Too Much Information

When I was in active caregiver mode, I found a book titled Breathing Space by Jeff Davidson (2007 edition is still available), and found a powerful way to decrease the level of stress in my daily life. I state it as:

Cut Down On the Amount of Information Coming at You.

Before I began caregiving for my Mom, I watched local and national news on TV, I read a local newspaper, two national newspapers and several magazines, and I listened to radio talk shows and spent lots of time on the phone and with e-mail and the Web.

I was Connected!

Then I became a caregiver, and I allowed the pattern of information flow to continue.

I was Connected...and completely overwhelmed.

Breathing Space really helped me look at all the sources of information literally flying at me. I started to detach. I chose one evening TV news program. I stopped listening to the radio shows. I stopped all the magazine subscriptions except one that I truly enjoyed (mini-vacations here). I stopped reading all the newspapers. I got myself off every marketing e-mail list that did not have to do with my caring and limited my e-mail and online time to one-half hour every day. During certain hours of the day, I let all my personal calls go directly to voice mail and only checked messages twice a day.

I finally began to feel that breathing space Jeff Davidson talked about. And saved some money, too.

In our society, there is an unspoken rule that we NEED to be connected to information and people 24/7/365. That's just not true.

Why do you NEED to listen to three news programs, all of which are reporting the dire straits of the world? You're caring for a parent. That can be pretty dire all by itself. At the very least, it's plenty stressful. You don't need to know every detail about the world's stress, too.

Why do you NEED to answer every phone call the moment it arrives? Truth, most calls can go directly to voicemail and you can screen them later.

Become aware of every bit of information around you. Think about how each source of information affects you emotionally, how much time each takes, and whether it's adding any value to your crowded life. If the information stresses you, takes too much time telling you things you already know, and rarely brings you pleasure (only another "have to"), get it out of your life.

Create Information Breathing Space. Ah-h-h.

Blessings on your caregiving day!

Should I Be Anxious?

There are a LOT of statistics making the rounds of the Internet, some with no references to back-up the data, some reported by the American Institute of Stress and re-reported in ezine articles. One I've just read states that 75 - 90% of all doctor's visits are caused by stress-related illness. Headaches, high blood pressure, back pain, heartburn, ulcers--there can be a stress component to these and many more physical complaints. Even if only half the statistics are true, they are enough to tell us that stress, and the accompanying anxiety or anger, can affect our health, our mood, our lives.

We know that everyone has stress in their lives--caregivers have their own unique versions of stress--but the important factor is how we handle that stress, the anxiety, the anger.

In June 2010, ABC News did a report on anger management and Dr. Redford Williams from Duke University shared a 4-question check that you can take when you're feeling angry. I think it works just as well for anxiety. When you feel irritated or get that stomach-churning nervous feeling, ask yourself:

1. What situation is triggering this feeling? Is this an important situation? Is someone in danger? Is there some injustice happening? Is it important to my well-being?
2. Is it appropriate to be angry/anxious in this situation? Would my friends get angry in this situation? Would anyone feel anxious?
3. Is the situation modifiable? Can I change anything about what's happening?
4. Given the circumstances and possible consequences, is it worth it to do anything in this situation? Should I act on my anger/anxiety?

Pay close attention to Question 3. For caregivers, especially those of us who like to be in control, this is usually the most important question. In caregiving, we must often accept that we can not do anything in the current circumstance.

A "No" to any one of these questions, Dr. Williams says, means that the situation does not warrant intense emotion or action. Take a couple of deep breaths, remind yourself this is life with some frustration thrown in, use any mini-vacation techniques that work for you.

Four "Yes" answers, however, mean that this is probably a situation where your anger or anxiety is justified, and you should consider acting to change the situation.

I don't have many anger flare-ups, but I am a master of anxiety. I can get tied in knots about the smallest things. But when I use the 4-question check, I can objectively judge whether I need to be anxious about the situation or just LIB (Let it Be). Nine times out of ten, it's an LIB. For Number 10, I try to decide if I need to change or whether I need to influence the situation.

In caregiving, there are many opportunities for stirring the anxiety pot, but the 4-question check can help you calm that pot and realize that you can save your anxiety for another day.

Ah-h-h. That feels good!

Blessings on your caregiving.

Nothing Is Set In Stone

Molly began helping with her father’s care a few months ago and is finding the experience far more difficult than she ever imagined. “I have such a hard time making decisions,” she admits. “What if I make the wrong choice? What if Dad doesn’t like the home nurse I hired? How can I choose when it’s Dad’s health, his life, I’m deciding? I want to do the right thing, but I’m afraid I’ll mess up somehow.”

We all want to do what’s best for our parent. We want to do what will work for us, too. In this striving for the best, for perfection in choosing, remember: there’s one thing certain in caregiving…Change.

Your parent’s condition will improve. Or worsen. Care services that worked well for a while suddenly don’t. The physician who has been seeing your parent retires. The rehabilitation therapist suggests that your parent may not be able to live alone again. The surgery that wasn’t needed last month is now critical.

The decision you made last week was made in last week’s situation and with last week’s information. This week will probably be different. Nothing is set in stone.

Adjustment and change. Normal.

What a relief!

Your first decision doesn’t have to be perfect. It just has to fit the circumstances and information you have that day.

Considering Options
When you’re making a decision that seems particularly difficult or complex, try the following:

• Create a list of alternative choices. Write down as many as you can think of. One of those choices may be to postpone the decision. Brainstorm.

• Evaluate each choice. If you don’t have enough information about a choice, ask questions, find out more. Note the possible positive outcomes to each choice and the possible negative outcomes.

• Weigh the importance of those positive and negative outcomes on a scale from 1 to 10 (1 = I don’t care if this outcome happens; 10 = If this outcome happens, it will substantially affect my life and my parent’s care). There may be many negative outcomes to one choice, but those outcomes may not matter much to you or to your parent’s well-being.

• With your evaluations and the weights of the outcomes in hand, make a choice. Notice that now you have back-up choices if your first one doesn’t work out.

Permanent Consequences
There are some decisions that, by their nature, do have permanent consequences for you or your elder. The choice to remove an artificial respirator when signs of life have faded, the decision for surgery that will remove diseased tissue…these bring a permanent change to a person's health status. Using the suggestion for considering options above still applies, but the outcome weights will be near 10 for some choices. These decisions are particularly difficult.

But over the course of caregiving, nearly all the decisions you make for your parent will not have permanent consequences…inconvenient, less than optimal, aggravating consequences perhaps, but not permanent.

Resist acting or thinking that a decision is one of life-or-death when it is not.

To read more, try:

Simon, Sidney B. Getting Unstuck: Breaking through Your Barriers To Change. Chapter 4: Change and Options. p. 85-114. Grand Central Publishing, 1989.
This chapter provides more details about brainstorming choice options and how making effective decisions keeps you moving forward.

Throughout the caregiving experience, remember that you always have a chance to make changes, to adjust, to do something better, to do it differently. That’s the wonder and happiness of being human. We always have options. Usually more than we imagine. Next time we'll start exploring sources of information that will help rev up your imagination.

Blessings on you and your caregiving!

Your Situation Is Unique

This week here at Parentcare 101, we're talking about some life-long lessons that we caregivers need to take to heart. Today's topic discusses a fact that we often forget. Everyone's caregiving situation is unique. Let me share some stories from caregivers I've met.

Martha lives farthest from her hometown where her father still lives. She gets along well with one of her brothers, but has never felt close to the other two. Now that her father is ailing, she knows that they all need to talk about what’s going to happen, how they will care for him. It doesn’t help that her father is the classic curmudgeon. She dreads the conversation for she knows her brothers will expect her to do everything—and if she’s not careful, she just might take on that traditional role.

Kenneth is an only child. He and his parents have always been close and when his mom and dad both fell ill, he did not hesitate to arrange his life so that he could be with them as much as possible. He commutes the 100 miles several times a week. After a year, his wife can’t understand his continued devotion. She’s not sure she could do that for her parents. But she does understand that the hours Kenneth spends, he gives freely, from love.

Jordan’s father was abusive and walked out on the family when Jordan was 12. Now, when Jordan has a family and a good job, his ailing father is demanding aid from him. Jordan gave his father the number of the Area Agency on Aging in his father’s city and left it at that.

In my own situation, I was very surprised when a social worker commented, “You’re very fortunate, you know. You and your sister are talking and agree on the kind of care your mother should have. And all your relatives are happy to let you do what you want in the situation. That’s pretty rare.”

Family circumstances mold the way we approach a parent’s care. Some adult children freely give their time to their parents out of love. Others must wrest their caregiving from a morass of negative memories. In some families, the siblings are not talking. In some families, parent and child are best friends; in others, there is pitched battle whenever the two meet. Adult children live at varying distances; one with four children, one with none, all of them holding jobs, some married, some not. The variations of family types are infinite.

To add to the confusion, there is no contract between you and your parent, spelling out how much you owe your parent. There was no legal document drawn up at your birth with the mutual obligations specified. There are no guidelines to tell you how much each sibling should contribute or will. You make those decisions for yourself.

Across families, the care choices to be made, questions to be answered and the emotions are often the same—do we use home health care or move Dad to an assisted care facility? I'm so relieved Mom is settled in her new place. Which nursing home? I feel guilty that I’m not doing enough. How much can Mom do on her own? How will we pay for Dad’s care? I'm angry that my sister won't do more.

But for each situation, the caregivers enter uncharted territory. The way the decisions are made and how they are carried out are always different, based on the family situation.

Choose what’s best for the FAMILY.

Your family includes, first of all, YOU. Then comes everyone closest to you : spouse, children, parents and everyone involved with the caregiving: siblings, friends, relatives. That’s a lot of people, all of whom have worries, responsibilities, desires, just like you. Cut yourself--and everyone else--some slack.

What's the point here? There are several. Remember...

· Every family is different, so take ideas from other families, but do NOT compare your decisions against those made by other families. Do what’s best for your family.
· What you can give today may not be the same as what you can give in the future. Revisit your role in the process frequently.
· Review your priorities often; they will change with changing circumstances. How other families care may not be what you’re prepared to give or capable of giving. Recognize this, listen to advice, but remember that your situation is unique.

Think about the specifics of your care situation, the people involved, the finances available, the housing resources available, the relationships. Have you heard of any other caregiving circumstance exactly like yours? Do you listen to advice, but rework it to fit your own circumstances?

Once you’ve decided on what’s best for your family and for you, let go of the anxiety and get on with the doing. Do what you can. It will be enough.

Your First Priority is You

Are you kidding? I have my kids, my job, my spouse, my parent to think about. They’re my top priorities.

Think about your life now.

How do you feel...

When you haven’t gotten enough sleep, haven’t eaten a decent meal in days, have pushed yourself until your head and shoulders and stomach throb with tension?

When you haven’t had a chance in weeks to connect meaningfully with another person, talk out your worries, have fun just doing nothing?

When you haven’t had a moment to yourself in days?

You can't serve others with energy, patience and love when you have less than your best to give.

Making Yourself Your Top Priority Does NOT Mean…
· Ignoring the responsibilities and obligations that you have to your loved ones.
· Refusing to do something for your parent simply because it is “inconvenient” or because you “don’t feel like it”.
· Misusing your choices in life to disregard real needs your parent may have.
. Becoming self-absorbed.

Making Yourself Your Top Priority Means…
· Recognizing that you have a right to your own life, that your needs are just as important as anyone else’s.
· Letting your own life and well-being take precedence so that you will be ready physically and emotionally when you most need it.
· Refusing to give of your time and energy unstintingly to others without giving yourself the same proportion of time and energy.
. Striving for balance within your life so that you are not the last person to whom you apportion your time and effort.

Recognizing your own needs, dealing with your own emotions, getting help when you need it, considering your personal goals throughout the period of your caregiving—all these things insure that you will have the endurance to care effectively for a long period of time, especially if that period of time begins to stretch from months to years. Taking care of yourself is not selfish when you are a caregiver. It is essential.

To maintain your well-being, experts agree that you must pay equal attention to five areas of your life:
1. Physical: the health of your body. Establishing good health habits, nutritious eating, rest, exercise and regular medical check-ups.
2. Mental: keeping a limber mind, learning something new every day, solving puzzles, maintaining a sense of humor, fostering your creativity, organizing your life experience in your mind, the sense of self-worth.
3. Emotional: the capacity to feel deeply, be sensitive to feelings (yours and those of others), a willingness to experience feelings and the appropriate responses to those feelings.
4. Spiritual: The core dimension of you, the profound sense of who you are. Living with a sense of hope, recognizing a set of clear values and a sense of worth and peace. Feeling that there is meaning and purpose to your life. Giving yourself time for quiet, reflection, prayer.
5. Relational: Developing rich and meaningful relationships with others. Building a supportive network of friends who offer understanding, closeness and empathy. Being part of a community of folks who care for one another.
from "Seeking Your Healthy Balance" by Donald and Nancy Tubesing

Remember also that you have other priorities after yourself and before your parent.
· If you are married, you made a commitment to your spouse that brought you together as a new family, separate from your parents. Statistically, your spouse will survive long after your parents have passed on. Long-term, it makes little sense to jeopardize your marriage and alienate your partner while caring for your aging parent.
. If you have children, your responsibility to them also takes precedence. Your parents are part of the past and guided you to where you are now. Your obligation is to see that your children are guided into the future. Do not ignore your children’s needs while caregiving; guiding the next generation is a way to honor your parents.

Suggestions:
· Read this blog, visit the Parentcare website, the Parentcare 101 Bookstore, use all the resources and suggestions you find to help you balance your life and remind you to nurture yourself.
. When you are overwhelmed, remind yourself that your first priority is you. Give yourself a 15-minute break of quiet, then set your priorities and tackle the problems facing you.

For Reflection and Sharing:
When you read "Your first priority is you.", what is your reaction? Do you think you can take this advice seriously? Have you taken this advice to extremes and ignore your parents' true needs? What would it mean in your life if you gave yourself the same measure of time, consideration and care that you do others? What one thing can you today to put a little more balance in your life?

Your First Priority: Resources

Many of the ideas in today's post Your First Priority Is You were taken from the following resources. Use them to help you find your balance in caregiving and set your priorities. Books that are in print are available through the Parentcare 101 Bookstore.

• Dolan, J. Michael. How to Care for Your Aging Parents…And Still Have a Life of Your Own! Los Angeles: Mullholland Pacific, 1992. (Read especially the Epilogue)
• Golden, Stephanie. Slaying the Mermaid: Women and the Culture of Sacrifice. Harmony, 1999.
• Louden, Jennifer. The Woman’s Comfort Book: A Self-Nurturing Guide for Restoring Balance in Your Life. HarperSanFrancisco, 2005.
• Moffatt, Betty Clare. The Caregiver’s Companion: Words to Comfort and Inspire. iUniverse, 2000.
• Tubesing, Donald A. and Nancy Loving Tubesing. Seeking Your Healthy Balance: A Do-it-yourself Guide to Whole Person Well-being. Pfeifer-Hamilton Publishers, 1991.
• Uustal, Diann B. Caring for Yourself - Caring for Others: The Ultimate Balance. Educational Resources in HealthCare, Incorporated, 1997. (Out-of-print, but worth reading. Check your local library).

To search for articles or more information on the web or in your library, try these search concepts combined with an AND:

Concept 1: Self-Care, Self-Nurturing, Wholeness, Whole Person Well-Being, Wholistic Medicine, Self-Help Techniques, Nurturing Behavior, Life Balance
Concept 2: Caregivers—Psychology (subject heading in library catalog), Caregiver Stress, Compassion, Fatigue

Search examples: Wholeness and Caregiver Stress; Life Balance and Caregivers; Wholistic Medicine and Compassion

Myths of Eldercare

I'm wrapping up this week of blog introduction with a reality hidden beneath the fuss and flurry that is often a caregiver's life. A reality that affects how you and your parent react to the dynamic caregiving situation you both have entered. A reality of which you may be totally unaware.

After the first months of caregiving, as I recognized that my relationship with my ailing mother was more complicated than I ever imagined, I spent a lot of time reading and talking to others about the emotional and relationship side of parentcare.

What I learned along the way was that I had bought into the Myths of Eldercare:

MYTH 1: In all families, parents and children love each other unconditionally.

MYTH 2: No matter the quality of the parenting, parents deserve a child’s unquestioning devotion, duty, love and service.

MYTH 3: Every child is obligated to care for his parents as they age.

MYTH 4: A person honors her parents only if she sacrifices her own life and mental health for the sake of the parent. Without total sacrifice, the child can not be judged as “good”.

Note the "all-or-nothing" quality of each of these myths. They are rarely stated outright and never written down. We breathe them in from our families' actions, conversations with friends, from newspapers and television. The myths invade us as easily as secondhand smoke and become a part of us. And in living, we act as if these myths were immutable laws. They become the bars of a cage, restricting the options we have in life. Often we don’t even think about what we are doing. We just act.

What are the Facts of Eldercare?

FACT 1: Parents and children should love each other unconditionally. But let's be honest, dysfunctional families exist. Even in "normal" families, love's depth and expression are different and different even between each parent and child.

FACT 2: Parents are human, and their love is not always given in a fair or evenhanded manner. Some parents are abusive; some have abandoned their families. Being a parent is no guarantee that a child will offer unquestioning devotion, duty, love and service. (Talk to a teenager sometime for clarification on this point.)

FACT 3: There is no contract or rule that obligates a child to care for an aging parent. The Bible says, “Honor Thy Father and Thy Mother,” but it’s vague on how to do that. In any case, you can not mandate love or respect.

FACT 4: Sacrificing your own well-being in caregiving does your parent no good. It drains precious energy away from caregiving and weakens you. To care for someone else, you must first care for yourself.

What I'm asking you to do now is to be honest with yourself. Have you accepted any or all of the myths as Truth? If you have, how might your belief in the myth affect how you talk with your parent, decide priorities in your life?

And just as important...does your parent believe in any of the myths? Does that belief bring with it expectations that you might not be able to meet?

A counselor once told me that 80-90% of our behavior comes from the subconscious, from our instincts, from beliefs deep within us. Until we pull the myths up into our thinking, conscious decision-making brain, we will act on them instinctively, perhaps to our detriment.

What myth do you believe? Is your belief filling you with guilt or with joy in your caring? Do you need to discard that myth for something more realistic, more positive? Is your myth helpful?