Losing Perspective by Compulsively Trying Harder

Take a look at your hand and pretend that it represents a problem you are having. Now put your hand (your problem) one inch or less away from your nose. What can you see? Not much besides your problem! In fact, if you're like most people you probably can't even see all the edges of the problem, never mind a solution. But if you put your hand down and take in the wider view, you can see the rest of the room and the view outside the window. Your life gets bigger and encompasses more possibilities, the problem seems less overwhelming and you can automatically breathe more deeply which reduces your stress and anxiety.

Caregivers of people with brain-impairing illnesses often find their lives reduced to nothing more than taking care of that other person. When I ask how they are or what's new nine times out of ten my clients respond by telling me how their patients are. I have to persist in getting my clients to open their focus wide enough to even include their own health.

I understand this. I'm the same way! The only thing in my life is the problem I'm having and if it can't be resolved right away I just try to focus harder. I try to control what's going to happen because the crisis makes me afraid. I think about the problem constantly, turning it over and over in my mind attempting to figure out what couldn't be figured out before. I reject proposed solutions out of hand if they don't match my imagined vision of how things "have" to go and then chastise myself for supposed "missed" opportunities. I'm damned if I do, damned if I don't because clearly if things aren't going the way I want them to after all this time there's something I must have done wrong and, therefore, I ABSOLUTELY MUST TRY HARDER! And don't you try to distract me away from this intense focus. I KNOW I'm right to be trying so hard because -- can't you see? -- I obviously haven't succeeded yet! The problem's still here!

Can anyone live a satisfying life like this? Sometimes you just have to take a break.

There are people with cancer who somehow continue to live satisfying lives. I always find their stories fascinating because if I were in their shoes I know I would frantically put all my attention on surviving. Yet I recently read a wonderful story about a woman with a recent cancer diagnosis who opened my eyes because she started out doing exactly what I would do. She researched all the latest conventional and alternative therapies, she changed her diet, started exercising, did visualizations and worked very hard to control her feelings because she read that she "couldn't afford a single negative thought." Her life became reduced to her illness and what she was doing to combat it.

Then one day she woke up. All her time was consumed with surviving but what was she surviving for?

It suddenly occurred to her that she had to put her illness into the context of a much wider life - that if she had a reason to live and spent more of her time doing exactly THAT she at least wouldn't have wasted the time she had left. So she took a break and went on a healing retreat where she could be cared for and take some time to rest, meditate, relax and dream. She asked herself the question: since she didn't know how much time she had left (and nobody does know how much time they have) how did she want to spend that time? What made her heart sing? What gave life meaning? How could she leave a legacy or make a difference in someone else's life? What did she want to remember on her death bed that she hadn't experienced yet?

She didn't give up her cancer-fighting protocol but she now saw these activities as a beginning in making her life happen. The steps she took to deal with the cancer slowly started to take up less of her time as she started to shift her attention to what gave her life meaning. Some of her anxiety and fear faded away -- she was too busy focussing on the beauty, wonder and intensely interesting activities of the present moment -- and her enjoyment of life increased. The tumor has not changed size -- at least not yet -- but it does seem a lot smaller in her psyche. It doesn't really matter how the story ends. We don't know yet whether she'll beat this scary monster or not. But she's bigger than that. Her existence is shaped by her illness but it encompasses more life, more dreams, more of who she is and that makes all the difference.

We can't always control what happens in life. Earthquakes happen, our lives get disrupted and we have to spend time picking up the pieces and making new choices instead of doing what we thought we most desired. The roof falls in. Do you walk away and start over somewhere else or do you hold your ground and rebuild? The parent who has abused you all your life needs caregiving assistance. Do you hire people to help her and feel guilty because you're not there or do you do the work "like a good daughter" while she continues to make your life hell? Your loving partner has a brain injury from which he will never recover. After the initial crisis has passed, do you ask for a divorce or stay by his side even though he will never be able to be a real partner for anyone ever again? These are not easy questions with straight forward answers. Neither are they situations where you just do what needs to be done, solve the problem as quickly as possible and get back to your old life. There are moral struggles, practical implications, sometimes heartbreaking consequences no matter what you do.

Sometimes the answer is to step back. Take a break, get a fresh perspective.

Ask yourself what gives life meaning, what makes it worthwhile and, if possible, try to find ways to incorporate your highest values into the life you have now. Given what has happened how do you wish to respond? What are your priorities in this life situation? How do these priorities fit with your deepest values, hopes and dreams? This has nothing to do with "shoulds" and moralistic expectations. It has nothing to do with what you hoped to have in your life at this time. It's about what matters in the present moment and what -- over time -- you want to work towards.

The previous blog was an excerpt from The Spiritual Journey of Family Caregiving. If you like what you read on this site, why not buy the book? You'll be glad you did!

How To Help A Lonely Elder

This info was written for people in Santa Cruz, CA but there's enough good suggestions here to help you find similar possibilities in your hometown, I'm sure:

Everyone feels lonely from time to time but the elderly are at a greater risk because most of their loneliness comes from long established habits combined with the loss of longtime friends and companions.

The key to breaking isolation is to very slowly and gently add activities that get the lonely person into the presence of others. In addition to extra contact from existing family and friends, start with activities that are easy to participate in such as church services or special interest classes. Senior centers offer a variety of activities especially geared towards seniors but Santa Cruz is also rich in adult education opportunities ranging from Parks and Recreation classes to community education courses at the University or Cabrillo College. If travel was always a source of pleasure try group tours or day trips. If the person enjoys reading try the public readings and book signings presented by local bookstores. If the person used to gain pleasure by caring for others (children or a spouse) consider volunteer opportunities with a social service agency or child care center. Even a part-time job can make a difference.

For very frail or housebound seniors, an adult day program that includes transportation and medical supervision might serve the purpose. (In Santa Cruz, try Elderday 458-3481 and Cindy's Celebrations 479-7509). If the person truly can't or won't leave the house, it is possible to arrange for a volunteer or paid companion to visit there. Try a Friendly Visitor program (427-5070) or Senior Companion (475-0816 ext. 10). Many others find that what they need most is to live with other people -- try assisted living or retirement communities or rent out a room to another senior citizen or college student (Senior Network Services Shared Housing Program 462-6788). In Santa Cruz it is even possible to try out having a housemate for a very short time by offering a room to a visiting professor or foreign exchange student for one semester or by providing space for a Shakespeare Santa Cruz performer for the summer. (458-3506)

Loneliness May Be Hazardous To Your Health

Social isolation and loneliness is a major contributing factor in all kinds of illnesses. A famous study exposed paid volunteers to a cold virus and then recorded how many actually came down with symptoms. It was found that those who described themselves as more lonely or isolated were far more likely to get sick. Other studies have shown that loneliness increases the risk of heart disease and cancer and reduces the life expectancy of those already diagnosed. A recent article in Science News reported that people who live alone are 50% more likely to develop dementia than others and that those who live alone and have no friends are 60% more at risk. It is my opinion that loneliness is probably more dangerous than smoking, lack of exercise and poor diet combined and there are some physicians who are beginning to agree.

Dr Dean Ornish became famous for his multi-faceted program for recovery from heart disease. It included a very strict diet, exercise, meditation and support group participation. He had tremendous results and assumed that the most important factors were the exercise and diet plans. However, his follow-up research did not bear this out. In his most recent book Love and Survival: The Scientific Basis for the Healing Power of Intimacy he writes that he is now convinced that, although diet and exercise is important to the success of his program, the single most effective factor seems to be the support group. People who feel loved and cared for thrive.

It is theorized that having only one strong social bond isn't as effective as having a variety of social relationships which is why a support group can be so effective. Strong family relationships or church and community ties are equally helpful. So my question to you all today is: how are your friendships and social ties? Is there a way they could be strengthened? Are there social activities you would like to try but keep putting off? Make social activity a priority and see how it affects your life. It's well worth the effort over time.

From my book The Spiritual Journey of Family Caregiving, available directly from me for $14.95 plus shipping.

More Food-Related Tidbits for Dementia Patients

Sugar and caffeine can contribute to agitation. If this is a problem for your patient try substituting decaf coffee or herbal tea and use a sugar substitute.

Does your loved one have incontinence or mild bladder dysfunction? Try eliminating citrus, caffeine and sugar. Remember chocolate contains caffeine! Try carob instead. (No, it doesn't taste the same but it's better than nothing.)

From The Spiritual Journey of Family Caregiving

Do You or Your Dementia Patient Snack on Crackers or Sugary Snacks All Day?

Be aware that overuse of sugar and sensitivity to wheat is extremely common and can create dementia-like symptoms in healthy people. Fatigue, fuzzy thinking, mild confusion, water retention, even arthritis can all be exacerbated by dependency on these products.

How do you tell if this is a problem for you or your patient? For two weeks try substituting potatoes, 100% rye bread, rice or other grains for bread and other products made with wheat including soy sauce. Eat more protein and vegetables and use a sugar substitute like stevia or give up sugar altogether for the same time period. If you don't have another health condition creating the symptoms and you are not allergic to anything else you should see a significant change within that period of time.

Be warned! This is not an easy task! Just like any other physical dependency, the body tends to crave the very substances making it sick. Not only that, sugar and wheat are everywhere in our society. Sugar includes honey, corn syrup, maltose, dextrose, maple syrup, jellies and jams, etc. Wheat is in almost everything made with flour. Still, if you find enough substitutes to satisfy the cravings, the increase in energy and clear thinking alone may be the worth the effort.

From The Spiritual Journey of Family Caregving. Buy it now directly from the author.

Is it possible to prevent Alzheimer's Disease and Reverse Early-Stage Memory Loss?

As soon as people find out what I do they often ask me what they can do to prevent Alzheimer's Disease and other brain-impairing illnesses. There are no definitive answers but in my work as a family consultant I've noticed a few trends.

Many of my clients tell me that their brain-impaired relative was "just fine" until they suffered some devastating emotional setback such as the death of a spouse or other close relative, a change of residence or community, or a forced retirement. Then, what used to look like normal aging blossomed into full-blown dementia.

Why is that? My boss at the Alzheimer's Association always used to say that the disease must have been present before, it just wasn't noticed because there was nothing to bring it to the family's attention. I think it is much more likely that the changes we associate with "normal" aging actually indicate accumulated damage from multiple causes and then emotional devastation delivers the final blow.

What are the multiple causes? We know that the brain depends on the proper utilization of amino acids to create the neurotransmitters we depend on for healthy brain functioning. In Alzheimer's Disease these neurotransmitters become scarce. However, things that disrupt amino acid metabolism are plentiful and well known.

First and foremost is nutrition and, in particular, how much protein a person eats and how well they metabolize it. Amino acids are found in protein sources like meat, chicken or fish and in adequate vegetarian combinations of beans and whole grains. In order to properly utilize these amino acids, however, a person needs to have adequate amounts of folic acid, B6, B12 and Vitamin C. The body breaks down the amino acids to create other compounds the body needs for various functions. If that does not happen properly in the case of the amino acid methionine, compounds that would otherwise be used to lower cholesterol are not made while a metabolite called homocysteine is created which is toxic in large amounts. High levels of homocysteine injure the arteries and encourages the formation of plaque. There also seems to be some correlation between high homocysteine levels and early stage Alzheimer's Disease.

Things that interfere with amino acid metabolism include not eating enough vegetables (the dark leafy kinds have folic acid in them), having an allergy or sensitivity to wheat or other foods, excessive exposure to pesticides and other environmental toxins, and long term exposure to mental stress and depression.

Things that help the body cope and recover from these things include:

* Adequate but not excessive protein consumption (remember, you need B vitamins and folic acid to metabolize the protein -- it takes a lot of spinach to make up for that Big Mac!)

* High dosages of folate, Vitamins B6 and B12

* Lots of lightly cooked fruits and vegetables

* If you have a wheat sensitivity (which is very common) give up bread, pasta, cookies and other wheat-containing products (I guarantee you'll lose weight!)

* Adequate fresh clean water

* Exercise and mental stimulation (don't watch TV all day!)

* Love and active engagement in life

I believe these last two items are most important. Even people who have already been diagnosed with Alzheimer's Disease ward off the worst effects of the disease and maintain their ability to function longer if they are positively engaged in life than people who are clearly depressed and withdrawn. And sometimes -- I've seen it only a few times in five years of doing this work -- the symptoms of memory loss and confusion can go away almost completely when a person renews their ability to find joy and excitement in being alive and gets the care and attention it takes to make that happen.

The previous blog post is an excerpt from my book The Spiritual Journey of Family Caregiving available now directly from me for $14.95 plus shipping.