and others
  • Your core  values – honesty, love, joy, happiness, reliability, respect, openness, trust, accountability, etc.
  • I will be kind to myself, when I make mistakes
  • Having fun
  • Resting/Sleeping

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

No one is perfect. We will all mess up, from time to time. What is the pattern? Do the same things keep happening over and over? Are you making allowances for them/it? Why?

Pat

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

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

June 15, 2022

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

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

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

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

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

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

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

Personality Traits of a Happy Caregiver

  • Patience – especially with questions, angry outbursts, length of time to do things
  • Compassion – understanding what the other person is dealing with
  • Empathy – understanding the feelings that others may be feeling or thinking
  • Humor – finding something to laugh about in these difficult situations. We know how serious things are, but we need to laugh. Not at the person, but at the situation or other things.
  • Present – be in the here and now, focusing on what they can do
  • Detail Oriented – good management skills
  • Able to Accept Help – a good caregiver lines up a team to help out
  • Able to Set Boundaries – know your own limits and say “no” when needed
  • Flexible – able to cooperate with others
  • Assertive Advocate – getting the answers needed, making sure their loved one has what they need; being firm but not being an asshole (at first)
  • Creative – some days things will work and other days you have to find something else that works
  • Good Communicator – learn to communicate with your loved one in the way that they can communicate, especially if they are non-verbal now

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

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

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

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

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

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

Pat

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

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

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

June 8, 2022

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Here, I stole this from Family Caregiver Alliance.

Tips for Winning More Support from Your Siblings

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

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

The above 8 steps are from Family Caregiver Alliance

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

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

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

Pat

Signs of a bad caregiver.

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

June 1, 2022

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

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

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

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

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

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

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

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

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

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

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

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

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

FYI

SIGNS AND SYMPTOMS OF SPECIFIC TYPES OF ABUSE

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

Pat

When is overthinking bad?

Calling all perfectionists and overachievers …

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

May 18, 2022

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

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

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

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

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

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

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

Is it possible to stop overthinking?

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

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

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

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

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

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

How can you tell if you are overthinking?

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

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

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

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

Sometimes, you just have to declare it DONE!

Pat

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

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

May 11, 2022

Observations

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

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

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

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

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

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

Psychosis can be:

  • Due to stressful life experiences or trauma
  • Part of a neurological condition such as dementia. Alzheimer’s disease, or Parkinson’s disease
  • Triggered due to a brain injury
  • Medication side effects
  • Effects of illicit or illegal drugs such as marijuana or cannabis
  • Effects of alcohol withdrawal
  • Triggered by menopause
  • Triggered during times of severe stress or anxiety

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

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

Understand that some classes of drugs can cause psychosis.

Classes of meds that may cause psychosis:

  • Muscle relaxants
  • Antihistamines
  • Antidepressants
  • Cardiovascular medications
  • Antihypertensive medications
  • Analgesics
  • Anticonvulsants
  • Antiparkinsonian medications
  • Chemotherapy agents
  • Corticosteroids
  • Stimulants

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

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

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

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

Common signs and symptoms of psychosis includes:

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

  • Hearing voices or sounds that others don’t
  • Seeing things that others do not see
  • Tasting things when you haven’t had or eaten anything
  • Feeling someone touching you who is not there
  • Smelling things which other people cannot smell

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

You may worry:

  • That you are being followed by secret agents or members of the public
  • People are out to get you or to kill you (may be strangers or people that you know)
  • That a chip has been implanted in your brain to monitor your thoughts
  • That your food or water is being poisoned
  • That you are a powerful person or God

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

  • Problems concentrating
  • Memory problems
  • Difficulties understanding new information
  • Having a difficult time making decisions

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

  • Paranoia and terror
  • Hallucinations. A person might see, smell, or hear things that aren’t there.
  • Delusions. A person may adopt demonstrably false beliefs, such as that a demon is pursuing them.
  • Dangerous behavior. A person might attempt to fly, harm themselves because a voice told them to do so, or become a danger to others. Some people who experience psychosis become aggressive.
  • Disconnection from other people or from reality. A person may appear catatonic or totally withdrawn.

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

  • It appears while under the influence of or withdrawing from a drug.
  • It comes on suddenly.
  • It is typically more intense than other forms of psychosis.

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

Methamphetamine

Cocaine

Marijuana

LSY

Peyote

Mushrooms

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

PCP

Ecstasy

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

Pat

Manage your energy, not your time!

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

April 27, 20222

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

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

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

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

What can you do to rest your brain? 

  1. Go for a walk
  2. Take a nap between 10 minutes up to an hour
  3. Take a shower, leisurely
  4. Play sports
  5. Stretch
  6. Go outside
  7. Journal
  8. Color or Draw
  9. Watch animals play
  10. Listen to music

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

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

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

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

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

Pat

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

Conflicts inside our mind

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

April 20, 2022

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

A few examples:

  1. You feel frustrated and angry at the health care system (doctors, hospitals, insurance companies) but, yet, you need them.
  2. You are disappointed in the lack of communication but you are unsure how to fix it.
  3. You are not sure that your loved one has the financial resources that they will need to have the best care possible for them, yet, you are not sure how much, if any, you can contribute.
  4. To be an advocate, you need good, science-based information that works for you and your needs.
  5. The frustration of unmet clinical concerns (diagnoses, treatment plans, home needs).
  6. Our inner child emerges and is ready for battle.
  7. Our compassion and losing the ability to be compassionate.
  8. Our Ego gets bruised and then we act out instead of seeking to find the best solution.
  9. Conflict with yourself – taking care of yourself along with taking care of your loved one.
  10. Unresolved family issues rear their ugly head.
  11. And many more…

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

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

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

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

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

Back on task.

What does the evidence say to you?

What does the logic say to you?

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

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

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

Write these things down and answer them:

I am concerned about ____________________________________________________

I am afraid that _____________________________________________is going to happen.

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

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

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

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

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

Pat

When to take a rest day.

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.

Which of these fits you today?

8 SIGNS YOU NEED A REST DAY

1. YOUR RESTING HEARTRATE IS ELEVATED

2. YOU FEEL TIRED

3. YOU’RE MOODY

4. YOU FEEL SICK

5. YOU’RE ALWAYS SORE

6. YOU’VE HAD A FEW BAD WORKOUTS IN A ROW

7. NOTICE YOU’RE NOT GETTING ANY STRONGER

8. YOU FEEL THAT YOU NEED A REST DAY

From Tough Mudder https://toughmudder.com/blog/no-excuses/signs-need-a-rest-day/

14 Signs you need a rest day from being a helper or care giver

  1. Feeling “trapped” or hopeless
  2. Losing patience or compassion for your loved one
  3. Overreacting to small accidents
  4. Resenting or neglecting your loved one
  5. Withdrawing from your personal hobbies and friendships
  6. Oversleeping or not sleeping enough
  7. Overeating, not eating enough, or eating a lot of high-sugar foods
  8. Having health problems
  9. Abusing drugs or alcohol
  10. Having thoughts of suicide
  11. Making mistakes
  12. You are irritable
  13. Signs and symptoms of depression
  14. You feel exhausted most of the time

I can’t say it any better than Daily Caring has said it in their article.

6 WAYS TO MAKE IT EASIER FOR CAREGIVERS TO TAKE A BREAK

1. Accept that you’ll feel guilty
Guilt is a normal part of caregiving simply because you care – it’s never going to disappear. 

Don’t let this stop you from getting the caregiving help you need.

Taking regular breaks is the best way to maintain your overall health and your ability to provide care.

Besides, how good would you feel if you never took any breaks and your health declined to the point where you could no longer care for your older adult? 

It doesn’t do them any good if you’re not physically or mentally well enough to be their caregiver.

2. Don’t ask your older adult for permission
This isn’t a decision that your older adult gets to make. 

Many older adults refuse outside help because they’re uncomfortable with the idea. 

And someone with dementia doesn’t have the cognitive ability to make a rational decision.

When seniors refuse, they’re not thinking of your needs and are often not considering their own true needs either. 

That’s why you need to make the decision, regardless of how they feel about it.

All that matters is that they’re safe and well cared for when you’re not there.

3. Start before you really need it (if possible)
It may take some time to find the right person to help and for them to learn the caregiving routines. 

That’s why it’s helpful to find help before you really need it.

When you’re putting together a team of family, friends, and volunteers, it can be less stressful if you have some time to get the team in place and work out the details.

To make the transition easier, you could have someone come and shadow you until they learn the ropes and can be left alone with your older adult. 

Or, you could have someone come for a short time in the beginning and gradually increase their time as everyone adjusts to the new situation.

4. Combine paid services with help from friends, family, and volunteers
Hiring caregiving help can be expensive. But even if the cost is high, maintaining or improving your health is worth it.

Being open to different sources of help also lowers the cost of taking regular breaks. 

Ask family or friends for help and seek out local volunteer programs that offer companionship services.

Then supplement those hours with paid help as needed.

5. Check in to know that your older adult is well-cared-for
You might be afraid or nervous to leave your older adult with a stranger or a family member with limited experience. 

To give you greater peace of mind, use simple, discreet ways to keep an eye on them and make sure they’re treating your older adult well.

You could sometimes come back early as a surprise check-in to see what’s been happening. 

Or while you’re out, call occasionally to hear how things are going. 

Another good move is to ask the caregiver to take notes so you’ll know what happened while you were out.

6. Be creative when introducing the hired caregiver
Nobody wants to be told that they’re getting a babysitter. 

If your older adult is very resistant to outside help, be sensitive and creative when introducing them to the household. 

A careful approach is especially important to prevent seniors with Alzheimer’s or dementia from reacting with fear or anxiety.

For example, you could introduce the person as your helper around the house and have them help you with meal prep, light housekeeping, and simple care tasks. 

After a few of these visits, it will seem normal that they’re around and it will be easier for you to leave to “run errands.”

You could also position it as doing that person a favor. Perhaps you could say that this person is in need of extra income, so you’re helping them out with a few hours of work here and there.

If family or friends are helping, you could say that they wanted to visit and spend some time catching up. When they become regular visitors, you can start popping out to “run errands.”

By DailyCaring Editorial Team

Pat

How to make stress work for you?

April 6, 2022

Let’s start with a definition of stress.

Stress: a state of mental or emotional strain or tension resulting from adverse or very demanding circumstances.

Now, notice that it does not say anything about negative or positive stress. Have you ever even wondered about that? Some may think that all stress is negative. Not true. Positive stress happens, too. Positive stress (Eustress) or good stress is the type of stress response that we feel when we are excited.

Stressors are thoughts or challenges. They can be positive or negative. Stress and how it affects you depends on your mindset.

What Is Stress Mindset?

Again, it’s how you view stress, what it means to you.

  • Is it a threat – something that will negatively affect your emotional state, your performance (physical and mental), even your health?
  • Or is it a challenge that lifts you to a higher level of energy and performance? (i.e. the stress response is helping you cope.)

Why Stress Mindset Matters

A negative stress mindset views stress as harmful, a threat – and therefore something to be avoided, averted, maybe even suppressed. Negative consequences are:

  • You’ll avoid challenges and opportunities for growth and development (as with a fixed mindset).
  • Trying to avoid stress, and in particular trying to suppress the body’s stress response, actually amplifies it and makes the feeling of stress and anxiety worse, and probably longer lasting.
  • You can get locked into a state of chronic stress response, which is actually harmful (unlike short bursts of stress) – your stress mindset becomes self-fulfilling.

A positive stress mindset means stress is a challenge to be embraced, moving you to perform better. The stress response is your body’s mobilizing energy to help you meet the challenge. It feels like excitement, not anxiety. In other words, although there is still a physical stress response, it doesn’t feel like stress at all.

I stole, I mean, borrowed this from Stress Resilient Mind

Distress Stressors:

  • Financial crises
  • Solo caregiving
  • Death of a loved one
  • Relationship problems
  • Illness or Injury
  • Abuse
  • Feeling neglected
  • Worrying about someone else
  • Work problems
  • Deadlines

What happens to the body during stress?

The body’s autonomic nervous system controls your heart rate, breathing, vision changes and more. Its built-in stress response, the “fight-or-flight response,” helps the body face stressful situations.

When a person has long-term (chronic) stress, continued activation of the stress response causes wear and tear on the body. Physical, emotional and behavioral symptoms develop.

Physical symptoms:

  • Aches (headaches, body aches, etc.)
  • Pains (lower back pain, neck pain, etc.)
  • Chest pain or heart racing
  • Trouble sleeping
  • Exhaustion
  • Dizziness
  • Muscle tension
  • Jaw clenching
  • Stomach problems
  • Weaker immune system
  • Trouble with or lack of interest in sex

Emotional or Mental symptoms:

  • Anxiety
  • Irritability
  • Sadness
  • Depression
  • Panic attacks

Stress is subjective and cannot be measured with tests. Only the person experiencing the stress gets to determine how severe it is! That being said, we can look at the physical and mental symptoms you are having and we can also assess whether you are handling the stress with healthy or unhealthy behaviors.

Negative Stress:

Examples of unhealthy behaviors:

  • Alcohol misuse – drinking too much and/or too often
  • Medication misuse – taking a medication for other than its intended purposes
  • Food misuse – overeating, excessive eating of sweets, eating disorders
  • Smoking
  • Gambling
  • Shopping

Examples of healthy behaviors:

  • Deep breathe for 3-5 minutes four to six times a day
  • Eat for nutrition
  • Hydrate with water and other non-caffeinated beverages
  • Walk or run regularly – four to five times a week for 20 minutes at a time
  • Practice relaxation techniques
  • Mindfulness meditation
  • Sleep enough
  • Make time for your hobby
  • Talk therapy
  • Re-framing the situation
  • Journaling for 10 minutes each day
  • Setting realistic goals

Find your own personal mantra:

  • I did not cause this and I cannot fix this.
  • I cannot control the outcome; all I can do is to do my best.
  • I cannot change this situation and no amount of worrying will change the situation.
  • It is okay that the situation is not okay, I am moving forward and doing my best.
  • I can control how I react now, and that is all I can or have to control.
  • It is okay that I did not get it all done today, I have accomplished a lot today.
  • Things are not too good today, but I have adapted.
  • Let it go = let it be just as it is, right now

Create your own saying or mantra. One that is empowering and meaningful to you.

Sometimes stress is telling you to pay attention, something needs to change around here. Something is out of whack. Look at it. Is there a fix? Yes. Great, do it and move forward. Is there a fix? No. Great, let it be and move forward.

I know, I know. It is not normal to let things be and move forward. We all have to understand that our problems arise when we refuse to believe that what is happening cannot be fixed and we don’t like it! It is the internal struggle that is wearing us out. How much better off would we be, if we would accept things the way that they are, right now? It does not mean that we don’t try to make things better. It does not mean that we don’t move forward. We adapt. We reassess.

Re-frame the situation. How in the hell do you re-frame the situation? Start by noticing “stinking thinking.” Get ready to write some things. No, you cannot just think about them. That is part of the problem, you are in your head too much. Get the paper and pen or pencil.

  1. Write down your thoughts. (What is causing the anxiety?)
  2. Fact-check your thoughts. (Are they true? What is the proof?)

Truth is on a spectrum, it takes in to account your experiences, life stories and belief system. Facts are facts. They are true everywhere and for everyone.

 3.When you are really feeling stuck, ask, “Is this helpful?

4. What would you say to a close friend that is having the same thoughts are you are?

5. What is realistic, not positive? Finding a positive thought about a negative situation is not realistic. You don’t have to put a positive spin on it.

6. Screw “the bright side,” find “the meaning.” Get out of the “all-or-none” type of thinking. It doesn’t have to be an “either/or” situation, it can be a “both/and,” type of situation.

7. What is the next right action to take?

8. Try this for a week or two. Give it time or work or fail. Then reassess, make a plan and try again.

Reframing is not the best way to deal with every situation, but it sure can be a helpful tool. Use reframing to take an alternate view of the situation.

What are your skills and traits? Identify your strengths. Identify the areas that you are not so good at to find out either what you need to learn or you will learn that you need to let someone else handle the job.

If you are using all of your energy focusing on the negative, then you will have little to no energy left to find any good in the situation or to look for possible solutions. Use your energy wisely, you only have so much focused energy to use every day (about 3 hours).

Positive Stress:

Some stress can be good for you. How do you know if it is good stress?

Positive Stress Characteristics:

  • Focuses Energy
  • Motivates you
  • Within our coping abilities
  • Feels exciting
  • Improves performance
  • Short-term (you will still have physiological changes to your body)
  • Challenges for learning, growth and achievement
  • Sense of purpose

Positive Stressors:

  • New relationship
  • Wedding
  • Upcoming holidays
  • Retirement
  • Vacation
  • Pregnancy
  • Taking on a new project at work
  • Physical conditioning
  • Learning something new
  • Buying a home
  • Graduating
  • New job
  • Self-care

Positive stress is key for developing resilience. That is what we are all after. The ability to handle whatever happens both good and bad. To get back to the point that we know we are going to be okay.

Pat

If it isn’t visible, it isn’t happening and other bull$%^!

If it hasn’t happened to them, they have no idea what is going on. But, a lot of them have an opinion about how you are; how you should or should not feel. Even if they have experienced it, it may not be the same as how you experience it.

March 9, 2022

We are all different. Our life experiences are different. Our pain tolerance is different. Our bodies are different. Sure, they are comparable, but they are not exact. We metabolize foods and medications differently or not at all. So many variables affect our immune system. So many things affect the inflammation inside of our bodies.

Biological processes are variable. Cultural traits are different. Genetic make-ups are different. We all have special qualities. We have our own body type.

When did healthy become based on appearance?

You can be really thin and be very unhealthy. You can be overweight and be really healthy. People of all shapes, sizes, weights, can either be healthy or unhealthy. You are in your body 24/7 how do you feel and what is going on with you? Is your body nourished with the foods that it needs? I am not talking about stress eating or emotional behaviors, just plain old giving your body what it needs to function at its highest level. Food, hydration, rest, activity and sleep are all important for a healthy body.

What happens when a body has an autoimmune disorder? An autoimmune disorder is a condition when your own immune system mistakenly attacks your body. It destroys healthy body tissue by mistake.

How would you think a person might feel while all of this is going on inside their body? They have pain, tiredness, fatigue, nausea, rashes, headaches, dizziness and more depending on what disease they have. They feel these things, All-of-the-time, because they have these things all-of-the-time. It would be rare for them to not to feel bad because their body is under attack.

My hope is that these folks are working with their doctors and other health care providers to find out what works best for them and their needs. To have the best quality of life possible. I only want folks to take the medications that they need. To use other means to help manage their conditions. Nutrition, hydration, strengthening, mindfulness-based stress reduction meditation, stretching, rest and activity. It takes all of these things plus medications to improve quality of life.

I get it. It is hard to do all of these things, work full-time, have a family life, friends, etc. Don’t look at it as giving things up. Look at it as caring for yourself to improve your energy and strength so you can spend more time with those that you love and do the things that you enjoy doing. Your friends and family can do all of those things with you, except, take your medication. It is probably easier to have a work-out buddy to keep you engaged and committed to the routine. That is the key anyway. It will become a routine and then a habit. Once it is a habit, you no longer have to use a lot of brain energy to figure out all the particulars.

Living with a chronic disease is hard. It is hard on the person that has it and it is hard on those that love them. It sucks to make plans and then they get cancelled because of a flare-up or a bad day. Once or twice, you can usually get over it, but more than that, it begins taking a toll on all involved.

No body wants to make plans because they get cancelled. A wall begins to build up. Everybody is pissed and nobody is talking to nobody about the elephant in the room. Maybe, it is because you don’t want each other to feel bad? Maybe, it’s because, you know that sometimes shit happens and you have to adjust.

It is great to realize all of that. You must also talk with each other about it. How you see things, how it makes you feel and what you want. You aren’t really mad at each other; you are mad at the situation. If you are mad at each other, I suggest you go and get counseling now. It does not matter if it is a partner relationship or a friend relationship, you do need help in navigating these issues.

Too often, only the medical side is addressed. No body wants to deal with the messy part of a chronic illness. The parts that leave families strained and sometimes broken. You have to deal with the messy parts. Once you do and you have a workable plan, it can make all the difference in your relationships. It is not easy, but the results are worth it. In my business, I deal with the medical side and most parts of the messy side. If you need a therapist, I will recommend that.

Learning and understanding what is truly going on with a person that has a chronic illness is eye opening. Being able to modify plans or activities will improve relationships. You want them at their best, so what are you going to do to help them get to their best?  Can you relate to what they are experiencing?

Pain is subjective. We all have different tolerances and what may be a 10 (the absolute worst pain you have ever had) may be a 3 or 4 (mild to moderate) to me. I am sure you have heard people state that they have had a kidney stone and it was the worst pain possible. It has to be worse than having a baby. Why? Because you “say so?”  Because the pain you experienced was the worst pain in your life does not mean that it was worse than the pain of childbirth. Some of you mom’s that have had both can speak to this. I have heard a few moms say that childbirth pain was the worst and I have heard a few moms say that the kidney stone pain was worse.

Here comes a rabbit chasing. No one needs to suffer from uncontrolled pain. I understand that all pain cannot be eliminated and that is not really the goal of treating chronic pain. We treat chronic pain to help those with that type of pain to live the best quality of life possible. An active life. A fulfilling life. Managing the pain to a tolerable level is the goal. Treating chronic pain takes a multi-prong approach. Medication alone will not provide the relief needed. Strength training is one way to reduce pain. Running or walking is another way to reduce pain. Eating for nutritional needs, is yet, another way to reduce pain. Hydrating every day is another way to reduce the pain. It is all connected. Yes, I know there are many different types of pain. Thus, the multi-prong approach. I don’t believe in cookie cutter approaches to treating pain. People are different, their pain is different, their tolerances are different, medications work for some, but do not work for others. It is very easy to get frustrated when every thing that you try does not work. I use a combination approach with my clients and that seems to work better for pain relief and pain control. It will take effort, some fine tuning to the plans to get the right combination that works for you, but it will be worth it. Rabbit chasing over, for now.

After a while, folks just give up. The one with the chronic illness and the one without the chronic illness, just give up. If your loved one has a chronic illness, help them to become they best they can be. Encourage them to take back control of their life. Help them to focus on the solutions and not the freaking problems. What can they do? What can they improve? What will it take to help them? You can’t make them, but you can encourage them, believe in them and help them when they ask. You can’t do it for them and they do get to decide what they will or won’t do.

To the one without the chronic illness, you need to take a look at your beliefs about the one that has the chronic illness. This may get ugly. Do you understand what they go through every day? Do you understand that they feel like they let everybody down? Do you understand your part in not being able to go and do? Are you becoming an enabler to their lack of action or lack of participating in activities? There are other things, but you get the idea.

Don’t give up! There are things to try. There are things that will make your life easier. Get ready to look forward to activities again. Yes, you have to think about getting ready. You have to reason it out in your mind. The negatives will come rushing at you. All of the “you have tried this and it didn’t work,” thoughts will flood your mind. It may not have worked then, but it is possible that it will work now by doing “x,y and z.” If you are not open to the possibility that things can get better and actually be better, then they won’t.

Who do you need to add to your health care team? Me? A sports psychologist? A nutritionist? A therapist/psychologist? A trainer? A workout partner? A deal with my anger and other emotions therapist?

An autoimmune disorder may cause destruction of body tissue, may cause an abnormal growth of an organ, or even cause changes in organ function. The areas most often targeted are blood vessels, connective tissue, joints, muscles, your skin, red blood cells, your thyroid or your pancreas and other endocrine glands.

Very few of these disorders can be seen. It is all happening inside the body.

Here are some of the most notable autoimmune disorders:

Next time, we will touch on other non-visible health conditions such as migraine, depression, heart disease, etc.

Pat

How the senses change in dementia…

No, they are not just being difficult.

March 2, 2022

Your loved one is having an unexpected reaction to the food they are eating. They stop eating, declaring that it has no taste. They become very apprehensive while walking through a door into a restaurant. They are nervous and are becoming more and more irritated. They cannot seem to judge how to sit down in the seat. They seem so distracted that they cannot read the menu or decide what to order.

These things and more are due to the brain not being able to process the sensory inputs correctly or in a timely manner. Their sense of taste and smell have lessened or may even become non-existent. When areas are too dark, they are unable to differentiate the floor from the walls, tables or chairs. Their depth perception is way off and maybe they begin to sway more and even fall more. Noisy places can send them over the edge. Too much sensory information overload can cause a meltdown and unwanted lashing out behaviors. The talking, the music, the televisions may be too much for them to handle.

You probably will not be able to calm them down and so it is best to remove them from the situation. They cannot follow the conversation with all of the distractions. They will become disoriented more easily and their balance will be affected as well.

Why is this sensory overload happening? It could be an auditory processing disorder. That can be tested by an audiologist. In mild cognitive impairment, any dementia, including Alzheimer’s disease too much “noise” can strain the brain and make it work harder. Our brains only have so much focused energy to use during the day and an impaired brain, has way less energy to use. If they expend all their energy on the “noise” issue they have no energy left to work on anything else. They may be able to hear well, but they cannot process/interpret the sensory input. By the way, hearing also affects balance.

Sight/Vision issues:

  • Lack of depth perception
  • Decrease in ability to detect movement in the room
  • Decrease in ability to see colors
  • Problems recognizing people, faces or things
  • Shadows and light can mess with their minds and what they think they are seeing   .
  • They may be able to see, but are unable to interpret what they are seeing.
  • Things may appear blurry.
  • They may no longer have peripheral vision.
  • They will need more light to see.

Smell issues:

  • Sense of smell decreases
  • They can no longer smell smoke, odors, foods that may be spoiled.

Taste issues:

  • Sensitivity to taste declines in dementias.
  • The last taste to go is the sweet taste.
  • They will add a lot of salt, if the salt shaker is visible.
  • It is perfectly fine to use other spices to help them “taste” their food.
  • When the sense of smell goes, taste goes too.

Touch issues:

  • They may be unable to tell when things are hot. You might want to decrease the hot water heater temperature.
  • They may not know when they have cut themselves with a knife.
  • They may not be able to tell the difference in hot water and cold water on their body.

Hearing issues:

We talked a little about that in our example above.

  • A person with dementia may have normal hearing, but they will probably be unable to process the information correctly. Remember, we hear with our brains.
  • Competing noises are very distracting. Even if it is normal to you, a person with a dementia cannot filter out the extraneous noises.
  • Are the batteries in their hearing aids good? Are their hearing aids working?
  • Do they need to be checked by an audiologist? NOT, a hearing aid specialist.
  • They need a quiet setting. Low music is usually fine. TV is not good and needs to be turned off, while they are eating and talking.

Impaired movement issues:

  • They may take shorter steps.
  • They may drift to one side.
  • They may shuffle their feet.
  • They may slow way down as they walk.

Balance issues:

  • It becomes harder to judge distances and they may bump in to things.
  • They struggle or can no longer negotiate stairs.
  • Balance and coordination may be off and so they trip or fall more easily.

Stiffness/Shaking issues:

  • The muscles can become more rigid which makes it more difficult to move.
  • The muscles can become tighter and restrict movements.
  • The muscles can waste away from inactivity and malnutrition.

Coughing/Choking issues:

  • The ability to chew and swallow may become compromised and even lost.
  • It becomes easier for them to aspirate and a pneumonia set up in their lungs.

A person with a dementia is actually having brain failure. The brain can no longer receive, process, interpret and react to sensory signals appropriately. What is so frustrating is that sometimes our loved ones are “all there and with it,” other times, they cannot do anything. No rhyme or reason. Some days and moments are good and other days & moments suck.

Pat

What is your resistance costing you?

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:

  1. You procrastinate
  2. You are too busy
  3. You are impatient
  4. You forget things
  5. You are not organized
  6. You feel stuck or paralyzed
  7. You are very impatient
  8. You can’t or won’t make a decision
  9. You find a reason Not to act
  10. You complain a lot
  11. You become defensive
  12. You look for limitations and barriers
  13. You avoid people or change

Antidotes to resistance:

  1. Acceptance of how things are, right now
  2. Observe and acknowledge how you are feeling
  3. Let go of blame or judgement
  4. Move – walk, run, work out, hike
  5. 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?

  1. Identify your “want” in the change (not the should)
  2. Give yourself time to prepare for change
  3. Visualize your life during the change and after the change
  4. Prepare for set-backs and moving forward again
  5. Be kind to yourself and acknowledge all of your victories (both large and small)
  6. Create an action plan (Empowering Health Options does this, too)

Pat