Category Archives: Living with a Neurological Condition

The article describes the symptoms of burnout:  “People who are burned out are often detached from others, feel drained and unable to cope, and lack their usual energy. They also often experience physical symptoms such as headaches or stomachaches.”

Some useful suggestions for avoiding burnout are shared, including:

•     stay connected with others
•     shift your standards
•     set boundaries for yourself
•     schedule time for yourself
•     change your environment
•     move your body
•     list your fears

I liked all the suggestions except for getting a side hustle (which is why I didn’t list it above).

Certainly this article applies to avoiding “caregiver burnout” as well. The full article is copied below.

Robin

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https://vitals.lifehacker.com/how-to-avoid-burnout-in-the-middle-of-a-pandemic-1843322169

How to Avoid Burnout in the Middle of a Pandemic
May 7, 2020, 4:30pm
by Rachel Fairbank
Lifehacker.com

Burnout is defined as a state of emotional, mental and physical exhaustion brought on by prolonged stress. Given the nonstop barrage of stressors these past few months, many of us are probably well on our way to developing burnout, if we aren’t there already.

“Burnout is chronic stress gone awry,” says Sheryl Ziegler, a psychologist and author of the book “Mommy Burnout: How to Reclaim Your Life and Raise Healthier Children in the Process.”

Stages of burnout

The stages of burnout include a honeymoon phase, in which a person devotes extra time and energy to dealing with their stress; followed by mitigation strategies, when a person is crankier than usual but is still trying to juggle everything; followed by chronic stress, a point when people have an even harder time coping and often find ways to detach themselves from others; and finally, by full-blown burnout.

If these stages sound familiar, well, at least you’re not alone. As a society, we seem to be on a path to burnout together. We started in those ambitious first few weeks with big plans: We were going to learn how to bake and knit! After a few weeks of trying to juggle quarantine and work from home and homeschooling and job loss. Now we all seem to be stuck in a phase of chronic stress, either lashing out at the people around us or detaching from the world at large.

“A lot of people are in the second and third stages right now,” Ziegler says. “We are all here.”

That said, there are strategies that we can employ, even in an era of physical distancing and omnipresent fears about our health and safety. These are some of Ziegler’s recommendations for avoiding burnout during a pandemic.

Know the signs of burnout

“Knowing the signs of burnout are really important,” Ziegler says. What stage you might be in will vary, and it’ll look a little bit different for everyone. People who are burned out are often detached from others, feel drained and unable to cope, and lack their usual energy. They also often experience physical symptoms such as headaches or stomachaches.

As Ziegler points out, it’s normal to be stressed and anxious, given everything that is going on. But just because this stress is understandable doesn’t mean we can’t find ways to cope.

Stay connected with others

We may have to practice physical distancing, but that doesn’t mean we can’t be creative about staying connected with others. When it comes to preventing burnout, strong social connections are key.

As Ziegler suggests, in addition to friends and families, lean on online communities that might share some of your concerns. Whatever your situation is, whatever your struggles are, there are people out there who can relate. Make sure to prioritize these connections, as they will help buffer you from burnout.

Shift your standards

It is okay to cut down on the number of hours of school each day or to say no to extra job duties at work. As Ziegler points out, as much as we want to do everything, there just aren’t enough hours in the day. It’s important to be selective about what we take on as well as practical about what we can accomplish, given our constraints.

Set boundaries for yourself

Boundaries are really important, especially in these times. Boundaries can help make your workload and home life a little bit more manageable. It’s okay to say no to things, it’s okay to adjust your expectations, and it’s okay to prioritize what’s most important.

Schedule time for yourself

If we put a meeting on our calendars, we do everything we can to make sure we show up to it. Caring for yourself, in whatever form that takes, is just as important.

“Every day, schedule time for yourself,” Ziegler says. “When we are under stress, we don’t tend to squeeze in healthy things for ourselves.”

So carve out a time for yourself. Put it on your calendar and give that time as much priority as a work responsibility. Your mental health and wellbeing is important.

Have a change of environment

Even small changes of environment can help keep us from feeling overwhelmed. This could be as simple as moving from the living room to kitchen or going for a short walk around the block. Given that we are all at home all the time now, a small change of environment will go a long way toward helping us feel mentally refreshed.

Move your body

As Ziegler points out, there’s a big connection between staying active and maintaining good mental health.

“People have to remember working out is good for your mental thoughts,” Ziegler says. As we are a lot more sedentary than usual, moving can help us stave off some of the effects of abrupt changes in our routines.

Even if you only have ten minutes, it’s worth fitting in a few calisthenics or a quick walk.

Practice mindfulness with your diet

Being at home all day while stressed means a lot more snacking and a lot more unhealthy foods. Unfortunately, although in the short term, reaching for a bag of chips or a carton of ice cream feels good, when it comes to balancing stress, these snacks hurt more than they help. Being mindful about what you are eating will help in the long run.

Power naps are rejuvenating

If you have twenty minutes, consider taking a power nap to boost your energy and productivity. Find a quiet spot, set the alarm and do your best to relax. If it’s hard, Ziegler points out that power napping is something that gets easier with practice.

Early afternoon, when your concentration and ability to focus is suffering, is a good time for a power nap. Twenty minutes is the sweet spot, as 30-60 minutes can leave you feeling more tired than when you fell asleep. Of course, if you’ve got 90 minutes for a full nap, that also works, but that’s harder to carve out of your schedule.

Notice your words

Words have a way of becoming reality. “We have to notice our words,” Ziegler says. Allow yourself to vent, allow yourself to release all your fears and worries, but then find a way to pivot and channel your fears and worries into something productive.

A side hustle can help you feel in control

If you are worried about your job security—or if you have been laid off—developing a side hustle can be a productive way to pick up new skills while also giving you a way to regain control over your situation.

Now is the time to think about what other skills you have you can use to your advantage. If nothing else, this will help you regain a sense of purpose, which is key to weathering periods of potential burnout.

List your fears

There are so many fears and anxieties in the world right now, and for good reason. Instead of bottling up them all up, Ziegler suggests listing them all out and then—and this is the key part—coming up with strategies for how you would cope if the worst happened.

“Give yourself your moment,” Ziegler says. “Then, stop, and make a plan around it.”

Are you afraid of losing your job? Not being able to pay rent? Getting sick and needing someone to care for your children? Name these fears, then start making plans. Just the act of thinking through them will help your regain a sense of perspective and control.

Right now, the world is a scary and stressful place. There is no avoiding it. However, even in the middle of all these worries and anxieties, there are still actions we can take to help mitigate the worst effects. Adjust your expectations, carve out time for yourself and do whatever is in your power to preserve your sanity for the long run. Because it’s going to be a long run.

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Rachel Fairbank is a freelance science writer based in Texas. When she is not writing, she can be found spending time with her family, or at her local boxing gym.

In late March and April 2020, Home Instead Senior Living hosted “Caregiving During Covid-19,” a Facebook Live Series every Monday and Thursday for 30 minutes. The fifth chat in the series, on April 13th, was a Question-and-Answer about social isolation.

Social isolation and loneliness is a common problem for seniors.  This period of physical distancing and social isolation due to covid-19 is giving the rest of us a glimpse into the lonely experience of many seniors.  Hopefully, that shared experience will help us:      
– become more aware of seniors around us who may be lonely, and       
– develop creative ways to prevent or relieve their loneliness.

The conversation between two gerontologists addressed:
– factors that can lead to social isolation for seniors,
– signs we may notice if someone we love is lonely or depressed, and
– proactive things we can do to help prevent or relieve loneliness for seniors.

I liked this suggestion: Ask your loved one what would make them feel more connected? 

The recording from April 13th can be found here:

homeinstead.com/covid-19/news/social-isolation

Denise Dagan from Stanford Parkinson’s Community Outreach listened in on the discussion and shared her notes.

Recordings from the nine discussions or chats can be found here:

homeinstead.com/covid-19/resources/livechat

Robin

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Social Isolation Q&A
April 13, 2020
Home Instead Senior Living
Notes by Denise Deagan, Stanford Parkinson’s Community Outreach

homeinstead.com/covid-19/news/social-isolation

Moderator: Lakelyn Hogan, gerontologist
Guest: Molly Carpenter, gerontologist and author of Competence to Care

Lakelyn – In this time of social distancing, staying connected is more important than ever because seniors are prone to social isolation, which can lead to loneliness and depression.  Now, we are all getting a glimpse into what seniors often experience. What are your general thoughts on this topic?

Molly – You make an excellent point in saying the covid-19 period of social distancing is a glimpse of what seniors often experience due to mobility issues or chronic conditions.  Our awareness of their daily experience is the only way we can reach out and do something to help seniors.

Isolation is an objective measure of when someone doesn’t have enough people to interact with.

Loneliness is the emotional distress of not having social interaction.  It looks different from one person to another and it very subjective.  You can have a lot of friends, but still feel lonely.

Sometimes, family will move a senior into a care facility thinking they will have so much social interaction, but that person can still feel lonely.
——
Lakelyn – What other circumstances can make a senior feel lonely, besides mobility, etc.?

Molly – There are so many:

• Your living environment – being unmarried, widowed, having no children or no children nearby
• Social changes – currently cancelled book clubs, church groups, closed senior centers, etc.
• Distance – rural area residence
• Location and Transportation – suburbs without public transportation and no driver’s license
• Mobility – pain while walking, limited handicap access, inability to afford a motorized wheelchair or scooter
• Hearing and Vision limitations
• Life changes – being widowed, becoming a caregiver, moving/relocation, retirement, etc.

——
Lakelyn – Isolation and loneliness can impact your physical health.  Studies found loneliness can be worse than smoking (15 cigarettes/daily), alcoholism and obesity.

Molly – There are health implications.  In the last 10 years research articles talk about loneliness causing an increased risk of heart disease/stroke, dementia, depression, perceived stress, pool sleep, even death!  
——
Lakelyn – There are visual cues you can look for while interacting with our loved ones to recognize symptoms of loneliness so we can do something to relieve their loneliness.

Molly – These signs look a lot like depression and loneliness can lead to depression.  If you see these signs, be sure to bring the issue up with their doctor and have them tested for depression.

• aches and pains
• increased tension
• anxiety/panic attacks
• low energy/lack of motivation
• cognitive impairment
• sleep issues/too many naps during the day
• weight gain or loss
• poor diet
• appetite changes
• comments about hopelessness
• feeling down in the dumps

——
Lakelyn – What can we do to prevent loneliness or isolation for our loved ones?

Molly – First, think about the word, “relationships.”  We all have to work on our relationships.  With our seniors, we may have to take the lead and reach out more often, pay closer attention, and take action.  Seniors tend not to say anything so you need to just step in.

• Be proactive and persistent
• Take an individualized approach
  • Consider their personality – do they need quiet time or more active 
  • What did/do they enjoy doing – consider their life experience
• Use technology to chat, play games, etc.
• While on the phone or video chatting.  Eat a meal together or dessert, have a happy hour, watch the sunset – be creative with what you do together, virtually.
• Pick up the phone
• Send handwritten notes/cards
• Quality over quantity – even if you haven’t contacted someone in awhile, they may still appreciate the gesture
  • Especially if you share that something made you think of them, make a quick call/text/card, etc.
• Don’t get discouraged if your initial contact seems unwelcome – keep trying.
• Ask them what would make them feel more connected?  They may prefer a phone call to video conference, or vice versa.

On April 1st, the Parkinson & Movement Disorder (PMD) Alliance (pmdalliance.org) presented a wonderful webinar on “Practicing Wellness to Build Resilience.”  The webinar focused on the connection between resilience and physical health.  The speaker, Julia Alleyne, MD, defined resilience as finding our own inner strength to deal with discomfort, distress, and uncertainty, when we are unsure what the outcome will be. 

She believes that resilience can be built by:

• Having gratitude
• Having empathy for others
• Understanding happiness and the ability to experience human connection
• Having a sense of purpose

One issue we see a lot with caregivers is their unwillingness to practice self-care. Dr. Alleyne ties self-care to this sense of purpose:

Having purpose to fulfill your own needs is not selfish. It’s self-care. You are lessening the burden to others, and increasing your ability to care more for others. Change the idea of selfish to self-care, that you are helping others as well as yourself.

Dr. Alleyne says creating a wellness corner in your own space is very useful. It doesn’t have to be big or elaborate. Some advice:

• De-clutter it. Clutter represents a to-do list, which is interfering with ability to focus on the here and now. Try to create a space to refocus.
• Have something to focus on. This might be a painting, picture, fireplace, etc.
• Plants to nurture
• A place you feel relaxed and grounded
• Could be a windowsill, maybe with plants, statues, stone, picture, etc.

The webinar is worth watching or reading the notes (see below). The webinar was recorded and can be accessed here:

youtu.be/_Y3fqW_Ca_8

Adrian Quintero, with Stanford Parkinson’s Community Outreach, took notes from the webinar. See below.

Robin

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“Practicing Wellness to Build Resilience”
Webinar by Parkinson & Movement Disorder Alliance
April 1, 2020
Notes by Adrian Quintero, Stanford Parkinson’s Community Outreach

Julia Alleyne, MD became interested in wellness at the age of 13 when her father broke his leg while skiing. She was the oldest of five kids, and believes her resilience started with having to take on responsibility and use skills she didn’t know she had in a situation she didn’t quite understand.

Dr. Alleyne went on to become a physiotherapist. In her practice she had a focus on exercise, prevention and health maintenance. She believes the partnership between patient and provider is key. Early in her career she wanted to empower people to have better self care and feel they could have a say in their well-being.

Later on, Dr. Alleyne went into sports medicine, and worked with Canadian Olympic teams. A survey was given to the athletes that found 75% of them didn’t sleep well during the games, and as we know, sleep is so important. Also they found that athletes who did yoga at home didn’t do it during the games.

At some point a wellness center was established during the games. Another doctor on Dr. Alleyne’s team got a cancer diagnosis during the Olympic games. He went to the wellness center everyday to get peace of mind. The center was a peaceful and calm place made for rejuvenation. It helped the doctor cope better, and athletes benefited from the center as well.

Wellsense Website

Dr. Alleyne was not “into” social media when COVID hit. But with more people working at home, news stories building, she decided to put up a post. The post was about framing this current situation with inner strength, not letting worry erode what we already have. She made a commitment to do something everyday we are in this together. This lead to the creation of a website, Wellsense (wellsense.net), which serves as an open, public website of wellness. Dr. Alleyne wishes to turn science into common sense so people can connect with it.

A post about resilience has been the most popular post on the site. How do we define resilience? She says it’s finding our own inner strength to deal with discomfort, distress, and uncertainty, when we are unsure what the outcome will be. Dr. Alleyne sees the definition to be about our own inner strength. How do we build resilience? It’s about our mindset, how we look at the world.

When we look to people who have overcome difficulty, we see they continued to have hope, and they didn’t get lost in the big picture. These people are not unrealistic optimists, but rather they see there has to be a way to do things, and that attitude becomes practiced.

Some Resilience Builders

• Having gratitude is a wonderful resilience builder
• Having empathy for others, we actually build our own empathy and strength to deal with ourselves
• Understanding happiness and the ability to experience human connection
• Having a sense of purpose, which contributes to a sense of value and worth

Wellness List

When Dr. Alleyne worked with the Olympic team, the athletes had a wellness list as a reference. This was based off of indigenous people’s medicine wheel with four quadrants to wellness — physical, emotional, intellectual and spiritual. When you nurture and balance each of the quadrants, you have health.

• Physical: How am I physically feeling today? (Sleep, eating, hydration)
• Emotional: How am I doing emotionally? (If it’s the blah zone, where do I need to be? How can I get more energy going? Listen to music? Positive self talk?)
• Intellectual: How am I doing intellectually? (Starts with awareness of self, of relationships, and surroundings)
• Spiritual: How am I doing spiritually? (What’s my belief system? Is it “Do unto others as you would have them do unto you” Whatever it is, make it an action. Maybe you need to listen to music, read a reflection, pray, etc.)

The emotional zone you can shift; you can change your emotions. Examples are using music or self talk. Scientifically, self-talk is based in Cognitive Behavioral Therapy (CBT). You look at the three different realms of feelings, thoughts, and actions.

• What are my feelings? (Down – news not getting any better.)
• What are my thoughts? (I don’t want to get out of bed. Is this really ever going to end? What’s the point?)
• What are my actions? (At that point, I say to myself, before I take action, can I change my feelings or thoughts? What’s my choice for today? The choice gives us control.)

Creating a Special or Sacred Space for Self-care

Dr. Alleyne says creating a wellness corner in your own space is very useful. It doesn’t have to be big or elaborate. Some advice:

• De-clutter it. Clutter represents a to-do list, which is interfering with ability to focus on the here and now. Try to create a space to refocus.
• Have something to focus on. This might be a painting, picture, fireplace, etc.
• Plants to nurture
• A place you feel relaxed and grounded
• Could be a windowsill, maybe with plants, statues, stone, picture, etc.

Possible Silver Linings from this Pandemic

• Having more time with our “home buddies” (pets- for her, bonding with a cat)
• She thinks when this is over we will have deepened connections to those most important to us
• Hoping we will understand much better how to care for elders as valued members of society who need help
• We have to emerge as a stronger society. The virus is most destructive with vulnerable people, and we have to learn how to care better for the vulnerable.
• Become barrier free. Right now there are lots of opportunities to learn technology and do things on-line. She thinks that’s good, it’s pushing us to modernize, and not be as dependent on physical experiences. In communities with disabilities there are so many barriers, taking down these barriers is good.

Social Connection

There is research in the Parkinson’s Disease world that social connection is a good prognostic. In aging and wellness spaces, talk about socially connecting is helpful; whether it’s a walk, yoga class, dancing in a group, etc.

How do we continue to socially connect in this social distancing era? And how do we access people who are not connected to Internet?

In Europe, we saw the need to connect without technology. Opening windows and singing on balconies and hearing another voice is a connection.

That can go further with the telephone. You don’t need the Internet to feel connection. It can happen through a window, leaving something on a doorstep, ordering or receiving a delivery, etc.

The news is starting to show stories of connection. In Toronto people are opening their windows and singing the national anthem. Then they are honking their horns at evening as thanks to frontline workers.

We have to reach out and we have to be able to respond. If you’re feeling isolated, reach out. If someone is trying to reach out, respond. Reach and respond keeps us connected.

Sense of Purpose

What happens to people who feel they can’t give and help right now? What about people who are being told to stay inside when they volunteered before?

Dr. Alleyne has some tips on keeping a sense of purpose in this time frame. She says purpose is filling a need – it might be our own or another. The problem is we don’t know how it will all fit together until years later. We don’t know the full value of our actions. Does it fill a need? If so, go further with it. Don’t worry about evaluating the purpose. All purpose is good. How do we pivot or reshape our own expectations when what we have been doing as a purposeful activity has changed? This requires coping skills and creativity.

Having purpose to fulfill your own needs is not selfish. It’s self-care. You are lessening the burden to others, and increasing your ability to care more for others. Change the idea of selfish to self-care, that you are helping others as well as yourself.

At this point, Dr. Alleyne asked attendees a survey question: On a scale of 1-10, when faced with a difficult situation, how did you actually cope?

1 means “I did not cope. I needed lots of help.”

4 means “I managed eventually but had difficulty figuring out my way.”

7 means “I did better than I expected and learned new coping strategies.”

10 means “I copied much better than expected and I even helped others.”

Based on the answers, her input is:

1-3: If your answer was in this range, call for help early. Don’t let it overwhelm you. The longer you aren’t coping well, the harder it gets.

4-6: You want a bit of number one – ask for help early.

7-9: (no comment here)

10: That builds confidence, and confidence is a tremendous resilience builder.

The reality is we learn from every situation. We learn what we know, and we learn what we don’t know. That helps us shape how we will deal with the next situation.