Only a Breath Away: Relaxation Techniques to Reduce Caregiver Stress

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We’ve all been given the advice “take a deep breath” when experiencing high levels of stress or anxiety, and while that usually does the trick, many of us are unaware of the full health benefits that can come from practicing certain breathing techniques. Family caregivers in particular are prone to experiencing anxiety, chronic pain or sleeplessness, but they may not know that there are plenty of non-invasive, non-pharmaceutical ways to get relief, including deep breathing, visualization and meditation.

These techniques, which aim to elicit a “relaxation response,” can be learned on your own, through books and YouTube videos, though one-on-one training from a professional often proves to be the most effective.

If your family member has home care in place, you may be lucky enough to get a clinician who is trained in these complementary health therapies and can work directly with you and your loved one. Amelia Muir, BSN, RN-BC is a Behavioral Health Nurse with the not-for-profit Visiting Nurse Service of New York. She was trained at the Watson Caring Science Institute in Boulder, Colorado, which offers a caring model that focuses on the whole person, rather than just their disease. The model strives to create a healing environment for patients and families that takes into account both the physical and spiritual self. In her work as a behavioral health nurse, Amelia’s counseling sessions can sometime become stress-inducing as patients relive difficult experiences and memories. The training Amelia underwent enables her to share her knowledge of meditation, mindfulness and positive thinking with her patients, who can immediately see results as their breathing evens out, and blood pressure lowers.

While this may sound a bit “hokey” to some, there is some hard research behind the use of these techniques for reducing stress. For example, most of us are familiar with the “flight-or-fight” response identified nearly 100 years ago by Harvard physiologist Walter Cannon. He defined a “stress response” (SR), a set of involuntary physiological alterations that include increases in heart rate, blood pressure, respiration rate, and metabolic shifts that liberate energy. But more than 30 years ago, cardiologist Herbert Benson characterized another physiological state, the relaxation response (RR). The RR, which can be voluntarily elicited, is associated with decreases in oxygen consumption, respiratory rate, and blood pressure, along with an increased sense of well-being. 1

Many people can elicit the relaxation response on their own–through exercising, engaging in a hobby, or practicing their religion. We sometimes call this “getting in the zone” or “getting those endorphins flowing.” For those living with multiple comorbidities and who take multiple medications, including those in managed long-term care, like VNSNY CHOICE, this relaxation technique can be life-changing when financial resources to see a special therapist or attend a community workshop are not an option. The problem for family caregivers is that they often feel that they cannot find the time to engage in such activities, particularly if it means they’d be leaving their loved one alone in order to do the activity. It falls upon their caregivers to manage these tasks while also prioritizing time for themselves for the sake of their own health and well-being. We also have to be realistic that the caregiving years pose unique challenges on a person’s time and freedom. Techniques to reduce stress and improve well-being will be best utilized when they can be done in the home.

Blood pressure reduction is one of the most consistently observed changes during studies of the relaxation response.2 A 2008 study at the Benson-Henry Institute for Mind Body Medicine at Massachusetts General Hospital in Boston, MA, showed that patients utilizing the relaxation response were able to eliminate an antihypertensive medication while maintaining adequate blood pressure control more easily than those who did not use the RR.3 Lower blood pressure is indicative of a body relaxing, both physically and, hopefully, psychologically.

So what can you expect from a nurse practicing a complementary health therapy? According to Ms. Muir, the first thing she does when working with a family caregiver under stress is listen to what is making them feel overwhelmed. Then she asks what they are doing to manage their stress. “More often than not, they are not doing anything productive. Either they’re too exhausted, or they can’t get out of the house to participate in enjoyable activities. They may be substituting unhealthy behaviors — such as smoking, watching TV, overeating, or arguing — which ends up making them feel worse. So I teach them strategies they can do in the house, things that don’t require a lot of energy at the start.” For example, breathing exercises.

When we are anxious or angry the stress response causes us to breathe quickly and shallowly. Rapid, shallow breathing can in turn lead to a racing heart, increased tension and interrupted sleep. Improving shallow breathing through focused efforts to calm and deepen your breathing can be very calming. You can do this for five minutes or even just one minute, and you can do it on a regular schedule each day, or any time you feel anxiety creeping up.

Madelina A. is a caregiver for her brother who has Parkinson’s disease and arthritis. Their relationship has always had a lot of conflict, and for Madelina, this is the hardest part of being a caregiver — spending a lot of time with someone you don’t easily get along with. “The physical tasks of caring for him don’t bother me very much. But when he complains about his life, or about what I’m doing, or how I’m managing the house, it makes me feel this is all not worth it.”

Ms. Muir introduced Madelina to breathing and visualization exercises and encourages her to use them every day when she first gets up, but especially when she starts to feel the conflicts with her brother heating up. “I tell her, don’t wait until you’re about to snap. Go in the other room as soon as possible, and start your breathing.” Madelina has learned that deep, slow breathing really calms her, and she’s learned how to visualize positive outcomes in her caregiving. “While I wouldn’t say I’ve become a master at meditating, it does help me to visualize myself as a competent caregiver, and to be mindful that that my brother is fighting with me because he feels vulnerable, dependent and afraid. Sometimes, this is all I need to get through an afternoon.”

Ms. Muir tries to cultivate mindfulness in family caregivers. A buzzword you may have heard, mindfulness is simply being aware of what is actually going on at the moment, and reacting appropriately to that reality rather than some What-If scenario. “Many people fear what MIGHT happen and get bogged down by the worst case, hypothetical, scenario. But the reality they are facing today, or the pain they are actually experiencing at the moment, is tolerable. So I tell them to ask themselves — rate your back pain at this very moment. Don’t allow your memory of your back pain, or your fear of what it could be, to influence that rating. Often, when they really examine what they are experiencing, it helps them relax.”

So if you’re experiencing symptoms such as depression, anxiety, chronic pain or fatigue, consider complementary therapies — breathing exercises, visualization, and meditation, as one more tool in your toolbox, rather than lashing out or taking a pill or a drink. Adopting strategies to manage stress at home will enable you to continue to provide necessary care for your loved one for the long-term.

The Savvy Senior talks about travel discount for seniors

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Dear Savvy Senior,
What types of senior discounts are available to older travelers? My husband and I are approaching retirement and love to travel, but love to save money too.

–Almost Retired

Dear Almost,
There is actually wide variety of travel discounts available to older travelers — usually starting at either age 50, 55, 60, 62 or 65.

But, you first need to be aware that when it comes to senior travel bargains, the “senior discount” may not always be the best deal. Hotels, airlines and cruise lines, for example, offer advanced bookings along with special deals and promotions from time to time that may be a lower rate than what the senior discount is. Always ask about the lowest possible rate and the best deal available.

With that said, here’s a breakdown of some different senior travel discounts that are available today.

Club memberships: If you’re a member of AARP, there are dozens of travel discounts available on hotels, rental cars, cruises and vacation packages. To find them, see discounts.aarp.org/travel or call 800-675-4318. Annual AARP membership fees are $16 or less if you join for multiple years.

If you don’t like AARP, there are alternative organizations you can join like the Seniors Coalition or the American Seniors Association that offer discounts on hotels and rental cars.

Airlines: Southwest Airlines has the best senior fare program in the U.S., offering discounts to passengers 65 and older. American, United and Delta offer some senior fares too but they are extremely limited.

Trains: Amtrak provides a 15 percent discount to travelers 62 and older, and a 10 percent discount to passengers over age 60 on cross-border services operated jointly by Amtrak and VIA Rail Canada.

Bus travel: Greyhound offers a 5 percent discount on unrestricted fares to seniors over 62. Peter Pan, which serves the Northeast region of the U.S., offers the same deal. Trailways, a privately owned bus company also provides senior discounts but they vary by location. And, most local bus lines and public transportation offer discounted senior passes.

Car rentals: Most car rental companies offer 5 to 25 percent discounts to customers who belong to 50-and-older organizations like AARP. Discounts are also available to AAA members. To shop around for the best rental car deals use travel aggregator sites like orbitz.com or kayak.com.

Hotels: Most hotels in the U.S. offer senior discounts ranging between 10 and 30 percent off. Age eligibility will vary by hotel. Hyatt offers one of the biggest discounts, up to 50 percent off, to guest 62 and older.

Cruises: Most cruise lines offer special deals to AARP members. But, if you’re not a member, discounts on some cruise lines (like Carnival, Norwegian and Royal Caribbean) are also available to passengers 55 and older. The best way to find these is to contact a travel agent, or check with the cruise line your interested in.

Restaurants: Senior discounts are fairly common at mom-and-pop and family-style restaurants, as well as fast food establishments. The discounts will range from free coffee, to drinks, to discounts off your total order. Chains known for their senior discounts or specials include Burger King, Chick-fil-A, Church’s Chicken, Dairy Queen, Dunkin Donuts, IHOP, Subway and Wendy’s.

Entertainment: Most movie theaters, plays, ballets, symphonies, museums, zoos, aquariums, golf courses and even ski slopes provide reduced admission to seniors over 60 or 65. If you’re over 62, you’re also eligible for the popular “America The Beautiful Senior Pass,” which provides a lifetime entry to 2,000 national parks and recreation sites. You can obtain this pass in person at one of the federal recreation sites for $10, or through the mail for $20.

To look for other travel discounts see seniordiscounts.com, a great website that lets you search by location and category for free.

On a budget and need a cell phone?

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Dear Savvy Senior,
What are the cheapest cell phone options available today to seniors living on a shoestring budget? I only need it for occasional calls.

–Seldom Calling Senior

Dear Seldom,
For financially challenged seniors who only want a cell phone for emergency purposes or occasional calls, there are a number of inexpensive no contract plans you can get. Or, depending on your income level, there are also free cell phones and monthly airtime minutes you may qualify for. Here’s where to find some of the cheapest deals.

No-Contract Phones
One way infrequent cell phone users can save money is with a prepaid cell phone – also known as pay-as-you-go phones. With a prepaid phone there’s no contract, no fixed monthly bills, no credit checks and no hidden costs that come with traditional cell phone plans. With this type of service, you buy a special prepaid phone then pre-purchase a certain amount of minutes (for talk or text) that must be used within a specified period of time.

While most major carriers like AT&T and Verizon offer inexpensive prepaid plans, as do independents like Net10, Cricket and Virgin Mobile, some of the best deals are offered by TracFone and T-Mobile.

TracFone has phones that start as low as $10 and call plans that cost under $7 per month. And T-Mobile has a super-cheap 30-minute plan for $10, and minutes don’t expire for 90 days. That averages out to $3.33 per month. If you need more talk time, they also offer an annual plan where $100 gets you 1,000 minutes that are good for a full year. T-Mobile does, however, charge a one-time activation of $35.

Or, it you would rather have a no-contract senior-friendly phone with big buttons and simplified features, the Doro PhoneEasy 618 sold through Consumer Cellular is probably your cheapest option. It costs $60 for the phone, with calling plans that start at $10 per month.

Free Cell Phones
If your income is low enough, you also need to check into the Lifeline Assistance Program. This is a government-sponsored program that subsidizes wireless (and landline) companies who in turn provide free cellphones and around 250 minutes of free monthly airtime and texts to low-income Americans. (Some programs in some states provide more minutes, some less, and some charge a small monthly fee.)

There are currently around 15 million Americans who have a free cell phone through the Lifeline program, but millions more are eligible.

The free phones and minutes are provided by a number of national prepaid wireless companies like Safelink and Assurance Wireless, along with a host of other regional carriers throughout the country.

Many states have more than one wireless company that provides the free phones and minutes. If you are eligible, the free cell phone you’ll receive is a basic phone that also offers text messaging, voice mail, call waiting and caller ID.

To qualify, you’ll need to show that you’re receiving certain types of government benefits, such as Medicaid, Food Stamps, SSI, home energy assistance or public housing assistance. Or, that your household income is at or below 135 or 150 percent of the Federal Poverty Guidelines – it varies by state. The 135 percent poverty level is currently $15,754 for singles and $21,235 for couples. The 150 percent level is $17,505/singles, $23,595/couples.

To find out if you’re eligible, or to locate the wireless companies that provide Lifeline government cell phones in your state, visit lifelinesupport.org. You can also learn more at freegovernmentcellphones.net.

Reacher Grabber must be the technical term….

 

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Dear Need,
A good reacher grabber is a very handy tool for anyone with mobility issues. It works like an extension of your arm allowing you to reach down and pick things up off the ground without bending or stooping over. It can also help with reaching and grabbing things in high overhead places, as well as areas that are difficult to get to.

But with so many different reachers on the market today, finding a good one that works well for you is not always easy. Depending on your needs, here are some top options to consider.

Lightweight reacher: If you want a reacher primarily for picking up small lightweight items around the house, the “Aluminum Reacher with Magnetic Tip” by Duro-Med is multifunctional. Available in 32 and 26-inch lengths, it has a trigger-style handgrip with a serrated jaw that provides a secure grip when lifting objects. It also has a magnet built into the tip for picking up lightweight metal objects like a paperclip, and a small hook (or horn) that aids in retrieving things like clothes, shoes or keys. But, because of its lightweight design, it doesn’t work as well at retrieving heaver items like canned goods from shelves.

All-purpose reacher: For retrieving small and medium-sized items, the “Ettore Grip’n Grab” can handle most chores. Available in 16, 32 and 50-inch lengths, it has a soft comfortable trigger handgrip and a rubberized jaw that’s strong enough to lift objects up to 5 pounds and up to 4 inches wide, yet sensitive enough to pick up something as small as a dime. The jaw can also swivel 90 degrees to reach things in awkward spaces.

Ergonomic handle reachers: If you have hand or wrist arthritis that makes gripping difficult, the 31-inch “Medline Reacher” has a handgrip that lets you use all five fingers to close the jaw for better gripping power. Or, consider the new “HealthSmart GripLoc Sliding Reacher,” a 43-inch two-handed reacher with a power slide handle that opens and closes the jaw (no hand squeezing required), and a twist lock that locks the jaw when it’s clinched to secure your item.

Folding reacher: For easier storage or travel, the 32-inch “EZ Reacher Collapsible” has a slip-joint in the arm that allows it to fold in half. It also has stainless steel fingers with silicone suction cup tips that do a nice job of picking up large and small items; and a pistol grip with an optional safety lock that locks the jaw onto items without continuously squeezing the trigger.

Adjustable length reacher: If you need a reacher for various lengths, the “PikStik TelescoPik” has a lockable sliding shaft that adjusts from 30 to 44 inches. It also has a trigger grip and a rotating rubberized jaw that can lift up to 5 pounds.

Outdoor reacher: For outdoor use, the 36-inch “Unger Nifty Nabber” is ideal for heavy-duty jobs. It has a rubber-coated jaw for a strong and reliable grip with a built-in magnet, an aluminum handle and can lift 20 pounds.

Where to Buy
You can buy reacher grabbers at many pharmacies, retail, medical equipment and home improvement stores. But, because it’s a specialty item, the selection is very limited. Your best bet is to buy one online at amazon.com, which sells all of the top reachers at prices ranging between $12 and $40. Just type the product name in the search bar to find it.

How cute are they?

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When these lovebirds married in March 2011 in California, they broke Guinness’ record as the world’s oldest couple to get hitched. The two have been dating for nearly 30 years, but they decided to make it official on Lunsway’s 100th birthday. Surprising their wedding guests (who thought they were attending a birthday party) with vows and a kiss, Lunsway told his new wife: “I want you to hang around for a lot of years — because I’m going to be 110!”

Caregiving Stress Busters

Freeze your food— All illustrations by Chi Birmingham

Caring for a sick loved one can take a huge toll on your health. Try these 6 simple tips on how to take better care of you:

1. Make the freezer your friend

“Telling caregivers to ‘eat right’ is useless advice,” says Washington, D.C., dietitian Katherine Tallmadge. Caregivers usually know what to eat; they just don’t have time to cook healthier meals.

Her answer: batch cooking, which lets you freeze individual portions that you can eat during the week. She tells harried caregivers to make a big pot of a hearty, all-in-one meal like a soup with meat, beans and vegetables, or a stew.

See also: the AARP Caregiving Resource Center

MeditationDe-stress with meditation.

2. Mix in Meditation

Twelve minutes of daily meditation can dramatically improve the mental health of caregivers, report UCLA researchers. In that study, 65 percent of family caregivers who practiced a chanting yogic meditation called Kirtan Kriya every day for eight weeks saw a 50 percent improvement on a depression-rating scale. Meditation also increased telomerase activity — a sign that cellular aging had slowed, says study author Helen Lavretsky, M.D.

Healthy SnacksEat healthy snacks.

3. Stockpile Healthy Snacks

Nutritious foods you can grab on the run help keep blood sugar levels on an even keel and energy levels from flagging, says Tallmadge. She nixes the typical granola bars — “too high in sugar” — opting instead for what she calls “real food” with hunger-busting protein. That means a handful of whole almonds or a PB&J sandwich. Plus, healthy snacks are a good way to add more fruits, vegetables and fiber to your diet.

Slow Down to end stressSlow down and take time for yourself.

4. Slow Down

Whether it’s heating up food for dinner or helping someone in the bathroom, the advice is the same: Don’t rush. “It sounds obvious, but when you’re stressed and distracted, you’re more prone to having accidents. What you don’t need is to cut or burn yourself, or slip in the tub,” says Karen Rowinsky, an Overland Park, Kansas, social worker who specializes in caregiver counseling. Such accidents can be a warning sign that you’re at your limit, a 2006 study finds.

VolunteerVolunteer at an animal shelter.

5. Volunteer

This may seem counter‑intuitive — you’re already doing so much to help your family member. But helping out in a different way, in a different setting, can be gratifying and therapeutic, says Barry J. Jacobs, Psy.D., author of The Emotional Survival Guide for Caregivers: “One woman told me she volunteers weekly at an animal shelter because the pets are so responsive.” Plus, volunteers live longer than nonvolunteers, a University of Michigan study found last year.

Improve your sleep habitsGet some more shut-eye.

6. Improve Your Sleep Habits

Disrupted sleep saps your energy for dealing with the demands of caregiving, says Cleveland Clinic geriatrician Ronan Factora, M.D. Brain scans of sleep-deprived patients in the University of California, Berkeley’s sleep lab also found that brain measures of anxiety shot up by more than 60 percent in those who were the most fatigued. So adopt good sleep habits — a dark room, fewer distractions in the bedroom — for more restful sleep.

Call us to schedule your personal visit

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To learn more please call 408.402.6211. Visit us at LOS GATOS MEADOWS

Month-to-month, assisted living, and memory care.

Our fee structures and rental options show new and improved pricing and provide competitive and attractive financing choices.

The increasing need for assisted living and memory care adapt to the changing needs of the senior. Living with the security of knowing that as you age, if your “care needs” change, it’s all taken care of by staff who know you and managed with faith-based values by a reputable not-for-profit organization. Independent and assisted living to innovative skilled nursing and memory care—all are in one location. Our location is within walking distance to historical downtown Los Gatos. This community enjoys great weather and small town conveniences, along with access to metropolitan San Jose and San Francisco (and airports). A mix of neighbors, restaurants, cinema, galleries, and shops are at your doorstep. Dining services, housekeeping, and daily activities offer you the choices that making living here living well.

10 Tips for Family Caregivers

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Here are some great ideas:

 

1. Seek support from other caregivers. You are not alone!
2. Take care of your own health so that you can be strong enough to take care of your loved one.
3. Accept offers of help and suggest specific things people can do to help you.
4. Learn how to communicate effectively with doctors.
5. Caregiving is hard work so take respite breaks often.
6. Watch out for signs of depression and don’t delay in getting professional help when you need it.
7. Be open to new technologies that can help you care for your loved one.
8. Organize medical information so it’s up to date and easy to find.
9. Make sure legal documents are in order.
10.Give yourself credit for doing the best you can in one of the toughest jobs there is!

How much exercise do I need?

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The American College of Sports Medicine and American Heart Association recently published guidelines for physical activity in older adults. Here is a summary of the recommendations.

Aerobic exercise (walking, jogging, dancing, biking, swimming, etc.): To promote and maintain health, older adults need moderate-intensity aerobic physical activity for a minimum of 30 minutes  five days each week or vigorous intensity aerobic activity for a minimum of 20 minutes three days each week. (Moderate intensity is when you feel “warm and slightly out of breath,” and vigorous is when you feel “out of breath and sweaty.”)

Resistance exercise (weight lifting, calisthenics): To promote and maintain health and physical independence, older adults will benefit from performing activities that maintain or increase muscular strength and endurance for a minimum of two days each week. It is recommended that eight to 10 exercises be performed on two or more nonconsecutive days per week using the major muscle groups.

Flexibility exercise: To maintain the flexibility necessary for regular physical activity and daily life, older adults should perform activities that maintain or increase flexibility at least two days each week for at least 10 minutes each day.

Balance exercise: To reduce risk of injury from falls, older adults with substantial risk of falls (those with frequent falls or mobility problems) should perform exercises that maintain or improve balance.