By Carol Zernial
WellMed Charitable Foundation Executive Director

While cleaning out the piles of articles, papers, books, cassettes, etc. that belonged to my mother, we discovered that her anxiety was much more severe than we had realized. We knew that she suffered from anxiety and had once been diagnosed with Panic Disorder, but we didn’t know how hard she worked at managing it.

My sister made an interesting observation: Mother’s anxiety-reducing techniques that she used every day were so ingrained that she was still putting them to good use when she moved into a memory care unit where everything was different – homelike but not home. Alzheimer’s had taken away her words, memories and so much more, but her muscle memory for calming herself was observably intact.

Dancers use muscle memory all of the time. Choreography and steps can be so complex that we can’t consciously think through each individual movement for each part of our body simultaneously. Competitive athletes instinctively adjust to the moves of their opponents, handle the ball effortlessly, and ski or swing the club/bat/racket etc. with the muscle memory of a lifetime of practicing these exact moves over and over again.

My mother could still peel potatoes in the kitchen without any help long after she couldn’t put together a sentence. Muscle memory goes deep. It is routine repetition. They say that anything can become a habit if you practice it for at least 3 months. So what habits would we like to have as caregivers and just to live a better life?

If someone with dementia can retrieve the deeply embedded habits of a long “cleansing” breath, of using humor to calm a tense situation, of reciting words of reassurance to herself and others, we as caregivers can develop muscle memory for habits that we want to exhibit without thinking.

For those of us who seem to be angry all of the time, we can develop the habit of asking ourselves why we are angry and at what or who? This simple question might help us find the real source of our frustration: It could be us. Perhaps we don’t really know what to do. Perhaps we are simply hungry or tired. Perhaps something significant needs to change.

For those of us who are on the run all of the time, overwhelmed by our long “to-do” lists, we can develop the habit of asking ourselves which of our tasks are the most important. What do we have to do today? What can someone else do? What can wait? Can we simply give up?

For those of us who think that everyone and everything is against us, we can ask ourselves if someone or something is really out to get us. Why do we think that person is acting that way? If we were in their shoes, how would we act? If we ran that company, how would we respond to us? We can get in the habit of assuming positive intent and tilting towards being empathetic rather than coming out fighting.

Muscle memory can either keep us in the rut we are currently in by doing the same things over and over. Or we can strengthen some new muscles, and develop new routines and responses that serve us better in our busy lives. If we keep practicing them until they are truly ours, we won’t even have to think about it.

WellMed Charitable Foundation Executive Director Carol Zernial is a noted gerontologist, radio show host, and emeritus Chair of the National Council on Aging. The non-profit WellMed Charitable Foundation focuses on complimentary programs impacting seniors and family caregivers, including weekly telephone learning sessions, evidence-based classes on stress reduction and more. Find out more at www.CaregiverSOS.org or toll-free at 1-866-390-6491.

WellMed Charitable Foundation Executive Director Carol Zernial is a noted gerontologist, radio show host, and emeritus Chair of the National Council on Aging. The non-profit WellMed Charitable Foundation focuses on complimentary programs impacting seniors and family caregivers, including weekly telephone learning sessions, evidence-based classes on stress reduction and more. Find out more at www.CaregiverSOS.org or toll-free at 1-866-390-6491.

By Carol Zernial
WellMed Charitable Foundation Executive Director

Sometimes when we hear a speaker or read a book, the words really ring true to us. We’ll nod our heads in agreement or feel like this is how we wish everything could be. Because I have the privilege of interviewing authors and speakers who are caregiving experts for the Caregiver SOS on Air podcasts (free at www.caregiversos.org), I often have these moments of recognition. Here are some I found the most meaningful and helpful.

» Happiness is a choice we make: John Leland, journalist for The New York Times and author of the book of the same name, really hit this home for me. It was like John had joined forces with my late mother who was an original member of the “power of positive thinking” club. Choosing happiness doesn’t mean that our circumstances have changed or that everything is rosy. It means that we can let go of the negative emotions that swamp us and drag us down. We can do this through gratitude, curiosity, faith, or even sheer willpower. John indicates that it gets easier the more we practice. After all, we can’t really change anybody except ourselves.

» Share the care — organize a group to provide care: Sheila Warnock made me wonder how I had missed creating, not a support group, but a group of people to provide care. So many caregivers go it alone or with a family member or two. Through her book, she describes how two caring people can set up teams to break down caregiving tasks into doable bites that prevent any one caregiver from burning out. A “funny family” is a larger group of family, friends, willing colleagues, etc., who provide different aspects of care over time. The teams can be mobilized for a variety of situations – from a serious illness to a difficult pregnancy.

» Let the professional be the bad guy: Our friend and psychologist, Dr. Jamie Huysman, is a strong voice for letting licensed professionals, such as professional geriatric care managers, physicians, first responders, and psychologists, deliver any difficult news – like when it’s time to give up the car keys. We know what happens to the messenger, right? This allows us as the family member or friend to be there to acknowledge the difficulty of the situation and provide the love and comfort. There are times when professional assistance is worth the investment.

» We are not right or up because we are well, and those who are sick are not down or wrong: I have never had the pleasure of interviewing author Deborah Duda, but her words changed my thinking about illness and death. We allow way too much judgement to get wrapped around caregiving, sickness, and dying. We sometimes forget that illness and death are simply a part of life. It’s refreshing that we have started talking about living with Alzheimer’s, living with cancer, living with disability. This allows us and the person for whom we care caring to be actively engaged in life, and prevents the isolation that traps caregivers and their loved ones.

It is easy these days to feel like we have information overload. It can be hard to tune out the voices in our heads or on the news, and hear words of hope, healing, acceptance and life. We have to be willing to hear them, and willing to change our thinking. Change can be a challenge, so we can’t be discouraged if we fall off the horse or have to try again. Wouldn’t it be nice to feel better, to let go of the anger and resentment, to make positive choices, and to feel alive, too? It sounds like good advice.

WellMed Charitable Foundation Executive Director Carol Zernial is a noted gerontologist, radio show host, and emeritus Chair of the National Council on Aging. The non-profit WellMed Charitable Foundation focuses on complimentary programs impacting seniors and family caregivers, including weekly telephone learning sessions, evidence-based classes on stress reduction and more. Find out more at www.CaregiverSOS.org or toll-free at 1-866-390-6491.

By Carol Zernial
WellMed Charitable Foundation Executive Director

We all want to be happy. We pop our heads up now and then to measure how happy we are. We buy things that will “make” us happy. We devote quite a bit of time and emotional energy searching for this seemingly allusive state. Don’t we have an inalienable right to life, liberty and the pursuit of happiness? So when we don’t feel happy, something must be wrong with us or our lives, right?

As a reporter for The New York Times, John Leland decided to write about the experiences of the oldest old, which must certainly be a sad tale about the downward spiral of old age, illness and death. This can often be our perspective as well. But the stories became his book, Happiness Is A Choice You Make: Lessons From a Year Among the Oldest Old. In them, John talks about how he went looking for depression and loss, and found people focused on happiness instead. Could this be us, too?

John recently spoke to a large group of caregivers at our annual Caregiver Summit. He wears a shirt with the names of the people he interviewed who are all age 85 and over. Each person made an impression on him with their resilience and positive outlook despite old age, illness, and yes, even death.

Ping Wong had worked physically demanding jobs her entire life – standing on her feet for years. As an older woman who was now physically worn out without much income, she qualified for some home care services – an aide to cook some meals and clean. She was astounded at her good fortune that she was now the care recipient!

The stories John collected each feature someone who can’t help but be happy despite their circumstances. When he realizes that they are happy, not because they are lucky or everything is going their way, but because they choose to be happy, he decides he would like to be more like them. I think this was my biggest take away – how he had internalized the notion that happiness is something we all really can choose. And why not? This type of reframing is exactly what we teach in our Stress-Busting program for caregivers. We can’t change other people or our circumstances, but we can change how we react.

We all want to be happy. What if we counted our blessings every day: The love we feel toward people in our lives, the change of the seasons, soft sheets on the bed, the companionship of a cat or dog. Rather than spending time wondering how to be happy, what if we choose to let go of the worry for things that we can’t really control anyway? What if we made it a goal to find a memory that makes us smile at least once a day? We might even write it down, so it’s easy to find again.

Choosing to be happy isn’t really a new idea. But if it’s us doing the choosing, and it’s our lives that are changing – because we want to feel better and let go of the anxiety and anger, then it’s new to us. I could see the John was serious about reacting differently and living his life differently. What if we choose happiness too?

WellMed Charitable Foundation Executive Director Carol Zernial is a noted gerontologist, radio show host, and emeritus Chair of the National Council on Aging. The non-profit WellMed Charitable Foundation focuses on complimentary programs impacting seniors and family caregivers, including weekly telephone learning sessions, evidence-based classes on stress reduction and more. Find out more at www.CaregiverSOS.org or toll-free at 1-866-390-6491.

By Carol Zernial
WellMed Charitable Foundation Executive Director

Have you ever done something that seemed completely frivolous just for the fun of it? Have you done something frivolous since you became a caregiver? For most of us, caregiving is serious business. We’re dealing with serious illness or disabilities, medical appointments, long hours, and a load of emotions – doing something just for the fun of it doesn’t always come to the top of our list. That’s where Lincoln comes in.

Last week, I was speaking with a friend and colleague who had missed a conference call we had set up. He informed me that he had just enrolled his mother in hospice and some things were falling through the cracks. It turns out that his mother has been caring for his father who has Alzheimer’s for a number of years. In her eighties, she has literally worn herself out caregiving.

But the hospice story takes a magical turn.

It turns out that his mother had an IRA that no one knew about. Because of her age, she is required by law to take out a certain amount of money every year or pay a penalty. When asked what she wanted to do with the money taken out of the account this year, she said,” You’re father’s name is Lincoln. I think we should buy him a Lincoln car.”

My friend reminded his mother that Lincoln has Alzheimer’s disease and can’t drive. “Well,” she said, “then he should be driven in a Lincoln. Couldn’t his caregivers drive him around in his car?”
The more my friend thought about this frivolous idea, the more he liked it. The morning his mother had a long doctor’s appointment and was out for about 4 hours, he went down and rented a Lincoln and returned to pick her up in the new car. She was delighted!

He purchased insurance that allowed for his paid caregivers to drive Lincoln in the lap of luxury of his new car. Soon, Lincoln and his wife were going everywhere in style.

My friend’s mother is very frail. A few days ago, her hospice workers reported that they couldn’t get her out of bed. She wouldn’t take a shower. My friend called his mother and asked if she
wanted to go for a ride in the Lincoln. She immediate got up, showered, and was ready to go. The idea of splurging – of spending time, money or energy on something that really is just for
fun can make no sense at times. Renting a Lincoln for Lincoln makes no sense – and yet it makes all the sense in the world. He either always wanted one or his wife wanted him to have one.

I’d like to think that a guilty pleasure would actually relieve some of the guilt of being an imperfect caregiver. We might not be able to get a luxury car, but we could splurge on a triple decker scoop of our favorite ice cream. We might buy lunch from that favorite deli down the street that we used to go to all of the time. We might take a taxi or Lyft around the lake, around our old neighborhood, or just around town on a pretty day with the windows down.

I like the think of Lincoln and his wife sitting in their Lincoln smiling at whatever is going by. They may be on their way to a dreary medical appointment, but life is good on leather seats.

If you’d like to drive along with Lincoln too, see if his new website is up and running at LincolndrivingLincoln.tv. I know I’ll be looking out for him and smiling just for the fun of it.

WellMed Charitable Foundation Executive Director Carol Zernial is a noted gerontologist, radio show host, and emeritus Chair of the National Council on Aging. The non-profit WellMed Charitable Foundation focuses on complimentary programs impacting seniors and family caregivers, including weekly telephone learning sessions, evidence-based classes on stress reduction and more. Find out more at www.CaregiverSOS.org or toll-free at 1-866-390-6491.

By Carol Zernial
WellMed Charitable Foundation Executive Director

Caregivers sometimes have to make tough decisions – literally decisions of life and death. It doesn’t matter if we knew this moment was coming. It doesn’t lessen the intensity of the decision if the person is very old or in poor health. The question will be asked: What do you want to do now? But that’s not really the question, is it?

When we are making decisions about surgery, ventilators, feeding tubes, Do Not Resuscitate (DNR) orders, or even a decision to go for the full code – to try everything humanly possible – it’s not really a question of what we want to do. The real question is what does the person wants to do who is facing delicate surgery, life-prolonging interventions, or even death.

Hopefully, we have had the opportunity to have these discussions with the person for whom we are caring. Knowing clearly what the person would want if they can’t communicate for themselves is a lifesaver for us. Any discomfort we may have in starting the conversation about death with a loved one – of any age really – will become a great source of strength and comfort in a dark hour when we know what they would say.

It’s important to repeat this conversation as our loved one gets older, gets sicker, is in greater pain or, in the most likely outcome, is deteriorating. A person might make a different choice if the pain becomes too great or the effort to stay alive doesn’t equal the quality of life.

The question is not what we want. The question is do we know what our loved one would want at this time and in this situation. We have to step back from ourselves and be their voice – no matter how difficult and no matter how much we might want to disagree.

We might have to stand up for a decision we know our loved one would want against the loud voices of other family members. We might have to summon all of our strength to say, “Please just make them comfortable” knowing that comfortable means allowing our loved one to slip away.

The matriarch of our family, my 97-year-old great-aunt, recently passed away. In addition to her many other interests, she had formed a death and dying “club” where she and her older friends talked about what they wanted at the end of life. We all knew exactly what she wanted even when she could no longer say the words. When her time came, her friends and family came to her apartment in a steady stream for three days – holding her hand, brushing her forehead, whispering words of love and friendship. It was an amazing ritual.

We are not all going to be so “lucky” as my aunt, but she created this possibility. Embracing difficult conversations about life and death, and respecting these final wishes mean that we can all live life, up to the last moment, on our own terms.

WellMed Charitable Foundation Executive Director Carol Zernial is a noted gerontologist, radio show host, and emeritus Chair of the National Council on Aging. The non-profit WellMed Charitable Foundation focuses on complimentary programs impacting seniors and family caregivers, including weekly telephone learning sessions, evidence-based classes on stress reduction and more. Find out more at www.CaregiverSOS.org or toll-free at 1-866-390-6491.