New Caregiver Group starting!!  Sign Up Today!

Ø    Do you have an aging parent/spouse who needs caregiving?

Ø    Are you noticing feelings of guilt, grief and anger?

Ø    Are you feeling alone or misunderstood in your caregiving role?

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

Our group will:

Ø     Give you a safe setting to share your thoughts, feelings and challenges with other caregivers

Ø     Provide therapeutic interventions by a licensed and experienced counselors

Ø     Address emotional issues tied to your caregiving role

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

  12401 Olive Blvd, suite 205

  Creve Coeur, MO 63141

Cost:                 $40/session for the six-session group*

                        *check with your insurance plan as it may cover the cost

Day and time :  2 Mondays/mo, 10:30 am to noon

April 23^rd

May 7^th,  21st

June 4th, 18th

July 9th

OR……

2 Wednesdays/mo, 5:30 pm -7:00 pm         

April 18^th,

May 2,16

June 6^{th ,}  20^th

July 11^th

The groups will be facilitated by Sylvia Nissenboim, LCSW , who has over 25  years’ experience working with caregivers and older adults and their  families. She is a counselor, published author and national trainer/consultant.

Join us! 

Call today to register! 

314-477-3144

 Email   Sylvia@sylvianissenboim.com

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

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

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.

If nothing else,  spouses and/or their adult children of older adults should make note of these three most critical areas which, if changes are noticed, next steps need to be planned.

Safety...have there been fires in the kitchen, calls from a parent who has gotten lost in their car, unreported accidents or more than one fall in the bathroom??

Mood..have you seen your older family withdrawing from previously enjoyed activities, or increasingly isolating themselves?  Are they blue, eating less, sleeping poorly,   and appear to feel  hopeless?

Cognition…have they shown signs of losing skills they once were capable of (washing the clothes, setting the security alarm, setting up and/or taking  their medications as prescribed?)

These are examples within the top 3 most important changes that should alert you to call a family meeting, observe these changes more closely and see if professional assistance…geriatric social worker, geriatrician, neurologist…might be needed to do a preliminary evaluation.

Waiting will only narrow your options….act now!

Today’s St. Louis Post Dispatch had an interesting article on the topic of the importance early diagnosis of Alzheimer’s Disease and the  possible treatments available, that can reduce some of the early symptoms.  It goes on to speak to the fact that over half of those struggling with this or a related condition do not seek professional guidance, nor do they bring this to their doctor’s attention for referral to a geriatrician.  See the full article here.. http://tinyurl.com/ngk8ma

Caring for family members who are showing signs of memory loss can be very difficult. This article points to the fact that over half of those struggling with this condition do not get help. Avoidance of a diagnosis has two downsides. Firstly, medication and referrals to community resources are less likely accessed if the person with the memory loss is not seen by a geriatrician or multidisciplanary team of geriatric professionals. Secondly, the family is unnecessarily struggling alone, until they reach out to the Alzheimer’s Association or other local eldercare resource.

For both these reasons, I hope this excellent article has helped at least one family make up their mind to make an appointment with their doctor sooner than later. Everyone wins. Staying in the dark only extends the period of time a family unnecessarily goes through this alone. Sylvia Nissenboim, LCSW