Category: #caregivers

Supplements that can mess up your meds

Posted on March 22, 2023 by - #caregivers, Medications not working, overmedication, too many meds

Supplements and Medications Interactions

At your last checkup, your doctor told you to take calcium 500 – 600 mg twice a day because your bone density tests indicate that you have osteopenia. Osteopenia is a decrease in bone mineral density below normal reference values, but not low enough to meet a diagnosis of osteoporosis.

Ok, no big deal. You pick some up and begin taking them. Wait, there could be a big deal. Do you take medication for your thyroid, such as levothyroxine? Are you taking doxycycline or ciprofloxacin for an infection? If yes, you cannot take the calcium supplements with the thyroid medication or the antibiotic. They need to be separated by two hours. There are other medications that are made less effective by calcium. 

March 22, 2023

Calcium effects – Medication interactions

Calcium binds up the medications (those that are affected by it) and makes them less available for absorption and may decrease the effectiveness of your medications. Some of your medications may increase the absorption of calcium causing too much calcium in your body. Kidney problems or serious side effects of calcium may occur.

You may have tolerated problems in your earlier years, but now you are 60 or older and things are changing. Your kidneys don’t filter as well. Your liver may not be able to metabolize things as well as it once did, causing an increase in side effect problems or adverse drug events.

Be more aware of supplements and drug interactions

I want you to be more aware of what can impact your medications. Some things cause too little of your medication to be absorbed. Some things cause too much of your medication to be absorbed. If you are taking supplements, find out what you can and cannot take with your current meds. Find out the best time to take your supplements.

Iron, Potassium, Vitamin K

Over-the-counter Iron supplements, potassium supplements, or vitamin K supplements can cause problems too. St. John’s wort is another supplement that may cause problems. A lot of folks are on medications that are used to treat high blood pressure medications, heart medications, antidepressant medications, and blood thinners such as warfarin, or antiviral medications.

It matters!

You need to know what can and can’t be taken together. You need to know when to take what. You need to know that the fat-soluble vitamins A,D,E,K can build up in your body. Some of you have been told that you “pee out what your body doesn’t absorb” which is not entirely true. Did you know that your body can only absorb 500 – 600 mg of calcium at a time?

PPI’s and Medication interactions

Even gastric acidity affects some medications. Are you taking a proton pump inhibitor (PPI) such as Prilosec® (omeprazole), Nexium® (esomeprazole), Prevacid® (lansoprazole), etc.? If you have to take an iron supplement and you take a PPI, your iron is probably not being absorbed as the gastric acid is “less acidy.”

Certain foods can also interfere with medication absorption. Examples include Grapefruit, Kale, Dairy, Yogurt, Alcohol, and Tyramine-rich foods.

Common things that we don’t think about that affect medications:

  1. ·       Nicotine use
  2. ·       Alcohol
  3. ·       Caffeine
  4. ·       Our diet
  5. ·       Changes in medical conditions
  6. ·       Changes in illness (usually a decline)
  7. ·       Infections

Aging and what the body does to drugs

With aging comes changing pharmacokinetics. Pharmacokinetics is what the body does to drugs. These changes include Absorption, Distribution across body compartments, Metabolism, and Excretion. The metabolism and excretion of many drugs decrease, which means your dosage probably needs to decrease as well. Absorption is not usually a clinically significant problem unless other factors come into play. As we age body fat usually increases and total body water decreases. This can affect the distribution of drugs that are lipophilic (dissolves in lipids or fats). Hepatic (liver) metabolism through the cytochrome P-450 system, decreases with age. Renal (kidney) elimination. This one actually begins to decline at about age 40.

As you can see, there are a lot of factors that can impact your medication’s ability to do its job. Your pharmacist can help you with these issues. 

Pat

Can you have a difficult conversation and be respectful?

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

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

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

March 15, 2023

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

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

When you are self-aware and emotionally healthy:

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

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

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

·       You are empathetic to the other person.

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

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

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

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

When you are not emotionally healthy or self-aware:

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

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

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

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

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

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

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

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

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

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

·       Rest and get good sleep.

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

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

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

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

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

Our scenario:

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

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

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

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

The main thing – stop driving

Why’s –         

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

§  Problems with mobility or coordination

§  Vision problems

§  Hearing loss

§  Sleep disorder

§  Seizures

§  Inability to turn their head and neck very far

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

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

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

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

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

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

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

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

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

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

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

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

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

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

A few tips:

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

·       Do not be sarcastic.

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

·       Look at them in the eye.

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

·       Stick to their abilities and not their age.

·       Remember to value the relationship.

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

·       Watch your tone.

·       Remember to deep breathe.

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

·       Have them drive you around.

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

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

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

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

What disrespect looks like and sounds like

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

·       People stop talking when you enter a room.

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

·       They continuously interrupt you.

·       Angry or rude outbursts

·       Bullying

·       Shaming you

·       Arrogant behavior

·       Sarcasm or Taunting

·       Sighing, Making faces, Eye rolling

·       The silent treatment

·       Dismissing ideas without listening to them

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

Pat

Could it be an adverse reaction to a medication?

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

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

March 1, 2023

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

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

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

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

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

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

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

·       Digestive system bleeding

·       Heartburn

·       Fatigue

·       Sleepiness

·       Nausea/Diarrhea

·       Lightheadedness

·       Dizziness

·       Constipation

·       Skin rashes

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

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

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

·       Antibiotics

·       Anticoagulants (blood thinners)

·       Insulin

·       Opioid pain meds

·       Benzodiazepines

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

·       Lipid modifying agents

·       Urological medications (ex. Urinary incontinence meds)

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

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

Leave a message if I am unable to answer.

Pat 865-684-8771

Husband Caregivers, Shower your Wives…learning how to do it better

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

Tips on how to be more helpful when assisting your loved one to bathe or shower. These are things that you need to think about when becoming a spousal caregiver. Understanding your own feelings and beliefs in this personal issue. Understanding your loved one’s feelings, wants and beliefs in this most personal area. It is difficult to ask for help with personal hygiene chores when you can no longer do your own self-care. February 8, 2023 You two have been through a lot. You are a team, usually. You are both independent and self-sufficient. Then, things change and you are no longer self-sufficient. You have become a care recipient.  You need help because of a stroke. You need help because of cancer. You need help because of Parkinson’s disease. You need help because of Alzheimer’s disease or other dementia. No matter the reason, your wife needs help with one of the most intimate parts of her life. It could be a temporary help because of surgery, We don’t think about it much, but we each how our own ways of doing things. We have our own patterns and our own order of doing things. Most partners do not know their significant other’s daily routine. When you are the helper, you must be aware that your loved one has their own way of doing things. They have their own schedule and order in which to do things.

Learn Each Other’s Routine

Try this experiment. Each of you writes down exactly what you do from when you wake up to when you go to sleep that evening. I mean everything with the time of day noted. We won’t get into the getting dressed procedure. I know, some of you have this puzzled look on your face. We all have our preferred way of getting dressed and we have very specific ways we do things. For example, I place my left arm first, whether it is my shirt or jacket. It is automatic for me; if I even try to do it with my right arm first, I can’t do it easily AND I am out of sorts mentally. Now, the next day write down your partner’s daily routine with times noted. Do this from what you have observed or what you assume they do. You will probably get the big things right, but probably not all of the little things. Find a time to go over the information. Make it a date night. Talk about it and see how close you are to knowing each other’s routine. What are the similarities? What are the differences? This is a big-picture type of exercise. We all have our own routines. When you are the helper or caregiver, it is best for the caree (your loved one) to be as comfortable and safe as possible. In order for that to happen, you need to know their routine and their times. We automatically do things in our routine and we don’t realize that others have other routines. Doing their routine becomes doubly important when your loved one has Alzheimer’s disease or another type of dementia.

Men don’t automatically know how to care for female anatomy

Guess what? Female anatomy is different from male anatomy. We don’t automatically know how to help the other person with bathing. We don’t automatically know how to wash and clean some private areas effectively. We don’t automatically know what to lotion and what to powder. Sometimes, we don’t know what we don’t know until we get in the big middle of it. That can be very stressful. Caregiving is hard and you want to provide the best personal care possible. What follows are the supplies needed and the how-to tips to help you help your wife.

Bathroom

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

Shower Supplies

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

Order of Washing -Be Gentle

    1. Wash the face and neck first and dry the face
    1. Have them place a washcloth over their eyes while you wash their hair and condition it. Ask them to tip their head back. Scalp massages feel really good.
    1. Dry the hair with a hand towel
    1. If they can, have them hold the shower handle
    1. If they can wash themselves, then you soap up the washcloth or pouf
    1. Wash their back in a circular motion all the way down to the buttocks
    1. Wash the arms and underarms next
    1. Wash the front torso and under the breasts – wash skin folds well, too
    1. Rinse them off really well
    1. Place a towel over the top half of the body and pat dry a little (helps keep them warm)
    1. Wash the legs and have them lift up one at a time or gently lift them up. If they can stand then have them stand.
    1. Wash the feet and in between the toes (while they are sitting)
    1. Tell them it is time to wash private parts. Offer them the option to wash their own private parts, even if you need to help some.
    1. Use a clean washcloth and clean the vulvar area – use a different clean area of the washcloth for each swipe
    1. Clean from clean to dirty = front (vaginal area) to back (anal area)
    1. Separate the labia with one hand and clean gently with a downward motion to the perineum area (area between vagina and anus)
    1. Separate buttocks and clean from bottom to top area
    1. Rinse very well
    1. Talking throughout the bathing process and telling them what you are doing or will be doing next seems to help everyone calm down
    1. Use a towel to pat dry and dry well
    1. Areas that need extra care to be dry – vulvar area, anal area, underboob area, all skin folds and in between toes
    1. Gently get them out of the tub. Dry them off again or place a terry cloth robe on them to help with that. They can either stand or sit on the commode (lid down and with a towel placed on the lit) while you lotion them, powder them, and put on deodorant. Dry and style the hair. ** Note, some want to dry and style their hair before applying lotion and anything else. Some brush their teeth either before getting into the shower or right after getting out and drying off. Ask what they want to do. **
    1. Apply barrier or skin protectants to areas needed (usually incontinent folks need this)
    1. Never lotion between toes (want to prevent fungal or other infections)
    1. Places to put powder or talc – underboobs (skin under the breasts, and torso area where they touch), skin folds (anywhere there is skin-on-skin contact that does not get a lot of air circulation)
    1. Do not put anything in or right around vagina (it is self-cleaning)
    1. Help them into their clean clothes
    1. They may need a nap after a bath, it is hard work
Getting clean makes all of us feel better. Change the sheets on the bed on a bath day. Some bathe every day and some bathe 2 or 3 times a week. That is fine. Find what works best for your loved one and you. It is also fine if you hire a shower aide to come into your home to help with bathing your loved one. You will still have to do the daily cleansing needed which includes face, underarms, underboobs, skinfolds, feet, in between toes, vulva area and anal area. This is sometimes referred to as a sponge bath.

Products to Consider:

Soaps/Body Washes

CeraVe Body Wash for Dry Skin

Kiehl’s Grapefruit Bath & Shower Liquid Body Cleanser

Aveeno Restorative Skin Therapy Sulfate-Free Body Wash

Dial Clean + Gentle Body Wash, Aloe

Neutrogena Hydro Boost Fragrance-Free Hydrating Body Gel Cream

Olay Moisture Ribbons Plus

Dove Beauty Sensitive Skin Body Wash

Dove Body Wash for Dry Skin

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

Lotions/Moisturizers

CeraVe Moisturizing Cream

Cetaphil Restoring Lotion

Eucerin Daily Hydration Lotion

Vaseline® Intensive Care™ Advanced Repair

Lubriderm Daily Moisture Lotion Shea + Enriching Cocoa Butter

Gold Bond Healing Lotion

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

NIVEA Essentially Enriched Body Lotion

Facial Moisturizers

CeraVe AM Facial Moisturizing Lotion

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

Aveeno Positively Radiant Daily Moisturizer SPF 30

Cetaphil Daily Facial Moisturizer SPF 35

Unscented Neutrogena Hydro Boost Water Gel Face Moisturizer with Hyaluronic Acid

Aveeno Calm and Restore Oat Gel Moisturizer Unscented

Cetaphil Gentle Clear Moisturizer

Neutrogena Oil-Free Daily Sensitive Skin Face Moisturizer

Eucerin Redness Relief Day Lotion Broad Spectrum Sunscreen

Best Body Lotions for Men

Nivea Men Maximum Hydration 3 in 1 Nourishing Lotion

Aveeno Daily Moisturizing Body Lotion

CeraVe Daily Moisturizing Lotion

Dr. Jart+ Ceramidin Body Lotion

Vaseline Intensive Care Lotion

Jack Black Cool Moisture Body Lotion

Dove Shea Butter Lotion

Men Facial Moisturizers

Neutrogena Hydro Boost Face Moisturizer

Kiehl’s Ultra Facial Moisturizing Cream with Squalane

La Roche-Posay Toleriane Ultra Soothing Repair Moisturizer

Bulldog Mens Skincare and Grooming Original Face Moisturizer

Jack Black Double-Duty Face Moisturizer SPF 20

Cetaphil Fragrance Free Daily Facial Moisturizer

Skin Care Products for Incontinence – Barriers and Protectants

BAZA Clear Skin Protectant Ointment

Sween 24 Superior Moisturizing Skin Protectant Cream

Calmoseptine Ointment

3M Cavilon Durable Barrier Cream

Boudreaux’s Butt Paste Rash Cream, Original

Incontinence Cleansers

PeriFresh No-Rinse Perineal Cleanser

Aloe Vesta Skin Cleansing Foam

Theraworx Protect Advanced Hygiene & Barrier System

Feelings that a Well Spouse Has

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

Good relationships take work on the parts of both people involved under the best of circumstances.  What happens when one of the partners becomes seriously ill or will need help for more than six months? It may be from a stroke, cancer, traumatic brain injury, mental health/psychiatric disorders, spinal cord injuries, dementia, Alzheimer’s disease, Parkinson’s disease, etc. What happens when relationship challenges rear their ugly head? Will you address it? Will you ignore it? Will you stuff your feelings way down deep? Will you deal with it in a healthy way? Decisions, decisions, decisions. January 25, 2023

Spousal Caregiver Challenges

Challenges arise when the changes come. There will be changes. No one can tell you when they will come or what they may be. Deal with them as they come. You can stuff your feelings, but eventually, they will come out. It won’t be in a good way, either. Acceptance is hard. Accepting things as they are, right now is hard. We have to give ourselves grace for every moment. Learning about their chronic health condition will help you to understand what is happening. Yes, I know there is usually more than one. Accurate information about what is happening and what will come will help you be more prepared to handle situations.

The challenges that cause the most aggravation are:

    1. Toileting and incontinence issues
    1. Showering/Bathing
    1. Eating out
    1. Repetitive questions
    1. Relationship strain
    1. Fatigue
    1. Guilt
Learning healthy ways to cope will help in this journey. Yes, it will be a journey. You will have good times, bad times and okay times.

Things you can do to help yourself destress:

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

Feel Your Feelings

It is okay to feel your feelings. It is okay to talk about your feelings. It is even okay to not have an answer. It is not okay to act aggressively or become verbally or physically abusive. Physical abuse includes doing things “rougher” than is necessary. Feeling sadness, anger and frustration are normal feelings. It is how you handle those feelings that make the difference between a healthy relationship and an unhealthy or abusive relationship. Don’t bottle up your feelings, you will eventually explode.

Warning Signs that you Need Help:

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

Caregiving does have to be a burden

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

Aging Eyes Need More Light, So How Much & What Kind?

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

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

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

January 18, 2023

How do you see?

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

One of my experiences

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

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

Folks that have Alzheimer’s or another Dementia…their Brain is Failing

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

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

Check out the Home for Problem Areas

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

Suggestions

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

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

Bulbs, Watts, LED’s, CFL’s

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

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

Pat

Getting “Life” Things in Order: You want it. You need it. But, you can’t seem to do it…why?

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

Maybe, it is because you don’t know your “why.” Your own personal “why” is what motivates you. You can say “I need to…” or “I should …” do X,Y, and Z.  Yet, it never gets done. Is it because you don’t know where to start? Is it because you are not sure what to do or what is important? Is it because you don’t really see the benefit of doing “it?” January 11, 2023 Simon Sinek, says to always start with your “WHY?” Why is it important? How will it help you or your loved one? How will it improve your life? How will it decrease your stress? Why do you do what you do?

The Stress-Buster Binder is for you, if you want an easy to use format.

Will a fill-in-the-blank PDF help you?

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

How will it help?

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

Topics Included:

A durable power of attorney Financial

 Power of attorney  for Health

HIPAA

Health Care Proxy

Financial Affairs

End-of-life decisions

Advance directive

Will

Things you may also need, that you didn’t-know you would need

Medical History

Online Accounts – passwords and security questions

And more…

Pre-printed Binder Kit (pages are in sheet protectors) Checklist

You also receive clean sheets to make copies. This is great for updating the records and for when you need to use medications given check-off sheets. The complete binder kit is $249.00 and can be mailed anywhere in the contiguous 48 states for $17.00, as of this date 10/25/2023. Prices for printing and mailing may be updated as those prices increase. Yes, I am telling you to get the binder before the price increases.

Computer version Checklist

Fillable PDF file for family use $129.00 Fillable PDF file for single use $69.00 Pat

What will You Do to Feel Happier & More Relaxed this Coming Year, as a Caregiver?

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

With the start of a new year, most of us think about getting organized and decluttering our spaces. We know that we would feel better, be happier, and have the ability to do more. We want it. But, will we invest in the time it takes to get us there? Some will and some will not. Do you see the value of taking time and putting forth the effort to make your life easier, in all areas? January 4, 2023

What do you value?

What you value, you will make time for. What you value, you will do. It is that simple. It doesn’t matter if you “would like to” or if you “need to,” or even if “I have to.” None of those things matter. You get to decide what you will do or will not do. It really is a decision that you make. Find the health and well-being things that you enjoy. Nobody likes to do the grunt work. We would all rather do the “fun” stuff, but that is not the way things work. There is an upside. What you take care of now, you won’t have to fool with later and then you get to have more fun. You can get rid of the “I should’s” or the “I need to…” kinds of things and all of the stress that comes with that.

Being Organized is Your Friend (it helps your caregiver stressed brain a rest)

Organization is your friend. Getting organized is a process, it does take time, but it will be worth it in the long run. Think about it, no more searching for 20 minutes and sometimes hours on end. You know where it is and you can go and get it. Being able to put your hands on the information you need is awesome. Think of all the stress you don’t have to deal with because you have your stuff in order. Organization helps your brain to rest. Your brain needs downtime. That is another article and we will get to that later. Remember, you only have about four hours of focused brain energy every day. Organization will boost your health. By decreasing your stress, you have already helped your health. You will rest better, sleep better, have a better outlook on life. Organization helps you to control the things that you can control. There are so many things outside of our control, do what you can to manage the things you can. Organization helps you be healthier. You make time for meal prep. You plan food for your meal times and snacks. Organization will help you to be more productive. Yep, it’s true. Getting your ducks in the same pond will help you perform your duties better and more easily. They don’t have to be in a row, but they do need to be in the same pond.

Decrease Family Caregiver Overwhelm

Organization decreases overwhelm. How would you like to know who is doing what on each day? How would you like to know what you will or won’t be doing each day? How would you like to know what is coming up so you can make better plans for your days and weeks? Organization allows for spontaneity and unexpected problems. You know what must be done and can see what needs to be moved to a later date.  Things are going to “come up.” And stuff will “hit the fan.” Being able to make adjustments on the fly is what you need and organization helps you to do that.

Feeling Stuck or Paralyzed?

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

 Start with two areas in your life. You get to choose which two

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

Maybe, you will do better with big bucket areas:

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

What does organization look like?

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

Oopsie! I messed up…

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

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

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

As long as your loved one is fairly independent, all is well. The time will come when they need you to physically help them.  Getting up from a chair. Help with bathing, Help to get out of bed. Help with toileting. Can you do it correctly and safely for both of you? Think about what can happen if you don’t know how to move and transfer someone correctly. You can wrench your back and then what? They can fall and hit their head or break a bone. December 14, 2022 Maybe your mom can help you to move, right now. What happens when she can’t and is dead weight? Your dad is able to use safety bars to toilet and shower, right now, but what about over the next year?

Keep them safe and yourself healthy – Skills You Need

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

Did you know that there are online courses or videos to help you learn the skills needed?

There are some online courses or videos for you to access. It would benefit you and your loved one to view the videos and take a course or two. I am sure that many are on YouTube, but be careful to find out where their expertise came from. Educating yourself and learning new things will help you and your loved one. Be safe. Be safe for yourself. Be safe for your loved one. Learn how to put a gait belt on your loved one and how to use it appropriately. Be prepared to help them up from the floor after a fall. Do you know how to check for injuries Before moving them?

Remember these essential safety tips

DON’T
    • Bend from your waist
    • Try to pull your older adult up
    • Ask them to hold onto your shoulders or neck
    • Let them use toilet paper holders, towel bars, or other non-sturdy items to help them sit or stand

A few resources for you to check out:

Getting in and out of a car video by Teepa Snow

https://www.youtube.com/watch?v=te4SW_0Af8k
https://seniorsafetyadvice.com/
How to use a gait belt
https://www.youtube.com/watch?v=i2nJ3roEyD0

Training Programs and Resources

Alzheimer’s Association

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

Family Caregiver Alliance Events & Classes

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

The Veteran’s Administration

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

The Caregiver Action Network

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

Generations Home Care

https://www.homecaregenerations.com/family-learning-center/

American Red Cross

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

Family Caregivers Online

https://familycaregiversonline.net/caregiver-education/video-tips-training-for-caregivers/

Invest in yourself for your loved one.

Be safe, Pat

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

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

It may be disease-related or due to other reasons that can be addressed and fixed. December 7, 2022 You notice that your mom has lost weight. Maybe, she was a larger woman who could lose a few pounds. She tells you that she is not hungry or doesn’t have much of an appetite. She does not appear to be underweight, so you don’t think too much about it.

Unintended Weight Loss

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

Ask more questions such as:

    • Is your mouth sore or is it hard to chew?
    • Is it hard to swallow?
    • Do you feel like you are choking when you swallow?
    • Have you lost your appetite?
    • Does your stomach hurt?
    • Do you have swelling or are you retaining fluid?
    • Can you only eat a little bit at a time?
If yes, to any of these, a visit to the primary care physician is in order.

Physical issues also contribute to malnutrition

Try to find a physical cause. Can they get to the store? Can they cook for themselves? What are they eating? Frozen dinners, soup, cheese, and crackers? Are they drinking enough fluids? They may be eating, but it may not be enough for their nutritional needs. There is usually an imbalance of protein, fat, carbs, and calories that the body needs every day.

What else can cause malnutrition?

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

Common chronic diseases that affect (usually decrease) appetite:

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

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

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

Problems caused by malnutrition:

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

FYI

**An obese person can still be malnourished.** **It isn’t always diagnosed in a hospital setting or a physician’s office without information from the patient or family members.** If you suspect your loved one is malnourished, you may have to be a more vocal advocate to get it checked out. It is perfectly okay for you to speak up and keep speaking up until you have been listened to and someone does a malnutrition lab workup. A Registered Dietician (RD) can be of tremendous help. Pat

I Have Too Many Choices, How Do I Choose, or is this analysis paralysis going to kill me?

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

Too many choices, too many decisions, too much overwhelm, and decision fatigue all contribute to you feeling and being stuck. Do you feel as if you are “just surviving” every day? That stinks, doesn’t it? But, what to do and how to get started moving forward again? November 30, 2022

Maybe, it is what to do first?

Sometimes, the issue is that we do not know what to do first. Not only that, but we stress over what is the most important thing to do first. We are afraid to be wrong and so, we do nothing. I think the acronym F.A.I.L. is appropriate here, it is your First Attempt In Learning. Yes, you are learning what works and what does not work. Failure is an event and never a person.

Afraid of making the wrong decision- pros and cons

We like certainty. We want to know that we have made the “right” decision. Our brains do not like uncertainty, it makes them work overtime to feel safe. Our brains get hijacked by our emotions and we cannot think logically. Stop overloading your brain. You do have a decision-making process, but sometimes overthinking causes you to procrastinate. Do you feel like you have to “shop around” and keep all your options open before making a decision? Two or three would be ideal, but we have to go to 10 places and keep comparing. How many of us get too obsessed or too anxious? You know who you are and you are nodding your head in agreement. You may have many options, but are they good options for you and your loved one?

Analysis Paralysis

How much energy are these decisions taking? Is it really worth that much stress, anxiety, or energy-wasting? Have you ever thought about when this choice overload happens? It usually happens when we don’t have enough good information or knowledge in the area of need. Use your good resources. Set your limit to three of those resources. Find a knowledgeable person and have them provide you with your best two or three options for your needs. (That would be a plug for my services, in case you didn’t catch it.) I know that you are afraid of making the wrong decision. I want you to know that you can make another choice if the first one isn’t working very well. You can pivot. It really is okay.

What does feeling stuck look like?

    • You have been searching for something that interests you and you find it. Then you look at all the steps it takes to do it and talk yourself out of doing it.
    • You keep thinking about what could be better or different all the time. You may even be future-oriented. You get into the “when I get this, I will be happy” or “when this happens, I will be happy.”  The problem is that you are here, right now in the present and this is where your focus for happiness would be best served.
    • You really want something – for yourself – a new relationship, a better job, a new house, to get in better shape, etc. – However, before you start, you lose your motivation. Maybe, you do get started and then you lose your motivation.
    • You have a feeling that something isn’t right in your life, even if you can’t put your finger on it.

Is it a lack of motivation?

Motivation is red hot for a while, but then it burns out and all you have are a bunch of ashes. What now? For one, the realization that motivation is never enough to achieve a goal. It takes commitment to the process. Doing it even though you don’t feel like it is another realization. Be consistent. Continue after a break. Maybe you feel trapped as a family caregiver. You don’t mind helping, but now you feel like you never get out. It is a difficult adjustment. Be careful, resentments can build up before you know it. You feel like you are missing out. You feel trapped by doing the same tasks over and over. Consider this, challenges are matters of perspectives and our own attitudes. Is there some middle ground that you and your care receiver can agree to? Challenge yourself on “stinking thinking.” It could be your perspective and attitude that are the problems. Feelings change and they don’t last forever. It is best to make choices on the information that you have at the time. You will encounter a tough decision and you will feel overwhelmed. There are no perfect solutions so stop trying to find the perfect solution.

Some ideas to help you not feel trapped:

    • Only you can change the things in your life that you are unhappy about.
    • Live a healthier life by moving (walking/running) and eating better.
    • Be consistent, motivation alone is not enough.
    • Accept uncertainty. We can make good decisions, but we cannot choose the outcome.
    • Reconnect with your personal values.
    • What can you do, right now, that will be helpful?
    • Be the hero of your story and not the victim. Stop saying, “I don’t want …”
    • Stop focusing on the things that are causing you to suffer. Focus on whatever fills you up.
    • You may not have good options, so choose the option that you will regret the least.
    • See if you are in the “all or nothing” thinking. It can be a “both/and.”
    • Write down some “I could …” statements.
    • Write down three different things you are grateful for every day.
    • Be proactive rather than reactive. You will have more control and less stress.
Determine the number of good resources you will use. Three and no more than five. Do a pros and cons list. Throw the right choice out the window. Good enough for now, is okay. Pat

Secrets that folks over 65 try to hide from their families…

Posted on November 10, 2022 by - #alzheimers, #caregiver, #caregivers, #dementia, Caregiver Information

    1. Short on money

    1. Buying a lot of “stuff”

    1. Gambling

    1. Drinking more alcohol

    1. Prescription drug misuse or abuse

    1. Illegal medication misuse or abuse

    1. Binging on sweets

    1. Financial abuse – from a family member, a friend, or a caregiver

    1. Elder abuse or Neglect – from family, friends, neighbors, or caregivers

    1. Automobile accidents

    1. Driving Infractions or Getting a Ticket for something

    1. Hiding bruises – either from falls or abuse

    1. Eating a lot of take-out

    1. Changes in the way they dress

    1. Closing the doors to rooms – to keep junk hidden, the messiness, or the dirtiness

    1. Limiting driving to short trips and not far from home

    1. Poor personal hygiene – from not changing clothes to not bathing nor brushing teeth

    1. Unopened mail

A few behaviors that may mean they are trying to hide information:

    1. They discourage visitors. It may get to the point of them not letting anyone inside their home. It starts as “We will meet you at the restaurant.” “The house is such a mess, let’s do it another time.” They may even say that they know “you are busy with your job.” They begin to avoid or conceal certain things. 

    1. Hiding mistakes – driving, spending, buying, They don’t want to argue or deal with repercussions.

    1. They make a lot of excuses for their forgetfulness or their behaviors

    1. Changes in activity – you are looking for changes in their normal routines

    1. Speaking for their spouse

Why might they do some of these things? “Denial (De Nile) isn’t just a river in Egypt. Secret still gives them some control.

    1. Denial – If you don’t acknowledge it or talk about it, then it doesn’t exist and nothing is wrong.

    1. Pride – They can’t admit that they can’t do a lot of things necessary to live on their own. We all are an independent and prideful bunch. 

    1. Embarrassment – maybe they become self-conscious or ashamed of what they can no longer do. Especially if it has to do with personal hygiene. Embarrassment rears its ugly head when they have some financial difficulties. They cannot afford food, medication, and getting repairs done to the house. It may or may not be any fault of their own.

    1. Fear – of losing their independence

    1. Depression – chronic health conditions seem to cause a rise in depression. Depression is not always the ‘woe is me” stuff.

Depression is not a normal part of aging. It may mimic dementia.

Signs and Symptoms of Depression in folks 65 years and older:

    1. Memory impairment

    1. Trouble retrieving some words

    1. Takes longer to process information and deliver an answer

    1. Depressed mood

    1. They no longer have pleasure or want to do the things they used to enjoy

    1. Noticeable weight loss or weight gain

    1. Sleeping too much or too little

    1. Feeling fatigued

    1. They experience feelings of worthlessness

    1. Having excessive or inappropriate feelings of guilt

    1. Recurrent thoughts of death or suicide

    1. Feel confused

    1. Struggle to pay attention

    1. Be grumpy or irritable

    1. More aches and pains

    1. Move more slowly

    1. Crying spells

    1. Apathy –  lack of interest or concern

Medical reasons for changesIf they still have their partner, the partner will try to help and cover for them. When they are tag-teaming it is more difficult to figure out what is going on. It isn’t always intentional, but it can be intentional. To be fair, it may have happened slowly and they are taking care of each other the best way they know how to help. Observe to see if the spouse is finishing tasks for them, finishing sentences for them, or making excuses for some type of behavior.

November 9, 2022

Too Secretive Because of Too Independent?

No one likes to admit that they may need help. We are all very independent and quite stubborn. Most of us fear losing our mental faculties more than we fear losing physical capabilities. I understand that. Too often, people feel that they are “getting dementia” or “Alzheimer’s disease,” but that may not be the issue at all. Which is why it is important to go through a diagnostic workup. It could be fixable, such as better nutrition and hydration. It may even be a type of depression. Of course, it could always be a generation thing to keep secrets. They may also ignore or have resistance to seeing “what is” so they don’t have to deal with it or reveal it. 

  1. Falls
  2. Pain
  3. Dizziness
  4. Financial difficulties

We always want to rule out the things that can be ruled out. What if it is a lack of nutrition, dehydration, loneliness, or isolation? Those are fixable and doable. If it is depression some medications can help. Shoot, even running has been shown to help mild to moderate depression. Once we know what it is, it really is much easier to handle.

Pat

What Caregivers Do Need from Family and Friends?

Posted on November 2, 2022 by - #caregiver, #caregivers, #parkinsonsdisease, Caregiver Information

Caregivers need to hear that they are appreciated for providing care.  They need practical help that almost anyone can help if they are willing to put forth time and effort. You have said, “If there is anything you need, let me know.” Did you mean it? I am going to tell you what they need and want.

There are beneficial things you can do and say to caregivers or helpers. Last week we talked about what not to do and say. This week we move towards helpful things to do and say.

November 2, 2022

What to say to family caregivers

  • This time we are going to be talking about what you can say and do to help your friend or loved one who is a caregiver. Did you really mean it when you said, “Let me know what I can do to help you?” If you mean what you say and say what you mean then this article is for you. If you do not mean what you say then you can stop reading now. We are going to get into the practical and doable things.

What caregivers and helpers want and need to hear

    • Recognition and Understanding – Recognize that what they are doing matters and is helpful. Try putting yourself in their shoes, and be understanding when they are stressed and need to vent. Be understanding that they are exhausted and need a break from both thinking and doing. A short visit to shoot the breeze or watch a movie. Find a distraction when they cannot leave their caree (care receiver).

    • Time to recharge – Offer to stay or sit with the care receiver for two to four hours so they can go and do whatever they want to do. Are you willing to do this once a week, once every two weeks, or once a month? What day and time? Be specific.

    • Provide respite care – This could happen a couple of ways. Find a facility that allows for respite care and find a company that provides in-home care so the primary caregiver can get away. Cost is usually the main factor. How many friends, family or church members can donate money to provide this much-needed service? Imagine what a week away would mean to them.

    • Take them out to eat and to a movie. If you can, pay for the in-home care or find someone to sit with the care recipient for three or four hours. Most of the time, it really is just being there in case the care recipient needs something. It is not like you would be asked to do anything medical.

    • Emotional support – They may need to vent. They may need to talk about what is going on with their care recipient. They may need to talk about something else.

    • Feel heard and understood – Acknowledge how hard this may be for them. Understand that they have bad days and feel anger, hate, and rage.

    • Send flowers

    • Offer to be the communication person – keep others updated or put info on a website like Caring Bridge

    • Send a thinking of you text and state – no need to respond

    • Coordinate the offers of help and support

    • An email with a joke or two

    • Remind them they are loved and cared about

    • Say, “I will be keeping you in my thoughts and prayers, every day and sending you good vibes.”

    • Share “remember when” stories about your relationship

    • Share funny stories that you have witnessed

    • Laughter provides many great benefits – watch a funny video

    • Say, “I love you.”

    • Offer to sit with their mom or dad so they can go out with their spouse and kids.

    • Ask, “How can I be a good sounding board for you?”

What caregivers would like you to do and how to effectively help them

Yes, it would be great if the caregiver had a list of things to be done and errands to run, but most have not had the time to do one. Maybe you are the one to make the list and place it on the refrigerator so folks can sign up.

    • Never offer to do anything that you do not want to do. The look on your face and being told no is more than the caregiver can handle. They will shut down.

    • Ask, “When is the best time to come for a visit and how can we help during the visit?”

    • I am coming over on Saturday from 2 to 5 to stay (with your loved one) so you can take a break. Be specific.

    • Give a Visa/MasterCard gift card of $50 – $100 and say, “Enjoy.”

    • Pick up a meal from their favorite restaurant and deliver it.

    • Make a meal and deliver it – use throw-away containers

    • Make a few freezer meals and take them over.

    • Set up a meal train to provide meals anywhere from 3 to 7 days a week (ask about likes/dislikes)

    • Make phone calls and do research for them – if asked

    • Donations to help cover lost work and medical expenses

    • Offer to coordinate medical bills, EOB’s and medical claims. Only if you know how.

    • Give a gift certificate to a spa/massage

    • Mow the yard (either the caregiver’s yard or the care receiver’s yard or both)

    • Do laundry – Pick it up and bring it back

    • Help clean the house – vacuum, dust, sweep, mop, wash dishes, change the sheets, clean the shower/tub and toilet, wipe down surfaces – nobody expects you to deep clean

    • Clean the gutter

    • Take their car in for an oil change

    • Run the errands – grocery shop, pick up Rx’s

    • Sit with the care receiver so the caregiver can run errands

    • Take the care receiver to the doctor’s appointment

    • Deliver a care basket – good snacks, a book to read(nothing about caregiving allowed), favorite lotion and skin care things, gift cards, blanket, neck pillow, board game, cards, Mani-Pedi gift certificate, etc.

    • Wash and vacuum the car

    • Rake leaves

    • Shovel snow

    • Clean out the refrigerator

    • Change the air filter

    • Shred old documents

    • Help clean out a closet or room

    • Clean out the garage

    • Replace light bulbs

    • Walk the dog

    • Clean out the litter box

    • Take animals to the vet

    • Take animals to the groomer

    • Wash the outside windows

    • Clean the oven

It is okay to choose what to do for a family caregiver

Think about the things that you do at your own home. The caregiver needs those things done either in their own home or the care receiver’s home. Find 2 or 3 things that you don’t mind doing and do them. Do the things that you don’t mind doing. Do not do things that you hate doing. For example, I don’t mind doing laundry, taking the cars in for service or cleaning, or running errands. I hate washing the outside window and cleaning the oven and I won’t do them. Other folks have different likes and dislikes. So, what I hate doing, someone else doesn’t mind doing.

Be specific about what you will do and when you will do it. Ask, if that is okay with them, and if not, be flexible. Clear communication is important. Do not assume.

Can you help financially?

It is not a requirement to help out financially. If you can, that would be great but not a necessity. Your time, efforts, and help will mean more. So there is no misunderstanding, be upfront about what you can and cannot or will and will not do. It is perfectly fine to state that you can’t help with the financial expenses, but you can run errands and pick up things that have either been paid for or they can send you some form of payment.

Most caregivers don’t assume you will pay for things, but they may forget to give you a way to pay. Just remind them that you need a check or card.

Pat

What Caregivers Do NOT Need to Hear from Others

Posted on October 26, 2022 by - #alzheimers, #caregiver, #caregivers, #dementia, #parkinsonsdisease, Caregiver Information

You may mean well. You may even mean what you say, but you are hurting them rather than helping them. Will you be open to learning how to better support someone who is helping a loved one? It will require some effort and thinking on your part.

October 26, 2022

I meant to help

I have said some things in the wrong way. I really meant to help, to be supportive and available. What went on in my own mind, did not play out well for someone I was trying to help. I had to realize that I was looking at their situation through my own ways of caregiving and what I would have liked help with.

If you truly want to be a help to your friends or family members who are caregivers, you have to buck up and take the time to learn what they need and want help with. No, that does not mean rapid-fire questions. A lot of the time, they do not know what they need or want because they are in hell and too stressed out to think.

What do you do? How about you learn what they don’t need and don’t need to hear?

    • Judgement – Don’t second guess them or their choices. You don’t know their family dynamics and you are not in their shoes.

    • Horror stories – They don’t need or want to hear about all the messed up crap that happens in nursing homes or what happened to “so-and-so.” Just shut up, there is no good that can come from that.

    • Don’t ask what they need – Granted, this is difficult as you may want to help, but you don’t know what to do. Give them the gift of your time. You know the things that need to be done at your own home. Mowing, cleaning the house, laundry, running errands, grocery shopping, and making dinner.

    • Don’t make more work for them – Don’t just show up, don’t call and say. “the gang is coming over to visit you.” They will feel the need to clean up and get the place cleaned up.

    • Don’t ignore them – Maybe they can’t attend functions much anymore, but you can keep including them. Update them and let them know that you are thinking of them.

Now we will move on to, Things You Should Never Say

    • “If you ever need a break, call me.” – What the hell. They do need a break and they don’t have time to go take a shower, much less call you.

    • “You have to take care of yourself, too.” – Do you really think that they don’t know that? You are adding more stress and guilt, so unless you are offering to sit with their caree (care receiver) so they can take care of themselves, shut up.

    • “You look tired.” – They are tired.

    • “I don’t know how you do it.” – They have no choice.

    • “God doesn’t give you more than you can handle.” – That statement is wrong on so many levels.

    • “You will get your reward in heaven,” – You have just discouraged them more.

    • Why do you keep going to visit them, they won’t remember it anyway.” – Their loved one still deserves love and care. They may not remember your name or who you are to them, but they sense and know that you are someone who loves them and cares for them.

    • “You should put them in a home.” – You don’t get to decide what is best for them and their loved ones. Pretty much, anything that has a “should” or “would” in it … Keep it to yourself.

    • “I could never do what you do.” – You don’t know what you will or won’t do until you are in your own situation. All relationships are different. All families are different.

    • “I wish there was something I could do to help.” – Bullshit, you would do something if you wanted to. We will get into the things you can do and say next week.

    • “You should get some help.” – Do you really think that they haven’t thought of that? Maybe, they can’t due to finances. Maybe, they have hired folks that do not show up.

    • “How are you doing?” in front of the caree (care receiver) – Really? Do you want them to vent right in front of their loved one?

    • “You need to find some time to relax.” – I am sure they would love to, but when and how?

    • “Don’t feel guilty about …” – Feeling guilt is a part of caregiving.

    • “Everything happens for a reason.” – No, it doesn’t. Stuff happens and we have to deal with it.

    • “I know just how you feel.” – No you don’t. You may have had a caregiver type of experience, but it is not the exact same. Situations are not exactly the same, people are not exactly the same, and needs are not exactly the same.

    • “What doesn’t kill you, makes you stronger.” – Do you think this hardship is making them stronger? That is foolish.

    • “At least it’s not cancer.” – At least it’s not…statements cause more pain to the caregiver.

    • “Just think positive thoughts.” – Way to go, you have just increased the feelings of guilt and pressure they put on themselves.

    • “Your mom (dad) used to be a great person.” – Don’t talk about their loved one in the past tense. It is hard enough to watch a loved one decline, without being reminded of what has already been lost.

Think before you speak. Practice what you will say. Say it out loud. How does it sound? Is it uplifting or helpful? How might it be taken by someone who is stressed out and exhausted?

Practice Saying It Outloud Before You Say it to the Caregiver

If you find yourself using any of the following, don’t do it. “I think,” “You should,” “I would,” “You could,”

Shut up. I get it, I want to help and fix things too, but some things are not meant to be fixed by you. That is a hard lesson, but a helpful lesson on being fully present and letting them vent. You just sit there and be the listener.

Next week we will talk about what to say and do to help a caregiver.

Pat

Husband’s say, “It’s just something you do.”, but won’t say, “I am a Caregiver.”

Posted on October 20, 2022 by - #alzheimers, #caregiver, #caregivers, #dementia, #multiplesclerosis, #parkinsons

Men often feel unprepared when their role in the family changes. Even if, they played a significant part in child raising (changing diapers, bathing, reading to them, holding them when they cry, etc.), they do not know how to help an adult that needs help with ADLs (activities of daily living).  It is just something that you do. You may have seen your mom or dad help their parents or each other when needed. The word “caregiver” never entered your mind. Maybe, “caregiver” is a negative word these days.

October 19, 2022

Ruck up – “man up” for a difficult situation

I like that phrase. It doesn’t matter if you are a man or a woman, the sentiment is “handle it.” You can handle it and you will need help. Everything may be okay for a year or so, but, eventually, you will need help. Learn to delegate. You will still have plenty to do.

Is there a difference between caregivers or male family caregivers?

I did not identify as a caregiver because I was not doing hands-on care. I was helping out. I was doing what needed to be done. Along with working full-time and dealing with my own home and life with kids.  I was scheduling, and I was seeing to her needs. I ran errands, took her to doctor appointments, cleaned the house, mowed the yard, and did the laundry. My dad did not identify as a caregiver because he was providing care for his spouse. I wish that we didn’t have to deal with gender roles. It keeps getting less and less, but it is still an issue., especially with personal care. 

I didn’t want to be seen as a caregiver

I did not want to be seen as a caregiver. Maybe it was because I did not want to admit to myself the reality of the situation. If I did, then it would be real. I did not want to be seen as a caregiver because it made me feel weak. I wanted to “fix it,” but I couldn’t. I didn’t want to be a caregiver because it meant I had to give up some things that I wanted to do. I didn’t want to give up my life and free time. If I admitted that I was a caregiver, I would have to make changes in my life.

I did not realize that I had choices, opportunities, and helpers willing to help. I could have boundaries and provide good care. I could take care of my own needs and my family’s needs as well as care for my mom and my dad, who was the primary caregiver.

My dad never identified as a caregiver

My dad never identified as a caregiver. This was his wife and he was going to keep her at home and do what needed to be done. He learned a lot. He learned how to cook a little, clean the house, do the laundry, pay the bills, make doctor appointments, etc.

He never talked about how he felt. It didn’t matter, he had a job to do and it was going to get done. A few years later, a few mini-strokes later, a personality change and a decline in physical health all began to take their toll. Mama was not rational and daddy did not know what to do or how to handle it. He finally told me that he did not know how much more he could take. Long story short, we got her the help she needed (when daddy stopped fighting us) and things improved immensely.

He stayed in the CCU (critical care unit) area for families from the first visit until the last visit. He got to visit 10 minutes about every 4 hours. I couldn’t get him to leave, even when I was there. He finally agreed to stay with me at my house (which was 20 minutes away versus an hour from where he lived). Mama was there for about a week. She did not make it.

He did what was necessary and he was a caregiver

He took early retirement and did what needed to be done for his family. He loved her and had responsibilities as a man and husband. My brother and I saw his example of how you take care of your family. Was he perfect? No. Is that a requirement? No. Did he love her? Yes. Did he do the best he could? Yes. Was he a good caregiver? Yes.

My brother and I saw as we were growing up that you help your family in whatever way that you can. You jump in and do what is needed. We didn’t think anything about it, we just did it. That is the way a lot of us were raised.

That is great, but nobody really talked about the stress and emotions that you deal with while helping. Times were different when I was growing up only about 50% of the females or moms worked outside of the home. It is much higher than that today. Men are more hands-on with child rearing too. Good thing, too. 45% of caregivers are now men. They need different things than women caregivers. Hell, one thing is that they need to identify as “caregivers.” Men care provide just as good of home care as women can. 

Men approach caregiving differently

Men approach caregiving responsibilities differently from the way women do. Men focus on tasks and practical things that need to be done. Not so much on the nurturing tasks such as bathing, toileting, or dressing them. They can do them, but they need some training. Men are problem solvers and they tend to hire help to do some of the responsibilities that they either cannot do or do not want to do.

How frustrated might you be if you had never changed the sheets or cooked a meal? Yes, you can learn but you can also hire that stuff out.

Who are the ones most likely to have major health issues?

The strong silent types are those that will have major health issues sooner rather than later. Sadness is a part of all caregiving. Things that are lost deserve to be grieved. You may even hear men say, “What good does talking about it do?” It keeps crap from getting bottled up and further stressing you out. I get it, being stoic is about self-preservation. You can’t deal with the sadness, anger, and anxiety so you push it all down. It will eventually all come up and out. Support groups are great for all caregivers.

You are often unprepared and usually overwhelmed when the need hits. Why is identifying as a caregiver a good thing? It opens you up to possibilities of help and care. It also helps your primary care doctor know what to look out for in your own health needs.

Caregiving is a demanding job both physically and emotionally

Can you be a man and be a caregiver too? I think you can. Some men may feel it makes them look weak. That is not true. A caregiver has to be strong both physically and mentally. It is a very hard job. Strength under control is how I look at it. You have the physical strength when you need it, but you can be kind, nurturing, and loving too. To me, that is a protector. Another good thing about men as caregivers is that they are more vocal advocates for their loved one when they are in a caregiving role. 

Guys, you may feel that you are failing if you aren’t able to “fix-it.” You are not a failure. Sometimes, things cannot be fixed. You have to be strong enough to let things “be as they are.” That sucks and it hurts. It doesn’t mean that we do not have hope or work toward goals, but we can accept things just as they are, right now. I can accept reality but I never give up.

Feelings pop up, resentments pop up

You will feel alone. You will feel resentment. You will begin the grieving process before they are gone. It is your job to take care of your own physical and emotional needs. If you don’t then you will not be an effective caregiver for very long. Then what?

Have a list ready and share the care responsibilities that you can share

Place your to-do chores list on the refrigerator and leave a place for names of who will do the chore. People usually ask what you need or what you need to be done. Of course, you can’t think of a thing when they ask…

This way they can check the list on the refrigerator and pick what they can help with. Yes, you can put a time frame or day on the chore that needs to be done. Put everything that someone else could do on your list and see what you get.

Examples

    • Dinner Monday

    • Dinner Tuesday

    • Dinner Thursday

    • Laundry Wednesday (take home and bring back)

    • Clean the bathrooms

    • Mow the yard

    • Clean the gutters

    • Change the sheets Friday

    • Vacuum, Sweep, Mop

    • Sit with her from X to Y on Friday

    • Take her to the beauty parlor on ______ at _____

Getting help is not a sign of weakness, it is a strategy for being a successful family caregiver. 

Pat