Neurofibrillary Tangles don’t Prohibit Zentangles

Like many caregivers (paid and unpaid) my friends are my lifeline. I get satisfaction from being a caregiver, but sometimes I need to get my brain out of my world and into another, in order to keep perspective. I had such an opportunity to change worlds in 2013. Creating Zentangles has been a part of my life ever since.

An acquaintance had suddenly, tragically lost her husband. They had a new business, and I had interviewed them for a local cable TV show.  My show was the last picture/video she had of him. We became fast friends. But she needed time to get her life back together: two kids to raise and get through school, a business to redevelop and a broken heart to mend. In 2013 we went to lunch and she told me how she was doing it all – she was doing a lot of personal work and one of her outlets was Zentangles.

Since then I’ve been teaching myself. I find that my tangles reflect my life (I keep nothing inside!) and when I’m calm, they are calm. When I’m frenzied so are they.  In 2014 I put the practices I’d learned to the ultimate test: I tried to teach the basics to Daisy Girl Scouts (kindergarten and 1st grade girls) on their very first campout.  For some, this was their first time sleeping away from their parents. We all doodled, shaded, colored, and every girl slept through the night! The parents were amazed and impressed that I had been so “skilled” as a leader.

That inspired me to try tangling with another unique group: clients living with dementia. I am a gerontologist (I geek out about aging), and a Certified Dementia Practitioner. Since I’ve also been a caregiver, I know that anything that helps a person with dementia to relax is priceless. I started working with my clients, and I found Zentangles to be an amazing form of expressive arts for most people (not all).  You can get my free e-book Guide to Using Zentangles in Dementia Care by going to www.agingcareacademy.org.

It strikes me as ironic that many of my clients haven’t explored this art form, relaxation therapy or however you want to label it, UNTIL their neurons started to tangle.  What I love about ZT is that the structure offers support, but there are no right/wrong ways. This makes it a natural “failure free” activity to do with people living with cognitive disorders – but if you are a caregiver who does it for escape – feel free to keep this therapy to yourself!

Pamela Atwood, MA, CDP, CADDCT is Director of Dementia Care Services at Hebrew HealthCare in West Hartford CT (www.hebrewhealthcare.org) and the founder of Aging Care Academy (www.agingcareacademy.org). You can follow her on Instagram at pamela.atwood and watch her free Confident Caregiver Series videos on YouTube (search Pamela_Atwood).

 Caregivers hand

Conflict in the Family – Will Mediation Help You?

This month’s dementia care article is guest-authored by our colleague Karen Dworski, LCSW. Thank you Karen for sharing your insights, and by supporting our shared communities. 

Mediation for Families Facing Dementia

by Karen Dworski, L.C.S.W., ElderPath Consultant and Mediator

Few people are prepared to hear that their mother, father, brother, or sister has been diagnosed with a dementia (now called a Neurocognitive Disorder). Just like the grief process described by Dr. Elizabeth Kubler-Ross in her work on the five stages of grief, family members of a loved one with a Neurocognitive Disorder go through a similar grieving process: denial, anger, guilt,sadness and acceptance.* Often families struggle with the denial stage, such as when a family member, say a daughter in California, is in contact with her Connecticut sister who is managing care for their mother who has been diagnosed with Alzheimer’s disease. So often I hear that the California daughter says, “Mom’s fine! I talk with her every week and she makes sense, she knows who I am.”  Or a son who is not a caregiver may struggle with his mother’s decision to place his dad in a memory care assisted living, struggling with his own guilt about not being available to give enough support to keep his dad home.

These are two of many scenarios that occur when family mediation can be very helpful in assisting families with the emotions and decisions related to caring for a loved one with a Neurocognitive Disorder (dementia). Often families benefit from sitting down with a dementia care specialist who can facilitate a discussion about care, covering such issues as:

  • what is each family member’s goal for care for that loved one with a Neurocognitive Disorder?

  • What is a realistic assessment of the loved one’s level of dementia and stage of the disease?

  • How to help a family understand the level of functioning and explore the options, develop different plans of care that meet the needs of the loved ones in a way that basically satisfies the family- finding the right path for elder care.

  • How to have this discussion and bring family to the same page, preserving family connections and relationships

As a social worker and therapist specializing in geriatrics and Neurocognitive Disorders, I meet with families in their homes or my office to mediate these issues.Often families are surprised to find out about the many good options for care that are available, from in- home care that ranges from a few hours to 24/7 care, supplemented by adult day recreation programs, to excellent memory care assisted living communities and nursing homes. An important part of the mediation is to address the grief, loss, and sometimes denial that family members experience, bringing them to an accordance around a plan of care. Of course, the discussion also includes reviewing funding for care, and referrals to funding sources where possible.

I recently met with a daughter, Jessica, from Massachusetts and her father’s partner of over 20 years, Doreen. Doreen had been providing care for Jessica’s father for the last 3 years and his father’s Neurocognitive Disorder was advancing rapidly, leaving him currently with the developmental abilities of a 5 year old child, needing help with many functions of daily life: medication management, dressing, bathing, meal preparation, and recently toileting assistance. Doreen was burned out from working full time and providing all the care except for a 2 hour a day caregiver 5 days a week. Jessica’s father was home alone except for 2 hours a day with a caregiver, so he was often bored and began to feel more depressed. We identified Jessica’s wish that Doreen could continue to care for her father, yet she understood Doreen’s exhaustion and the need to stop caregiving and return to being a companion/partner. We talked about the way Doreen’s role over the last 3 years slipped into one that was primarily caregiving instead of a life partner, and how stressful and lonely that was for Doreen. During the 2 hour mediation session, Jessica and Doreen agreed on a plan for in-home 24/7 care with Doreen moving  out over several weeks, but continuing to visit a few nights a week after work in the role of companion/partner. They were aware of the option of moving Jessica’s father to a memory care community and ultimately to a nursing home with a dementia care specialty, but that wasn’t the first choice.

With the aid of mediation, both Jessica and Doreen were able to develop a plan where everyone’s basic needs were met: Jessica’s needed to know that Doreen would continue to be a part of her father’s life and that her father would have the care and support he needed.  Doreen sorely needed a respite from caregiving and to be able to return to her role as companion/partner. Jessica’s father would have high quality paid caregivers who would provide the stimulation and activity needed to keep him from becoming depressed and would keep his functioning as high as possible over time. Both Doreen and Jessica agreed on the steps needed to put in home care and remove Doreen from direct caregiving. Ultimately, they agreed on a good plan for Jessica’s father and, importantly,  their relationship with each other was preserved, one of the goals of good mediation. As you can see, family mediation can provide the right help at the right time.

*See Grief and Loss as Alzheimer’s Progresses:https://www.alz.org/care/alzheimers-dementia-grief-loss.asp

https://www.alz.org/care/alzheimers-dementia-grief-loss.asp

Karen Dworski, L.C.S.W. is a Consultant and Mediator for ElderPath LLC; www.elderpath.net860-652-8809; karen.dworski@elderpath.net

Thank you Karen for submitting this. And thank you all for reading our blog. For more information about stages of dementia, services which may help you or how to schedule a dementia consultation, call Hebrew HealthCare at 860-920-1810. ~Pam

#1 Way to Avoid Conflicts with Confused People

One of the greatest challenges families and care professionals face in caring for people with dementia  is responding to agitation. When I train caregivers, a strategy we stress is to avoid the things which cause agitation, instead of having to respond to it. And there is ONE technique that is most important to avoid conflicts when someone is confused or disoriented.

FOCUS ON FEELINGS, NOT FACTS

Agitation is usually a result of a communication conflict. Caregivers tend to focus on correcting the person with dementia about facts they’ve misstated or forgotten. At a recent support group meeting we discussed this. With her permission, I share the response from one of our members:

They do not need to live by facts anymore as that is not the world they are living in.  I’ve been thinking a lot about it and am really understanding that their feelings of their story is a comfort to them.  They don’t have the ability to process feelings the way we can, so supporting those stories helps them feel supported – like they matter.  I think that is critical in their lives.  They may feel that they can’t contribute anymore therefore they are not important/they don’t matter. 
There is a great benefit when caregivers focus on feelings; quickly caregivers see results. She continued:
If we add excitement and enthusiasm or at least agreement to their story, they perhaps feel validated and a bit more significant.  I’ve already been applying this since I returned home.  Thank you again for imparting such wisdom.
Thank you to Brenda M and all of the participants in our support groups. Your courage and emotional generosity inspires US each month.
Let us know what techniques you have found successful to prevent agitation.

Zentangles For Wellness

Zen is a Buddhist-based philosophy of meditation and intuition. Commonly, it is thought of as profound state of calm and enlightenment. By definition, it is a noun. In recent popular culture, it has been used as an adjective to describe an enlightened or peaceful quality.

Zentangle is a structured form of doodles. They are based in intuition and, when practiced, create a meditative state. “Zentangles” is a registered trademark and certified instructors (CZT) are in several communities. For disclosure, I am not a CZT. I am self taught with several different books available on the subject.

Although there is structure, there is no right or wrong way to do Zentangles. This fact makes it a natural failure-free activity to do with persons with dementia.zentangle heart

Creativity has many positive benefits. Research (including Ebersole & Hess, 1998) done over the past several decades has verified that creative expression helps:

  • Create balance and order
  • Give a sense of control over the external world
  • Make something positive out of a loss, bad experience or depression
  • Maintain your sense of integrity
  • Help resolve conflicts
  • Make thought and feeling clear
  • A greater sense of well-being and personal growth
  • Improve relationships

The design above was posted by thelawsonsofspanishlakes.blogspot.com

Request your free copy of “A Guide to ZenTangles for Dementia Care” today at http://www.agingcareacademy.org

 

Cyber Monday Gift Ideas for Seniors

by Pamela Atwood, MA, CDP, CLL

Happy Thanksgiving. In case you haven’t noticed ~ the holidays have started. Negative political ads have been replaced by holiday “needs” in a nearly-constant bombardment of commercials, while Facebook-ers debated whether or not to shop on Thanksgiving. I think shopping for me would be much more pleasurable if I had a good sense of what each person on my list really wanted. As I was thinking last Friday of the “deals” I was surely missing as work trumped Black Friday, it struck me that you might like a list of ideas for those on your list who are elderly or living in Assisted Living or Nursing Homes. For a complete list of ideas and resources, visit www.agingcareacademy.org and scroll down to “Your Personal Consultant.”

Hobby & Leisure – there are great resources available for everything from adapted puzzles to games and reading. The puzzles should always be age-appropriate (not childlike), and suitable for the current ability – from 4 or 6 pieces to 50 pieces. Magnetic puzzles with stands are great for those with neck problems. For reading, my newest resource is based in solid research from a physician and speech/language pathologist: Reading2Connect.com. This product has adapted graphics and photos, plus reading content tailored to various abilities — people with advanced dementia may still be able to read! Games which spark memories, use contrast and easy to manipulate materials are available at alzstore.com, best-alzheimers-products.com and memoryjoggingpuzzles.com.

Cognitive Fitness – books, activity cards, games and software are available in all shapes and sizes. Attainmentcompany.com offers the Whole Brain Workout series. Resources throughout the web offer products such as “Connect: Memory Enhancing Game” which can be used in a number of ways to improve neuronal flexibility for all abilities.

Physical Fitness – being confined to a wheel chair does not mean you should quit being active. Some of the best exercise videos are now available at very little cost. Enjoying yoga, aerobics and stretching and strengthening is now possible in your own living room or day room. Check out chairdancing.com, gentlefitness.com and the award winning PBS special sitandbefit.org.

Quality of Life – No one should have to watch garbage television, wonder where the family is or be isolated because of changes in communication. A communication book, talking photo album or alternative TV program would improve quality of life for all. Attainmentcompany.com, Alzstore.com and Best-Alzheimers-Products.com can provide ideas for any gift giving budget.

If you order through Amazon, sign up for AmazonSmile and add Hebrew Health Care as your charity: a % of your total will be donated so your gift is twice as nice.  Thank you, and Happy Holidays!

 

Top 4 Stress-Busting Categories

I’m going through my old files today – some simple spring cleaning is good for the soul. I think it reduces stress for me. Stress is a natural (and necessary) part of life, and we all have positive and negative ways of coping with stress. When I’m really stressed though it seems that I can think of many more negative stress relief strategies than positive. In my spring cleaning I’ve found a list of 24 positive stress-busting strategies. Happy day!

There are four basic categories and I thought I’d share them with our readers, especially for those stressed with age-related changes or care-partner stress.

Physical and Lifestyle Strategies – these are positive habits that are physical in nature and they have some of the most profound impacts on stress. From exercise to diet, changing your physical habits significantly busts stress.

Emotional Strategies – ensuring laughter in your day, and nurturing your soul through music you love are just two simple things to uplift the emotions and reduce stress.

Cognitive Strategies – gaining

control of our thinking is a habit to be developed, and these strategies help develop armour against stress. Challenging our comfort levels with “shades of gray” and practicing awareness of “stinking thinking” with distraction strategies helps us prepare for fluctuating stress levels.

Philosophical/Spiritual Strategies – the power of prayer may be obvious, but also just having a more philosophical view of the world in which we live can reduce stress. These strategies probably take the most reflection and practice to make habit, but may also have the most profound impact on keeping stress at bay.

Develop a list of your own positive stress-relief strategies and try to strike a balance with the kinds of relief you utilize. This is important to ensure positive aging – for instance, if your greatest or only stress relief happens through running, how will you cope with stress if you lose the ability to run/walk? A variety of strategies is best.

FOR A COMPLETE LIST OF THE 24 POSITIVE COPING STRATEGIES, VISIT http://www.agingcareacademy.org today!

Health Risks Associated with Caregiving

Hello readers,

I am pleased to share more thoughts about health risks for caregivers. In a previous post, I misquoted research done and it was picked up by reader Claude Thau of Kansas (if I’m remembering your home state correctly). The JAMA article I quoted actually indicated that caregivers had 63% higher mortality indicators than noncaregivers. I misquoted the article and I am happy to provide the clarification.

Certainly the point of the original post was that health risks for caregivers can and should be minimized — and that’s why I’m really happy to have Mr. Thau’s attention drive home the point once again.

I bring this message of “CAREGIVERS, SEEK WELLNESS” as a once-again (albeit temporary) caregiver myself.  My 58-year old cousin from Dallas was diagnosed with younger-onset Alzheimer’s a few months ago. She has come to CT to have me teach her how to live with it. And so I am. But my heart stops when I “lose” her in the grocery store, even if for a moment. And my brain is distracted when I’m at work, wondering when she will reappear from volunteering with our residents. And I don’t sleep well, considering the financial strain every time she has an urge to buy something or gets up to use the restroom, or even rolls over in bed. And my heart aches with my 9-year old’s frustration when “Auntie P” wakes her up to check on her in the wee-hours of the morning.  My dog loves her though as Pat feeds the dog breakfast again…(we had to hide the treats).

So I know first hand how hard it is – but we MUST take time to get to our own MD visits, do some tai chi before they wake up in the am, rest and rejoice with friends through support groups – or journal to get it out of your system. Be well caregivers, in any way you can when you can. We are here to support you and will help you think of ways to minimize your risk factors. Check www.agingcareacademy.org for more ideas.

And now I’m off to schedule my overdue mammogram – thank you Ms. Sarah, secretary on our Dementia Special Care Unit for reminding me that I’m important too!