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Faith Community, Family Caregiver, Hospital Professionals, Senior Care Professionals, The Family Caregiver

The Impossible: Doing the Hard Things with Resilience

August 3, 2020 Leave a comment

Alan Packer said, “We can do hard things—it’s the impossible that takes a little longer.” Well, we have been doing hard things for quite a while now. In fact, it seems that we are in the ‘impossible’ phase now. Truly, I believe we have been working on accomplishing the “impossible” for quite some time now, aided by resilience.

Who are WE?

‘We’ are made up of health care workers, direct and indirect care workers in long term care. ‘We’ also includes essential workers in service industries, people who have lost their jobs or are currently furloughed, and those who are balancing work and family responsibilities.

The ‘we’ also includes all of us when we wear masks, wash our hands repeatedly, and remain socially distant. ‘We’ are making sacrifices.

To be honest, some of us are definitely being called to make more sacrifices than others. People working in nursing homes, assisted living, hospitals and hospice, to name a few. Not only are they giving it their all at work, they also sacrifice time with family and interactions with loved ones.

How do they do it?

Keeping up and keeping on is one of those hard things. One of the ways to keep on keeping on is through resilience.

What is resilience?

Resilience is the capability to spring back into action, to recover quickly after adversity. In physics, Merriam Webster defines resilience as ‘the ability of an elastic material (such as rubber or animal tissue) to absorb energy (such as from a blow) and release that energy as it springs back to its original shape.” If that doesn’t describe essential workers, especially those in the health care and long term care industries, I don’t know what does.

How to Build Resilience

You can’t give energy after something happens if you have no energy to spare. Self care goes a long way in helping to build resilience.

Having some control in your environment also contributes to maintaining resilience. Genetics and engaging in healthy habits play a role in building resilience. The National Alliance on Mental Illness has additional suggestions and ideas on resilience.

In the meantime, thank you to those still fully engaged in caring for the mental and physical health of others. Please keep on doing the hard things. “We” appreciate you.

Kathy Dreyer, Ph.D., is an Advisor at AGE-u-cate® Training Institute, which develops and delivers innovative research-based aging and dementia training programs such as Dementia Live® and Compassionate Touch®, for professional and family caregivers; kathy.dreyer@ageucate.com

Senior Care Professionals

Reopening Nursing Homes: Balancing Needs and Safety

July 27, 2020 1 Comment

In May 2020, the Centers for Medicare and Medicaid Services issued a memorandum for state and local officials to outline nursing homes reopening. The recommendations provide guidance on evaluating what steps to take to prevent COVID-19 transmission in nursing homes. In looking back to May 2020 and now, what, if anything, has changed? How are nursing homes balancing resident safety and resident needs with the COVID-19 restrictions in mind?

Updates on Restrictions

Lifting restrictions varies by state and communities in each state, as noted here in this AARP map. For example, New Jersey and Indiana are now allowing outdoor visits, with infection control measures in place. On the other hand, the state of Oklahoma is encouraging family members to visit their loved ones in long term care, while requiring masks and following protocols.

Is This Progress?

It is difficult to connect with loved ones on a limited basis. In some cases, a five-minute outdoor visit is the only way families are allowed to visit. It is painful to see the effects of isolation on loved ones, while unable to do anything about it. According to the American Psychological Association, the COVID-19 restrictions that require social distancing affect older adults and create additional loneliness. As a result, the combination of reduced family caregiver support and social isolation takes its toll. The number of reports of residents dying due to the effects of the COVID-19 quarantine continue to grow.

Balancing Needs

It is difficult to balance the need for safety with the need for companionship. Exchanging safety and protection for social isolation is not a fair deal. On the other hand, families want and need to see their loved ones. In one case, Mary Daniel went so far as to take a job as a dishwasher in the community where her husband lives. Mary has also started a Facebook group called Caregivers for Compromise as a way to influence the process of reopening communities in Florida and other states. It is a positive response and a way to support change in the visitation procedures while maintaining safety.

Happy Medium

It should not take a family member taking on a job in a community to see a loved one. Family members are essential to every resident’s wellbeing, and there must be a way to enable safe visits that mitigate the effects of the COVID-19 quarantine.

Compassionate Touch®, Dementia Live, Family Caregiver, Senior Care Professionals, The Family Caregiver

Broken Heart Syndrome: Another Effect of the COVID-19 Pandemic

July 13, 2020 Leave a comment

As if life could not get worse. A recent study suggests more people are suffering with stress cardiomyopathy during this COVID-19 pandemic. Stress cardiomyopathy is also called broken heart syndrome.

SYMPTOMS OF BROKEN HEART SYNDROME

Symptoms are similar to that of a heart attack. There is chest pain and shortness of breath. Low blood pressure and an irregular heartbeat are other symptoms. There are not usually any blocked arteries.

CAUSES

The causes of stress cardiomyopathy are not fully known. However, stressful events can cause broken heart syndrome. As a result, a person can be affected in both their body and heart.

The COVID-19 pandemic is obviously stressful. Additional stress comes from restricting visitors in nursing homes. Stress also comes from changes in residents’ routines and activities. Residents are experiencing increased stress. Direct care workers are also dealing with their own stress, their residents’ stress, and family members’ stress.

ESSENTIAL AND NONESSENTIAL

At this time, only essential workers are allowed access into the nursing home. Why are family members not considered essential? The Centers for Medicare and Medicaid Services is starting to allow nonessential personnel into nursing homes, under specific guidelines. What about family members, friends, and other loved ones? Safety is important. Unfortunately, safety does not always ensure wellness or wellbeing.

Allowing family members to visit, either as essential or nonessential personnel, can improve the wellbeing of direct care workers and staff. It gives them a break from needing to support the entirety of each resident’s emotional needs. It also helps the residents feel less isolated and stressed.

Balancing safety against wellbeing is a challenge. Until we support residents’ health, safety, and wellbeing, we will see the illbeing and other negative effects continue even after this COVID-19 pandemic ends.

Kathy Dreyer, Ph.D., is a Grant Manager at AGE-u-cate® Training Institute, which develops and delivers innovative research-based aging and dementia training programs such as Dementia Live® and Compassionate Touch®, for professional and family caregivers; kathy.dreyer@ageucate.com

Dementia Live, Family Caregiver, Senior Care Professionals, The Family Caregiver

The Art of Caregiving: Going at the Right Pace

July 6, 2020 Leave a comment

Caregiving has been defined as the willingness to go at another person’s pace. Just like a pace car in auto racing, there is the person who sets the pace in caring, and the person who follows along. The pace car in racing sets the tempo of the other cars before the race officially begins. The person setting the pace in caregiving can be the care receiver or the caregiver. Ideally, a care receiver with dementia should set the pace, with the caregiver following.

Tell-tale Signs of Moving Too Fast

A care receiver with dementia may not want to do what is needed, such as eat breakfast or go to the doctor. The care receiver will show signals and cues to relay their feelings. For example, the care receiver may become still, unwilling to move. The care receiver may become agitated. There may be repeated questions and reluctance. This is especially true if the caregiver is in a hurry. Attempting to get a care receiver to move at a quicker pace is not helpful or beneficial. Also, a raised voice or attempting to physically move the care receiver along at your pace will not work.

A person with dementia will respond to your cues and match your feelings. If you start to get stressed out, so will your care receiver. When things are not progressing, it is time to slow down the pace. That can mean acknowledging the care receiver’s feelings and providing support. It can also mean listening and playing detective to determine the feelings behind the behavior.

What’s Your Caregiving Pace?

It also helps if you are pacing yourself as a caregiver. Are you taking on too much in your care receiver’s care? Who else can provide help? Sometimes a person with dementia responds better to one person than another. Finding another person who is better suited to take the care receiver to a doctor appointment can be helpful. If having someone come to the house to be with your care receiver to look at photos for reminiscence, to share a meal, or just be there, you can take a break.

Just like a pace car needs to have oil changes, full tires, and an engine that works, it takes maintenance and care to provide care for your care receiver and yourself. Both need care and support. When you are attempting to work with your care receiver, do some diagnostics to check where your care receiver is. Are they tired? Could they be hungry or thirsty? Are they in pain? What are their triggers? What are yours? By considering these, you can help your care receiver and yourself in the caregiving race.

It may feel like you are constantly racing. Despite the need to get everything done, take time to slow down, even if it’s for a few minutes during the day at different times. Take care of yourself to take care of others at a pace that works for you and your care receiver.