One of my patients recently complained. I asked her what her doctor said. She told me she had forgotten to tell her doctor. She told me that she had become used to the problem and “accepted” it. Many senior-related articles advise writing down symptoms and questions before visiting the doctor. Good advice; as far as it goes. It’s the stuff that falls off the radar that could be the most important. The doctor needs information from the patient or the patient’s advocate. That information is the basis to decide which questions/tests to pursue.
What kind of information doesn’t get to the doctor?
Age is a stage of life, not a diagnosis. Sadly, some seniors think is a diagnosis. Seniors may accept pain or changes in their bodies as “just getting old”. Pain is a symptom. It’s our body’s way of telling us (at any age) that something isn’t working. Please take your senior’s complaints seriously, even if all they say is; “I don’t feel good.” That complaint is a place to start. Repeated complaints indicate a persistent problem. I use three points to examine complaints: frequency, intensity, and duration. How often do they complain? How long have they complained? Do they report things are worse or better than earlier? Doctors analyze these kinds of information to help them decide what questions to ask next. Please complain; it’s helpful.
Some seniors believe they shouldn’t complain. You may need to explain to them that this is a report on their health rather than an annoyance. Some seniors complain without words. Does the face contort? Does the voice tighten? Do they seem more irritable at certain times of the day? Something’s going on. Ask them to please complain to you out loud.
Earlier this year I knew something was “off” within me. I went to the doctor but the lab tests were inclusive. Nevertheless, I persisted. I tracked what I felt and when. I brought this information back to the doctor and insisted on considering other options. Eventually my pattern was clear enough to prompt the doctor to ask other questions. I received a new medication and it worked! I complained, but really I was advocating for myself. Some seniors cannot self-advocate. That’s why caregivers are so important. Please persist if the first treatment doesn’t work. Please complain for them.
By the way; this is a portion of my course; Preparing to Parent Your Parent. Senior Sidekicks can bring this course to your church at a time convenient to you.
Imagine you’re sitting quietly in a meeting or religious services; suddenly your heart starts pounding. You feel like your blood is coursing through the veins in your arms and legs. It’s bewildering and scary: Why?! There is nothing about this setting that calls for such a reaction. Yet, you have this reaction. It is important that caregivers understand what leads to this reaction and what they can do about it.
It’s a “fight or flight response gone wrong. It developed when we had to run away from Saber Tooth Tigers. Our ancestors were successful, that’s why we’re here. Those ancestors passed down to us their methods of coping with their world. Our modern world doesn’t have the same kinds of stressors, especially for caregivers. Our stressors are less clearly defined And they last longer. Our stressors change shape; one minute we’re dealing with the house-the spouse-the kids-and-the job. Then there’s a crisis and we’re caregivers for Mom! From that point forward, our caregiving increases but with no way to know when the need will become greater or how long caregiving will last.
Our bodies respond as our ancestors’ once did; we produce Cortisol to rise to this crisis. The process goes like this: Stress causes the Hypothalamus to secrete. That triggers the Pituitary Gland to secrete. The Adrenal gland secretes Cortisol. This process has several names: HPA Axis, HPA Cascade or Syndrome X, or AKA Insulin Resistive Syndrome. (Wouldn’t it be helpful if we could all agree on one name?) It’s not the crisis that’s the problem. It’s the crisis that doesn’t end that creates bad effects on caregivers.
The effects show up in different ways. Cortisol encourages promotes fat deposits in the outer layer of the body, especially the waist. Some caregivers gain weight. We can measure this effect by doing a BMI (Body Mass Index). Other caregivers have different conditions; heart disease, Type-2 Diabetes and Stroke. We can measure Cholesterol levels through a C-Reactive Protein lab test. We can also do a cheek swab to check Cortisol level. However, how many doctors don’t even ask patients if they are caregivers. The tests are there but they are not used to evaluate identified caregivers at this time on a general basis. You need to ask for them.
When our bodies rise to meet a crisis: they must also let down. Even Saber Tooth Tigers would give chase and then give up. The caregiver’s duties do not end the same way. In fact, they do not “end” unless we place some “ending points” into the caregiver’s life. That is the role of self care, to provide end points such as respite and small moments. That’s why it’s necessary to spread the caregiving load so it doesn’t fall on one person. That is why we need to enlist family to give caregivers this kind of support. Otherwise, the caregiver can be sitting quietly in religious services and the Cortisol response “alarms” for no exterior reason. We need to advocate for caregivers to be recognized in the medical arena. Learn more by taking our course; Preparing to Parent Your Parent.
When someone advises you to, “take care of yourself”; that doesn’t explain how. Elder caregiving is so new that some methods are still under development. However, we know some things that work and some to avoid. Self care does not mean a day at the spa. For many caregivers such a day would be out of reach financially or out of time to devote to a spa. Therefore, plan to care for yourself in moments, not hours. Think about your life like your heart; it beats all the time. Actually your heart takes a tiny rest between each beat that allows it keep going. When you care for yourself in moments, you pause and continue.
Try these ideas. Put up a sign saying, I NEED A MOMENT, to remind yourself to pause. Put up other signs family can see to remind them that you might need a moment before you can respond to their requests. Is the person in need bleeding or on fire? If the answer is no, then it’s OK for you to take a moment. It’s OK to train your family to allow you to do so. It’s OK for you to ignore repeated pleas for your attention (for a moment). Training takes time but you’re worth it.
What do you do in that moment? Be sure you are safe. If you’re up on a ladder, get down first. Focus on something blank, like a wall or the ceiling. Breathe, deeply, through your nose, hold and count to 3 or 4. Let your breath out through your mouth but slowly; 1-2-3-4. Now, if you can afford the time, try looking at something peaceful; out a window, at a picture, or at some memento that is meaningful to you. Breathe again the same way.
Many caregivers respond with; “I don’t have time to …” You’re right, time is at a premium. Most caregivers find themselves in that role at the same point they also have the house-the spouse-the kids-the job-the pets and MOM! You have a lot on your plate. Sometimes caregivers believe they can wait until they have time. By waiting until later, the damage from lack of self care will have done its worst. Undoing damage is much harder. The best intervention is prevention. Prevention comes in bits of time you claim now.
Suppose you actually have a whole hour to yourself. It’s a gift! Ask yourself, “What refreshes me?” Notice I didn’t say what can I eat nor where can I sit down? Some caregivers eat to cope with stress. We need nourishment but not that way. Rhythmic movement, like walking, can help us feel less worn and is surprisingly refreshing. If you can’t go far; walk around the house or around the block. If you live in an apartment building, walk in the hall. “Go get the mail”, that errand will buy you a few minutes. Try to set a self care routine just as you have set other routines with child care or at work. Routines help us get things done without doing us in.
Some things to avoid include sugar and alcohol. The stress hormone, Cortisol, takes sugar and converts it into weight around your middle. Sugar may not be sweet; baked goods convert to sugar. As part of a balanced meal they’re fine; as a snack, not so much. Large amounts of food can have a numbing effect; like a Thanksgiving dinner. When we feel numb, our minds seem to turn off. When you see you have time and turn to the refrigerator; ask yourself why are you eating? In a similar way, alcohol can create a numb feeling. We believe we’re relaxed but a caregiver’s immune system is more vulnerable and needs extra protection that alcohol doesn’t provide. Alcohol is also a depressant, which won’t help caregivers.
So how does one “turn off” the constant “list-making” that goes on in the caregiver’s mind? Try other things. Try relaxing teas like Passion Flower, Elder Flower or Chamomile. Try playing some relaxing music that’s meaningful to you. Try a rhythmic movement “dance” (try it with your partner). Try a hot shower or better, a hot bath. Try placing essential oil of lavender in your bedroom. All of these set the stage for relaxation. Develop your own mediation or routine to think about at bed time instead of a to-do list. There are also tapes available. So self care comes in moments you claim as your own. To learn more ways to cope, take our course: Preparing to Parent Your Parent.
This is the first of a three part series about the often-heard advice to caregivers to “take care of yourself”.
What does that mean? Since elder caregiving is relatively new, many caregivers aren’t sure. Let’s begin with the word self care; it means considering yourself as part of the caregiving plan. Your health and mental well-being are a vital part of providing care. Think of your contribution in other ways: wouldn’t you take care of equipment used to care for the elder? Wouldn’t you make sure to have enough supplies on hand? Wouldn’t it be hard to provide care without equipment and supplies? Think how much harder would it be if you weren’t able to provide care? You’re the most important part.
Caregivers may believe that they should put their needs aside: no! That’s like pouring yourself out without putting anything back. Such a belief leads to caregiver burnout. Some caregivers burnout emotionally, others develop health problems, and still others find their families are disrupted. All are symptoms of burnout. Many symptoms go unrecognized. Now that you are aware, you can be alert to the influence of caregiving on your life.
Some caregivers believe that the entire task is theirs alone; not necessarily. Part of self care is letting go of that assumption. We ask for help in other parts of our lives; accountants, plumbers, physical therapists, or lawn crews. No one believes these helpers take away our responsibility; they contribute to our successful process.
What do you do in a typical day? How many of those tasks require direct interaction with the elder? Who else could do them? For example; laundry must be done. Why does it have to be you? Does it matter to the elder who does it? Letting others into the care process is part of letting go. Letting others in is part of self care.
Self care can mean admitting to yourself that you feel certain things in response to caregiving. Some of those feelings are not too “nice”. Frustration, anger, despair and sadness are all parts of the caregiving journey. If a friend came to you admitting to these feelings would you send them away? Perhaps you would listen to them and sit with them. Sadly, I meet caregivers who whisper their negative feelings if they say anything at all! Part of self care is becoming your own “best friend”. You and that self need to talk to each other. Admitting to those not-nice feelings doesn’t make bad things happen. In fact, it allows you to let out some of the pressure behind those emotions. Self care begins with recognition of one’s value, affirmation and support for the caregiver.
To learn more, take our course: Preparing to Parent Your Parent or call (217) 787-5866
Caregivers experience a jolt when confronted by their bosses about changes in their job performance. For some caregivers, these issues are the first sign that something has to change: now! Perhaps they didn’t realize that they were regularly tardy or missed important meetings. Did they know that they also missed important details in doing the job? Your boss noticed.
Most bosses don’t know what to do to help the caregiver with those issues. They just want employees back on track at work. Senior Sidekicks knows how to help. Take our course Preparing to Parent Your Parent to get back on the job track. Why take this course; because you must handle caregiving differently. In just 5 classes, you will learn ways to cope with and better manage caregiving.
Senior Sidekicks brings this course to you; at your church or club. Senior Sidekicks teaches Preparing to Parent Your Parent at your convenience; evenings, weekends, lunch hours or days. One low price gives you 5 classes, a manual, and chance to bring your significant other for half price! This course shows your boss that you’re tackling this problem and wrestling it to the ground! Call Senior Sidekicks today at 217-787-5866.
If you developed symptoms such as poor sleep, changed appetite, or more serious conditions, you’re not alone. According to The Executive Summary: Caregiving In The US 17%-35% of caregivers report poorer health.
Caregiving creeps. At first it’s the occasional errand. Then it’s dealing with financial matters. Other senior caregiving issues pile on; unpaid bills, medications ignored, and inaccurate reports about doctor appointments. You find that you’re monitoring medications, and accompanying your senior to the doctor. All the while, there are other parts of your life; your spouse and children, your job and home. Trying to do all these tasks as a caregiver while also keeping up with your own life becomes a monumental job! Something has to give.
Where are you in all these duties? Many caregivers believe they can take care of themselves “when they have time”. Caution: caregiving you have no more time. Self care is vital to preserving yourself, your family, your job, and your sanity. Senior Sidekicks’ course; Preparing to Parent Your Parent explains why caregivers need to do self-care. Senior Sidekicks knows how busy you are. This course is convenient; delivered to your area: your church. We offer it at convenient times; evenings, weekends, or lunch hours. You receive 5 classes and a manual for one low price. If you bring your significant other, they pay half price. Call Senior Sidekicks today to learn more. 217-787-5866.
We have seen how caregiving creeps until it fills one’s daily life and affects one’s job. What about the people in your immediate family? Do your children behave differently? Are they withdrawn or act out? Have you received school reports about problems? We expect sibling rivalry when a new baby comes home. What if the one who demands the parent’s attention is not a baby; it’s Grandma? That’s not what most caregivers anticipate. Yet, a distracted parent is still a distracted parent.
What about your spouse? The marriage vows cover sickness and health, richer or poorer. They don’t include vows to care for your parent and mine. Perhaps we should add new vows should since caregiving now involves 43.5 million people; according to Caregiver.org/Statistics and demographics. That number will continue to climb! Most couples haven’t considered caregiving the same way they considered where they would live or how many children to have.
Yet, caregiving affects many households as well as individual caregivers. Isn’t it time to address caregiving together, just as couples do with other life decisions? Senior Sidekicks’ course, Preparing to Parent Your Parent, is designed to get spouses into working with each other. Those who enroll can bring the spouse at half price. Together, you will learn about handling various parts of caregiving and compile a manual for future reference. You can arrange the course for a location near you; like your church. Senior Sidekicks will deliver the course at times convenient for both of you; evenings, weekends, lunch hours, or days. Call us today at 217-787-5866.
While standing in a checkout line, I struck up a conversation with an elder. He said his house was too big but wouldn’t move because he would need to downsize first. The elder said that he had decided not to clean out, instead, to leave it for his kids. Really! That’s an unwise choice for many reasons:
“I lost so much time from my family”.
“It cost me my job (or promotion)”.
“I had to stop my education and it was harder to go back”.
“I felt so alone, like my parents had abandoned me to this task”.
“I felt overwhelmed”.
“I developed high blood pressure”.
“My sibs and I fought about sharing the work, it’s still hurts”.
So, what will be your legacy to your children?
There it is: the street where you grew up and the house coming into view. All your memories flood back as you park the car and unload the bags. When you come inside, things aren’t the same. No decorations and no special smells or music greet you. Your parent is delighted to see you but that is as far as it goes.
Holidays reveal the way things are now. It takes extra effort to put up decorations and bake special dishes. Your parent may no longer be capable of doing the extras.
How does that scene might make you feel? It is hard to view your family home which is now unfamiliar in its lack of holiday efforts. Perhaps, in your heart of hearts, you had a feeling things would be different this year. Perhaps, you even felt some physical symptoms as you reached the old neighborhood. Perhaps you felt irritable during this trip. The intuitive parts of us “record” small bytes of information from contacts with our parents earlier in the year. These impressions were stored away because the other parts of our lives are so busy. These bytes of impressions don’t go away because we grew up with these parents. We know them in depths we cannot put in words. Your feelings are your intuition comparing the way things were with the current data and flashing a signal to prepare you: heed that signal. Once you understand that these vague physical symptoms are signals they lose their power. You are not getting sick, but you may feel sick at heart. Feeling a sense of loss is real, so are feeling sad or lonely. Realizing things have changed is also real.
Here we are at your parents’ doorway; what do we do with our feelings? The doorway is not the place to deal. Let’s go through the process and look for times and ways to handle your feelings. We have all had some nerve-wracking event and we all know how we reacted then. We are the same people now. Your feelings will hit you, plan for it.
Take a moment for yourself when you feel symptoms or irritation. Yes, take a moment for yourself. You will not be able to cope with this process if you do not take yourself into account. If you are alone put your pen down, or take your fingers off the keyboard. Feel your feelings. That might include shedding a few tears, let them flow. It will work better than at your parent’s doorway. Perhaps you do not shed tears, punch something safe to punch! Take a few deep breaths.
Next; reach for your positive memory. Select one or two things that were special to you about the holidays at home. Was it music? You know where the records are stored and you can retrieve them. Was a particular dish? If you can’t bake it, there are people who can. Order it for pick up. That pick up trip could be an outing for you to share with the parent or a chance to give you a break during the visit. Perhaps it’s decorating you remember. Think about those items and prioritize. Don’t get everything out. Putting up a couple decorations is another activity you can share with your parent. Resolve yourself to the new situation. This will not be a holiday like the past. You can make it a celebration: which is our presence with each other. That’s the greatest present.
"A Senior Moment" is written by Ms. Sara Lieber, owner of Senior Sidekicks. Ms. Lieber has over 30 years of experience in senior care.