Car Crashes, Strokes, and Alzheimer's Disease:

The Dangers of Sleep Deprivation

by American Heart Association

Most people are familiar with the obvious consequences of sleep deprivation—the heavy eyelids, short attention spans and excessive yawning after a poor night's sleep.

But there are more consequences of meager sleep than people realize. Research shows skimping on sleep is linked to numerous health problems, including stroke, obesity and Alzheimer's disease.

"It's like with diet, every cell in the body benefits from food in some way," said Michael Grandner, director of the Sleep and Health Research Program at the University of Arizona College of Medicine in Tucson. "Sleep is similar in that way. The whole body (benefits)."

Just one night of sleep deprivation can lead to accumulation in the brain of the beta amyloid protein, a key component in risk for Alzheimer's disease, according to a 2018 study. Researchers found signs of the protein in the hippocampus, which plays a major role in forming new memories and is one of the first areas affected by Alzheimer's.

There also is evidence that lack of sleep contributes to excess body weight. One study found people who slept fewer than seven hours each night were more likely to have a higher average body mass index and develop obesity than those who slept more. Sleep restriction also was associated with salt retention and inflammatory markers.

"Sleep plays many roles and is involved in most regulatory systems in the body," Grandner said. "This includes everything from how cells transport glucose to manage energy, to how the immune system recognizes tissue for repair."

Sleep disorders have been recognized in recent years as health factors that can increase the risk for heart attack and stroke. A 2018 study found sleep disorders, particularly sleep apnea, are prevalent among people at risk for stroke. Another recent study found people who slept fewer than six hours a night—compared with those who slept six to nine hours—had a 20% higher risk of heart attack.

One-third of U.S. adults get less sleep than they should, which also has been linked with Type 2 diabetes and depression, according to the Centers for Disease Control and Prevention. Not getting enough sleep also can cause injury and death through car crashes and workplace mistakes.

It is possible to suffer a sleep disorder without realizing it, Grandner said.

"A lot of sleep disorders are underdiagnosed and undertreated," he said. "If you're concerned about your sleep, it's important to see a specialist."

Some common sleep disorders include:

Insomnia—the inability to fall asleep and stay asleep through the night
Sleep apnea—causes interruptions through breathing irregularities
Restless leg syndrome—causes "creeping" sensations and aches in the lower legs
However, inability to sleep is not always a medical problem. It could simply be a matter of poor sleep hygiene, such as bad habits that lead to later bedtimes and insufficient sleep, said Marie-Pierre St-Onge, director of Columbia University Irving Medical Center's Sleep Center of Excellence.

"Maintaining good sleep hygiene and a stable schedule helps regulate cycles—not staring at a phone or computer right until you go to bed, for example," she said. "Looking at your emails before bedtime not only shines light in your eyes that disrupt sleep signals but can also cause some stress. Thinking about the next day's task may prevent you from falling asleep."

Drinking coffee late in the day can be a culprit as well, she said. Life stressors can carry over into nighttime, too.

"People working multiple jobs, struggling with work-life balance sometimes struggle," she said. "We're also seeing that children and adolescents aren't getting enough sleep, which is why there's been this push to delay school start times so they can get more sleep at night."

But for those having trouble getting proper sleep, there are ways to make improvements, Grandner said. He stressed the importance of winding down before bedtime to get the body prepared for rest, comparing the practice to slowing down a car before taking an exit off a highway.

He recommends keeping a regular sleep schedule, avoiding food too late at night, and getting out of bed to walk around if sleep is not coming immediately.

"Busy professional people are very distracted during the day, and they hope their brain is like a light switch you can turn off whenever you want to," Grandner said. "A lot of people need to think about giving themselves enough time to wind down. They should see their sleep as an investment in the next day's productivity and potential."

(www.medicalxpress.com)

What Are Grief Dreams?

Common and comforting, dreams about the dead are changing during the pandemic

By Kevyn Burger

“He said, 'Hey babe, I love you and goodbye,'” Britt Louie recalls of a grief dream featuring her deceased husband, Fred.

In the middle of the afternoon, Dan Callahan flopped on the couch for a nap. Roused briefly by his daughter, he rolled over to resume his snooze.

That’s when his wife Brenda walked in. The same Brenda who had died suddenly two months earlier at age 59.

“It wasn’t a dream; I know what a dream is. This was a…visitation. She was there,” insisted Callahan.

“She was dressed for work, wearing her blue skirt. She sat down beside me and I felt her weight. The Dan of the dream knew she was dead. I said, ‘How is this possible?’ She gave me little peck kisses and said, ‘Don’t worry about it. It’s okay. I’m okay, you’re okay. Let it be. Just go with it.’”

At the time of the dream, Callahan, who lives in the Twin Cities, described himself as “disoriented” by the loss of his wife of 38 years.

The Callahans met the summer after high school when they worked at Valley Fair, a local amusement park, and had been together ever since. With their four children raised, the couple had begun to contemplate their post-work options. But on a January morning, Brenda felt out of breath on her way to work. She drove herself to a hospital where she suffered a massive heart attack and could not be revived.

“It’s been traumatic to lose the person you were so happy with for so long,” Callahan said. “She died before I got the chance to say goodbye. Seeing her filled me with joy and calmness.”

Unique Characteristics of Grief Dreams

What Callahan experienced, termed a “grief dream” by psychologists and social scientists who study them, is a fairly common occurrence. In the midst of the current global pandemic, dreams of those who have died may become more common as thousands of people come to terms with the loss of a loved one.

And while most such dreams bring comfort, not all of the dreams of the dead console the dreamer.

“Grief dreams have unique characteristics. They’re vivid; they don’t fade by the time you wake up. Forty years later, people can still describe them in detail,” said Joshua Black, of Ontario, Canada, whose research prompted him to create the GriefDreams website and a weekly podcast, with 155 episodes (and counting) that include interviews with people who dreamed of dead parents, spouses, siblings, children, grandparents, even dreamers who suffered prenatal and pet loss.

“I see these dreams as playing an important role in how we survive as humans,” he said. “They help at the time of greatest stress.”

Grief Dreams of His Father

While earning his master’s and doctorate in psychology at Brock University in Ontario, Black contributed significantly to the limited research on grief dreams. He conducted a half-dozen studies on the phenomenon, then co-authored articles published in academic journals. One of his studies concluded that grief dreams are quite common, especially among bereaved husbands and wives.

“If the deceased had been sick in life, they look healthy in the dream. Often the spouse returns with advice or to help with parenting.”

“Our survey on spousal loss surprised us. Within two years, eighty-six percent had a dream of their deceased spouse or romantic partner and ninety-two percent considered them positive,” he said. “If the deceased had been sick in life, they look healthy in the dream. Often, the spouse returns with advice or to help with parenting. There are sexual encounters. Some spouses appear in dreams to give their approval to a new relationship.”

Black’s research was inspired by his own grief dream, which he called life-changing.

“After my father died, I went though a rough phase. It was like the color went out of my life. I was going through the motions,” he said. “Then I had a dream that my father was in my room. He’d had a lot of issues in life but he never looked better. There was a lightness to him. I told him, ‘I miss you, I love you.’ I hugged him. When I woke up, the darkness I had carried was gone. That dream gave me what I had been longing for.”

The Pandemic Pierces the Dream World

The current pandemic-induced bottleneck at hospitals interfered with Britt Louie’s ability to be with her dying husband Fred. Diagnosed with an advanced form of cancer, Fred had brain surgery on March 31 and survived for a week following the operation. Because of visitor restrictions at the hospital in Glens Falls, N.Y., Britt saw him only once.

“He told me, even if I die, I won’t leave you,” she recalled.

Six weeks after her husband’s death, during a week she described as “really rough,” Louie had three dreams about him in three subsequent nights.

“In the first, Fred didn’t say anything, but I told him how much I miss him. He wrapped me in his arms, put his head on my shoulder and we cried together,” she said. “In the second, he was sitting in my car and gestured me over, then he kissed me so tenderly. The third night, my phone rang and it was him. He said, ‘Hey babe. I love you and goodbye.’ He hung up and in the dream I knew he was dead.”

Louie is still trying to make sense of her experience.

“The day after the first dream, I was wrecked. It was so real, but when I rolled over he wasn’t there and that hurt,” she said. “But now I cherish those dreams. I think about them every day.”

Author TJ Wray predicts the COVID-19 era will produce many dreams that are far less comforting than Louie’s.

“It’s too soon in the pandemic to have the data, but I’m assuming that those who lose someone to COVID-19 may experience trauma dreams caused by the scenario of that loved one dying alone and frightened. It’s all in place right now,” said Wray, the author of Grief Dreams: How They Help Us Heal After the Death of a Loved One.

Wray didn’t set out to study dreams. The death of her 43-year-old brother prompted her to write, Surviving the Death of a Sibling, a book aimed at others suffering the same wrenching loss. When many of the bereaved brothers and sisters she interviewed mentioned grief dreams, she got curious and that became the basis of her next book.

Wray learned that a small percentage of grief dreams are what she identifies as trauma dreams.

“Trauma dreams are the most challenging, the ones when someone wakes up in a cold sweat, screaming. They happen when a loved one died in a shocking or gruesome way; they were murdered or died in a horrible accident, or if the person witnessed the death or found the body,” she said.

Wray manages a Facebook group for grieving adult siblings and said that she is hearing from siblings who suffered traumatic loss and are now “re-triggered” by the pandemic.

“There’s a resurgence of trauma dreams from previous grief experiences they thought they’d dealt with. We see siblings who are ten years out now re-traumatized by this scenario of mass death,” she said. “They haven’t lost anyone to the virus. Just watching their newsfeed and seeing images of people on ventilators can do it.”

Black anticipates the dreams of the pandemic will ultimately be a rich source of research for academics and analysts. He has already begun to collect stories.

“Maybe a portal opens when you sleep and there’s communication we don’t understand.”

“I’m hearing from people who have worked through their initial grief. They are experiencing their loved one coming back to try to reduce their fears and help them regulate their emotions,” he said. “People wake up after these dreams and say they feel less anxiety.”

For more information, please visit: www.elizz.com.

The Benefits of Journaling

for Caregivers

by Lisa Hutchison

Journaling is one self-care practice caregivers can utilize to connect within. This ritual becomes a personal record of your observations and experiences. It is your choice whether you share your writings or not. Most caregivers keep their journal private to ensure they have a safe place to vent about the specific difficulties they face.

Some caretakers prefer a blank journal to free write, which means writing whatever comes into your head without censoring it. Others prefer a journal with prompted questions specific to a topic of interest to them. You can purchase journals online for energy healing or caregiving. Inside you will find questions and suggestions to guide you. Often those who are not as comfortable with writing, prefer a prompted method. No matter what kind of journal you use, it is a relatively inexpensive way to reduce and manage daily stress.

You do not have to be a writer, to journal your thoughts and feelings. It is your decision if you express yourself in bullet points, short sentences or complete paragraphs. Others may feel more at ease drawing pictures or shapes with words or phrases inside.

The Benefits of Writing for Caregivers

1. Convenience and Freedom

There are many reasons caregivers find value in journaling. The number one advantage is convenience. As a caregiver, your time is precious and packed full of responsibilities. Many people find freedom in choosing when and where to write because there are no rules. This means you can journal while waiting at a doctor’s appointment for the person you care for or while he or she is asleep.

2. You will increase self-awareness

Writing forces you to slow down and pay attention to what is going on in your life. As you connect within to the forgotten parts of yourself, you discover healing and hope. The page will not judge you and gives you ample room to explore. By acknowledging the emotional hurts, you decrease anxiety and depression.

As you maintain your journal, you can look at previous entries and notice certain patterns in your life. These may appear as ongoing issues or conflicts. Keep writing and read your thoughts, you may find a solution for a long withstanding problem.

As you connect to the present moment, you become empowered to make healthier choices. You will begin to notice sooner when your body aches or how hungry or thirsty you are.

3. Writing helps you express your thoughts and feelings into words.

Writing is not only creative but also therapeutic. This tool can be cathartic by releasing pent up feelings of anger, resentment, fear, sadness and jealousy. As a caregiver, you are outwardly focused on how others feel. Often you ask; what can I do to make you feel better? In order to refill your cup, you need to turn some of that compassionate focus around.

Ask these questions to yourself daily;

How am I feeling?

What do I need and want?

4. Journaling helps you develop a plan to protect and maintain your energy

Writing helps increase your understanding of what maintains and depletes your energy. As an empathic helper, it is important to learn how to protect your energies from people, places and situations. There are numerous ways to set boundaries and limits. Once you find what works for you, implement these strategies into your daily schedule.

As you write, think about what gives you energy and fuels your passion. Use your journal to write about all you accomplish in a day, what you are grateful for and what is good about you as a person. When you experience a tough day, look back on these and remember there are brighter days ahead. Not all caregiving is bad or difficult. There are positive memories, moments of laughter and triumphs (no matter how small they may be). Record these good moments in your journal.

How do I get started?

Get a journal and a pen to write with- Purchase a prompted journal or blank one, along with a writing instrument.
Next create solitude- Give yourself ten minutes a day of alone time. This could be when you wake up or before you go to bed.
Now you have created a time and space to journal, there are no restrictions. Write about whatever you like each day, even briefly. Remember, you can speak what is on your mind but there is a certain power in seeing your truth in the written word.

(www.caregiver.com)

Dealing with Caregiver Guilt

by Malika Brown, MSW, LSW

Caregivers often carry around undeserved guilt, believing that they aren’t doing enough for their loved ones. This guilt can make the caregiving role even more stressful than it already is. One might ask why a caregiver feels guilty when they’re doing such a courageous job. Here are some reasons:

Resentment for personal time lost – It’s normal to feel like you’re missing something when so much of your time is taken up taking care of someone else. The caregiver thinks that they shouldn’t feel this way.

Unresolved issues – Many times, there are issues stemming from childhood or arguments in the past that hinder the caregiving process. Many caregivers feel guilty about this.

Comparing yourself to others – Some caregivers will look at another caregiver and think that they could never accomplish what that other person did.

Knowing placement is inevitable – There can be tremendous guilt involved when a caregiver has to place their loved one in assisted living or a nursing home.

Dealing with your own issues – You may be dealing with personal or health problems yourself, which takes away from your caregiving responsibilities.

Ways to Cope with Caregiver Guilt

Acknowledge the guilt – It’s normal to feel guilt from time to time. Once it’s recognized, we are better able to deal with it.

Look at the bigger picture – Although you may be stressed with a particular situation now, it will not last forever. Look at the sacrifices you make for your loved one and realize that you are doing a great job.
Accept that you’re human and have flaws – All of us make mistakes from time to time. Some of us may be good at the physical aspects of caregiving, while others may be better able to handle the emotional toll. Recognize your strengths and don’t focus on the negative.
Make time for yourself – This is easier said than done, but it’s a must! Even if it’s just an hour or two a week, go out and have coffee with a friend, catch a movie, attend a caregiver support group, or just curl up and read a book. Taking time out helps you put your situation in better perspective.
Know that you are making the best decision for you and your loved one at that time – This can be hard to accept, especially if you’ve made a promise to a loved on in the past that you can no longer keep. A change in a situation may force you to break that promise, but realize that the promise was made under different circumstances. You are making the best decision with new circumstances.
Deal with unresolved issues or accept them for what they are – Many times, we may be taking care of someone who we resent, for many reasons. You can choose to try and resolve those feelings from the past to allow you to care for that person fairly. You can also choose to allow someone else to care for that person because you know you cannot rightfully do so. Either way, this is something you need to consider if your past with that person is an issue for you. Talk to a professional if necessary to make the best decision for both you and your loved one.
Reach out for support from family and friends; seek caregiver support groups or professional help to work through your feelings of guilt. Know that you are not alone in your caregiving journey and the help is available. Most of all, remember that you are doing the best that you can!

Helping Children Cope

with Traumatic Events

Children and teens are more vulnerable to being traumatized by the coronavirus pandemic, violent crime, or other disasters. But with the right parental support, they’re also able to recover faster. The effects of trauma on children and teens.

Being involved in the COVID-19 pandemic, a serious accident, violent crime, terrorist attack, or natural disaster, such as an earthquake or hurricane, can be overwhelmingly stressful for children. A disaster, crisis, or other troubling event can cause traumatic stress, undermine your child’s sense of security, and leave them feeling helpless and vulnerable—especially if the event stemmed from an act of violence, such as a mass shooting or terrorist attack. Even kids or teens not directly affected by a disaster can become traumatized when repeatedly exposed to horrific images of the event on the news or social media.

Whether your child lived through the disturbing event itself, witnessed it, or experienced traumatic stress in the aftermath, they’re likely to be affected by an array of intense, confusing, and frightening emotions. While unpleasant symptoms may fade over time, there’s plenty you can do as a parent or guardian to support and reassure a traumatized child. Using these coping tips, you can help your child manage symptoms of traumatic stress, rebuild their sense of safety, and move on from the traumatic event.

Signs and symptoms of traumatic stress in kids and teens

Traumatic stress is a normal reaction to a natural or manmade disaster or other disturbing event. It can leave children of any age feeling overwhelmed by stress and trigger a wide range of intense emotions and physical or behavioral reactions. These in turn can affect your child’s mood, appetite, sleep, and overall well-being.

Signs of Trauma in Kids and Teens

Infants under age 2 may:

Fuss more or be harder to soothe
Exhibit changes in sleep or eating patterns
Appear withdrawn

Children age 2 to 5 may:

Show signs of fear
Cling to parent or caregiver more
Cry, scream, or whine
Move aimlessly or freeze up
Regress to earlier childhood behaviors, such as thumb-sucking or bedwetting

Children age 6 to 11 may:

Lose interest in friends, family, or activities they used to enjoy
Experience nightmares or other sleep problems
Become moody, disruptive, or angry
Struggle with school and homework
Complain of physical problems such as headaches or stomachaches
Develop unfounded fears
Feel depressed, emotionally numb, or guilty over what happened

Adolescents age 12 to 17 may:

Have flashbacks to the event, suffer from nightmares or other sleep problems
Avoid reminders of the event
Abuse alcohol, drugs, or nicotine products
Act disruptive, disrespectful, or aggressive
Complain of physical ailments
Feel isolated, guilty, or depressed
Lose interest in hobbies and interests
Have suicidal thoughts

Whatever the age of your child, it’s important to offer extra reassurance and support following a traumatic event. With your love and guidance, the unsettling thoughts and feelings of traumatic stress can start to fade and your child’s life can return to normal in the days or weeks following the crisis or disturbing event.

Helping your child cope with a disaster or traumatic event

Your child’s reaction to a disaster or traumatic event can be greatly influenced by your own response. Children of all ages—even independence-seeking teenagers—look to their parents for comfort and reassurance at times of crisis. If you experienced the traumatic event alongside your child, it’s crucial to take steps to cope with your own traumatic stress.

Even young infants can pick up on their parents’ anxiety and stress. By taking care of your own emotional health and well-being, you’ll be more of a calming influence and better able to help your child. Since the childhood impulse to imitate is strong, if your child sees you taking steps to cope with the effects of the trauma, they’re likely to follow.

You can also:

Remember that children react to trauma in different ways. And their feelings can come and go in waves. Your child may be moody and withdrawn at certain times, frozen with grief and fear at other times. There’s no “right” or “wrong” way to feel after a traumatic event so don’t try to dictate what your child should be thinking or feeling.

Encourage your child to openly share their feelings. Let them know that whatever feelings they are experiencing are normal. Even unpleasant feelings will pass if your child opens up about them. While many teens may be reluctant to talk about their feelings with a parent, encourage them to confide in another trusted adult such as a family friend, relative, teacher, or religious figure. It’s important to talk—even if it’s not with you.

Allow them to grieve any losses. Give your child time to heal and to mourn any losses they may have experienced as a result of the disaster or traumatic event. That could be the loss of a friend, relative, pet, home, or simply the way their life used to be.

Discourage your child from obsessively reliving the traumatic event. Continually dwelling on or replaying footage of the event can overwhelm your child’s nervous system. Encourage activities that keep your child’s mind occupied so they’re not solely focusing on the traumatic event. You could read to your child, play games together, or simply watch an uplifting movie.

De-stress as a family. Even young children can use simple breathing exercises to relieve stress and feel more at ease in the world, while older kids may be able to master other relaxation techniques.

Tip 1: Rebuild trust and safety

Trauma can alter the way a child or teen sees the world, making it suddenly seem a much more dangerous and frightening place. Your child may find it more difficult to trust both their environment and other people. You can help by rebuilding your child’s sense of safety and security.

Make your child feel safe again. Hugging and reassuring can help make a child of any age feel secure. While teens may try to tough it out and avoid being held, your physical affection is still important in making them feel safe again.

Encourage your child to pursue activities they enjoy. Try to make sure your child has space and time for rest, play, and fun.

Maintain routines. Establishing a predictable structure and schedule to your child’s life can help to make the world seem more stable again. Try to maintain regular times for meals, homework, and family activities.

Speak of the future and make plans. This can help counteract the common feeling among traumatized children that the future is scary, bleak, and unpredictable.

Keep your promises. You can help to rebuild your child’s trust by being trustworthy. Be consistent and follow through on what you say you’re going to do.

If you don’t know the answer to a question, don’t be afraid to admit it. Don’t jeopardize your child’s trust in you by making something up.

Remember that children often personalize situations. They may worry about their own safety even if the traumatic event occurred far away. Reassure your child and help place the situation in context.

Tip 2: Minimize media exposure

Children who’ve experienced a traumatic event can often find relentless media coverage to be further traumatizing. Excessive exposure to images of a crisis or disturbing event—such as repeatedly viewing video clips on social media or news sites—can even create traumatic stress in children or teens who were not directly affected by the event.

Limit your child’s media exposure to the traumatic event. Don’t let your child watch the news or check social media just before bed, and make use of parental controls on the TV, computer, and phone to prevent your child from repeatedly viewing disturbing footage.

As much as you can, watch news reports of the traumatic event with your child. You can reassure your child as you’re watching and help place information in context.

Avoid exposing your child to graphic images and videos. It’s often less traumatizing for a child or teen to read the newspaper rather than watch television coverage or view video clips of the event.

Tip 3: Engage your child

You can’t will your child to recover from a traumatic experience, but you can play a major role in the healing process by simply spending time together and talking face to face—free from TV, phones, video games, and other distractions. Do your best to create an environment where your kids feel safe to communicate what they’re feeling and to ask questions.

Provide your child with ongoing opportunities to talk about what they went through or what they’re seeing in the media. Encourage them to ask questions and express their concerns but don’t force them to talk.

Communicate with your child in an age-appropriate way. Younger children, for example, will respond to reassuring hugs and simple phrases such as “It’s over now” or “It’s all going to be okay.” Older children, though, will draw more comfort from hearing facts and information about what happened.

Acknowledge and validate your child’s concerns. The traumatic event may bring up unrelated fears and issues in your child. Comfort for your child comes from feeling understood and accepted by you, so acknowledge their fears even if they don’t seem relevant to you.

Reassure your child. The event was not their fault, you love them, and it’s okay for them to feel upset, angry, or scared.

Don’t pressure your child into talking. It can be very difficult for some kids to talk about a traumatic experience. A young child may find it easier to draw a picture illustrating their feelings rather than talk about them. You can then talk with your child about what they’ve drawn.

Be honest. While you should tailor the information you share according to your child’s age and personality, honesty is important. Don’t say nothing’s wrong if something is wrong.

Do “normal” activities with your child that have nothing to do with the traumatic event.

Encourage your child to seek out friends and pursue games, sports, and hobbies that they enjoyed before the incident. Go on family outings to the park, enjoy a games night, or watch a movie together.

Tip 4: Encourage physical activity

Physical activity can burn off adrenaline, release mood-enhancing endorphins, and help your child or teen sleep better at night.

Find a sport that your child enjoys. Activities such as basketball, soccer, running, martial arts, or swimming that require moving both the arms and legs can help rouse your child’s nervous system from that “stuck” feeling that often follows a traumatic experience.

Offer to participate in sports, games, or physical activities with your child. If they seem resistant to get off the couch, play some of their favorite music and dance together. Once a child gets moving, they’ll start to feel more energetic.

Encourage your child to go outside to play with friends or a pet and blow off steam.

Schedule a family outing to a hiking trail, lake, or beach. Spending time in nature can ease stress and boost a child’s overall mood.

Take younger children to a playground, activity center, or arrange play dates.

Tip 5: Feed your child a healthy diet

The food your child eats can have a profound impact on their mood and ability to cope with traumatic stress. Processed and convenience food, refined carbohydrates, and sugary drinks and snacks can create mood swings and worsen symptoms of traumatic stress. Conversely, eating plenty of fresh fruit and vegetables, high-quality protein, and healthy fats can help your child or teen better cope with the ups and downs that follow a disturbing experience.

Focus on overall diet rather than specific foods. Kids should be eating whole, minimally processed food—food that is as close to its natural form as possible.

Limit fried food, sweet desserts, sugary snacks and cereals, and refined flour. These can all negatively affect a child’s mood.

Cook more meals at home. Restaurant and takeout meals have more added sugar and unhealthy fat so cooking at home can have a huge impact on your kids’ health.

Make mealtimes about more than just food. Gathering the family around a table for a meal is an ideal opportunity to talk and listen to your child without the distraction of TV, phones, or computers.

When to seek treatment for your child’s trauma

Usually, your child’s feelings of anxiety, numbness, confusion, guilt, and despair following a crisis, disaster, or other traumatic event will start to fade within a relatively short time. However, if the traumatic stress reaction is so intense that it interferes with your child’s ability to function at school or home—or if the symptoms don’t begin to fade or even become worse over time—they may need help from a mental health professional.

When traumatic stress symptoms don’t ease up and your child’s nervous system remains “stuck,” unable to move on from the event for a prolonged period of time, they may be experiencing post-traumatic stress disorder (PTSD).

Warning signs include:

Six weeks have passed, and your child is not feeling any better
Your child is having trouble functioning at school
Your child is experiencing terrifying memories, nightmares, or flashbacks
The symptoms of traumatic stress manifest as physical complaints such as headaches, stomach pains, or sleep disturbances
Your child is having an increasingly difficult time relating to friends and family
Your child or teen is experiencing suicidal thoughts
Your child is avoiding more and more things that remind them of the traumatic event

Suicide prevention

in traumatized kids and teens

Take any suicidal talk or behavior seriously. It’s not just a warning sign that your child or teen is thinking about suicide—it’s a cry for help. Please read Suicide Prevention or call a suicide helpline:

In the U.S., call National Suicide Prevention Lifeline at 1-800-273-8255.
In the UK, call Samaritans at 08457 90 90 90.
In Australia, call Lifeline at 13 11 14.
In other countries, visit IASP to find a helpline near you.

www.helpguide.org

Written by: Melinda Smith, M.A., Lawrence Robinson, and Jeanne Segal, Ph.D.

creative-fruit-dessert-with-kiwi-banana-

Being Stoic for Another's Sake

Comes at A High Cost --

After the Death of a Child.

Is Your Way of Grieving Working?

(Research results and article written by the Association for Psychological Science)

In the wealth of studies about parental grief, little attention has been paid to precisely how couples relate to each other as they struggle to come to terms with the death of a child. A new study addresses this gap in bereavement research by focusing on the way that couples together process the grief of losing a child.

Among life's many tragedies, the death of a child is one that is perhaps the greatest for parents. No matter what the age of the child or the cause of death, the irrefutable fact of the loss is one that shatters the normal cycle of life, leaving parents traumatized and often incapacitated by grief. Research on coping with bereavement has focused primarily on the individual, despite the fact that family and married relationships are all profoundly disrupted by the loss. But in the wealth of studies about parental grief, little attention has been paid precisely to how couples relate to each other as they struggle to come to terms with the death of a child.

A new research article published in Psychological Science, a journal of the Association for Psychological Science, addresses this gap in bereavement research by focusing on the way that couples together process the grief of losing a child. "Scientific literature focused on individual rather than interdependent processes in coping with bereavement, despite the fact that bereaved people do not grieve alone and the way one person grieves likely influences another," says psychological scientist Margaret Stroebe, who conducted the research with her colleagues at the Utrecht University and VU University Amsterdam.

In this study, the researchers interviewed 219 couples who had lost a child. The parents were from 26 to 68 years old, and the causes of their children's death ranged from stillbirth, to illness, accident, SIDS, suicide or homicide. They were asked to rate how much they agreed with statements like, "I stay strong for my partner," "I hide my feelings for the sake of my partner," or "I try to spare my partner's feelings." The researchers collected the data at three different timepoints: six, thirteen and twenty months after the loss. These questions examined a phenomenon they referred to as "Partner-Oriented Self-Regulation" (POSR), which captures the way in which couples either avoided discussion of their loss or attempted to remain strong for the sake of the partner. Many husbands and wives believe that these two strategies help to alleviate grief, but Stroebe and her colleagues found that the strategies actually exacerbated the problems of grieving. They found that POSR was not only associated with an increase in the person's own grief, but also with an increase in the partner's grief. Moreover, these relationships persisted over time.

There is a paradox, Stroebe says, "While parents seek to protect their partners through POSR, this effort has the opposite effect, and it is associated with worse adjustment over time. Surprisingly, our results suggest that POSR has costs, not benefits, and not only for the partner but also for the self."

These surprising results may be explained by the role of self-regulation in the grieving process. Our ability to self-regulate is essential for dealing with the world, but exerting excessive efforts to contain our emotions and regulate our feelings, thoughts, and behavior exact important

interpersonal and individual costs. Like a muscle that becomes exhausted after exertion, too much self-regulation actually depletes our ability to self-regulate in various domains, including physical health and goal accomplishment.

Ultimately, these attempts at self-regulation may prevent partners from coping with the loss of their child. Suppressing emotions can have adverse effects on grief between couples. One partner may think that painful feelings aren't accepted, for example, or a partner might misinterpret no apparent grief as a lack of actual grief. "One important implication of this research is that, when appropriate, parents can move away from POSR and toward sharing their grief, thereby easing their suffering," Stroebe says.

(www.griefHaven.org)

Grieving the loss of a parent: it’s personal

by Jane Vock

Nancy Kriseman, author of The Mindful Caregiver, draws on the concept of “finishing well” to describe a way to approach loss. What does it mean to “finish well” and what is required of you as a caregiver, as a daughter or son, to do this? First off, it means working on your “unfinished business.” Alright, so what is that? For caregivers, it means when you are stuck in negative feelings about your caregiving situation and experiences such as guilt, anger, regret, resentment, etc. When stuck in these negative feelings, the natural flow of grieving is blocked and this can, in Kriseman’s words, “…wreak havoc on your mind, body, and spirit.”

Let go of all judgements and criticisms. Yes, all of them!

In truth, you did the best you could as a caregiver. Period. If you could have done better, you would have. Your parent also did the best they could. If they could have been a “better parent” or “better care receiver,” they would have. Period. This is a time to let go. If you are stuck in anger, guilt, or resentment, for example, the natural feelings of grief that typically come with loss become blocked. And in essence, you create more “unfinished business.”

As with all other LifeStages of caregiving, you will experience this Closing Lifestage with more ease if you allow the feelings to come up and flow through you. Caregivers are no strangers to loss. In fact, the entire caregiving journey is often defined by various types of loss. When the end of caregiving is approaching because your mom or dad is nearing death or has already died, there is also the loss of a caregiving role/identity as well as the loss of a father or a mother.

What is the best advice?

Grieve it out. Complete the experience. Grief is a natural response to loss. While we usually associate grief with the death of someone, any loss can trigger grief including the loss of the caregiver role (loss of identity) and the loss of a cherished dream (how you imagined your life would be, your relationship with your parents or aging would be, retirement would be, etc.).

Some people may refer to the stages of grief and this may be a helpful type of map for you to make sense of how you are feeling and may feel in the future. Be careful, however, not to impose a rigid way of grieving onto yourself.

Elizabeth Kubler-Ross, widely known as the expert on grief and grieving in North America, wisely states that the stages of grief “…were never meant to help tuck messy emotions into neat packages…there is not a typical response to loss , as there is no typical loss. Our grieving is as individual as our lives.”

The messiness of grief makes us acutely aware that the processing of loss cannot be controlled, and is, by definition, untidy and complicated. The only thing you can do “wrong,” so to speak, is to push your feelings away, ignore them, dismiss them, or judge them.

Common grief responses

Even though there is tremendous variability, there are some common grief responses:

shock and disbelief
sadness
guilt and remorse
regret
anxiety
fear
doubt
heaviness
anger and blaming
frustration
dread
feeling of being separate
feeling lost
loss of interest
feeling helpless
hopelessness
a yearning
tiredness/fatigue
lack of appetite
insomnia
dreams and/or nightmares
relief
peace
joy

I know. The list is long! You may be surprised to see relief, peace, and joy on the list. Grief and relief can, and often does, show up at the same time. Caregivers who are grieving are often reluctant to publicly acknowledge these latter feelings and can even judge these feelings and then feel guilty. Yikes! Add this guilt to your “unfinished business.”

The process of grief and grieving

So-called ‘normal’ or common grief often begins with the experience of highly intense, time-limited periods of distress that are sometimes referred to as grief bursts or pangs and metaphorically as a (tidal) wave of grief. The experience of grief symptoms tends to occur less frequently, with a briefer duration and lesser intensity over time. Again, be cautious about imposing or accepting someone else’s imposition of a time frame for your grieving. Experts have no agreement on any specific grieving time period, and the best that can be said is that grieving symptoms resolve within the first year or two.

How you grieve, and even if you grieve, depends on many factors including your personality, your coping style and strategies, your life experience, your values, your faith and/or spiritual belief system, the quality of the relationship with the person you were caring for, and the nature of the loss (its significance to you). These factors (and perhaps others not cited here) are exactly what make grieving a highly personal and individual experience.

If you have questions as to whether you are experiencing ‘normal’ grieving, you can consult a health care professional. It may also be beneficial to access a bereavement group or bereavement counseling.

(www.elizz.com)

What is Hospice?

by Jon Radulovic, MA

Hospice seeks to “de-institutionalize” the dying experience and provide a more humane system of care for those who have received a terminal diagnosis of six months or less. The first hospice program in this country was opened in New Haven, Connecticut in 1972; this was based on the Hospice Model of Care developed by Dame Cicely Saunders at St. Christopher’s Hospice in Great Britain. Currently, there are over 3,000 hospices in the United States and Puerto Rico.

Hospice is a concept of caring that brings comfort and support to people facing a terminal illness, and to their families. Hospice addresses all the symptoms of the disease with special emphasis on controlling pain and discomfort, allowing the patient and family to focus on maintaining quality of life. Hospice also deals with the emotional, social and spiritual impact of the disease on the patient, the patient’s family, and significant others. Hospice care brings this comfort and support directly into the family’s home enabling the patient to spend his or her final days in a familiar and loving environment.

A hospice team consists of physicians, nurses, aides, social workers, spiritual care givers, counselors, therapists, and volunteers – all of whom are specially trained to provide pain and symptom management for the patient and support for the family or other intimate network. Physicians who have been active in the patient’s care are encouraged to be part of this interdisciplinary team.

Because each person’s needs are unique, the hospice team works with the patient and family to develop a personalized care plan which ensures that the patient and family are at the center of all decision making. Always, the focus is on controlling pain, managing symptoms, and providing comfort, dignity and quality of life.

A unique characteristic of hospice care is the availability of bereavement resources that are an integral part of the hospice philosophy. Hospices have trained professionals working to assist the patient and family with the many aspects of grief which are present during the illness and then continue to provide bereavement services to the family for at least one year following the death. Their experience and understanding of the issues relating to grief, loss, and bereavement have led many hospices to serve as bereavement resources for their local community. Many hospices have support groups and other bereavement services available to serve people in need that have not been hospice clients.

Hospice is an aggressive medical choice that focuses on symptom management, comfort, dignity, and quality of life. Hospice neither lengthens life nor hastens death.

Whenever possible, patients are cared for in their own, or a family member’s, home. However, many hospices have facilities that provide the same care for hospice patients and their support networks. Hospice care is also available in nursing homes and other assisted living settings.

Hospice workers provide the patient and family with information and opportunities to participate in the decision making process.

Data shows that hospice care is less costly than care in a hospital.

The Medicare Hospice Benefit covers 100% of hospice services. Many private insurance plans, HMO’s, and Medicaid in many states also offer hospice benefits.

Bereavement care and resources are available to the family for at least one year; no other healthcare delivery system offers such support.

The patient, family, and/or physician can initiate an information/referral call or visit as soon as a terminal disease is diagnosed, or at the time a patient decides to move from a treatment plan focused on curing the disease to a plan focused on providing comfort and pain relief.

Editor's Note: For more information on End-of-Life hospice care, please go to our FAQ page (Frequently Asked Questions). Please click on the button below...

For more info...

Helping Someone with Depression

Your support and encouragement can play an important role in your loved one’s recovery.

Here’s how to make a difference.

How can I help someone with depression?

Depression is a serious but treatable disorder that affects millions of people, from young to old and from all walks of life. It gets in the way of everyday life, causing tremendous pain, hurting not just those suffering from it but also impacting everyone around them.

If someone you love is depressed, you may be experiencing any number of difficult emotions, including helplessness, frustration, anger, fear, guilt, and sadness. These feelings are all normal. It’s not easy dealing with a friend or family member’s depression. And if you neglect your own health, it can become overwhelming.

That said, your companionship and support can be crucial to your loved one’s recovery. You can help them to cope with depression symptoms, overcome negative thoughts, and regain their energy, optimism, and enjoyment of life. Start by learning all you can about depression and how to best talk about it with your friend or family member. But as you reach out, don’t forget to look after your own emotional health—you’ll need it to provide the full support your loved one needs.

Understanding depression in a friend or family member

Depression is a serious condition. Don’t underestimate the seriousness of depression. Depression drains a person’s energy, optimism, and motivation. Your depressed loved one can’t just “snap out of it” by sheer force of will.

The symptoms of depression aren’t personal. Depression makes it difficult for a person to connect on a deep emotional level with anyone, even the people they love the most. It’s also common for depressed people to say hurtful things and lash out in anger. Remember that this is the depression talking, not your loved one, so try not to take it personally.

Hiding the problem won’t make it go away. It doesn’t help anyone involved if you try making excuses, covering up the problem, or lying for a friend or family member who is depressed. In fact, this may keep the depressed person from seeking treatment.

Your loved one isn’t lazy or unmotivated. When you’re suffering from depression, just thinking about doing the things that may help you to feel better can seem exhausting or impossible to put into action. Have patience as you encourage your loved one to take the first small steps to recovery.

You can’t “fix” someone else’s depression. As much as you may want to, you can’t rescue someone from depression nor fix the problem for them. You’re not to blame for your loved one’s depression or responsible for their happiness (or lack thereof). While you can offer love and support, ultimately recovery is in the hands of the depressed person.

Recognizing depression symptoms in a loved one

Family and friends are often the first line of defense in the fight against depression. That’s why it’s important to understand the signs and symptoms of depression. You may notice the problem in a depressed loved one before they do, and your influence and concern can motivate them to seek help.

Be concerned if your loved one…

Doesn’t seem to care about anything anymore. Has lost interest in work, sex, hobbies, and other pleasurable activities. Has withdrawn from friends, family, and other social activities.

Expresses a bleak or negative outlook on life. Is uncharacteristically sad, irritable, short-tempered, critical, or moody; talks about feeling “helpless” or “hopeless.”

Frequently complains of aches and pains such as headaches, stomach problems, and back pain. Or complains of feeling tired and drained all the time.

Sleeps less than usual or oversleeps. Has become indecisive, forgetful, disorganized, and “out of it.”

Eats more or less than usual, and has recently gained or lost weight.

Drinks more or abuses drugs, including prescription sleeping pills and painkillers.

How to talk to someone about depression

Sometimes it is hard to know what to say when speaking to someone about depression. You might fear that if you bring up your worries the person will get angry, feel insulted, or ignore your concerns. You may be unsure what questions to ask or how to be supportive.

If you don’t know where to start, the following suggestions may help. But remember that being a compassionate listener is much more important than giving advice. You don’t have to try to “fix” your friend or family member; you just have to be a good listener. Often, the simple act of talking face to face can be an enormous help to someone suffering from depression. Encourage the depressed person to talk about their feelings, and be willing to listen without judgment.

Don’t expect a single conversation to be the end of it. Depressed people tend to withdraw from others and isolate themselves. You may need to express your concern and willingness to listen over and over again. Be gentle, yet persistent.

Ways to start the conversation:

“I have been feeling concerned about you lately.”

“Recently, I have noticed some differences in you and wondered how you are doing.”

“I wanted to check in with you because you have seemed pretty down lately.”

Questions you can ask:

“When did you begin feeling like this?”

“Did something happen that made you start feeling this way?”

“How can I best support you right now?”

“Have you thought about getting help?”

Remember, being supportive involves offering encouragement and hope. Very often, this is a matter of talking to the person in language that they will understand and can respond to while in a depressed state of mind.

Tips for Talking about Depression

What you CAN say that helps:

“You’re not alone. I’m here for you during this tough time.”
“It may be hard to believe right now, but the way you’re feeling will change.”
“Please tell me what I can do now to help you.”
“Even if I’m not able to understand exactly how you feel, I care about you and want to help.”
“You’re important to me. Your life is important to me.”
“When you want to give up, tell yourself you will hold on for just one more day, hour, or minute—whatever you can manage.”

What you should AVOID saying:

“This is all in your head”
“Everyone goes through tough times.”
“Try to look on the bright side.”
“Why do you want to die when you have so much to live for?”
“I can’t do anything about your situation.”
“Just snap out of it.”
“You should be feeling better by now.”

The risk of suicide is real.

What to do in a crisis situation.

If you believe your loved one is at an immediate risk for suicide, do NOT leave them alone!

In the U.S., dial 911 or call the National Suicide Prevention Lifeline at 1-800-273-TALK.

In other countries, call your country’s emergency services number or visit IASP to find a suicide prevention helpline.

It may be hard to believe that the person you know and love would ever consider something as drastic as suicide, but a depressed person may not see any other way out. Depression clouds judgment and distorts thinking, causing a normally rational person to believe that death is the only way to end the pain they’re feeling.

Since suicide is a very real danger when someone is depressed, it’s important to know the warning signs:

Talking about suicide, dying, or harming oneself; a preoccupation with death
Expressing feelings of hopelessness or self-hate
Acting in dangerous or self-destructive ways
Getting affairs in order and saying goodbye
Seeking out pills, weapons, or other lethal objects
A sudden sense of calm after depression

If you think a friend or family member might be considering suicide, don’t wait, talk to them about your concerns. Many people feel uncomfortable bringing up the topic but it is one of the best things you can do for someone who is thinking about suicide. Talking openly about suicidal thoughts and feelings can save a person’s life, so speak up if you’re concerned and seek professional help immediately!

Encouraging the person to get help

While you can’t control someone else’s recovery from depression, you can start by encouraging the depressed person to seek help. Getting a depressed person into treatment can be difficult. Depression saps energy and motivation, so even the act of making an appointment or finding a doctor can seem daunting to your loved one. Depression also involves negative ways of thinking. The depressed person may believe that the situation is hopeless and treatment pointless.

Because of these obstacles, getting your loved one to admit to the problem—and helping them see that it can be solved—is an essential step in depression recovery.

If your friend or family member resists getting help:

Suggest a general check-up with a physician. Your loved one may be less anxious about seeing a family doctor than a mental health professional. A regular doctor’s visit is actually a great option, since the doctor can rule out medical causes of depression. If the doctor diagnoses depression, they can refer your loved one to a psychiatrist or psychologist. Sometimes, this “professional” opinion makes all the difference.

Offer to help the depressed person find a doctor or therapist and go with them on the first visit. Finding the right treatment provider can be difficult, and is often a trial-and-error process. For a depressed person already low on energy, it is a huge help to have assistance making calls and looking into the options.

Encourage your loved one to make a thorough list of symptoms and ailments to discuss with the doctor. You can even bring up things that you have noticed as an outside observer, such as, “You seem to feel much worse in the mornings,” or “You always get stomach pains before work.”

Supporting your loved one’s treatment

One of the most important things you can do to help a friend or relative with depression is to give your unconditional love and support throughout the treatment process. This involves being compassionate and patient, which is not always easy when dealing with the negativity, hostility, and moodiness that go hand in hand with depression.

Provide whatever assistance the person needs (and is willing to accept). Help your loved one make and keep appointments, research treatment options, and stay on schedule with any treatment prescribed.

Have realistic expectations. It can be frustrating to watch a depressed friend or family member struggle, especially if progress is slow or stalled. Having patience is important. Even with optimal treatment, recovery from depression doesn’t happen overnight.

Lead by example. Encourage the person to lead a healthier, mood-boosting lifestyle by doing it yourself: maintain a positive outlook, eat better, avoid alcohol and drugs, exercise, and lean on others for support.

Encourage activity. Invite your loved one to join you in uplifting activities, like having dinner. Exercise is especially helpful, so try to get your depressed loved one moving. Going on walks together is one of the easiest options. Be gently and lovingly persistent—don’t get discouraged or stop asking.

Pitch in when possible. Seemingly small tasks can be very hard for someone with depression to manage. Offer to help out with household responsibilities or chores, but only do what you can without getting burned out yourself!

Taking care of yourself

There’s a natural impulse to want to fix the problems of people we care about, but you can’t control someone else’s depression. You can, however, control how well you take care of yourself. It’s just as important for you to stay healthy as it is for the depressed person to get treatment, so make your own well-being a priority.

Remember the advice of airline flight attendants: Put on your own oxygen mask before you assist anyone else. In other words, make sure your own health and happiness are solid before you try to help someone who is depressed. You won’t do your friend or family member any good if you collapse under the pressure of trying to help. When your own needs are taken care of, you’ll have the energy you need to lend a helping hand.

Speak up for yourself. You may be hesitant to speak out when the depressed person in your life upsets you or lets you down. However, honest communication will actually help the relationship in the long run. If you’re suffering in silence and letting resentment build, your loved one will pick up on these negative emotions and feel even worse. Gently talk about how you’re feeling before pent-up emotions make it too hard to communicate with sensitivity.

Set boundaries. Of course you want to help, but you can only do so much. Your own health will suffer if you let your life be controlled by your loved one’s depression. You can’t be a caretaker round the clock without paying a psychological price. To avoid burnout and resentment, set clear limits on what you are willing and able to do. You are not your loved one’s therapist, so don’t take on that responsibility.

Stay on track with your own life. While some changes in your daily routine may be unavoidable while caring for your friend or relative, do your best to keep appointments and plans with friends. If your depressed loved one is unable to go on an outing or trip you had planned, ask a friend to join you instead.

Seek support. You are NOT betraying your depressed relative or friend by turning to others for support. Joining a support group, talking to a counselor or clergyman, or confiding in a trusted friend will help you get through this tough time. You don’t need to go into detail about your loved one’s depression or betray confidences; instead focus on your emotions and what you are feeling. Make sure you can be totally honest with the person you turn to—choose someone who will listen without interruption and without judging you.

Authors: Melinda Smith, M.A., Lawrence Robinson, and Jeanne Segal, Ph.D.

(www.helpguide.org)

Caregiving Issues Facing

the Multi-Generational Family

by Helen Hunter, ACSW, LSW

There are many family situations today where you can find three, four or even five generations living under one roof. While the circumstances that result in multi-generational living vary from financial to health-related to simple family closeness, those who live in these types of households deal with many issues. Serving as the main caregiver for an older relative, dealing with grandchildren and having one of their own children living back at home after several years on his/her own can be a challenge for the best of families.

In dealing with your older relative, the most critical aspect is not just tending to their physical needs, but providing them with the emotional support they require as well. Often, it is coping with these emotional needs that is most time consuming and stressful. Family members often ask “How do I talk to my relative about. . . “(You fill in the blank.) The answer is “Not easily.”

Remember, your job is to help your older relative make informed, reasonable decisions for themselves, not to make the decision for them. It is also important to realize that they may be frightened about their overall condition, and that this frightened state is relayed through anger toward YOU, the main caregiver. It is crucial to keep the lines of communication open between the generations so that both of you can express your fears and concerns as honestly as possible. You may also wish to gain as much knowledge as possible regarding the older person’s condition so that you know what to expect of them now and in the future. In that way, you can let them maintain their sense of independence and well-being and provide the needed care when it becomes necessary.

Children, even at an early age, can be asked to take on family responsibilities. They can be very helpful and resourceful. They can perform everyday chores like cleaning and help in preparation of meals and laundry. They can also help Grandma or Grandpa by sitting with them, reading together or watching TV, among other things. By involving children, you are giving them an honest look into the daily caregiving process and you open the door to start a dialogue about aging issues in general.

The relationship between an older relative and a child is invaluable in that the older person provides educational and historical information that is passed on to another generation and the child can give new and fresh insight on things for the older person.

When an older relative begins to fail, either mentally or physically, it can be very confusing and sometimes frightening for a child. There are many resources geared specifically for children that explain the aging process. Children are seen as extremely therapeutic assets as families deal with the daily issues associated with the care of a relative.

Older relatives can also be an invaluable resource to their grandchildren. They can serve as educators, story tellers and, in many instances, serve as the primary providers of care to their grandchildren. Many older people end up “raising” their grandchildren due to a variety of circumstances. These older relatives struggle not only with the daily demands of care needed by their grandchildren, but also with the concerns and struggles that their own children (the grandchildren’s parents) face and their own health and financial issues.

Those who are in the “sandwich generation” often are faced with the daily demands of care needed by their parents or older relatives AND are responsible for the raising of their own children. In addition, they may have to deal with their own health and financial worries. Other responsibilities faced by this generation include the demands of a work schedule and their relationship with a spouse or significant other, in addition to their ongoing relationship with siblings and close friends.

Regardless of their age, there are many instances where the main caregiver in the family refuses to acknowledge that they can’t handle the load. They are too caught up in the daily grind that they don’t recognize the warning signals, which can include extreme fatigue, lack of rest, irritability, and frustration over lack of free time. Letting others know your feelings and that you need help is crucial to the caregiver’s mental and physical well-being.

It is also important to negotiate the exact roles of each family member in terms of providing care. Some may feel more comfortable with hands-on duties – others may want to only focus on household chores or helping with transportation or financial and legal issues.

There are many instances where the care receiver is very stubborn and resistant to any help, even from family members. In these cases you need to be FIRM in expressing the reality of the situation and that the person needs assistance. It is particularly important for those living in multi-generational households who often are providing 24 hours a day/7 days a week care to have an occasional respite break.

With family members living longer, many individuals are faced with the prospect of being a caregiver for a significant number of years. More and more families are opting to live in a multi--generational household for a variety of reasons, including providing care for a loved one. It is important for the family to recognize that, in many cases, they will not be able to tend to all the needs of their relative, and that they will have to rely on others for occasional support. The support is available – just ask.