Category: #parkinsons

Do you have “choice paralysis?”

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

November 30, 2022

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

We like certainty. We want to know that we have made the “right” decision. Our brains do not like uncertainty, it makes them work overtime to feel safe. Our brains get hijacked by our emotions and we cannot think logically. Stop overloading your brain.

Do you feel like you have to “shop around” and keep all your options open before making a decision? Two or three would be ideal, but we have to go to 10 places and keep comparing. How many of us get too obsessed or too anxious? You know who you are and you are nodding your head in agreement.

How much energy are these decisions taking? Is it really worth that much stress, anxiety, or energy-wasting? Have you ever thought about when this choice overload happens? It usually happens when we don’t have enough good information or knowledge in the area of need. Use your good resources. Set your limit to three of those resources. Find a knowledgeable person and have them provide you with your best two or three options for your needs. (That would be a plug for my services, in case you didn’t catch it.)

What does feeling stuck look like?

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

Motivation is red hot for a while, but then it burns out and all you have are a bunch of ashes. What now? For one, the realization that motivation is never enough to achieve a goal. It takes commitment to the process. Doing it even though you don’t feel like it is another realization. Be consistent. Continue after a break.

Maybe you feel trapped as a family caregiver. You don’t mind helping, but now you feel like you never get out. It is a difficult adjustment. Be careful, resentments can build up before you know it. You feel like you are missing out. You feel trapped by doing the same tasks over and over.

Consider this, challenges are matters of perspectives and our own attitudes.

Is there some middle ground that you and your care receiver can agree to? Challenge your on “stinking thinking.” It could be your perspective and attitude that are the problems.

Some ideas to help you not feel trapped:

  • Only you can change the things in your life that you are unhappy about.
  • Live a healthier life by moving (walking/running) and eating better.
  • Be consistent, motivation alone is not enough.
  • Accept uncertainty. We can make good decisions, but we cannot choose the outcome.
  • Reconnect with your personal values.
  • What can you do, right now, that will be helpful?
  • Be the hero of your story and not the victim. Stop saying, “I don’t want …”
  • Stop focusing on the things that are causing you to suffer. Focus on whatever fills you up.
  • You may not have good options, so choose the option that you will regret the least.
  • See if you are in the “all or nothing” thinking. It can be a “both/and.”
  • Write down some “I could …” statements.
  • Write down three different things you are grateful for every day.
  • Be proactive rather than reactive. You will have more control and less stress.

Pat

It’s just something you do.

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

October 19, 2022

Ruck up – “man up” for a difficult situation

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

I did not identify as a caregiver because I was not doing hands-on care. I was helping out. I was doing what needed to be done. Along with working full-time and dealing with my own home and life with kids.  I was scheduling, and I was seeing to her needs. I ran errands, took her to doctor appointments, cleaned the house, mowed the yard, and did the laundry.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Examples

  • Dinner Monday
  • Dinner Tuesday
  • Dinner Thursday
  • Laundry Wednesday (take home and bring back)
  • Clean the bathrooms
  • Mow the yard
  • Clean the gutters
  • Change the sheets Friday
  • Vacuum, Sweep, Mop
  • Sit with her from X to Y on Friday
  • Take her to the beauty parlor on ______ at _____

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

Pat

Burnout stage or Nervous breakdown stage?

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

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

October 12, 2022

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

A few things to watch out for:

  • You call in sick for a day or two (sometimes, longer).
  • You miss appointments.
  • You avoid or back out of social engagements.
  • You have trouble with healthy eating, exercising regularly, sleep, and your personal hygiene starts slipping.
  • You withdraw from people and don’t want to leave your home.
  • You lose interest in things that used to bring you joy.
  • Panic attacks.
  • PTSD flashbacks

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

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

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

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

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

Extreme burnout will lead to a mental health crisis.

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

Some causes of caregiver burnout include:

  • Emotional demands: A caregiver can feel emotionally drained, especially if they are aware that the person they are looking after will not get better despite their efforts. For example, this could happen if a person is caring for someone in palliative care.
  • Conflicting demands: These are the additional demands a person has outside of their caregiving role, such as looking after children, going to a job, and making time for their partner.
  • Ambiguous roles: Often, the role of a caregiver is all-consuming. It is easy for a person to lose sight of who they are outside of their caregiving responsibilities.
  • Workload: Some caregivers may be looking after someone with complex needs. In these instances, it is important a person seeks temporary relief and gets assistance from other carers.
  • Conflicting advice: In some cases, treatment procedures may change as research progresses. While these changes aim to give people the best care, they can cause a significant amount of disruption and stress if a caregiver has an established routine.
  • Privacy: Additional clinical support, such as nurses and other healthcare professionals, may visit a caregiver’s home throughout the week. While this can be helpful, it can also take away their privacy.

All of these factors can contribute to a caregiver feeling overwhelmed, self-critical, and drained. If they do not address these feelings, they may start experiencing serious symptoms of caregiver burnout.

Caregiver burnout symptoms 

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

Symptoms of caregiver burnout include:

  • disrupted sleep
  • persistent irritability
  • altered eating patterns
  • anxiety
  • increased alcohol consumption
  • high-stress levels
  • lack of joy
  • loneliness
  • loss of hope
  • suicidal thoughts

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

The three stages of caregiver burnout are:

  1. Frustration: A person starts feeling frustrated and disappointed that the person in their care is not getting better. They cannot accept that the person’s condition will decline regardless of how well they look after them.
  2. Isolation: After a while, a person may begin to feel lonely in their caregiving role. They may also grow tired of hearing negative opinions from family members, especially if these family members do not appreciate or recognize the time and effort caring requires. At this point, the caregiver may withdraw from friends and family.
  3. Despair: Eventually, a person may feel helpless and isolated. They can find it hard to concentrate, struggle to find joy in hobbies or interests, and avoid social interactions. The level of care they provide may also begin to drop as they spend less time on their own well-being.

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

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

Pat

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

How to balance expectations and reality

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

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

October 5, 2022

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

Some clues that you may be in denial about something:

  • You wonder, “If only she (or he) would …?
  • You doubt or dismiss your feelings.
  • Hope things will improve when …
  • You begin to feel resentful.
  • You walk on eggshells, trying to avoid a blow-up or avoid talking about the problems.
  • You may be worried that you will develop dementia yourself.
  • You avoid talking about the issue.
  • You avoid thinking about the problem.
  • You promise to address the problem in the future.
  • You minimize or rationalize what is going on
  • You become numb to your feelings

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

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

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

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

What expectations do you have?

Common signs that you have expectations:

  • Anticipating a certain outcome.
  • Having and holding a vision in your mind of how things will play out.
  • Having a set idea of what you want or need to happen.

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

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

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

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

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

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

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

  • Happy & Sad
  • Scared & Excited
  • Confident & Doubtful
  • Love & Anger
  • Grief & Joy
  • Wanting time with your partner & Alone time
  • Believe in yourself & have a fear of failure

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

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

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

Which caregiver role fits you, right now?

January 5, 2022

Which caregiver role fits you, right now?

  1. Hands-on caregiver – you are physically there and you help with their daily needs (i.e., dressing, bathing, toileting, brushing their teeth, meal preparation and feeding).
  2. Companion care – they can do most things on their own and you are there to provide company, keep them engaged with conversation (emotional support) and make some meals as well as medication reminders and light housekeeping. Maybe, take them to an appointment or on errands.
  3. Long-distance caregiving – you probably live an hour or more away, you may be helping with money management, and you may be in charge of making appointments, finding in-home care assistance, and planning for emergencies.
  4. Accidental caregiver – Oh crap, I did not see this coming, right now. I know that I have to help, but I am not sure what I am good at? I will muddle through.
  5. Reluctant caregiver – you may find yourself responsible for someone who has abused you in the past or that you do not get along with. This one is very difficult and it may be best to find help immediately and place yourself in the long-distance caregiving camp.
  6. A Swoop-in, create havoc and swoop on out caregiver – these folks need an ass whipping. They come in every once-in-a-while, state and do whatever they feel like, without regards to the care receiver or the other care givers and get things stirred up and then they leave. Most likely, these folks are just waiting for the care receiver to die so they will not have to be bothered.
  7. Provider of support to the caregiver – Physically and emotionally help the caregiver to excel at being a caregiver. You help the caregiver with the chores or things that need to be taken care of at their house or the house of the care receiver. (Laundry, house cleaning, cooking a meal or two, mowing the lawn, cleaning the gutters, running errands, etc.)

Some of you have never identified as a caregiver, it is just something that you do. You are helping your mom. You are helping your dad. You are helping your wife. You are helping your husband. You have never viewed it as caregiving, they need help and I will help them. It is that simple.

You never even give it a second thought. That is what family does for each other. I get it, I have been there too. It is what good friends do for each other too. While we don’t identify with the word “caregiver,” that is what we are. A lot of us are the Lone Ranger. We are fine, for a while. We can manage our lives, our jobs, our homes and all of our loved one’s stuff, for a while. Usually, it is about 18 months in and we are stressed out, frustrated, tired and overwhelmed. We look up one day, and wonder how we got here? It happened so slowly and it wasn’t too bad or too hard. But, now, it takes a lot more time and effort to help our loved one.

Our love for them has not changed. Our goals for them have not changed. Our goals for ourselves have not changed. What has changed is our own health. We are tired and we just cannot get rested. Our eating habits are worse, we have gained weight and those stress headaches and lower back pain keep us off of our game. Work is work. It hasn’t slowed down and I am expected to perform at my best every day. I can’t concentrate as well as I used to. I find myself worrying more about my loved one and I can’t remember the last time I had some free time.

What would help you the most in the next three months?

Do you need an easy to use, fill-in-the-blank essential information binder?

The three things it will do for you –

  1. Decrease your stress level
  2. Empower you to be more in control, to make better decisions
  3. Information will be easily accessed when needed

What is included in this Stress Buster, Time Saver, Information Binder:

  1. Banking Information (including retirement information)
  2. Bills – list of and when due
  3. Doctors and other Health care providers list
  4. Documents needed
  5. HIPAA release form
  6. Home information (home, vehicles, rental property)
  7. Income to be received (from Social Security, Retirement, Renters, etc.)
  8. Legal Documents needed
  9. Medical bills and EOB’s (explanation of benefits, with tips and info)
  10. Medical history (incl. diagnoses, surgeries, devices used, etc.)
  11. Medicare and Medicare Advantage Plan (how to check on EOB or MSN for coverages and benefits)
  12. Medications (list of medications, administration check-off list, incl. over-the-counter medications0
  13. Online accounts (User names, Passwords, Answers to security questions)
  14. Tasks to be done sheets

Available as a Binder Kit (with pages in sheet protectors, highlighters, ink pens and a mechanical pencil) 

OR

As a downloadable, fillable PDF file for Single use or Family Use

Use this link for more information and to Order product.

Binder Kit

The next thing that may help you or your loved one is to KNOW whether the medications you are taking are working for you, against you or doing nothing for you. It is a genetic test for medications. You do it once and use the information for the rest of your life. It is a cheek swab. Have your own doctor, physician’s assistant or nurse practitioner order the test (they may use a prescription pad), get it to me and we will get you started.

For more information and a list of medications that have a genetic impact, click on this link

Right Med® Test Kit

Scroll down to blue bar that states Right Med Mediation List and click on that link to see the list of medications.

Services offered are listed under the Options tab. Click on link below to access options page.

Options

Option 1 is for an overview and is available to all.

Options 2 and 3 are researched, doable plans of action using best practices and your individual needs as guidelines. You will be heard and understood. These require a conversation and acceptance as they are customized and detailed.

** I won’t waste my time or your money, if these options are not for you. **

Options 2 and 3 are customized for the individual with researching, troubleshooting and support plans for the individual and the family.

The difference in Option 2 and Option 3 – Option 3 includes follow-up for three months instead of one month. With Option 3, updating the support plan is included. I am your guide and will help you to keep moving forward.

My goal with Option 2 or Option 3 is to help you have an understanding of your options, what you may be facing in the future and how to be as prepared as possible. To have the information that you will need to make decisions and choose the best options for you and your family.

Who do you know that could benefit from any of these products or services?

I need your help to get the word out about these products and services. I want to help those that need these things. If I can make their journey less stressful, that is what I want to do. Please pass along this information to those you know. Thank you for your time and effort.

All products and services are available throughout the U.S.

Pat

Will you ever be okay with being wrong?

How many better decisions could you make IF, you felt it was okay to be wrong?

December 29, 2021

Okay to be wrong? Nope, I can’t even think it, much less say it out loud. For those of us that are “recovering” perfectionists (Remember, I am a work in progress.), still have a hard time believing that being wrong is okay.

Trust me, I know that making a mistake can be deadly. That was drilled into us at pharmacy school. But, not every mistake will be deadly. It may cause some harm or no harm. None of us want to hurt another person, we are here to help you to get better. To thrive. My yearly average was pretty good. Some years, I made no mistakes and some years, I made one. It sucks to have to write-up the incident report. Thankfully, mine was never the wrong medication. Wrong strength, wrong dosage form (tablet instead of capsule), incorrect directions, wrong doctor name, wrong original date, wrong quantity, all count as errors or mis fills. Every mistake and every incident gets written-up and sent in to corporate.

I hate making mistakes! I get angry at myself. I replay the incident over and over in my mind. Sometimes, I can figure out what happened and sometimes, I cannot. If it is a procedural error, such as disruption with a phone call or a customer at the window, then we can put things into place to mitigate those disruptions. If it is a look and mis-see error, usually you cannot fix that. Once you have “seen” drug, names and directions, you tend to see the same thing every time that you look at the prescription and the label. That is why it is best if a technician types in the prescription and the pharmacist checks it with fresh eyes. You always want at least two sets of eyes on it. I did not really mean to go this deep on this.

The point is, if you can identify a “fix” or a better way to do it next time, then you have learned something and most likely you will not make that same mistake again. You have learned and moved forward.

Isn’t that what is best for all of us? But, no, we keep beating ourselves up for past mistakes and errors. If we do that long enough, we will never make another decision that may impact someone else.

What if we could, be a little kinder to ourselves and allow ourselves to learn from what went wrong? Learn from what did not work? We catastrophize, we imagine the worst possible outcome of an action or event. For example, “If I flunk this test, I will fail this course, I won’t graduate and I will be a failure in life.” Another one is, “If I don’t recover fully in the first two weeks, after surgery, then I will never get better and I will be in pain or disabled the rest of my life.

97% of the time, none of that is true. You keep studying and doing better in your class. If you fail, you will have to re-take it, and then you will graduate. Healing takes time and you do get better as time goes on. You do have to do your part with rehab, moving and taking your medication as directed. Your pain will lessen and you will be able to get back to your activities.

I guess that we all need to catastrophize occasionally. Maybe, it keeps us on our toes? If you are going to catastrophize, then you have to go all in with your thinking. Ok, the worst has happened. Now what? Keep going.

What if we don’t catastrophize? What if we stop the automatic negative thoughts that come to us? What if the negative thinking is hurting you more than it is keeping you safe? If you always look for the bad or the worst, you will find it! The opposite is also true. If you look for the possibilities or the good, you will find that too. Stress and anxiety really does play a part in how we think about things.

You are right, sometimes things will get bad. But, not everything gets bad. We don’t deny reality, we do our best to accept it and provide the best quality of life possible. I will never give up planning and hoping for the best. I have learned that it is okay to make a mistake. It is okay to make adjustments. It is even okay, to try another approach. Trying is never failing. F.A.I.L. – First Attempt In Learning

It is our own screwed up mindset that keeps us afraid and that fear of failure rears its ugly head. Our self-worth gets tied up in to how well we perform. Think of a baby that is learning to walk. How many times do they fall? How many times do we tell them, “You can do it?” Or “try again?” They are learning something new and it is going to take a little time for them to learn. What would happen if the first time that they tried to walk and fell, they just sat there and cried and never tried to walk again? We would take them to their doctor to find out what was going on. We would think, “Ok, they fell, but they can try again and again and soon they will be able to walk.”  We will even help them to get up and move those legs.

Have you ever been pushed to explain your reasoning? Even when someone is curious and really just wants to know, we get all mad and start defending our position rather than explaining. That conversation never ends well, does it? What if we can be curious and wonder about our choices. What options have we thought of? What options could be found if we talked with others?  Don’t guess. Don’t assume, ask questions when you do not understand. I like to use a round table discussion where everyone is helping to brainstorm. Everyone throws out their ideas and nothing is ruled out until after the brainstorming session has ended.

None of us is very comfortable being critiqued. If you work for a company, then you will have a yearly evaluation. Sometimes, they are not pleasant. It is not that they are bad or really even negative, just some things that we need to improve. When we realize that we are receiving feedback to help us to become better and more efficient, we tend to accept the information easier than if we think we have done something wrong. Don’t let your automatic negative thoughts run away with you. Take a minute or two and assess the situation. The people around you want you to succeed. If they don’t, then find new people to be around.

I guess we did chase a rabbit or two during this blog.

Let yourself be open to learning new things. If you are wrong, admit that you are wrong. I promise you; it won’t kill you to admit such a thing. I have done it myself and it did not kill me. In fact, when I stopped trying to be perfect, most decisions became easier to make. They turned out quite well, too. I am smart enough to know when I don’t know. I find others that are smarter than me and I ask questions. I learn new things and new ways of doing things.

When you are right, don’t be an ass. Tomorrow, you could be wrong. Do you want to be right or do you want to be happy? Decide if you want to be a leader or a follower. A leader will take charge and make a decision after considering the current options. A leader knows when they have made a mistake. A leader will say, “I have messed up. This did not work out as I had hoped. Let’s try this.” A leader will say, “We made a good choice and things are working out nicely. Thank you all for your input.” When we admit our mistakes, we make it easier for others to admit theirs. Being wrong does not mean you are bad. Being wrong does not mean you should feel shame. Being wrong is just a thing that happens sometimes.

If you try to avoid mistakes, maybe you are not open to learning new things? Making mistakes does not make us a failure. Failure is an event and never a person. I wanted my techs to check me. I always told them that I had rather they be wrong than me be wrong. We need to challenge things that we think are wrong. They may or may not be wrong, but we need to find out. Question when you do not understand. Something new takes two, three or five times to hear before being understood.

Admit your mistakes. Look at the new skill you will learn. Resilience is what you learn when you get back up and try again. Resilience is one key to succeeding. You will not like making a mistake nor should you, but you do need to accept that you have made a mistake.

When you make a mistake what will you do? Will you pretend that it did not happen? Will you point the finger at someone else? Or will you take responsibility for your mistake and learn from it? Will you forgive yourself and move forward? If someone else makes a mistake, will you empathize with them instead of blaming them?

Besides, when you admit your own mistake … no one can ever hold it over you.

Pat

Who are you? Who are you helping?

I am the daughter of a dad with Alzheimer’s.

I am the son of a mom with Parkinson’s.

I am the wife of a man that has had a stroke.

I am the husband of a woman that has breast cancer.

I am the partner of one that has complications of diabetes.

December 22, 2021

You find yourself helping your mom with grocery shopping, taking her to the doctor, and having her hair done. You find yourself helping your dad by mowing the lawn, cleaning the gutters, and cleaning the house.

Maybe, you are doing their errands, laundry or going to the bank for them.

No big deal, it is just what you do for family. They took care of you when you were younger and now it is your turn to help them.

Health issues arise. Both physical and mental. They are no longer the independent, self-sufficient person that they once were. A part of you thinks that this is temporary, but the other part of you knows that this is the beginning of a decline in someone that you love.

We talk about parents and their needs, but it could be a spouse or partner. A life-altering tragedy has occurred and now you are helping them. You still have the same responsibilities you had before with your own job and your own health needs. Don’t forget about your civic responsibilities, church activities or friendships.

Over time, their needs take up more time and effort. Your free time becomes less and less. There will be times that you cannot take care of your own things very well as you are helping them with their things. It happened slowly and you didn’t really notice it until something like an unpaid bill smacks you in the face. You beat yourself up for missing the due date. You have never missed a due date before. Oh crap, I have had to take money out of my savings to pay some of my bills. Oh yeah, I had to miss a week’s work.  When was the last time I ate dinner with my kids?

I need a break; you think to yourself. But, how and who will step-in?

It is about this time that you start to look around and see how much time your helping has turned in to over these past couple of years. You start wondering and evaluating what has been happening and what would be best.

Questions to ponder:

  1. Is what I am doing for them necessary or can they do it themselves?
  2. Are you doing these things so others will sing your praises?
  3. What can be delegated to other people?
  4. Are you trying to exert control over a situation that is uncontrollable?
  5. Are you feeling guilty?
  6. Do you feel resentment building up?
  7. Are you open to others helping?

These are hard questions. These are necessary questions for you to answer to help you realize where you are and how you feel.  Maybe you have some guilt trying to run your life. A little guilt is good for us. It makes sure we are doing things for the “right” reason. When you start the “Should” in your thoughts and sentences, watch out. Big guilt heading your way. “Should’s” need to be stomped out of our vocabulary. That would stop a lot of the guilt. Are your “should;s” coming from what other people say? You could say, I can’t do that, but you are more than welcome to do that.

You are not all powerful. You are not all knowing. You do have options. Be open to seeing the possibilities. What do you want to be? What do you want to take care of? What are you good at? Your own attitude towards situations do make a huge difference in how you feel about a task.

Set certain days for certain things. Example, Medical Mondays – all appts. Need to be on a Monday morning. Grocery store Thursday evenings. Find the day and time in your own schedule that will work for you.

People are usually willing to help. However, they cannot read your mind. Make that list of things and keep it ready. Pull it out and sign them up. Need a meal fixed, put it on the list. Does the yard need to be mowed? Put it on the list. Laundry? They can pick it up and bring it back when they are finished. Do you need a “go-fer” for the day? Add your errands to the list.

Your new normal does not have to be awful. Your new normal does not have to always be stressful. Your new normal does not have to take over your own life. Your new normal does not have to cause resentment

Your new normal can be a blessing. Your new normal can bring your whole family closer together. Your new normal can help you learn to delegate better. Your new normal can help you to communicate better. Your new normal can be whatever it becomes because you are open to the possibilities.

Pat

Let it be … Even though every fiber of your being tells you to control it!

December 8, 2021

Some of you are breaking out in a sweat right now. WTF! I can’t let it be. It will be a disaster. He won’t do it like I do it. It will be a mess when I get back. If I don’t tell them what to do, they won’t do anything. And many, many other statements.

What to deal with first?

Let’s start with the control freak or as I like to call them, the person that “likes to take charge.”  

Who are you and why are you a control freak? Usually, a control freak is driven by an urge that they want everything done in a way that THEY feel is correct. Sometimes, it is because the control freak does not have control in an area of their own life and they will seek to control something that they feel they can control. It is also possible that the control freak has an obsessive-compulsive disorder, an anxiety disorder or possible a personality disorder. Sometimes, it is the person that has been through it before and has the experience. Other times it is the person who will step up and handle the situation. So, you see, there may be many factors as to why a person seems to be a control freak.

If you are the control freak, check yourself before you wreck yourself and your relationships. What are the real reasons behind your behavior? Is it truly to help the other person or is it for your own benefit? Do you trust others to handle situations as they arise? The better question is, will you trust others to handle situations as they arise?

Being effective does not mean you always have to control things, people or the situation. The reality is that we cannot control things, people or situations. The only thing that we can control is ourselves and our own views. We can’t control the outcome. We can control our mindset. We can control our work ethic. We can control how we treat others. No, they don’t make you treat them any certain way, you choose to treat them a certain way. We can control what we eat, how much exercise we do, how much rest and destressing we do. We can control asking for needed help before we get to the end of our rope. We can control what we focus on. Know that what you focus on shapes what we do and how we feel. Will you focus on possibilities/solutions or will you focus on the problems?

I have heard this phrase a lot, but I could not understand it for the longest time. “Let it go.” How in the hell do you let something go? You still think about it. You still wonder. You even still try to fix it. I finally read something that helped me to understand what “let it go” really means. It means to “let it be.” Let it be just as it is, right now. There is nothing to do but accept it as it is, right now. You don’t have to like it. You don’t have to fix it. You don’t have to feel a certain way about it. I know realize why I have always hated the phrase, “it is what it is.” I hated it because it frustrated me and because I could not accept that “it” could not be changed. Only accepted, as it is, right now. I didn’t have to like it. I didn’t have to fix it. I didn’t have to do anything.

It’s funny, when I stopped fighting the things that were not going to change and changed how I reacted to them I was much calmer and more at peace. I had to learn that it was my own reactions that were hurting me. I had to decide what I will accept or put up with and what I could not accept or put up with. Decision’s time!

Things you CANNOT Control:

  1. If people like you or dislike you
  2. Other people’s feelings
  3. Other people’s thoughts or beliefs
  4. Other people’s actions
  5. Who our relatives are?
  6. The weather
  7. The past
  8. The exact outcome. Of anything. Ever.

If it is not an immediate danger. Cool your jets. If death is not imminent, wait. Sometimes, things need to work themselves out. A few failures are a good thing. They are learning times. Failure is an event and never a person.

Be the flexible, can-do person. Understand that plans change. Priorities change quickly. Adapt to making the best decision possible with the information that you have, right now. Update as needed.

Have no attachment to the outcome. Calm down, you have to learn to be in the present moment. There may be so many factors that go in to an outcome and we cannot control all of them. Be open to possibilities and outcomes, just don’t become attached to them.

Learn to accept change. This is so very hard. We are creatures of habit. That is not a bad thing, it becomes very frustrating and maddening when we do not make allowances for things beyond our control. Work on focusing on the top three priorities. Focus on the things that matter the most and let go (let it be) of the other things. Stop trying to change the unchangeable. Just because we accept “what is,” does not mean we give up hope or stop trying for the best quality of life possible.

What if the care receiver is the control freak?

When the strength and courage that you admired in your parents has now changed into control freak behavior, how can you handle them and it? You will be provoked. You will be angry. You may hear constant complaining. You may even feel like a servant sometimes. Annoyed, Frustrated, Resentment and Anger coming up! Sadness will be there too. Watch out for your triggers to be triggered.

Manipulation by elderly parents:

  1. They may guilt trip you
  2. Nice to your face but talk about you to others
  3. They want everything done in a specific way
  4. They complain about family members, nothing pleases them & everything you do is wrong
  5. Easily becomes upset at just about anything

Why is this happening?

It may be their nature and they were always this way. It could be a new thing that has happened over time. Usually, they are trying to regain some kind of control over their lives and situation. The loss of personal power and control is awful. It is sometimes scary to have to depend on someone else for your needs.

Have them do everything that they can do, even if it takes longer. Let them make decisions, whenever possible. Ask for their opinion and advice. Everyone wants to feel useful. Don’t force them on to your schedule for the more intimate needs such as bathing. Let them decide on that time. It may only be an inconvenience to you, imagine what it must be to them. Let them keep their dignity and I promise you will have fewer battles. Of course, you may have to set boundaries and that is fine. Put yourself in their shoes to understand where they are coming from and do your best to accommodate them. We all want autonomy and independence.  It may be time to bring in the backup care givers.

As a care giver, you are there to provide them with help with what they cannot do. Your role is not to take over but to become more of an aide or helper. Encourage them to do all the things that they can do, even if it takes longer. Family dynamics will certainly play a role in a care giving and care receiving need. Everyone has a right to feel safe and to be safe.

Routines are good things. Once we have our routine, we no longer have to use excess brain power to figure things out. We just do them. Routines are good for care givers and care receivers. Figure out the best routine (one that is doable for the receiver and the giver) and implement it. Update, when needed. Agreement is the key. The care giver must be more flexible than the care receiver. The more you can fit in to their routines, the less pushback you will have. Remember to enjoy each other. Those are the moments that you will treasure.

Pat

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Wednesday Wonderings …Rules for “Vivi the Ventor” and “Lindsay the Listener”

December 1, 2021

Right off the bat …

To all of our partners, spouses and friends and families:

  1. Yes, we love you, we want the best for you and we want to help, if possible.
  2. No, we do not know when you are just venting.
  3. No, we do not know when you want suggestions or solutions nor when you don’t.

If you are anything like me, you get in to so much trouble by assuming others are asking for your help, ideas or solutions when really they are just venting and want to be heard. I am not opposed to listening and letting someone be heard, I need to know that is what you want. Have you ever noticed that the same people that want you to “just listen,” are also the same people that get pissed when you don’t offer solutions or help them when they are ranting and raving? It truly is a no-win situation. You get into trouble when you just listen and then you get in to trouble when you offer solutions or suggestions.

Let’s have an agreement for the “Ventor” and the “Ventee” aka the Listener. What will this agreement do? It will get everyone on the same page at the same time. It will improve your communication. Since communifriggin’cation is the key to everything, it might just stop the needless fighting, anger or hurt feelings.

I would suggest that you work on the agreement as soon as possible. Once the talking/venting begins it is too late. Each of you have unique ways that you deal with things. Your friends, partner, spouse, families do not deal with things the same way as you. If you only do one thing …make it clear that you just want to be heard, understood and supported OR you want ideas, help and possible solutions. Come up with two words that you can say and the other person understands. For example, you can say “rant” then the other person will know that you want to vent. If you say “help,” then they know to listen and then help you come up with possible solutions.

What happens if Vivi starts talking and Lindsay has no clue about what to do? Then Lindsay has to listen, understand, and empathize. No Fixing! No offering suggestions! I know that to just listen, understand and empathize is very hard to do. I always want to fix it or find a solution. I am a work in progress, but I am getting better and better at not offering unsolicited advice.

Rule #1 – The person being talked TO is “Lindsay the Listener” and the person doing the talking is “Vivi the Ventor.” Be quiet and listen for understanding, and NOT to reply.

Rule #2 – “Lindsay the Listener” will have to be on their toes ‘cause when “Vivi the Ventor” starts talking, they just start talking. You have no warning and are hardly ever told by Vivi that they “just want to vent.”  As the current “Listener”, you must become the one that takes those two seconds to breathe and think before responding in any way, shape or form. Lest you become the one getting yelled at! If you have not been told if this is a venting session or a brainstorming session, then you must ask nicely.

Rule #3 – “Vivi the Ventor” has a responsibility to tell “Lindsay the Listener” what is going on and what is expected of them. No assuming allowed.

Rule #4 – “Vivi the Ventor” gets to feel however they feel.

Rule #5 – “Vivi the Ventor” and “Lindsay the Listener” both must agree to be respectful towards each other.

Rule #6 – Vivi may need to vent or discuss but Lindsay either cannot handle it at the moment or has something else that needs to be dealt with. Set a time to talk later.

Rule # 7 – Do not interrupt. You may ask for clarification when they are finished with their thoughts. Repeat back to them what you have heard to make sure you understand.

Rule # 8 – Be fully present. Do Not look at your phone or the TV.

Some people are natural born problem solvers and others need some time to figure out what course of action to take. What are the known challenges that are preventing you from moving forward? What are some barriers that arise once you begin moving forward? Identifying challenges and barriers are easy for some people and not so easy for others. We all have different perspectives and life experiences. Different is not bad or wrong, it is just different.

Are you able to listen for understanding or are you waiting for your turn to respond? Are you willing to be uncomfortable when they express their feelings/concerns? It is much easier to rush to problem solving than it is to deal with feelings and emotions that are being caused by the problem. Everyone gets to have their own feelings and everyone deserves to have their feelings validated. You may not agree with their feelings or emotions and that is fine, but they get to have them and feel them. Maybe all the other person needs to hear is “that sucks” or “I am sorry that you are having to deal with that.” Maybe, they just want to know that you have their back no matter what.

Learn what empathetic listening means. Empathy is about listening to the emotions and feelings that the other person is describing. Maybe you could ask, “How do you feel about this?” They probably want to feel supported by you. Understand where they are coming from and what they are feeling about what has happened.

Venting can have a dark side. If you find yourself venting about the same things over and over again then it is time to move on to problem solving. Are you venting for more than 3 minutes? If so, you are probably replaying the same thing over and over again while getting madder and madder. You are letting it become entrenched in your thoughts. That is not doing you any good and it may keep you ruminating about the issues. Ruminating keeps you stuck. If you cannot change anything about the problem then you must change how you view or deal with the problem. Start processing your possible solutions out-loud. Yes, get the thoughts out of your head. What if the same types of situations keep happening? Other than pissing you off, what else is behind it? Be open to the possibility that there is a lesson that you need to learn. Do you need to let it be, just as it is (also known as letting it go)? Let it be. What a novel idea. Be curious. No judgement (it is what it is). Just observe. You really can let your thoughts wonder and not attach any meaning to them. Just go, “huh, wonder what that is about?” and keep on keeping on. Not everything is meant to be figured out. I get it, I drive myself crazy too trying to figure out the meaning behind something. Most of the time, there is no meaning, there is no problem, it is just a thing. Don’t misunderstand, there are problems/issues that do need to be thought about, figured out and a plan of action developed …but, not everything.

If any of these apply to you then stop venting.

  1. You have no intention of changing anything about the situation or the way you react to it
  2. The person you are venting to is dealing with harder or more complicated situations
  3. If you have absolutely nothing positive to say about anything, start working on finding gratitude for 3 things in your life every day.
  4. You deny any personal responsibility for what is happening or how you are reacting

Everyone needs to vent every now and then. It is cathartic and helpful. It can help you to clear your mind so you can begin working on solutions to improve the situation. When we find ourselves venting we probably to need to get those strong emotions off of our chest and deal with that conflict in a healthy manner.  Venting is not complaining. When you find yourself complaining, watch out? Complainers tend to focus on their own dissatisfaction, pain or uneasiness. Complainers only see it from their own point of view. Complainers see themselves as always right and others are wrong. Complainers become energy vampires that zap the listener.

Expressing your feelings is healthy. Complaining focuses on judging someone or something which does not help the complainer nor the listener. Which type of person do you want to be? Will you let others vent to you or is it always a one-way street? Some people take on a false sense of responsibility to fix things or help whenever others dump things on them. It is fine to be a helper, but not to the expense of your own peace of mind. Be wise. You cannot fix everyone or everything. Remember, you cannot make another person happy. Happiness is an inside job for each of us to handle on our own.

Pat

How can I tell people what I need? (Hint, you cannot be subtle nor can you use telepathy.)

November 17, 2021

It would be so much easier if other people just knew what you needed and wanted and did it! No one can read your mind. No one can really understand what you are going through. Even if they have helped take care of a loved one of their own, their needs may have been completely different from your needs.

Communi-friggin’-cation! It is the key to everything. That is my own word for communication. Did you know that other folks communicate totally different from you, well, maybe it is the understanding that is different? You know what you need, inside of your head, but how do you communicate that need so that others will understand?

Are you one that thinks …
Well, if they knew me…they would know what I need?

I have told them how tired I am and I need a break.

Well, if they could help me, I guess they would.

I talk about how hard it is, all the time. It has taken over my whole life.

No, I’m good, I can just handle it all.

Hey, I need you to be here on Saturday the 8th from 9 am until 6pm.

I need you to do the laundry, change the sheet and provide dinner on Sunday.

How many different styles of communication are there? Four major ones. Body language is another style, but that is for another day. We are talking about being verbal and asking for what you need or want. Wants are okay to ask for too.

Passive

Passive communicators go with the flow and are sometimes seen as wallflowers. No muss, no fuss. Sometimes they may be unaware of their thoughts or feelings, but more than likely they ignore their own feelings, wants and even their thoughts. They may seem to be easygoing, but underneath anxiety rules. They fear disapproval.

Passive communicators bottle things up. They hardly ever fight and usually cede everything. They stuff and they stuff their feelings and wants. You can stuff things for so long, but they will eventually bubble to the surface. Resentment, here I come!

Aggressive

Aggressive communicators dominate the conversations and state their opinions often overriding others’ opinions. They use direct eye contact, leaning forward, staring at you and moving towards you sometimes.  They are very poor listeners and use a harsh tone, even if they don’t mean to be using a harsh tone.

Aggressive communicators are not quiet and yes, they are the ones that yell. They almost never back down. Your feelings will not be considered. Think more of a “win” type personality and not the “win-win” type.

Passive-Aggressive

A passive-aggressive communicator will confuse the hell out of you. Why? Because they cannot get all of their thoughts, and meanings outside of their heads in a cohesive manner or in a way that makes sense to others. They may be easily frustrated. They can become quite irritable and resentful. They will use sarcasm, talk to another person instead of the person that they need to be talking to. They will criticize others. I don’t get this one, but I have seen it happen. They show oppositional behavior. They will be the one that states, “I will help.” They will help and they will Complain the Whole Time. These folks are angry and their words do not match their body language. Gritting their teeth, making their hands into a fist all the while either being indifferent or smiling.

Passive-aggressive communicators are angry and they know that they are angry, but will deny that they are angry or that anything is wrong. Sarcastic barbs coming your way or maybe you will get the silent treatment.

They silently seethe and the other person has no idea what in the world is wrong.

Assertive

An assertive communicator is confident. They are open to discussions and clarifying whatever may be unclear or confusing without being an ass. They are usually calm and will state what they want or need without imposing their requests on others. This type will look for a consensus, if possible. They usually listen and seem to care about others. You may have healthy and loud discussions but it does not feel like you are having an argument. They will share their thoughts, opinions and how they feel about something. They are open to you doing the same. Not only are they able to listen, they are able to hear.

What communication style to you have? What communication style do others in your life have? Can you see how things get all messed up when everyone is talking and no one is listening or hearing?

We have all heard it before, seek to understand first. Understand where the other person is coming from, try to put yourself in their shoes. You may not be able to fully, but try as best you can. We all have our own peculiar ways. We are different people with different experiences and we look at things differently. It isn’t wrong, it is just different. Search for common ground. What can you agree on? What is best for the care receiver? What is best for all involved as care givers? Each of us have strengths and each of us have things we don’t do very well.

Let your empathy and compassion for others help you in moving towards being an assertive communicator. A good sense of humor helps too.

What strengths help you become a better caregiver?

  1. Resilience – The ability to withstand or recover quickly from difficult conditions; I can negotiate for what I need and navigate systems.
  2. Patience – The capacity to accept or tolerate delay, trouble, or suffering without getting angry or upset.
  3. Flexibility – Ready and able to change so as to adapt to different circumstances; accept what is happening in the moment.
  4. Compassion – The ability to translate empathic feelings into action (desire to alleviate suffering).
  5. Optimism – Expect a favorable or positive outcome.
  6. Confidence – Sure of one’s self and one’s abilities.
  7. Organization – Methodical and efficient in arrangement or function.
  8. Ability to Laugh – To easily see and appreciate the humor in the situation.

Use these to rate yourself on the above strengths:

1 – Always

2 – Sometimes

3 – Hardly ever or Never

Be honest and help yourself to know what you are good at and what you are not so good at… Hopefully, you will find that others have different strengths than you and will be a good helper.

To identify and acknowledge your personal caregiver strengths, set aside a few minutes for personal reflection. Ask yourself the following questions:

  • What gives me energy?
  • What am I good at? What do I do best? What do I do well?
  • What am I naturally good at? What comes naturally to me?
  • What are my best character traits?
  • What things do I look forward to doing?
  • When faced with challenges or adversity, what strengths do I bring to these challenges?
  • What do I handle well?

When you ask for things, be specific. Have a list at the ready. You may need things done at your house instead of at the care receiver’s house. Be as flexible as you can. You must agree to a day and time or it will not get done. Never a “whenever” or a “sometime next week.” Pick a day and time, negotiate for another day and time, if necessary. Keep a running list of things that need to be handled. Heck, place it on the refrigerator for folks to sign-up.

Headings for the list include: What action or Task, Where (care receiver’s house or care giver’s house), What day, Alternate day, Who will handle this

You will have to be direct. Not an ass, but state what your Mom/Dad and/or you need their help. Are you willing to step-up, pitch-in and help? If they say yes, then pull out the ready-made list and get to work. If it is a task that takes time and they do not have time, then by all means suggest a less time-consuming task or request a specific amount of money (be fair and reasonable) to hire out the task. If that doesn’t work then ask them what they can contribute and shut your mouth until they begin figuring out things, Yes, it will be uncomfortable, but just be still and quiet. Be open to brainstorming sessions. Try to make your “ask” into statements. For example, instead of saying, “Can you do some things for me?” state that “I need XYZ from the store today.” “I need you to provide dinner on Friday.”

What if you ask and get told “no” to your direct request? You may even get brushed off or told off, where do you go from there? You still need back-up and help. It is going to suck, but you will move forward as if you are an only child. You may need to hire outside help, ideally with the care receiver’s money.

I have seen a family of 4 siblings work it out to care for their aging parents at separate times.  They all stepped up and did whatever was needed. They were all professionals and very busy with their careers, but they made their parents the priority. They communicated, worked together, had a list and each of them used their strengths to the fullest. Their parents we never alone.

I have also seen a family with 3 siblings leave it all to one sister. No help, no money, just bitching and “trying” to run things. It was horrible. That one sister realized she would have to handle her mom on her own. She did and her mom was well cared for. It did take some of the sisters’ own money, to help with outside care, but they managed and she had a good experience with her mom for the time her mom had left. She also told me that she had no regrets and that her conscious was clear. She is civil to her siblings, but not really much of a relationship with them now. Of course, it wasn’t much of a relationship before either. 

Maybe you will have to say your piece to those that will not contribute in order to let go of your anger or resentment at them. Do let go of your anger, you don’t have the time or energy for it.

There may come a time when you have to say “No” to caregiving.

You may find that you must set limits on caregiving responsibilities. You are exhausted, overwhelmed and your own health is suffering. It most often happens to those that do not take care of themselves during the care giving process. You do count. You do matter. Add your needs in to the mix.

What does saying “no” mean to you? Could it mean that you leave the loved one to fend for himself?

 Maybe it means that you are tired, isolated and depressed and you have to stop, possibly “no” means that you need to take a breather and you realize that some things will have to change if you are going to proceed and help as a care giver. Boundaries is not a dirty word. Emotional limits are reached quickly when either a crisis happens or you have taken no breaks.

Practice your “I” statements to work on your boundaries.

  • “I can no longer drive you to all of your medical appointments due to my work schedule and my limited time off. I know this will be a change for you. I suggest we look into other transportation options such as the Busy Bee Medical Transport Service.”
  • “Mother, I am unable to continue with the responsibility of cleaning the house weekly. I want to spend my time with you on other matters. I know it’s hard to let newcomers help, but I think it is time to hire a homemaker service you would be comfortable with.”
  • “Dad, I can no longer assist you down the outside stairs. I am worried about your safety and mine. I believe we need to build a ramp for easier access to your home. I have found a carpenter who has reasonable rates for construction.”

In each of the above statements, there is a presentation of what the speaker cannot continue to do, an acknowledgement that the change will have a consequence for the elder and a suggested solution. No attempt is made to make the elder feel guilty about the effort the caregiver is expending or the caregiver’s stress level. It is understood the elder knows the caregiver is working hard.

Setting the boundary is the caregiver’s responsibility. Deborah Colgan, MA, M.Ed., NCC

You can state what you need. You can be direct. You can set boundaries.

Pat

Wednesday Wonderings … Oopsie! That did not work, now what?

November 10, 2021

You worked and you thought and you worked some more. By golly, you have a plan. It is a good plan. You are so proud (and relieved).  Now, it is time to work the plan. I mean you are so excited and you just know that this is the right plan and the “right way” to do this thing. Granted, it was all in your head of how it would all play out, but still, it worked.

Then reality set in. A few fits and starts at the beginning, but you were still on your way. And then, out of nowhere whoa, the brakes get slammed on … hard. What the hell? Why all this resistance? Why is this not working? Why the melt downs? All of these things are running through your mind. You are replaying what happened. You are confused. This should have worked. I saw it work in my mind. We Are Trying This Again!

You do and the brakes get slammed on again. Hmmm, are you ready to look at what did not work? Are you ready to ask others why this did not work or are you still the Lone Ranger?  Are you ready to accept that it might not have been a good plan? If you aren’t, then look up the definition of insanity, you know, the one that states that you keep doing the same things over and over again, in the same way and you expect different results, 

This scenario plays over and over again in all of our lives. At work, at home and with loved ones that we are helping. Think back to your own experiences at work when you had the most brilliant idea for a way to handle an issue. I mean it was win-win for everyone. You had everything in place and began implementing the plan. It was okay and there were a few folks that balked, but you were determined to push on. Soon, the plan was not working as you had envisioned and the situation became more unstable and somehow it was not a win-win for everyone. Dang it! What happened? Maybe, you did not have buy-in from the start from the others that were going to be impacted by the plan. Maybe, the plan was not fleshed out enough for consistent implementation? Maybe, you had one or two people that did not like the plan because they were not consulted on something that would impact them? What do you do? Do you scrap the plan and start over? Do you look at what worked well and make adjustments on what did not work well? Do you bulldoze over others objections? Do you seek input from others who will be impacted with the plan?

What a pickle! Can you see how these things happen in caregiving or helping others? I can. I have a plan and I think it is the greatest plan to help all involved. But, I did not even talk to all involved to see what they thought about the plan. I only thought about what I thought would work the best. My own perspectives, my own wants and my own…everything. I did not realize that at the time, I just thought that I knew best. I did not know best. How can I make a plan for others and not include their wants, needs or ideas?

I felt that if I was handling things, then I get to decide everything. That did not work at all. You talk about stress, strife, fighting, anger, even a lack of trust. I only thought that I knew best. I didn’t know jack. I had to realize that we needed to work together to make a plan that would work for all of us. All Of Us! Not just the care receiver, but the care giver, too. It was not easy to realize that I did not have all of the answers. I had the knowledge and I had the contacts, but I did not have my mom or dad’s perspective. Don’t make the same mistakes that I made. It was much easier than I had anticipated. It was so much easier once I knew what they needed and wanted help with. It was so much easier to work around my schedule when I shared my schedule with them. I am all about less stress and more effective ways of doing things. I am a life long learner and I like learn new things. One of the new things that I learned is that it is okay to be a recovering perfectionist. I learned that progress beats perfection every time. So much less stress too. Perfection keeps us stuck. We don’t have time to feel or be stuck.

What if you could provide better care AND get your life back? Sometimes, you can do it on your own and sometimes you will need my services.

When making a plan involve all the people that will be affected by the plan. (There may come a time in a dementia patient that they can no longer participate, but while they can, let them participate.)

  1. List the issue
  2. List who may be impacted by this issue
  3. Does this issue need to be done/handled at a certain time?
  4. Who can best handle this issue?
  5. If this does not work, what can be tried next?
  6. Brainstorm – write everything down (pare down later)
  7. Reevaluate and update, if needed
  8. Be flexible
  9. Come to a consensus or an agreement
  10. Implement the plan

The above tips will help to keep you on track. If you are a person that goes to worst case scenarios then you must act as if the worst has happened and make a plan for what you will do, you have to move past the worst-case scenario into what you will do next.

Remember, you only have so much brain energy to use on difficult situations every day. It is about two and a half hours. If it is important enough to make a plan then it is important enough to be at your best when your make the plan. Sleep, eat, and hydrate.

One thing that I want you to realize is that there will be important and urgent things and there will be not important and not urgent things. Don’t let yourself waste your time, efforts and energy on the things that are not important and nor urgent.

Handle only three things at a time, that is all you will be able to handle well anyway.

Pat

Wednesday Wonderings … How can I know if my medications are working?

November 3, 2021

Have you ever wondered if the medications that you are taking or someone that you love is taking are helping you, hurting you or even working at all? Have you ever wondered if you are having an unexpected reaction or side effect to your meds?

What is pharmacogenomics?

Pharmacogenomics is the study of how genes affect a person’s response to drugs. This relatively new field combines pharmacology (the science of drugs) and genomics (the study of genes and their functions) to develop effective, safe medications and doses that will be tailored to a person’s genetic makeup.

This definition is from the U.S. National Library of Medicine

Basically, your genes affect how and if certain medications are metabolized in your body. And why is that important? Because you need a medication to be therapeutic (to do its job well). Some drugs, called prodrugs, are inactive when administered (taken) and then they are metabolized into the active form to provide benefits. What happens if you cannot metabolize that medication into its active form? It will be like taking water. It won’t do anything because your body cannot change it into its active form. What if you take a medication and your body rapidly metabolizes it too quickly? You will not get the benefits of an Effective therapeutic dose. You are burning through it too quickly. What happens if you metabolize the medication very slowly? It can build up inside your body and cause more and more problems along with more intense side effects. Most medications are metabolized in the liver and excreted through the kidneys.

Metabolism, liver, kidneys, liver enzymes, excretion rates, inactive and active metabolites, metabolism rates, phases of metabolism, blood flow, changes in liver volume, etc. all of these things come in to play. What I want you to know is that you can find out how you metabolize certain medications and you and your doctor can decide what medications are best for you and your particular needs. You can also find out if you need more or less of a certain medication. Do the test once and use the information the rest of your life.

What are some of the benefits to having this test?

Helps your doctor find the medications that may work best for you

Helps you to know which medications to avoid

Helps you to know which medications dosage may need to be increased or decreased

Severe drug reactions can be reduced or eliminated

Stops the trial-and-error method that usually takes months to see if it helps or not

May help decrease opioid dependency

May increase pain relief

Bothersome side effects may be decreased or avoided

Do it once and use the information the rest of your life

Who can truly benefit from this test?

If you have been diagnosed with:

Depression

Anxiety disorders

Obsessive-compulsive disorder

Dementia

Autism

Insomnia

ADHD

Schizophrenia

Pain

Lipid disorders (high cholesterol)

Alzheimer’s disease

Parkinson’s disease

Multiple Sclerosis

Breast cancer

Epilepsy

Cardiovascular disease

Asthma

HIV/AIDS

Autoimmune disorders

Check-out the Medications that are impacted by your genes.

To see the medications list, go to WWW.EmpoweringHealthOptions.com

Click on the Products tab

Go about midway down the page and click on the blue bar that has the RightMed® Medication List

**Remember, some physicians prescribe medications for off-label use, which means they are using it for something other than what the medication is approved to treat. **

My own experience with pain medications has led me to encourage others to take this test. I had arthroscopic shoulder surgery in the early 1990’s. They sent me home with Percocet® (Oxycodone and acetaminophen) and Phenergan® (promethazine). I get home, ice and take my medications. I am out like a light in about 45 minutes. Now, I had never had any type of pain medications before and I don’t remember having any anti-nausea medications as an adult. After two hours, I am apparently whining in my sleep. I am awakened and I am hurting, but I am so sleepy. The promethazine is kicking my ass and I cannot wake up. The pain is fairly intense. Over the next 24 hours I am taking my pain medications as directed and only taking half of the promethazine. I do believe that the only thing that was helping me was being knocked out by the promethazine. I called my doctor and told him that the Percocet® was not working. He told me that was the strongest that they have. I know that’s a lie, I am a pharmacist. I understand that doctors are concerned about drug seekers, but hell, I just had surgery the previous day. He called in Tylenol#3 (acetaminophen and codeine). I took that and guess what? It did not work either. I knew that I was screwed and would have to deal with this on my own. I iced, I breathed deeply and I took a half a tab of promethazine every 8 hours and Ibuprofen 800mg every four hours. I am thinking that I never ever want another surgery in my lifetime! After about 5 days, I could stand it. Then came physical therapy. You do what you have to do. I cannot imagine what I would have gone through if I had anything other than an arthroscopic surgery.

As a pharmacist I knew that not every medication worked for every person. We all knew that; we just did not know why. We knew it had to be something inside our body make-up, but what? We knew that when Ultram® (tramadol) came out that it worked for some people and it did not work for others. I believed people when they told me that certain medications were not working for them, and I would have them ask their doctor to try X, Y, or Z. Just because something is “supposed” to work does not mean that it does work for all people.

Funny how when we don’t really have the answers, that we tend Not to believe it could be happening. We doubt the person and not the medication. Well, no more! Now we know that some medications are impacted by our genes. I now know that I cannot metabolize Percocet®. My body cannot metabolize Tylenol#3® nor can it metabolize tramadol. They are pro-drugs which means they need to be converted into the active form inside the body in order to work. So, I was taking sugar pills for my body. I have a genetic “defect” for CYP-2D6. But, by God, I now know what will work for me and the dosage that I will need. I have the tests to prove it for all the skeptical physician’s worried about drug seekers. My primary care physician has a copy of it in my records and now I tell them to call him for the results, if they want.

So, if you are going to have a planned surgery and you don’t know what pain meds work for you, it might be worth it to have this test. I know that it is expensive and it is going up after the first of the year (in 2022).  Only you can decide what is of value to you. It was valuable information for me and I can use it the rest of my life. No more waiting and hoping. No more wondering for months on end. No more wasting money and time. 

Have you been diagnosed with depression? Have you been started on a medication? What did your doctor and pharmacist tell you? Hopefully, they told you to take it at the same time each day, do not miss doses and give it 3 months. You do. It doesn’t seem to have helped very much, maybe a little. You return to your doctor and he or she takes you off of that medication and you begin again with another medication for 3 months. Nope, this one is not helping and you are now dealing with sexual arousal dysfunction. You return a third time, maybe or you stop going back and just suffer. You are 6 months down the road with no real results to speak of. Six months of your life that you will never get back. You tell me, what is that worth to you and your family?

Are you a chronic pain patient that want the best quality of life possible? Let’s find the medications that will work for you and not wipe you out. Let’s find the right combination to help you to get back to living. I know that you will not be pain free, but you have every right to expect it to be manageable.

Everyone deserves the best quality of life possible for them.

Do it now, before the price goes up in January 2022.

Most HSA’s and Flexible Spending plans allow coverage for this in-home test.

Pat

The 5 different types of metabolizer status are described below.

  • A person who is a “Poor Metabolizer” for a medicine will process that medicine very slowly. The medicine might not work if it is processed slowly, or it could put them at risk for side-effects.
  • A person who is an “Intermediate Metabolizer” for a medicine will process that drug slowly, but not as slowly as a poor metabolizer. This means that the normal amount (or dosage) of certain medicines may not work for them, or may cause side-effects.
  • “Normal Metabolizer” for a medicine usually benefits from the normal amount (or dosage) of the medicine. This means the metabolizer status does not put them at increased risk for side-effects.
  • A person who is a “Rapid Metabolizer” or “Ultrarapid Metabolizer” for a medicine can process the medicine very quickly. A medicine might not work if it is processed very quickly, or it could put the person at risk for side-effects.

Wednesday Wonderings … When we are faced with ‘No” good choices, how do we decide?

October 27, 2021

Right, Wrong, Good, Bad – those are the words we use to describe our decision-making choices. What makes a decision right or wrong? What makes a decision good or bad? Yeah, I know, it’s like porn. You can’t describe it, but you’ll know it when you see it.

A decision that is right for you may be wrong for me. A decision that is good for me may be bad for you. Hang on, here we go… Your perceptions and life experiences are your guides. Your gut feelings are tied in to past experiences and results. Sure, we all like to think that our decisions are made with great care and a lot of thought. Wait, I need to throw my bullshit flag.

Hear me out before you take your toys and go home. All of us have unknown biases. All of us have tunnel vision on certain issues. All of us hate the idea of even making a “wrong” decision. It is one thing to make a wrong decision for ourselves, but let that decision affect other people that we love and that piles on the stress, pressure and worry. I never want to hurt the ones that I love. I always want to make the best decisions possible. I especially want to make the right decision when it affects those that I love.

How can we make the best decision possible when we don’t recognize our biases? How can we make a good decision when we really don’t know what good resources are? To me a good resource is a trusted resource. A trusted resource often educates. A trusted resource is NOT an advertisement. Use the CRAAP test. See the bottom of the article for a worksheet.

Facts are Facts. You don’t have to like it. Truth on the other hand takes in to consideration you own views, beliefs and ideas about a subject and sometimes you throw facts in the mix. Unknow biases. Question why you believe what you believe. Be skeptical. Can you accept what you have thought or believed most of your life could be wrong? How did that last word “wrong” make you feel? We do not want to be “wrong” ever! Change the word “wrong” to incorrect and see how that makes you feel. Can you accept that your friends and families’ beliefs and opinions may be incorrect? I am able to accept that I am incorrect. I am not inclined to believe that I am wrong. I get defensive if I am “wrong.” I can’t stand to be wrong! That is why I will do my research from trusted sources. I may not like what I have learned, but at least I know the facts and I can then figure out what will work best for me and my loved ones. Find three trusted resources and read the information using the CRAAP test information.

Be open to learning something new. Be curious. Let yourself ponder and think. We try to control the outcomes with our decision-making. Have you heard the phrase, “trust the process?” Why do people tell us that? Because we cannot control the outcome. We can only do our best. Sometimes, it is making a decision with the information that we have, right now. We may need to change our decision or update as we learn new information. That is okay. When we know better, we do better.

What happens we are faced with NO good choices? What do we do? How can we decide?

We make the decision that we will regret the least.

Get rid of the “should.”  Every time that you say or even think the word “should.” Stop and change that word to “Want.” What do I want? How do I want things to go? What do I really want down the road? Take time to think. Think through your options. Brainstorm and don’t dismiss anything, right now. You can pare down later. Are there compromises or alternatives?

  1. What are your values, wants and needs?
  2. Talk it through with a good listener. Tell them you are talking and you just want them to listen.
  3. Maybe you need someone else’s perspective (maybe someone who has been in a similar situation).
  4. Test out the decision in your mind. Go all the way through. Remember, you cannot control the outcome. How will this affect me in the short=term, in the long-run?
  5. Doing something always beats doing nothing.
  6.  Listen to your gut. Your intuition is important.
  7. There is not right or wrong decision, only what is best for you and your family.
  8. When all of the choices suck, which one will you regret the least?

Choice overload will cause you to not make a choice. Paralysis by analysis is a real thing. Too much information will keep you on the indecision wheel. Find 3 choices by doing your research with trusted resources. Realize that decision fatigue happens to all of us. Making tough decisions takes a lot of time and a whole lot of energy. You will second guess yourself. Go with what you know and not how you feel once you have made your decision. Accept that there will probably be trade-offs. Know what your values are. What is important to you.

Very few decisions can’t be changed or updated. Try to find a “both/ and” decision rather than an “either/or” decision.

Sometimes you will have to make a decision that you will regret the least. Be kind to yourself.

Pat

The CRAAP Test Worksheet

Use the following list to help you evaluate sources. Answer the questions as appropriate, and then rank each of the 5 parts from 1 to 10 (1 = unreliable, 10 = excellent). Add up the scores to give you an idea of whether you should you use the resource (and whether your teacher would want you to!).

Currency: the timeliness of the information………………………………………………………………………..

• When was the information published or posted?

• Has the information been revised or updated?

• Is the information current or out-of date for your topic?

• Are the links functional?

Relevance: the importance of the information for your needs…………………………………………….

• Does the information relate to your topic or answer your question?

• Who is the intended audience?

• Is the information at an appropriate level?

• Have you looked at a variety of sources before choosing this one?

• Would you be comfortable using this source for a research paper?

Authority: the source of the information……………………………………………………………………………

• Who is the author/publisher/source/sponsor?

• Are the author’s credentials or organizational affiliations given?

• What are the author’s credentials or organizational affiliations given?

• What are the author’s qualifications to write on the topic?

• Is there contact information, such as a publisher or e-mail address?

• Does the URL reveal anything about the author or source?

Accuracy: the reliability, truthfulness, and correctness of the content…………………………………………

• Where does the information come from?

• Is the information supported by evidence?

• Has the information been reviewed or refereed?

• Can you verify any of the information in another source?

• Does the language or tone seem biased and free of emotion?

• Are there spelling, grammar, or other typographical errors?

Purpose: the reason the information exists……………………………………………………………

• What is the purpose of the information?

• Do the authors/sponsors make their intentions or purpose clear?

• Is the information fact? opinion? propaganda?

• Does the point of view appear objective and impartial?

• Are there political, ideological, cultural, religious, institutional, or personal biases?

Total:

45 – 50 Excellent | 40 – 44 Good

35 – 39 Average | 30 – 34 Borderline Acceptable

Below 30 – Unacceptable

Created by Juniata College