Category: #caregiver

Burnout stage or Nervous breakdown stage, as a Caregiver?

Posted on October 12, 2022 by - #alzheimers, #caregiver, #caregivers, #dementia, #parkinsons, Caregiver Information, stress

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

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

October 12, 2022

Everyone’s Caregiver Stressors are Different

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

A few things to watch out for:

    • You call in sick for a day or two (sometimes, longer).

    • You miss appointments.

    • You avoid or back out of social engagements.

    • You have trouble with healthy eating, exercising regularly, sleep, and your personal hygiene starts slipping.

    • You withdraw from people and don’t want to leave your home.

    • You lose interest in things that used to bring you joy.

    • Panic attacks.

    • PTSD flashbacks

Things pile on

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

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

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

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

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

Extreme burnout will lead to a mental health crisis.

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

Some causes of caregiver burnout include:

    • Emotional demands: A caregiver can feel emotionally drained, especially if you are aware that the person you are taking care of will not get better despite their efforts. For example, this could happen if a person is caring for someone in palliative care.

    • Conflicting demands: These are the additional demands a person has outside of their caregiving role, such as looking after children, going to a job, and making time for their partner.

    • Ambiguous roles: Often, the role of a caregiver is all-consuming. It is easy for a person to lose sight of who they are outside of their caregiving responsibilities.

    • Workload: Some caregivers may be looking after someone with complex needs. In these instances, it is important a person seeks temporary relief and gets assistance from other carers.

    • Conflicting advice: In some cases, treatment procedures may change as research progresses. While these changes aim to give people the best care, they can cause a significant amount of disruption and stress if a caregiver has an established routine.

    • Privacy: Additional clinical support, such as nurses and other healthcare professionals, may visit a caregiver’s home throughout the week. While this can be helpful, it can also take away their privacy.

All of these factors can contribute to a caregiver feeling overwhelmed, self-critical, and drained. If they do not address these feelings, they may start experiencing serious signs of caregiver burnout. Caregiving is both emotional and physically exhausting. 

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

Symptoms of caregiver burnout include:

    • disrupted sleep

    • persistent irritability

    • altered eating patterns

    • anxiety

    • increased alcohol consumption

    • high-stress levels

    • lack of joy

    • loneliness

    • loss of hope

    • suicidal thoughts

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

The three stages of caregiver burnout are:

    1. Frustration: A person starts feeling frustrated and disappointed that the person in their care is not getting better. They cannot accept that the person’s condition will decline regardless of how well they look after them.

    1. Isolation: After a while, a person may begin to feel lonely in their caregiving role. They may also grow tired of hearing negative opinions from family members, especially if these family members do not appreciate or recognize the time and effort caring requires. At this point, the caregiver may withdraw from friends and family.

    1. Despair: Eventually, a person may feel helpless and isolated. They can find it hard to concentrate, struggle to find joy in hobbies or interests, and avoid social interactions. The level of care they provide may also begin to drop as they spend less time on their own well-being.

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

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

Pat

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

Caregivers: How to balance expectations and reality when your care receiver won’t get better?

Posted on October 5, 2022 by - #alzheimers, #caregiver, #dementia, #multiplesclerosis, #parkinsons, Caregiver Information

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

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

October 5, 2022

Family caregiver denial

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

Some clues that you may be in denial about something:

    • You wonder, “If only she (or he) would …?

    • You doubt or dismiss your feelings.

    • Hope things will improve when …

    • You begin to feel resentful.

    • You walk on eggshells, trying to avoid a blow-up or avoid talking about the problems.

    • You may be worried that you will develop dementia yourself.

    • You avoid talking about the issue.

    • You avoid thinking about the problem.

    • You promise to address the problem in the future.

    • You minimize or rationalize what is going on

    • You become numb to your feelings

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

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

Caregivers have expectations

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

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

What expectations do you have?

Common signs that you have expectations:

    • Anticipating a certain outcome.

    • Having and holding a vision in your mind of how things will play out.

    • Having a set idea of what you want or need to happen.

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

When life isn’t fair

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

Learn to accept, “what is.”

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

We don’t deny reality

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

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

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

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

    • Happy & Sad

    • Scared & Excited

    • Confident & Doubtful

    • Love & Anger

    • Grief & Joy

    • Wanting time with your partner & Alone time

    • Believe in yourself & have a fear of failure

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

Pat

When folks with dementia wander or become aggressive, what can caregivers do?

Posted on September 28, 2022 by - #alzheimers, #caregiver, #dementia, #multiplesclerosis, #parkinsonsdisease, Caregiver Information

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

September 28, 2022

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

Regular Movement and Exercise Can Decrease Agitation and Aggression

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

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

Does your loved one with dementia wander?

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

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

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

Why we need to get tired

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

Don’t forget about brain use activities. They are important too. Coloring, making something, building something, and doing a puzzle are all important, too. It does not have to be perfect. 

I know that some of you caregivers are thinking, “I just want to get X, Y, and Z done.” Let your loved one help, give them a job. Be fully present and engaged with them. It won’t take any more time and it may even take less time because you won’t have all of the interruptions. People with dementia often want to help or contribute in some way. This is another area where daily routines are very beneficial. Set a time to go outside for a walk. Set a time for working out, doing brain work and help with folding towels. Yes, even if they have already been folded. Mess them up and give them to your loved one so they can help. 

People before things.

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

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

Strength and balance exercises are very important.

The health benefits of exercise include:

    • Improved mood

    • Better sleep

    • Reduced likelihood of constipation

    • Reduce or prevent wandering

    • Reduced aggressive behavior

    • Reduced risk of falls

    • Increased maintenance of motor skills

    • Improving heart health

    • Improved strength

    • Improved balance

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

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

For the mind:

    • Do a puzzle

    • Play a board game (Connect Four, Chutes & Ladders, Checkers)

    • Read a book aloud to them

    • Play a card game

  • Reminisce (ask them about childhood, hobbies, work life)

Pat

Behavior in a person with a dementia such as Alzheimer’s disease ALWAYS has a reason

Posted on September 22, 2022 by - #alzheimers, #caregiver, #dementia, #parkinsons, Caregiver Information

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

September 21, 2022

When people with dementia can’t tell you what is wrong

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

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

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

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

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

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

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

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

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

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

Sleeping problems in dementia

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

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

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

Medical possible causes of sleeping problems in dementia

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

    • brain damage (caused by the dementia) that affects the ‘biological clock’ in the brain that directs our sleep patterns

    • illness such as angina, congestive heart failure, diabetes or ulcers

    • pain caused by conditions such as arthritis

    • urinary tract infections that cause a frequent need to urinate

    • leg crampsor ‘restless legs’, which can indicate a metabolic problem

    • depressionthat causes early morning wakening and an inability to get back to sleep

    • side effects of medication, such as antidepressants and diuretics

    • snoring and sleep apnoea

    • ageing that causes sleep patterns to change so that some people need more sleep and some need less.

Things you can try include:

    • Discuss with the doctor the possibility of stopping or changing diuretic medication (which makes a person urinate), because this may be contributing to the problem.

    • Arrange a medical check-up to identify and treat physical symptoms.

    • Treat pain with an analgesic (pain-relieving medication) at bedtime if the doctor agrees.

    • Discuss with the doctor whether sedatives may be contributing to the problem.

    • Ask the doctor whether an assessment for depression may be necessary.

    • Ask the doctor about possible side effects of medication.

    • In some situations, it may be necessary to consider discussing with the doctor the appropriateness of either using tranquillising medication or sleeping medication. Sleeping medication may be helpful in the short term to establish a better sleep cycle, but both types of medication can have negative effects, such as increased confusion.

Environmental causes of sleeping problems in dementia

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

    • The bedroom may be too hot or too cold.

    • Poor lighting may cause the person to become disoriented.

    • The person may not be able to find the bathroom.

    • Changes in the environment, such as moving to a new home or having to be hospitalised, can cause disorientation and confusion.

Things you can try include:

    • Keep the environment as consistent as possible.

    • Check whether the person is too hot or cold when they wake up, because dementia can affect the body’s internal thermostat.

    • Provide adequate lighting if shadows, glare or poor lighting are contributing to agitation and hallucinations.

    • Move the mirror in the bedroom if the person becomes confused when they do not recognise their own reflection or the reflection of others in the room.

    • Install night-lights that might help cut down on confusion at night and may help the person to find the bathroom.

    • Place a commode next to the bed if finding the bathroom is a problem.

    • Make sure the bed and bedroom are comfortable and familiar, because familiar objects may help to orient the person.

    • Avoid having daytime clothing in view at night, because this may make the person think it is time to get up.

    • Make sure that the person is getting enough exercise – try taking one or two walks each day.

Other causes of sleeping problems in dementia

Other causes of sleeping problems may include:

    • going to bed too early

    • sleeping too much during the day

    • overtiredness, causing tenseness and inability to fall asleep

    • not enough exercise, so the person does not feel tired

    • too much caffeine or alcohol

    • feeling hungry

    • agitation following an upsetting situation

    • disturbing dreams.

Managing sleeping problems with food and drink

Some suggestions include:

    • Cut down on caffeine (coffee, cola, tea, chocolate) during the day and cut them out altogether after 5 pm.

    • Cut down on alcohol and discuss the effects of alcohol and medication with the doctor.

    • If you think the person may be hungry at night, try a light snack just before bed or when they wake up during the night.

    • Herbal teas and warm milk may be helpful.

Managing sleeping problems through daily routine

Some suggestions include:

    • Try not to do any tasks in the late afternoon that may be upsetting to the person.

    • If the person refuses to go to bed, try offering alternatives such as sleeping on the sofa.

    • In some situations, it may be necessary to consider discussing the appropriateness of either using sedative medication or sleeping medication with the doctor. If the person wanders at night, consider allowing this, but check that the house is safe.

    • Try a back rub before bed or during a wakeful period.

    • Try a radio beside the bed that softly plays music.

    • Gently remind the person that it is the evening and time for sleep.

Hoarding in dementia

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

Some causes of hoarding behaviours include:

    • isolation – when a person with dementia is left alone or feels neglected, they may focus completely on themselves. The need to hoard is a common response

    • memories of the past – events in the present can trigger memories of the past, such as living with brothers and sisters who took their things, or living through the Depression or a war with a young family to feed

    • loss – people with dementia continually lose parts of their lives. Losing friends, family, a meaningful role in life, their income and a reliable memory can increase a person’s need to hoard

    • fear – a fear of being robbed is another common experience. The person may hide something precious, forget where it has been hidden and then blame someone for stealing it.

Managing hoarding

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

    • Learn the person’s usual hiding places and check these first for missing items.

    • Provide a drawer full of odds and ends for the person to sort out, as this can satisfy the need to be busy.

    • Make sure the person can find their way about – an inability to recognise the environment may be adding to the problem of hoarding.

Repetitive behaviour in dementia

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

Managing repetitive behaviour

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

    • If an explanation doesn’t help, distraction sometimes works. A walk, food or doing a favourite activity might help.

    • It may help to acknowledge the feeling expressed. For example, ‘What am I doing today?’ may mean that the person is feeling lost and uncertain, and a response to this feeling might help.

    • Do not remind the person that they have already asked the question.

    • Repetitive movements may be reduced by giving the person something else to do with their hands, such as a soft ball to squeeze or clothes to fold.

Wandering in dementia

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

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

Reasons that a person with dementia might wander include:

    • changed environment

    • loss of memory

    • excess energy

    • searching for the past

    • expressing boredom

    • confusing night with day

    • continuing a long-held habit

    • agitation

    • discomfort or pain

    • believing they have a job to perform.

Managing wandering

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

    • Get a physical check-up for the person to help identify whether illness, pain or discomfort has triggered the wandering.

    • Discuss the side effects of medication with the doctor – try to avoid medication that may increase confusion, and cause drowsiness and possibly incontinence.

    • Consider the psychological causes of wandering to try to determine if the person is anxious, depressed or frightened.

    • Make sure that the person carries some form of identification that includes their current address, if travelling

    • Use identification cards available from Alzheimer’s Australia.

Sundowning in dementia

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

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

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

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

Know your own warning signs of frustration:

    • Shortness of breath

    • Knot in the throat

    • Stomach cramps

    • Chest pains

    • Headache

    • Compulsive eating

    • Excessive alcohol consumption

    • Increased smoking

    • Lack of patience

    • Desire to strike out

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

Pat

Engage your loved one who has had a stroke or has a dementia, don’t be a babysitter!

Posted on September 15, 2022 by - #alzheimers, #caregiver, #caregivers, #dementia, #parkinsonsdisease, #strokesurvivor, Parkinsons, Stroke Survivor

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

September 14, 2022

When you are doing basic tasks

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

Your loved one can sense your attitude

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

We talk a lot about dementia patients, but let’s focus on care receivers that have a physical disability, such as stroke survivors. Stroke survivors need repetition and to continuously try things. It takes them longer but they can get better and better. 

They need help and encouragement.

    • Encourage them to do the exercises they have been given by their physical or occupational therapists. You have to rewire the brain and movement is key.

    • Allow them to do what they can do, even if they struggle. Unless they ask for your help, let them keep working on it. Be helpful, but not overbearing.

    • You may have access to a social worker or counselor, and use them for help and resources. An occupational therapist can help with identifying home modifications that would help.

    • New stroke side effects may arise after going home. Be alert and contact their doctor.

    • Understand that sometimes, the stroke survivor may have a little setback, before they move forward again.

    • Always push past the plateau. There may be a time (3-6 months after a stroke) that “getting better” seems to level off. It may seem that way, but the brain is still healing and working. Keep on, keeping on. Changing exercises or rehab strategies may help, too.

    • There may be emotional changes after a stroke. There may also be outbursts of laughing or crying due to pseudobulbar affect.

    • Report falls to doctor

    • Don’t give up, keep striving for the best. (Independence depends on this.)

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

Some of the symptoms that a stroke survivor may experience:

    • Loss of control of movement &/or feeling in some parts of the body (This usually occurs on the side of the body opposite from the side of the brain affected.)

    • Changes in muscle tone on the affected side of the body

    • Involuntary muscle contractions

    • Difficulty sitting, standing or walking

    • Reduced ability to balance

    • Problems with speaking and/or understanding speech

    • Confusion and/or poor memory

    • Decreased control over bladder, bowel or both

    • Difficulty swallowing

    • Reduced control over emotions

The following is from Johns Hopkins Medicine

What are the effects of stroke?

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

The brain is divided into 3 main areas:

    • Cerebrum (right and left sides or hemispheres)

    • Cerebellum (top and front of the brain)

    • Brainstem (base of the brain)

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

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

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

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

    • Movement and sensation

    • Speech and language

    • Eating and swallowing

    • Vision

    • Cognitive (thinking, reasoning, judgment, and memory) ability

    • Perception and orientation to surroundings

    • Self-care ability

    • Bowel and bladder control

    • Emotional control

    • Sexual ability

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

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

The effects of a right hemisphere stroke may include:

    • Left-sided weakness or paralysis and sensory impairment

    • Denial of paralysis or impairment and reduced insight into the problems created by the stroke (this is called “left neglect”)

    • Visual problems, including an inability to see the left visual field of each eye

    • Spatial problems with depth perception or directions, such as up or down and front or back

    • Inability to localize or recognize body parts

    • Inability to understand maps and find objects, such as clothing or toiletry items

    • Memory problems

    • Behavioral changes, such as lack of concern about situations, impulsivity, inappropriateness, and depression

The effects of a left hemisphere stroke may include:

    • Right-sided weakness or paralysis and sensory impairment

    • Problems with speech and understanding language (aphasia)

    • Visual problems, including the inability to see the right visual field of each eye

    • Impaired ability to do math or to organize, reason, and analyze items

    • Behavioral changes, such as depression, cautiousness, and hesitancy

    • Impaired ability to read, write, and learn new information

    • Memory problems

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

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

Although strokes are less common in the cerebellum area, the effects can be severe.

 Four common effects of strokes in the cerebellum include:

    • Inability to walk and problems with coordination and balance (ataxia)

    • Dizziness

    • Headache

    • Nausea and vomiting

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

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

Some common effects of a stroke in the brainstem include problems with:

    • Breathing and heart functions

    • Body temperature control

    • Balance and coordination

    • Weakness or paralysis

    • Chewing, swallowing and speaking

    • Vision

    • Coma

Unfortunately, death is possible with brainstem strokes.

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

FYI – Help stroke survivors to stay motivated.

Set relevant and achievable goals

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

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

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

Find what motivates them

When motivation fails, discipline takes over – just do it

Pat

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

Posted on September 8, 2022 by - #alzheimers, #caregiver, #caregivers, #dementia, Caregiver Information

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

September 7, 2022

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

Try for a both/and solution and not an either/or solution when you are the caregiver

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

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

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

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

Here are some ways that your own mind will kick your ass when you are wondering what your caregiving responsibilities are…

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

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

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

Things you do not have control over:

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

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

Will you reduce your personal stress?

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

The following information is from Family Caregiver Alliance

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

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

Steps to Managing Stress (Before you get to caregiver burnout)

  • Recognize warning signs early. These might include irritability, sleep problems, and forgetfulness. Know your own warning signs, and act to make changes. Don’t wait until you are overwhelmed.
  • Identify sources of stress. Ask yourself, “What is causing stress for me?” Sources of stress might be that you have too much to do, family disagreements, feelings of inadequacy, or the inability to say no.
  • Identify what you can and cannot change. Remember, we can only change ourselves; we cannot change another person. When you try to change things over which you have no control, you will only increase your sense of frustration. Ask yourself, “What do I have some control over? What can I change?” Even a small change can make a big difference. The challenge we face as caregivers is well expressed in the following words modified from the original Serenity Prayer (attributed to American theologian Reinhold Niebuhr):
  • “God grant me the serenity to accept the things I cannot change,
    Courage to change the things I can,
    and (the) wisdom to know the difference.    ”
  • Take action. Taking some action to reduce stress gives us back a sense of control. Stress reducers can be simple activities like walking and other forms of exercise, gardening, meditation, or having coffee with a friend. Identify some stress reducers that work for you.

Pretty good information, huh?

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

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

10 Health Problems Caused by Chronic Stress

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

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

Pat

What are the two things that, usually, trigger a need to move a loved one into an assisted living facility (especially a person with a dementia or Alzheimer’s disease)?

Posted on August 31, 2022 by - #alzheimers, #caregiver, #dementia, Caregiver Information

I know, it is usually more than two things, but, these two, in particular, seem to ramp up the need for 24/7 in-home care or transitioning to an assisted living facility. Toileting and Bathing. Some helpers/caregivers can help a spouse or partner with toileting and bathing duties with no problem, but when it comes to an aging parent, they can’t seem to handle those areas. Some are willing to learn how to do these things safely and some are not going to do them at all. Still, others will do it in an emergency situation, but not all the time. Whatever you choose is the right decision for you.

August 31, 2022

Emotions, feelings, physical strength, and preparedness are all important factors in helping someone to toilet or bathe. Embarrassment, Stress, Rebellion, Stubbornness, Shame, and whatever else shows up will have to be dealt with respectfully. Everybody will feel embarrassed.

Helping Your Loved One with Privacy and Personal Hygiene

We all want to do our private business by ourselves. Imagine, that you have had surgery on your right shoulder and your left arm is hooked up to an IV bag on a pole. Now, imagine that you have to go to the bathroom badly and it is not to pee. Can you wait on a nurse? No. A side note, it is so much easier to let someone, you don’t know, who is trained in helping a patient poop and then clean their bottom, help you than it is to let a partner, spouse, or loved one help you. I was so embarrassed to have someone that I knew and loved to wipe my bottom. It was an awful feeling. The person doing the wiping was great and it did not seem to bother her as she said, “I’ve cleaned my kids’ butts, no big deal.”

Pooping is a normal bodily function. Peeing is a normal bodily function. Why did I wig out over having to go? Because I could not take care of my needs at the time. I was vulnerable. I was embarrassed. I needed help. I am the one that helps others, I don’t need help. Although, I am not sure that I could wipe someone’s bottom that I love or care about on a regular basis. I probably could in an emergency, but not all the time. I guess we really don’t know what we will or won’t do until we are put in the situation. I have learned to never say never. Some of you are thinking, “Well, if you did it once, then you can do it again and again.” Probably, but I don’t want to!

You better be strong and patient

It takes time, effort, and physical strength to help a loved one toilet and bathe. It takes someone that knows how to do these things appropriately and safely. It takes someone that is patient and kind throughout the entire process. Will both of you get over the embarrassment? If you can, then all the better to help your loved one be as independent as possible. Realizing that some help with toileting and bathing will help your loved one stay at home longer.

Safety needs for older folks and memory care folks

Grab bars are a must for the toilet and shower/bath. A raised toilet seat will help too. Non-slip decals need to be placed in the tub. Brighter light is a plus. Some bathrooms need to be heated with a ceramic floor heater or an oil-filled radiator heater. Be sure whatever you get, is appropriate and safe for a bathroom.

Schedule regular bathroom breaks every 2 – 4 hours. Give them time to get there. Pack your patience and a loving demeanor along with a loving tone. Give them directions and let them know what you are doing.

    • The toilet seat is right behind you. Squat down slowly to sit.

    • I am going to help you stand up now. Scoot your butt forward.

    • Lean forward and put your hands on my forearms when you are ready. Then ask them to raise/stand up. (Do not pull on their arms or legs. Hold on to the trunk of their body or their hips.)

Learn to wipe properly

If it is the opposite gender from you, learn to wipe properly. For example, an adult son, helping his mom toilet needs to know that to wipe a female, you wipe from the front to the back. So, put on your gloves and wipe from the vagina towards the rectum. This keeps fecal matter from getting into the vaginal opening and the urinary tract. Use wet wipes for cleaning and throw them in the trash can. Keep the private areas clean to lessen the chance of a UTI.

If the person you are helping has a dementia, remember that they can sense emotions so keep calm and carry on. Do not make a big deal out of anything. Do not mention clothes or the mess. Sing a song and carry on. They are going to have an accident.

Nighttime Accidents:

Either they cannot make it to the toilet on time or they have no awareness that they need to “go,” The unawareness may be due to a dementia. It may also be that they have no warning from their brain signals that they have to “go.” They do not feel the urge. Sometimes, they feel the urge too late and can’t make it on time. Shit happens,  literally. Use the adult undergarments. Don’t call them diapers. Absorbent underwear with pads under the bottom sheet in the pelvic area may help protect the mattress. If urinary or bowel incontinence is an issue at night, go ahead and place two bottom sheets on the bed with pads in the appropriate place. Keep the mattress dry. That way, you can strip off the top layer, get them cleaned up, and back into bed without too much fuss.

You may also try using an absorbent menstrual pad under the absorbent underwear to catch excess urine.

If they have a poop incident at night, you may have to strip them, get them in the shower, and wash them. Place some Vicks Vapo Rub under your nose to block some of the smell.  Lotion them and redress them. If they are calm, then back to bed, and if not, go to the kitchen for a little snack or treat. Rinse the poopy clothes in the toilet to get as much fecal material off as you can. The same goes for the sheets and blankets. Launder in the washing machine. Sing a song and soldier on. The calmer you are the calmer they will be. If they do not have a dementia, the calmer you are the less stressed they will be. It is okay, it was an accident.

Do’s and Don’ts

Learn their habits. When do they normally poop? After breakfast? After the second cup of coffee? After dinner? When do they usually pee? Another useful tidbit … wear easy-on and easy-off clothes. Help them to maintain their privacy and dignity as much as possible. Dignity is based on people’s feelings, emotions, and perceptions & other peoples’ reactions to them. Watch your tone of voice. Do not use words of any kind that associate with a “baby-state.”

    • Close the door when they are in the bathroom. Give them privacy (if it is safe).

    • Cover the top of their lap with a towel.

    • Give them extra time to sit. Bodies need to relax to pee and poop.

    • Knock before opening a door.

    • Turn your head away when they are pulling their pants up or down.

    • Do not discuss their business with others.

    • Do not restrict their fluid intake because of incontinence. You may slow it down after dinner, but never stop them from drinking. You need to encourage drinking throughout the day.

Let’s move on to showering.

Showering or bathing 3 times a week may be sufficient. You can use wet wipes for underarms, privates, feet, and rolls (where skin touches skin) on the other days. Lotion is good for their body and so is a face moisturizer. Clean clothes and underwear every day. Teeth brushed twice every day and flossed once a day.

Shower day:

    • Gather all supplies you will need (shower chair or bench, body soap/wash, pouf with a handle, 3 washcloths, shampoo, conditioner, shaving cream/gel, razor, 3 towels,  robe, body lotion, etc.) Some use a barber’s cape to cover them.

    • Heat the bathroom with a heater.

    • Deep breathe and get yourself in the right frame of mind to help them.

    • Follow them in and help them toilet and undress. While they are on the toilet, start the shower and check the temperature before putting them in. A hand-held shower head is very useful. Warmer than lukewarm water, but not hot.

    • Have them use the grab bars and guide them to the shower seat. ** Note: if you know that you will be the one washing the private parts and bottom …Latex gloves on, have 2 washcloths ready, and use one for their front and one for their backside. Rinse well and then have them sit. **

    • You may drape a towel over their lap and shoulders to maintain dignity.

    • Allow them to wash on their own. You only help if they can’t get everything washed.

    • Wash the hair and condition it, first (always rinse well).

    • Wash the body from face down. Start with the face, neck, and ears. Then proceed to the shoulders, back, right arm, and left arm. Front of body, under breasts, right leg, right foot, and toes, left leg, foot and toes, Be gentle when lifting limbs. You may have to ask them to lean forward or to the side. Have them clean their bottom and private parts, if at all possible. This is easier while they are standing. Decide what works best for them, private parts first or last.

    • Drape a terry cloth robe around them (it helps in the drying process).

    • Try to pat dry and not rub vigorously (again, you want them to do everything they can do).

    • Look at the skin for any red or cracked places. If there are some, contact their primary care doctor. You may need to use a skin protectant like Calmoseptine.

    • Lotion everywhere, except between the toes. Make sure between the toes are completely dry. Make sure the genitals, perineal area, and bottom areas are dry as well.

    • Ask them about their normal routine for shaving. Some men shave in the shower and some shave after their shower at the sink. Ask the ladies if they want to shave, as some may no longer shave or even need to shave their legs. Ask them about shaving their underarms too.

    • Ask them if they prefer the morning, evening, or afternoon for a bath/shower.

When you need to help them wash body parts:

    • If you need to help them wash, use latex gloves (this barrier may make them and you feel more comfortable).

    • Use a clean washcloth for the genitals area and another clean washcloth for the anal area

    • For females, clean from front to back. Washing the inner thighs, labia groin and perineum.

    • dry the skin folds and skin underneath the breast.

    • Apply face moisturizer

    • Apply lotion.

    • Apply deodorant.

    • Brush teeth.

    • Get them dressed in clean clothes and comfortable for a little rest afterward. They will be tired. Give them their favorite drink or snack.

    • For males, clean the tip and shaft of the penis and the scrotum & perineal area. For uncircumcised men, pull back the foreskin, wash, rinse and place the skin back into position.

    • Wash the anal area (where the poop comes out). Use a clean area of the washcloth with every pass.

    • Be quick, gentle, and efficient. Rinse well.

Always have clean sheets once a week after a bath. The little things do matter.

Yes, you will have a load of laundry to do after bath time. Accept it.

Pat

Pondering: When you think about “thinking about” making a decision

Posted on August 4, 2022 by - #alzheimers, #caregiver, #caregivers, Decision criteria

It happens one of two ways. One, you see or hear something that triggers the thought. Two, an incident happens and you know that you will have to deal with it sooner or later. You will hear yourself say, “I need to check on “this thing.” Sometimes, it will be, I am going to have to make a decision on “this thing,” and I need to start thinking about it.

August 3, 2022

We ponder a lot, but are we stalling?

We think about thinking about stuff all the time. It isn’t high up on our priority, but we know that we will have to deal with “it” soon. Soon, as in, it’s coming. Oh well, we don’t have a timeline/deadline yet, so I guess I can think about thinking about it later. The “it” may be an oil change. The “it” may be a medical issue. The “it” may be a work project.

We do this pre-contemplation for a lot of things in our lives. How do we prioritize? What can we do to make the prioritization process easier? Surprisingly, we need inspiration. A moment of clarity about new possibilities and options. Do you want to reach your goals? Your inspiration helps in your journey to reach your desired goals.

Which of these words for inspiration helps you to see your capabilities?

Creativity                    Inventiveness                          Ingenuity                                 Imagination

Originality                   Individuality                           Artistry                                    Revelation

Brainwave                   Brainstorm                              The “Aha” moment                 Genius

Insight                         Vision                                      Incentive                                 Motivation

Find Your Top 3 Goals or Decisions to be Made

Now, that you have identified some of your capabilities you would be best served to find your top three goals. Hang with me here. You need your top goals to figure out what is important to you and to help guide the direction that you will be going. Laser focus is much better than the shotgun approach. Why? To maximize your energy levels. Remember, you only have so much focused energy per day. The other way that it helps is so you can decide what really does need to be done, what can wait, and what can be discarded (things you don’t need to do or you don’t need to do yourself). What if you could focus on the things that you can control?

You cannot control your feelings or thoughts. But, you can be curious about them and accept them as they are with no judgment of good or bad. You can control how you react and act. Be present, right now. The present situation is what you can work on. You cannot change anything about the past. There will be challenges and obstacles and sometimes, you will need some help.

You can control time and effort, but not the outcome

You can control how much time and effort you put into a problem, relationship, or work issue, but you cannot control the outcome. We all hate that part. Have your “can do attitude” ready for the things you can control.

Back to prioritizing. You know that we chase a few rabbits. Urgency and importance are the key factors in prioritizing. The Eisenhower box is a great tool to use.

Are you able to recognize what needs to be accomplished? Do you comprehend the task? Do you know why you should do it? Feelings and emotions will probably arise about prior experiences or things we have lived before. Prior choices, prior consequences, prior successes, etc.

What systems do you have in place for yourself to help you succeed? Routines, habits, scheduling, flexibility, rearranging ever-changing priorities, allowing for adequate amounts of time, etc.

Patience and persistence will pay off while learning this new skill of prioritizing and planning. You will mess up and you will feel frustrated, but you will progress. Practice kindness to yourself, not beating yourself up. Just get back on track and try again. We are not looking for perfection we are looking for progress. Celebrate your efforts. That is what builds resilience.

What are some barriers to prioritizing?

    • Not making time to prioritize.

    • Not seeing the “big picture.”

    • Getting distracted by time wasters or the little things.

    • Not delegating what can be delegated.

    • Refusing to adapt when you get new or better information.

Learning your core values also helps in prioritizing and making decisions.

Pat

What is your stress sweet spot?

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

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

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

July 27, 2022

Vacation Time and Break Time

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

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

Good Stress

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

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

Good stress:

    • It feels doable.

    • We know the stress is only temporary.

When good stress  becomes bad:

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

    1. You can’t control it.

    1. It takes up all of your time.

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

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

Bad Stress Will Wear You Out

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

Bad stress:

    • It no longer feels doable.

    • The stress is not temporary.

Could your stress be harmful?

You make mistakes on things that are routine for you.

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

You feel stuck or paralyzed.

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

You are not eating well.

You are not working out or exercising.

You are not sleeping very well.

.

Is it possible to turn bad stress into something good?

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

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

    1. Identify the resources that you have at hand.

    1. Collaborate with others.

    1. Learn something new.

    1. Have a positive perspective.

    1. Sometimes, you just have to be positive.

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

    1. Good and restful sleep.

    1. Eat for nutritional health.

    1. Do something physical.

    1. Meet with your social support system.

    1. Quiet your inner critic.

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

Pat

How your attitude affects your problem solving skills

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

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

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

July 20, 2022

Friggin’ Amygdala and the Problem-solving Process

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

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

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

Structure of Attitudes

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

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

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

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

This model is known as the ABC model of attitudes.

Does a negative attitude affect problem-solving skills?

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

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

The FISH Philosophy to help problem solve

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Back to problem-solving.

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

Improve problem-solving skills

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

    • Some ways to create a positive attitude:

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

    • Take breaks during your day

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

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

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

    • Look forward to something outside of work

    • Practice meditation, walk, work-out

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

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

    • Hang-out with positive people

    • Be open to possibilities

    • Stop the “stinking thinking”

    • Sit with your feelings and acknowledge them

    • Recharge your batteries

    • Stop complaining

    • Assume responsibility, choose your response

    • Laugh

Pat

Caregivers: Do You Know Your Limitations?

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

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

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

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

July 13, 2022

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

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

Realizing and Recognizing Your Limits Can Actually Benefit You

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

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

Definitaion of Stress

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

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

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

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

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

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

    • Anger – an angry person often reacts without thinking

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

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

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

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

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

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

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

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

Signs of Caregiver Burnout

    • Feeling anxious

    • Feeling irritable

    • Feeling stressed

    • Feeling resentment

    • You are neglecting your own health

    • You are missing out on important events

    • You are not eating properly

    • You are not exercising

    • Your finances are taking a hit

    • You feel lonely

    • Increased alcohol consumption

    • Overreacting

    • Impatience

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

Pat

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

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

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

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

July 6, 2022

Know your strengths and weaknesses

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

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

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

Some tasks that caregivers do, provide and handle.

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

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

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

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

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

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

    • Handle finances and other legal matters

    • Be a companion

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

    • Be some emotional support

    • Be backup care and extra care when needed

    • Take care of lawn maintenance, outside house maintenance

    • Help with wheelchair usage

    • Help with oxygen usage

    • Help with CPAP machine usage

    • Help them walk with a belt to decrease fall risks

    • Help turn them and move them in bed

    • Help with hearing aid insertion and removal

    • Help with false teeth

    • Bathe them (maintaining modesty and dignity)

    • Change sheets with them in the bed

    • Pay bills

    • Housekeeping

    • Laundry

    • Help/Monitoring physical therapy exercises at home

    • Checking blood sugar (how and when)

    • Checking blood pressure

    • Checking weight

    • Handle a crisis or an emergency

    • And much more

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

Online Trainings Available

Tennessee Department of Health

NFSP

Meet Caregivers Caregiver Training

Caregiver Training online course

A Place for Mom trainings and videos

APFM videos and courses

These will get you started.

What about your own physical strength?

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

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

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

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

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

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

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

Pat

One of the Caregiving Tolls: Negative Emotions Caregivers Feel

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

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

June 29, 2022

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

Accepting what you feel

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

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

Give yourself permission to vent

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

Don’t feel guilty about your feelings.

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

The problem isn’t that you have negative feelings

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

Suggestions:

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

    • Go to a support group meeting

    • Cry

    • Go for a run or walk

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

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

    • Cleaning

    • Take a break, call in reinforcements

    • Take a hot shower or soak in a bath

    • Watch a TV show or a movie

    • Whatever is healthy and works for you

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

When the guilt and negative emotions rear their ugly heads

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

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

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

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

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

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

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

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

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

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

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

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

Try this exercise when you feel safe.

    1. Identify the emotion

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

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

    1. Let that emotion return back inside of you

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

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

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

Pat

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

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

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

June 22, 2022

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

    1. You are not patient.

    1. You do not have the time.

    1. You are finding excuses not to do it.

    1. You cannot do the kind of care required.

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

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

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

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

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

It may depend on your loved ones specific needs

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

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

Maybe, their needs have increased

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

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

Time to set bourndaris as a family caregiver

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

Yes, caregivers often have guilt

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

Are you feeling guilty because?

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

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

    • You aren’t taking care of yourself?

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

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

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

    • You moved your mom into assisted living?

    • You resent the time caregiving takes?

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

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

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

    • It is normal to feel frustrated, in general.

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

    • It is normal to feel anger at times.

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

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

    • It is normal to silently scream in your head.

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

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

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

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

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

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

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

    • It is normal for you to miss your job.

    • And, a bunch of other things.

Setting boundaris will keep caregivers and care receivers safe

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

Examples of non-negotiables:

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

    • That you speak to yourself in a kind manner.

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

    • Keeping your word to yourself and others

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

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

    • Having fun

    • Resting/Sleeping

Find your most important values

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

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

Pat

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

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

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

June 15, 2022

Are you a caregiver?

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

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

It gets hard to be a caregiver, my own experience

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

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

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

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

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

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

Personality Traits of a Happy Caregiver

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

    • Compassion – understanding what the other person is dealing with

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

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

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

    • Detail Oriented – good management skills

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

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

    • Flexible – able to cooperate with others

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

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

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

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

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

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

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

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

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

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

Pat