Friday, December 26, 2014

Where Is The Vicks?

 Lori did not feel well, and was fading. The holiday season, along with hosting her daughter's Christmas party, car pooling, shopping, church activities, musical activities and care giving activities were exhausting her.  All of Lori's joints hurt, her throat was sore, and she had the chills.  Lori cleaned the house, made meals for her mother, drove her mother to appointments and was convinced she was coming down with something. So she upped her vitamin C, and took some healing herbs, a chiropractic adjustment and a much needed nap. With little warning,  Lori had a cough, and it wasn't just a quiet productive cough, but a violent, non-stop dry cough. Lori was coughing all night, and Lori's mother was worried.

  Lori needed sleep, but was not sleeping. She would go to bed at 8PM, then at 1AM, all the lights in the house would be turned on, followed by shuffling feet and mumbling. Lori's bedroom door would fly open, followed by her toothless mother wearing unmatched socks, tasseled hair, and an over sized robe "Where is the Vicks?" Lori, you need Vicks so I'm taking the car to the drugstore. We need to get you well, now where are the car keys?" Lori would get up with her mother who already had gone into her grand daughter's room looking for Vicks. All of the cupboards in the kitchen were opened looking for Vicks, the medicine cabinets in all of the bathrooms, and even the kitchen drawers had been prodded for Vicks. "You need Vicks and a vaporizer, Lori." Lori would calm her mother down, and would close all of the cupboards, and would turn off all of the lights. Her mother would finally settle down, and with all of the lights off, Lori would go back to bed. Then at 3AM, all of the lights would go on followed by shuffling feet and mumbling. Reminiscent of the movie, "Groundhogs Day" where the same scene is repeated over and over again,  Lori's bedroom door would fly open, "Where is the Vicks?  Lori, you need Vicks." The same scenario would play over and over again every few hours. The first night, Lori's mother woke her up 3 times. The second night, 4 times, and by the third night, Lori was fearful of developing walking pneumonia, or even death (okay, a slight exaggeration) from lack of sleep, and ended up seeing her doctor. Lori was afraid that her mother would get sick, too from sleep deprivation.

  Experts on communication techniques regarding dementia (Naomi Feil, MSW), say that all behavior has meaning behind it. Lori had a history of having pneumonia as a young child where her mother would stay up all night with her slathering her chest with Vicks and rocking her to sleep next to a vaporizer. So, Lori was not offended by the interruptions that happened in the middle of the night, because she admitted that she herself was guilty of waking up the entire house with her non-stop coughing. "That's it, Lori." Her mother said on night three. We are not only getting you Vicks, but you are going to see a doctor tomorrow. Bronchitis can easily turn into pneumonia, Lori."  Her toothless mother at 3 AM was making a lot of sense. No one would even guess she had dementia with those comments, and then as always with dementia - there is one thing said, that gives it away and this is what Lori's mother said: "And tomorrow we will call your Uncle Ron, and he will see you immediately. He always enjoys seeing you Lori." Lori's Uncle Ron was a medical doctor, and he and Lori had a very close bond. But Uncle Ron was dead.  He died 10 years ago, and lived in another state. "Okay mother, I will see the doctor tomorrow, I promise."

  So, Lori saw the doctor, and the medical staff admitted that antibiotics would not work for what appeared to be a virus, and that the flu shot that had been advertised non-stop on the radio, according to the medical staff, was not appearing to stop the flu strain in our town!!  So, since Lori was not a fan of drugs anyway - she agreed to take a strong cough suppressant as needed at night to help her and the entire house to sleep, to sanitize everything, to wash her hands and to follow her mother's advice by going to the drugstore and purchasing a vaporizer and 2 large jars of Vicks!!!

  When the care giver needs a care giver, it can sometimes be, the care giver's mom!!!  And what was interesting to notice, was without Lori's interaction (when Lori was laid up for 6 days), Lori's mother would appear to be in her own silent world. When Lori started feeling better, Lori's mothers energy level seemed to improve too, and the staring into space, ended. Lori's mother initiated more activities on her own. She would invite her grand daughter to play marbles on the living room floor, she would play with the dog, would write in her journal, would watch football games and liked to play Sudoku.

 Copyright 2014 Caregivers Get Fit! Mama  Nicey

The information in this blog is information. It is not meant to be a replacement for getting medical advice from your own health professional regarding your own individual health challenge or condition. Dr. Denise will not diagnose, treat, or give direct personal consultations/advice to you on this blog for any medical condition, but will give general examples, and scientific research on many different health topics.  How you decide to use the information is between you and your own medical/ health professional.


Wednesday, December 17, 2014

Christmas Memories

As they say in many books, and philosophies, “You can’t go back in time.” And so the fact remains, “What is, and what will be, will be.”  However, during the holidays, namely Christmas, which Lori’s mother has always celebrated, the past becomes once again explored.  And how does this happen, one would ask?  Very simply. Great moments that have been recorded in her mother’s past memory, become re-ignited by holiday traditions.
So, by putting up the tree, and bringing out the decorations from the basement, Lori’s mother once again in her mind goes back to 1943.  Every explanation goes back to the same story of her German grandmother’s cookies, and her mother’s cherry pie. She sees her father sitting by the radio in the living room in his favorite high back corner chair drinking beer and listening to Glenn Miller  And in quiet reflection, she turns to Lori and says, “I don’t know why we don’t go back there anymore.”  “I wonder if they put the tree up, or if they will be getting snow?”  Lori listens, and then asks questions. “What is your favorite memory of Christmas?”  Lori’s mother has a thoughtful grin on her face, and says, “I don’t know, I guess just spending time with my parents.  I miss them most around the holidays, especially Christmas. “Then her mother says, “And there was a time when we didn’t go down South to see the relatives. I so wanted to see my grandparents, but halfway down the highway, my father turned the car around, and we went back home.”  Lori was curious, saying. “Why did you not see the relatives that year?”  Her mother said, “We had a lot of snow, and the flurries got worse with each mile we drove.  We had no choice but to turn around and go home.  I hated missing my cousins that year, but my father said it was too dangerous to travel.”  “So, what did you end up doing, mom?” Lori wanted to listen, and with each story, she would learn more and more about her mother’s past.  “Well, Lori,” her mother scratched her head, and looked up at the ceiling. “We just had a quiet Christmas at home, I guess. Of course, my mother always made pies for the holiday dinners with the relatives, so we must have eaten plenty of cherry pie. We didn’t have much money Lori, but we had love in the home, and a hot meal on the table. And you know more than anyone else, Lori how well your grandmother could make baked chicken and mashed potatoes!” 
Vivid pictures, like movies run through the minds of people with dementia every day.  Many times, people observing the behaviors of people with dementia observe actions that appear to be disconnected from reality, and present time consciousness.  In a workshop that I recently attended in Atlanta last month,  the originator of Validation, Naomi Feil, MSW described the behavior of a very old man who would constantly insist on laying supine (belly up), underneath his bed.  No one could understand why this man was constantly found under his bed “belly up.”  Every day, this man insisted on laying “belly up,” under his bed for hours.  Most people would think the man had gone, “mad,” or that he was experiencing “hardening of the arteries.”  However, someone using Validation, as taught by Naomi Feil, MSW would take the time to study the man’s history. His past medical history along with his family history, occupational history and social history. And the conclusion of the discovery of one’s past history always, (in every case), leads to greater understanding. We need to truly connect with people suffering from dementia, and one way to do this is to realize that everything, (every action), has meaning.  And every thought and action is anchored in the past.  Through exploration of the man in the above example’s past, and thorough assessment of his history, it was apparent  that this same man, oftentimes  misunderstood by his habit of laying “belly up,” under his bed every day,  for over 40 years had a history of working as a car mechanic!  And what do car mechanics do every day? They spend a great majority of their time laying, “belly up,” under cars! So, with Christmas and other holiday traditions come memories.  And one way to connect on a deeper level with our loved one’s suffering from dementia over the holidays, is to ask questions. According to Validation, questions that we ask can bring us closer to greater understanding. Lori found out from her mother that she is highly attached to sensations connected to Christmas memories. The sense of smell is her most prominent sensory memory. Her mother would often describe her experience from 1943 by using sensory terms, ( Ie: “Her grandmother’s baked goods, her mother’s cherry pies, her grandfather’s apple strudel, the turkey dinners,” etc. )  So, Lori is planning on making a turkey dinner for Christmas with (you guessed it), cherry pies and apple strudel. The German Christmas songs will be sung around the tree, bringing the past to the present, and connecting on a deep level with family traditions to make for a memorable celebration. And, even if Lori’s mother forgets the celebration on the next day, she will once again feel the nurturance and love that she experienced as a child in 1943. And Lori will connect on an even deeper level with her mother through song, good food and joyous family connections. 
May the joy and light of the holidays bless the world with peace, unconditional love and understanding!!!

Sunday, November 23, 2014

Hide The Keys!

It had been a long day. Lori was very sad  after receiving news about a family friend who was struggling to stay alive after being hospitalized. Her focus on her daily activities had been thwarted by this news and she was thrown off of her care giving routine.

The day proceeded normally with cooking, cleaning, making sure her mother took her medications, driving her mother to see her doctor, running daily errands, walking the dog, bringing her mother to her hair appointment, and seeing to her daughter's school activities. But Lori made a mistake, and the mistake could have had serious consequences. Very serious consequences.

 By 8PM, Lori was in her mother's room watching a home improvement show, and woke herself up with her own snoring. She quickly remembered to give her mother her evening medications, tucked her mother in, and then decided to go to bed, herself. "Good night mother, I love you, " said Lori to her mother. "I love you, too Lori, " said her mother. Lights were turned off, and Lori went to bed.

Then it happened. It was 5:30AM, and Lori heard the sound of the front door opening and closing with a "CRASH."  Lori's husband slept through this, and Lori noticed that her dog was still asleep on her daughter's bed. "MOTHER!" Lori thought as she ran into her mother's room.  Her mother was gone and the sound of the engine turning with a loud "VAROOM," sound was heard coming from the driveway. Lori realized that in her exhausted state of mind the night before,  that she had mistakenly turned in before hiding her car keys!!

 Lori flew out of her house, just in time to open the passenger door of her car. And there sitting with the determination of a WWII fighter pilot was Lori's mother, "I've gotta go now Lori, before they find me.  They're after me and they WILL FIND ME and force me to go back with them. I need to go NOW!"  "I don't know why so many people are after me, or what I ever did to deserve this, but they are on their way, and I am NOT going to let them catch me!"  Lori was just flabbergasted, but had to think of something to say, and it had to be something that would re-direct her mother. But first she had to validate where her mother was at in the moment.

Lori was reading a book by Naomi Feil, MSW on communication techniques to avoid caregiver burnout and to handle agitation and wandering in people with dementia called, "The Validation Breakthrough," which gives simple techniques of how to communicate with people with Alzheimer's and dementia -like symptoms. Lori thought on her feet and said, "Mom, this sounds serious. Let's go inside where it is safe, so we can come up with a plan." Lori's mother immediately turned off the car and gave Lori the keys. "But we need to get away NOW Lori, NOW!!!  They WILL find us." Lori matched her mother's emotional intensity and said, "Well, let's go inside so we can be safe, NOW!  Right NOW okay? Come on mom, follow me!!" Lori's mother looked around, and with the grace of a dancer, moved quickly, and followed Lori's every step.
  Lori and her mother went back into Lori's house, and after moments of of pacing back and forth in the living room, Lori's mother decided to join Lori for hot chocolate in the kitchen.  "Who are we running from, mom?" Lori's mother was very frightened and confused and while she stirred her hot chocolate said, (looking around, so no one else would hear),   "My cousin and his friends, and they won't give up, Lori until they find me!"  Lori was concerned about her mother's heart which was weak, and her cardiac condition which could worsen under stress, so she tried to keep her calm. Validation has many phases which Lori was just learning, but she remembered to ask her mother "Who, What, Where and How," questions along with prepositions and numbers which she learned from studying Validation techniques.

 "Where were they going to get you?" "Outside, Lori." "Well, mother, it is good that we are inside now, isn't it?" Lori's mother looked puzzled, but then after pausing answered, "You are right , Lori." "Mom, what did they look like?" "They looked just like monsters, Lori. They had monster faces and human bodies."   "That sounds scary, mother. How many were they?" Lori, there were two of them," "Could you check the doors, Lori?"  "Would you like me to check the doors to make sure they are locked?" "Could you, Lori?" "I will, mother." And as Lori got up from her chair to check the front and back door, Lori's mother also requested the family dog. Lori said, " I will also get the dog and have her come downstairs so she can sit with you." Her mother said, 'I always feel safe with the dog." Her mother patted the dog on the head while the dog wagged her tail, leaning against Lori's mother's frame. "We are going to be okay," she said to the dog. "We don't have to worry at all, because we have eachother, okay?" Her mother put her eyes directly in front of the dog's eyes, and gradually looked more relaxed. After checking the locks, Lori told her mother that the police patrol the area every few hours.

 Her mother then took a deep breath and relaxed even more.  "I don't know why people want to come and get me, or what I have done." "Mom, did you do something that would make somebody want to come and get you?" Lori's mother said, "No, I can't think of a thing that I could have done." "Well, mom I don't think you did anything either, but I know for sure that no one can make you go anywhere with them, unless you choose to go. Do you want to go somewhere?" "No Lori,  I am getting tired now and think I will go to bed.  I must have had a bad dream." Lori's mother started yawning. "Mom, you are safe here with us, and we will always make sure that you are safe.  How do you feel now?"  "I would like to go back to bed Lori,  because I am so tired, but I am not going to take off my sneakers, Lori.  Lori's mother nodded her head, said a prayer and with her shoes on, put her covers on over her sneakers and quickly fell asleep.

Lori learned some important lessons. Firstly, to not let fatigue cause her to forget to hide the car keys!!  Secondly, to always be prepared to handle unexpected behaviors and confusion of her mother's dementia by knowing how to ask the right questions. Lori's knowledge of a few simple questions from Naomi Feil's book,  "The Validation Breakthough," validated her mother's feelings, and offered comfort, lessened anxiety and redirection for a safe outcome, and a restful sleep.

For more information on, "Validation," and the Validation Training Institute, go to:

Copyright 2014 Caregivers Get Fit! Mama  Nicey

The information in this blog is information. It is not meant to be a replacement for getting medical advice from your own health professional regarding your own individual health challenge or condition. Dr. Denise will not diagnose, treat, or give direct personal consultations/advice to you on this blog for any medical condition, but will give general examples, and scientific research on many different health topics.  How you decide to use the information is between you and your own medical/ health professional.

Friday, November 21, 2014

Hide The Eggs!

Lori had been warned several times before having her mother move in with her to always hide the eggs if she had to leave the house.  Her mother loved to cook and eat eggs, and appeared to have not forgotten her favorite habit.  It didn't matter if they were fried, scrambled or poached, the routine was always the same. She would shuffle out of her bedroom in her robe, with her hair tastled, unmatched socks and slippers on and her teeth would be soaking in a Listerine- filled Tupperware container by the bathroom sink. It was hard to predict where or when she would get her craving for eggs.  Sometimes it would happen at 3:30AM. and other times would be after a long nap, or even a desire to have eggs for a late morning second breakfast, because she would forget that she had already eaten once before in the first place.

The fact that she liked eggs wasn't the problem, especially now since research is pointing to the health benefits rather than the risks of eating eggs. However, the problem was having her making eggs in the house when no one else was home, and forgetting to turn off the gas stove!!!  And, " knock on wood," that scenario hadn't happened yet, but could happen.  So, what was done was something everyone must do, because safety and peace of mind for both Lori and her mother were at stake.

When I was a first time mother of an infant, I maintained my peace of mind through preparation. And the mantra was always the same, "Prepare for the worse, but expect the best."  If I had to go anywhere I would not only fill the diaper bag with everything I needed, (extras included.)  But I would have a snack bag full of easy to get to and eat goodies.  I would also pack extra drinks, and snacks for me, too.  Yes, I became a pack rat, but the truth is that I rarely got stuck in a situation that would lead to unnecessary risks or anxiety ridden exchanges.

The same philosophy was adopted by Lori when she became her mother's carepartner. Lori had a strategy which worked well in her household to prevent disasters from happening at her house in her absence by her mother who suffered from dementia, and loved to make eggs.   Her strategy involved, "hiding the eggs, " only when she was not at home to supervise her mother in the kitchen. And the supervision was a very subtle supervision, because Lori's mother's dignity was at stake, too. So, Lori would quietly supervise by just being close enough to observe the egg making process as a silent safety inspector. This took some practice, because Lori's mother did not like being pampered, or nurtured. She was very aware of Lori trying to help her walk up steps, etc. So, Lori would bite her tongue, and not react when her mother would pour too much olive oil in the frying pan, or would have the flame up higher than Lori would choose to have the flame.  Her mother enjoyed the independence of being able to make eggs, all by herself. She also enjoyed making her own bed, and feeding the dog.  So, all of these activities were extremely important for her mother's self esteem.

 However, since her mother had dementia, her mother's actions regarding the performance of the domestic activities were "out of sync" with how someone without dementia would perform the activity. As a caregiver/care-partner to her mother, Lori decided to forgo her ideas of "how" things would normally be done. It was more important for her to honor her mother's desire for independence, giving her mother  opportunities to embrace self reliance. She did this in much the same way, as she raised her child.

When her daughter was two, and made her bed the wrong way, she would praise her daughter's efforts, rather than correcting her young daughter's techniques. So, if the bed was lumpy when her mother made it, it was lumpy, and that was okay. At times, Lori's mother would question why the bed was lumpy, and then after questioning the lumpiness of the bed, after her mother would leave the room, Lori would remake the bed.  If Lori made the bed after her mother made it (but was complaining of having a lumpy bed that she herself had forgotten about creating) , and it looked perfect after Lori (unknowingly to her mother) would smooth out the lumps, her mother (in her forgetting) would say, "See how nice my bed and my room look today, Lori." And Lori would say, "Mom, you really know how to make your room look cozy."

 Lori's mother thought she herself had made the bed, and would then sit with a look of confidence and accomplishment.  She would not remember Lori vacuuming the room, or tweaking the pillows on the bed, she would only remember that she was directly involved in cleaning the room and would take all the credit for the room's tidy appearance. Lori would never lie directly to her mother about anything, but making the bed look nice for her after she  requested a lump free bed, was a way of honoring her request for tidiness.

 A decision was made by Lori and her family at the onset,  when her mother started showing signs of dementia to do all that could be done to preserve her mother's dignity, and to create a "happy bubble" of existence for her. Going with her into her reality, by meeting her at the bridge from past to present was one method that Lori used to communicate with her mother.  And following her mother's lead was another way to connect with her mother.

Lori thought of serving her mother's needs in the same way she would serve the needs of her newborn baby.  If her mother wanted to fry eggs at 3AM (which happened rarely because her mother was sleeping through the night), Lori would wake up with her to quietly supervise her efforts, and would happily serve her mother in the same way that she would wake up to care for her newborn baby when her daughter was an infant.

And how did Lori learn so much about a mother's love? From her mother!!  It was her mother who cared for Lori's grandmother through all of the stages of Alzheimer's Disease, and she never complained. She served her mother with non-judgement, active listening, a willingness to be led, a joyful spirit and with unconditional love.

Copyright 2014 Caregivers Get Fit! Mama  Nicey

The information in this blog is information. It is not meant to be a replacement for getting medical advice from your own health professional regarding your own individual health challenge or condition. Dr. Denise will not diagnose, treat, or give direct personal consultations/advice to you on this blog for any medical condition, but will give general examples, and scientific research on many different health topics.  How you decide to use the information is between you and your own medical/ health professional.

Wednesday, November 19, 2014

Meet Me At The Bridge

"Meet me at the bridge," was a common expression that my ancestors used 100 years ago. Families would meet extended family members every Sunday after church on the outskirts of town at the footbridge by the entryway to the park. They would gather in their "Sunday best," cradling wrapped baked goods in wicker baskets for picnics by the lake. Everyone in town would do this. (There were no computers,  cellphones or TVs.)  Lawns under the oaks, pines and elms by the lake would be littered with families gathering for laughter, fellowship and conversation. They would sit in the fresh air on checkered blankets, sharing fried chicken, potato salad,  home made apple pie, bread and butter pickles and lemonade. There would be games of "hide and go seek," rowboat races, magic shows and dancing to the sounds of fiddles, banjos, guitars, ukelele's, barbershop quartets and local ragtime bands. Times were simple then, and social interactions were "face to face."

Today, caregivers also have bridges. Bridges connecting the past to the present. Bridges building a greater awareness of memories, feelings, behaviors and actions with intentions of manifesting clear and honoring pathways to spiritual, physical and emotional well-being. What is the bridge? Where is the bridge? And how do we, " meet at the bridge, " to fully express the inner wisdom that each and every soul, regardless of physical, mental or emotional limitations,  has as their unique inborn, innate capacity to express ?

These are all life sustaining questions worth pondering. And with the advent of more and more people growing into their elder years afflicted with dementia and other health challenges into their 90's, it is imperative that caregivers embrace a shift from today's accepted paradigm of control, chemical/physical restraint and institutional isolation led by medicine, into a pro-active awakening stance of collective healing wisdom. A paradigm shift from, "out-side in, " to "in-side out." Healing led by active listening, becoming present to the "presence of the moment," connecting as one through prayer, meditation, music, exercise, yoga, dance, singing and role playing. Finding therapeutic ways to use the sounds and smells of nature to create bridges from the past to the present by surrounding people with beautiful plants, trees, friendly pets and colorful landscapes. Offering healthy choices in purified water and air. Prolonging healthy living through whole food organic nutrition, social interaction and through the most potent, and primal connection of all, the power of touch.

 Leading us from past to present into the hidden passageways of elder wisdom and healthy aging is one woman, Naomi Feil, MSW. Naomi Feil was born in Germany in 1932, and grew up as a child in a home for the aged where her father was the administrator, and her mother was the social worker.  After graduating from Columbia University in the 1960's and getting fed up with the traditional ways of communicating with very old, disoriented people, Ms. Feil developed her own therapeutic model called Validation. Validation is used to enhance dignity, reduce stress, and improve well-being.

 Validation theory, which borrows from psychology ( Carl Rogers, Erik Erikson, Sigmund Freud),  NLP and Akido (going with the flow),  explains that with an empathetic attitude, if one can, "step into the shoes," of another human being, and "see through their eyes," then it is possible to understand the sometimes, bizarre behaviors of very old disoriented individuals. And the basic premise of this model is that if we as individuals spend our lives suppressing our strong emotions, and never work out what we need to work out as things come up for us when we are younger, then these strong emotions, (ie: anger, hate, greed, love, passion or jealousy, to name a few), will dramatically be expressed in old age.  As Naomi Feil, MSW, explained this last week in Atlanta in a workshop of hers that I attended she said this: "The most important principle in "Validation," is: When you swallow strong emotions, they come out strong in old age!"  She also explained that there is ALWAYS a reason for bizarre behavior, and by knowing someone's life history, it is possible to use techniques to lessen anxiety when these strong emotions are triggered, and to create a better quality of life. Using Validation communication as it is intended to be used, according to Ms. Feil, causes the sleeping brain cells to wake up, and the old person never becomes a sleeping dead person.

I truly believe Validation is a VERY IMPORTANT step that humanity must take, in order to understand a rite of passage that brings with it, wisdom, truth, love and surrender as a pathway into a higher level of being. This can only be found by crossing the bridge that leaves limitations, judgement, control, separation, and fear behind. We can then embrace our highest good of living a quality life well into our elder years and leave this world ( when we are called to go), surrounded by loving support, peace, understanding, contentment and dignity.

For more information on Validation go to:

Copyright 2014 Caregivers Get Fit! Mama  Nicey

The information in this blog is information. It is not meant to be a replacement for getting medical advice from your own health professional regarding your own individual health challenge or condition. Dr. Denise will not diagnose, treat, or give direct personal consultations/advice to you on this blog for any medical condition, but will give general examples, and scientific research on many different health topics.  How you decide to use the information is between you and your own medical/ health professional.

Tuesday, November 11, 2014

Grandma's Kool-aid And Toxicity

I must have been 6 years old, and my grandmother (in my opinion as a youngster), made the best orange kool-aid on the planet.(Alright, I know kool-aid doesn't make the top of everyone's list when it comes to healthy beverages, but as a little kid in the 1960's, kool-aid was my favorite drink!)

 I watched grandma make kool-aid once, and found that it wasn't the kool-aid at all that I liked so much, but the water she was using from her well.Whenever we had family gatherings we would gulp down grandma's tasty well water which was filled with rich minerals from the earth that had a delicious, taste of it's own.

 One day, upon arrival at my grandparent's house,  I took a big swig of water and immediately spit it out. It had a plastic, chemical flavor. "Grandma, what happened to your water?" ( I was in shock, "Yuck!" I thought while crinkling up my nose.) "Our water now has fluoride in it so we can have healthy teeth," was my grandmother's reply.

 I was ticked off. This didn't make sense to me. The pure flavor of the water was gone forever,  and my grandmother's water tasted like chemicals. "How could that be good for us,  I thought as a 6 year old?" And I was right. Fluoride is a toxin, and it's use in our water supply as forced medication against dental caries has been controversial for years,  causing many countries around the world to ban water fluoridation due to health concerns. (See for more information on the dangers of fluoride.)

 Regardless of where you stand on the question of fluoride in water and toothpaste, or whether you brush your teeth at all,  the fact remains that we as human beings are swimming, LITERALLY SWIMMING in a sea of toxins. (Toxins in our food, toxins in the air, toxins in our water, in our shoes, cars, homes, paint, in our children's toys, in drugs, in the plants and animals we eat, and even toxins in our tissues, bones, cells, brains and entire bodies!!) Toxins are EVERYWHERE!!!  These toxins, man-made and organic,  build up in our bodies over time and can lead to disease and even death.And these toxins aren't going away, they are here to stay growing in numbers more and more every day!!

What can be done about these uninvited environmental invaders to preserve a healthy life?  Three things: 1) Reduce chemical, physical and emotional stress. 2) Detoxification  through exercise, perspiration and intermittent fasting 3) Healthy nutrition to balance the gut flora, maintain alkalinity and reduce inflammation.  Although nothing is full proof, practicing all three of the above will raise immunity, detoxify the system and increase the functional capacity of the body to preserve health.

Chiropractic, massage, meditation, yoga and acupuncture are excellent ways to reduce chemical, physical and emotional stress. Cardiovascular exercises such as cycling, race walking, elliptical work and rebounding are great ways to raise the body temperature to detoxify through perspiration. And some cultures, for thousands of years have used saunas to detoxify, but some cardiologists today have cautioned against sauna use in individuals with high blood pressure, or heart disease. Intermittent Fasting in the form of cellular cleansing is fasting that is supported by proper nutritional intake. This system can be found at:  Watch the video called: "Are You Toxic?"

Through proactive lifestyle choices, we can become best equipped to handle the negative consequences of living in a toxic world to embrace health and longevity.

Copyright 2014 Caregivers Get Fit! Mama  Nicey

The information in this blog is information. It is not meant to be a replacement for getting medical advice from your own health professional regarding your own individual health challenge or condition. Dr. Denise will not diagnose, treat, or give direct personal consultations/advice to you on this blog for any medical condition, but will give general examples, and scientific research on many different health topics.  How you decide to use the information is between you and your own medical/ health professional.



Tuesday, November 4, 2014

Teachermom Stress

The alarm sounds at 5AM. It's Monday morning and her 3 year old son has had a rough night.  She packs her lunch, hops in the shower, makes a light breakfast for her little one, and then interrupts her snoring husband's slumber to give him a peck on the cheek before loading the car.  There's her packed sack lunch, 650 sheets of colored construction paper, magic markers, two boxes of glue, 30 boxes of popsicle sticks and 6 cans of dried paint.  (All of this and more, by the way, was ordered from her own bank account, because of school  budget cutbacks.)  Then, of course a crabby little boy who doesn't want to go to daycare,  is tired from lack of sleep the night before, wants to stay home in his own bed to "sleep in, " but since his father worked the night shift (to make up for his mother's low take home pay), he can't stay home and needs someone to look after him while his mother teaches other people's children at a public school 45 mins. away from his house.

So, Johnny cries all the way to daycare, and his mother has to watch the road. It is a  dark,cold, frigid morning in "Timbuktu," (AKA a small rural town with a small population in the middle of nowhere),  where the deer population at dawn has been known to leap through the air from forest floors into car windows. She drops off her son to a display of heart wrenching screams, which pulls at her heartstrings every time, and makes it to school just in time to be the first teacher in line at the copy machine. Just when she feels her day is "going as planned," (she doesn't have the stress of waiting in line to make copies and has time to sip a hot cup of coffee in the teacher's lounge), a frantic school administrator calls her into the lobby with only 3 copies of lessons run,  completely throwing off her schedule. ""Okay, I know the weekly flyer reads "Tuesday" for you, but we need you to drop everything and pull "car duty" today, too. " "Mrs. Hornblower has the flu!"  So, with tennis shoes, (no boots or gloves), she stands in the  frigid, slush-ridden snow opening and closing  car doors for children exiting minivans at the main entrance of the school, totally exhausted and stressed out at 7:15 in the morning BEFORE  even teaching her first class of the day. And this is just another day. A typical one, too!

If we factor in pressures of ,"No Child Left Behind," "Benchmark Assessments," "Behavioral Problems, " "Overcrowding," "Absentee Parenting," and " Educational Budget Cutbacks," we have a very important profession becoming the most highly stressed profession. And as a health care professional, I can say that this dynamic of unreasonable  physical and emotional demands along with a lack of societal support, is leading to a  teacher healthcare disaster unlike any other, which may in time lead to a teacher shortage.More and more teachers are having stress-related health problems such as obesity, diabetes, heart disease and depression to name a few. This is not okay. There are some GREAT teachers out there who deserve better!!

Wellness programs in the school need to focus on the staff, and not just school lunch menu planning. The environment of the school starts with happy and healthy teachers in my opinion, which are directly influenced by administrative policies. How many school systems offer wellness educational opportunities for teachers? Can you imagine what it would be like to have a warm and healthy breakfast waiting for teachers when they arrive at their schools every morning, along with an onsite health club and massage chair just for the teachers???  A little spoiling in my opinion could go a long way. Instead, teachers have to be everything from their own secretaries, to parents to the few children who lack parenting at home, and who become behavioral problems that disrupt the entire learning environment of the entire classroom day after day after day!! This can be draining for anyone, but having a classroom of 3 to 5 children out of 30 who constantly act up can be exhausting!!  And depending on the support staff, whether they support the teacher or not, can cause some teachers to feel isolated, helpless and alone. I taught for one year, and was so exhausted at the end of the day, that I would fall asleep without dinner at 7PM, sometimes in my clothes!!!

How can teachers avoid burnout?  Studies prove that half of teachers beginning their career will be out of the profession in five years, and that, 25% will encounter depression, or burnout.  So what can be done?

Since I am a doctor and wellness consultant, I will speak to stress. I believe the best antidote for stress is to move your feet. Exercise works and can always be arranged around any schedule. I always tell people to get a medical work-up first,  to see what their physical fitness level is, and then to go for it!!  Walking 40 mins. a day can do wonders to clear your head, and even moderate walking can be a great stress buster. Although weight training, swimming and rebounding are my favorites!!

Good nutrition is next. Superfoods can work wonders for weight loss and sugar regulation. Undenatured whey protein, high quality vitamin and mineral support, adaptogen support, and a system of weight control. The best I have seen in years is what Isagenix offers. (I myself have lost 60 pounds on this system!) Isagenix has an entire program of weight loss, longevity products and products for athletic performance. Go to: to order the products.

Bodywork is a great stress buster. Chiropractic care works directly with nervous system interference caused by mental, physical and chemical stress.  Massage works wonders to support chiropractic adjustments and to calm over worked muscles.

Talk and listen.  Find someone to talk to for emotional support. A group of teachers, a pastor, a counselor, or a dog. (I'm not kidding when I say a dog. ) And listen. Walk in the woods, or by water and listen to your heart.

Caregivers reading this, if you are a teacher we appreciate you!!  And if you are not a teacher, do something nice for a teacher this week, your kindness will go a long way. (I'm partial, I'm married to one!)

Copyright 2014 Caregivers Get Fit! Mama  Nicey

The information in this blog is information. It is not meant to be a replacement for getting medical advice from your own health professional regarding your own individual health challenge or condition. Dr. Denise will not diagnose, treat, or give direct personal consultations/advice to you on this blog for any medical condition, but will give general examples, and scientific research on many different health topics.  How you decide to use the information is between you and your own medical/ health professional.


According to a study conducted by Resilience Education, teachers often leave the teaching profession because of depression. In fact, the National Center for Education Statistics reports that nearly 50 percent of all teachers leave teaching after only five years in the profession. Teachers, like others in demanding jobs, may become depressed as a result of workplace stress.

Read more :

According to a study conducted by Resilience Education, teachers often leave the teaching profession because of depression. In fact, the National Center for Education Statistics reports that nearly 50 percent of all teachers leave teaching after only five years in the profession. Teachers, like others in demanding jobs, may become depressed as a result of workplace stress.

Read more :

Saturday, November 1, 2014

Cindy Through The Glass

The plants had been watered, the wind was blowing and the clouds were moving like passing ships on the horizon. I looked through the glass on the door leading to the deck as I folded the towels, and Cindy was listening to every word she said. Her head was cocked to one side, almost as if she had questions of her own, but moaned instead,  just before falling off to sleep with a yawn and a "thump" landing with her chin on the slatted wooden floor. It was a very close one-sided partnership of sharing and listening. There was no judgement, just love and an occasional gesture of physical affection. Cindy liked to get her belly scratched, and Lori's 84 year old mother liked to lavish Cindy with ear rubs, table scraps and long winded conversations.

Mornings were met with the same routine. A 6 AM walk and then kibbles falling hard like granite pebbles into a  round plastic bowl. A symphony of canine crunching, lip smacking, snorting and  then the worst habit of all, Cindy's unladylike elegance of always drooling on the floor.  Cindy liked to lay facing the closed bedroom door because she knew at any moment, even if she had to wait 2 to 3 hours, that Lori's mother would soon appear with her love-filled toothless smile in her nightgown, slippers, disheveled hair and half-buttoned robe. And then, a greeting unlike any other Cindy would jump, run in circles and yelp with such passion and gratefulness at once again seeing her long lost friend. It was almost cruel to have trained Cindy to not enter Lori's mother's room.  But Cindy was a very large girl weighing over 85 pounds, and would surely want to sleep in the bed, leaving very little room for a human to have a restful sleep. They were joined at the hip, two as one. An old woman and her dog!

So, was the research true about pets helping people to live longer lives? Research about blood pressure being lowered, immune levels going up, and people with dementia having better outcomes? Maybe so. And why not? What are the side effects of having pets around, as long as a caregiver is present to see to the needs of feeding and walking the animal care partner? And with that being said, is there a void that pets meet as care partners that human care givers have yet to learn?  Are we doing this whole thing wrong?  Maybe we ought to listen and observe more to what the animals are teaching us? Questions worth pondering indeed!

Lori was almost finished folding the laundry and then looked out the window. Lori's mother was pointing up to the sky, and Cindy was following her pointed hand. Lori's mother looked like she was giving a lecture to Cindy, and Cindy was sitting up and wagging her tail. The curiosity was mounting in Lori's mind, so Lori went outside and sat in the cushioned chair beside her mother.

 "Wow, mother it is a beautiful day today, and the air is so crisp. What are you thinking right now, mom?" "I'm thinking about the trees and the clouds, " said Lori's mother. "Really?  And what are the clouds telling you, mom?" "They are showing me faces, and the trees have seen so much history, Lori."  "I wish the trees could talk, " said Lori's mom. "Well, if they could talk to us right now, what do you think they would say?"( Lori was always so happy to hear her mother expressing herself, because there were many moments when her mother would just sit in silence, and would give two word sentences, "I'm fine." She would and could spend hours in the same chair looking off into space, saying nothing, but, "I'm fine," followed by silence. However, after inviting Cindy to be her constant companion, that all ended. Lori's mother had become a chatterbox.  )

 Lori's mother's face glowed in the sunlight underneath the blue, cloud filled sky. "Well, you see that boulder over there?" Lori's mother pointed to the boulder underneath the pine tree in the neighbor's yard. "The trees would tell us that there is a hidden treasure underneath that rock, buried by confederate soldiers." Lori's mother said. "And what else would the trees say?" Lori enjoyed seeing her mother come to life, and enjoyed sharing these moments with her. "I'm afraid there would be sadness, too Lori," said Lori's mother. "What kind of sadness, mom?" "Sadness of a war, Lori. The soldiers would camp underneath the trees, and would eat hardtack and beans. They would write letters to their families around a campfire, letters of "good-bye" not knowing if they would live another day, and the trees would see it all." (Lori's mother would then, without giving Lori a chance to answer shift from saying something profound, to totally changing the subject like four year old's often do. ) "You see that cloud over there?" Lori's mother had so much enthusiasm in her voice at that moment, that Cindy too appeared to have a smile on her face, and started wagging her tail, almost as if she understood what her favorite companion was saying. Lori's mother then started laughing a hearty laugh. "What do you see, mom?" Lori stretched her head up to the sky, and there as clear as a bell, was the shape of a floating rabbit in the clouds. The ears, the body and the tail, slowly moving in the clouds. "Do you see it, Lori?" I do, mother, I see it!" Lori, too was laughing. "It's a bunny rabbit in the clouds, Lori!"  "I see it mom, I see it."

Then all of the attention was on Cindy who was filled with energetic enthusiasm. "Cindy, BUNNY RABBIT, BUNNY RABBIT!!"  Then Cindy flew off of the porch and ran into the woods. Lori's mother laughed and laughed. "Well, we won't tell her the bunny isn't real, " said Lori's mother. "The trees are calling her, and she is happily living in her own world," said Lori's mother taking in a deep sigh, wearing a contented grin.  "She is happily living in her own world!"

Copyright 2014 Caregivers Get Fit! Mama  Nicey

The information in this blog is information. It is not meant to be a replacement for getting medical advice from your own health professional regarding your own individual health challenge or condition. Dr. Denise will not diagnose, treat, or give direct personal consultations/advice to you on this blog for any medical condition, but will give general examples, and scientific research on many different health topics.  How you decide to use the information is between you and your own medical/ health professional.


Tuesday, October 28, 2014

Longevity and Nutrition

"She keeps to herself, a lot." She sleeps all day long.She won't bathe and her memory is getting worse." And the medical doctor said, this is all that can be done for her! How are we supposed to sit back and watch our loved one suffer, dwindling away as a shell of the human she used to be?" These are all questions I have heard from friends, family members, co-workers etc., over the years regarding the elderly.  It is almost as if an unwritten, invisible expiration date has been placed on a body part, or hidden in some undisclosed location, and there doesn't appear to be anything that can be done about it. People get old, they break down, they isolate, they forget, they lose bowel and bladder control and they die.

"NOT TRUE!!!!!  DON'T BELIEVE IT!!!"  That is what I say. As baby boomers advance into the elder years, they are going to bring education, intelligence and dignity into the once known invisible aging population,  and it is going to start with the wellness revolution of nutrition, bodywork, positive thinking, mental focus and fitness.  It will not include limitations of having someone in a white coat writing a prescription of  "drugs and surgery only."  It will be with the pro-active due diligence of exploring holistic and natural ways of embracing healthy lifestyle choices to preserve the benefits of longevity.

So, let's start with the above observations above in paragraph one. Let's say all of the above observations are true, leaving  the question of: "What can be done about giving our loved one's opportunities to embrace a better quality of life?" Having a good doctor is a good idea. But having a doctor educated on nutrition and wellness in the aging populations can sometimes be hard to find.( And I am not professing to flush the prescribed medications down the toilet, either. But to find a doctor who not only understands drug interactions, but who understands nutrition, the implications of environmental toxins, food sensitivities and drug induced malnutrition.)

 In the above example, the symptoms were analyzed, and then more drugs were prescribed by her physician, along with a corn syrup/sugar laden drink touted by a dietition on TV as being the best drink for aging populations!  So,(according to her lab studies on record), the doctor treating the family member never looked further into why the sugar levels had been elevated for 5 years, and prescribed more of this drink which was laden with more sugar to help with her malnutrition.  And when the D3 levels had fallen to dangerously low levels while under the care of her traditional M.D., ( which shocked this family member's new holistic internist when he reviewed her medical records), her behavior was blamed on dementia.( Here is a quote from a study on D3 from the United Kingdom: “We expected to find an association between low Vitamin D levels and the risk of dementia and Alzheimer’s disease, but the results were surprising—we actually found that the association was twice as strong as we anticipated,” said study author David J. Llewellyn, PhD, of the University of Exeter Medical School in the United Kingdom.)

 When Folic Acid was low and was not being metabolized efficiently by her system, (possibly for years), her new holistically oriented internist caught it, and she is now receiving proper supplementation which has helped her greatly, and the levels are now being monitored to normal levels by lab studies.  There was a cascading effect of malnutrition giving horrific results and a traditional medical doctor who never thoroughly checked her blood, stool, urine and hair for drug induced nutritional deficits, and environmental toxins that could have been contributing to her memory loss, but kept treating her symptoms over and over with drugs. Drugs with side effects leading to more symptoms leading to more tests, more diagnoses and more prescriptions!   Her traditional doctor did nothing wrong according to medical practice standards because many MD's, (excluding the holistically oriented ones), appear to have a limited education in nutrition.  From what I have seen as a caregiver of a family member with dementia, other than maybe testing for D3 deficiencies, the traditional medical doctors do not appear to run the same level of tests for  nutrient deficiencies on a general scale as the holistic medical doctors do.

 This woman was given a diagnosis of Alzheimers by her original internist , but when her new holistically oriented internist ordered new labs,  he diagnosed her with Type III Diabetes also known as Vascular Dementia, and said that the only doctor to diagnose Alzheimer's needed to be a  neurological specialist. It wasn't until this woman's blood was checked, her hair was checked and her urine and stool were checked for nutritional status that she was able to get help, which turned around her behavior and lifestyle habits giving her a better quality of life. Her cardiologist cut her heart medication in half. The change with a thorough medical/ nutritional evaluation and specific monitoring has been amazing!

Today, this woman with dementia still has moments of forgetting.  But with very careful monitoring by her holistically oriented family physician, regular lab work every few months, daily supplementation, ingestion of a nutritional longevity products that recently beat out the "Heart Healthy Diet," by 50% (See longevity products at:, exercise, meditation, chiropractic, massage, social interaction, and positive validation therapy by her caregivers, she is living a comfortable life.

Has she been cured? No. But her activities of daily living have greatly improved. She no longer craves sugar, sleeps through the night 95% of the time and is energetic. She makes her own bed, gets dressed everyday rather than staying in her pajamas, likes to take baths, puts make-up on without prompting, does her own nails, folds laundry, is doing word scrambles again, writes daily in her diary, exercises on an exercise bike, goes for walks daily, goes to a drumming circle, sings in a choir and remembers things from a day before. Will she ever be completely cured of dementia? Who knows? But her quality of life has improved.  She is not a shell. She is a human, and deserves the best quality of life available.

As caregivers, we need to do our homework by checking drug side effects, staying diligent with doctors, writing down questions before office visits, and having our elderly checked for malnutrition. Recent Pubmed studies from the National Institutes of Health indicate that drug induced malnutrition among those suffering from dementia can oftentimes be left unchecked in nursing homes.

  Because malnutrition can lead to serious diseases including dementia, and even death, it is a very serious issue. Researching the benefits of probiotics, cellular cleansing, CoQ10, fish oil supplementation, and glutathione rich, un-denatured whey protein is a good start in understanding ways to help your loved one to embrace a higher quality of life!. Virgin coconut oil, with medium chained triglycerides, also has lasting benefits for overall health and longevity.  (See: for more info. on nutritional longevity products for active seniors and the elderly.)

Researching ways to provide good nutrition as a caregiver is important, along with finding the right doctor. Traditional medical doctors are not nutritionists, and are not accustomed to checking the blood, urine, stool, nutritional habits and hair on every patient in one routine medical work-up. Finding a holistically oriented doctor with a background in nutrition who goes the extra mile to get specific lab work done for healthy aging can prevent malnutrition and can possibly save someone's life. 

Copyright 2014 Caregivers Get Fit! Mama  Nicey

The information in this blog is information. It is not meant to be a replacement for getting medical advice from your own health professional regarding your own individual health challenge or condition. Dr. Denise will not diagnose, treat, or give direct personal consultations/advice to you on this blog for any medical condition, but will give general examples, and scientific research on many different health topics.  How you decide to use the information is between you and your own medical/ health professional.


Monday, October 20, 2014

And Then There Was Nancy

In the late 1980's, my first year as a psychology major brought me to a  long term, state run mental health facility for older women.  Some of the women had been living on the ward for over 30 years. My assignment was to spend a few months visiting one of the residents, and to observe behaviors. Rita, (not her real name) was in her late 60's and was very skittish when I met her. Our first few 2 hour meetings were spent in silence.  I would talk, and she would briefly look at me, and would then look away,  never establishing eye contact. Having a life-time of experience living with a mentally ill parent, and working as an animal rights advocate, dog trainer, and animal handler helped me to follow Rita's lead. Dog's and horses who are skittish, need time to feel safe, and many times need to make the first move towards establishing a contact. This takes a great deal of patience and understanding, and cannot be forced. (I remember watching 3 wranglers on the ranch once, forcing a horse to do something without establishing a trusting, nurturing contact and the horse almost trampled them. They then started whipping the horse  into submission, as if the horse was the problem,  and that they needed to "teach the horse a lesson."  The horse was scared to death by their lack of willingness to build a bridge of comfort and respect before physically handling the horse.) After a few visits of developing trust,  Rita started establishing more eye contact, and started sharing things with me. She would tell me about her childhood, about her life on the ward, and would gossip about other residents, etc. I would visit Rita twice a week, and according to the staff, this  2-3 month college project was the only way that many of these women ever received visitors.

One day, the sky was so blue and the air was aromatically thick with Autumn. You could literally smell the leaves, and the pine trees in the breeze. I thought of Rita being in the sterile four walls of the facility, and thought that maybe she would like to take a stroll with me on the grounds. After getting permission from the staff, I sat with Rita and then suggested that maybe a stroll on the grounds would be something we could do together. There was hesitation from Rita, but I didn't see it. I thought that I knew for sure that she would enjoy getting out, and wasn't thinking of her initial reaction to my suggestion.  Again, I mentioned the walk in the courtyard, and with some convincing, Rita started walking down the hall with me.  About midway to our doorway leading to the outside world, Rita started hyperventilating. We stopped walking and she started mumbling and then rocking her torso.  I brought her back to her favorite chair. She slowed down her breathing and eventually stopped rocking. As tears fell down her face, she kept on repeating, "I'm not ready to leave, I'm not ready. This is my home. This is my home."  I assured her that she was okay, and would not have to leave the facility, even for a walk if she didn't want to. She then calmed down. After sitting with each other and doing deep breathing together, I asked her what she liked most about her home. Without hesitation Rita said one word, "Nancy."

Nancy was one of the nurses on the ward, and was clearly the most loved nurse by the residents. Nancy rarely raised her voice like the other nurses did, and when she was out for the day, her absence was felt by everyone. The ward  itself, even the walls,  felt different when Nancy was gone. Much more chaos existed, much more confusion and episodes of acting out, etc. When Rita had her episode in the hall, I looked back at Nancy, and she mouthed silently to me , "She'll be okay. It's alright," giving me the confidence to bring her back to her chair, etc. Nancy seemed to have a silent desire to see everyone succeed, and to be happy. Her demeanor was one of calm.

Watching Nancy communicate with the residents on the ward was my first experience of seeing anyone using validation therapy. Nancy appeared to enter into the world of whomever she was with, bringing comfort and understanding to every conversation. The residents felt very secure when Nancy was working with them, and rather than using force to get them to comply with her demands, Nancy would connect with them, and would then redirect them to follow through with her requests, having them think that whatever actions they were taking, were actions of their own choosing.  It was highly skillful and incredibly effective. It reminded me of techniques I had been taught as a dog trainer which utilized operant conditioning and positive reinforcement. And behind it all was respect, love and a deeply held conviction to maintain dignity.

Caregivers who find themselves constantly correcting people, may be trying to bring people into a reality that is not their reality. When most of us look up at the sky, we see that it is blue and filled with clouds. If the person that we are caring for has dementia and insists that the sky is red and full of flying elephants, who are we to disagree with them?  In their own minds the sky is red, and that is how they are seeing their reality. Our job is not to correct or to try to bring them back into our reality, it is to connect in much the same way as Nancy did in the above example. People need to feel safe, and that they are being heard. It is not always what we say, but how we say it that will be remembered.  The woman on the ward truly appreciated Nancy's vocal tone.  She never raised her voice, and although she had clear boundaries, she also had every woman on the ward knowing that she cared for them and would be a soft place to land if they needed her.

I was recently visiting a friend who told me of two sisters who lived together for years, until one of them had been diagnosed with Alzheimer's Disease and eventually died. My friend said, while the sisters were still living together, she would hear one of the sisters screaming at the sister with A.D. into the wee hours of morning on a regular basis.  She wasn't allowed to sleep, because her sister with A.D. would wander at night vacuuming the house, taking pictures off of the walls, and cleaning out the closets. My friend's neighbor screamed so loudly once, that the sister  with A.D. ended up leaving her house at 3AM, causing the sister without dementia to wake up the entire neighborhood by screaming in my friend's driveway dressed in her pajamas and curlers, when her sister disappeared. My friend found the sister with A.D. in her car,  which the woman with A.D. had escaped to because she couldn't understand why her sister was always yelling at her. "Why is she constantly yelling at me?"  In her own mind, 3AM meant nothing. All she knew was that she wanted to clean the house at that time, and couldn't understand why her sister was constantly opposed to her cleaning habits.

The woman in the story with A.D. eventually became so agitated from the yelling, that she became violent and had to live in a nursing home away from her sister before passing away. The woman's violent episode  against her sister was blamed on the A.D., and no one ever thought that maybe the constant screaming in her ear, and anger driven exchanges from her caregiver caused her to become extremely agitated,  which possibly led to her violent actions. No one knows for sure, but the point is that many people living with dementia are misunderstood and need to live in peaceful, nurturing, and supportive environments.

Wednesday, October 15, 2014

Waiting For The Bus

   The shopping van had arrived, and when Maggie was quizzed by the driver on her friend Heidi's whereabouts, she shyly said, "I think she went to the restroom!"  The van driver waited 10 minutes before pulling away from the assisted living facility, leaving Heidi behind.  Twenty minutes later, Mabel wanted to use the  lobby's rest room,  but noticed the door had been locked from the inside. So,   Mabel thinking the rest room was occupied, went back to her room and watched an episode of, "As The World Turns."  The day went by, still no Heidi,  and the driver of the van just assumed that Heidi had gone back to her room, and Heidi was never reported as missing.

  Four hours had passed,  and 3 people had complained about not having access to the lobby's rest room. The custodian, wearing a tool belt and kaki pants was summoned to fix the broken lock.  Knocking on the door by several people had yielded no results and a sudden panic set in. ( FYI: This happened in the early 80's. I think by now, most facilities have keys to their restrooms to avoid this scenario.) Before calling the fire department, Mrs. Anderson, the building supervisor decided to enlist  the assistance  of 2 janitors who used drills, screwdrivers, wrenches and rubber hammers to take down the door. An hour later, the metal door had been completely removed from it's hinges by two janitors.  And there in front of residents reading magazines, the receptionist and building supervisor solved the mystery of Heidi's whereabouts.  Heidi was peacefully and pleasantly sitting on the toilet fully dressed in her winter coat, gloves, hat, and color coordinated purse,  totally oblivious to the activity around her. When she wouldn't budge from her perch, Mrs. Anderson, the supervisor said, "Heidi, what were you doing locking yourself in the restroom,  and sitting on the toilet in your winter coat for 5 hours? "Why didn't you open the door when we wanted to know if anyone was in the bathroom?" "Do you have any idea of the trouble and expense people went through to open this door?" Heidi,  appearing to, " come to, " took in a deep reflective breath and then paused, creating a defensive and slightly annoyed posture as if someone had asked her the most absurd question in the world.  And then, with delightful confidence, she lengthened her spine as if she had just remembered the winning letters to a "Spelling Bee" competition answering, "I was waiting for the bus!" " I was waiting for the bus, okay?"

It wasn't long after this incident that Heidi was asked to leave this facility and admitted into a long term nursing home for people with Alzheimer's Disease. Heidi was still ambulatory when she took up her permanent residency in the home. Soon, with much medication and  with very little creative stimulation, Heidi's health deteriorated, and Heidi died.

 How would the above scenario have played out, if Heidi was a 5 year old? What would have happened if Heidi's caregivers would have been people trained in proper communication techniques that honor the gift of presence without judgement?  How might the dialogue have gone? Let's just say that Heidi was a 5 year old who had been observed, on many occasions as being a child who liked to play "hide and go seek?" The caregivers putting the people on the bus would have been able to see that  5 year old Heidi was not present, could have followed through on the lead from her friend by knocking on the bathroom door. Seeing that the door was locked , a caregiver could have said, "Come out. come out wherever you are!"  Or for an elderly woman, "Heidi, the bus is leaving now. Come on,  Heidi,  time to have a fun shopping day. We saved you the best seat, Heidi!"

Greeting Heidi with accusatory questions such as Mrs. Anderson's response can cause even more confusion. Most people suffering from dementia understand that something is wrong with them.  They can easily become depressed and withdrawn from accusatory words and actions by caregivers. When a small little baby "spits up" on us it is expected. We understand that babies are spontaneous, and nothing can be predicted. We just prepare ourselves for everything and lovingly interact with our baby in playful and helpful ways. When a person has dementia, they are also spontaneous and unpredictable. And "yes" sometimes they may "spit up" on us by doing things that are inconvenient like locking themselves in the bathroom while waiting for a bus. These types of behaviors are to be expected, and through positive affirming communication, we can prepare for them.

A friend recently gave me the analogy of losing one's keys when she said, "A person who is forgetful, is like a person who loses their keys. The individual may not remember where they originally placed their keys, but eventually finds them. Whereas, a  person with dementia sees a set of keys in the palm of their hand, can't remember why the keys are in their hand, and can't seem to recall what the keys in their hand are used for."

 However, from what I have seen, is that the person with dementia knows they don't know and are confused and scared,  all at the same time.  One thing that I have communicated to someone with dementia (when there appears to be frustration from forgetting) is, "Would you like an update?"  I never would say, "Are you confused about the keys?" I would never specifically point anything out by asking direct questions, but proactively leave a space of acceptance without judgement followed by silence. If the person with dementia chooses to respond, they may say, "Can you give me an update?" Or at other times a person will say, "I'm fine." There are other times that amazing wisdom is expressed which comes out of nowhere, and can be liberating, leaving an opening for deep intimacy and spiritual connectedness.  But these moments can only happen when there is a feeling of trust, acceptance, and non-judgement.

   In Heidi's mind she was just waiting for the bus, and since it was cold outside, the warm and quiet bathroom was a very logical solution to her needs. She wasn't aware of the passage of time. Only the warmth,  peace and quiet comfort of a secure environment.

Monday, October 13, 2014

South Dakota's Jingling Keys

It started with a loud, "crash," then a "bang," followed by mumbling and the jingling of keys. Lori woke up with a"jolt," thinking to herself, "What on earth is happening?"  Slowly lifting the eye mask off of her face and wiping the sleep from her eyes, she could see the digital clock in the corner of her room reading it was, 4:30A.M. Then it dawned on her, "Mama!" Oh dear, it was clear to see that Mama was packing up her entire bedroom.

Lori walked down the steps to the Master suite which Lori and her husband gave to her mother when she moved in with them. It was a large bedroom filled with pictures of her mother's treasures along with a color TV. There was a bathroom off of the bedroom which made everything convenient for her mother who suffered from dementia and other health challenges. When Lori arrived to her mother's room she was shocked, and almost let out a,"GASP," but decided to not react. "Mother, how are things going?" Her mother looked focussed and annoyed. "I'm on a schedule, Lori. I don't know how in the world we are going to fit everything in the car." Everything in the room was packed in garbage sacks and suitcases.  Somehow, in the wee hours of the night, Lori's mother had managed to pack everything in the room. Pictures on the wall had been taken down and wrapped before being put into boxes, Lori's linens from the closet were packed, toiletries were packed, the bed was stripped, the TV and cable unit was dismantled, and it even looked like she had started to take down the curtains!

"Mother, forgive me if I am having a lapse with my memory, but it's early and I may have forgotten. Are you going somewhere?"  Her mother stopped, and looked surprised. "Lori, don't you remember?" Lori didn't say a word. Her mother picked up another hanger, and continued to pack. "I'm going to visit my mother. We have some catching up to do," she said.  "Oh, that's right," said Lori. (Lori's grandmother had been dead for over 30 years.) Then Lori saw her car keys in her mother's hands. "So, are you going to drive all the way to South Dakota, or are you going to fly?" Lori quizzed her mother. Her mother started laughing as if Lori was the most ignorant person in the world. "No, silly girl, I am going to drive."  (Lori's mother had not driven a car for years due to her dementia.)  "That's a lot of driving, mother. Are you sure you are up to it?" Lori was fishing for words to say. She knew she couldn't hand over her car to a woman with dementia. Lori's mother started getting agitated. She pursed her lips, straightened her spine and took a deep breath. Lori then decided to honor her mother's reality and said, "Mom, you have my support always. If driving 3,000 miles alone to S. Dakota is important to you, then I am behind you 100%.  In fact, I too would like to see grandma."  Lori's mother then changed her defensive body language, stopped pacing and sat closely to Lori. She yawned, and Lori said, "Mom, why don't you join me for a big breakfast. Then, after breakfast, after you drive the kids to school you can have the car." Lori paused again after saying that. Lori's mother said, "After I drive the kids to school?  Lori, I don't know my way around here and the highways are confusing! I'm going to go back to bed.  I'll join you for breakfast later!"  Lori's mother went back to bed, and after she fell asleep, Lori quietly unpacked the room, reassembled it putting pictures back on the wall,etc.  When Lori's mother woke up from her nap, she walked into the kitchen and said, "Good morning, Lori." "Good morning mother," said Lori. "How did you sleep?" Lori's mother looked puzzled, "Well, I slept fine, as always.  What's for breakfast, I'm starving?" Lori made breakfast for her mother, and her mother never mentioned going to South Dakota again.

Lori's note to herself: Dementia proofing the house.  "Time to hide the car keys!" People with dementia can get lost in their own homes, and the problems are exemplified when they leave a familiar environment and get lost far away from home.   Driving without a license is not only illegal, but unsafe for the community. Having someone driving up a one way the wrong way, or pressing the gas instead of the brake can also lead to horrific consequences. The main lesson Lori learned from being awakened at 4:30AM and seeing her mother packing up the house,  was to prepare for the worse, and to expect the best. Hiding the car keys would be a good start followed by a visit to the Alzheimers Association's website and getting a home safety packet. 

With patience, planning and loving communication it is always possible to continue creating happy memories with aging loved ones challenged with dementia, even if they fantasize about driving 3,000 miles away from home without a driver's license to visit a family member who has been deceased for 30 years!  Lori honored her mother's reality and then, by becoming present with her mother's needs, she was able to shift her mother's focus to constructive and safe action.

Friday, October 10, 2014

A Return To Dignity

It was a beautiful day in September.  The trees were losing their leaves, and acorns, stones, broken twigs and pinecones were scattering in every direction underneath my feet.  And each step was bringing me closer and closer to a sacred, and yet familiar curiosity.  Many years had passed, all reflected in deeply hidden memories, some of which I would choose to forget. But nonetheless, there it was again,  all at once appearing  as flashing images and brightly colored passages bringing me back again to another gated, window barred, long term psychiatric facility. 

Unlike other psychology majors enrolled at the university, I was very comfortable spending time with mentally ill people.  I had a lifetime of experience, and was given the secret spark of wisdom and understanding, at the tender age of four. I was told that people who were mentally ill were no different than people with the stomach flu. In my young mind, I clearly understood that mentally ill people did not always” throw up” the same way people did from tummy aches, because they did not have sick tummies. Mentally ill people, would at times, act or say things that sounded scary, or confusing to us not because they were bad people, but because they were “sick in the head.”  (That is the way it was explained to me as a 4 year old by my mother who helped me to understand my dad’s behavior, and it made sense to me.) However, what I haven’t been able to understand my entire life is, “Why do  people in social situations treat people with mental challenges differently than people who appear to be without mental challenges?”  Some of the greatest artists, scientists and geniuses in the world have been known to suffer from mental illness. Without the contribution of these beautiful and unique souls, our society would not be the same.

  I was in my second year of college. I was studying pre-med and psychology, and although my first experience visiting a mental institution was as a four year old, my first project in college was to spend 3 months detailing the behavioral habits of mentally ill women living in long term psychiatric facilities.  Little did my professors know, was that my childhood experiences alone, observing behaviors of patients at psychiatric institutions in the 1960’s, far outweighed the limited knowledge gained from a 3 month psychology behavioral assessment assignment.

My father was institutionalized in the 1960’s.  I was four, and remember visiting him during one of his  stays at a state run psychiatric hospital. People strolled freely on the grounds shadowed by nurses in cat-eyed glasses, ratted up hair and white, starch- ridden, bobby pinned cardboard caps.   The halls were filled with psychotropic sleepers wearing soiled t-shirts, striped robes and polka dotted pants. The women wore lipstick lines up to their noses, with too much rouge holding half lit cigarettes with pampered Hollywood gestures of imagined elegance.  People sat in smoke-filled rooms, grouped together by the staff in self-created isolation. There was pacing in repeated patterns of lines and circles, screaming at the walls, talking to the air, and dancing with invisible strangers. Like a gallery on display exploding with colors of raw emotions, unique and uncontrolled artistry was at play right before my eyes.  I breathed in these colorful expressions slowly and reflectively with child-like excitement. I had never seen adults behaving this way.  And in my innocence, having an unfiltered world view, I only saw a beautiful playground full of unique and creative souls, held together as one in a special place far removed from the limitations of the world.  It was fascinating to see as a four year old. I thought everyone had bloodshot eyes because they were happy. I thought people danced and talked to the air because they were free.  The bars on the windows left questions. ” Why were so many grown -ups wearing their pajamas?" and “Why couldn’t my daddy come home with me?”

 The happiest day of my life as a four year old, was when my mother told me to sit on the front porch one day to wait for a surprise. In less than 5 minutes a car arrived and dropped off my dad. He picked me up in the front yard underneath the maple tree and swung me around in his arms. He wasn’t mentally ill to me, he was just my dad. And I loved him enough to look beyond his suffering, and the suffering his mental illness had brought to our family. It was just the raw and pure emotion of unconditional love between a father and his daughter. 

 Signing in with the receptionist to start my college project on that particular day, left a chill running up my spine. I knew, there was no doubt that my father needed to be institutionalized back in the 1960’s, but hearing the loud reverberating echo of thick metal doors, and jingling keys closing behind me left me wondering, “What would it be like to have someone sign away my freedom, shutting me off to the world outside, bringing me into a sanitized, highly medicated society with tall fences and metal bars on the windows?”   The loud metal doors closed with a “crash,” followed by an echo reverberating through a long corridor.  

  I spent three months visiting the women’s ward of the sanitarium and after watching hundreds of episodes of “Wheel of Fortune” and getting to know some of the women who had been institutionalized there for 30 years was left questioning why so little had been done other than medication and isolation to help people suffering from mental illness over the years? With budget cuts, the sanitarium was soon closed down and I never heard what happened to the women who lived on the ward. Perhaps they were relocated to nursing homes. (Unlike the thousands of mentally ill across the country who are now hungry, homeless and sleeping in cardboard boxes. Or others who may need hospitals or specialized outpatient counseling and treatment which are no longer available to fill their needs because of government cutbacks.)

What I would like to see, regarding the treatment today of people suffering from mental illness?  Many things. But mainly love, compassion, patience, understanding and a return to dignity.

Monday, October 6, 2014

The Subway Stranger

   The air was brisk, the leaves were falling and I was beginning a new career in Manhattan, electrified to embrace changes that were happening in my life. I was a new doctor with a beautiful office two blocks away from Central Park caring for professional film makers, actors, musicians and corporate executives,   who valued natural healing.  Leaving my office on that evening in October, I never knew that in just a few short minutes, a total stranger was going to quietly share his own un-invited opportunity for change with me, simply by sitting next to me and not uttering a word to me on the train.

  Rush hour in NYC always meant a race against time, and my deadline was to board a diesel powered, diesel fuming transit bus awaiting my arrival at Port Authority. This meant catching the subway, jogging through traffic, climbing up escalators, buying tickets and securing a seat on the bus, all in less than 30 minutes. This daily ritual of commuting back and forth to New York from New Jersey had to be timed with the precision of a militaristic, left-brained, mathematically inclined athlete, which I wasn’t even close to being, but somehow,( in order to beat the crunch of the rush ),  ended up enacting with the skill of a highly trained marine.  

  There I stood, standing shoulder to shoulder with commuters wearing trench coats, sipping energy drinks and reading magazines waiting for the “A” train to take me back to the Port Authority.  After hearing the sound of squeaky brakes followed by mumbled gibberish, the subway stopped, and to my delight, rather than standing, I found the last available seat on the crowded train.  Listening to the slow starting momentum of metal and steel, I took a deep breath, a grateful sigh of relief.  And then, without warning, I saw something that hit me like a” ton of bricks, “and nearly broke my heart. 

Sitting next to me on the subway train was a handsome twenty-something man with thick dark hair who was beautiful, and model perfect.  His appearance alone ought to have taken my breath away, but the sadness that he carried in his spirit that day was so obvious, that sitting next to him gave me a lump in my throat, and filled my heart with a deep, unexplained sadness. I felt the weight of his sadness between my shoulders, at the nape my neck, and at the center of my heart,   all at the same time. It was so strong that I had to work hard to hold back my tears, but “Why?” I thought.  “Why do I feel so sad?” 

 Then, with little effort, I found the answer to the subway stranger’s sadness. He was holding printed pamphlets on “Understanding Leukemia,” in both of his hands. He had a blank stare, looking down at the floor, a blank stare gazing out at the moving graffiti dancing in colors on the subway walls. A blank stare of clouds surrounding crowds of people talking, laughing and sleeping. A blank stare, casting his vision EVERYWHERE and anywhere else, choosing to ignore the lab values, office logos, written reports and  information on crumpled paper he held so tightly between his fists and trembling hands. 

The sadness that the subway stranger displayed with his blank stare and slumped appearance, seemed  to reflect an inner realization that important changes, unwelcomed ones,  were about to be made in his life. Changes on the horizon that he had no say about. Changes that could lead to regeneration, personal growth or triumph. Along with changes that he may have feared the most. Changes leading to the reality of not having his dreams fulfilled, or changes ending any opportunity of having any future at all.

 I sat in silence, praying and calling on the angels, and before I could utter a word to him, the subway stranger vanished into thin air.  Somewhere into the crowded city quietly dashing under the blinking yellow sign that read,” Welcome to 42nd Street, “and I never saw him again. 

 As Helen Keller once said, "When one door closes, another opens. But often we look so long, so regretfully, upon the closed door, that we fail to see the one that is opened for us. "  I will never know what happened to the Subway Stranger, but after sitting next to him, (on that busy, "rush to the finish line" evening in October), my commutes on the subway, were never quite the same. The change for me was in having a renewed appreciation for LIFE, and a reminder to not stress out whenever the train is late. To STOP, RELAX and BREATHE without reacting, when things don't go my way.  And to find joy, GREAT joy, in just living another day!  

Copyright 2014 Caregivers Get Fit! Mama  Nicey    All Rights Reserved
The information in this blog is information. It is not meant to be a replacement for getting medical advice from your own health professional regarding your own individual health challenge or condition. Dr. Denise will not diagnose, treat, or give direct personal consultations/advice to you on this blog for any medical condition, but will give general examples, and scientific research on many different health topics.  How you decide to use the information is between you and your own medical/ health professional.

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