1. How to reduce anxiety and stress in the Caregiving during Covid-19
Continue to maintain a routine as much as possible
This will reduce confusion to the person living with dementia and create more stability for the caregiver as well.
Engage in conversation with the person living with dementia about the possible changes in his daily routine possibly due to the Covid-19 restrictions so that he will not be caught unaware and be disoriented.
Be patient if he cannot really comprehend what Covid-19 is all about.
2. Live as normally as possible
a. Do not live in fear of the virus or how the dementia is going to cause the person with dementia (PWD) to become more and more dependent. Live one day at at time..
b. Get PWD the necessary vaccinations for Covid-19.
c. Teach the PWD how to do proper hand washing, how to wear a mask or ensure that he does it the right way.
d. If there is a cluster at the dementia day care, to withhold the sessions and consider caregiving at home temporarily. Care plan at home should include engaging the person in normal routine like morning walks without going to crowded places, engaging him in meaningful activities.
e. Continue to ensure the chronic health issues and dental needs are being met. Ii is important that my mother continues to visit her dentist regularly as she is on medication that may increase the risk of necrosis of the jaws. As part of health promotion and early interventions for her, she is on medication that strengthen her bones so that if she falls, the risk of hip fracture is lower. It is of utmost importance to plan realistic goals for PWD so that she can continue to live her life to the fullest and with dignity and joy.
3. What to do if caregiver falls sick during the caregiving
a. Have a plan in place so that Caregiver need not react in crisis. Involve the other family members in the caregiving process so that the entire caregiving burden do not fall on me alone. I also use respite care like dementia day care services. Others may choose to use home nursing services.
Self Care for Caregivers
4. Journal regularly. Fill it with gratitude daily. Think HEARTFELT
(Refer to blog on Attitudes and Motivation in Caregiving for the acronmyns of HEARTFELT)
Write down 3 goals each day. Let it be SMART. Achievable. Example of a SMART goal:
S is for Specific: Your goals should be well defined. Engage mother in rehabilitation and physical exercises
M is for Measurable: You must be able to measure it. Rehabiliation once a week with the physiotherapist.
A is for Actionable: Develop action plans to achieve the goals. I review the care goals with the physiotherapist periodically.
R is for Realistic: Goals must be achievable. It must not be too big that you find it too challenging to start. She is able to complete the exercises within the one hour of rehabilitation and she felt a sense of achievement.
T is for Time-based: A goal is a dream with a timeline. Nil falls within 6 months to a year and able to maintain her instrumental activities of daily living (iADL) in the year 2022 and 2023.
Ever since my mother started rehabilitation once to twice a week, her last fall was in 2019. Previously in 2017, she used to fall once every 6 months.
5. Look through your journal once a month to reflect, learn and improve yourself.
I keep a journal for my thoughts and another journal for caregiving.
This is a sample of the caregiving journal:
March 2020: Mother sobbed in the toilet. Trigger due to inability to use her handphone. She was frustrated. Other triggers include: I told her not to boil too much water as there are enough water to drink for the day.
May 2020: Mother has frequent outburst that day. She was upset with me for being too tired to engage in a conversation with her. She was later annoyed that I was not too tired to have conversation with my children that night about something else.
After reading this part of the journal, it helped me recognise the triggers that may cause frequent outbursts or distress in my mother. That I need to make time to talk to her even if I am really exhausted after work so that she will not feel lonely or neglected.
Since I turned part time, I make it a point to speak to her every day before I go to work or start my morning routine like marketing and cooking.
Both my husband and I have also identified that the inability to use the handphone as one of the triggers. She too like to be able to listen to music on her phone, watch youtube videos on it. However, she was not very tech savvy. Because of this awareness, we are always on the look out for her and to assist her when she has difficulty accessing her favourite songs. We have become more sensitive to her needs and try to meet them as much as we can.
6. Gain physical margin through emotional margin (Reference: Restoring margin in physical energy)
Ways to increase emotional margin is:
One way: Taking several small breaks throughout the day to maximize focus and energy.
Second way: Is to reach out to friends that will encourage you
During this period of time when face to face time spent with friends or close family members are reduced, it is important to allocate time spent over whatapps call/video call. This will prevent isolation of the caregiver and continue to encourage healthy relationships between the caregiver and his friends.
Third way: Engage in activities together with family members
Activities that can be conducted indoors include:
Encourage laughter during conversations
Bake a cake with my teenage daughter
Make sushi with the other teenage daughter
Playing card and board games with my family
7. Go for walks to gain a new perspective. Use it as a form of exercise to strength the body of the caregiver. "Exercises changes the brain in ways that protect memory and thinking skills," writes Heidi Godman, the executive editor of the Harvard Health letter.
8. Pick up a new hobby like baking bread, pizza, learning how to make Chinese rice wine (made from glutinous rice)
Delicious sushi made by daughter
9. Go for own health screening. For females, go for mammogram and pap smear. For those age 50 and above, go for colorectal screening. If caregiver has chronic health issues, plan for respite care to ensure that caregiver go for regular check-ups. (Just like the oxygen mask analogy in an airplane that experienced a period of turbulence and emergency, put on the oxygen mask for yourself first before you do so for the one you love)
10. Have a realistic expectation of yourself and for the PWD during the engagement with PWD.
Avoid pitfalls in the mismatch of activities with her level of cognitive function (Refer to the short blog on 13 Sept 2021)
If I plan to bring my mother for a walk to the market and it rained, I must be prepared to change the plan and not be disappointed. With an open mind, if the goal set is to spend time with her through a walk to the market, the activity can be changed to watching a television series together at home in a rainy day. In this way, the goal is realistic and is achievable as well as enjoyable.
I really hope that you too will find these tips useful and if you have any additional tips to share, do feel free to comment in this blog. Take care and stay thriving.
I
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