Category: #dementia

How to decrease wandering and aggressive behaviors

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

September 28, 2022

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

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 Are they withdrawn?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

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

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

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

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

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

Don’t forget about brain use activities. They are important too. Coloring, making something, building something, and doing a puzzle are all important, too.

I know that some of you are thinking, “I just want to get X, Y, and Z done.” Let your loved one help, give them a job. Be fully present and engaged with them. It won’t take any more time and it may even take less time because you won’t have all of the interruptions.

People before things.

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

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

Strength and balance exercises are very important.

The health benefits of exercise include:

  • Improved mood
  • Better sleep
  • Reduced likelihood of constipation
  • Reduced 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

Does behavior in a person with Alzheimer’s disease have a reason?

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

September 21, 2022

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

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

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

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

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

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

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

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

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

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 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

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.

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

Are you engaged with your loved one or are you just doing chores?

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

Most of the tasks you will be doing, will not take a lot of brain power or concentration. Some tasks will, 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.

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.

We talk a lot about dementia patients, but let’s focus on care receivers that have a physical disability, such as stroke survivors.

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

Effects of a right hemisphere stroke in the cerebrum

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

Effects of a left hemisphere stroke in the cerebrum

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.

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 hit when you are a caregiver?

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

September 7, 2022

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

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

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

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

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

Here are some ways that your own mind will kick your ass.

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

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

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

Things you do not have control over:

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

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

Will you reduce your personal stress?

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

The following information is from Family Caregiver Alliance

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

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

Steps to Managing Stress

  1. 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.
  2. 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.
  3. 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.

  1. 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

  1. Weakening of the immune system, which increases vulnerability to colds and other infections
  2. Mental health disorders (e.g., anxiety, panic attacks, depression, mood swings)
  3. Cardiovascular problems (e.g., high blood pressure, elevated heart rate, high cholesterol levels, increased risk of heart attack and stroke)
  4. Metabolic disorders (e.g., metabolic syndrome, insulin resistance, diabetes, obesity)
  5. Gastrointestinal issues (e.g., ulcers, vomiting, diarrhea, constipation, heartburn, chronic bowel disorders)
  6. Muscle tension and pain (e.g., backaches, neck pain, jaw pain, tension headaches, migraines)
  7. Sleep problems (e.g., insomnia, stress dreams, sleep deprivation)
  8. Chronic fatigue syndrome
  9. Respiratory problems (e.g., shortness of breath, rapid breathing, exacerbation of existing lung diseases like asthma and chronic obstructive pulmonary disease)
  10. 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?

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

August 31, 2022

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

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

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

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

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

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

  • The toilet seat is right behind you. Squat down slowly to sit.
  • I am going to help you stand up now. Scoot your butt forward.
  • Lean forward and put your hands on my forearms when you are ready. Then ask them to raise/stand up. (Do not pull on their arms or legs. Hold on to the trunk of their body or their hips.)

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

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

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.

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:

  1. 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.
  2. Heat the bathroom with a heater.
  3. Deep breathe and get yourself in the right frame of mind to help them.
  4. 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.
  5. 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. **
  6. You may drape a towel over their lap and shoulders to maintain dignity.
  7. Allow them to wash on their own. You only help if they can’t get everything washed.
  8. Wash the hair and condition it, first (always rinse well).
  9. 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.
  10. Drape a terry cloth robe around them (it helps in the drying process).
  11. Try to pat dry and not rub vigorously (again, you want them to do everything they can do).
  12. 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.
  13. 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.
  14. 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.
  15. 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

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

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

July 13, 2022

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

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

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

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

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

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

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

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

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

  • Anger – an angry person often reacts without thinking
  • Giving up – you quit everything and you no longer care about the goal (this is not the same thing as deciding to give up on an unreachable goal)
  • Loss of confidence – you might take a hit to your self-esteem too by giving up
  • Stress – too much stress breaks our bodies down (irritability, anger, anxiety, fatigue, headaches, depression, low back pain, stomach pains, migraines, ulcers, etc.)
  • Depression – continued stress or anxiety that causes brain chemical changes
  • Abuse and misuse – drugs, alcohol, food, shopping
  • Anxiety, Fear, Sadness, Guilt, or Shame are other responses to frustration.

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

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

Signs of Caregiver Burnout

  • 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

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

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

July 6, 2022

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

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

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

Some tasks that caregivers do, provide and handle.

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

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

Tennessee Department of Health

NFSP

Meet Caregivers Caregiver Training

Caregiver Training online course

A Place for Mom trainings and videos

APFM videos and courses

These will get you started.

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

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

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

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

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

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

Pat

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

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

June 22, 2022

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

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

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

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

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

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

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

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

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

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

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

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

Are you feeling guilty because?

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

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

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

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

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

Examples of non-negotiables:

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

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

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

Pat

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

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

June 15, 2022

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

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

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

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

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

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

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

Personality Traits of a Happy Caregiver

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

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

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

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

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

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

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

Pat

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

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

May 11, 2022

Observations

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

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

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

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

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

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

Psychosis can be:

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

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

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

Understand that some classes of drugs can cause psychosis.

Classes of meds that may cause psychosis:

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

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

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

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

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

Common signs and symptoms of psychosis includes:

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

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

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

You may worry:

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

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

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

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

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

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

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

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

Methamphetamine

Cocaine

Marijuana

LSY

Peyote

Mushrooms

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

PCP

Ecstasy

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

Pat

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

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

March 9, 2022

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

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

When did healthy become based on appearance?

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Here are some of the most notable autoimmune disorders:

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

Pat

How the senses change in dementia…

No, they are not just being difficult.

March 2, 2022

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

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

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

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

Sight/Vision issues:

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

Smell issues:

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

Taste issues:

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

Touch issues:

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

Hearing issues:

We talked a little about that in our example above.

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

Impaired movement issues:

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

Balance issues:

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

Stiffness/Shaking issues:

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

Coughing/Choking issues:

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

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

Pat

Has your life been hijacked by responsibilities outside of your control?

How do you feel about that? Okay, now, how do you feel about how you feel? Whew! That in itself is enough to make your head explode, isn’t it?

February 16, 2022

I learned a new phrase today, as I was doing some research on dealing with feelings, and I came across “meta-emotions.” I have never heard of that term before. I was thinking about my own experiences of how I felt about the frustration and anger that I felt when my life was hijacked. I did berate myself for feeling that way. How could I feel that way? I love my mama and I will do anything that I can for her. The frustration and anger was never about her. It was about the situation.

Meta-emotions can be classified into four types: negative-negative (e.g., feeling embarrassed about feeling sad), negative-positive (e.g., feeling guilty about feeling happy), positive-positive (e.g., feeling hopeful about feeling relieved), and positive-negative (e.g., feeling pleased about feeling angry).

I could not make things better. I could not fix this so we did not have to deal with all of this crap. I wish that I could tell you that I adapted well. I did not. I made it much harder than it had to be on myself. I sure learned the hard way, that I would have been better off if I had learned to accept things as they were & adapt to the ever-changing situation.

Nope, just stuff it all down. Deep down, inside. Soldier on. That will work for a while, but not forever. It will come out. It will come up in screwy ways. You won’t even know why you are feeling like you feel. It may years down the road. You can’t figure out why your emotions are all over the place. Maybe, if you got still and curious you could figure it out? Talk therapy is a much quicker way to figure it out.

I think everyone needs to do some talk therapy. Shoot, three or four sessions may be all that you need. Therapists will give you the tools you need to figure some of this “emotions” stuff out. You will also be taught how to deal with it in an appropriate manner. In other words, you won’t have to show your ass.

You won’t have to keep beating yourself up for feeling bad about feeling bad. If you are a helper or care giver you have probably dealt with all kinds of emotions. I use feelings and emotions interchangeably sometimes because I won’t slow down and figure out which one it is. Here is my attempt at understanding the difference. Emotions are neurological reactions to external stimuli. They are instinctive and we are not usually conscious of them. That friggin’ amygdala, again. It really is trying to keep us safe. We have to help it, by realizing when we are in danger and when we are really NOT in danger. Feelings are the reactions to the emotions.

  1. Something triggers you
  2. You have an automated response (your fear emotion, anger or whatever the emotion, is being sent out through your body)
  3. That lasts about 90 seconds and then that part is over
  4. What happens next, is up to you. Will you cling to that emotion or will you interpret the situation as not life threatening, reassess and move forward?
  5. Realize that how you think and how you feel directly impacts how your body reacts. This is the point where you take a breath or three and separate yourself from the experience to observe it, be objective and be curious about how you feel. No judgement allowed.

How do you manage difficult emotions?

Can you reinterpret what you experienced? Can you look for the good in the bad? Sometimes, we have to sit with that uncomfortable emotion. We have to feel it to process it. That is not fun. The upside is that we can learn from it and we don’t have to always have the negative emotions when we are triggered. We can learn. “Whatever you resist will persist.” I have no idea who said that first, but I have heard it a lot.

Emotions may not signal danger, but they may signal that you need to make a change.

Care givers have many, if not all of these emotions at one time or another. See if you can relate?

  1. Guilt
  2. Resentment
  3. Anger
  4. Frustration
  5. Worry
  6. Loneliness
  7. Defensiveness
  8. Grief

Questions to ask yourself when you feel certain emotions arise:

  1. Is what happened unexpected?
  2. Is what happened enjoyable?
  3. Is what happened going to make it easier or harder for me to get what I want?
  4. Can I control it?
  5. Will I be able to cope with what happened?
  6. Does what happened match with what I think is right or wrong?
  7. Is what happened my fault or someone else’s?

(I borrowed these questions, but I cannot find my cite link.)

What are the positives of negative emotions?

Sadness or grief may make you pay more attention to details?

Anxiety or stress may encourage you to find new ways to deal with situations.

Anger or frustration may make you see that it is time for help or another set of eyes on a situation or problem.

Guilt may help us to figure out what is ours to deal with and what is not ours to deal with.

Negative emotions may be what you need to motivate you to make a change.

**Any time that you deal with your emotions, you will get tired and feel drained. It is very exhausting, but it is worth it in the long run. **

Pat