THE END

I hope you enjoyed reading my book What to do What to do When Mom Moves In.  There are a few things that I left out, but you can read the whole thing by going to Amazon.com where you can buy the book.  I hope to have it on Amazon as an ebook in the future.  Thanks for reading it.

DEATH CONTINUED

     There are many stages of grief, and some recur.  For example, you might have just begun to compose yourself when someone’s sympathy brings the tears again.  We mourn the loss of our loved one not only because they are gone, but because we are alone to face the world without them.  Sometimes after a death we become angry at our loved one for leaving us alone, even though it isn’t their fault.  We are hurt, devastated and finally angry.  We often discover that we are angry with ourselves for not saying what was in our hearts before it was too late.  So often we hold back our thoughts.  We hesitate to say what is in our hearts.  We need to say, “I love you” when they can hear us, not after they are gone.

     For some there are too many unresolved feelings that can lead to depression and illness, even self-abuse.  The us of alcohol or drugs will simply prolong the agony.  Sometimes counseling is needed to help us through.

     Grief counseling is available through your clergyman or counselors, or through grief seminars.  These seminars bring together groups of people who share their feelings of loss, frustration, anger and resentment, with the goal of finding peace and contentment in their lives.  It is helpful to be with people who are grieving for their loves ones, the same as you.  It is an emotional time, but the ultimate release of these emotions brings a calm contentment that lets you get on with your life.  Most people who come to the group angry or depressed leave calm and ready to resume their life again.  They come to accept dying as a part of living.

     If you believe in the hereafter, it makes death easier to accept, knowing that it is the beginning of a different life, filled with happiness and free of pain.  Sometimes this makes it easier to bear.

     My mother grieved by staying busy.  Se redecorated the whole house, bought new furniture and bedspreads, and stayed active with her projects.  Of course, she didn’t like being alone.  That is a problem for some people, the fear of being alone in a big house.  You usually have family around for a while, but when they leave you are alone with your thoughts. 

     I found that the best way to forget about your fears and your problems is to do something for others.  You can’t think about yourself when you are helping others.  For me it works, but everyone is different.  We all grieve in our own way.  What is good for me may not be good for you.  Find your way.

     Some people have a hard time accepting the loss of a loved one.  They go into denial and won’t talk about it at all.  They prefer to think of their loved one as away, with the thought that they will come through the door someday.

     Closure, that is what is needed.  When there is no funeral it may be easier on the family at the time, but sometimes they fail to receive closure.  The funeral makes it final.  At least conduct a graveside memorial service with the family around.

     Your love one will always be alive through memories, pictures, and maybe videos.  There will always be a corner of your heart reserved for your lost loved one.

THOUGHT FOR THE DAY

More things are brought by prayer than this world realizes.

DEATH

     Coping with the death of a loved one is never easy and often feels like an emotional roller coaster.  You may agonize over the unresolved questions, the things you wish you had said, but didn’t.   The feelings of guilt that you could have done more haunt you and your mind is in constant turmoil.  Your emotions take you to places you don’t want to go, deep into your heart and mind where your true feelings are stored.  Some of those feelings say it was time for your loved one to go, but that makes you feel guilty.  Another feeling is that of relief that the heavy burden of responsibility has been lifted from your shoulders.  Those feelings are normal.

      When the final moments come and you are watching your loved one slip away, you can almost see their spirit leave their body as they become lifeless.  The loss is overwhelming, tears flow and the emotional release is uncontrollable.  There is a sudden void in your heart.  The close companionship that you shared as your loved one slowly drifting away is something you will cherish for years to come  Sharing those intimate moments makes losing the a little easier to bear, but in another way it makes it more difficult.  You were so close, sometimes for the the first time, then they are snatched away and you still have so much you wanted to say  It is the most heart wrenching experience you can have in this life.  And yet, yo get through it and life goes on.

     The grieving process begins.  It is important to let those emotions go, to cleanse your body with the tears of sorrow.  Without this release, the emotions fester and create problems for the mind and body.  Death is a tie to let go, to give back to God what he loaned us for a short time.

     The grief you feel will pass in time, but it takes a while to come to teams with death.  For some it is a month or two, for others it takes a year or two more.

     Talking about your feelings helps.  After the funeral friends and relatives gather together to talk about the good times they shared with their loved one.  This experience is so important.  Emotional sharing helps to heal the loss.  While funeral gives closure, the opportunity to grieve with family and friends gives you the chance to share emotions and memories of happier times.

     Talking with your family and friends about the departed is necessary to overcome the grief and regain your composure, so that you can eventually resume your normal life.  And amazingly, life goes on...whether you want it to or not.  Sometimes you feel you would like to freeze time so you won’t have to return to your routine or cope with people, especially those who don’t know of your loss.

EMOTIONAL HEALTH

     There are so  many outlets for your emotions.  For some it is working in a garden for a little while that can relieve stress.  Digging in the dirt and planting beautiful flowers brings peace to your soul.  Watching things grow seems to give you a better perspective on life.

     For others it is music, either playing an instrument or just enjoying a beautiful song.  Music helps you relax, like a good massage.  They say that music soothes the savage breast.  I really believe this to be true.  Listening to a good opera or the velvet voice of Frank Sinatra can take you to another place, another time, and give you a peaceful feeling.  It also brings back beautiful memories.

     For some, exercise relieves stressful emotions.  Working off the frustrations of life can work up a sweat.  Then have a sauna to cleanse your pores, relax with a gentle message, and see how the world looks to you.  This does wonders for your overall feeling at well-being.

      Lose yourself in a good book, while you curl up on the sofa with a hot cup of tea or coffee.  It will transport you to another dimension at least for awhile.

      If time is in short supply, even a hot bubble bath will soothe your stress and relax your muscles and your mind.  It doesn’t matter what you do, just find whatever fits your needs. 

     When the pressure builds it is time to find a release.  Whatever that release is...use it.

              THOUGHT FOR THE DAY

He giveth power to the faint, and to them that have no

                 might he increaseth strength.                            

                    

                                                       ---Isiah 40:29

MORE EMOTIONAL HEALTH

     With all those thoughts cluttering my mind, no wonder I would get depressed at times.  Instead of feeling sorry for myself, I tried to find the good in all of the pain.  I know that’s not easy, but it beats feeling negative.  I wanted someone to help me, to tell me I was doing the right thing and that these feelings were normal.  Sometimes I felt like I was going mad and all I wanted to do was scream or break something...anything to relieve the tension I felt inside.

     I cleaned, moved around our few belongings in the apartment.  I wanted to change my situation in life.  Cleaning helped, and so did baking.  I think the key word was change...I wanted something to change.  Somehow it was a small satisfaction to know that I still had control over some aspect of my life.

     Control...maybe that’s why I got so frustrated!  I didn’t have control over my life anymore, they did...Mom and Wayne and the ever-present doctors.

     I like things organized and everything was unorganized.  Instead, I had to organize my life around the needs of others.  It was like having two babies that both needed your attention at the same time.  I couldn’t get away for even a few minutes, just to be by myself.  So I cherished every stolen moment.  I wanted easy, but whoever said that life was easy?     

     They say that God never gives you more than you can handle...but He was pushing it!

     It was had to fall asleep on those nights when Wayne slept very little.  My mind would wrestle with all those thoughts until I would really fall asleep exhausted. 

      Does this pain ever go away?  Sure, it passes just like other emotions.  And it helps to channel those emotion.  If you have a hobby retreat to it for a while.  I found an outlet for all the frustration I was feeing...writing saved me.

     Writing was like having my own private therapist, only I didn’t have to bare my soul to a stranger.  I know that if I had all those feelings bottled up inside me, I would have cracked eventually.  No one can take that much stress and stay sane.

EMOTIONAL HEALTH CONTINUED

     It is difficult to control your emotions at moments like this, but you must find the strength.  You can’t let your loved one know how frightened you are; instead remain upbeat and positive, even when your loved one tells you they don’t think they will ever see home again.  It’s rough when they think they are going to die...you must convince them otherwise.  Your loved one needs hope, something to hold onto, just as you do.

     How do you do it?  You reach deep down inside yourself and find that determination that will help you cope.  Then hang on to it for dear life; never waver or you will sink into he depths of despair, from which you may not return.  Grim determination and a positive attitude somehow go hand in hand.  Learn to hang on tight, keep your sense of humor and you’ll make it.

     At first our routine was a killer...my back was telling the tale.  I asked the physical therapist for help and she taught me ow to transfer a patient from a bed to a wheelchair without hurting my back.  The nurses taught how to feed and medicate my husband through a G tube.

     It was all worth it!  We found a routine that worked for us.  The main problem was that Wayne slept all day and would be awake all night.  This required some adjusting on my part.  I have always been a night person, but I had to be awake all day too, or at least most of the day to take care of my mother, who was also staying with us in the apartment, since Pamela brought her to Portland and had gone back to London.

     I would try to sleep when Wayne slept, or at least part of the time.  I usually got about five to six hours in small spurts and I stayed awake from midnight until six in the morning.  We adjusted, as usual...what more could we do?

     When he was in dialysis for four hours, I did all the shopping and treated myself and Mom to a lunch out once in awhile.  This wasn’t the easiest time for me, Mother, or my husband, but we managed with the help of all our friends.

     It is certainly a time when you need your friends and family.  It isn’t easy when you are living two hundred miles away.  Your mind is cluttered with thoughts during a time like this.  You miss your home and the little luxuries that you enjoyed.  I kept thinking about our dock and how it needed to be refinished.  I sure missed sitting out there, with a gentle breeze blowing and a tall iced tea in my hand, watching the sky divers float down in their colorful parachutes.  We always loved our deck.  We had breakfast there often during the spring and summer.  Now, it was summer and I missed those wonderful times with my husband.  I knew that it would never be the same again, but I could always hold on to those memories.  I just hoped and prayed that someday soon we could be home leading a normal life again.  But I knew that dream meant a lot of hard work and dedication to making a little progress each day.

     

     

EMOTIONAL HEALTH CONTINUED

     I knew that I had to look at the problems at hand, and concentrate on Wayne.  He would be released from the hospital soon and I wondered if I could handle his care myself.  I fought the idea of a nursing home with all my heart.  I was disillusioned with nursing homes after dealing with them with his father and then his mother.  I never dreamed that we would be in the same boat so soon.  You never think that a crisis will happen to you...at least you pray for deliverance.  But problems arise, so you have to face them and get on with your life, however it has changed.  The real test of your endurance is to find a balance between what has to be done and what you can handle yourself.

     In my case, I read all the information I could get my hands on about my husband’s condition.  I asked questions of the nurses.  Why was his procedure being done? Why were these medications being given, and what were the side effects of each drug?  I bought a book on medications so that I could understand their benefits and side effects.  Sometimes this works, but other times it can confuse you completely.  It is still better to discuss any questions with your doctor when you can corner him long enough.  When Wayne’s doctor tried to leave the room, I would ask them to sit down and discuss my husband’s situation and give me a tentative prognosis.  I say tentative, because most doctors ten to give you the worst case scenario and I believe in thinking positively.  I knew that I was facing a bad situation, but I refused to give up just  a doctor believed a condition would not get any better.  I believe in the power of positive thinking and I work with it all the time.  I believe that if you continually think and work toward the positive end, it will help.  I’m afraid that I am know as an eternal optimist.  But, I must say, in my defense, that things go my way more often than not.  I have always been a very lucky person.  My advice is to look for something good to happen it most likely will.  If you look on the dark side, that instead is what you will probably find.

     So, thinking positively, I worked out a plan for caring for my husband, with a long-range plan for his recovery that would take him back home and out on the golf course.  I worked with him in his physical therapy sessions and at home, make sure that he had the best care I could give, and encouraged him to exercise his mind.

     It is hard to see the person you love unable to walk or remember an incident or a conversation.  I believe the worst pain in when they don’t even know who you are.  They look at you with empty eyes, sometimes frightened because they don’t know what is happening..  That empty look is the first hurdle you have to overcome---at least it was for me.

     

EMOTIONAL HEALTH

    When Wayne lost his kidney function we adjusted to having him on dialysis, but when he had a stroke, then a perforated bowel and peritonitis on top of it, I cried loud and long...then I prayed until I couldn’t find any more words.  When I came to terms with the problems that I was forced to face, a calm took over and I was able to look at the situation with a new perspective.  It is hard to detach yourself when your beloved husband is lying on a sterile bed, looking so vulnerable, but if you must make plans for the future and the care of this person, you must know how to become detached.

     When Wayne recovered a little bit from the stroke and the perforated bowel, I noted that his condition left him with memory loss and difficulty summoning the proper words when he was talking.  He was confused at times, but it wasn’t too extreme and we could have dealt with that problem, but with the peritonitis complicating his condition we almost lost him.

     At first when I realized the seriousness of his illness, it was hard to control my emotions.  I started tearing up for no apparent reason.  In fact, my emotions were often near the surface and I couldn’t push them down anymore.  Of course, I was always full of questions and worry about Wayne’s condition.  What am I going to do?  When will I get to take him home, or to the apartment?  What is his prognosis?  Is he going to be a vegetable for the rest of his life?  I knew that I would rather see him die than vegetate.  But then I didn’t want to be without him either.  It seemed like I was going crazy with all these questions.

     I mourned the loss of our future.  What happened to our dreams of traveling?  We’d planned on living in Arizona in the winter with all our friends and spending the summers in Hermiston with our family.  Our parents stole our dream when we had to care for them instead of being free to travel.  Then Wane began to fail and his health problems ended all our plans, for the moment anyway.  Sometimes I felt cursed---it had been one problem after another.  It makes you ask why?  Why are we the only ones who would care for our parents?  Why couldn’t the other siblings take their turn?  That’s an easy one to answer.  With my mother, she refused to travel to Los Angeles to visit our family.  She was afraid of flying and Southern California is so far away that if she wanted to come home, it would take too long.  Mother has always been fearful.  She was afraid of flying, driving too far from home, traveling with a group, and all the things she could do to enjoy life, she wouldn’t even consider.  With Wayne’s mom and dad, we were close.  His brother lived in Tucson, Arizona and visited very little with his parents.

     

MORE ABOUT FEELINGS

    Sometimes the pressure of your situation makes you angry at everybody and everything in your life.  It isn’t fair to the children, who haven’t done anything yet feel the tension in the family.

     You may get angry at your parent for forcing you into this predicament.  You just want it to come to an end.  You want them to pass away and be done with it.  You’re not alone in these feelings.  It is normal to feel resentment when your whole life has been turned upside down.

     But there are benefits and lovely moments in caregiving too, since it’s not just all problems.  Count the precious years that your loved one has lived and imagine the changes that have taken place during their lifetime.  Imagine living through this period of rapid change, a witness to man learning how to fly, then watching the first walk on the moon.  It must be amazing, to say the least.  Think of the stories they have to tell.  At the very least you can hear all the important events in their lives, or hear stories about their parents’ lives.  You have a treasure of family history just waiting to be recorded for future generations.  So instead of counting your losses, explore the past and really hear your heritage.

     If there are children living at home, they learn to care for, respect, and get along with the elderly.  In our society respect for the elderly is slowly being lost.  Children who live with their grandparents are enriched by knowing how another generation lived.

     There is a special bond that forms between and elderly person and a little child.  They have a lot in common; even with the age difference, they are compatible.  A child likes to take care of an older person, much like play-mothering.  Little children are so free with their love.  How wonderful to teach a child in the early years to care for and get along with the elderly.  It makes it so much easier in the future, when thy have the task of caring for their aging parents.  A good lesson for the young---we could use the same lessons.

     Emotions are wonderful!  Show your emotions to your loved ones.  Don’t hold those emotions  in until it is too late---tell them how much you love them today  Know that you have done everything you possibly could to make their last years with you comfortable. You will be glad you did.

FEELINGS

FEELINGS

    Sometimes a caregivers emotions are volatile, with big highs and very deep lows.  These feelings are mixed with confusion and frustration when things aren’t going too well.  It doesn’t take much to bring these emotions to the surface.  but you ride the tide, with well all its ups and downs.  You learn that you can’t hold your feelings in, or eventually it will make you sick.  And remember, words once spoken under the pressure of extreme emotions can’t be taken back.  It’s better to vent in other ways and never say the words to the person causing your distress.

     When my husband’s mother was living with us, I started to write to get my feelings out.  It seemed to help and I have continued this practice for the last thirteen years.

     When Mother Kuhn moved in I was resentful at having to care for her.  I resented how my world changed completely, and I fumed that it was all caused because she had smoked all her life.  Smoking caused her Empysema and finally killed her.  I reasoned that it wasn’t my fault she smoked herself to death, but I was forced to take care of her anyway.

     I think giving up my privacy when she moved in was the worst part of it.  Wayne and I had no time alone, except at night.  Eventually the tension got to both of us and we argued for the first time in our married life.  I mean really argued.  Over the years we certainly had little disagreements, but this was serious arguing..  Thank goodness those times were few.

     However, we had it easier than some other families who are trying to raise little children while looking after their ill parent.  They are called the “sandwich generation.”  They find themselves sandwiched between a growing family and an aging parent.  It is quite a juggling act for these families to cope with caregiving.  When a person rises early to get her children dressed and off to school, drives her husband to work, then spends the rest of the day caring for an ill parent, it doesn’t leave much time for anything else.

     Some of these young women feel they have lost themselves...they don’t seem to exist anymore.  It is just one task after another, with no time to call their own.  They know it will come to an end someday, but wonder how much they can handle until their parents pass on.  These woman will probably spend more time caring for their parents than they will raising their children.  It is a difficult fact to face.

ELEVATOR FUN

     When I was spending so much time in the hospital with Wayne, I noticed that it was always quiet in the elevator.  People just don’t talk much when they ride from floor to floor.  Have you ever noticed how silent everyone is when you step onto an elevator?  They look at the floor, unless they have a partner to talk with.  Even then, they stop their conversation until they reach their floor.  I guess they’re afraid that someone will hear some deep, dark secret.  In any case, elevators are usually a silent ride to your floor.  Sometimes there is music playing on the elevator, but I feel uneasy when I can’t speak to people.  I guess I’m a busybody, but I like to meet new people and learn where they are going and what is going on in their lives..  Give me ten minutes and I will know your life history.  Based on my curious nature I began an experiment while Wayne was in St. Vincent’s Hospital for so long.

     I decided to strike up a conversation with at least one person each time I rode the elevator, which was about twelve times a day.

     I started my experiment with a crowded elevator the first day.  All the even floors were pressed, so I made mention that we would not be stopping at any odd floors today, speaking in my best elevator operator voice.  When we started up, I called out the floors:  “Second floor, conference rooms, credit union, cafeteria, and if you need beautification, the beauty salon.  All out for the second floor please.”

     Everyone laughed and waited for the next floor.  I had all the floors down pat, because I had been there so long, I knew where everything was.  It was sort of like the old days when the elevator operator would call out all the floors in the department store.  But it made everyone feel more at ease, and they laughed as they left the elevator.  I rode all the way up to the ninth floor that time, even though my husband was on the seventh floor.  It was a lot of fun.

     I got to meet so may interesting people on the elevator.  There was an osteopath, who asked me if I knew what osteopathy was.  I met a tall, dark, handsome man in transportation (they take patients to various activities, such as physical therapy) who took my husband to dialysis.  I found out that he was a model for newspaper ads when he wasn’t working a the hospital.

     Sometimes you meet people that you know on the elevator---yes, even two hundred miles from home.  It sure is nice to have friends who will travel three and half hours just to say hello and see if we need anything.  Wayne’s golfing buddies rode up in the elevator with me.  Of course, they came to visit with my husband, but it’s always a nice surprise to see someone from home.

     When there were tears on the cheeks of a person entering the elevator, I always kept quiet.  I have shed a few myself and know that these times are best spend in quiet reflection.

     I looked on the board at the nurses station one day and found that I knew two people that were in the hospital at that time  It was a surprise to see their names, so I looked them up.  One was the groundskeeper from our golf course.  He was in the room right next to my husband’s and I didn’t even know it.  We had a nice chat about home.  It helped me and I know it was good for him too

     So, you see, there are a lot of wonderful people on the elevator...but you won’t know unless you look up once in a while. Believe me, there are a lot of interestng people with wonderful stories, if you just ask.  I did and I made new friends, even if it was just for a moment.

THOUGHT FOR THE DAY

Moments of peaceful reflection give us the time to

                                                                                           count our blessings.

MORE SELF-TALK

     Self-doubt can make you feel isolated, depressed and anxious.  Instead, look for ways to build your self-esteem.  If you feel good about yourself, you will radiate a positive outlook and pass this on to your patient.  After all, you are a loving, capable caregiver and you can feel good about how you are helping your loved one.

     Maybe it’s time to surround yourself with people who will support and compliment you.  Your friends probably admire you, believing that you are a wonderful person to take on your patient’s care.  Most people couldn’t handle this tough job.  Don’t stay away from your friends, you need them now more than ever.  How long has it been since you took a friend to lunch?  Too long, I bet!  Take some time off and treat yourself and a friend, even if it’s just for a cup of coffee.

     Don’t be afraid to recognize your own accomplishments.  It isn’t selfish...after all you are doing a good job and you probably won’t get much positive feedback from your patient.  Give yourself a pat on the back for all the good you do.  When someone compliments you on a job well done, accept their praise with a smile.

     Many of us are overwhelmed by the responsibility of care for another person.  We expect too much from ourselves.  No one is perfect, so don’t try to be.  You are not responsible for the happiness of your parent, or whoever you are caring for.  No matter how great your efforts, chances are they aren’t going to be completely happy.  You may try to spend more time with them, or take them places, thinking this will make them happy, but it sin’t always true.  When a person gives up their home and everything they own except a few personal items, they are most likely going to miss those things.  No amount of caregiving will make up for the losses this person has experienced.

    Do the best you can and don’t worry if you feel tired, frustrated or angry once in a while.  At times you may lose your temper, but so will the person you are looking after.  We are all human.

SELF-TALK

     We all talk to ourselves from time to time.  When you make a mistake or do something dumb or silly, you berate yourself or laugh at yourself.  Do you ever rant and rave about what is happening to you?

     These days do you find that you are talking to yourself more often?  When things aren’t going right, I too start beating myself up with negative talk.  Sometimes I talk to myself out loud.  If anyone heard me they would think I had gone off the deep end.  When I’m really angry I talk to myself a lot.  Since I can’t complain to the person I’m caring for, I complain to myself.  Usually I’m voicing things that i would like to say, but don’t allow myself to for fear of hurting someone’s feelings.

     Pay attention to your inner words and avoid being too critical of yourself.  You are doing a wonderful job, even when no one bothers to praise your efforts.  When you are too critical of yourself you can become depressed.

     You start doubting yourself and thinking that you should have handled an incident differently or that you are to impatient.  When you are trying your best, but can’t meet everyone’s expectations, it is bound to cause you discomfort.  You begin to doubt your ability and coping skills.  You are constantly giving to others, but you never feel like you are doing enough.  You begin to feel that your efforts fall short---maybe you are not up to the job.  Don’t give in to those doubts and start criticizing yourself.  Stay as positive as you can.  These feelings will pass.

ATTITUDE PART 3

     Overall we get what we expect.  What we get is largely determined by our state of mine---our attitude.  If you look for the best you probably will find it.  But, if you look for the worst in everything, you’ll probably find that instead.

     When Wayne was in the hospital and we weren’t sure if he would make it, I stayed as positive as I could, with a big smile for everyone including my husband.  Sometimes it wasn’t easy, but it would have been much more difficult if I had focused on how frightened and uncertain I felt.  I had enough people around me believing that he wouldn’t make it, but I remained optimistic.  Sometimes the only benefit I could find was that his illness gave me the opportunity to learn caregiving from the best teachers.  Luckily, the doctors and nurses at St Vincent’s Hospital in Portland are the best.  Without their guidance and education, I couldn’t have handled care for my mother along with my husband in a strange town.

     The staff understood my feelings and let me blow off steam.  They would put their arms around me and comfort me. Tthey listened to me.  They helped me retain my faith that everything would indeed work out for the best.  They also helped me come to terms with the possibility that Wayne might not make it.

     I felt I had nothing to give them in return, so I tried to give back a little to them by baking cookies for all the nurses and doctors on the seventh floor.  I became the cookie lady.  Once a week, I would make special Italian cookies and chocolate chip cookies for all the nurses and the dialysis crew.  The doctors learned that the dialysis unit was a place to go for snacks.  At least I could show my appreciation for all their help.  I know it was a small thing, but they enjoyed it and so did I.

     Attitude is everything!  Even the happiest people get depressed once in a while.  Knowing that attitude is so important, we can use this information to help us create a positive attitude.  It is just as easy to be positive, as negative.  It is your choice.  Choose to be happy---positive---it makes life so much better for everyone.

     The key to a good attitude is hope.  When hope is gone, all is lost.  As long as there is hope for the future, you can face anything that is handed you.  Hang on to your goal.  Work toward it every day.  Whether it is to provide a pain-free life for an aging parent or to get a loved one back on his feet again, hold onto the hope, the goal, and the positive attitude and you will succeed.

     Emile Coure’, the famous psychotherapist, said that if you simply repeat ,“Every day, in every way, I’m getting better and better,” your problems will tend to diminish, your luck will improve and your attitude will become positive.  You will have hope for the future.

     Keep yourself in a good state of mine---be positive.  No matter how you mange it, do it!  You will find that when you do, you will be relaxed, easygoing, happy and in control of your life.  It sure beats the alternative.

     You ask, “How can I be positive, when my world seems to be crumbling around me?”

     I say, ask for strength and guidance from a higher power.  Put on a positive face until you feel positive, and don’t forget Coue’s words.  “Every day, in every way, I’m getting better and better.”  And you will.

     As caregivers you must keep a positive attitude to pass it on to your loved one.  No one likes a sour-faced caregiver.  We need compassion sympathy and courage to give them hope for a better tomorrow.

MORE ATTITUDE

     Have you ever gotten up and felt wonderful?  The birds are singing, the sun is shining and the world is beautiful.  Then you meet someone who is in a grumpy mood and who can’t see the beauty of the morning.  They might make a remark that angers you and by the time you get to work, your mood has changed and you are ready to bark at everyone.  It is funny how someone else’s bad mood can be contagious.  You start out happy and end up wanting to kick the cat.

     I have learned to pity those grumpy people I meet, but I won’t let them ruin my day.  Instead of taking on their mood, I try to coax them out of their bad mood with a little humor or perhaps just by listening to their problems.  Sometimes my approach works and they begin to look at things differently.  At least it is worth a try.  After all, we all need help once in a while.

     When you are beset with worry and stress, it is hard to remain upbeat.  How do you stay positive in stressful situations?  No matter how difficult the situation.  I try to find the good in everything.  There is always something hopeful in every ordeal, even if it only serves to bring you closer to your family.

      How can you count your blessings when you’re miserable and worried?  Naturally, it is difficult, but you can do it if you try.  Seek inspirational books or tapes and surround yourself with caring optimistic friends.  Find a friend who will listen while you blow off steam.  Sometimes you’ll discover that all you need is someone to listen Someone with a smile.

     Have you every known someone who is always smiling, always upbeat?  They are a pleasure to work with and they make you feel good, even when you are down.  So why aren’t we all like that?  It would make life so much more enjoyable.

     It appears that this type of person most often gets wheat they want---or is it that they just want what they get?

ATTITUDE IS EVERYTHING

ATTITUDE IS EVERYTHING

We live with words every day.  We have words for everything, but, there is one word that is the most important word of all.

     The word is attitude!  The way you look at life.  Everything I have learned about attitude proves that it is one of the most important keys for a healthy and productive life.  Without a good attitude, nothing seems to go right.

     “If you have a good attitude good things seem to come to you, if you have a great attitude, great things happen, and if you have a so-so attitude, your world will be just so-so.” So said Earl Nightingale, one of the my favorite motivational speakers, on his Nightingale/Conant Insight tapes.  He also said the following:

     “How is your attitude?  Here is a way to find out just how your attitude is.  Answer this question with a yes or no. ‘Do you feel the world is treating you well?”

     “If you answer yes without hesitation, your attitude is good.  If you answer no, your attitude is bad.  If you can’t really answer yes or no, you are average.
     “Our world is a reflection of our attitude.  It’s up to you.”

     I feel that Mr. Nightingale hit the nail right on the head.

     It will help if you can keep a positive attitude.  It has been said that “Attitude is everything!”  I feel that is a true statement.  It is our perception of a situation that makes it positive or negative.  When a situation arises that takes control of your life and your patient’s life, it upsets the balance of things.  If you perceive it as negative your muscles will tense, you will get a headache, a backache, shortness of breath, and a racing heart.

     If you perceive a situation as positive you will relax and go with the the flow, with no bad experiences.  It is far easier on the body and the mind to keep a positive attitude.  Work around problems and sometimes it works out better in the long run.  Don’t sweat the little things.  As they say, “They are all little things.”

CONTINUATION OF ABUSE

     Abuse usually occurs when arguments take place, stress builds to the boiling point, then someone loses their temper and it happens.  Many things can contribute to an abusive situation.  Stress is created by bringing a parent into a home for care, with all the demands associated with caregiving.  There can be financial problems that stretch the budget beyond its limits.  Perhaps one caregiver is making too many sacrifices to fill the needs of the person who is ill or elderly.  Sometimes a lack of physical and mental support for both parties leads to problems.  The isolation of a caregiving situation can make the caregiver feel lost or trapped.  Even the family problems that existed before the patient moved in are now blown all out of proportion under pressure of the confined circumstances.

     It doesn’t take too much to set a person off and anyone can become an abuser.

     In the United States, forty-eight states have laws against elder abuse.  In Oregon, there are laws specifically focused on abuse of persons sixty-five or older, including sanctions against injury of, neglect of, or failure to care for residents of any age in nursing homes, and protective service to anyone over eighteen who is aged, blind or disabled.

     The law requires that physicians, nurses, hospital staff, county health workers, human resource employees, therapists, counselors, and police officers must report possible abuse cases.  Private citizens, clergy and relatives of nursing home residents should also report abuse cases.  We must all be on the outlook for problems.

     The people who just want someone to help them get through their last years on Earth shouldn’t be miserable.  These people have already lost their homes, belongings, freedom, and now someone is yelling and screaming at them, and sometimes hitting them, just because they are old and cannot fight back.

     Parents are supposed to be loved and cherished as they grow older and can no longer care for themselves.  It is up to us as caregivers to do the best we can to make their last years as comfortable as possible---even when they have a bad attitude.  It isn’e easy sometimes, but they are our parents and they need us, just as we needed them when we were small and helpless.  Now they’re helpless and looking to us for care in their  “Golden Years.”  Cherish and take good care of your loved ones---they will be gone too soon.  Make sure the last memories you hold of them are happy ones.

THOUGHT FOR THE DAY

I’d rather one should walk with me than merely show the way

                                 

                                            Edgar A Guest

ELDER ABUSE

WARNING SIGNS OF ABUSE TO AN ELDER

     The National Center on Elder Abuse lists the following indicators as important clues to, but not necessarily signifying, possible abuse.

•   Bruises, burns or cuts
•   Dehydrated or malnourished appearance
•   Signs of confinement (tied to furniture, locked in room)
•   Anxiety, confusion, withdrawal or depression
•   Lack of cleanliness, grooming
•   Sudden bank account withdrawals or closings
•   Overmedication or over-sedation
•   Expressions of shame, embarrassment, and fear

WHY WOULD A CAREGIVER BECOME ABUSIVE?

     Abuse tends to occur when the stress level of the caregiver is heightened as an elder’s condition worsens.  Elders in poor health are thus more likely to be abused than those in good health.

     Caring for frail older people often places great strain on a caregiver, particularly when: an elder patient is mentally or physically impaired, the caregiver is ill-prepared for the task, or necessary caregiving resources are absent.  Under these circumstances, the increased stress and frustration experienced by a caregiver may lead to the abuse of an elder patient.

CHARACTERISTICS OF AN ABUSIVE CAREGIVER

     Pay attention to the following signals which may demonstrate that a caregiver has become abusive.  The caregiver:

•   Forbids the older person to speak for him or herself without the presence of the      caregiver;
•   Threatens, insults and demonstrates aggressive behavior;
•   Demonstrates an attitude of indifference or anger toward the older person;
•   Demonstrates problems with alcohol or drugs;
•   Has a previous history of abuse;  Demonstrates an obvious lack of assistance to the elder person.

     Caregivers, about on in ten, lose control once in a while.  Elder abuse can be physical, emotional, financial, or any combination of these.  It can take many forms, such as:

•   Hitting or slapping
•   Withholding food or medication
•   Physical restraints, when unnecessary
•   Yelling insults or threatening violence
•   Misuse of funds
•   Theft
•   Physical neglect
•   Emotional neglect
•   Sexual abuse

  Financial exploitation

     Often the elderly person who is being abused won’t talk about it.  They fear that they’ll lose their care and love.  The family setting can look ideal, but abuse can be hidden, especially emotional abuse.

THE DARK SIDE

THE DARK SIDE

When caring for others you learn a lot about yourself.  You are sometimes forced to confront your dark side, the aspect of all of us that thinks terrible thought, like wishing it would all end and you could just walk away from all the problems. or you might find yourself wishing your loved one will just die and be done with it.

     Sometimes we say things that we don’t mean when we’re tired, angry or feeling overwhelmed.  These hurtful, mean words may just be frustration speaking.

     When you find yourself dwelling on vicious or destructive thoughts, you meet your dark side and it is a frightening moment.  You might wonder if you are going off the deep end?  You wonder how you could think evil or unkind thoughts about someone you love?  You can and you will.

     You mull over your bleak thoughts and ask yourself the meaning of your pessimism and pain.  It is you?  Are you losing control?  Maybe that’s it...you are losing control, control over your life, by adding another generation into your home.  Someone has invaded your space, changed your lifestyle, taken away your freedom, and suddenly you have to rearrange your priorities and routines to accommodate them.  Maybe all your plans for the future are either put on hold or cancelled.  Control...maybe that’s the problem.  Understanding the problem can make it so much easier to face.

     But facing your dark side doesn’t take it away; you just learn to live with it.  There were many times when I wished that my suffering would end.  I was so tired and I couldn’t keep doing everything.  I would get short with Mother and Wayne’s erratic behavior and it would bring me to tears.  I wanted to scream or hit something or just run away and leave the mess for someone else.

     I can certainly see why some people run away from home.  They just can’t cope anymore and need to leave to be free from all the responsibility.  I can also understand, to a small degree, how people can abuse someone they are caring for when stress is about to break them.  Everyone feels close to breaking at sometime or another.  But it is how we handle those difficult feelings that counts.  Look for solutions.  Talk it out, work it out, cook it out, write it out, but find your way to work through these dark feelings.  You are not alone.

     This is where a support group might help you.  You could talk with people who are in the same situation that you are facing.  There is nothing quite as nice as finding someone who will listen and understand what you are feeling, simply because they have had the same feeling sometime during their caregiving time.  It is wonderful to know that you are not alone and that others have had the same dark thoughts that have been going through your mind.  You are not crazy, even though sometimes you think you are.

     Learn to understand your dark side and it will be easier to deal with.  It will also help to have a friend with whom to discuss your feeling.  I would have gone crazy without my friend...my journal...I wrote it every night.

     While I am on the subject of the dark side and how it can lead to abuse, I think it is worthwhile to define what elder abuse is.  According to the Senior News Network, elder abuse is defined as the mistreatment of an elderly person by a caregiver or relative. Not only physical abuse, but mental abuse as well.  Victims generally do not report it, or afraid of reprisals if they speak up.  These reasons are largely why elder abuse is one of the most under-recognized and under-reported problems in the United States.  At greatest risk are the frail and isolated elderly.

     The National Aging Resource Center of Elder Abuse estimates the incidence of abuse in domestic settings at approximately two million cases per year, although it is difficult to determine the exact scope of this hidden problem.  Only one out of fourteen incidents actually comes to the attention of authorities.

EMERGENCY BELL

EMERGENCY BELL

I am always looking for something to make life easier for my loved ones while I am caring for them. A friend of mine told me about an idea he had for his wife. His wife was very ill he needed something for her to use to call him in case she needed help.  He had these all over his house.

     It is a doorbell...not the normal doorbell, but one with multiple bell buttons.  He placed these buttons in places where his wife might need help, such as: next to the commode, on the wall next to the tub, in her bedroom on the headboard, and next to her chair in front of the television and attached to her wheelchair.  It was ingenious!  She could push the button with little effort, to call for help anytime she needed it.  

     This is something I could have used while caring for my elderly Mother-in-law, who was confined to bed. 

     It costs very little and gives your loved one so much more control over their care.  They will love it.  He keeps the doorbell in his office, where he works all day, and can go to her aid anytime she needs him.

     He could go out to work in the garden and take the doorbell with him, so if she needed him he would know.  What a good instrument to help the caregiver.  Your loved one will be happy too, because she will then be a little more in control of her life.  To the ill person...that is important.

     We lose all control of our life when we need a caregiver.  You would think that would not be so, but it is.  Even though the caregiver is family, you still lose control of everything you are used to doing on a daily basis.  This little doorbell gives you back a little of that control.

     If you are a caregiver, you might want to look into getting one of these doorbell for your loved one.  It will give you peace of mind.

CONTINUATION OF BED BATH

       When a patient is bedridden, the circulation isn’t as good as it should be.  A gentle massage can improve the circulation and give the patient a feeling of well-being.  Don’t stop with the back; gently massage the arms, legs, and feet.  Using an upward motion, massage up with the heel of the hand and then circle around and massage down.  Continue rubbing long enough for it to be effective, from three to five minutes.  Your patient will love it.

     Help the patient to put on a gown or pajamas.  Comb the patient’s hair and arrange it comfortably.  Remove all bath equipment.  Now your patient is ready for the day, or perhaps a nap.

     If your patient is not able to dress himself, you will have to provide assistance.  Perhaps you will be picking out the type of clothes they will wear.  Encourage your loved one to get dressed and not to sit around in a nightgown and robe.  When the patient is dressed to go out into the world, they feel better.  Sitting around in a robe tends to lead to a depressed state.  You don’t want that.  You want your loved one to feel as though they could go out of the house anytime, even if they have to be in a wheelchair.  If your loved one is in bed all the time, their lack of good circulation may leave them feeling cold.  In this case, I have found that sweatsuits work well to warm their fragile body.  The soft fleece lining in sweatpants tends to warm their legs and help the circulation.  Warmth and message will help improve circulation, at least temporarily.

     When the patient is immobile it helps to have a sweater or warm shawl.  It seems that the shoulders and back get cold when just sitting.  It takes some extra care to keep them warm.  A lap robe is good to keep the legs warm too.

     It is important to brush or comb the patient’s hair and keep them looking and feeling neat and clean.  No one likes to have company if their hair isn’t fixed properly.  I know that my mother was always asking me if her hair looked all right.  She wanted to look her best at all times...and she did.

THINGS TO REMEMBER

•   Always use a rubber sheet or plastic under a draw sheet on the patient’s bed.
•   Warm the room before bathing
•   Have all needed supplies close at hand
•   Warm a blanket in the dryer to cover the patient while bathing
•   Put a second blanket in the dryer to keep the patient warm when you are finished
•   Talk to the patient during the bath to keep them comfortable
•   Gently massage the patient’s back, legs, and feet to increase circulation
•   Remember to smile and keep a positive attitude
•   Report any unusual conditions observed to the doctor

BED BATH

  When you take on the care of another person, you will be faced with many jobs, some easier than others.  It isn’t easy to reverse the role of mother or father and child, but that is what happens when you are caregiving.  You take on the role of the mother and care for your mother as if she were a child again.  One of the jobs you will be faced with is giving your loved one a bath.

     Chances are when a loved one can no longer bathe, you will have to step in and bathe them.  There are a few things you will want to remember to do before you start a bed bath.

     Warm the room.  Someone who is confined to bed needs more warmth than you or I.  Use a space heater or turn up the thermostat.  It’s a good idea to warm a blanket in the dryer to place over the patient before you begin.  Place another blanket in the dryer to have nice and warm for when you are finished.

     Lay out all the needed supplies: a basin filled with hot water, wash cloth, mild soap, talcum powder, and of course, clean clothes for the patient.  Be sure the water is hot, as it will cool quickly during the bath.  You may have to add hot water as it cools.  Be sure to change the water if it becomes too soapy.

     Now for the bath.  Help the patient remove their clothing.  Place a warm cotton blanket under the patient and over the pillow, removing any unneeded pillows.  Place towels or a blanket under the patient to catch any moisture as you bathe them.  Place the warm blanket over the patient to keep them comfortable.  You will be moving this blanket to expose the area that you are bathing.  Using a blanket not only keeps the patient warm, but also preserves their dignity.  You will also need a couple of towels for drying the skin as you proceed.  Make sure the towels are soft so that you don’t damage the skin.

     Start with the face.  Wash, rinse and dry the face, moving from the nose out to the hairline, making an S motion around the mouth.  Wash, rinse, and dry the neck and ears with attention to all the folds of skin.  Be sure the soap is rinsed off thoroughly, because it has a drying effect on the skin.

     Now move gently down to the torso.  Pull the blanket down to the waist and cover the chest with a towel.  Soap, rinse and dry the patients chest and the sides of the chest under the towel, using long, firm but gentle strokes.  Be sure to wash under the breasts.  As you cleanse each portion of the body, observe the condition of the skin for any problem areas.  Cover it quickly with the warm blanket.  Move the towel to expose the shoulder and one arm, bathe that portion of the body, then cover it quickly, going on to the other side.  Take the basin of water and carefully place the patient’s hand in the warm water and wash it.  Dry the hand and be sure to get between the fingers.  When you are finished with the torso, carefully roll the patient on their side to wash the back.  Gently dry the back with a towel before returning the patient to their back.

     Then fold the towel up, exposing the lower part of the body, and begin washing the legs and the feet.  Bend the patient’s leg and place the foot in the basin of water.  Take particular care of the toes and between the toes.  Dry them carefully, rubbing gently to remove any dead skin.  Talk to the patient while you are bathing them, to keep them comfortable.  Finish by washing the private parts (they may want to wash themselves).  It is important to keep the genitals clean to prevent soreness or infection, especially if your patient is a man and he hasn’t been circumcised.  It is important to pull the foreskin back to wash the penis completely, getting into all the folds and pulling the foreskin back into place when you are finished.

     If your patient is bedridden, sprinkle baby powder on their body and smooth it on the back with a gentle massage.  It will help to eliminate friction that could lead to bedsores, and the gentle massage will help them relax.  

     If you see pressure points where the skin is becoming red, give these areas special care.  The circulation in these areas needs stimulation.  Massage gently around the red spots, kneading with the heel of the hand or the tips of the fingers to stimulate circulation.  Rub around rather than on the reddened areas to lessen the danger of causing breaks in the skin.  If left untreated, they could lead to painful bedsores.  One caregiver told me to apply Maalox to bedsores.  She said it worked beautifully.

     

     

LIFTING

     While I was taking care of Wayne in the apartment, I had to transfer him from the bed to the wheelchair often.  This was a real chore, especially when he couldn’t stand or walk at all.  The physical therapists gave me instructions that helped me to save my back.

      When a patient can’t walk or even stand, it is up to the caregiver to assist the patient so that they don’t slip or fall.  It is important to observe certain conditions when lifting a patient, to keep from injuring your back.  The proper manner to transfer a patient is using the legs, not the back.

     A belt is used by physical therapists, a strong woven belt about three inches wide, that fastens with Velcro.  This belt is used to stabilize a patient being transferred from one place to another.

     You place the belt around the patient’s waist and fasten it snugly.  Place your feet around the patient’s feet to keep them from slipping and keep their feet controlled.  Place your hands on each side of the patient, grabbing the belt from the bottom.  If the patient can help, he should place his hands on your hips or around your wait.  This gives the patient a secure feeling and he can help lift.  Now, you are ready to transfer the patient from one place to another.  Place the chair to the side of the patient, so that you can pivot him to the chair.

     To protect your back, bend your legs in a semi-squat position and lift straight up, pivot the patient toward the chair and place him in the chair.

     If the patient can assist you a little, have the patient grab the arm of the chair to assist in the transfer.  There is a transfer board available through the hospital that makes it easier to slide the patient from bed to chair or chair to car.  It works very well.  You must have a wheelchair with a removable arm rest for this to work.  You remove the armrest, place the board on the wheelchair and on the car seat, then slide the patient from the chair to the car seat.  It makes it easy for you and the patient.  I used this method with Wayne for quite awhile.

     When Wayne was with me in the apartment, he used to stiffen up when I tried to transfer him from the bed to the chair, making it very difficult to get the job done.  There were times when he slipped off the chair and slid to the floor.  I used this method of lifting to get him from the floor to the chair.  We are talking about dead weight, when the patient can’t help you.  I would scoot him over to the chair and then grab the belt and lift with my legs, until I got his butt on the edge of the chair.  I then pushed with my knees to help him slide to the back of the chair.  It was difficult, but it worked and I didn’t hurt my back.  It isn’t easy to lift 145 pounds of weight from the floor, but it can be done.

     If the patient is lying on the floor in the fetal position, another option is placing a straight chair on its side under the patient’s butt, as though he were sitting on it.  Then you roll him and the chair over, so that the patient is on the chair.  Then lift the patient and the chair to a sitting position, watching that the patient doesn’t fall off the chair.  Be sure to use your legs with this method too.  It helps if you have assistance for this procedure.  This is the way the emergency medical team got Wayne off the bathroom floor when he collapsed.

     These are ways to help you help yourself when lifting your patient.  Always take care of your back.

     

PREPARING THE PATIENT'S BED

PREPARING THE PATIENT’S BED

     Save yourself a lot of trouble and make accidents easier to clean by preparing the bed with a rubber sheet or a piece of plastic and a draw sheet.

     A draw sheet is a sheet folded in half and placed over the normal sheet to pad the area under the patient’s posterior.  When an accident occurs it can be cleaned up easily by removing only the draw sheet and the plastic.  

     I have learned that when you are dealing with the unknown be sure to prepare yourself for the worst.  At first this wisdom meant be prepared for a mess.

     It is also important to learn how to change a bed while the patient is in it.  There will be times when you will not be able to put the patient in a chair while changing the bed.

     First, turn the patient on her side.  Help her flex her knees for ease of turning.  If the patient can’t turn alone, grasp the draw sheet across the patient and pull it toward you as you pull the sheet.  The patient should have both legs bent for ease of staying on their side.  Now, loosen the soiled linen and roll in toward the patient.  Put the clean sheets on that side of the bed and roll the new sheets under the patient along with the old ones.  Next, roll the patient over the bundled sheets and onto the clean ones and smooth the new ones in place on the other side, as you take away the soiled ones.  Keep the patient with knees flexed for comfort.  Add the plastic pad and draw sheet in the same manner, pulling the draw sheet tight as you tuck it under the mattress.  Now add the top sheet, blanket and spread and you are finished.  If the blanket bothers the patient’s feet when they are on their back, simply make a pleat in the top sheet and the blanket, to give them more room for their feet.

     This method of changing a bed is simple and doesn’t require moving the patient from the bed.  If your patient can get up, have them sit and relax while you change the bed.

     You should change the bedclothes twice a week, if the patient spends most of their time in bed.  It will keep them more comfortable and lessen the chance of bedsores or pressure points.