Tell your story and laugh

In the second month of my new job as activities assistant and art teacher in a nursing home; I was arranging materials and tools on a long table. Directly in front of me, on the other side was an articulate and chatty gentleman who I knew had been the CEO of a large corporation. We discussed a current event while I prepared for the craft class.

I turned around to speak to someone and when I turned back I saw Mr. CEO using the scissors that I had placed in front of me to cut the pants he was wearing right along the thigh, slightly above the knee. Horrified, I hustled around the table and said "maybe that isn't a good idea, may I have the scissors back?". He cheerfully returned the scissors. As I returned to my spot at the table, I wondered how was I going to explain how Mr. CEO came to cut his pants. Then I glanced over to see he was now in the process of tearing his pants up to his crotch. A beautifully tailored pair of pants had just become an accessory to a strange strip-show. I put up my materials and suggested that we take a return ride to his room. He cheerfully agreed.

We exit the activity room, turn the corner, and greet the Administrator who arches her eyebrows in a question mark fashion.  "Mr. CEO was using scissors to cut his pants, I explained, but we have decided not to use scissors anymore." "An excellent idea," she dryly observes and continues on while I wonder if this is my last day on the job.

Later I spoke to the gentleman's wife who simply laughed. "I asked him what he was doing and he said he was making cut-off shorts because it was so hot!"

I've told this story on myself many times because it illustrates how fast behaviors can change with someone suffering with dementia. Mostly though it reminds me that a sense of humor saves your life as a caregiver. Surprise behaviors can derail your day if you lose your ability to laugh. A caregiver recently told me how she jokes and teases her client into laughing and mid-smile puts medicine on her tongue. Mission accomplished without the combative contest of wills.
Twilight Zone meets Buster Keaton when you care for someone suffering from dementia. On the days the front wall of your storefront falls down (Steamboat Bill, Jr. (1928); maybe it's best to stand in the ruins and laugh.

Nearly everyone who has worked with others with chronic illness has a story of how sad intersects the hilarious. What's yours?

Cats; possibly the best senior choice

One of my many unapologetic pleasures is lying in a rope hammock in my backyard. Strung between the cherry tree that doesn't bear fruit and a large Leland cypress, I am hidden from the neighbors but still have perfect view of cobalt blue and billow-white clouds.  A twenty minute break in its gentle sway never fails to alter the attitude positively.

Lately my black tiger-stripe, Cosmo has decided to join me. He stretches his front paws onto the rope's edge and I lean to the side to give him a better vantage. He then jumps up and comically stumbles onto my lap. Sometimes he hangs his head over the edge and stares at flying insects, sometimes he stretches out tummy to my tummy side and gently head-butts my hand. Pet me please. His presence gilds an already near-perfect past time.

For two years, I brought an exceptionally social cat for pet visits once a month at a long term care facility where I worked. While dog visits are common people rarely bring in a cat, because cats are rarely as accommodating. But Kazoo would lie quiet next to bed-ridden residents or patiently sit on a table and let people pet and admire. Even cat-averse staff marveled at how he placated some residents.

Much has been studied and written about the health and healing advantages of having a pet, especially a dog. But the American Humane society recommends considering a cat for older owners. Many seniors simply can’t keep up with a dog’s needs, which makes adopting a cat a much better choice. Here are some of their pointers:

• Unlike dogs, cats are happy staying indoors all the time. 
• Most adult cats require only 20 to 30 minutes of playtime per day, and interactive play does not require the owner to be mobile. A kitty fishing pole or laser toy lets senior cat owners engage their cat in play while sitting in their favorite chair. 
• Cats are also very content to spend most of their time sleeping on their owner’s lap or bed. 
• If you are adopting a cat, consider an older one which is less likely to disturb the household.

Of course, cats are not care-free. They must be fed and kitty-litter box emptied. If these tasks are too burdensome for your elderly loved one, perhaps family members could consider a cat-share arrangement, where a pet cat stays with the senior during the day and comes home to another residence in the evening. If you are visiting daily, or even every third day, filling up the food dispenser and checking the litter box are small tasks compared to the companionship afforded by a purring cat.

If you are a cat-lover you know how much your cat entertains, amuses and comforts.
If you are not a cat-lover, but know a senior in your life who could use some mood-lifting affection, consider adopting a feline friend.  

Always Best Care Senior Services; a family of giving care

ABC Raleigh's President and Operations Supervisor, Sanjay Das started Always Best Care to provide the kind of loving, compassionate care that his own Mother provides for his grandmother. The agency opened its doors in February 2014. He and his wife moved to the Triangle in 2011 from the Boston area and love this area. In this article he explains what motivates his approach to providing superior care to senior adults.

Sanjay, can you talk about how your family's caregiving influenced you to start Always Best Care?



This business is a tribute to my maternal Grandmother who raised me; my second Mom. She brought together a community of women in India and helped them learn and train each other in the art of hand-crafted articles & clothes. She began this enterprise in her forties, and continued until she was in her 70s. I experienced it all first hand but didn't realize the tremendous impact she had on our community until I was an adult. As she grew older, I hired someone to run errands for her and others since we live so far away and they needed help. Their needs progressed over the past 10 years; now my Mother cares for my Grand-mom who has 24x7 care. My Father-in-law had live-in care, and my Father lived in a family care home towards the end of his life. Providing senior care is my way to continue my Grand-mom's legacy, and do something meaningful.

What aspects of being an IT professional help you in your current work?
I enjoy solving problems; finding the best solution for each senior and family. Each situation has unique needs; matching that up with each of our caregiver's strengths is what I enjoy.

What complex problem have you solved recently?
One client we helped recently had very specific cognitive, but not physical needs. Even though we started with independent living, we realized switching to a good assisted living community would be a better solution. We needed to find a community appropriate for someone with unique mental but not physical limitations. This challenge required me to expand my search criteria to look for an assisted living community that has safe, excellent independent resources and services around the community (not just within the community itself).We achieved the results we needed working hand in hand with the family and the facility community. It's a wonderful gift when that happens.

What new skills do you have to learn/practice?
I've had to learn many new things! I work with clients and caregivers, (who are the core of our agency), manage financials, sales, marketing. I am most motivated to build relationships that matter, and am continually learning how to improve quality of life for our clients.

You say you are "passionate about nature". What activities do you do to be outside or to embrace Nature?    I'm a hiker at heart, and enjoy running, gardening; anything outdoors really.

Working in the health-care industry requires a mindful attention to your own health. What are some of your own healthy habits?
I follow an amazingly powerful book: The 3 Season Diet, by John Douillard. I've applied John's approach to a seasonal diet and healthy living (based on an ancient Asian way of life called Ayurveda), enhanced with raw foods, no sugar, and jogging. That combined with deep breathing and meditation keeps me going, without any coffee.

Tell me about one aspect of running Always Best Care that gives you joy.

Nearly everything around running this agency is a lot of fun (even if tons of hard work). I thoroughly enjoy my interactions with people, whether they are our team members, clients, referral sources or partners.

Four Ways to Fight Isolation

Loneliness and isolation are kissing cousins. We can feel lonely in the midst of a crowd because we don’t sense any connection. But living isolated engenders loneliness and feeds depression because you have lost your connections to the people and activities you once enjoyed. If you have struggled with long term illness or disability you have probably experienced both.

Humans are supremely social creatures who need physical, social and emotional connections to stay healthy. So how does one replace isolation with engagement and purpose?  While it takes serious intention to make necessary adaptations, it is possible to live with purpose and pleasure despite limitations. The following are ways I have seen people remain engaged in community. Let me know your ideas!

Plan to go out: Think about how to go out even for just an hour. Make a date with a friend or family member to accompany you. People are willing to assist, but don’t know what you need unless you tell them. Call ahead to see if there is a wheelchair ramp and then go to a farmer’s market, a festival or outdoor concert. Choose to go to your favorite donut shop, coffeehouse or church service. Yes, it’s more work and takes more planning to do these outings but they are worth it.

Open your home: If it is too difficult for you to go out, invite people over. Some resist this idea. You may not want to invite people in when you are not feeling your best, but if don’t you are inviting isolation and it’s resulting loneliness. Offer your home for meetings and gatherings. Host a lunch and ask everyone to bring a dish. Invite neighbors and friends over for coffee, a glass of wine or a card game. Sometimes people stay away because they are uncertain when or whether they are welcome. Create welcome.

Volunteer: Call any organization you wish to support or those that interest you to see how you can help. Volunteers greet people at a special event or pack socks for soldiers. Volunteers are needed to schedule people to give blood or follow up on fundraising commitments. Some of these activities can be done from home. When you give back, you don’t feel alone and you will meet like-minded people.

Use technology wisely: FaceBook and Email will not replace personal interaction but they can help you stay in touch with long-distance loved ones. Also there are many on-line support groups that can help you feel less alone with a chronic illness. Use them wisely; finger to keyboard will not replace a smile, a hug, a chat.

Moving Day and the Gardener; How to weed out your belongings

I like weeding in the garden. This surprises non-gardeners and gardeners alike, because weeding is often perceived as a onerous part of the gardening experience. But I don't garden in the rain or snow and I don't weed in the hottest part of the day. Weeding allows me to be outside in the sun and to quite literally smell the roses (or Hyacinth's as they are blooming now.)

Weeding also instructs my life. This morning I cleared away not only weeds but planted growth that invaded another area. I removed ugly old blooms once verdant and attractive. In life we are often tasked with doing the same, called to remove what was once lovely or confine a good but runaway pleasure.

This truth is most evident and often most painful when as seniors we are forced to prune our belongings to move into a smaller place. Simply changing your residence heightens the stress to our lives as documented by psychiatrists Thomas Holmes and Richard Rahe in 1967. Possible complications of ill-health, loss of a loved one or moving to a new geographical region, and the task of weeding out belongings overwhelms.

But here are three strategies you or someone who is helping you can use that will help the process and may even bring some comfort. These steps can be approached one room, one cabinet or one residence at a time.

1. Clear out the obvious debris. In a garden it may be obvious what is dead or weedy but it usually requires knowledge of the garden. Ask someone who knows you to help you dispense with the old documents, clothes, magazines, dishes etc. that simply aren't bringing life anymore. Name the stuff as debris and throw it out. Put it in garbage bags or haul to the dumpster and don't look at it anymore.
Recognize the work required and feel proud when you accomplish this step.

2. Choose the non-negotiable item. You know, the one you would take if the house was on fire. Start with one, because no matter where you are moving, you can probably take at least one beautiful, meaningful item. Some people choose items like a Bible, a wedding photo or framed family portrait. Depending on where you are moving, you may be able to go room to room and pick one or two items from each. Assemble these items in a box or bag and label it. I would label mine "beautiful and still blooming". Stop and rest, recognize your life's valuable gifts and be grateful for this step.

3. Attack the middle ground. Attacking the middle ground is really step one and two; repeat.  In this process you may determine to give things away, put things in storage or sell items which cannot move with you. However no matter how large or small this remaining middle ground is, you have a framework to continue the process and you (and the person helping you) can recognize the progress.

Time-constraints impose their demands, as any season will, and often we are forced to do this pruning and weeding task faster than we desire. When this task is approached with this gardener's framework, we can have hope that we aren't just "throwing away all my stuff" as one client told me. We can look to see what new things emerge from a cleared ground.

When Dawn isn't writing or gardening, she helps Always Best Care clients lead active, hopeful lives in her role as Activity Coordinator.

Providing getting-to-know-you care

What do you look for when you need help taking care of your loved one, whether for a short or long time? How you answer that of course, depends on the level of assistance you need. Do you need someone just to stay with Mom or give her medications? Does she need simple reminders or daily assistance with dressing, eating and personal care?

Always Best Care in Raleigh provides solutions to your care needs starting with two, always-in-place approaches. First, we help you assess the needs of your loved one by sending a well-qualified medical professional to ask questions and observe your loved one. She will make accurate and compassionate recommendations based on her years of knowledge and your budget and time contributions.

Denise knows her clients and knows their needs.   

Secondly we will provide a care-giver who not only knows how to help, they will be the person who wants to help. Denise exemplifies this essential quality.

When you first meet Denise, you will first notice her quick and friendly smile.  Her clients soon notice her patient and kind attentiveness to their needs. One client commented; “Once she knows my needs, she remembers.”  “I like working with people” Denise says, “I like getting to know them.”

This "getting to know" quality is what everyone who needs help desires. It brings comfort in a time of difficulty and often inspires hope when tempted to despair. Our core mission is to provide that kind of caring.

Denise is native to North Carolina. She’s a proud mother of her four children. She enjoys her pet Chihuahua named Missy who is just a tad protective. “She’s the one that takes care of me,” she says laughing. “She helps me unwind.” Always Best Care in Raleigh is proud of the special care Denise brings to everyone she serves.

The art of breath (healthy breathing strategies) - the deep breath

How you breathe is vitally important to your wellbeing. It becomes even more important as you age or when you are under stress. Why? Breathing is how you get vital oxygen into your body and cells, while exhaling "polluted" or "used-up" air. You can use various breathing techniques to enhance your energy, calm down, and prevent the onset of colds and coughs, especially as we transition from summer to fall and winter.

Here is a deep breathing technique. Use it to calm down and become present, thus gaining more while doing less (as opposed to constant multi-tasking).

Become aware

• Sit comfortably; take off any belts
• Become aware of how you are breathing; don't change anything, just become aware of your body breathing, sensing which parts of your body are involved – maybe the chest, maybe the belly/stomach, your nose, mouth, etc.
• Take a deep breath in; however way you normally take deep breaths
• Let the breath out slowly
• Take 2 more breaths this way
• Sense how you are already calmer than you were when you started this exercise

Deep breath

• When you are ready, start a breath by focusing on and filling your belly/stomach first
• When your belly is full, continue the breath into your chest/lung/heart region
• And finally when that region is full take the last bit of air into the area under the shoulders
• These are not separate breaths or steps, just one continuous flow of breath filling 3 different areas of your body
• Let the breath out slowly
• See which feels more comfortable - exhaling through your mouth or nose; at least initially do whichever feels more comfortable; be kind to your body
• Take 3-5 of these deep breaths, then relax your breath
• If your eyes feel like closing at any time, let them; closing your eyes will deepen your focus, meaning your breath; but do whatever feels comfortable
• How do you feel? Is there a sense of peace and calm inside and around you? Enjoy whatever sensation comes up

Practice

• Tony Robbins, the Master personal and business coach says practice makes perfect
• Use this deep breathing mechanism say twice a day, just a few breaths at a time
• It will take time to help the breath flow freely both when inhaling and exhaling; take your time, do as your body allows, being kind to yourself