“Unfortunate Irony Turns Renowned Scientist Into Caregiver For His Wife”

This is a nice article about a scientist who spent years studying Parkinson’s and then became a caregiver for his wife who was diagnosed in 2011 with Lewy body dementia (called “cortical Lewy body disease” in the article).  The wife, a former preacher, had been diagnosed with Parkinson’s in 2004.

This article was published on Flatland (flatlandkc.org), the digital magazine of KCPT Public Television in Kansas City, MO.  My browser did NOT like the Flatland website, which is a shame because there are some photos accompanying the article.  The article was shortened and re-published on NextAvenue (nextavenue.org).  Below, find the text of the original article and links to both websites.

Robin


www.flatlandkc.org/news-issues/cover-story/bill-priscilla-neaves/ –> my browser did NOT like this website

www.nextavenue.org/sad-irony-scientist-caregiver/ –> shorter version of article is here

Faith And Love
Unfortunate Irony Turns Renowned Scientist Into Caregiver For His Minister Wife
By Barbara Shelly
Flatland
January 1st, 2018 at 6:00 AM

Churchgoers at a tidy, white-steepled United Methodist Church in Carrollton, Missouri, heard a frank admission from their guest pastor one spring morning in 2007.

“When asked to preach this Sunday, I almost said no,” Priscilla Wood Neaves told the congregation. “Why? Not because I lacked training and experience, and I have always enjoyed preaching.”

She had, in fact, fought for the right to preach. As a girl growing up in the 1950s in the Texas panhandle, Neaves was told that women could not be ordained ministers in the United Methodist Church. The information was erroneous, but not until she left Texas for college, marriage and motherhood did she encounter a female pastor who could disprove it.

Eventually Neaves graduated from the Perkins School of Theology at Southern Methodist University, became an ordained Methodist minister and hospital chaplain, and gathered a wealth of life experiences to frame her sermons.

And then life dealt a blow that temporarily stilled her voice.

“I was diagnosed with Parkinson’s disease three years ago,” Neaves told the congregation in Carrollton, “and I have not formally ‘proclaimed the Word’ since then. I guess it was because of feeling a mixture of fear and anger directed toward God.”

Listening in the congregation to the candid and unusual sermon was the preacher’s husband, Bill Neaves. Never entirely comfortable with church and organized religion, he kept a low profile. Few in the country church knew that, while Priscilla was wrestling with her medical diagnosis, Bill was engaged in a professional and political struggle involving the search for cures for diseases like Parkinson’s.

Childhood sweethearts from Spur, Texas, Bill and Priscilla Neaves both packed up briefcases stuffed with credentials when they moved to Kansas City in 2000.

He had been dean and executive vice president for academic affairs at the University of Texas Southwestern Medical Center in Dallas, a lauded institution where Nobel Prize winners worked with other faculty members to advance science and medicine. She was a chaplain at Children’s Medical Center Dallas — a front-line responder to small patients and their families in moments of fear, relief and overwhelming grief.

James Stowers, founder and CEO of American Century Investments, had consulted with Bill Neaves about a research facility he was creating in Kansas City. He envisioned a place in his hometown where premier scientists would have resources and time to study the causes of diseases and embark on a search for cures. Stowers asked Neaves to be the first president and CEO of the Stowers Institute for Medical Research.

“I was enthusiastic about it,” Neaves says. “Few people want to support basic science.”

But he needed to persuade Priscilla. She had balked at several other moves when opportunities had arisen. After a dinner with Stowers; his wife, Virginia; and other family members, she agreed. Neither Bill nor Priscilla Neaves had any way of knowing that during the next few years his new job would come to involve politics as much as science, and her physical and spiritual health would be put to the test.

Priscilla quickly dived into life in Kansas City by joining the board of directors of the medical ethics research and advocacy group now known as The Center for Practical Bioethics. She also joined the Institutional Review Board for Children’s Mercy Hospital.

The first signs of trouble appeared in the fall of 2003. Priscilla didn’t feel well; something was off, she said. She wasn’t able to walk with her normal stride. When the odd symptoms persisted for a few weeks, Bill tapped his medical contacts.

In January 2004, a physician at the University of Kansas Hospital diagnosed Parkinson’s disease. Another physician at Washington University Medical Center in St. Louis concurred.

As Priscilla noted in her sermon a few years later, the news came as a blow. Parkinson’s disease is a neurodegenerative disorder that hinders the brain’s ability to produce dopamine, the transmitter that enables people to regulate motor functions.

Still, the disorder progresses slowly in most people, and Priscilla was accustomed to a busy and productive life. She became a full-time volunteer chaplain at Carroll County Memorial Hospital in 2006 after the couple purchased a farm about 60 miles northeast of Kansas City. In that capacity, she provided spiritual resources and facilitated support groups for cancer and Parkinson’s patients.

Though his wife’s health was a concern, Bill Neaves was ebullient about progress at the Stowers Institute in its early years. First-rate scientists had indeed been willing to come to Kansas City, and they were engaged in rigorous and productive research.

One cloud on the horizon was legislation that kept resurfacing in the Missouri General Assembly. Pushed by Matt Bartle, a lawyer and at the time a state senator from Lee’s Summit, its stated purpose was to ban human cloning. But Bartle’s definition of cloning went far beyond a scenario in which a squawking baby might emerge from a laboratory. His bill aimed to ban even the copying of human embryos as small as a few dozen cells.

Those miniscule lab dish embryos are home to embryonic stem cells that can be formed with a patient’s DNA. Scientists believe the newly created cells can be used to repair tissue, organs and nerves damaged by all manner of injuries and diseases. In the early 2000s, they eyed the laboratory procedure with great hope.

To Bartle and others, it represented a moral threat. That’s because, once embryonic stem cells are harvested, the tiny embryo that sheltered them is destroyed. What some people viewed as a somewhat mysterious lab dish procedure, religious conservatives saw as the willful termination of human life.

The issue made it to the November 2006 ballot in the form of a constitutional amendment that would protect all scientific research in Missouri that was legal under federal law.

Jim and Virginia Stowers spent $30 million to bankroll the campaign supporting the amendment. Opponents formed their own coalition and also raised millions of dollars. Missouri citizens were besieged by television ads alternately lauding the promise of stem cell research and issuing dire, if misleading, warnings about cloning.

Bill Neaves was in the thick of it all. He wrote essays and traveled the state, speaking to groups to explain what embryonic stem cell research meant for science and the Stowers Institute. He touted its potential to stop or slow the suffering from devastating diseases. He mentioned Parkinson’s disease. What he never said publicly was that the person closest to him had been diagnosed with that illness.

The constitutional amendment passed by a razor-thin margin — a difference of 50,800 votes out of 2.1 million cast.

Ultimately, science itself stepped in to bring an uneasy truce. A Japanese researcher found a way to make adult cells behave like embryonic cells, with the same capacity to repair and rebuild damaged body parts. The reprogramming method is less costly than the somatic cell nuclear transfer procedure, and it sidesteps the ethical issues. It is now the preferred avenue for many scientists, including those at the Stowers Institute.

With his wife at his side, Bill Neaves had done his part to stand up for science. But science could not immediately return the favor. It could not stop the frightening changes that were going on in Priscilla’s body.

“For more than a quarter-century, I have retreated each summer to the Beartooth Wilderness on the Boulder River in Montana,” Priscilla Neaves wrote in July 2008. “I relax, enjoy, meditate and relate to God’s magnificent mountains and forests. Perhaps my Native American heritage encourages me to celebrate nature — my paternal grandmother was half Choctaw.”

From the deck of the wilderness home she and Bill cherished, Priscilla wrote of her love of nature, as experienced in Montana, West Texas and New England — all places she had lived. Bill would later include the meditation in a compilation of his wife’s sermons and writings. Soon after that, Priscilla’s illness made further trips impossible. “Mercifully,” Bill wrote in the afterword of the book he compiled in his wife’s honor, “we rarely realize that we are doing a beloved thing for the last time.”

The previous couple of years had been difficult. The couple lost their son, William Jr., in May of 2007. Living in Houston, he had waged a long struggle with alcoholism and died of its complications. “Priscilla was amazingly stoic about it, but I know it must have been incredibly difficult for her,” Bill says now.

She continued her work as a voluntary chaplain and frequently preached sermons in the chapel of Carroll County Memorial Hospital.

“When questions about the meaning and purpose of life hit us like a tornado, God’s grace can be most tangible,” she told her small congregation in 2009. “Job’s way can also be ours. I know. I have been there.”

By this time the Stowers Institute was thriving. Jim and Virginia Stowers had given $2 billion worth of American Century stock to its endowment. Labs were filling up with impressively credentialed scientists. A spinoff biotechnology company, BioMed Valley Technologies Inc., had been formed to move treatments and therapies into clinical development.

In June 2010, Bill Neaves announced he would retire as president and CEO of the institute. He had already begun handing off the day-to-day operations to a protege, David M. Chao.

Neaves talked about wanting more time for research and various projects. He was especially excited about returning to research he’d begun 40 years ago, studying the asexual reproduction patterns of some species of lizards. He didn’t disclose publicly that his family was dealing with an all-consuming illness.

Priscilla’s symptoms were increasingly resembling more of a dementia-type illness than traditional Parkinson’s disease. At the end of 2011, specialists at the Mayo Clinic in Rochester, Minnesota, found that Priscilla was suffering from cortical lewy body disease — a brain disorder closely related to Parkinson’s but even more devastating. The destruction proceeds beyond motor control to destroy brain neurons associated with cognitive functioning and movement.

Bill Neaves recalls that his wife absorbed the terrible news calmly. “Priscilla was still pretty much intellectually intact then, and I was very impressed with what she said,” he recalls. “The neurologist said, ‘This is what we have, and it will probably be fatal within a year and a half.’ Priscilla said, ‘Well, glad to know what I’m facing, and I know firsthand that a lot worse things have happened to people than what is happening to me.’”

The couple had moved several months earlier into an apartment in Bishop Spencer Place, a retirement facility in midtown Kansas City that has provisions for nursing care. Linda Yeager, who was chaplain there at the time, remembers that Priscilla sought her out.

“She was very anxious for me to know that she was a minister herself, and she was very interested in helping other people,” Yeager said. “She wanted to share her books, and she wanted to do research and help people. She was greatly respected and loved.”

But Priscilla’s disease was progressing rapidly. By 2012, she was experiencing anxiety, confusion and paranoia. Daily tasks such as routine teeth brushing became a struggle.

On the advice of her family physician, Priscilla moved to a Leawood facility that treats patients with dementia. She became bedridden, mostly paralyzed from the chest down, with limited use of her hands. Once a passionate voice on nearly every topic, she now spoke only intermittently.

For nearly a year, Priscilla was officially in hospice care.

Bill, who describes himself as “a compulsive-type person,” began preparing for his wife’s death. He made cremation arrangements. He visited a printer and prepared a death announcement for Priscilla. Then he focused on putting together her book, “Sermons and Meditations,” which offers an eloquent, widely sourced study of theology from the perspective of a feminist and an environmentalist.

“That was a very therapeutic thing for me,” Bill says of the book project.

And then the mysterious, maddening, wonderful creation that is the human body served up another surprise. At the end of 2013, Priscilla’s disease stopped progressing. It had run its course, a specialist told Bill. With good care, she could live for a long time. But the damage already done — the paralysis, the speech loss, the loss of memory and cognition — was likely irreversible.

These days, Bill awakens most mornings at 5 a.m. in the apartment he and Priscilla share at Bishop Spencer Place. He sets about slicing up fruits for Priscilla to eat at lunch and supper. About an hour later he escorts his wife to the skilled nursing portion of the complex and sees that she is settled at her usual breakfast table. He makes sure she drinks water.

Bill, 74, and a year older than his wife, then drives to the Stowers Institute, arriving around 6:30 a.m. A tall, rail-thin figure in blue jeans, he glides around its hallways at a clip that feels like a trot if you’re trying to keep up with him. He knows everyone by name, from top scientists to the servers in the cafe. He teaches a research course and writes papers, mostly for scientific publications. He also serves on the boards of several institutions.

Sometimes he visits the institute’s reptile facility, where he and a Stowers scientist, Peter Baumann, continue the study of unisexual lizard reproduction.

A couple of years ago, the scientific journal “Breviora” honored Neaves by lending his name to a new lizard species, aspidoscelis neavesi — Neaves’ whiptail lizard. And very recently, the “Bulletin of the Museum of Comparative Zoology,” out of Harvard University, named a different species aspidoscelis priscillae — Priscilla’s whiptail lizard. This is only appropriate. When they were much younger, Priscilla spent months collecting lizards with Bill in the deserts of New Mexico.

Bill Neaves returns to Bishop Spencer Place around 10:30 a.m. and stops in the cafe to buy Priscilla a cup of coffee. He helps her eat lunch and, again, makes sure she drinks water. Then it’s back to the Stowers Institute until about 3:30 p.m. Late afternoons and evenings are consumed by a routine of coffee, dinner, companionship and bedtime preparations.

It’s an “incredibly ritualized schedule,” Bill acknowledges. “But I read somewhere a few years ago that one of the practical bits of advice for people who are into Zen is to turn what might otherwise be routine activity into real rituals. That seems to work for Priscilla and me.”

If life had served up a different set of circumstances, Bill Neaves might be traveling the world right now, speaking at scientific conferences and soaking in the tributes due the founding president of a world-class research facility.

“I’m really glad I don’t have to do that anymore,” he tells me.

“Not that I wouldn’t rather be sitting on our deck looking over the trees at the Beartooth Wilderness in Montana with Priscilla, enjoying a glass of chardonnay, but this isn’t … isn’t bad,” Neaves says. “It’s better than I thought it would be. There’s still enough of Priscilla there to make it feel very rewarding to have the time with her.”

And what about Priscilla, the woman who broke barriers in her church, raised two children, comforted grieving families and lived with Bill in places as far-flung as Boston and Kenya?

For all of her life, she had been a reader, a writer and a thinker. As a hospital chaplain, she kept copious notes about her encounters with patients and their families.

“I was impressed by this woman’s strength,” Priscilla wrote, after an encounter with a single mother. “She did not act like a victim, although she has been victimized and suffered many hard times. She did the best she could, and that was pretty amazing.”

Now the ravages of a terrible disease have left Priscilla unable to write down her thoughts, or verbalize them. But remarks in the sermons that her husband compiled seem prescient.

“Cherish the time you have with those you love,” she counseled a group in the Carroll County Hospital Chapel. “Don’t wait for tomorrow. Don’t let the deadlines and demands of daily life delay the dreams you share.”

And this: “As we all move closer to a grave, the fleeting time we are given with each other is so precious when measured against the time of eternity. How are we using that time?”

—Barbara Shelly is a veteran journalist and writer based in Kansas City

5 Things Family Caregivers Need to Know About Family Leave (NextAvenue)

This week is the 25th anniversary of the Family and Medical Leave Act (FMLA). This law allows employees up to 12 weeks of unpaid time off from work to care for family or their own health without losing their job. Of course, many families can’t manage so long without pay. Currently, there is talk of an expansion of the law to include paid leave.

Here is an article from NextAvenue (nextavenue.org) explaining more about what FMLA currently covers and where it may be headed.

Robin


 

“5 Things Family Caregivers Need to Know About Family Leave”
February 7, 2018
Diane Harris

https://www.nextavenue.org/family-caregivers-family-leave/

This week marks the 25th anniversary of the Family and Medical Leave Act (FMLA), which allows employees to take up to 12 weeks of unpaid time off from work to care for a new child or sick relative or to manage their own serious medical condition without fear of losing their job. The biggest cause for celebration, however, isn’t for what the law has accomplished over the past quarter century, but rather what may come next.

“Momentum is clearly growing among policymakers and employers for an expansion of the law that will include paid leave,” says Lynn Friss Feinberg, a senior strategic policy adviser for the AARP Public Policy Institute. “It’s increasingly seen as a bipartisan issue.”
What Could Help America’s Family Caregivers

That would be especially good news for the nation’s 24 million family caregivers who hold down a job while looking after an ailing family member. Employees who take a leave after having a baby or to deal with their own health issues may be able to partially fund that time off with state- or employer- provided short-term disability insurance, but that option isn’t available when you’re caring for someone else.

Says Feinberg, “Most family caregivers can’t afford to take a leave.”

That is, if they’re even eligible for time off under the FMLA to begin with. Businesses with fewer than 50 employees are exempt and recent hires and part-time workers are excluded. The upshot: Only about 60 percent of the workforce qualifies.
5 Things Family Caregivers Should Know About Family Leave

If you need time off to care for your spouse or an older relative, here are five important things to know about what the law can and can’t do for you — and the changes that may lie ahead:

1. FMLA isn’t just for new parents. “People often assume the law only applies to moms and babies, but the most common use is to deal with your own health issue,” says Vicki Shabo, vice president for workplace policies and strategies at the National Partnership for Women & Families.

In fact, more than half of the employees who took a leave over a 12-month period used the time to manage their own illness, according to a Department of Labor survey. The second most common reason was to care for a new child (cited by 21 percent); 18 percent needed time off to help a parent, spouse or child with health problems.

Yet as the public discussion over paid leave heats up, parental leave and family leave are still often conflated. In his State of the Union address, for instance, President Donald Trump called on Congress and the country to “support working families by supporting paid family leave.” But the proposal he included in his budget last year was limited to paid time off for new parents.

Says Shabo: “It’s important to look beyond the language at the comprehensiveness of a proposal or policy to make sure it includes all of the FMLA reasons.” More about such proposals shortly.

2. You can’t use the federal law to care for your father-in-law or mother-in-law. You typically can’t get time off under the FMLA to help your brother, sister, grandmother, grandfather or adult child either. That’s because the law narrowly defines “family” as a spouse, parent or child under 18.

Exceptions are made for a relative or other person who helped raise you as a minor by providing substantial day-to-day or financial support, and for a grown child who is severely disabled.

All told, more than one-third of family caregivers provide help for an adult family member who falls outside of the FMLA’s parameters, according to a National Alliance for Caregiving and AARP report.

3. You may get more family-leave help from your state or city than from the federal government. States have been the pioneers in pushing family leave laws beyond the boundaries set by the FMLA.

About a quarter of states have protections for unpaid leave that go beyond the FMLA, providing coverage for people who work for small businesses, extending time off beyond 12 weeks or defining family more broadly to include grandparents, in-laws and other relatives. (A summary of the state rules is in this National Partnership report.)

Meanwhile, paid sick days are now available for family caregiving duties in nine states and 35 localities. These help with some common caregiving tasks that may not be covered under the family leave law, such as taking Dad to a doctor’s appointment or getting Aunt Emily settled in at a new care facility. (What’s available in your area? Look here.)

Plus, a handful of states now have paid family leave policies, including California, New Jersey, Rhode Island and New York. Bills passed last year by Washington and the District of Columbia are scheduled to take effect in 2019 and 2020.

The California law, as an example, replaces 60 to 70 percent of wages for up to six weeks; the New York law now offers up to eight weeks with 50 percent of pay and will expand to 12 weeks at 67 percent of pay when it’s fully implemented in 2021. (Details on the state programs are here.)

Look for more states to hop on the bandwagon. Shabo says Massachusetts is likely to pass a paid family leave law this year, and campaigns are heating up in Colorado, New Hampshire, Oregon and Vermont.

4. Employers are lagging on paid leave for family caregivers. More than 100 leading and brand-name companies — such as Deloitte, Facebook, Microsoft and Nike — have added or expanded paid leave policies in the past three years, but still only 13 percent of private-sector employees are covered, the Bureau of Labor Statistics reports.

Worse yet for anyone caring for parent or spouse with health problems: Most of the new corporate programs, despite being called “family leave,” only cover new parents; just 20 percent including provisions for family caregivers. Those that do often fall woefully short of need, with many capping replacement pay at two weeks or less — a mere three days in the case of Capital One and four days for FMC, according to a National Partnership report.

Still, AARP’s Feinberg is hopeful that demographics and personal experience will motivate more companies to cover family caregivers in the future.

“By 2024, nearly one in four people in the labor force will be age 55 and older, including midlife and older women who are more likely to take on a caregiving role,” she notes. “More people in C-suites are being personally affected by caregiving challenges too, and that will help drive awareness of the need for paid leave policies across the life span of working families.”

5. More federal help may be coming (emphasis on may). As part of the new tax law, starting in 2018, employers that provide paid family and medical leave to workers who earn less than $72,000 a year are now eligible for a tax credit of 12.5 to 25 percent of the cost of each hour of paid leave, depending on how much of the worker’s earnings the benefit replaces. Employers must compensate workers for at least 50 percent of their regular earnings.

Don’t cheer yet.

Critics point out that the leave can be as little as two weeks, employers are only required to cover one or more of the purposes outlined in the FMLA, the tax credit is scheduled to end in two years and it only covers caring for the family members in the original FMLA law (in other words, no credit for assisting an in-law, a grandparent, a brother, a sister or an adult child).

Also troubling: “Economists across the ideological spectrum agree that the provision is unlikely to incentivize new policies to be put in place but rather will just be a subsidy for employers with existing policies,” says Shabo. That echoes the conclusion of 14 experts in a joint report on paid family leave from the American Enterprise Institute and the Brookings Institution last year.

Caregiving experts are more enthusiastic, however, about the growing number of supporters for the Family and Medical Insurance Leave (FAMILY) Act, introduced five years ago by Sen. Kirsten Gillibrand (D.-N.Y.) and Rep. Rosa DeLauro (D.-Conn.) and now co-sponsored by an additional 28 senators and 146 representatives (but no Republicans).

The bill would allow workers at any size employer to get up to 66 percent of their pay for as many as 12 weeks of leave to manage serious family or medical issues for care of a child, parent, spouse or domestic partner. The program would be funded through small employer and employee contributions of 0.2 percent of wages each, up to a cap of $128,400 in wages in 2018 (about $1.50 a week for a typical worker), with self-employed people paying both parts, as they do now with contributions to Social Security.

Among Republicans, Sen. Marco Rubio (R.-Fla.) is working with Ivanka Trump on a proposal that would let workers who want to take parental leave tap into their Social Security benefits to fund it, then delay getting payouts at retirement age by the time off taken. For example, according to Politico, someone who’d begin receiving full Social Security benefits at 67 but wants to take six weeks of paid leave wouldn’t start claiming Social Security until six weeks after turning 67.

Critics point out this poses particular risk for women, who are more likely than men to take time out of the workforce for caregiving, more reliant on Social Security for income in retirement and more apt to struggle financially as they age.

No one is placing bets yet on which plan, if any, will actually pass.

Advocates like Shabo worry that the idea that something is better than nothing could lead to a program that leaves out large groups of family caregivers, sets length and wage replacement limits too low or doesn’t provide for an adequate and sustainable method of funding.

“This is a huge moment of opportunity,” she says. “But the stakes for getting a policy right, one that is reflective of the needs of the entire U.S. workforce and their families, have never been higher.”

“Healing from Bad Luck Fatigue” – Webinar Notes

Last week, Denise Brown of CareGiving.com hosted a webinar titled “Healing from Bad Luck Fatigue.”

The title is a little strange (I think). The premise is that caregivers sometimes feel as if they have bad luck as they are constantly coping with problems. Denise Brown provides some tips on dealing with the associated fatigue.

The webinar recording can be found here:

www.caregiving.com/caregiving-webinars/caregiving-webinar-archives/webinar-healing-from-bad-luck-fatigue/

Brain Support Network volunteer Adrian Quintero listened to the webinar and shared notes.

Robin


Notes by Adrian Quintero, Brain Support Network volunteer

“Healing from Bad Luck Fatigue” Webinar
January 31, 2018
CareGiving.com

 

TAKE A BREAK AND THEN FACE FORWARD

  • The advice of taking a break may feel counter-intuitive. We can believe that if we are not actively trying to find solutions to the problems, we are not taking the problems seriously enough. 
  • It is possible to overwork a problem, over work your brain. With too much stress, we can’t think clearly and find solutions we need. One suggestion is to tell yourself “I’m going to go to bed, when I wake up I”ll know just what to do.” This allows a way to both take a break, and also be working on the problem too, subconsciously.
  • It can be easy to obsess about the past, what has or hasn’t happened. The suggestion is to “face forward”, and that the solution is ahead of us. 
  • Taking a break could mean a day to not think about it, or even just for a moment. 
  • Important to remember taking a break is not giving up responsibility, but “giving solutions a chance to find you.”

LET GO

  • Moving from resentment and bitterness into possibilities and opportunities
  • Being present in what is can help with figuring out what to do next
  • Rather than beating ourselves up over something we can’t change or control
  • To remember mistakes are okay, we are all human
  • Letting go of emotions that can drain our energy, such as past hurts
  • Letting go of the idea we alone must fix the situation we are facing

LET OUT

  • Releasing feelings such as irritation, anger, frustration. Remembering that bad luck has happened in our lives, and we have every right to be mad about it
  • Releasing in a physical way- walk, jumping up and down, any thing that feels good. Physical activity, even simple, can help let it out.
  • There is much research that says exercise can really help our mental health
  • Writing, venting to friend or support group, helps bad luck not take a hold so tightly
  • “Once you let it out, you can let in” Releasing what’s not wanted or needed allows space for answers, support, resources, new insight into our situation and problems we are facing
  • We want to let in the idea that others can help, even if this may be others we don’t yet know

LET IN

  • We alone, as individuals, don’t have to fix everything 
  • Our faith (if that is part of our lives, support, ideas
  • Often times shame (maybe of how we are handling a tough situation), can keep support away from us
  • Remembering we deserve support from people who understand our situation and struggle

REMAIN CURIOUS

  • Curiosity is a great skill to have in life. It can be a way we stay well, though we often don’t think of curiosity this way
  • When we are open and curious in our lives, we remain out of judgement of ourselves, situation, and others
  • Suggestion to think and ask ourselves “how will this work out?” 
  • We could start the morning with question such as “who will help me today?” or “what will make me smile today?” 
  • When ask a question, our minds search for answers. Asking a question that can lead to an answer that will help. 
  • Think about questions want answers for. We can start the day with question

PICK UP PENNIES

  • May sound goofy! It can be thought of as a practice in accepting abundance
  • When we are deep in bad luck, we are fighting scarcity, and feeling there is not enough. Pennies can be a simple way to think about abundance differently
  • Working with the idea of not to walk by and dismiss abundance, but take it and receive it

EMBRACE YOUR PERSPECTIVE

  • We might feel like “I am the only one with the worst luck in the world” This can feel very true, but doesn’t serve us well to see life this way
  • Can be helpful to understand it’s not just any one of us. We have bad luck right now, and we are not the only one. This idea can be isolating and make it harder to see an end to bad luck. Our shared experience with others, and reminders the bad luck is not personal, even though it can feel that way
  • Looking to nature for inspiration: There are 4 seasons, winter doesn’t stay for 12 months, we move through changes just like nature does. Bad luck might be the winter of your year, you will move into spring (that could be part of the curiosity questions “When is my spring coming? When will days be longer and heart be lighter?”)

GIVE THANKS

  • Giving thanks to other things we may see (nature, etc.) even during times of bad luck. Perhaps feeling grateful for opportunities to learn from nature
  • Looking for opportunities in our day to give thanks. Maybe in ordinary parts of the day we normally overlook. (gas in car, food in fridge, etc)
  • Could create rituals around gratitude during an activity we love. She gives an example of swimming laps, touching the wall, thinking “thank you,” each time. Could be giving thanks in the morning for a fresh start, new chance
  • This can be a calming way to manage the chaos of bad luck

ACCEPT THE OPPORTUNITY TO HELP ANOTHER

  • This might seem odd when you are barely able to help yourself, overwhelmed caring for another, and overtaken by things not going right. One of best ways we can help ourselves is to help another. How can we help without it feeling like a burden? Could be a simple thing- smiling at someone, opening a door, something small and simple, that doesn’t cost you anything
  • This can serves as a way to see oneself in a new light. Sometimes caregiving can feel like we aren’t making a difference, the declines are winning, and helping other in a tangible way where the difference can be seen can be inspiring.

BELIEVE IN THE MAGIC OF THE UNIVERSE

  • During times of bad luck it can feel as if there is no good magic in the world, and no possibility of miracles
  • Magic could be defined by faith, such as a bigger purpose, or higher power, someone/ thing that we can’t see but touches our lives. In this way, magic is always there, even during bad luck times
  • Magic could be that the sun rises the next day, and we can too
  • Think about what you’ve achieved. Not the traditional achievements we might think of, but in standing up and supporting another during a difficult time, you bring magic to that, you make that happen.
  • You’ve been magic or a miracle for others in the caregiving work that you do

“Life After the Diagnosis: Expert Advice on Living Well with Serious Illness” – podcast

Last summer, Steve Pantilat, MD, was interviewed by GeriPal, a blog (geripal.org) that focuses on geriatric medicine. Dr. Pantilat is a palliative care physician at UCSF. The interview occurred shortly after his book was published — “Life After the Diagnosis: Expert Advice on Living Well with Serious Illness for Patients and Caregivers.”

We posted a link to the podcast of the interview on Brain Support Network’s Facebook page at the time, but I just got around today to listening to the podcast. Here’s are some highlights for me:

* “There’s this idea that somehow if we talk about what’s really happening, like how serious your prognosis is, or the fact that you have in fact a life limiting illness, that somehow that’s gonna take away hope and so, let’s not talk about it, we need to leave people with hope. But I worry that what that leaves people with is false hope. And that fundamentally, false hope is no hope. And if we talk about hope, we can really promote it and we can encourage it and to recognize that people have hope, even when we take care of people who are days away from the end of life, who are actively dying. They still have hope for things that are meaningful to them. And by talking about it, we can really encourage people to have hope, and to build on and to recognize, yeah, there’s hope for cure, sure. But there’s hope for a lot of other things that can coexist within the hope for cure, or alongside that hope, and we can encourage that.”

* “[We] talk about a good death but I don’t see death as good. I’ve seen it only as being sad and filled with grief and loss, and nothing we do seems to make it good. And the tragedy … I recently took care of a forty-two-year-old woman with an eight-year-old child in the hospital. She died in the hospital. People would say, ‘Oh, that’s a bad death,’ but you know, what was bad is that she died. And if she had died at home, it wouldn’t change the tragedy and the sadness and the grief and loss associated with her death.”

* The interviewer mentioned a story in the book about Sergei, an 80-year-old whose wife has dementia. Sergei hopes that the wife will get better. The interviewer asked Dr. Pantilat if this is false hope. “That I would say is false hope, we know that dementia does not reverse. …I realize that there was nothing I could say that would fundamentally change his hope in his wife getting better and I realize my role at that point was just to support him in that hope. … But, you know, there’s a time to push and there’s a time to accept and support and that was a time to accept and support.”

* “Realistic prognosis focuses hope. They give patients reliable and realistic information they can use to make decisions.”

* “[We] often give people this false choice, we say, ‘Do you want quantity of life or quality of life?’ And it’s somehow, if you want quantity of life, you have to accept all the possible interventions to attack your illness or to treat your illness. Every chemotherapy regimen, every procedure, and so on. And what we know now is that, in fact, there comes a time when some of those things not only don’t help you live longer but may actually ruin your quality of life. Chemotherapy in the last six months of life, for example. And that somehow if you want quality of life, it means you’re not gonna live quite as long. And what we know from Palliative Care, from the research, from the literature in our field, is that you can get both. And Palliative Care helps you live better and at least as long, maybe longer, but certainly no shorter, and you can live well and long. And part of my book, the point is to really get people to engage with and ask for and demand Palliative Care to live well and to live long.”

* He talks about using a word like “progress.” “Like progressive illness, your illness has progressed. ‘Oh, that’s great!’ No, that’s terrible. So I now think about this when I talk with my patients and I say, ‘Your heart failure is worse,’ rather than saying, your heart failure has progressed…”

* “Dignity is one of those very loaded words that’s in fact very personal. … And so we often use this word as a code for certain things. Like, respect your dignity by withdrawing interventions and what we should … If we’re gonna use that word, we [physicians] really need to embed it in what the patient and family think of as dignity and their interpretation of dignity and try to support that idea, not our own.”

* “If despite CPR, you die, your final moments will have been spent at the center of a tornado and while a team works on your body, your family will be watching the horror or be banished from the room. In either case, they won’t be with you, at your side, holding your hand.”

* “I think there’s a way in which people with serious illness think, ‘Why not? Why not just try it?’ And the evidence really suggests that when your illness is very advanced, to the point that you die of it, CPR isn’t really gonna help you. It’s not gonna help you at all and you’re gonna end up sicker. I think there’s a way that people think it’s like reset the computer. … But we all know that even if you survive CPR, you’re gonna be worse off than you were and there are implications, maybe not for you, I think this idea that somehow it’s suffering for the patient, I think is not right. We do CPR generally on people who have died. And so I don’t see that there’s a lot of added suffering to the person who’s died but there is this impact on their loved ones who might be at the bedside. And we have to remember what their experience is as well.”

* “[We] have to be careful to remember that all we’re saying is, ‘When you die, when your heart stops and you stop breathing, we will not try to revive you because it won’t work. We’ll let you die peacefully.’ But that has no bearing on all the other care that we will continue to provide. And we have to emphasize what we’ll continue in the meantime and all the care we will provide to make sure people are comfortable and well cared for so that we don’t see this decision about CPR at the very end as somehow implicating something more than it is.”

You can read the full transcript and listen to the podcast here:

www.geripal.org/2017/07/life-after-diagnosis-podcast-with-steve-pantilat.html

Dr. Pantilat was also interviewed at the Commonwealth Club of California last summer. A recording of that interview can be found here:

www.commonwealthclub.org/events/archive/podcast/life-after-diagnosis-how-live-well-serious-illness

And he was interviewed on KQED’s Forum show last summer. That recording is here:

ww2.kqed.org/forum/2017/08/01/living-well-with-chronic-illness/

Happy listening!

Robin

 

“Caring for the Caregiver: How to Prevent Burnout”

In mid-January 2018, CBC, a broadcasting network in Canada, aired a documentary called “The Caregivers’ Club.”  It is the club that no one wants to join.  This documentary is only viewable in Canada.  (I couldn’t find it on YouTube.)  The documentary follows three families coping with dementia.  I suspect that most of the documentary applies to all caregiving situations, not just those coping with dementia.

There are several good articles on the CBC’s website about caregiving.  These articles accompany the documentary.  One of the articles is on “Caring for the Caregiver: How to Prevent Burnout.”  Though the article is focused on dementia caregiving, most of it applies to all caregivers.

The author, an occupational therapist, shares these warning signs of caregiver burnout:

• You are not enjoying social activities and friends
• You find it a chore to leave the house
• You are more irritable and have mood changes
• It is difficult to concentrate and get things done
• You are having trouble sleeping
• Your weight may be affected (up or down)
• You feel anxious or depressed
• You have physical complaints such as headaches, pains
• You get sick more often, with both minor and major ailments

Most of the article is copied below.

Robin
—————————-

www.cbc.ca/cbcdocspov/features/caring-for-the-caregiver-how-to-prevent-burnout

Caring for the Caregiver: How to Prevent Burnout
Published about Sunday, January 14, 2018
CBC
by Nira Rittenberg

As Canada’s population ages, the number of caregivers who are involved in dementia care is on the rise.  The latest statistics from the Alzheimer Society show that there are 25,000 new cases of dementia every year and by 2031, the number of cases will increase 66% from today.

Individuals with dementia often require quite a lot of care, and it’s usually the family that provides it. CBC documentary, The Caregivers’ Club profiles three Ontario families as they struggle to care for their loved ones.

Caregivers for People with Dementia Burnout More Often
Caregiving is challenging, and people with dementia often require long care hours. This type of caregiving is associated with higher levels of burnout than non-dementia caregiving.  Research has shown that it is much more difficult to do than caring for someone with a physical disability.

For almost all carers there is the balancing act of family life, careers and other relationships. Some caregiver demographics, such as homosexual, Indigenous and caregivers of individuals with early onset dementia, may experience additional stressors in their roles. Each of these caregiver groups has challenges that are specific to their situation.

Early onset dementia caregivers are often in the phase of life where they are raising younger children and carry more of a financial burden. They may have not fully developed their caregiving skills and feel more unprepared for the task. Homosexual caregivers often have to deal with prejudice and lack of sensitivity in the healthcare system; while Indigenous populations may not have access to mental health services.

Stress Warning Signs
The stresses of caregiving can be insidious and often trace back to the caregiver neglecting their own mental and physical health. These triggers may happen slowly and make burnout hard to identify.

Some warning signs include:

•         You are not enjoying social activities and friends
•         You find it a chore to leave the house
•         You are more irritable and have mood changes
•         It is difficult to concentrate and get things done
•         You are having trouble sleeping
•         Your weight may be affected (up or down)
•         You feel anxious or depressed
•         You have physical complaints such as headaches, pains
•         You get sick more often, with both minor and major ailments

Caregiving Will Not Change the Course of the Dementia
Some caregivers feel the self-imposed responsibility that their efforts can somehow change the course of the illness by keeping the individual with dementia “happy and healthy.”  Many caregivers report that they end up feeling upset with the person they are caring for. Though they are aware that feeling this way is not rational, it makes them feel worse.

Many caregivers saddle themselves with unrealistic expectations of what they can handle on a daily or practical level. Money, resources and ability to manage may not be adequate and can make a caregiver feel impotent.  The lack of ability to control this situation combined with a complex health care system can be difficult and frustrating.

Fortunately, not all symptoms occur for every caregiver, and there is no timeline on when they will feel that things are not working.

How to Access Support for Caregivers
The good news is research has shown that support can make things easier for caregivers.

Interventions can come in different forms like receiving help to get things done and assistance with housework, bathing or other tasks.

The caregiver also needs support to deal with the stress of watching someone they care about deteriorate to help them cope with the emotional struggles that are part of the journey.

These supports can come from both professionals as well as peer caregivers. Every situation is different and supports should be built around need. There are a variety of services and resources that can help. The key is to find one that suits your family.

Reach out to your doctor or your local health agency. Find someone who will help your family to find what it needs to get the care, education and support to be both effective and healthy.

Nira Rittenberg is an occupational therapist who specializes in geriatrics and dementia care at Baycrest Health Sciences Center and in private practice. She is the co-author of Dementia: A Caregiver’s Guide.