Take a Break
June 25, 2020
Are you a full-time caregiver for someone with Alzheimer’s or dementia? A little breather may be just what you need.
Alzheimer's disease is life-changing for both those who are diagnosed and those close to them. Having a helping hand when you need it is key to keeping yourself, and your loved one living with dementia, healthy and happy.
When you need a break, consider adult day services.Not only is it good for you, but it’s good for your loved one. Adult Day Services offer people living with Alzheimer's and other dementias the opportunity to be social and to participate in activities in a safe environment.
Adult Day Services may be for you if:
- You are a full-time caregiver: Adult Day Services can provide a much needed break. While your loved one is at adult day, you'll have time to rest, run errands or finish other tasks.
- You work during the day: Adult Day Services can help you to balance a job with caregiving duties.
- You want a safe, caring environment for your loved one: Adult Day Service is a chance for your loved one to share time with their peers. It provides a chance for them to be social and to participate in engaging activities such as music and exercise programs, as well as fun outings.
Did you know that Woodside Place of Presbyterian SeniorCare Network offers Adult Day Services at its campuses in Oakmont (412-828-5600) and Manchester Commons (814-838-9191)? We are here to help!
Taking a Familiar Walk: Dementia Amid COVID-19
June 12, 2020
A daughter experiences the neighborhood from her mom's perspective
By Laurie Matlin
My 95-year-old mother has reached the limits of her patience with the daughter in her basement. As one of her nine children currently helping out, I take no personal offense. Even for people without dementia, COVID-19 can complicate a well-planned life.
“I’m going away,” she declares one mid-spring day. “Everyone in this place has something to do but me!” My dad and I have just emerged from his office from where we ordered groceries online. She doesn’t understand this new system, and she believes I have overstepped my role.
Mom finds her wool coat and struggles with its zipper. Dad leans in to see how he can help. They turn to me, and I quickly zip the uncooperative coat.
As a power play among younger people who might wish to exert control, running away can be particularly problematic for people with dementia like my mom. Yet here we are, Dad and I both acting as accomplices as if Mom were a temperamental kindergartner bound to return before dinner.
She reaches for her hat and scarf. “Do you want the red one?” Dad asks helpfully. She ignores him and grabs the gray hat with matching scarf. Strands of frizzy silver curls slip out from under her cap, and she slides red Keds onto her feet. Wearing the same sweat outfit she has donned over the past few days, she suddenly looks more youthful.
“You can’t come with me!” she barks at me. Dad pleads for her to reconsider.
“I’m going away,” she declares one mid-spring day. “Everyone in this place has something to do but me!”
“I’m just going for the mail,” I tell her. Stay non-confrontational, I whisper to Dad.
With Dad on one side and me on the other, she manages a step from the front door, then another step off the stoop. Her eyes narrow, and she begins a steady pace along the front sidewalk.
She pauses at the driveway. “Which way did Sam go?” she says aloud to no one. Sam was my late brother with Down syndrome who regularly walked to a bus stop for his job.
Mom looks left, starts in that direction, then stops.
“There’s neighbors there,” she speaks again to herself, allowing me privileged insight as to how her mind is working.
Following Closely Behind
She glances in the opposite direction and sees a hill. “That’s too high,” she says, and I marvel how one part of her is speaking for another part to hear. She resumes her original direction, but now crosses the street.
“Hi Fran!” Pauline, the neighbor she sought to avoid, waves after watching for a bit. Mom makes no acknowledgement, her feet pattering on the pavement. Ten feet behind her, I serve as her shadow in stealth. I smile at Pauline, shaking my head and pointing to my ears to suggest Mom’s hearing inadequacies.
I follow Mom down the hill and around the bend. Tracking her requires few skills attributed to private eyes; I could have practically stepped on the back of her shoe without being spotted. While systematically on guard, she is less capable of easily turning around.
The neighbor teen on his driveway peers momentarily at this odd-looking lady who is overdressed in temperatures approaching 80 degrees. He smirks, resuming the whump, whump, whump of his basketball before pivoting in an easy layup.
From the other side, the mail truck approaches. The mailman looks at Mom as if he’s unsure how he might be of help. While swift for a person her age, Mom walks gingerly, almost like a child with autism, her big toe angling up, and it is perhaps this rigidity that alerts the viewer that something is slightly off. Mom slows at the tree, grabbing a branch. She seems to wish to wait for the mail truck to pass before resuming her plan.
It is at that moment that she turns around and finds me standing at her back. “Hi Mom! What are you doing over here?” I feign happy surprise that our paths should cross at just this moment. The ruse seems to work. “I am heading over there,” Mom points with no rancor in her voice.
I fall in line with her pace and we turn down another street. “The road is closed that way. Maybe we need to go a different way,” I suggest, pointing to the diamond-shaped construction sign. She continues past the sign. We proceed as two toddlers locked in parallel play, aware but not working at all together.
A Walk She Needed
“Where are you going?” I ask after a bit.
“Sam walked this way to catch the bus. It took him downtown,” she explains.
“And then what?” I ask.
“Who knows?” she replies without pausing. She tolerates my presence, perhaps welcoming another mind to support her if things turn rough. I marvel at the workings of her plan, as if following breadcrumbs left by Sam in a different time when buses operated because that’s what buses are supposed to do.
“Why do you want to go downtown?” I ask.
“I want to get to the railroad. Where my father worked,” she explains. She has talked recently about her need to get to her father at the train station, a commuter system that no longer exists in our town. Her father died a half-century ago.
She says she needs to rest and maneuvers herself atop a a tree stump cut at waist level. She watches the birds and feels the breeze, then eventually gets up to walk again.
“You’ve come an awful long way,” I suggest.
“I thank you for walking with me,” she says so softly I lean to hear her words. She still doesn’t look at me, but her voice conveys warmth that surprises me.
No answer.
“I wonder if we might turn around,” I probe gently.
“I’d like to get to the top of the hill,” she starts and then seems to change her mind. She turns around, like Forrest Gump who abruptly ends after running across the country.
“I thank you for walking with me,” she says so softly I lean to hear her words. She still doesn’t look at me, but her voice conveys warmth that surprises me. There is something she needed in this, I realize.
Life Is More Than Just Staying Alive
We continue silently, less fast-paced than on the outward jaunt. She rests at times, but then starts moving again. She reaches the side door to the garage.
“Do you need a hand?” Dad’s face suddenly appears at the doorway, surely watchful for her return.
“No, I can do it myself.” Her voice is resolute but without confrontation. Still, she takes his hand, then ambles up two steps.
When she turns, her eyes suggest a glimpse of a larger world. Her autonomy expanded just a little, other parts loosened from more rigid bounds. In this moment, her opinions still matter and her inner compass is shaken to new life. She looks straight at me.
“Thank you, Laurie,”she says, as if for that moment she can see me as something more than the invader in her land.
Life is more than just staying alive, her presence seems to say. Like unsteady feet on pavement, uncertainties will always arise. “Let life happen to you,” the poet Rilke wrote more than a century ago. “Life is in the right, always.”
The dual punch of dementia and COVID-19 is not easy, not even one little bit. But if we pay attention, maybe there’s still something we can learn.
Laurie Matlin is on personal leave from her job as a hospital and palliative care chaplain resident while she helps to care for her parents. A former journalist, she has been keeping a video diary of what she calls a sacred time in her family's life.
Your Brain Has an Immune System, and You Can Boost It
June 5, 2020
It can help you deal with stress, self-esteem and motivation in the pandemic
By Stephen L. Antczak
You’re probably familiar with your immune system — your physiological immune system, that is. It’s the one that sends white blood cells to dispatch with pathogens. But what about your psychological immune system? This is an especially important idea to think about now, in the time of COVID-19 and social distancing.
The term “psychological immune system” was coined by psychologists Daniel Gilbert, who is probably best known for his book Stumbling on Happiness, and Timothy D. Wilson, who is known for his research on self-knowledge. But the basic concept goes back to Sigmund Freud and his ideas regarding defense mechanisms, which were elaborated on by his daughter, Anna Freud, in her book, Ego and Mechanisms of Defense. In fact, “ego defense” is, at least for our purposes, a mechanism to protect the self, or self-image, from whatever threatens it.
A good way to think about the psychological immune system is provided by Emily Rosenzweig, senior behavioral scientist at Ochsner Health, a nonprofit academic health care system in Louisiana: “A range of mental processes triggered by a threat to our sense of self-esteem, self-worth and self-concept.”
What can threaten a person’s self-image, or their self-worth? How about being referred to as a “nonessential” worker?
What can threaten a person’s self-image or self-worth? Here’s an example: being referred to as a “nonessential” worker and told to stay home, losing a significant amount of income in the process.
Positive Self Talk
Here’s where you can use your psychological immune system to help. You can tell yourself that you are valuable to society, the current pandemic situation is temporary and the lives of many others are diminished, even if just a little bit, by your absence.
You should also admit to yourself that people can still live meaningful lives without you, and that’s OK, too. It doesn’t diminish your value as a human being.
Positive self-talk can be quite helpful. However, don’t overdo it.
For example, you wouldn’t want to tell yourself that without you being there, the lives of others are completely devoid of meaning and those people are just miserable. Knowing that’s probably untrue would likely make you feel worse.
“There’s a sweet spot,” says Rosenzweig. But, she adds, “you can’t deny existing negative emotions.” If you try to completely obliterate those negative emotions, however, you’ll probably wind up feeling worse as your brain produces counterarguments that undo your attempts to make yourself feel better.
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Less-Than-Ideal Coping Mechanisms
Being aware of your psychological immune system means you’ll be better able to recognize when it kicks in.
Think about the coping mechanisms you use in a stressful situation or when dealing with the difficulties life throws at you. Do you feel better when you pour yourself a glass of wine or three? Do you avoid dealing with things by binge watching Netflix?
Avoidance is one of your psychological immune system’s tactics, even though it may not be good for you in the long run. Like your physiological immune system, your psychological immune system can opt for the short-term fix over long-term wellness.
Not that drinking one glass of wine or watching two episodes of your favorite show are counterproductive. We all need some downtime. Both are easy to overdo, however, and that undermines the effectiveness of your psychological immune system.
Once Again, Exercise Is Key
So, what can you do to bolster optimal functionality of your psychological immune system?
First of all, you need to feel motivated.
Dr. John Ratey, associate clinical professor of psychiatry at Harvard Medical School and author of the bestselling book, Spark: The Revolutionary New Science of Exercise and the Brain, has a suggestion: Exercise.
“Exercise reduces stress and anxiety, and promotes a better mood — all factors that go into motivation,” Ratey says.
Of course, you also need to feel motivated to exercise and in the tug-of-war between staying fit and Netflix, that motivation can be hard to come by.
Ratey suggests doing something easy, like going for a walk every day, preferably outside, even if it’s just a short walk.
Can’t go outside? There’s an app for that. Ratey suggests downloading the free 7 Minute Workout app on your phone. “It’s all bodyweight exercises, and it activates all major muscle groups.” There are many other workout apps you could try as well.
Developing Goal-directed Behavior
There’s also something you can do to maximize the effectiveness of exercise, at least when it comes to your brain and your psychological immune system: Use exercise to help you turn goal-directed behaviors into healthier new habits while making progress towards your goals.
Having a goal is a good way to motivate yourself, but also a way to focus on those behaviors you need to make progress towards that goal.
For example, getting out of debt and becoming financially solvent requires a series of smaller steps to achieve. A good first step in that direction is to create a household budget, which is something you can work on a bit each day while social distancing.
Here’s how exercise fits in: Stress can impair your ability to undertake goal-directed behaviors by making you fall back on normal habits. If your habits are binge-watching Netflix, drinking alcohol or eating cereal late at night, stress may reinforce those less-than-ideal behaviors.
But exercise reduces stress and increases motivation. So, it’s a behavior you might undertake to achieve the goal of better cardiovascular fitness, losing weight or both. In that way, it’s a goal-directed behavior all by itself. But exercising will also help you stay motivated and focused on your other goal-directed behaviors, by reducing stress and increasing motivation.