Dakim Blog

January 1, 2010

First Things First: A Caregiver's Motto to Create Order to Your Day

Written by: Dakim

Author and business guru Stephen Covey coined the phrase “first things first” to remind people to not focus on the daily “fires” that arise (drama, issues, mini-emergencies) but to reorder the day and take care of the things that really matter first. Easier said than done. Most caregivers spend the majority of their time doing the myriad of chores, errands, calls, and personal care their loved ones need. It’s tough to remember what’s truly important when an adult diaper needs changing or a whole bottle of very expensive pills just fell into a sink full of dishwater.

That’s why starting your day is so important. A few minutes of calm thought and preparation can affect every aspect of your day.

Creating Order to Your Caregiving Day:

  • Don’t rush out of your bedroom in the morning. Spend a few minutes in prayer, thought, and reflection.
  • Don’t allow your feet to hit the floor without noting three things to be grateful for.
  • Keep a journal, the Bible, a book of poetry, or other inspirational material next to your bed. Words of encouragement can soothe you in times of worry and grief.
  • Use that paper and pen to plan out your day. Your caregiver brain is frazzled, so keep a pen and paper with you at all times. It’s your brain outside your brain—let it keep track of things for you.
  • Do some deep breathing and stretches before you turn the bedroom doorknob. Feel your body. Be grateful for every muscle and bone you have.
  • Get dressed—shoes and all. It tells the world you mean business. And brush your hair. (I can’t tell you how many days I forgot to do that when I was caring for my mom!)
  • Remind yourself that you are choosing to care-give. You believe in it. Choice is power.
  • Remember that list in your pocket? You were probably a tad too optimistic. Pick the three most important items (first things first) and make sure those get done early in the day. Even one item checked off is a victory.
  • Take care of yourself first. Train your spouse, elder parent, and kids to get up after you—and to know that if they interrupt your first half hour or so, they’re on their own. You’re not on duty yet. (No one gets so much as a nod good morning until I’ve had my coffee, prayer, and journal time.)
  • Remember Covey’s other wise words: Think efficiency with things, effectiveness with people. Greet your loved ones in the morning like they matter—because they do. Ask them what their plans are for the day—they might not have thought of a plan yet, so you’re helping them get a jumpstart to their day.
  • Get those chores and to-do’s done fast. Zip through that monotonous list and let your day know you mean business. No whining or dragging—just do it. (Nike chose a good slogan!)
  • Make sure you’ve got a little fun tucked in every day. If you’re running errands, stop by DQ and get a small-dip cone. If you’re walking the dog, take the ball and let him play (and you, too). If you’re going to the doctor’s office, slip that steamy romance novel into your purse and read a couple of paragraphs before getting your teeth cleaned. Life’s little pleasures make the tough stuff tolerable.

Not every caregiving day is great. You’re not always at your perky best. I do know that when you put first things first—with purpose and passion—that eventually it will become your new norm. You’ll find yourself halfway through your morning and much to your surprise, you’re zipping right along. Habit becomes the backbone of your day and gives you a sense of calm and trust.

The very “first” thing to remember about caregiving is why you’re caregiving in the first place—because someone you love needs you.

December 30, 2009

Caregivers, Are You Focusing on Problems—or Solutions?

Written by: Dakim

Caregiving can often feel like you’re stumbling from one problem to the next.

When I was caring for my mom, who had Parkinson’s and Alzheimer’s, I felt like I couldn’t do enough, give enough, or fix the pain and loss we all faced. It was too easy to feel like a failure—and the more I gave in to frustration and apathy, the more those feelings grew. I found that the best thing I could do was to prioritize, focus on the little things I could do, and find little solutions along the way.

What’s your biggest caregiving challenge?

Is it getting the doctors to listen to you and give your loved one the meds or treatment they need?

Is it getting along with your elder parent?

Is it dealing with the challenging behaviors of Alzheimer’s?

Is it being there—for your mom, your kids, your husband—and even having a sliver of time left for yourself?

3 Steps to Help You Focus on Solutions:

  • List exactly what the problem is and every little part.
  • List several possible solutions.
  • Break the solution down to small steps.
  • Do one step. Pick one that’s doable, that interests you—something you think you have a chance of accomplishing.
  • Now, leapfrog over the problem and focus on this one small part of the solution.
  • Celebrate your small victory. If you were able to make your situation even the tiniest bit better, you have something to feel good about.

It may not be the ideal solution, and it probably won’t solve the bigger issue, but impact is power. You start to feel hope again. This fuels you to try another small step and another.

For example, my mom was extremely difficult at night. They call it sundowning. It wreaked havoc on me and my family and left me exhausted. Sundowning has so many different components (pacing, agitation, wrecking her room, not sleeping, paranoia, trying to escape, stubbornness, not staying in the bed) that focusing on the problem(s) were too much.

But I did find that my mother was calm in the morning. I started fixing her a hearty breakfast, bathing her, and then napping in the chair beside her as she watched Andy Griffith reruns. She and I would usually nap, and I made sure she was up by noon or 1 p.m. so she would still have a chance of sleeping at night. It wasn’t perfect, but I could catch an hour or so of sleep, which was a godsend. That was only a small part, but it was the only thing that worked at the time. The more sleep I got, the better I felt—and finding one small solution encouraged me to look for more.

It may feel good to gripe about your problems to a girlfriend or your spouse. Venting is cathartic at times, but it’s not as good as making your life—and your loved one’s life—better. By focusing on the solution and breaking it into small, doable steps, you might find you can make a real difference.

December 24, 2009

12 Days of Brain Fitness Christmas

Written by: Dakim

Forgive me this little indulgence… It’s Christmas Eve, and I couldn’t resist. Feel free to sing along, and/or throw things at me. Ahem!

On the first day of Brain Fitness
My true love gave to me,
Brain training For neuro-plasticity!

On the second day of Brain Fitness
My true love gave to me,
Two power naps,
And brain training for neuro-plasticity!


December 17, 2009

For The Sake Of Your Brain: Fight Holiday Depression

Written by: Dakim

Ok, I’m setting down the wrapping paper, bows and ornaments for a minute, and addressing a problem for many people (and especially seniors) this time of year.

During the holidays, depression rates rise significantly, and depression is a major drain on cognitive function. The more blue you feel, the less effective your brain is… and if a seasonal funk becomes longer term, it has serious implications for the health of your brain. Even short term depression can be responsible for problems with memory, concentration, focus and decision making. Long term depression is associated with an actual reduction in brain size, with implications of increased risks for dementia and Alzheimer’s. symptoms.

So what can you do about it?


December 15, 2009

Alzheimer’s Caregiving: Is Your Care Receiver in Pain and Can’t Tell You?

Written by: Dakim

Alzheimer’s takes so many things from those it affects—their memories, connections, and often their ability to communicate what’s going on. While it’s agonizing to be unable to chat and laugh with your loved one, it’s an even worse feeling to realize they’re in pain—and not know it at the time. As Alzheimer’s takes its course, the connection between cognitive abilities (to comprehend) and communication abilities breaks down and makes it difficult to communicate feelings of pain. Some studies have shown that 25–50% of people with Alzheimer’s are experiencing significant levels of pain.

This divide can continue to grow and cause our care receivers to be unable to share when they have a headache, toothache, back pain, sinus infection, urinary tract infection, pneumonia, arthritis pain, or—even worse—symptoms of cancer, broken bones, or elder abuse.

Here are some “signs” that your loved one may be in pain:

  • Anxiety and agitation: UTI’s can cause a sense of heightened awareness—a nervous feeling that’s part pain and part irritation.
  • Wincing or tensing when moved: Watch their facial expressions as you lift them on and off the toilet or in and out of bed. Watch their muscles—see if they’re favoring one side or another, or acting protective of one area. Watch their hands or feet—do they curl or spaz when being moved?
  • Moaning, yelling, whimpering, swaying, or cradling: Think how you act when you stub your toe or have a toothache. How would you communicate that if you didn’t have words?
  • Changes in appetite, sleep, or avoiding certain habitual routines: Just like when we’re in pain, we can’t concentrate. We spend all our energies on our pain, and other normal routines get sidelined.

These are some of the basic pain indicators. They’re what humans tend to do when in pain. As a family member or friend, it’s your job to be their care advocate, to keep the continuity in their care. Even if your loved one is in a care home or has a health aide, don’t expect them to be on top of this. You know their personality and can notice subtle changes. You’re the one who has been in their life the longest. You’re the one they need, the one they’re most likely trying to ask for help.

Do some basic health checks each week. Look for cloudy or odd-smelling urine. Look for dark stool that has changed and might have blood in it. Put on a glove and run your finger through their mouth to check for abscesses or loose teeth. Do a light massage from head to toe, gently pull on their limbs and rotate them, and feel for broken bones, cracked ribs, and a swollen abdomen.

Check for bruises, swollen places, and lumps on the head. Make sure their pupils are the same size. Listen for a bad cough or for rattling in the chest (might be bronchitis, pneumonia, or congestive heart failure). You might want to buy a blood pressure cuff (they’re easy to learn to use), stethoscope, and have a good flashlight available. This can save you exhausting doctor visits and give you an indication as to what’s going on.

Even though your spouse, mom, or dad has Alzheimer’s, they don’t stop being themselves. You’ll still see aspects of their personality, and you know them—you’ll be able to pick up on small cues. Listen to your gut. If you really have a deep gut feeling that something is wrong, it probably is. Don’t rule out elder-abuse. It’s sad, but it happens. Sometimes care assistants are just rough and don’t realize how fragile an elder can be. Others are cruel. If you have doubts, install a granny cam and stop by often.

We have to be sharp and aware of what’s going on. Even though we’re exhausted and have too much to do, this isn’t an area we can slack on. Our loved ones needs us. And if you find something now that you’ve overlooked, don’t beat yourself up. You’ve been thrown into the deep end of the caregiving pool and sometimes it’s all you can do to keep from going under.

Guilt paralyzes and you don’t have time for inaction.

Now you know. Now you’re taking action.