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Facing Off With Reality: How Did I Get So Old?

Posted on June 3rd, 2015 by karen

by Myra Marcus

I was sitting at an outdoor café recently, next to a small group of women in their 80s. They were deeply engrossed in conversation and since I was within earshot, I decided to eavesdrop — unobtrusively, I hoped. They were celebrating the birthday of one of their group, and the conversation had veered to the subject of aging. There was a moment of silence and then I heard one woman blurt out, “How did this happen? How did we get to be this old?”

I asked myself that same question and tried to stave off the inevitable dread that comes with the topic. I told myself that I wasn’t like those women. I was “only” in my 60s, not in my 80s like them, but I was nonetheless overcome with panic, and even a bit of self-reproach for having moved about in my life, flitting around, oblivious to the fact that all our lives are finite and temporary. I should have been more attentive to the unavoidable eventuality all along, I know that, but as long as my mother was alive, I could always pretend that death was still at least a generation away. Unfortunately, my mom died about a year ago, and my generational protection disappeared. Now, just writing about my mortality causes me to shudder with fear. I have to force myself to take a few yoga breaths just to calm down.

So it seems that I’m on a mission to redefine my relationship with my own aging. Getting older is inevitable, I recognize that, but that doesn’t make it any more tolerable. Do you know that I used to purchase a full-priced movie ticket rather than take advantage of reduced rates for seniors? Just for fear of being “outed” as an old person? The sense of shame at belonging in the senior segment of the population was too much for me to bear. With each birthday, though, the despair has loomed larger and closer, with that same recriminating query of “How did this happen?” echoing in my mind.

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To Drive Or Not To Drive: Help Is Available

Posted on May 14th, 2015 by karen

by Kim Keller

In most of America, people are still very much reliant on automobiles to get around. Not so much in urban areas, where public transportation is highly developed, but everywhere else, driving is pretty much a cultural requirement. So, one of the hardest adjustments my mom has had to make is not being able to drive, even temporarily. She’s had some health challenges during the last few years that have impacted her ability to drive safely, so my sister Karen and I had to find alternate transportation and a pathway for Mom to return to driving her own car.

Here’s what we did:

After she had a stroke in 2009, there was a period when Mom’s cognitive ability was a bit shaky. She had trouble reading some street signs, and her decision-making capacity was not yet ready for the split-second requirements of Florida traffic. Her doctors told us it was a temporary situation, and Mom was certainly eager to get back behind the wheel, but Karen and I were concerned that it was too soon. So, after speaking with one of Mom’s doctors, we contacted a nearby rehabilitation center that had a program for evaluating the readiness of drivers who have incurred a physical and/or mental impairment as a result of injury, illness or normal aging.

A specialized Occupational Therapist conducted the testing. The therapist evaluated Mom’s ability to drive by testing her vision, her physical capabilities and her overall capacity to make quick judgment calls. The sensory testing was followed by an actual driving assessment.

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Daily Practices To Ease Everyday Stress

Posted on April 8th, 2015 by karen

by Kim Keller

Over the years I’ve collected an assortment of techniques to protect myself from the stress of everyday life. So, whenever I feel that tension building, I check to see which of my various safeguards I’ve let slip away, and I pull it back into my daily practice to refortify my defense against stress and anxiety.

All my de-stress practices fall into one of these three categories: (a) creating organization, which gives me a sense of control; (b) finding “me time,” which reminds me to take care of myself, even pamper myself a little; and (c) maintaining perspective, which helps me remember that life is bigger, crazier, more surprising and more wondrous than any or all of my problems. In fact, I read an interview not too long ago that gave me a whole new insight into handling stress.

Dr. Ellen Langer, a bestselling author and psychology professor at Harvard, was being interviewed in the Harvard Business Review. “Stress is not a function of events,” she said. “It’s a function of the view you take of events.”

In other words, events are not stressful in and of themselves. It is only the manner in which you choose to view the events that causes the stress.

“You think a particular thing is going to happen,” Dr. Langer continued, “and, when it does, you think it’s going to be awful. But prediction is an illusion. We can’t know what’s going to happen.“

Therein lies the rub. Just because we’ve imagined some event as terrible doesn’t mean it has to be. Dr. Langer’s suggestion for overcoming this negative expectation is the first of my ten techniques for washing away the worries that bedevil me.

Imagine you’ve interviewed for a great new employment opportunity. “Give yourself five reasons you won’t lose the job,” said Dr. Langer. “Then think of five reasons why, if you did lose it, it would be advantageous for you: new opportunities, more time with family, etc. So now you’ve gone from thinking something bad is going to happen to thinking even if it does, you’ll be OK.” Try to remember that stress is just the result of your perspective of events. So change your perspective. It’s that easy.

Here are my other nine techniques:

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Visualization: If You Can See It, You Can Be It

Posted on March 18th, 2015 by karen

by Lisa M. Wolfson

As a cancer survivor, I am constantly on the lookout to find new techniques for reducing stress and maintaining optimal health. One very helpful tool I’ve recently undertaken is visualization. This technique involves using your imagination to visualize specific things you desire to have, be or do, or events you wish to take place.

Visualization is particularly helpful while going through difficult times. It can help to take us to a better place or see things more clearly. The idea is to use your imagination to create detailed scenarios in your mind’s eye. This allows you to create a mental picture and then focus on this image for a period of time. The fundamental belief is that you can create a desired result in the outer world by properly adjusting your inner beliefs and perceptions.

Visualization can also be used with people who are sick or dying, or merely in pain, by having them focus on images of themselves in healthier, happier, safer times. For example, as parents, we often have our children try to visualize a fun experience from their past to help calm them down during a frightening medical procedure or other painful event.

Many of the world’s most successful and influential people are also firm believers in the practice of visualization. They are convinced that, by visualizing specific behaviors or scenarios, they can change energy patterns to bring about their goals and desires more quickly. By the same token, clinical psychologists believe that the human nervous system cannot tell the difference between an actual experience and an experience imagined in vivid detail.

Today it’s rare for successful athletes not to use some form of mental imagery to achieve greater results on the field of play. Professional golfers, for example, stand over a putt and visualize the ball rolling and dropping over the edge of the cup before they actually strike the ball. Pro tennis players imagine the precise landing location of each 150 mph serve before they even toss the ball in the air.

Visualization has many benefits, including spiritual development, emotional and physical healing, enhancing creativity, profoundly deep relaxation, opening the heart and healing relationships, curing negativity and self-defeating behaviors, improving performance in business and sports, and resolving psychological difficulties.

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Non-Verbal Communication: Breaking Through The Alzheimer Silence

Posted on February 18th, 2015 by karen

Printable Communication Board

by Karen Keller Capuciati

“I want her to tell me what she’s thinking and feeling, what she dreams about that makes her yell at night.”

But for Kari, who posted this concern on the In Care of Dad Facebook page, it’s not possible for her mom to tell her. She has dementia and has lost the ability to form words. “I can’t understand Mom any more,” Kari wrote. “I haven’t been able to in over a year.”

Her mom understands what others say to her — she can answer “yes” and “no” — but Kari feels that her mother has more she wants to say and it’s breaking her heart.

So I reached out to a group of geriatric-care professionals, with whom I meet once a month, to get some suggestions for Kari. Without knowing all the specifics of Kari’s situation, the group had some creative ideas for building a meaningful connection with a loved one when verbal communication has become severely limited.

Mary Underwood, Vice President of Memory Care at Maplewood Senior Living in Fairfield County, CT, believes that all her mom may need is a genuine connection. “Trying to have someone answer questions that they are not able to can be frustrating, not only for the caregiver but also for the person with the disease,” Mary said. “It is important to provide reassurance that they are okay. It can also be helpful to acknowledge the frustration that the person is experiencing. To say, ‘I know it must be hard to not be able to get the words out’ or ‘Even though you can’t tell me what you’re feeling, I want you to know that I am here to make sure you’re okay’ are comforting statements for your loved one. Understanding and connecting with the emotion they are experiencing is often more important than the fact of what is happening.”

Kathryn Freda, a gerontologist and eldercare manager, has had positive experience with elders using art to express themselves. “If it seems like an activity that they might be willing to participate in, I would ask my loved one to draw with pastels or larger crayons, or paint with a wide brush or fingerpaints, or mold clay into shapes. Art transcends normal thought,” Kathryn explained, “and I have often seen clients convey emotion through form and color.”

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Communicating Without Words: The Blessing Of Touch

Posted on February 4th, 2015 by karen

by Teresa Stecker

A friend of mine visited her childhood pastor, who suffers from progressive Parkinson’s disease. My friend shared how, as a child, she would draw pictures for the pastor and he would always hang them in his office. He always meant a lot to her and she felt a very special bond with him.

Now he’s in a nursing home, crumpled in a wheelchair, unable to even open his eyes due to his frailty. Recently she brought him a picture she had drawn as a child that she found in an old box in her basement. While describing every detail to him, she placed her hand between his. He didn’t verbally respond or open his eyes, but a tear came down his cheek.

Afterward, the pastor’s wife mentioned that people don’t visit him much anymore, because he doesn’t respond. But seeing that teardrop was an affirmation that he is still in there.

Touch is one of the basic needs of life. The craving for touch to communicate affection, comfort and reassurance is present in all of us from the day we are born. As we age, other senses may change and even fade away, but touch remains. And it has the power to reach through the fog, confusion and fear of dementia. A reassuring touch grounds those who are spatially disoriented. It brings people back to their bodies and increases their awareness of present time and space.

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How To Avoid A Caregiver Breakdown

Posted on January 28th, 2015 by karen

by Erin Tishman

You’ve heard the term “mind over matter”? Caregivers likely take this phrase to heart more than the majority of the population. Despite the constant pressure of managing their loved one’s physical and medical needs, many caregivers simultaneously balance jobs, family and other personal matters. So they hunker down, get in a good mindset and just do what needs to be done.

Truth be told, caregivers are a very strong and resilient bunch. At the same time, however, they are human and are susceptible to breaking down emotionally. No matter how many responsibilities a caregiver can juggle all at once, there’s a good chance they’ll all come crashing down if precautions aren’t taken.

Take Ellen, for example. She’s one of my clients. For years, she thrived as a typical working mother. She held a high-profile job as a marketing executive in a prestigious New York firm. Despite long hours at work and a tedious commute, Ellen made sure she was an attentive and active parent. She volunteered at her kids’ school, never missed a sporting event and was always home in time to cook dinner and help with homework. Ellen had found a work/life balance that most people only dream of.

Last year, Ellen’s seemingly perfect schedule was turned upside down when her elderly father was diagnosed with a terminal form of cancer. He was able to manage the disease for a few months, but soon needed constant medical care. Ellen moved her father into her home and assumed the role of primary caregiver. At first, Ellen kept her regular schedule intact. But when her father’s needs grew more intensive, Ellen’s carefully balanced routine started to crumble: she was forced to miss more and more meetings at work; shuttling her kids to extracurricular activities became a challenge; and just the thought of cooking dinner exhausted her.

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Socializing Alzheimer’s: The Connection Cafe

Posted on January 21st, 2015 by karen

by Karen Keller Capuciati

Charlotte and Cati were the least likely of friends. Charlotte, a therapist for a rape crisis center, is straightforward and serious by nature. Cati, a former athlete who has worked as a prominent international tennis judge, is extremely upbeat and quick to laugh.

They met at a café five and a half years ago and, despite their disparate personalities, they quickly became close friends and great support for one another. They would get together a couple times a week for coffee or to walk their dogs. They got to know each so well that they would sometimes finish each other’s sentences.

There was this one thing they had in common — both had been diagnosed with Alzheimer’s disease.

They might never have met if it weren’t for the Alzheimer’s Café they started visiting along with their caregiving husbands.

What is an Alzheimer’s Café?

The Alzheimer’s Café is a regular get-together organized in many towns for those with dementia and their caregivers, as an opportunity for all of them to get out of the house and into a social setting. It is an opportunity to relax and socialize in an environment that is both supportive and non-judgmental. They take place at public venues that have donated their space during their closed hours. For example, it might be at a luncheonette from 4 to 6 pm on the first Monday of each month or at a children’s museum cafeteria from 5 to 7pm (when it’s closed to the public) one Wednesday a month.

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Postcards From Florida

Posted on January 8th, 2015 by karen

December 29, 2014
Here’s the latest: Mom’s been in rehab for the past five weeks, recovering from hip surgery. Just before Thanksgiving, she was having dinner with her girlfriends, and she fell when leaving the restaurant and fractured her left hip. This certainly hasn’t been the holiday season we imagined! But the good news is, she’s doing well and I’m bringing her home in the morning. She’s pretty excited!

December 30, 2014
Phew! Mom’s friend Debbie cleaned out the refrigerator at home, and then went grocery shopping to refill it with essentials. I’m so grateful because it’s been just crazy busy moving Mom home!

December 31, 2014
Well, transitioning Mom back home from rehab has been a lot harder than we anticipated. We expected it to be “all good” when she finally made it home, but it’s not. No call button. No aides. Her daily routine is off. Everything feels different than in rehab: Mom says that the furniture at home feels too low, while her bed feels too high. It’s like Alice In Wonderland, when she drank the potion that made her so teeny that she could fit through the miniature door — and then she grew too big to fit in the room.

Note to self: When the dust settles, let’s find a better chair for Mom to get in and out of.

Morning, January 1, 2015
Mom’s been weaning herself off the pain medication way too fast! It’s causing lots of distress. We should’ve asked for more guidance to manage this one. Oy!

Evening, January 1, 2015
Mom’s overwhelmed by all the things that need to be done — bills, laundry, necessary correspondence, that kind of stuff — and her anxiety is exacerbated by the withdrawal from the pain meds. Plus, there’s a whole new group of people for her to become familiar with: the visiting nurse, the nurse’s aide, the physical therapists. This is not easy for Mom under the best of circumstances, and right now it’s even more complicated.

She’s still not fully recovered from the surgery, and needs to use a walker to get around (not sure how much longer). Her limited mobility is frustrating her, and her lack of control makes her feel even more anxious. We need to establish a routine to help her address all those tasks that are floating out there, unnerving her. A little structure goes a long way in making life feel more manageable.

During dinner tonight I’ll try to help her create a schedule and a master to-do list. We’ll take a few simple items from the list each day and put them on the schedule, things that Mom can realistically accomplish. That way, things get done and she starts to feel a little more confident and in control each day. We need to do this every night and stick to it.

Morning, January 2, 2015
I’m feeling the stress. I need to create my own schedule with a little “me” time each day. Before Mom wakes up in the morning, I’ll meditate from 8 to 8:30, and then, after she goes to bed, I’ll have time to read from 9:30-10. Then it’s lights out!

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A Year-End Commitment To Healthy Caregiving

Posted on December 31st, 2014 by karen

by Ed Moran, LCSW

Well, it’s that time of year again. Out with the old and in with the new. Each January 1st we vow to make drastic changes in the way we live our lives. We promise to eat healthier, lose weight, get more exercise, or quit smoking. We vow to spend more time with those we love, and less time with those who bring us down. We pledge each year to be nicer, to work harder, and to stop losing our temper in traffic.

We make these promises with the best of intentions, though I’m sure we can agree that most often our expectations are unrealistic. After all, trying to keep these resolutions will require significant time, effort and emotional energy, none of which the average caregiver can spare.

Caring for a sick loved one can easily take over your life. Whether you’re by their side at all times or not, it’s an enormous commitment that monopolizes your thoughts and emotions. Indeed, it starts to feel like we exist for the sole purpose of meeting their needs. Many take on this role without a second thought. Others feel pressured to take it on and maybe don’t even realize what kind of responsibility they’ve undertaken. Either way, full-time caregivers have very little brain space left over with which to engage New Year’s resolutions. That’s not to say the need isn’t there, that there aren’t things we can do to help handle emotional pressure and lead healthier lives.

For example:

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