Freedom Eldercare Blog

"Slow Down, You Move to Fast..…or How I Learned to Take 3 Minutes to Eat a Raisin!" By, Janet Pincu, MSW, LCSW, CALA of Freedom Eldercare

I am surrounded by people who claim to live stressful lives.  Both my daughters, balancing careers and family, speak to this issue daily.  My husband, colleagues, friends and I are constantly bemoaning the lack of “me time”.  An outcome of the frantic lives we live it is also the result of our need to be so freely connected by technology.  So many of us are searching for a way to tip the scales in favor of finding time to take long, deep, relaxing breaths.

Here are some stress busters to help "fill up the tank!"

• Anger Management - an effective tool in fighting stress.  Be aware of when you are becoming angry or annoyed at someone or something for what may be small or unimportant.  Try to let go, make the choice not to become upset or angry.  Lighten the load.  Try not to waste your time on the small stuff.
• Take deep, slow breaths. Before you react take the time to breathe in slowly and then breathe out slowly.  Try this three times.  Have you ever meditated? 
• When feeling stressed, talk slower!  The more stressed the more apt you are to speak too fast and feel less in control.  By slowing your speech pattern down you may find that you will be able to minimize that feeling of stress and anxiety.
• Prioritize, prioritize, prioritize!   Identify the task that you’ve put off.  Have you neglected the housecleaning, a work task, do you owe someone a long promised lunch date?  Take care of it now!  You’ll be surprised at how much better you’ll feel.
• Get out of the house.  Park your car a distance from the office or the grocery store and take that walk.   Take a breath of the fresh air.
• Make sure you drink lots of water and eat healthy snacks throughout the day.  Have you ever noticed how much more anxious or irritable you feel when hungry?  And sometimes it’s not really hunger you may be feeling but rather thirst or dehydration.
• Stand straight!  Your mother was right – poor posture can lead to all sorts of issues including feelings of tension and anxiety.
• ……And what about that raisin?  Jon Kabat-Zinn, the founding director of the Stress Reduction Clinic and the Center for Mindfulness in Medicine, Health Care, and Society developed a practice of teaching mindfulness meditation as a technique to help cope with stress, illness, pain and anxiety.  One exercise directs participants to pick up a raisin and hold it in their hand.  Look at the raisin, examine it, describe the wrinkles, the color, the texture.  How does it feel, smell?  Now put it in your mouth without eating it.  Be aware of how it tastes as you move it around in your mouth.  Finish chewing it and eating it as you describe the experience and taste of the raisin.

The exercise is about nurturing awareness and beginning to learn to focus on the here-and-now. It is about being in the present moment. Sometimes, much of our anxiety, fear, or unhappiness is a result of focusing our thoughts on the future and forgetting to be present here in this moment. Kabat-Zinn defines mindfulness as “moment-to-moment awareness…purposefully paying attention.”

"Knowing Your Medication" by, Laura Mansfield of Heart and Home Senior Care

It is a common occurrence for seniors to be hospitalized due to an injury or illness, discharged and then readmitted shortly thereafter for the same problem. Recently, research has been conducted, by private and public entities, with the goal of understanding the underlying reasons for this difficult cycle.

Research has shown that when seniors are discharged with a “to-do” list, such as scheduling a follow up visit to their physician or getting a new list of prescriptions filled, often the “to-do” list does not get done. While it is important that all items on the discharge list be addressed by the senior (or their caregiver), understanding ones medications and taking them precisely as prescribed should be at the top of the list.

Seniors often take many medications, multiple times each day. Understanding a complex medication regimen can be difficult at any age. A physician, pharmacist, or other health care professional can be great resources in helping a senior understand their medications. While it is important to know who to turn to for answers, it is even more important to know the right questions to ask. Getting answers to the questions below should help a senior understand their medications. Following a prescribed medication regimen should prove helpful in maintaining a senior’s health and, hopefully, reduce or even prevent hospitalizations.  

1.  Why was the medication prescribed?
2.  What is the correct dose to take and how often should it be taken?
3.  How should I use the medicine (taken orally or by administering to some part of the body such as skin, ears or eyes)?
4.  What should I do if I miss a dose?
5.  Should the medication be taken with food?
6.  How long will I be taking this medication?
7.  When should the medicine begin to make me feel better?
8.  What should I do if the medicine doesn’t seem to be working?
9.  What side effects might I experience and what should I do if they occur?
10.  Are there specific precautions I need to take while on this medication,   such as avoiding driving or consuming alcohol?
11.  How should I store the medicine?
12.  What should I do when all of the medication has been taken (get a refill or schedule a follow-up visit with my physician)?
13. Are there other special instructions about how to use the medicine?

"The Devoted Daughter: When is Enough Enough?" by, Barbra London MSW, LCSW, LNHA, Senior Vice President of Freedom Eldercare

The complex world of the mother daughter relationship is one of the most difficult to describe, understand or successfully achieve.  Myths of the devotion between mother and daughter of a bygone era were indeed, fiction.  At the turn of the century, our mothers died by the time they were about sixty and many children lived nearby and were dutiful without ever questioning (or hoping to even get away with questioning) our mother’s rules, advice and “guidance”.

In today’s fast past modern world with our daughter’s and our granddaughter’s working, often living significant distances from mom, how do we show our devotion, do the right thing, not feel guilty and yet still have our own lives?   Well, some of us achieve that difficult adult/adult relationship with our mothers and some of us are angry, resentful, put upon and disengaged from our mother’s throughout much of our adult lives.

Which kind of devoted daughter are you?

1. The first kind of daughter is able to express love and concern but also able to set limits and boundaries. These are women who usually lead full and rewarding lives of their own. They understand that that mom’s needs may be changing and needs requires attention. They are often the person who will research services and care on line and make arrangements with and on behalf of their mother.  Respect for mother’s involvement and choices are paramount in this adult adult/mother daughter duo. This daughter knows how to “get things done”.
2. You are the daughter who just CAN NOT SAY NO!  You have never really viewed yourself as a separate (or equal) person apart from your mother.  Mom has made unfair, unrealistic demands on you your whole life – and you have always been complicit.  You are probably on Zoloft or Paxil!
3. The third daughter really likes her mom.  She will do what is reasonable and fair as long as mom meets her halfway. This daughter will work things out with dignity and respect.
4. The final daughter is the one that doesn’t love her mom and doesn’t like her either.  For you, caring is an obligation, a chore - perhaps a promise you may have made to your beloved father before he died.  This daughter is also able to get things done- but it is done with anger and resentment every step of the way.

Here’s the key- if you recognize yourself above and are not happy that this is how your relationship is with your mother- you CAN change it.  Only fools believe that we can actually change our mothers (or our husbands, kids, etc) but we CAN change how we allow ourselves to react to them and how we interact with them.  It’s hard work, painful at times- and may even require outside professional help if need be- but you can still be a devoted daughter and know when enough is enough.

"Loss Squared……Surviving the Death of your Second Parent" by, Candy Blau, MA, Client Relations Director of Freedom Eldercare

The loss of a parent, at any age or stage is sad and traumatic. Usually when we lose our first parent, we are surrounded by friends, family, and rituals to help us manage our grief.  A lot of the ‘tasks’ associated with the death of a parent are typically handled by the surviving parent. Details, such as funeral arrangements, are taken care of so that we, as adult children, can be part adult and part child. While we suffer the loss of our beloved parent, we are comforted by the fact that we still have one left. There is still a grownup in charge.  Most often after the death of one parent, the surviving parent remains in the marital residence, assumes legal responsibilities for the will, and financial matters, and life goes on.

All that Changes with the Death of the Second Parent

The sense of loss when the second parent passes is magnified exponentially. We are now orphaned. No one on the planet knows us as long or as well. Our foundation is rocked and at the very time we need our parents the most, they are not here for us.

Add to our grief, the responsibility of cleaning out the house, managing the legal and financial affairs, and dealing with siblings, and you have a recipe for discord and depression.

Think You’re Ready, Think Again

If you have been involved in care giving for your parent, you may feel you are prepared for their passing. Not so. No amount of ‘knowledge’ can replace the raw feelings of being orphaned. You might think you have survived death once and that you can surely manage better now that you are experienced. No so.  Everyone has their own personal and unique relationship with their parents.  My mother and I were very close, and we spoke at least once a day on the phone. She died at 62 years old…way too young.  While I didn’t have that type of daily contact with my Dad, his passing rocked my world in a different way. When my mother died, I had three small children and a household to run. I was busy, I ran through the grief. I didn’t have the luxury of time to myself; my family needed me.

When my Dad died, just 4 years ago, I didn’t have the distraction of being needed on a daily basis. I had time to mourn and time to reflect. I also had the privilege of having my dad die in my home. I say privilege because I finally had the opportunity to talk to my father in a profound, meaningful way. The last conversations were not the usual superficial ones, which had been a mainstay of our past relationship.  I was able to hear the words that I had longed to hear my entire life. He died at peace and I got the gift of closure.

Some Useful Coping Tips

• Don’t let anyone dismiss or diminish your loss. Ignore people who say well meaning things like “She was old, she had a good life”, or “it’s a blessing”.  Well intentioned people minimize loss by focusing on the suffering before death. For a mourner, the loss is no less painful.
  • Reflect on the legacy left to you. Embrace your parents core values as if they were watching. Who knows, they may be.
  • Be kind to your siblings. Understand that they are suffering too. Understand that there is more than one way express grief.
  • Share the responsibilities for after death necessities with your siblings.  Don’t be a martyr and try to do it all alone.
  •  Honor your parents’ memory. A gift to a charity in their honor, a donation to a cause they believed in, will help memorialize their life.
  • Keep their memory alive. Talk to your children about their grandparents. Talk to your grandchildren about your parents. Talk to your siblings about childhood memories.
  • Don’t be afraid to ask for help. Professionals are available to provide counseling and support.
  • There is no handbook, no rules apply, everyone’s process is unique to them.

 

After receiving my Master’s degree in Gerontology in 1975, my father would proudly tell people that he paid for my education so that I could take care of him in his old age.  It was my pleasure, Poppy.

"Helping Aides Cope with the Loss of their Clients" by, Janet Pincu, MSW, LCSW, CALA of Freedom Eldercare

A long standing client, at the end of life and now placed on hospice, requested that her beloved caregiver, Anna, sit by her side throughout the night.  The hospice nurse had directed the caregiver in ways to keep Mrs. Smith comfortable.  As time passed and the client declined she was less able to communicate with Anna.  The caregiver became more and more frustrated.  After all, she had been trained to give care and not withhold necessities such as food.  How to support this caregiver as she anticipated the loss of Mrs. Smith became a team effort.  The team rallied round Anna as our agency’s staff social worker and the caregiver’s supervisors provided support and counsel.

Our caregivers are trained to care for their clients, to assist in improving their quality of life as they nurture and comfort. It is often, as in this context, that they may feel that they are failing when the person they have cared for is dying or has died.  Many times caregivers develop an extremely close bond with their clients - often as close or a closer relationship as the client might have with their family as they confide in and are provided comfort by their aides.  The aides may be spending longer hours with clients than their families and friends are able.

Too often we forget about the intensity of these relationships and the feelings associated with these losses.  We must recognize that feelings of guilt or anger may be felt by the caregiver when this loss occurs.  Could they or others have done more to help this client during this illness?

It is expected and accepted that the families and friends are permitted to mourn the loss of a loved one.  But what about the home health aide?  How may we encourage their expression of their loss, validate their needs and help them cope during this period?