Thursday, December 20, 2012

Remembering A Loved One During The Holidays

 Losing someone close to you is often a very painful experience. Holidays, anniversaries and other special occasions can intensify that pain, but planning a remembrance or ritual to celebrate your loved one’s life can ease the sorrow of these challenging times and help preserve memories of the affection you shared.

The holidays can be particularly difficult for those left behind, but may also offer a unique opportunity to honor your loved one. Placing a special ornament on the tree, setting out a cherished decoration or serving a favorite holiday meal can evoke fond memories. Friends and family may wish to share notes of remembrance placed in a stocking put up for your loved one. A candle might be lit in memory, or perhaps a toast or prayer can be offered in tribute before a meal. Money that would have been spent on a gift could be donated in your loved one’s name to a favorite charity, homeless or animal shelter, or a needy family.

Holidays can be special times to celebrate your loved one. Friends and family may come together to share stories and cherished memories, such as the way they laughed or their favorite quotes. Sharing these recollections with younger friends and family members is a wonderful way to honor your loved one, who may have passed before the children were old enough to know them. By gathering old photos, you can make a mosaic or a memory album of the times you spent together. Create a calendar from pictures or drawings with poems written to or about them, or simply write a letter to express your feelings.

Crafts offer many unique opportunities to remember those close to you who have passed. You might make a quilt from their favorite clothes, inscribe their name on a piece of jewelry, or compile treasured possessions and photos into a scrapbook that will be cherished for years to come. A wonderful way to remember a loved one who enjoyed cooking might be to create a memory cookbook. These favorite recipes can recapture loving memories of family dinners, picnics and holiday meals, especially if you include photos and captions with them.

Celebrating and honoring the memory of your loved one is an important part of coming to terms with your own grief and healing from your loss especially during the holidays.
As you make plans for these remembrances, be aware that we all respond to grief in our own way and have our own methods of coping. Communicate with your family and friends about how you want to remember and honor your loved one. During your grieving process, understand that you may continue to feel sad, angry or lonely for a long time. But you will also gradually experience increased periods of joy and happiness. These are all normal emotions, and feeling happy doesn’t disrespect your loved one’s memory. It simply reflects your progression from mourning to a celebration of the life you shared together as you journey through your grief toward healing, hope and renewal.

Thursday, November 1, 2012

Embracing National Hospice Month

Embracing National Hospice Month

This month, communities across the country are doing their part to spread the word that November is National Hospice and Palliative Care Month, and Hospice of Santa Cruz County (HSCC) is emphasizing the importance of the care that hospice provides for all residents, regardless of age, location or diagnosis.

Consistently more than 90 percent of people polled say they want to die at home surrounded by their loved ones, with their symptoms managed and their pain controlled.  However, more than 70 percent of us die in hospitals and other institutions. Though the use of hospice has increased, only 41.9 percent of patients nationally receive hospice care and often not until the last week of life, too late to attend to all the needs of the dying. HSCC strives to reach all appropriate patients and families so that support can be provided for many months ar the end-of-life.

During this last year HSCC provided compassionate, professional end-of-life care to 850 patients and their families throughout Santa Cruz and Northern Monterey counties.  The grief support team compassionately guided 1,619 hospice family members and 712 grieving community members through their grief journey.  Recognizing the special needs of children in grief, 994 grief support sessions were provided for children and teens.  All services are offered in English and Spanish.

“National Hospice Month reminds us that the care we are privileged to provide brings hope that helps people at the end of life to  live as fully as possible.  Hopsice care offers dignity and comfort when there is not a cure and surrounds families with support at one of life’s most challenging times,” said Michael Milward, chief executive officer, Hospice of Santa Cruz County. National Hospice Month also serves as a reminder that while there are many end of life care options, hospice provides the most opportunities to live life fully. Researchers found that the patients receiving hospice care reported a higher quality of life through the final course of their illness.

“We want to ensure that people understand that help is available and that’s why National Hospice and Palliative Care Month is so close to our hearts after decades of observance. November provides a special  opportunity to educate and inform communities,” said Milward. HSCC provides expert pain management, symptom control, social support and spiritual care to patients and their loved ones when a cure is not possible. Hospice services are covered by Medicare, Medi-Cal and by most insurance plans.

“There’s an inaccurate perception among the American public that hospice means you’ve given up, when It’s really about living life to the fullest. Hospice and palliative care allows patients and their families to focus on what’s most important, living life and creating memories that can be cherished despite an advanced illness,”  Milward said.

Monday, October 29, 2012

How to Shoot a Photo to Remember

How To Shoot A Photo To Remember

Editor's Note: Here is a great post we'd like to share by Susan Seliger via The New York Times.

Sometimes the realization comes almost too late — you sense that your parents or other loved ones may soon be gone, and it dawns on you that you don’t have any recent photos to remember them by.

Sure, you might have a few photos of them in their youth, before you even knew them. But what about a photo of them now, so you can remember the person you have come to know so intimately over these years of caring for them?

Those photos are harder to come by. As readers of this blog know, those of our parents’ generation did not grow up with a camera in their pockets to record every moment with friends on Facebook.

A lot of people who are now elderly “only have a high school senior photo – they don’t ever visit a photographer again,” said Steve Bedell, a professional photographer in Dover, N.H. “That’s why it’s so important to document these people at an older age.”

Mr. Bedell began doing just that several years ago, when his mother-in-law moved into a nursing home. He found the process so moving that he eventually took photos of 30 of the other residents, too, at no charge — to the delight of the residents and their families.

You don’t have to be a professional to take a memorable photo, of course. But snapping the elderly involves some unique challenges. So I consulted several experts in this area for their tips.

One thing they all agreed on: It’s never too late. Even if your relatives are frail or suffering from dementia or in the hospital or a nursing home, there are still ways to capture the essence of who they were and, beneath the lines and curving spines, still are.

Here’s how to take your best shot.

1. Help your loved one get dressed for the occasion.

“Hospital gowns depersonalize a human being,” said Dr. Jeffrey M. Levine, a geriatrician at Beth Israel Medical Center in New York who has been taking photos of the elderly across the country for decades. (See his Web site and many of the pictures in the slide show at the top of this post.) If dressing is not an option, at least help cover the person with a favorite shawl or quilt to add a personal touch.

“My father loved to put on hats and scarves and have his picture taken all bundled up,” said Susan Sermoneta, an English teacher at the Fashion Institute of Technology who spent six years photographing her father (some of the results are posted on her blog) until he died in February. Women, especially, may feel more relaxed in front of the camera if you’ve helped them apply some makeup or they have had their hair done (many nursing homes have salons).

2. Shoot in a cozy room, or at least in a comfortable position.

If your relatives are at home, find the room that makes them feel relaxed, like the kitchen. If they’re in a hospital, try to catch them when the hospital staff is changing the bed linens; they often move the patient to a nearby chair. Lying in a bed makes anyone feel weak and exposed.

3. Be sensitive to quirks and vulnerabilities.

If they have injuries or scars or IV tubes that make them self-conscious, reassure them that you’ll try to keep those things out of the photo.

“My father thought profiles were his best angle, so he would pose that way — always with his hands crossed over his chest,” recalled Ms. Sermoneta. “I asked him why, and he said, ‘If I don’t hug me, who will?’”

4. Bring in friends or other family members to engage with the person.

Never say “cheese!” Interacting with others will help animate their features and make them look — and feel — more cheerful and lively. Grandchildren and babies can be especially handy for eliciting natural smiles, said Mr. Bedell, “as long as you can control the grandkids” and send them home before everybody is exhausted.

5. Put on some music.

Music is relaxing (for the photographer, too), but for those with dementia, it also can sometimes spark unusual focus and clarity. (See “Revived by Music”, a blog post by my colleague Paula Span.)

“One elderly nun I photographed had lost her ability to speak because of dementia — but if you brought her to Mass, she could sing the hymns,” recalled Dr. Levine. “It connects dots in their brain and gives them a sense of well-being.”

6. Hand them a memory prop to get them talking.

Sometimes all it takes to get even elders with dementia talking happily about their lives is to have them hold an object that stirs up memories.

“I had a patient who was a fireman who kept a toy fire truck and the awards and medals that he had gotten,” said Dr. Levine. You should be careful with war memorabilia, though, Dr. Levine warned, as it may agitate some veterans.

7. Ask simple questions that play to their strengths.

Sometimes just asking about what games they played as children can trigger some great conversations. Questions that remind older people of who they used to be when they felt strong and independent can produce lively responses.

Dr. Levine recalled visiting an uncle with severe dementia who had been a doctor. “He still loved playing doctor,” said Dr. Levine, “so I asked him about a blood clot I had under the nail from slamming it in a door, and he grabbed my hand to examine it as he had done when I was a child.”

8. Forget the flash.

“You don’t want to have a big flash popping off in their faces,” said Mr. Bedell. It’s distressing, and the harsh light makes everybody look worse.

To use natural light, have your subject sit near a window or take her outside in the shade of a tree to get soft, even lighting. Remember, your subject should be facing the source of the light while you, the photographer, keep your back to it.

9. Don’t take pictures of people eating.

Resist that temptation, even though it may be one of the few times in the day when a very sick person is awake and alert. “They look really weird,” said Ms. Sermoneta. Not surprising – who does look their best when chewing?

10. Get close.

One of the big mistakes amateur photographers make, according to several of the pros, is that they are reluctant to get close enough.

That doesn’t mean you should stick the camera in your subject’s face. “I use a Telephoto lens so I can zoom in tight with just the head and shoulders filling the frame,” said Mr. Bedell. Even most standard point-and-shoot digital cameras have a zoom feature.

11. Know when to eliminate or include the background.

If your loved one is in a hospital or institutional setting, all those dangling wires and flashing machines can be just plain sad. Obscure that background by focusing closely on the person’s face (see Tip No. 13).

But sometimes people’s environment can provide the critical details you’re looking for to reveal their character and capture their spirit. “I photographed one nursing home patient who made herself a little shrine with angels, and a couple in Santa Fe who surrounded themselves with objects in their home that they loved,” said Dr. Levine.

12. Focus on body parts for variety.

After you’ve done the more traditional portrait, zero in on the parts. (Yes, sometime the sum of the parts is actually more than the whole.) “I like to zoom in on the hands, the eyes, maybe even shoot from behind or at other odd angles,” said Ms. Sermoneta.

13. Take lots and lots of shots.

“People always say to me, ‘Oh, I wish I had taken photos of my mother or father.’ Just take them!” said Ms. Sermoneta. Hundreds of them. “If you take enough, you’ll get one that feels true.”

14. Keep the sessions brief.

“I used to schedule 20 minutes for each person, but I found that the first 10 minutes is usually enough,” said Mr. Bedell — that is, unless you have friends and relatives around interacting with them.

In that case, you’re as good as invisible, so you can keep on shooting discreetly for as long as the subject’s energy — and yours — lasts.

15. Use these photo sessions as a chance to connect.
When you ask questions about your loved ones’ past, you’re not just getting them to look lively. You’re opening up an opportunity to discover things you may have never known.

For those whose relationship with a parent may have been awkward or troubled, examining the parent through a camera lens — instead of through the eyes of a vulnerable child — can provide the distance that, paradoxically, can bring you closer.

“My father was always hard to talk to — he was a drunk and sarcastic. Then he had dementia,” Ms. Sermoneta said, which made communication even harder. But she found that taking pictures of him gave her a way to see him more sympathetically and connect with him, without words getting in the way.

Friday, October 26, 2012

As Children Become Caregivers

as children become caregivers

Human nature dictates that we often experience child-parent struggles. The blurring of identities as our parents advance in age and we become their caregivers frequently intensifies these struggles. This can create tremendous strain on our ability to manage the day-to-day stresses of these new roles. But there are some relatively simple ways to handle the changes in your relationship and make the transition easier on you both.

Simply stopping and counting to 10 before responding to your parent will afford you precious seconds to calm yourself and potentially avoid an unnecessary argument. Those moments of deep breathing and hesitation can also give you an opportunity to more fully understand your reactions to stresses in your relationship. This, in turn, will help you transform your fight-or-flight instincts into more positive responses that can ultimately strengthen and deepen your bond with your parent.

If your parent has a tendency to use verbal negative cues to trigger you into offering an angry response, consider turning the avoidance of these “hooks” into a personal contest. See how many times you can refuse to take the bait, considering each time you pass up a negative hook an internal private victory. Understand that the best way to win an argument is by peacefully and calmly ending the discussion altogether.

Sometimes old patterns and routines can lead to falling into the same old traps and ruts. Try changing things up with new scenery and unexpected activities. This might refresh your outlook and help you and your parent see each other in a different, more compatible light where communication is easier and calmer. Along these same lines, introduce your parent to the adult you by involving them in your work, professional interests and colleagues if possible. By helping them see you as an adult instead of a child, it may be easier to break the old parent-child trap and talk with one another rather than at each other.

As your parents age, it’s important to maintain an open mind about your interactions with them. Understand that the aging process is difficult on them as well. Their lives are changing, as is yours, and these changes are often frightening and complicated. The fewer expectations you have on your relationship, the easier it will be to remain flexible and adaptive as you both journey through this unfamiliar territory. To remind yourself about the good times during those moments when things are less pleasant, keep a record of any positive interactions you have with your parents. You might even want to write a note to them during these times, to share your good feelings and happy experiences as a part of their lives.

Most importantly, remember to reward yourself for changing outcomes, avoiding old traps and restructuring your reactions. Refusing to take negative bait, being patient, and remaining flexible and adaptive are difficult challenges. Accomplishing these goals should be viewed as a personal victory. So give yourself a special treat for the effort you put into making these changes – a massage, favorite meal, time alone to read or relax to soothing music, whatever refreshes and renews you. As a caring and compassionate adult child of aging parents, you deserve it. And you’ll be better prepared to provide sensitive, loving support as a result.

Tuesday, October 9, 2012

Caregiving and Insomnia

caregiving and insomnia

As we grow into adulthood, the amount of sleep that we require diminishes.  As newborns, we can require up to 18 hours of sleep per day. At age 5,we need around 10 hours of sleep and at adulthood 7 hours is acceptable. Unfortunately, meeting these requirements is not always easy and with the added responsibility of being a full time caregiver, sleep may not seem like a top priority.

Caring for a loved one is a full time job, and the added effects of insomnia can hamper your ability give. While there are many varied factors that cause sleep disorders, there are several steps that you can take to ensure that you’re getting the best possible chance at a good night’s rest.

  • Establish a regular sleeping schedule. Going to bed at the same time each night and waking in the morning at the same hour can add consistency to your sleeping pattern and curb erratic sleep behavior.

  • Limit caffeine intake, especially after mid-day.  After consuming caffeine, effects can last from 8 to 14 hours.  Consider switching to decaf coffee or tea.

  • Watching TV, and looking at other devices such as cellphones, computer screens immediately before bed can hamper your ability to fall asleep.

  • Regular exercise can work wonders for maintaining a healthy sleep schedule. Not only does exercise promote physical and mental health, it also increases the need for the restoration that occurs during sleep. Exercise does not need to be strenuous to be effective, walking and water aerobics are great low impact activities that should be considered.

  • Check your medications to see if side effects include difficulty falling asleep or inability to stay asleep. If so, you may want to consider changing medications to one that does not include these side effects.

  • Turn cellphones (and other electronic devices) to silent mode while you are  sleeping. Disturbances can upset the circadian rhythm and affect future sleep cycles for days to come.

  • Remember to remain positive if you are struggling with a consistent sleep schedule. Being negative or pushing to hard can cause regression and possibly make matters worse.

The best way to care for your loved one is to start by caring for yourself and ensure that you get proper amounts of sleep each night. We hope these tips may be of service in helping you to assist your loved one and make your caregiving journey a bit easier. We want you to know we are here to assist you and your loved one with any of the challenges that you may be facing in your caregiving journey.

Monday, September 24, 2012

Eleven Tips to Relieve Caregiver Stress

Here are some great tips to help relieve caregiver stress.

  1. Recognize the signs of caregiver stress: sleeping or eating problems, anxiety, headaches, depression, guilt, and muscle fatigue or tension are just a few.
  2. Ask for help from friends and family: some would–be helpers hesitate to offer because they don’t know your needs.
  3. Stay connected: it is important to maintain relationships with others and not just the loved one in your care.
  4. Keep a journal: talk or write about your feelings, whether they are good or bad. A regular record of events and emotions will help you recognize stress before it becomes a problem.
  5. Learn all you can about the illness: what can you expect and what new issues might arise.
  6. One thing at a time: break a challenge into smaller parts.
  7. Take time away: it may be difficult, but try to find time for yourself. Don’t completely isolate yourself in the caregiving role. Take time for your hobbies, they will help take your mind off the situation and responsibilities even if it is just for an hour or so a day.
  8. Talk to others: look for support groups. It often helps to speak to others who are in a similar situation and can share your frustrations, feelings and concerns.
  9. Celebrate your successes: allow yourself to feel good about your efforts. This is not a role that demands absolute perfection, take pride in what you are doing for someone else, it really is a big deal.
  10. Breathe: take a deep breath, gain perspective. You are giving the best part of yourself to help someone you love. One day you will be able to look back and know what you contributed.
  11. Humor: stay in touch with your sense of humor. Sometimes laughter really is the best medicine.

Friday, September 21, 2012

Dealing with Caregiver Stress

dealing with caregiver stress

When someone close to us begins to face the realities of an advancing illness, many of us will begin to define ourselves as caregivers. Hospice can allow us to do just that, for one of the many options available with hospice care is the option of a family member serving as a caregiver. For many, becoming a caregiver offers connection, pride and the opportunity to express how deeply we care about our loved one. In a very real sense it is a heroic role and a truly demanding role. Though hospice family caregivers have great support and help from our hospice team, it is still a role that will take time and present challenges. Learning how to deal with the stresses that are a natural part of facing a loved one’s illness as well those that come from stepping into the caregiving role, will help you provide the best possible care.

With the end goal of ensuring the best possible care for your loved one, support from others will be important. Consider seeking help from other family members, faith communities, friends and even neighbors who may be willing to help. Though asking for help may be difficult, the benefits for you and your loved one will outweigh your hesitations. You are likely to find that many are glad to help, and may be waiting for you to need them.

It is important as a caregiver to remember to make time for yourself and to take care of your own needs. Remember, the care that you give your loved one suffers if you are not in the best possible place, both physically and mentally. It is vital that you remain healthy and able to provide your loved one with the best care you can and that begins with taking care of yourself.