I received an e-mail over the weekend concerning Dr. Cahill's guest blog of October 1st. I invite you to go to my home page - www.thealzheimerspouse.com- and read today's blog, as well as Dr. Cahill's guest blog of October 1st, which you can find by scrolling down the home page. After giving careful consideration to both blogs, please post your comments and opinions here. As mentioned at the end of my blog - I am always open to thoughtful, respectful debate on important issues that affect us as caregivers and spouses.
Dr Cahill says: "The answer is not to strive for a life without stress, but rather to learn to enhance our resilience by being mindful as to how we respond to the challenges that create stress."
Everything that Joan talks about in her blog causes stress. We cannot change the situation, the AD is going to cause all sorts of stress ... but we can change our attitude about it.
What reduces stress is doing something to improve the situation -- changing our attitude from that of helpless victim to that of someone determined to make things better, fighting back in whatever ways are possible. I was trying to find out more about Selye's book (it was written in 1974), and found this site:
It is Dr Selye's treatise "The Nature of Stress." It says (among a WHOLE lot more):
"Stress is not necessarily undesirable. It all depends on how you take it. The stress of failure, humiliation, or infection is detrimental; but that of exhilarating, creative, successful work is beneficial. The stress reaction, like energy consumption, may have good or bad effects."
(When I saw "creative, successful work" I immediately thought of divvi...)
"...While stress is reflected by the sum of the nonspecific changes as they develop throughout time during continued exposure to a stressor, the General Adaptation Syndrome (GAS) encompasses all nonspecific changes as they occur during continued exposure to a stressor. One is a snapshot, the other a motion picture of the response to demands.
"...A fully-developed GAS consists of three stages: the alarm reaction, the stage of resistance, and the stage of exhaustion. Yet it is not necessary for all three stages to develop before we can speak of GAS. ...Most of the physical or mental exertions, infections, and other stressors, which act upon us during a limited period, produce changes corresponding only to the first and second stages: at first they may upset and alarm us, but then we adapt to them.
"...we can adjust our personal reactions to enjoy fully the eustress of success and accomplishment without suffering the distress commonly generated by frustrating friction and purposeless, aggressive behavior against our surroundings.
"It is a biologic fact that man - like the lower animals - must fight and work for some goal that he considers worthwhile. We must use our innate capacities to enjoy the eustress of fulfillment."
So, for example, we were talking about getting stressed when we found out that our AD spouses had seriously screwed up income tax returns. First we respond by having hysterics (!!!) If we then rebound by collecting all the paperwork and getting an accountant to fix things, we adapt in a beneficial way -- "stress without distress", that is, without going all the way to the third stage of GAS, exhaustion (and death). But if we fail to take positive action, if we just continue having hysterics and hide under the bed, then we end up having a nervous breakdown -- "exhaustion" or "distress."
The treatise ends with recommendations on how to achieve "stress without distress":
"1. Find you own stress level - the speed at which you can run toward your own goal. Make sure that both the stress level and the goal are really your own, an not imposed upon you by society, for only you yourself can know what you want and how fast you can accomplish it. There is no point in forcing a turtle to run like a racehorse or in preventing a racehorse from running faster than a turtle because of some "moral obligation." The same is true of people.
"2. Be an altruistic egoist. Do not try to supress the natural instinct of all living beings to look after themselves first. Yet the wish to be of some use, to do some good to others, is also natural. We are social beings, and everybody wants somehow to earn respect and gratitude. You must be useful to others. This gives you the greatest degree of safety, because no one wishes to destroy a person who is useful.
"3. Earn thy neighbor's love. This is a contemporary modification of the maxim "Love thy neighbor as thyself." It recognizes that not all neighbors are lovable and that it is impossible to love on command.
"Perhaps two short lines can encapsulate what I have discovered from all my thought and research:
"Fight for your highest attainable aim, But do not put up resistance in vain."
No way! Yes, you can learn to take care of yourself. You can learn to say yes when someone offers help. You can explain what kinds of help you need, especially the odd things that no one ever thinks about.
You can learn to find ways to deal with stress. You can learn to do affirmations on a daily basis, and pray (if praying is something that works for you). You can learn meditation and deep breathing techniques. You can pay attention to the good things in your life.
But there is no way that dealing with the constantly changing situation that is cargiving a dementia patient, or the tiny things that drive you nuts, is stress relieving.
And I think that is even more difficult if you are talking about caregiving a spouse. If it is a parent, grandparent, uncle or aunt, you CAN arrange for good care, make sure it really is good, and then walk away. If it is a spouse, there is no walking away no matter how bad the marriage was. And trying just gives you even more stress.
I think part of the stress is the ever changing behavior and needs. What works one day may not the next. I went to a stress seminar and the one idea I took home was: There will always be one constant in your life and that is things will always change.
Sunshyne, wow,you flatter me, i am in shock, but lets not get carried away:) my survival for the most part depends on my ability to cope with stress every day while on this journey i see it as a test to my capabilities, and in some instances i do fail and dramatically. i think its very true, "upset, alarm, then ADAPT" -i would have to say this is a very intelligent course of action while dealing with any terminal disease and in particular this one. what are the options if we dont 'adapt"? exhaustion and distress on a permanent basis everyday-this benefits nobody, espec ourselves or the one we care for. 'choose your battles' -yes i try to make a conscious choice here. there are SO MANY along the way, you cant battle everything. some slide past without incident, some become a challenge and you contemplate couse of action , some you have to hit headon and accept the fact that you will lose alot of them. you remain steadfast in your intent to get thru to the end in the best possible mental state-and this is the most discerning fact as we all know the final outcome. I would have to say, caregiving is stressful but its the AMOUNT of stress you allow yourself to endure thats in question. divvi
All my life I have been a caregiver. As the oldest girl in a large family, I cared for the younger siblings. As a wife, and very soon, the mother of four,a grandmother of nine, as a teacher and school counselor, my life was caring for others. Finally, at retirement, I thought I could relax, travel, read, enjoy our life with my husband. I have adapted somewhat, simplified, lowered expectations, tried to enjoy the life I have. It is so hard, everyday is something new. I wake up from dreams of losing my husband in a crowd, terrified. My life revolves around AD, but it is what it is. Maryd
A week ago last night, my 58 year old sister, who lives 50 miles from here, ended up in the hospital with a huge gash in her ankle. There was some broken china in her living room floor, so we're assuming that she cut herself on that, but we have no idea how she did it. She quickly became septic and went into multiple organ failure - kidneys, liver, heart, lungs, . . . During that night, she talked a little, but then she quit responding at all. A CAT scan when she went into the hospital showed she had not had any strokes, but one a few days later showed she had, so apparently the stroke happened in the hospital. An EEG on Friday indicated substantial brain damage. The doctors said the next steps in keeping her alive would be to do dialysis and insert a feeding tube. They weren't sure about doing surgery though, partly because she had lost so much blood from the cut, which severed an artery. My useless brother, who "can't come to the hospital because it upsets him so much" and I are her only relatives except for my sons and some cousins, so we (meaning I) got to decide how to treat her. Her internist told me that they could probably keep her alive, but that she would be severely handicapped and probably spend the rest of her life in a nursing home. I told them to stop all treatment and just keep her comfortable.
Yesterday morning, she started responding - answering questions like "How are you?" by saying "fine", etc. Now the doctors are talking about dialysis again. On top of all that, my husband keeps asking why they haven't done an EEG. If I have to answer that one more time, I may loose it.
So this is supposed to be good for me? Yeah, I feel less stress already. Hah!
maryd, I can relate to the retirement plans. Just have to adapt as best we can. I understand the losing husband in a large crowd. That is enough to push the panic button. My H has severe spinal stenosis and he couldn't go very far now but when he could he would be out of sight in a second. And, WallMart is a easy place to lose them also when they are still mobile. I used to spend half my time keeping track of him in the store.
I have thought about this and at first thought there is no way this is a stress reliver. For me. However, it is less stressful for me to do the caregiving in my own home v Hospital/NH. At age 70 I have little energy anymore and the physical effort of getting out daily or twice daily to visit the Hospital/NH just about does me in. At home I can rest in the recliner while on duty. Depends on the physical condition of the patient. There are a lot of variables.
That said, I think some other people thrive on caring for sick people. The Hospice aide who came for my Mom just LOVED her job, bathing and dressing terminal ill patients. She would hug and kiss mom (and also DH, much to his embaressment). I cannot imagine loving a job such as that, but I am glad some people do. I think, in that case it might be a stress reliever, although it would be different caring for her spouse. Doing a job you love to do helps with stress in most any situation
I think this is too deep a subject for me. My mind doesn't work well anymore on a "deep level". {grin}
When my sons were 6 and 8 (active, combative, living in a new neighborhood to explore) I was young, I wasn't working, and had a great time exploring the area, tending the kids, etc etc. My next door neighbor had two kids, didn't work, and was stressed out of her mind. Then we adopted our daughter as an infant straight out of the hospital. At that time I got to thinking of the plates on tall sticks on the Ed Sullivan show - the juggler who would get one spinning, and another, and another, go back and tend the first one which was getting wobbly, add another, etc. I now had added, in our daughter, a new plate. And it was exhilarating to keep all three of those spinning; then I took a class in pottery, so that was ANOTHER plate, and a class in sewing with knit fabric, and that was another... etc. And was proud of myself for having so many plates spinning in the air while the next door neighbor was so stressed with just TWO plates (I mean kids).
We moved here, I learned more skills, worked, etc - and kept the plates spinning. When I became a computer support person at Brown (the family plates spinning smoothly for the most part), I started a whole new set of plates - help this person with their malfunctioning computer, that person editing a publication, the next person with the database.
But now, retired, work and family plates spun off in their own orbits, I have a few activities to keep me sane - and the erratically spinning husband plate to deal with. At 73, I'm feeling more stress than I have in years. When this last week or two I added a bout of diarrhea to it all, I felt ready to pack it in. No longer is the challenge exhilarating.
I just want it to be over with. Waiting for Godot.
And for what it's worth, Teen Cahill has a doctorate in Psychology, masters in Counseling, and bachelors in Education.
No biochemistry. No MD degree (and probably no pre-med). Not a clue about the chemistry of Alzheimer's. Just wishful thinking.
I tell you what . . . let's have Teena Cahill spend 2 weeks with a pretty-bad case of Alzheimer's. She will be the sole caregiver. All day, all night. Just 2 weeks.
THEN let's see if she thinks it can 'reduce stress' -- but we know this answer already. She has no idea what the true experience, in depth, is really all about.
Kitty, I always go to sleep at the theater. I think it hypnotizes me.
I think it would be a great idea for everyone to have the experiences with an AD patient for a few days. But then, a few days caring for a toddler exhausts me. Change in routine and our age, I guess, has a lot to do with it. I don't know how we managed our children when they were little.
I vote No, caregiving for an AD loved one cannot reduce stress. If its not their actions, there is something going on medically, then all the stuff that they used to handle that we now have to pick up on top of everything that we were already handling. Add to that, the stress of knowing what is coming and planning ahead so that if there is a quick change you can handle it.
I agree a certain amount of stress is actually healthy but this much??????? No caregiving cannot reduce stress.
The only exception I can see is if someone is a natural caregiver and truly enjoys it. They may be one of those that would find life stressful if they weren't caregiving.
What we have all avoided stating is that the ultimate stress is knowing that our spouse is dying. We are watching them die a little more day by day and trying NOT to think about it; hoping for a cure; denying that they are dying; and mourning each day for the loss of what we had. THAT is in the caregiver's mind and heart and will be stressful beyond the actual caregiving itself.
Now, on a lighter note...... we can make a cardboard poster and write AD on it, and put it on the back fence and shoot arrows at it; or throw rocks at it - or even pine cones..and relieve a little stress.
To answer the question can care giving for an AD spouse reduce stress? I will let the fact that I had 9 TIA (mini) strokes in as many months speak for me.
But one point you made Joan I think is important. Finances. When I was caring for my Grams, money was not an issue. Her significant other hired 2 full times nurses to help me. I DID enjoy caring for her. I had no stress except for the emotional trauma of knowing I was losing her.
When Lynn became sick, I was already disabled and had only SS for income. When he had to stop working it cut our income by more than half. I had to not only worry about his failing health coupled with my issues, but I now had to be the soul "worrier" When the car broke down, when the roof leaked, when the boiler stopped working mid winter........ all of these things added extra stress that just sent me over the edge.
So I guess my point is, in my particular case, finances play a major roll in my stress. If I had the funds to hire a nurse to care for Lynn or had the funds to not worry every single day how we were going to pay the bills, my stress would not be so bad.
But, even if it was simply caring for him with no other worries, I wouldn't be able to say it could actually be a "stress reducer" Caring for a spouse with Alzheimer's is emotionally and physically exhausting! Even though he is doing so much better on the Seroquel, there are still daily struggles that just scream stress!
I am with you Imohr, on the traveling back and forth - I am 75 and it is easier, at this stage to care for H at home. As you say - it depends on what level they are at. Perhaps ,at the complete bedside care stage, would be most difficult at the age I am now. At that time , I hope I will have Hospice helping and if not too expensive - home aide . i will have to wait to see, at that time. I noted you are from WV. - I am from Huntington - sometimes wish I was back there as i understand they have some good programs.
Hey, bludaze - Just saw your post - I am an OLD Retired R.N. - I know what you mean as to caregiving a pt and then go home. Nothing prepared me for this Alz. - We never heard of it in my day. I take my hat off to all the dear caregivers of their family members - you are all special people!!!! I am still learning from you all. This is a job you have to go through, to really know what it entails day after day!!
For the most part, I had a stress free life before AD. Oh, sure, the usual money worries, etc, but Scarlett taught me to 'think about that tomorrow'. Either accept it or do something to fix it right now. Can't fix AD -- no way, no how. I'm a 'one day at a time' person. Tomorrow will almost always be better. If he had something else just as bad, it would have been the same. I know people who spent their lives caring for a disabled child--they get thru it--but comparatively, I am grateful I've had what I've had. But I grew older, the body rebelled, I was close to a breakdown so I had to place him. Depends on circumstances - money as already mentioned, age, CG's health, small children still at home, other obligations to parents, career, etc. But as a general question w/out qualifications, can caregiving reduce stress? Nope, not on this planet.
I have thought of 2 questions: What planet is Dr. Cahill on? and Is Dr. Cahill a politician? (Always trying to put a positive spin on things, when there is nothing positive about it.)
And Janet, so sorry about the situation with your sister. Please keep us posted. Reminds me of when my mother was dying, she had "do not resuscitate" if a ventilator is needed, but they put her on a ventilator anyhow. Then we had to make the decision to try to wean her off. She had a few lucid moments when she said, I don't want to die, I have things to do, etc. Talk about ripping your heart out.
The stress of caregiving is driving me crazy. I tried to go to the Y today. My DH wanted to go, then,did not want to go,then, got in the car, then said no, his feet hurt. I went by myself. When I got there, I couldn't find my card, went back home. Took my drivers license to get in. The Y is close enough to walk, but I drive because sometimes after I work out, it is too hard to walk home. After 20 minutes, who shows up next to me on the treadmill? DH. I work out then wait for him. Did you drive, I ask. He can't remember. We walk out, he can't find his car. He finds his car, we go home. He has no idea why I am upset. I exercise to relieve stress. Today, it did not help. Maryd
I vote No also. I used to have lots of plates spinning (Briegull, you're a very creative writer) but it was fun. What I'm doing now is not fun. If caregiving can reduce stress, it would not be with a spouse and it would not be 24/7.
A firm NO right now. If I was strictly providing physical care giving, probably a YES. However, having to deal with the unknown moods and the up and down behavior, a NO. I won't know for sure if it will be a YES in the future but anything that is not like it is now would have to be better. A question that arose when I read it was "how does anyone find time to "take care of themselves" while caring for a LO?" I was asked yesterday if I would like him to wipe for me. This isn't the first time he has offered. Is he just trying to "get my goat" or does he really want to help me? I don't know. But he always acts sad when I tell him no. Could I handle the stress if I could take care of myself? Probably not. All that happens when things are better for a while is the down slide when things get worse again. I put a lot of thought into this. I lean towards NO.
Yes, we can handle “some” stress. Most caregivers would agree that caregiving is not “some” stress. And saying that “care-giving can actually be a stress reducer, if….” I don’t care how big the “IF” is, care-giving is not a stress reducer. And yes, it helps if you can set some boundaries and take care of yourself, but that’s not always possible. Dementia has a way of creeping past any boundaries that you try to set, and taking over the best laid plans of caregivers.
This sounded very much like some other things I’ve heard, the theme of which is—gee, if it’s that hard, you must not be doing it right! Grrrr…..
Briegull, I agree with you. After so long a period of time, challenge is no longer exhilarating.
Bettyhere & I must have posted at the same time. I ask you, how can a situation that causes stress, reduce stress? It is a ludicrous concept. I am not Mother Theresa. Nor is most of the population. Even Mother Theresa had her breaks. AND I don't think she ever had to worry about finances.
When the caregiver successfully resolves a problem stress is reduced. However, since caregiving is an ongoing situation involving multiple issues and problems lasting for an indefinite period of time, there is no respite from stress. Resolving one problem simply gives the caregiver a brief chance to take a breath before tackling the next issue/situation/problem. The issues/situations/problems are lined up and piled up all around us and all we can do is keep hold of the territory we still have control of and keep chipping away at the rest(trying to avalanche over us). Helping our spouse avoid an incontinance incident may reduce the sress of the incident, but the stress of being aware and intervening to avoid the incident is another stress. Exchanging one stress for another is no help at all.
Yesterday my husband managed to lose two hairbrushes, a set of tweezers, a comb, a DVD, and a pair of scissors. We found the comb, DVD and scissors. The other items are still MIA.
I only mention this because it is the mildest form of the stress we are under. The "hide and seek" game we play daily. The dog's leash was MIA for 3 weeks and found in a culvert at the back of our lot! <grin>
The other stresses in the middle range that we are under are harder to overcome. The ultimate stress is that in which the spouse faces knowing that the outcome is death. There is no escaping that stress no matter how hard you try. Whether your spouse is the love of your life (which most here are or were) or whether caregiving is being done as a sense of duty.
My prayers and daily glass of wine (sometimes two) keep my stress at a minimum. <grin>
Just to add to our stress, on top of everything else we have the stock market crash. All our income is from investments, mostly stocks, so I am not sure how we will survive. A few months ago I felt I had plenty of reserves to cover nursing home/home care, etc. Now I'm wondering how long before she goes on Medicaid.
AWW-Marsh so horrible whats happening, i was lucky and pulled ours out early and just CD's for comfort zone issues. you arent alone in this you know i feel for everyone who is losing. its going to be long run before things settle down. i know its unsettling but not much to do just ride it out i guess . divvi
Like Marsh much of my future is in stocks. Sadly one of them is Avanex which I got from an Alzheimer's site because they were near marketing a very promising drug for AD.
Polls show that 80% of Americans are under stress due to the economy. The worst hit are the seniors who can't wait out a period of recovery. Marsh, I really feel for you.
My 33 year old son took all his 401k out of the stock market 2 years ago. He had been hit once before, and swore, never again.
I'm going to borrow someone else's 2 cents to put in my 2 cents. DKing posted the following not too long ago.
"Vietnam was good training for this caregiving role. If something bad is not actively happening, something bad just happened or something bad is getting ready to happen. The trick seems to be, in both circumstances, keep everybody alive and get into the next day. Try and find some joy in between the bad stuff."
Caregiving reduces stress? I can't quite process that one. Thenneck
I read Dr. Teena's article I watched her video and up until now that I am reading all of your comments I was thinking to myself that I must be lacking somewhere. Something just didn't sit right. I am for the most part a sane (Define sane) intelligent human being but Cahill made the hair on the back of my neck stand up. I am struggling for my self preservation out of necessity to live and help my DH and yes wonder how I am going to pay for all of the NH bills not to mention the medications, the gas to and from the NH, and the stress of seeing him sitting there looking so pitiful and helpless because he is very aware of his surroundings. I read the statistics of all of us baby boomers needing nursing care and there are no nurses to cover what is needed now and no facilities are being built and I worry if I get sick who will keep DH in the style to which I have accustomed him to. I fell at work and cracked some ribs, tore my dress (okay not my favorite dress) but it brought some of these real thoughts to mind while I was laying there waiting to be rescued and praying that I could go unnoticed. So you see in a flash things are always changing and we must try and adapt and try to leave this place a little better than we found it. Stress reliever......... NOT....... NO WAY............