Nov 30, 2011

Avoiding depression

"Behaviors strongly associated with depression -- reduced physical activity and human contact, overconsumption of processed food, seeking endless distraction -- are the very behaviors that more and more people now can do, are even forced to do by the nature of their sedentary, indoor jobs." Dr. Andrew Weil

As caregivers for dementia, there is danger that we are existing in fertile ground for depression.  I don't know about you, but I have reduced physical activity (even with my discipline of daily exercise), decreased human contact (except with the person with dementia), and I sometimes out of exhaustion rely on processed foods (although not very often).  It is very challenging to do this task without feeling overwhelmed and/or depressed.  Dr. Weil says in a November 7 & 14, 2011, Newsweek article that we humans thrive in natural environments and social groups.  Two of the things which are harder to enjoy as caregivers for dementia.  He goes on to say that we are suffering from nature deficit; while experiencing information surfeit.  He recommends as a remedy setting limits for how much time we spend on the internet and with email.  Good suggestion. 

Nov 29, 2011

Brilliance

"What does what I say, say about me?"  Jack Sacco.

We are probably all familiar with the old saying that people with brilliant minds talk about ideas, people with average minds talk about things, and people with dulled minds talk about other people.  I am sure we have all been in a group where someone is talking too much, too loud, too long.  Perhaps that person has even been ourselves.  Gossip - talking about other people - can be a very intractable habit.  But, who would we rather be considered?  Someone with a brilliant mind, an average mind or a below-average mind?   Research suggests that habits can be easily changed.  All is takes is a commitment for 30 days, and that new behavior becomes a habit.  Along with the gratitude writing exercise, can we also incorporate the new practice - for 30 days - of not talking about people?  Let us practice instead talking about ideas.  What ideas do you have for making this caregiving task an easier one for you? 

Nov 28, 2011

Uphold dignity

"Uphold the human dignity of every single person, no matter what their race or beliefs might be." Monsignor William O'Connell

I have had the good fortune of knowing the man quoted above, and he did, indeed, live by that quote.  While he was speaking of racial differences and social/economic inequities, we can apply the same quote and attitude to persons with dementia.  I have spent a significant amount of my life energy advocating for those with intellectual and learning differences:  not unlike what we are now experiencing in being caregivers for someone with dementia.  Let us vow to treat the person with dementia, and all persons -- to include ourselves, with dignity.  A definition in Webster's for dignity is worthy.  Let us consider that every person, including ourselves, is worthy of respect, kindness, tolerance, and inclusion.  What does treating someone with dignity mean for you?  How can you treat yourself with more dignity?  For me, I can recognize my limits, I can ask for help, I can take care of my own health, I can make sure I have fun. 

Nov 27, 2011

Self pity

"If you go around in a mood of feeling sorry for yourself, you will go around alone." Peppermint Patty character of Charles Schulz

I have always loved the wisdom Charles Schulz displayed in his characters in the comic strip, Peanuts.  We watched, "Snoopy Come Home", last night and the above quote is from it.  The wisdom:  if you go around feeling sorry for yourself, you will go alone.  Isn't that the truth?!  One might think it is easy to feel sorry for onself and to feel burdened by the caregiving of someone with dementia.  But, really, what good does that do anyone?  A friend said to me recently that I do not talk much about my caregiving situation.  She is right.  I don't talk much about it.  Frankly, that would depress me.  Instead, I focus on what is right in my life, the things for which I am grateful.  How are you coming on the practice of writing 5 things in the morning about which to be grateful and 5 things at night about which you were grateful during that day?  Eugene D. Holden says it will transform us.  I am ready to be transformed.  How about you? 

Nov 26, 2011

Gratitude and joy

"As we practice gratitude for all needs met, in spite of appearances, we cultive a deeper sense of joy."  Eugene D. Holden

Mr. Holden seems to suggest that we express gratitude, even when what appears in our physical surroundings would not seem to support that.  Perhaps in being a caregiver for dementia, one might think that there is not sufficient reason for gratitude; but, really, is feeling sorry for oneself a better option?!  Happiness tends to depend on outside circumstances, but joy arises from within us.  And joy can be cultivated.  One of the ways to cultivate joy is by practicing gratitude. 

I watched a TED video with my daughter recently, and a monk on the video suggested that the only appropriate response for this (or any) day is gratitude.  Might our lives be better if we adopted that philosophy?  I think mine might. 

Nov 25, 2011

Gratitude for all

"Gratitude is a spiritual practice that allows us to be grateful for life. Gratitude is a consistent practice that flows in the wisdom of the world."  Eugene D. Holden

It may seem that gratitute is easier sometimes than others; when things are going very well, it is easy to express gratitude.  But what about the times when things are not going well?  How easy is it to be grateful then?  Eugene D. Holden suggests an exercise to develop our 'muscle' of gratitude.  It is:

For 7 days, every morning write five things for which you are grateful.  At night before you go to bed, write down five things for which you were grateful that happened that day.  He says that your life will begin to transform by practicing gratitude, and that this is an excellent practice to develop gratitude. 

Nov 24, 2011

Awake

"And as we let our own light shine, we unconsciously give other people permission to do the same." Marianne Williamson

The ballet, Sleeping Beauty, made me think of what some psychologists believe:  that great myths and fairy tales are so enduring because they speak to us deeply - in our psyche.  The young princess falls asleep to her life, and is awakened by the love of another human.  Can't we see ways in which this enduring theme has played out in our own lives?  Can you think of a time you have loved another in a way that allows them to be more fully themself?  Or perhaps you have received the type of love.  I did long ago from a beautiful therapist and friend.  Perhaps it is true that we cannot fully awaken to all we can be without the unconditionaly love from another person.  Can we be the person who provides that love today?  Is there a way, in the role of caregiver for someone with dementia, that you can love unconditionally?  Who knows what results such agape love might have. 

May you have the blessings of a good life on this Thanksgiving Day. 

Nov 23, 2011

Playing it small

"Your playing small does not serve the world.  We are all meant to shine.  We were born to make manifest the glory of God that is within us." Marianne Williamson

Sunday I went to see the Bolshoi Ballet's production of Sleeping Beauty.  For the first time ever an American was a lead dancer, and the review I read said he and the prima ballerina danced elegantly.  David Hallberg chose not to play small.  From perhaps unlikely beginnings, he danced with one of the most famous ballerinas in the world.  Good for him.  Prima Ballerina Svetlana Zakharova was exquisite.  She has not chosen to play it small.  Perhaps it is harder to see in our own lives if we have played it small.  Most of us are not world renowned or among the world's most successful.  But that is not the point.  Have we shone in our own lives?  Have we played it big in the small worlds in which we live?   A question to consider. 

Nov 22, 2011

Fear

"Our deepest fear is not that we are inadequate.  Our deepest fear is that we are powerful beyond measure."  Marianne Williamson

What if the above quote is true?  What if we fear success more than failure, personal power more than weakness?  Let's assume for a moment that it is true that we fear being our most powerful.  Then, perhaps, the best thing for us to do is to dare to become our most powerful.  How would your life be different if you chose to your absolute best self?  I believe that I would risk more, experience things more deeply, and not settle for less than what I want. 

Today let us think about being our most powerful self.   Now, let's actually live from our power.  What is there to lose?

Nov 21, 2011

Willingness

Become willing to express your highest and best regardless of the circumstances," Eugene D. Holden.

A dictionary definition of willingness is "freedom from reluctance, readiness of the mind to do or forebear."  Being a caregiver for someone with dementia provides a perfect circumstance to express our highest and best in spite of the circumstances.  And how do we do that?  By being kind and gentle to ourselves, the person for whom we provide care, and all others.  Can we do this 100% of the time?  I'm not sure that is humanly possible.  While I know I mostly express my highest and best, I do sometimes lose patience, become frustrated.  Perhaps the key is to "become willing".  We can each certainly do that. 

Nov 20, 2011

Sleep problems

"Many older adults have probelms sleeping, but people who have Alzheimer's often have an even harder time.  Alzheimer's may reverse a person's sleep-wake cycle, causing daytime drowsiness and nighttime reslessness.  These sleep disturbances often increase as Alzheimer's progresses."  Mayo Clinic Staff

People with Lewy Bodies Dementia often have an added sleep problem, REM sleep disorder.  This is part of the classic symptoms of LBD.  It occurs when the person acts out their dreams.  They can scream, thrash, and even get out of bed and run.  We have had great success with Clonazepam, which is what the Sleep Clinic at Mayo Clinic prescribed for Dwane.  If you are providing care for someone with LBD, I strongly urge you to get some good assistance from someone who has experience with sleep disorders and dementia. 

Nov 19, 2011

Emerging problem

Says Dr. Petersen: "When the baby boomers reach the age where they are at risk for Alzheimer's, which is not too far down the road, it's going to become a huge public heath concern. And it's not something we can wait to study when it happens. We have to anticipate it and try to prevent it. Otherwise, with millions more people who have cognitive impairment and dementia, it's going to be an enormous health care problem."


It is said that the Baby Boomer generation has changed systems throughout their lives, and now will change aging.  Hopefully, the emerging problem of thousands reaching advanced years will positively impact research.  It is something that we, as caregivers, might want to keep an eye on.  Let us hope there is hope on the horizon.

Nov 18, 2011

Early treatment

"It's important to get a prompt diagnosis, because the earlier you start treatment, the more effective it can be." Robert Stern, director of Boston University's Alzheimer's Disease Center Clinical Core.

Current research is being done to develop medications that slow or stop dementia, rather than temporarily treating the symptoms as current drugs do.  According to Stern, these drugs could be available within three years.  If interested, you could enroll in a clinical study.  For a list of trials with these medications, contact:   www.alz.org/trialmatch

You could be part of a cutting edge breakthrough.

Nov 17, 2011

So, what is normal forgetting?

"Misplacing your car keys is normal.  Failing to remember standing appointments or becoming confused in your field of expertise is not normal." Beth Macy, Parade Magazine November 13, 2011

Ms. Macy goes on to say that occasionally forgetting to pay a bill on time is normal; while losing control of the finances is not normal.  Having trouble summoning the right word is normal; while repeatedly losing the tread of a story or conversation is not normal.  Needing help setting up a dvd or computer is normal as we age; while becoming disoriented in a system once mastered is not normal. 

As I look back on our three years since the diagnosis of Lewy Bodies Dementia, I can see examples in each of these areas.  Dwane is perpetually confused with time in general, what day it is and when we might have something scheduled.  A first occurrence for me of concern was when he forgot how to put gas in the car; when he had worked in a gas station to pay his way through school -- and of course, has done it on a regular basis since self-serve was eliminated.  He also lost all ability to get finances straight, and I find in conversing with him, he often loses some important aspects of the conversation or the story line in a movie.  He used to record movies for his history classes, and now has trouble working the remote to turn on the television.  The examples Ms. Macy provides are excellent markers for when to be concerned about cognitive functioning.

Nov 16, 2011

Could it be Alzheimer's?

"The disease can take longer to diagnose in midlife because other health issues that can cause similar symptoms (such as thyroid disease, vitamin B-12 deficiency or depression) must be ruled out first," Beth Macy for Parade Magazine November 13, 2011.

A good article in Sunday's Parade Magazine.  The article gives examples of what is normal forgetting and what is not.  The article also recommends that a person, for whom there is memory or cognitive concerns, receive an evaluation from a physician or a memory care specialist, such as geriatrician, neuropsychologist, neurologist or geriatrics-trained psychiatrist.  These specialities may not be available in all areas, and I personally recommend a neuropsychological evaluation by a neurologist.  It is important to rule out medical causes first (such as the thyroid disorder, etc.), but then I think it is imperative that the person take a battery of neurological/psychological tests.  The information gleaned from this testing will inform the caregiver which parts of the brain and cognitive functioning are more and/or less intact.  Very valuable information when one then sets up an environment to support the independence of the person with dementia. 

Nov 15, 2011

Wisdom and gratitude

"After we leave school, we tend to head down one of two roads: 1.  We close our minds to new or different information while becoming more and more sure of ourselves; or 2. we watch, listen, and learn as we get older.  The second road has way more bumps and curves, but it's also the path to wisdom." Marilyn vos Savant.

I so agree with Ms. vos Savant's quote above, and it helps me understand some aspects of people.  I wrote another time that some members of my family appear to consider their opinions as facts.  Perhaps the reason for that is they chose to take the first road.  I am so grateful that life or Grace has helped me take the second road.  I love to observe and learn new and better ways of being in the world.  I am happy to give up a well-entrenched belief if I see evidence to its contrary.  I went to a speaker last night who said that the only way to develop consciousness is to let down the walls of our beliefs.  Perhaps that is true.  It seems to me that it is true that to develop spiritual and emotional maturity, we need to be willing to reconsider beliefs passed down to us.  Perhaps they are not what we ourselves truly believe.  Life is so interesting when one watches, listens, and learns.  Which way works best for you?  I choose the path to wisdom.

Nov 14, 2011

Truth and gratitude

"Truth is Reality beyond perceptual experience." Dr. Libby Adams

Truth is an often misunderstood quality.  A well-known Bible verse tells us that the Truth will set us free.  And, probably all of us have seen the quality of truth misused to advance someone's personal agenda.  Things some humans have thought over the years were true have turned out not to be.  Such as, the world is flat, the earth is the center of the universe, unaffectionate mothers cause autism, one race or gender is more intelligent or more worthy than another.  So, how do we know what is true?  It may be different for everyone, but one way to find truth is through meditation.  Meditation practiced will enable us to discern the voice of Wisdom from our own ego's voice.  Perhaps truth might be the upholding and honoring of every form of life.   What is your truth?  Your compass point?  What is your truth in being a caregiver for dementia?  I am determined to be a caregiver creating an atmosphere of respect and well being -- for us all.  That is a Truth for me.

Nov 13, 2011

Change as gratitude

Change your thinking, change your life." Eugene D. Holden

Change is something that humans may fear, and, indeed, there is security in the known -- even if the known is not optimal.  Others, perhaps those who venture to new lands, thrive on change.  I sometimes think about how different my life would be had it not been for my ancestors leaving the mother country.  They must have been an adventurous lot, as ocean passage in those days was arduous and dangerous.  I know I have some of their spirit in me, as I love change, and I am continually looking for better ways of doing things.  I was talking with a friend yesterday who said she can only stand to do something - like be in one job - for about 5 years.  I can resonate.  I believe that change is inevitable, so we can either embrace it or try to flee from it (and that will not work).  We don't even need to change jobs or relationships or geographic locations; perhaps all we need to do is change our thinking.  We can choose to think more positively.  My daughter asked me how I was doing so well in this caregiver role, and while I am sure it is due to a number of spiritual practices, I know it is also because I choose daily, even moment-to-moment, to change my thinking if it is not serving me. 

Today how can your thinking better serve you in the life you are living?

Nov 12, 2011

Love as gratitude

"Ghosh trusted me to do whatever it is I would choose to do.  That, too, is love." Abraham Verghese

I have finished the book, Cutting for Stone, by Abraham Verghese.  What a delightful read.  Full of passion, pathos, intrigue.  The above sentence captured me.  It is what I tried to do as a parent:  trust my children to do whatever he or she chose; knowing it would be what is best for them.  It would seem it is the love that the Divine must have for us; exampled in our freedom of choice --- which we exercise sometimes in our best interest and sometimes not.  So, today, I am grateful for all the people who have loved me enough to trust me to do what I choose to do at any moment.  And, I thank God for the grace to extend that level of love to others.  Even in being a caregiver for someone with dementia, there are many ways we can trust the person to choose rightly.  Perhaps our task is to discern when to intervene and when to trust.

Nov 11, 2011

Gratitude for freedom

Veteran's Day

Today I am grateful for my son and all the others who have served our country and our way of life.  In the case of my son, I was always grateful for the wisdom, integrity and good energy he brought to that service.  When he retired from the military, he said that my daughter and I had always provided light for him and the world.  What a lovely, lovely compliment to us both.  So, too, does he.

So, for all the men and women who have served to enable us all to have a safer life, a life more full of freedom:  I thank you.  I am so grateful.

Nov 10, 2011

Gratitude as intention


Intentions keep us focused." Eugene D. Holden

Some people dear to me express their amazement at my discipline in writing these daily blogs.  It is part of my intention in how I want to be within this caregiving task.  I want to do it graciously, and writing this blog daily helps me to do that.  I also know that knowledge is best shared, and this blog is a way to share reliable and helpful information.  I spoke with my spiritual director yesterday and we spoke of a way to pray:  he suggested the steps:  believe, claim, and give thanks.  It seems that the gratitude piece is an important step.   So, we can set the intention for how we want to be in life or in a particular situation like caregiving, and that intention helps us be and do what we intend.  And we can give thanks. 

Nov 9, 2011

Irony

"Death is the cure of all disease." Abraham Verghese

It seems that we humans try to avoid disease, although some of us are reckless in our behaviors, as if we were invincible and will not succumb to any disease.  I think we also fear disease, as the funny quote of Woody Allen would imply, "I don't fear death; I just don't want to be there when it happens."  It is funny because we can relate.  Death in the abstract is not scary.  Death in the form of a debilitating disease can be scary.  Dementia is a debilitating disease; and, while we are providing care for someone with dementia and busy doing it, we may not have time to contemplate that this is a disease that will end with death.  Probably not actually caused by the dementia; but by a dementia-related cause.  There is currently no way out of this disease except death.  Let us honor that, respect the days we have, and take good care of ourselves so we, too, do not succumb to this disease. 

Nov 8, 2011

Discipline

"Without discipline, there is no life at all." Katherine Hepburn.

It seems to me that the word, discipline, is sorely misunderstood.  Some adults use punitive measures with children or other adults and call that discipline.  It is not.  I once read that the root word of discipline is disciple, which means to teach and lead.  That is the type of discipline we can implement in our role as caregiver.  Teach, guide, model the behavior we want; and set up the environment to support the behavior we want.  Discipline is also a term we can apply to ourselves, and that is what Katherine Hepburn seemed to mean.  We can have the discipline to always be kind, to eat foods which are good for us, to exercise. 

With others and with ourselves let us celebrate and implement good discipline, and let us be grateful for the results.  Discipline, rightly done, does produce results -- of that we can be certain.

Nov 7, 2011

Gratitude

"As we express our gratitude, we must never forget that the highest appreciation is not to utter words, but to live by them." John F. Kennedy

This is the month that some countries celebrate the holiday, Thanksgiving, and it seems like a good time for all of us to remember to be grateful.  A friend recently wrote that she was feeling some negative feelings about driving early in a large city when she looked around her at examples of people who were homeless, and this shifted her attitude to being grateful for all she had.  Any one of can look around and be grateful for what we have.  Even in the role of caregiver for someone with dementia, we can see people who have it worse; far worse, actually.  So, today what is one thing for which you can be grateful?  For the month of November let us each day think of a new thing about which to be grateful.  Today my one thing for which I am grateful is that I am going for a walk with my daughter. 





Nov 6, 2011

Action


“Don’t hope – decide.” Tsering Dokkar Sherpa
In my years in psychological practice, it seems that the thing that keeps people mired is their lack of action.  They stay in the mulling, considering, hoping; and do not move to action.  A very wise therapist taught me that there are always at least three options in any situation, and I think she is right.  So, when faced with a dilemma or any decision to be made, think of at least three options.  Choose the one that seems best to you, which may mean that it is the one with the least negative consequences.  And, act on that choice.  That is the path to good mental health.  Think of at least 3 options, choose among them, and act on the one chosen.  If, at any point you feel you have taken the wrong path, repeat the process of thinking of 3 options, choosing one, and acting on it.  An easy technique for better mental health. 

Nov 5, 2011

Omissions

"Not only our actions, but also our omissions, become our destiny." Abraham Verghese

I have been reading a delightful novel, Cutting For Stone, by the above author.  Although fiction, it is based on his experience in Ethiopia and the U.S.  The above quote is such a good reminder for us.  Whenever we make a decision, it is inevitable that other options are ruled out:  they are omissions.  And, as such, omissions shape our destiny just as actions do.  So, it is prudent that we choose carefully.  In our roles as caregivers and in life in general, it is wise to prudently choose among our options -- because both the choice and the omissions shape our lives. 

Nov 4, 2011

Resource

" HABIT stands for Healthy Actions to Benefit Independence and Thinking. HABIT doesn't cure those patients with memory loss who participate. Instead, the program offers several tools unique in addressing the condition of mild cognitive impairment and caregiving." Mayo Alzheimer's newsletter.

If anyone lives near the Minnesota Mayo Medical Facility, the above program sounds promising.  It sounds like it helps to create an environment in which problems are eliminated/lessened -- what I aim to do through knowledge of behavioral management.  Any ways in which we can enhance our skill level and prevent problems is optimal, and this program sounds like an avenue to accomplish that. 

"HABIT is a 50-hour program for individuals recently diagnosed with mild cognitive impairment and a program partner. It's offered several times each year on the Mayo Clinic Campus in Rochester, MN. To learn more about the HABIT program go to": http://mayoresearch.mayo.edu/alzheimers_center/habit.cfm

Nov 3, 2011

Accomplishments

"I have the right :  To take pride in what I am accomplishing and to applaud the courage it sometimes takes to meet the needs of my loved one."  Jo Horne's Caregiver's Bill of Rights        

And, I would add, the courage it takes to meet our own needs within the caregiving role.  I have felt as if I have a virus or sinus infection stalking me.  Low energy, congestion.  And, just like when I had small children, there are still meals to prepare, other tasks - despite not feeling optimal physically.  Even in the best of health, caregiving is taxing.  So, let us take pride in how well we take care of the needs of our self and the person for whom we provide care. 

Nov 2, 2011

Individuality

"I have the right:  To protect my individuality and my right to make a life for myself that will sustain me when my loved one no longer needs my full-time help." Jo Horne, Cargiver's Bill of Rights.

Have you ever thought what your life will be like once you are no longer in this caregiving role?  Perhaps, like me, you sometimes even have trouble imagining a life after this.  But, we will have lives that continue, unless we are part of the 1/3 of the caregivers that die doing this task (according to research at the Roslyn Carter Institute).  The intention of this blog is to help us NOT be part of that percentage.  So, let us today consider:  what will my life be like when I am no longer caregiving?   Let us plan to have a life we can anticipate with pleasure. 

Nov 1, 2011

Taking care of yourself

You really need to take care of yourself because you won't be good for anyone else unless you take care of yourself.
-- Harry Bartholomew
The 5th right in Jo Harne's Caregiver's Bill of Rights is:  "I have a right to reject any attempt by my loved one (either conscious or unconscious) to manipulate me through guilt, anger or depression."  This is a particularly good one for me, as my upbringing trained me to be suceptible to feeling guilty if I displease someone.   And, let us not fool ourselves, the person with dementia is capable of using manipulation to get us to do what he or she wants!   Dwane has sometimes used our wedding vows as a reason why I should enable him to stay home by providing caregiving; which is amusing when one considers aspects of his own history. 

I am providing caregiving because I think it is the right thing for me to do in these circumstances for now.  And that is the only reason I am doing it. 

Please do not allow the person for whom you are providing care manipulate you into thinking you have to do any aspect of this caregiving.