The WellMed Charitable Foundation and UT Health School of Nursing, along with other partners, are in the planning stages of a dementia initiative in San Antonio that will be funded by a grant worth nearly $1 million over three years.

“This is a game-changer for our community,” Carole White, a professor at the UT Health School of Nursing, said recently on the Caregiver SOS podcast.

The grant increases the dementia capability of San Antonio. So, what does that mean?

“If we’re going to be an age-friendly city, first of all, we can’t be that without addressing dementia,” White said. “We know that one out of three people over (age) 85 have some form of dementia. Our aging community is much more likely to have dementia than a younger group.”

It’s about addressing the stigma associated with the disease and, in the process, improving a community’s dementia capability, say White and other experts such as WellMed Charitable Foundation Executive Director Carol Zernial.

“Until we start talking about dementia, and start realizing that people diagnosed with dementia are not what we think of—which is someone incapacitated and in stages—they are living with dementia,” White said.

The grant addresses three areas.

1. Help identify people living alone with dementia.

Patients and members of UT Health clinics and WellMed senior centers, respectively, living alone with Alzheimer’s will be identified using new sets of protocols.

“There are a lot of people who have mild cognitive impairment, early stages, and there is a point where they are no longer safe,” Zernial said. “For us, to change the way we look at people and practice and ID folks, to me this is one of the biggest take aways from getting these grant funds to develop these protocols to ID the people.”

White called them tools. For example, she said, “getting a social worker in to look at safety in the home. Is the stove being left on? Are they going out to get the food they need? So, somebody really doing an assessment of their environment. We often don’t do that.”

2. Assisting people with intellectual or development disabilities who have Alzheimer’s or who are at risk of developing some form of dementia.

“This group is at very high risk,” White said. “We never said it in the past, but with better medical care, people live longer, unfortunately, to develop a form of dementia on top of their intellectual disability.”

“This is an under-studied and, I think, under-cared for group,” she added.

Part of the strategy, Zernial said, is keeping them active and engaged in fun activities, and a partnership with Morgan’s Wonderland will help in this effort.

“People with Alzheimer’s and caregivers should have fun at least once a day,” Zernial said.

3. Focussing on family caregivers with people living with dementia.

About 60 percent of caregivers will experience some kind of behavioral symptoms that are difficult for them, such as resisting care or being agitated.

The grant will focus on an evidence-based intervention, working with family caregivers on identifying triggers, or the root, of the behavioral symptoms. Then they’ll be able to better manage the symptoms.

“The intervention we’re using is based on a model that behavioral symptoms are unmet needs with people with dementia,” White said. “Maybe they have a urinary tract infection or they’re dehydrated—addressing that … Maybe it’s something in the environment (like) clutter. Or, maybe it’s a very boring environment.”

Zernial expanded on White’s point.

“We know the medications don’t work well, and if they do work, they work for a limited amount of people for a limited amount of time,” Zernial said. “We can really improve the situations by looking at the environment and looking at those triggers.”

For more about the grant, listen to the complete episode.

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 Jamie Huysman, PsyD, LCSW

Happy Heart Month! This is the month in which LOVE and Heart Health are celebrated.

There is much talk about the decline of cursive writing which many of us equate with the classic letter.

Cursive writing these days is becoming relegated to the art of calligraphy rather than a touchstone of everyday penmanship. Having often admired the handwriting of others, I must confess that my own doesn’t live up to that standard. I’m a doctor; go figure.

Regardless, there is still something to be said for sitting down and writing a letter. It’s like part of your soul is revealed in the formation of the letters on the page, both personal and unique to you, the writer; your heart opened to the intended receiver, cursive or not.

The art of letter writing is not dead, but it has changed. There are now greeting cards for just about everything and everyone you can think of! Still, the addition of a handwritten note inside a birthday or Christmas card is an extra treat, adding something special to the sending and receiving of it.

Handwritten “Thank You” notes are still the norm of those who adhere to the rules of etiquette. I’ve known people that write letters to God, to their diaries, or just for the benefit of getting something off their chest, the contents of which will never be sent.

In a perfect world, all of us would have people in our lives and around us that build us up and let us know that we are loved and appreciated. If you have that, you are fortunate indeed. There are many who get the message that they are not enough. The need for outside approval can taint our perception of who we are and what our worth is. For all of us, it is really an inside job.

Thankfully, the concept of self-love has permeated 21st century consciousness! So, I‘m urging you to take matters into your own hands and write yourself a letter! Just as we are told that happiness comes from within, so does acknowledgement of ourselves. Thank yourself for being who you are and what you do.

Go ahead – write yourself a LOVE letter! It’s not narcissistic of selfish; it’s a reminder that you have qualities that deserve to be named and appreciated. Positivity is healthy…and infectious.

I have a friend that started sending herself cards and notes of appreciation. She even wrote, addressed and stamped one and gave it to a friend to keep “until needed”. She forgot all about it. Sometime later she confided to the friend that she was feeling overwhelmed and frustrated, that the loved one she was caring for was taking her for granted. A couple of days later she received the “until needed” letter she had written to herself and given to her friend. She told me that when she opened it her words to herself brought her to tears and made all the difference in making it through that day.

Now it’s your turn – get a card or blank piece of paper and pen and do it. Seal it and give it to a trusted friend or family member for safekeeping. It will be there when you need it. You deserve to know that you are loved. It’s good for your heart.

If no one told you that they loved you today, I do!

Dr. Jamie is a popular keynote speaker, media expert, and author. He co-authored the acclaimed “Take Your Oxygen First: Protecting Your Health & Happiness While Caring for a Loved One with Memory Loss.” Dr. Huysman writes for Caregiver SOS, Connections, JoanLunden.com, Huddol.com, and blogs on PsychologyToday.com.

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 Jamie Huysman, PsyD, LCSW

The year’s end is an excellent time to reflect and celebrate even the smallest of victories. We’ve made it through another year; we’ve done our best to meet its challenges. Life is the greatest of teachers when we allow ourselves to be open to its lessons.

Many of us will be glad to see this year go away and only in hindsight appreciate its value. That’s OK. Sometimes time and space are necessary to process and make sense of things. Take all the time you need.

For others, there is always great expectation around a new year. There is the anticipation of opening a new chapter. Out with the old; in with the new! And so, we embark on a new adventure with a clean canvas of days to come.

I like to set achievable goals instead of resolutions for a new year. Resolutions are many times a self-imposed limitation or setup—or both—for failure. I prefer to think re-solution! What if we all set a goal of taking better care of ourselves this year? There’s a lot of it going around! The self-care bandwagon has arrived!

Let’s make 2019 a year to really embrace self-care. To that end, here are some goals to work toward. Just do your best. That’s all anyone can ask of you!

Keys to Self-Care for Caregivers (and other human beings)

» If it feels wrong, don’t do it. Trust your instincts.

» Weigh your words before you speak; they have enormous power, so say what you need
to say without doing so at the expense of others.

» Never compromise yourself for the sake of others. There are people who will never be
pleased no matter what you do.

» Don’t believe your negative self-talk. You are so much more than you think.

» Make time for you! Pursue something that makes you happy.

» Learn to say NO without feeling guilty. Beware of succumbing to bullying and emotional
blackmail.

» Treat yourself the way you’d like to be treated.

» Let go of what you can’t control. You can’t change others, only yourself.

» Disengage as much as possible from drama and negativity. Every situation is not a crisis
that you need to fix.

» Do not be a slave to fear. In the words of the indomitable Eleanor Roosevelt, "You must do the thing you think you cannot do." She also famously declared, “You gain strength, courage, and confidence by every experience by which you really stop to look fear in the face.”

» Remain teachable. It is your greatest asset in the long run.

Wishing you a Happy, Healthy, and Self-Caring 2019!

Peace & Love,
Dr. Jamie

Dr. Jamie is a popular keynote speaker, media expert, and author. He co-authored the acclaimed “Take Your Oxygen First: Protecting Your Health & Happiness While Caring for a Loved One with Memory Loss.” Dr. Huysman writes for Caregiver SOS, Connections, JoanLunden.com, Huddol.com, and blogs on PsychologyToday.com.