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The Heart of CaregivingA GUIDE TO JOYFUL CARING
By SONIA S. MORRISON
AuthorHouseCopyright © 2012 Sonia S. Morrison
All right reserved.
"If you want others to be happy, practice compassion. If you want to be happy, practice compassion."—Dalai Lama
Using The Heart of Caregiving principles will provide lasting benefits. Focusing on body first, here are some questions we can consider.
What kind of fuel works best for me?
What are my beliefs and realities for the food and drink that I choose?
What food choices give me optimum energy and which foods make me feel lethargic or grumpy?
Am I hydrating myself and taking the time I need for my own toileting and hygiene?
Are there medications or supplements that need to be included in my food and hydration plan?
Is My Health Wheel balanced?
If my health wheel is not balanced, what is one tiny step that I can do, today?
Exercise examples from the past, included a bicycle as my primary transportation. I was the happiest when I danced six hours daily and played beach volleyball a few hours, several times each week. Now a ten-minute bounce, an hour walk, and a bit of grounding gardening are complemented with weekly dancing. Other adventures could be Pilates or Kickboxing classes, biking, rock climbing, hot tub, sauna, or swimming.
Many exercises, especially, Pilates, Qi Gong and Yoga, are beneficial for all three parts of ourselves; body, spirit and mind.
Many reliable health resources recommend a minimum of half an hour walk, five days a week.
Caregivers have a lot of experience to share. This is Joan McGuire Pounds response to one of my June 2011 interview questions. What is your funniest experience as a family caregiver? Enjoy this balanced body, mind and spirit grandma.
Rancher Now 101 years old
"I cared for the grandmother of two boys with whom I went to school. They were a ranching family and as such were a fairly tough group. Their grandmother was a frail little woman who was bedridden with hair down to her waist. We spent a lot of days cleaning her and feeding her. She was very alert for 101! She knew who everyone was and she had an amazing memory. We often spoke of her grandsons and the mischief they would create in school. They weren't bad boys but they were boys just the same. I found out from one of her grandsons that she came out west by herself and ran her own cattle ranch by herself for many years.
I was quite impressed that this little woman did all that. The family had tens of thousands of head of cattle by this time. I asked her about it and she told me that when she was moving out west, she had between 500-700 head of cattle and she did have several ranch hands that assisted her with the ranch; but she was right there with them working the cattle. I asked her if it was dangerous and she said it wasn't too bad if you kept your wits about you. She did say that she only had trouble one time and it wasn't bad after that. She told me that one day, she caught a rustler (someone who steals cattle) on her land. He had killed several head of cattle and she was able to subdue him and take him to the sheriff. I asked her how she did that (she was all of about 5 foot nothing and 95 lbs.) and she told me that she shot the rustler once in each knee, bound him in barbed wire and threw him in the back of the buckboard wagon and rode into town with him (about 75 miles one way) so that the sheriff could make sure that he made restitution to her for the cattle he killed. Once the word got out about what happened to him, there was no more trouble on the ranch!!! I asked her grandsons about the story the next day and they said, "If she said it, it was true!"
There are many myths regarding health and aging. For example, memory loss is not a normal symptom for healthy aging.
Truths: More than 1/10 of all Americans are 65 years or older. Most men are married.
Women are twice as likely to live alone and be widowed.
Loss of important people and meaningful things, including height, sight, taste, teeth, hearing (1/3 over age 65) and strength are common with aging.
Attentive Caregivers put their personal thoughts, feelings, troubles second to the person they are caring for. Caregivers may avoid negative feelings by being balanced and focused, while understanding older people and the disease process.
Practicing the six principles of care allows caregivers to understand how to participate as part of a team and offer emotional support while providing direct care.
Being balanced within allows caregivers to do focused care flexibly and creatively, while enjoying the celebration of life and caring.
Dignity is being treated with respect at all times. Clients heal and function best when they are treated as individuals and are allowed to direct their care. Our beliefs affect our health and attitude. Caregivers are best able to provide care to clients when they are balanced and focused in the present moment. Many caregivers feel overwhelmed by the tasks involved in caregiving. There are some basic concepts and tools that can combat this pattern of overwhelm. When we treat ourselves with dignity, it is a natural process to extend this behavior to those in our care.
How do we treat ourselves with dignity?
A simple adjustment to being instead of doing makes an amazing difference.
What we focus on expands, we can choose to focus on what we want. By acknowledging what we want within ourselves, we will create more of this value in our lives.
For example, daily; we can be grateful for ten things in our lives and appreciate ten things about ourselves for just five minutes of journaling. We can pick one value (such as; clarity, courage, creativity, focus, fun, being consistent, flexible or generous) and one of the six principles of care each day and think about how this relates to the person we care for. "How can I have fun with my client and treat them with dignity, today?"
Be thoughtful and do insist on connection and invite what you hate. Many things influence a person's behavior.
There is always a reason behind the behavior, Even if you do not understand what it is, there is always a reason behind the behavior. What are your experiences of someone doing something they wouldn't normally do, or that seems inappropriate or unnecessary? What have you done to put yourself in danger of harm, embarrassment or another kind of risk? A caregiver's responsibility is to provide care with kindness, no matter what the client's behavior is.
The Power of Closeness: Understanding basic needs and the life cycles can be useful.
From the time we are born, we search for closeness and connection. Peek-a-boo, tag and hide & seek are all games that play with connection.
Sometimes our loved ones do not connect or reconnect so easily. They may feel so isolated that they come out swinging both arms aggressively or retreat to a corner.
This is a signal that more connection is needed, even if it feels annoying, obnoxious or infuriating. Hyperactivity, inability to calm down and depression may be other symptoms of this need for connection. No value comes from punishing or leaving the loved one isolated.
Setting relaxed expectations and eye contact can be useful for breaking the ice. Playful physical and verbal bumbling attempts to be close, such as, begging and pleading, closing your eyes and kissing the air, wall or chair instead. When you open your eyes, this can bring laughter and a softening of the stuck feelings. Deep within, the client may have a feeling of something being wrong with them. Pay attention to how near or far, from the loved one, to see which distance brings the most laughter and repeat what brings more laughter.
A few minutes of eye contact and laughter can make all the difference in feeling connected while providing direct care. When you are finished say, "Great! I get no hugs, no kisses. But someday, someday, someday, I'll get one! I'll just have to try again next time! Thanks for a good run around the house!"
Be on the same physical level: Keep your body within one foot of your loved one. Keep your elbows at your waist level, whenever delivering direct care. Refer to chapter 3 for more details on safety.
Communicate what activity you want to do, before doing it. Refer to chapter 4 for further details on communication.
Cradle your loved ones body from underneath, with the soft pads of your palms only, to assist movement. This provides dignity and safety. To avoid pain and injury, do not grasp with your fingers.
Gender Differences to be aware of, for more effective care follow. Be respectful of the male hunter's one-track narrow focus versus the female dual roles of being a gatherer of information and pleaser of others. Awareness that males have the instinct for direct immediate action versus the diffuse awareness of female can save many hours of frustration.
Key tools for gender communication:
For him; don't interrupt, simply wait. Do not rephrase or give options.
For her; state the obvious in a thoughtful tone. Use questions to help her talk about feelings and see chapter three for further communication tips.
Which Rights Would You Give Up?
Be willing to lose your own dignity, in order to protect the rights of your client.
Individual rights are guaranteed by law and cannot be taken away without penalty. Because rights are crucial to a person's freedom rights are protected by law. People have a right to competent, compassionate care that is delivered with respect. A person in your care should not be expected to give up any of their rights. Caregivers have an obligation to be ethical and do the right thing.
Celebrate Power versus Powerlessness
What are your daily personal six principles of care? Because inner creates outer and roots create the fruit, these are my six principles of care, which may or may not work for you. I do them daily.
1) Be Grateful for ten things in your life.
2) Appreciate ten things about yourself.
3) Exercise; bounce on the balls of your feet, elbows in, chopping at waist level to be grounded, then chest level to be focused and above your head to the heavens, to get any stinking thinking out of the way.
4) Do the right thing.
5) Ask for what you want.
6) Be willing to receive it.
Celebrate every small and large success, immediately. The celebration will energize you for the next task and could be any joyful action. Some examples are a hearty "Well done", "Hooray!", a pat on the back, jump for joy, cup of tea, 15 minutes of grounding gardening, a phone call to share, reading, writing, listening to music or an inspiring bit of information.
Tip: Use a ten-minute timer and a journal as allies.
Don't smoke for at least 2 weeks before and after surgery.
Five "A"s for eliminating tobacco use and dependence: Ask, Advise, Assess, Assist, Arrange follow-up.
Assessing mental status by asking more than yes or no questions.
Assess immediate memory by telling 3 words, have them repeat and remember and then have them recall and repeat the 3 words in 5 minutes.
Assess short-term memory by asking for a description of something that happened in the last few days.
Administer oxygen, as soon as possible, for a heart attack or Myocardial Infarction.
Muscles function is for movement, posture, and heat.
Muscle injury assessment includes pain, paresthesia, paralysis, pallor, and pulse.
Parathesia means tingling, burning, pricking or numbness of the skin.
ROM means range of motion.
AROM means active range of motion.
PROM means passive range of motion.
After strokes these ROM exercises are important. Abduction is moving a limb away from body. Adduction is moving a limb towards the center of body.
Functions of kidneys: we form urine to remove wastes from the body, maintain acid-base and fluid-electrolyte balance, and assist in Blood Pressure control.
The kidneys help manage acid-base balance by regulating bicarbonate concentration of the blood.
Dark green leafy vegetables are the best sources of non-dairy calcium. Detection, Dispatch, Delivery, Door, Data, Decision, Drug are the 7 Ds of stroke care per the American Heart Association.
Digoxin toxicity's is most common when a green halo is seen around lights.
1) BE with yourself, daily.
2) DO take action to ensure use a 15-minute timer to write in a journal.
3) HAVE the life of your dreams by using the acronym, RICE to guide you into daily habits with lasting change. R.I.C.E.=Re-evaluate Intimacy (with self and others), Communicate changes and Exercise them. Intimacy is a shorter way of asking if you are living your life authentically and to your purpose. Remember, body, spirit and mind, need fuel, exercise and rest.
Are you evenly balanced?
HOW TO USE THE HEALTH WHEEL
Starting at the top right hand of the wheel place a mark in each of the eight sections, based on your satisfaction level. If you are not very satisfied with your exercise activity, place a mark towards the center of the wheel. If you are very satisfied with your exercise activity, place your mark towards the outside edge. After you complete each section, draw a line from each mark. How rounded is your health? What needs to change?
Stop the Doubt
Exercise-walk outside 30 minutes a day, 5 days a week
Read a book-even one page a day
Listen to or Sing a favorite song
Get Hugs, Laugh, Smile
Get a Massage, Sauna or Steam
Play with Children, Partner or Pet
Paint, Do Arts and Hand Crafts
Dance, Cook, Play Music
Conceive of Your Happy Life Write it down
Believe in Your Vision Be Happy
Take Action Daily
Achieve your Happy Life One Breath & One Thought at a time ...
If you have built castles in the air, your work need not be lost; that is where they should be. Now put the foundations under them. ~Henry David Thoreau
The best way for having fun as a caregiver, is to foster confidence and recovery for your loved ones.
Offer Assistance versus helping, when possible.
Focus on what they Can Do and Be Creative when they Can't Do.
Basic physical human needs Food and water, Protection and Shelter, Activity Sleep and Rest Safety and Comfort, including freedom from pain.
Basic psychosocial needs Love Affection Acceptance by others
Self-reliance and independence in daily living Interaction with other people, Accomplishments Self esteem.
How can we best promote these basic needs? By caring well for ourselves, will we be better prepared to promote independence and accomplishments of others? What is your most challenging experience as a family caregiver?
This is June McGuire Pounds response.
"The most challenging experience I have had as a family caregiver was attempting to provide quality care for my mother who was very independent and yet was losing her balance and falling down a lot. Her health was deteriorating rapidly and I wanted to do all I could to make her better. She was only doing what would make her better for the moment. It was very difficult for me to step back and honor her wishes to do what she wanted while I watched her slip away. I wanted to put her in a assisted living center and she was not going to have it."
Consider the mind and spirit of the person you are caring for, not just the physical aspects.
Listening and paying attention provide a simple and priceless thoughtfulness and compassion. This attentive listening allows pride and control to remain intact.
Some questions to be answered before the physical care can begin
Can the person bear weight on one or both legs?
Is one side stronger than the other?
Is there a good sense of balance?
Are there problems? vision hearing language or perception
Are there pains or fears with movement?
Are the movements predictable or has the person suddenly ever refused to cooperate?
Is there space to move?
Do you have assistance, if needed?
Do you have all the supplies and equipment needed?
Do you know how to use the equipment and your body properly?
Environment and belongings have special significance to the person you are caring for. Has anyone ever come into your home and picked up your things and moved them around so you couldn't find them? How did you feel?
Excerpted from The Heart of Caregiving by SONIA S. MORRISON Copyright © 2012 by Sonia S. Morrison. Excerpted by permission of AuthorHouse. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
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