Tuesday, March 5, 2013

How to Take the Stress Out of Caregiving


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Scout out a geriatric M.D.

Sometimes a family physician won’t have the expertise needed to diagnose or treat an aging person’s tricky health problems. “Both of my parents struggled with Alzheimer’s disease for over a year before they were even diagnosed,” says Jacqueline Marcell, 58, author of Elder Rage. “By the time they got help, my dad had became violent toward me, and my mom had almost died due to his inability to care for her. It was a nightmare.” If you think a specialist’s care could improve your loved one’s life, ask for a referral to a geriatric physician. “All of their training and focus is on the elderly, so they’ll pick up on subtle things that a general physician might miss,” says geriatric physician Linda Rhodes, M.D., author of The Essential Guide to Caring for Aging Parents. “They also understand how medications work differently in aging bodies and can make sure your loved one gets safe, effective prescriptions.”

Check the drugs

“My mom’s dementia had gotten so bad she couldn’t finish a sentence, but then she switched doctors and the new one insisted on seeing every single med she was taking,” says Jackie Larsen, 52, in Toronto, Canada. “Turns out she was on two different antidepressants, two different diuretics, three different narcotics...it was ridiculous. He weaned her off most of it and now she’s so clear-headed we can actually chat!” Seniors take more drugs than any other group in society, and many of these meds interact with each other, causing nasty side effects or even permanent harm, say UCLA researchers. To prevent this type of mishap, keep an up-to-date list of everything your loved one takes and make sure that every doctor they see reads that list before prescribing anything new. “Scrutinizing a long list of meds encourages doctors to be more thoughtful about what they prescribe and more aware of possible interactions,” says Dr. Rhodes.

Make the paperwork easier

A medical history, a contact sheet, an up-to-date list of meds...it’s incredibly helpful to have information like this at your fingertips. If you take 10 minutes to fill out some basic forms, you can save yourself hours of searching, writing and frustration later on, says Rhodes. (You can download everything you’ll need at LindaRhodesCaregiving.com). “Give completed copies to your family membersand keep extra copies on hand for doctors and other health professionals, so you’re all on the same page,” says Rhodes.

Help them want to eat

It isn’t about putting healthy, pre-made meals in front of them, it’s about finding out why they’ve lost their interest in food in the first place. “When ill people stop caring about eating, it’s often because their self-esteem is waning -- they no longer think they’re worth being fed and cared for,” says James Huysman, Psy.D., co-author of Take Your Oxygen First. “Another huge appetite-killer is depression, something 50 percent of elders struggle with.” A trip to a kind-hearted counsellor can help suss out the underlying problem and help find the most effective remedies.

Focus on their Zzzs

At least one in four people over age 65 has trouble sleeping through the night, and for folks with dementia, the situation can be even worse. That’s because many of them struggle with “sundowning,” a condition in which they get more restless, confused, anxious and agitated as the night wears on. If your loved one can’t sleep, a surprising solution could be available at your local health food store -- melatonin. This calming hormone is the same one your brain produces to put you to sleep at night and 12 different studies suggest that taking three to nine milligrams each evening helps reduce (and sometimes erase) sundowning symptoms for 70 percent of Alzheimer’s patients within three months. It can also ease garden-variety insomnia in as little as two weeks! Talk to your loved one’s doctor about it.

Don’t sweat the small stuff

Caregiving can involve an unending stream of little aggravations that can drive you batty, but if you pick and choose what you’ll get upset about, you’ll spend less time feeling stressed, irritable and edgy, and be less likely to burn out, says Rhodes. The bizarre things they sometimes say, the grumpy moods they slip into or the quirky little habits they pick up over time? Just shrug them off. The risky behaviors that could endanger their safety, like leaving the stove on or wandering outside at night, is where you should focus your energies. “I would have loved to add variety to my dad’s diet, but he got to the point where his morning routine had to stay the same or he’d get completely stressed out,” says Nicole Risdall, 39, in Los Angeles, Calif. “So I’d cook him the exact same breakfast and lunch every day and set everything exactly the way he liked it on the table. It made him comfortable and it just wasn’t worth worrying about.”

Tackle driving issues with care

Here's when Jackie Larson knew her mom needed to stop driving: “The day she pulled onto the highway going the wrong way, then kept driving into the oncoming traffic, thinking she’d eventually find an off-ramp!” says Jackie. At some point, your loved one probably won’t be safe behind the wheel of a car, either. But how do you bring that up? You don’t!

“When someone’s ability to drive is taken away, it’s very symbolic and very painful -- they’re losing their freedom and the messenger tends to get blamed,” notes Huysman. So take your concerns to a physician and let her tell your loved one it’s time to get off the road. “Then you can plan ahead and schedule transportation so he or she doesn’t miss any activities,” says Huysman. “You’ll be seen as the loving and supportive child, not the bad guy who made this happen!”

Move slowly 

Whether you’re heating up food for your family’s supper or helping an ailing relative get out of the tub, try to slow down, relax and focus on what you’re doing, suggests Jeanne Dennis, director of the Visiting Nurse Service of New York’s Hospice Care program. “It sounds obvious, but just moving more slowly and calmly can really reduce your risk of accidents.”

A surprise perk: According to researchers at Logan’s State University of Utah, even when people fake that they’re feeling serene (by moving and speaking more calmly) their brains produce a surge of serotonin and endorphins, the hormones that dampen stress in as little as five minutes.

Reminisce

“My mom had a couple of keepsake drawers in her dresser; one day I pulled out a photo and asked her to tell me about it,” says Henry Winkler, 67, actor and author of 23 books for children. “It was really fun to watch her light up as she talked about the people in the picture, so I started regularly holding up treasures and asking her to tell me stories.” Memories do matter and they take on even more importance as a person’s health slips away. Encourage your loved one to talk about how she lived, who she loved and what lessons she learned. It will be enormously comforting and a great way for the two of you to connect.

Remember, you’re the kid

Every once in a while, my mom would look me in the eyes and say, “I’m your mother, and you’re my daughter,” says Annelie Rudlaff, 43, in Woodland Park, Colo. “That said a lot. Yes, she needed my help, but she didn't want to be treated like my child.” Emotionally, it can be tough on the entire family when a person who used to be strong and capable starts losing the ability to function -- but it’s essential that even as your roles change, you keep reminding yourself that you’re still the kid, says Rhodes. “That will help your loved one maintain dignity, and it can reduce the friction between you, too.”

Sample support groups

True, connecting with new people can seem daunting if you’re already feeling pressed for time. But joining a support group can provide a surprising amount of stress relief and support. “Getting advice from people facing the same day-to-day challenges means so much more than being told what to do by well-meaning friends who don’t really get what you’re going through,” says Rhodes. Not sure where to begin? Your local hospital, senior center or adult day center can point you in the right direction. And if going out is a struggle, try an online support group, instead (Caring.com has a good selection).

Get away

Caring for an elderly or ill family member can be enormously rewarding, but it can be physically and emotionally draining as well. You need time to rejuvenate. Whether it’s just a few hours each week to run errands or a few weeks each year to take a much-needed vacation, don’t feel guilty about carving out some time to keep your own life in balance, says Dennis. You’ll come back refreshed and better able to handle the challenges of caregiving, she says.

Meditate

According to Harvard researchers, as many as 20 million Americans tried meditation in the last 12 months -- and classes are springing up in YMCA’s, community centers and hospitals around the country.

In a recent UCLA study, meditating for just 12 minutes daily dramatically improved the mental health of caregivers, cutting their blue moods, depression and anxiety levels in half within two months. Meditation is easy to learn and easy to practice.

Say what you need to say

“When people is aging fast or have a serious illness, it’s important to talk to resolve old wounds, thank them for what they’ve done for you, and tell them how much you love them,” says Dennis. “Those words are incredibly meaningful and powerful to a person who’s ill -- it’s a real gift to communicate those feelings while he or she is still able to fully appreciate them.”

Focus on the good

“My mom and I got into a really nice routine. Every morning I’d read a positive, uplifting story to her from the Bible or from a Christian book, and I’d post fun pictures on her bulletin board for her to look at during the day,” says Rudlaff. She also loved watching pastor Joel Osteen on TV, and her favorite phrase was “I’m too blessed to be stressed!” adds Rudlaff.


Via: How to Take the Stress Out of Caregiving

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