Focus on the Caregiver

• Do you have an aging parent/spouse with chronic, disabling conditions?
• Are you struggling with guilt, grief or anger?
• Are you feeling alone or misunderstood in your caregiving role?

Most support groups offer camaraderie, education, and community resource information. This group will provide that and advance to the next level by helping you develop and practice coping skills and identify the tools needed to reduce the emotional challenges you face as a caregiver.

The Focus on the Caregiver Group will:

• Take the support group model up a notch by addressing your emotional issues tied to your caregiving role

• Provide therapeutic interventions by a licensed counselor in a small group setting

• Give you a safe setting to share your challenges with other caregivers

Location: Tempo Medical Building (across from TGI Friday’s)

12401 Olive Blvd, Creve Coeur, MO 63141

Cost: $15/session  (no one will be turned away if finances are limited)

Day and time : 1^st and 3^rd Wednesdays, 7:00 pm to 8:30 pm

Additional groups may be added on other days, at other times, if needed

Light refreshments will be served.

Facilitator

Sylvia Nissenboim, LCSW,a counselor with over 25 years experience as a therapist and support group facilitator has focused on caregivers and their families since 1982. She is a therapist, published author and national trainer/consultant.

Call 314-477-3144 today to register, or send email to Sylvia@sylvainissenboim.com.

See p. 20 for article on Working Caregivers, Balance and Self Care tips

http://www.afacareadvantage.org/issues/ca_fall10.pdf

Have you ever seen your brain sweat? Don’t you think this is possible after heavy mental exercise — brain aerobics, if you will?

Have you seen the research and  brain exercise software designed to help you maintain your cognitive skills? Most recently there was a column in the New York Times discussing the latest research findings on this topic.  Over the last 6 years  I have been bumping into books, articles and interviews, all stressing this new brain health activity.  Posit Science, the Alzheimer’s Association Brain Health agenda, and AARP’s articles on mind aerobics have all joined in the fun.

Here I have developed a menu of brain aerobic exercises.  Consider which you might want to implement for  your clients and their families, your colleagues and yourself !

Stretch and Kvetch

This is an exercise in learning a new skill. It involves stretching beyond the comfort zone. Maybe it’s a new language, or new skill, but the point is that the learning should be a challenge, which is what the scientists say strengthens the synapses, wiring and connections in the brain.  Remember getting your first IPod? Well, when I got mine, I sat myself down, read the handbook (Ugh!) and followed the instructions for downloading music.  Yes, I kvetched (groaned and complained, for those of you not familiar with the term), but this mind stretch will prepare me for the next techno challenge that is coming around the corner.

Cognisthenics

Not ready for Super Jeopardy or the Millionaire?  Warm up your brain with cognisthenics, just like its companion, calisthenics, you work on strengthening those muscles in your head through short, but intense memory tasks. For example, list as many vegetables as you can in two minutes, write a 10-line poem that rhymes with the words “wine” and “roses,” sing your college football anthem from start to finish, recite songs you learned in the school choir and haven’t sung aloud in decades, do a math sequence of adding 5 to a beginning number, subtract three, add five, subtract three and keep going for a few minutes. There! Now, you are warmed up!

Memory Jogging in Place

This is also known as “Sweating to the Oldies – Memories, That Is.” Here are some exercises for memory jogging in place.  Have your exercise partner name countries, and then you shoot back the capitals. Or list the planets in order, then backwards. Even try reciting the alphabet backwards. Memorize a short poem (Shel Silverstein is a good start) and sing the theme songs from Gilligan’s Island, Green Acres, the Jetsons, and wrap it up with the Flintstones.  (have I aged myself??) Are you sweating yet?

You are working yourself up to the intensive now.

Try Mathelon

This exercise will keep you on your toes so you can easily compute the tip when dining out, calculate room dimensions when ordering carpet, compute kilometers walked and many more life situations demanding math skills.  Compute the square footage of each of your rooms (hint — length times width) in your head, add the ages of everyone in your family, now calculate everyone’s ages in dog years (last time I heard, it was 7 years for every one human year), and finally think of the last five purchases you made and figure out what they would have cost had they been on 30% sale.

Isn’t this fun? Let’s keep going! You should be sweating by now.

Pumping Iron-y

This fun exercise requires you to search for examples of irony. For example, isn’t it ironic that after developing all these brain exercises for you and your clients, I can’t come up with one thing that is ironic to use here as an example? That is a perfect example of Pumping Iron-y. (Pumping Puns, anyone?)

Finally, you have reached ultimate brain fitness, and you are ready for:

Marathon Funning

This regimen requires that you memorize three jokes each day and tell them to three people.  OK, for beginners in this category, memorize one and tell it to yourself three times a day. You are ready for the City Marathon Fun when you can maintain consistent three joke/three person/day intensity. This may force you to find new friends as your present victims might start hiding from you; but expanding your social networks is also part of good brain health.

Cog-yoga

Cool down. Lie on a mat. Focus on your core with cog-yoga. You have worked your mind hard, so it’s time for relaxing, for better focus. This exercise is done by closing your eyes, breathing deeply, bringing your navel to you spine, tightening all muscles, then releasing, and when any thought comes to mind, release it into the atmosphere. Just let it go. Try this for 10 minutes every day!

Like a true athlete, you may want to cross-train, so choose a different exercise to do daily with a partner, which makes it more fun and keeps you accountable.  Keep those synapses popping!

Please read this letter by a young woman with early onset dementia who could not be present for a keynote at a caregiver recognition ceremony we in the Missouri Adult Day Services Association coordinated a number of years ago.

It is meant for the caregivers of persons with dementia.  Clearly, she is an eloquent woman, who at too young an age, is facing dementia with strength and energy,  and playing a leadership role with the Dementia Advocacy Support Network International, in helping express the interests and concerns of those afflicted with memory impairing conditions.

I have her permission to share this with you. You can share this, with acknowledgment of the writer, with your colleagues and family caregivers.

No Place Like It

It is a privilege to be able to speak to you on behalf of an international group of people who have dementia, the Dementia Advocacy and Support Network International.  Because of our early diagnoses and of the improvement the new cognitive drugs have given us, we consider ourselves to be among the fortunate few who are still able to speak on behalf of others with dementia who no longer can.  On behalf of people with dementia in the United States, Canada, Australia, New Zealand, France, England and Brazil, please let me tell you what dementia is like and therefore, how much we appreciate you, our personal caregivers.

Those of us who have dementia have experiences much like Dorothy’s in the Wizard of Oz. You remember Dorothy?  A tornado came up in Kansas and scattered everything at Auntie Em’s farm. It blew poor Dorothy and her dog, Toto, all the way to Oz. In Oz, everything was different. Witches and Munchkins lived there. Flowers glittered strange ways, and the apple tree griped when she tried to pick an apple. The bewildered Dorothy confided in Toto.  She lamented, “We’re not in Kansas anymore.”

As she struggled to understand her much-changed world, Dorothy became desperately Homesick for the familiar old Kansas farm and her familiar, loving Auntie Em’. She missed them so! Dorothy’s only goal became to find her way Home.

Dementia is like that. Those of us who have dementia are different. The world is different. People relate to us differently. We feel scared and very much alone. Whatever frustrations our former lives held, at least they were familiar. Like Dorothy, we — desperately — want to go Home.  At Home, we knew our way. At Home we held valuable jobs. At Home we had friends. At Home we had families. We want to go Home. But how to get there?

We also need a yellow brick road. And maybe that is why we wander. We wander and rummage and hoard whatever we find that reminds us of home.  We can’t find the yellow brick road, and we can’t find the ruby slippers to travel it.

Dorothy discovered that she had always had within herself the brains, the heart and the courage to get home. We don’t. In fact, if you could only see how shrunken and shriveled our brains have become and how much we despair, you would be very proud of us for having the courage to carry on at all. We know we will not get better, but we do carry on, and mostly because of you.

You see, you are our scarecrow, our tin man, and our lion. You lead us along our way. More than that, you are our Yellow Brick Road; you are our Ruby Slippers; and you are our Wizard who leads us so very close to our Home.

We are aware of how much your world has changed as well. We are aware of the pain we have caused you. We know you miss us, and we would be different for you if only we could. We would give you back your life, your partner, your lover and your farm. We would set you free and give you all of Kansas. And we would work for the rest of our lives to fulfill your every dream. We will thank you eternally for your care and self-sacrifice. We love you as always – and more!

Carole Mulliken, VP

The Dementia Advocacy and Support Network International

Bob Herbert, NY Times columnist has a superb piece this morning on the unnatural alliances, and unnatural disasters that come from under-regulation, and under the table relations between government and giant corporations.  All of us, whether we are aware or not, are responsible for accepting this.  It is a betrayal of our trust.  The quality of our lives is literally in their hands and we have been complicit, through our inaction.

Whether in our food, automobile, energy or financial industries,  the safety and health decisions made in boardrooms which  short cut and adulterate measures for our protection,  have clearly come after decisions that would increase their profits.  At our expense.

Here’s the column…

Op-Ed Columnist

An Unnatural Disaster

By BOB HERBERT

Published: May 28, 2010

Bob Herbert

Go to Columnist Page »

Related

• Times Topics: BP Plc. | Gulf of Mexico Oil Spill (2010)

With all due respect to the president, who is a very smart man, how is it possible for anyone with any reasonable awareness of the nonstop carnage that has accompanied the entire history of giant corporations to believe that the oil companies, which are among the most rapacious players on the planet, somehow “had their act together” with regard to worst-case scenarios.

These are not Little Lord Fauntleroys who can be trusted to abide by some fanciful honor system. These are greedy merchant armies drilling blindly at depths a mile and more beneath the seas while at the same time doing all they can to stifle the government oversight that is necessary to protect human lives and preserve the integrity of the environment.

President Obama knows that. He knows — or should know — that the biggest, most powerful companies do not have the best interests of the American people in mind when they are closing in on the kinds of profits that ancient kingdoms could only envy. BP’s profits are counted in the billions annually. They are like stacks and stacks of gold glittering beneath a brilliant sun. You don’t want to know what people will do for that kind of money.

There is nothing new to us about this. Haven’t we just seen how the giant financial firms almost destroyed the American economy? Wasn’t it just a few weeks before this hideous Deepwater Horizon disaster that a devastating mine explosion in West Virginia — at a mine run by a company with its own hideous safety record — killed 29 coal miners and ripped the heart out of yet another hard-working local community?

The idea of relying on the assurances of these corporate predators that they are looking out for the safety of their workers and the health of surrounding communities and the environment is beyond absurd. Even after the blowout at the Deepwater Horizon site, BP officials were telling us (as their noses grew longer and longer) that about only 1,000 barrels of oil a day were escaping into the Gulf of Mexico. Nearly a month into the disaster, BP’s chief executive, Tony Hayward, was publicly offering the comforting assessment that the environmental damage resulting from the spill would likely be “very, very modest.”

They were somewhat wide of the mark (as reputable scientists were telling us day after day after day). We now know, of course, that this is the worst spill in U.S. history, that instead of 1,000 barrels a day, something in the range of 12,000 to 19,000 barrels a day have likely been spewing into the gulf. And the environmental impact can fairly be described as catastrophic.

The oil companies and other giant corporations have a stranglehold on American policies and behavior, and are choking off the prospects of a viable social and economic future for working people and their families.

President Obama spoke critically a couple of weeks ago about the “cozy relationship” between the oil companies and the federal government. It’s not just a cozy relationship. It’s an unholy alliance. And that alliance includes not just the oil companies but the entire spectrum of giant corporations that have used vast wealth to turn democratically elected officials into handmaidens, thus undermining not just the day-to-day interests of the people but the very essence of democracy itself.

Forget BP for a moment. When is the United States going to get its act together? Will we learn anything from this disaster or will we simply express our collective dismay, ignore the inevitable commission reports (no one pays attention to study commissions), and bury our heads back in the oily sand?

President Obama said on Thursday that his administration was “moving quickly on steps to ensure that a catastrophe like this never happens again.” Well, he can’t ensure anything of the kind. And, in fact, his corporate-friendly policy of opening up new regions for offshore drilling (that policy is only temporarily halted) will all but guarantee future disastrous spills.

The U.S. will never get its act together until we develop the courage and the will to crack down hard on these giant corporations. They need to be tamed, closely monitored and regulated, and constrained in ways that no longer allow them to trample the best interests of the American people.

Mr. Hayward of BP was on television on Friday referring to the Deepwater Horizon explosion and subsequent fouling of the Gulf of Mexico as a “natural disaster.” He was wrong, as usual. Like the unholy alliance of government and big business, this tragedy set in motion by Mr. Hayward’s corporation is a grotesquely harmful and wholly unnatural disaster.

I was heartened to read the article in a recent New York Times blog regarding the comfort and joy that can be experienced by persons with dementia.  I know I have witnessed music, movement, reading and oral history recording as  activities that can be developed for the improvement of mood for many people dealing with dementia.

Over the last 25 years, my work in adult day has proven to me, my staff and the clients that when properly prepared, staff can elicit powerful video or oral recordings of our clients’   histories, even those with dementia.  The client with help from their families  provide the names, places and other trigger words that can be helpful when eliciting stories.The preparation for this project is intense, but similarly is the joy experienced by the older adult both during the recording and after viewing the tape.

Studying the client’s social history, knowing their life story well enough to be able to trigger memories is core to the success of an oral history project with persons with dementia.  We know that word-find ability is limited, so the oral history is created through the use of   words that elicit colorful memories.

Born in Tennessee? Lived with parents on a small farm in Kansas?  Milked cows by hand? Rode trains with uncle who was a porter on the  Pacific train line?

Each of these are examples of trigger words or phrases that the interviewer knows will elicit a story or reminiscence.  In adult day centers, an approach referred to as ‘person-centered care’ obligates the staff to know the stories  and details of each client’s life so that  our interactions with persons who have more difficulty managing the details of the present can be engaged.  We help them reengage with their life stories.  Recording oral histories is another way to bring joy to the person with dementia. It is also a powerful gift for families to cherish long after their loved one is no longer able to share their memories.

For more information, please contact me at 314-477-3144.

http://newoldage.blogs.nytimes.com/2010/04/22/many-alzheimers-patients-find-comfort-in-books/?pagemode=print&&scp=4&sq=alzheimer%27s&st=cse

Focus on the Caregiver Group

• Do you have an aging parent/spouse with chronic, disabling conditions?
• Are you struggling with guilt, grief or anger?
• Are you feeling alone or misunderstood in your caregiving role?

Most support groups offer camaraderie, education, and community resource information. This group will advance to the next level by helping you develop and practice coping skills and identify the tools needed to reduce the emotional challenges you face as a caregiver.

The Focus on the Caregiver Group will:

• Take the support group model up a notch by addressing the emotional issues tied to your caregiving role

• Provide therapeutic interventions by licensed counselors in a small group setting

• Give you a safe setting to share your challenges with other caregivers

Location: Tempo Medical Building (across from TGI Friday’s)

12401 Olive Blvd, Creve Coeur, MO 63141

Cost: $100 for the four-week group

Day and time : to be determined by group members  (days and evenings available)

Facilitators

Two counselors with over 25 years’ experience working with caregiver will facilitate this 4-session group.

Sylvia Nissenboim, LCSW, her career has focused on caregivers and families since 1982. She is also a published author and national trainer/consultant.

Nancy  Mesey, PLPC, 25 years’ experience facilitating caregiver and related groups.  Specializations in Gerontology and Chemical Dependency

Call 314-477-3144 today to register, or send email to Sylvia@sylvainissenboim.com.

Support groups for caregivers have blossomed all over, and for very good reason.  They recognize that when people are carrying the responsibilities tied to caring for an older or disabled family member, they need to know they are not alone.  Caregivers need education, they need peers, they need validation.  But when is a support group not enough?

Caregivers learn early in the support group process that most information is given in a generic format, with some attention paid to member’s particular situations, but if a caregiver finds that their stress, decision making or emotional upset is causing them to lose sleep, feel depressed, drained or anxious, they may be experiencing symptoms that can only really be addressed in an individual or group counseling session.

Counseling interventions differ from those provided in a support group setting  in 4 ways.

• First, licensed clinical counselors have been trained to assist the client to explore unresolved  family dynamics that may be at the root of the client’s stress.
• Secondly, a therapist can often help the client identify common unconscious, but distorted, thought processes that cause the client to feel stuck, anxious or depressed.  Tools to assist a caregiver reduce the effect of these negative thought patterns are significant in helping a caregiver feel competent and valued.
• Third, a caregiver may have personal trauma or pain unrelated to the caregiving they are providing, but it acts as a  trigger, nonetheless, that affects their ability to provide quality care to their family member.
• Finally, there is the issue of privacy.  While most support groups review the rules of confidentiality with their members, a member may still feel that the source of their worries cannot be shared comfortably in a group without the facilitation of a licensed counselor or therapist.

Many clinical therapists help caregivers and provide them with the tools that will enable them to maintain their own emotional well-being while caring for a disabled loved one. Many of these tools will enable the client to more fully participate in their support group without the baggage of personal crises and negative self-talk that can be diminish the positive impact a support group can have in a caregiver’s life.

It is well- known in the field of aging, that too often, caregivers of persons with Dementia,  Alzheimer’s,  Stroke,  Parkinson’s Disease, for example, overlook their own health and wellness while taking on the care of a family member.  “You can’t take care of others if you don’t take care of yourself” is a common reminder that you will burn out if you don’t improve your life balance, and expand your supports and resources, so you are able to continue for the duration.

A simple to question to answer:

Are you being driven by your caregiving responsibilities, or are you at the wheel??

• “There’s nothing I can do about it….”
• “It’s just the way it is…”
• “I have no time for my own needs…..”

If these sound like your response to that question, its time to get back in the driver’s seat!!

Have you overlooked increasing the following activities, which will help you maintain your health and strength for the long run?

• Exercise
• Nutrition
• Sleep
• Friends, social support
• Enjoyable activity
• Family cooperation and collaboration
• Updated resource information

Getting a handle on these areas will help you maintain your own  health, and sense of balance and well-being.

Coaching to improve YOUR health and wellness while caring for an older family member is critical if you want to be the best you can be.

Telephonic coaching is a great way to start because it doesn’t require leaving the house to start taking care of your own well-being!!



Seems like everyone is stressed or in major activity overload these days!!

I thought it would be timely to share some techniques to remind us how easy it is to turn away from on-going tension.See if you can turn low moods into joyful moments by incorporating some of the following into your home and work life, sharing these with the folks with whom you come in contact, like caregivers and older adults who sometimes get tunnel vision. See what a session on humor does to your next group with these clients/customers/colleagues.
Here we go:
1. Make a joy journal, listing the gifts that come to you each day, for example, smiles, finding something, a pleasant event, a joke.
2. Take “healing breaks” — at least 20 a day (30 seconds, to 1 minute each).
3. Give yourself a “standing ovation.”
4. Be a child, play with toys, wear a tiara, blow bubbles.
5. Surround yourself with funny pictures of yourself and your family.
6. Have a positive party funded by negative people. Negative remarks throw $1 into a positive pot and use the money every couple of months to do something fun. (We can’t keep negativity out of our lives, but we can turn the inevitable upsets into positives.)
7. Pretend you are in control.
8. Place a mark on your body to show where you have “had it up to.”
9. Too much to do? Complain loudly (you will get further behind, but you’ll feel better, and….your party collection will increase).
10. Whine — do a group, family or friend whine.
11. Breathe and let go.
12. Do not sweat the small stuff, it’s all small stuff.
Enjoy this list. Copy it, distribute it and most importantly, use it!!
Try something you would not expect yourself to do. Surprise yourself! Life comes at us, and all we can do is choose how to respond. Give those around you the gift and it might even be returned.