Elder Care

Our Elasticity and Adaptability Depend on More Than Food

Except: Empty Plate: Food~Sustainability~Mindfulness By Tammera Karr and Kathleen Bell

In an equally real sense, researchers know that elasticity and adaptability during challenging events like pandemics, and life transitions; are a combination of how well-nourished the brain and body are — through mindful choices about nutrition and other behaviors. The conscious decisions to eat healthy foods, get quality sleep, spend time in nature, limit the ingestion of disrupting or harmful media/substances, or to take a moment of pause for gratitude — all constitute nourishment for our bodies, minds, and spirits.

Whole-brain perspective leads to renewed skills

Critical and whole-brain thinking, along with common sense, are often referred to as being not so common. The reality is that our modern education can be sorely lacking when it comes to past generations’ skills. Often, we are out of practice in using skills of common sense. Although we can look at history for clues on how ancient peoples survived and thrived, it doesn’t give us their expertise, nor the luxury to take the time to live as they did.

As we begin a new decade, our world is entirely different than ever before. Even if we might have the skill, time, and environment that supports a romanticized lifestyle of bygone days — we have to ask ourselves. Do we really want to work that hard? Can we give up the many facets of our modern world that define us now?

The incorporation of mindfulness and sustainability into the broader idea of nourishment for modern lives isn’t about turning back the calendar, politics, environmental agendas, or religious beliefs. It is about owning the choices we make and being the best version of ourselves, along with helping the next generation view their empty plate with open eyes of wonder and possibilities.

Bringing calm to chaos

Expanding ones perspective through the combined lenses of mindfulness; tradition, and science, it can allow for the best of all views to guide; and bring a balance between modern and traditional approaches to health, lifestyle, and nourishment.

Mindfulness is not solely limited to the practice of meditation; mindfulness also includes the ability to discern and make choices based on knowledge, facts, and intuition. Mindfulness is that moment of pause to recognize and acknowledge the present moment before moving forward, which may allow us to see both obstacles and the possibilities before us.

It is easy in the modern world to view ancient cultures and people with either idealism or disdain; believing modern society is somehow more advanced and superior to past cultures without pizza delivery, electronics, and central air. However, biases are not limited to only those of the past. There are times we pooh-pooh someone who lives in a metropolitan area for eating industrial fast-food instead of selections labeled organic; or roll the eyes over a modern homesteader making cheese and canning. How we view food, in particular, and the way people eat, is all about perspective.

The same is true about where diet and food fall into one’s thoughts about health. Clients may feel reading labels and buying health food is a waste of time and all a scam. Equally, clients can become so obsessed with the health and cleanness of their food they are practically paralyzed in the market; worse yet, it becomes almost impossible to enjoy a meal with them. This last part is so important because, as a species, we have shared a meal with others since the beginnings of evolution. This need to commune with others while eating plays a role in why restaurants are popular, especially for singles; eating with others allows for sharing ancient memories tucked deep in cellular mitochondria.

First, let’s be honest; the American food culture has been pretty messed up for over eighty years. There are real reasons to be concerned about food and water (we will look at water more later), especially where safety and quality are concerned. Part of the difference between the current generation and one’s great-grandparents began with the Industrial Revolution of the 1800s. By the 19th century with the assembly line’s initiation, canned and frozen foods began taking society from the farm or backyard to the Piggly Wiggly. It wasn’t until the end of World War II and the Agricultural Chemical Revolution that mega-corporations opened Pandora’s box of newly available chemicals for food crops and food manufacturing.

The late 20th century brought first-world countries (as defined by the UN following World War II) to a roundabout in healthcare approaches. The 21st century views on health care are a blended version of allopathic, integrative, traditional, and holistic models. These varied approaches can be at odds with each other, adding to consumer confusion and frustration. However, the silver lining of this moment-in-time is a growing acknowledgment and understanding of the priceless value that food from traditional and cultural sources provides.

Twenty years into the new millennium means four to five generations of individuals simultaneously alive today on the planet; some of whom have been taught to believe the Doctor Knows Best, Science is Good, Traditional Medicine is Quackery, and Better Living Through Chemistry. Additionally, the tech-industry is influencing food trends in ways that resemble bad science fiction. Bland or flavorless meal replacements like Soylent® are being touted as foods to prevent climate change — and better for the environment than eating livestock. Neither of these claims can stand up to fact-checking. The pandemic of 2020 revealed that airplanes, many industries, and fossil-fuel-powered vehicles were far more at odds with global climate conditions than cattle.

Thankfully, the younger generation of Millennials is embracing traditional agriculture, homesteading, gardening, and animal husbandry: along with artisanal and traditional food preparation. The authors cannot know for a certainty that generations following the Millennials will embrace and value sustainable lifestyles in the same manner — but we hope they do.

The pandemic of 2020 also brought about a return to the kitchen. With stay-at-home orders in place for months on end, individuals reacquainted themselves with the once mysterious room and unfamiliar activities of kitchen. The developments of 2020 gives hope that the growing challenges of food insecurity in the United States (due to affordability, availability, mobility, and multi-national food manufacturers controlling the type of foods available in many areas) can be ameliorated. A study released in 2018 on food insecurity in older adults found food insecurity was significantly associated with economic factors. The findings showed higher values for the prevalence of chronic diseases, poor management of chronic diseases, and decreased health-related quality of life in older adults living in communities. The cycle of food insecurity and chronic disease begins when an individual or family cannot afford enough nutritious food. The combination of stress and poor nutrition can make health management increasingly challenging.

Additionally, the time and money needed to cope with these health conditions strain the household budget, leaving little money for essential nutrition and medical care. This causes the cycle to continue, increasing the risk of worsening existing conditions. When food insecurity is present, sustainable health and mindful living are unattainable.

In the fall of 2020, the Wall Street Journal reported on the growing food insecurity in Latin American countries. It is easy to compartmentalize our thinking about food into what we see in the local market and be blind to the multitude of areas where food is affected by seemingly unrelated events in global economies. One area involves fossil fuels and transportation, as the Wall Street Journal article titled “Venezuela’s Food Chain is Breaking, and Millions Go Hungry” outlines. When gas, diesel, or canola oil-based fuels are unavailable or production is limited or halted, farmers are unable to fuel tractors or farm equipment to plant and harvest. When transportation of food falters due to fuel shortages, millions of tons of food spoil in depots, fields, and aboard cargo ships. What increasingly becomes available to consumers in countries like Venezuela are “junk” foods and non-edible items. Ana Nunes, a sixty-two-year-old retired municipal worker in western Venezuela, shared in the Journal article her meals consisting of a few corn-flour arepas (pancakes), and continued to say “instead of quality foods, the markets sell garbage like animal hides and rotten cheese.”

When individuals have access to community gardens or live close to food production; accessibility allows people to harvest and store foods while the nutrient content is at its highest. The availability and use of fresh foods provide quality nutrition, not empty calories. Historically, it has always been true that when humans have access to abundant food supplies; advances in culture, intelligence, and adaptability happen. When changes in local area economies involving increased availability of fresh foods occur, the population has a high capacity to produce positive, healthy changes that influence sustainability. This is a key component of humanity’s sustainability that involves the greater or lesser availability of fresh food. When vacant lots are revitalized into community gardens in large cities, people come together; and food insecurity in the elderly and in impoverished areas lessens, with the addition of countless other benefits.

During clinical practice, Tammera has had many clients who were children during the Great Depression of the 1930s and World War II. A recurring comment from these elders pertains to food and hunger; “we knew we were poor, but we never went hungry; there was always a garden and food to eat.”

Something to think about.

To Read More on Sustainability and Mindfulness
Empty Plate - Food, Sustainability, Mindfulness

The Love of Chocolate

Excerpt from Our Journey with Food ©2015, 2018
Revised 2/2021

 

By Tammera Karr PhD

The cacao tree, aptly named Theobroma cacao, by the famous botanist Carl Linnaeus. The cacao tree only grows within twenty degrees of the equator in the tropics’ damp conditions. Once mature, the tree will produce small, white flowers that can only be pollinated by midges, a fly no larger than a pencil’s tip. When cacao pods are mature, they are harvested by hand using a machete. Each pod is broken open to expose the beans and white pulp and collected into a pile. The beans and pulp remain outside in the heat and high humidity to undergo fermentation.

 

What is fermentation?

Fermentation is a metabolic process that occurs with microorganisms. Bacteria and yeast thrive in hot, moist climates, and the cacao pulp is an excellent nutrient source. In this case, the bacteria and yeast are needed to produce the precursor compounds necessary for chocolate’s characteristic flavor and aroma. Bacteria do this by eating some of the sugar and acid content, converting it into other molecules. Fermentation typically lasts for about a week. Once fermentation is complete, the farmers will separate the beans from the pulp, used as a nutrient source during fermentation. Next, the beans are left to dry in the sun.

 

A little history

In Greek, Theobroma translates to food of the gods.  Chocolate connoisseurs know there is more than a gustatory pleasure to be found in this food of the gods. In 1753, Carl von Linnaeus, a Swedish scientist, thought cacao was so important he named the genus and species of tree Theobroma cacao, which means cacao, the food of the gods. This food dates back to prehistoric times and was extensively cultivated in Mexico, Central, and South America for centuries before Europeans’ arrived. 173  The Mayan Indians began cultivating cacao about 600 AD. The indigenous populations ate only the fruit, which contains numerous health benefits. The seed or cacao nib was set aside for a psychedelic brew, called ayahuasca, and for medicines.  According to Aztec myth, the cacao awakened power and wisdom. When the explorer Cortes brought cacao back to Spain in 1528, it was sequestered and enjoyed only by nobility and the wealthy.

 

The many uses of chocolate

In medieval times, chocolate was viewed as a luxury item and an indulgence. In modern times chocolate is used as gifts for mothers and sweethearts. It is made into cocktails, cold and hot drinks, candies, powders, wines, and lotions. The Spanish are widely responsible for the introduction and development of chocolate foods and beverages.

 

The making of chocolate foods

The most critical step is roasting. Roasting generates hundreds of the flavor compounds associate with chocolate. The beans are roasted at high temperatures for roughly one hour. There are many chemical reactions responsible for cacoa color, flavor, and aroma. Cacoa naturally has a strong, pungent/bitter taste, which comes from the flavonols. Without roasting, the cacao beans would never obtain the flavor profile we associate with modern chocolate. Cacoa nibs are crushed to form cocoa butter and cocoa liquor. There are several processing steps involved in reducing cacaos bitter taste. Cocoa liquor has a very concentrated, chocolatey flavor with a trace of bitterness and acidity. Other ingredients like sugar, milk solids, vanilla, and emulsifiers are added to the pure cocoa liquor. The addition of these ingredients to the liquor results in a coarse, heterogeneous mixture that still must be further processed. The more chocolate is processed (through fermentation, alkalizing, roasting, etc.), the more flavanols are lost. 174

 

What science tells us about the health properties of chocolate

Flavonoids are naturally-occurring compounds found in plant-based foods that offer specific health benefits. They are part of the polyphenol group (chemicals found in plants). Flavanols are a type of flavonoid found explicitly in cocoa and chocolate. More than 4,000 flavonoid compounds are found in various foods and beverages, such as cranberries, apples, peanuts, chocolate, onions, tea, and red wine. Most popular commercial chocolates are highly processed, providing little if any health benefits.

Dark chocolate contains a large number of antioxidants (nearly eight times the amount found in strawberries). Flavonoids also help lower blood pressure nitric oxide production; they can also balance certain hormones. The fats in chocolate (1/3 oleic acid, 1/3 stearic acid, and 1/3 palmitic acid) do not impact your cholesterol. Dark chocolate helps restore flexibility to arteries while preventing white blood cells from sticking to blood vessels’ walls. Both arterial stiffness and white blood cell adhesion are known factors that play a significant role in atherosclerosis. Scientists found that increasing the flavanol content of dark chocolate did not change this effect. Research published in the March 2014 issue of The FASEB Journal.

The effect that dark chocolate has on our bodies is encouraging not only because it allows us to indulge with less guilt, but also because it could lead the way to therapies that do the same thing as dark chocolate but with better and more consistent results,” said Gerald Weissmann, MD, editor-in-chief of The FASEB Journal. Until the ‘dark chocolate drug’ is developed, however, we’ll have to make do with what nature has given us! 175, 177

 

Benefits of dark chocolate

 

Chocolate is a complex food with over 300 compounds and chemicals in each bite. Look for pure dark chocolate or dark chocolate with nuts, orange peel, or other natural flavorings. To enjoy and appreciate chocolate, take the time to taste it.  Most studies used no more than 100 grams, or about 3.5 ounces, of dark chocolate a day. One bar of dark chocolate has around 400 calories.

Enjoy moderate portions of chocolate (e.g., one ounce) a few times per week, and don’t forget to consume other flavonoid-rich foods like apples, red wine, tea, onions, and cranberries. Your best choices are dark chocolate instead of milk chocolate (especially milk chocolate that is loaded with other fats and sugars) and cocoa powder that has not undergone Dutch processing (cocoa treated with an alkali to neutralize its natural acidity).

Caution: According to the National Hazardous Substances Database: In large doses, theobromine may cause nausea and anorexia, and the daily intake of 50-100g cocoa (1.5 g theobromine) has been associated with sweating, trembling, and severe headache. Occasionally, people (mostly the elderly) have needed hospital treatment for a theobromine reaction.

References
  1. The Science behind Chocolate by Abbey Thiel: https://sciencemeetsfood.org/the-science-behind-chocolate/
  2. (Based on materials provided by Federation of American Societies for Experimental Biology.)
  3. The Poisonous Chemistry of Chocolate – https://www.wired.com/2013/02/the-poisonous-nature-of-chocolate/
  4. Is Chocolate a Healthy Choice for Valentine’s Day? That Depends on Which Kind, Wall Street Journal,
  5. https://www.wsj.com/articles/the-bitter-truth-about-  chocolate-1518100791

Stepping Into The Hornets Nest – Elder Care part 4

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By Tammera J Karr, Ph.D., FAAIM, BCIH, BCHN   ©2016

Many of you may have childhood stories like my husband and father of baldfaced hornet encounters.  When these stories are being told, there is always someone who steps in the nest first who walked away relatively unscathed, while others are repeatedly stung and attacked.

Dealing with difficult family affairs, especially those involving the elderly can hold these moments as well. What is the old proverb – good intentions pave the way to hell. Those dealing with difficult, at best seniors,  siblings, spouses, or even live-in care providers, will have moments they question their sanity for agreeing to be the “responsible one.”  There are volumes of unknown laws,  considerations, and medical pitfalls for the elder person to live with and for the designated family members to navigate – often under extream stress.

This is a perfect storm for migraines, high blood pressure, ulcers, IBS, insomnia, panic attacks, stroke, heart attacks and those are just the family members, not the elders. With seniors, it becomes easy for them to be over medicated, loss of appetite, outbursts of tears or anger, retreating into themselves, incontinence, or personal endangerment with erratic decision making.

The best-laid plans of mice and men,  all of a sudden change, rapidly when you decide to bring mom or dad into your home. They actually go out the window if your elders are more than you can handle, and they must be placed in a memory care facility for medication and mental evaluation against their will.  These are the times it is important for you to have documentation, be prepared for allegations of elder abuse, neglect or miss appropriations of resources; waged by other family members or even the elder in question.

Now, this certainly isn’t the case for everyone, but trust me there are those out there who have had their lives turned upside down by situations like these. Family caregivers begin reacting not responding to the crisis at hand, later regretting some of the decisions made in the heat of the moment. Relationships can be irreparably damaged.  Some of this could be avoided with careful planning before saying yes to our loved one’s requests to care for them, or before asking someone to care for you.

Everyone reading this who has elder family members or spouses should begin with attending classes on planning for the senior years. Classes are often free and offered through churches, senior services, and the veterans administration. Learn how to set up medical information portals to review medical records including medication lists. Ask questions about credit scores and banking liabilities before agreeing to be involved with financial decisions. And if it is a married couple needing simultaneous care investigate conservatorships, powers of attorney, medical guardianship’s, and advanced directives; all carefully before a crisis happens.

Talking but not heard, may be the case for both the elder family member and for those caring for them. This was brought more fully to my attention by Therese Johnson, Gerontologist, and Senior Care Consultant. Therese stressed the importance of validation communication with older family members.  She directed my attentions to the work of Naomi Feil and her book the Validation Breakthrough ; Validation is a way of communicating with older adults with Alzheimer’s-type dementia. This approach reduces stress, enhance dignity, and increase the happiness of the elder family member and those caring for them.

Since its inception in 1989, Validation has helped thousands improve their relationships with loved ones with dementia. Caregivers who use these techniques validate older adults’, rather than focusing on disorientation and confusion.

Research in the United States and Europe show trying to make older family members deal with the realities of what is happening, which can push them farther into disorientation and confusion, isn’t the best approach; it is better to talk to older folks in a different fashion, which allows them to come back to reality through validating their frustration, anger, fear and sense of loss. Many individuals in their seventies are then able to resume their lives with modest supervision.

Now I’m not known for my patience, which may mean my personality is not well suited as a caregiver. All the more reason to do homework before saying yes to that special older person.

When caregivers are under the hornets-nest-stress, they often look to foods to sooth, which in turn can create health problems for the care provider. Muddying ones ability to think clearly, support energy and healing ability of the body. Here is when others can be so invaluable to the struggling caregiver. Friends and family can provide nourishing food, and provide opportunities for caregivers to have safe conversations to detox from the problems of the day. Nothing can refuel the exhausted caregiver  as efficiently as a nourishing meal with laughter .

Here is to transition without the sting.

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Elder Care – none of this was in the owners manual!

Part Three

We have had numerous road trips to central California since March 2016 to help elder family members. But in May, we brought the Aunt and Uncle home with us. During this time, our focus has been on their needs and helping them regain some of their mental and physical strength. The care of elder family members was not new to us, but, and that is a big but, everyone is different, and the experience was vastly different from our time with the Mother-in-Law.

I caught myself wondering if there was an owner’s manual to cover real life challenges for both parties of this story.  Anne, a friend of ours in Texas said to me – “girl, you need to write a book on this.” Anne is now approaching her 50’s, and lives with her aging mother; she has lived through a multitude of life changes with family and clients. “No one has written about what it is like in the trenches,” she said to me…. “It is easy to see why family just dumps their older parents in care facilities, that way they don’t have to deal with the messy parts of aging.”

Some of the messy parts of aging involve adult diedies (diapers) as my Uncle calls them, then there is the other favorite “nose papers.”  I learned the importance of providing my Uncle with a masculine carrier for his emergency needs – no man of his generation is comfortable carrying a flowery bag or shopping bag into a public restroom. It is hard for them to maintain their dignity when they are faced with incontinence, especially when they are slower moving and unstable.  The length of time required for them to navigate to the bathroom, clean, change and straighten themselves is exhausting. The need to remain independent runs deep in many elder family members and the barging-in of an inpatient caregiver, to help them hurry up, in the bathroom is mortifying.

I selected a small easy to carry backpack in black for my uncle with a larger area for the diedies and flushable wipes. The outer smaller pocket was perfect for the medication or test kit he would also need, and the mesh side pockets kept water and smoothy bottles easy to access. Now he can walk into a public area prepared without embarrassment. Oh and I also stocked it with pocket-sized nose paper (kleenex) for the weepie dry eye or blueberry stain on his nose.

We learned the IMG_0001importance of having a trash can large enough to handle unmentionables with a lid in the home bathroom. This allowed for odor control, privacy, and convenience.

Change is never easy; it is especially hard for the elderly who have cognitive elasticity challenges (memory and anxiety), the change of purses, wallets, coats, shoes or suitcases may place your elder family members in a tailspin. The Aunt has used a black leather purse for decades, a well-meaning family member gave her and insisted she uses a bright flowery summer bag. For two weeks the Aunt searched each day for her purse where she knew all her valuable information and stuff was kept. Each day we would retrieve her new bag for her and remind her this was hers now. The anxiety was evident and potentially unnecessary. One day she couldn’t remember where her little Yorkies leash was (it was in her belly bag), it took until the next day for her to recover. For the first two weeks, the Aunt believed she didn’t have any clothes to change into because the suitcase in her room was green. Her suitcase was red, once we learned this, we quickly changed her clothes into a red suitcase we had on hand– she was fine after that.

Sundowners syndrome: making changes later in the day can be the hardest. For most of us, sunset isn’t a problem; it is a time to unwind and relax. For family members with Alzheimer’s or dementia, it can be a time of increased memory loss, confusion, agitation and even anger. Witnessing this increase in symptoms of disorientation at sunset can be troubling, painful, frightening and exhausting for family and caregivers.

Common Sundowning Triggers:

Too Much End-of-day Activity: Some researchers believe the flurry of activity toward the end of the day may lead to anxiety and confusion. We personally saw this to be true.

Fatigue: End-of-day exhaustion or suddenly the lack of activity was also a contributor.

Low Light: As the sun goes down, the quality of available light may diminish, and shadows may increase, making vision even more challenging.

Internal Imbalances: Hormone imbalances or possible disruptions in the internal biological clock that regulate cognition between waking and sleeping hours is also a principle cause.

Winter: The onset of shorter days exacerbates sundowning, we also saw the changes in  weather from sunny to stormy increased symptoms. Depression is a major challenge for those with memory issues.

Suggested reading:

Grace and Grit: Insights to Real-Life Challenges of Aging for Adult Children and Their Parents By Fritzi Gros-Daillon

How Hard Could It Be?: A Caregiver’s Story By Margaret Sheehan

How To Fold Superman’s Cape: A Woman’s Guide To Elder Care by James Burns Jr.

The complete elder care planner: For caregivers of aging parents or other family members  by Joy Loverde

 

To a grace-filled elder life transition.

Elder Care – Nutrition, Sleep and God’s Grace

AF in Hines

Part Two

by Tammera J. Karr, PhD, BCHN, BCIH

Two years ago, we said yes to an elderly family member when they asked if we would help them when the time came. We knew from past experience that this could mean trying times for both our elder family members and us, some of you like us may say –  “what was I thinking?” There may be days when you repeat yourself twenty times or days you hear the same stories over and over, deal with tears and anger. These are the days when Gods grace and peace will be your closest friend – that is once you can take a moment to recognize it’s presence.

These are the times sleep may be the most elusive for both you as a caregiver and for your elder family members. The change in environment can bring about increases in insomnia, pain, listlessness, confusion and short tempers. When sleep is in short supply it has an effect on cognitive functions; words may escape you, forgetfulness and spaciness may be your daily or weekly companions. Along with this may come an increase in headaches, blood pressure and cravings for sugar, salt and even alcohol. These are all ways of self-medicating in an effort to relax. The downside is food just like drugs never actually provides the relief hoped for.

There is research available today showing the benefits of L-theanine for the support of sleep architecture. L-theanine comes from green tea; Theanine is a constituent believed to counter-balance the stimulatory effects of the caffeine content in tea.  Theanine comprises approximately 1% to 2% of the dry weight of tea leaves; theanine is also present in Xerocomus badius (a type of mushroom).

Theanine lowers blood pressure in hypertension patients, prevent ischemic stroke and minimize memory impairment after the occurrence of stroke. Theanine increases alertness, is used in the prevention and treatment Alzheimer’s and various subgroups of dementia; L-theanine has been found to be useful in the treatment of anxiety; due to its ability to generate (relaxing) alpha waves in the brain and increase attention span.

We can’t overlook the food component of elder care. Food doesn’t have to be bland, but it has to be something our seniors are willing and able to eat. I like spicy food, my Aunts and Uncle do not. For them, simple peasant foods that are flavorful but not spicy are the better choices along with healthy protein sources and vegetables. Most seniors do not require three full meals a day, but rather small snacks and two meals. For those who are diabetic or concerned about memory challenges, selecting low glycemic foods and following a paleo dietary plan reduces inflammation and erratic blood sugar spikes. Don’t overlook the need for healthy fat; the diet should contain 15% saturated fats from real butter, animal and plant sources. With the remaining 15% coming from avocados, olive, nuts, seeds, and fish. Fat is crucial to blood sugar regulation and in maintaining weight for an elder who are borderline sarcopenia. Both fat and protein play key roles in the utilization of neurotransmitters necessary for cognition and memory.

As daytime temperatures increase, pay close attention to water consumption and sodium, low sodium levels and dehydration are common causes of memory loss and confusion. The standard of care is to restrict water for those with low sodium. However, this may be counter-productive and should be discussed with healthcare providers to be sure it is the best option for your senior and their health.

Minimizing inflammation is a huge part of dietary concerns for elder family members. While meat and potatoes may be the foods they want most, they can also be what is causing increases in pain for them. Gout is caused by sugar, processed flour, red meat and some fish like salmon high in purines. Here is when tart cherries come to the rescue for many. Cherries are highly beneficial for those with inflammatory illnesses, in side by side studies with prescription anti-inflammatory medications the cherries outperformed the prescription drugs and had no side effects to cause additional challenges.

While some may have a passionate relationship with the divine, others may be agnostic, or atheist. Often religious beliefs are varied within a family and can be a source of conflict. For me it isn’t about what church you go to but whether you have faith. During my mother-in-law’s final days, we knew she was set in her agnostic beliefs, instead of brow beating her or asking her to change her thoughts we prayed in quiet for a peaceful passing, which she had. A relationship with our maker is a private one; his grace is there for the asking, and you as the caregiver may be in the greatest need.

To a grace-filled elder life transition.


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Elder Care – before you say yes

by Tammera J. Karr, PhD, BCHN, BCIH

Part One

Life is ever changing, and with it are unexpected surprises and challenges. This spring has reminded me of this, as an elderly Aunt and Uncle have moved back to the west coast and have been needing help getting settled. This event has reminded me of the changes and challenges we went through when my mother-in-law moved in with us. The trials are never one-sided; they affect everyone in the caregiver/elder relationship. No matter how much you may love your family, no one can push your buttons like that of a parent or sibling.

Not everyone is well suited to being a caregiver, and often times those who are caregiver’s burnout or collapse from the “stress” of always being alert or vigilant to the needs of their charge. New parents go through this, then as time passes a balance – new normal settles in. This process isn’t quite so easy when it comes to our elder loved ones.

Our parents or older charges have lived life, been independent, functioning, and in charge for years, unlike children. They have moved and shaken business’, communities and shaped the world we live in. For them, the loss of independence is heartbreaking, frustrating and depressing. The realization they are in the final portion of their journey through life makes for anger, fear and confusion. As their bodies fail to answer their commands, their minds rebel – you see they mentally do not feel like an “old man or woman.” I distinctly remember my mother-in-law saying to me; “ it makes me so damn mad, my brain isn’t any different than when I was in my forties, but my body has betrayed me.”

When older family members move in with you, they have given up a big chunk of themselves in order to have your help and safety. They balk at “your rules” just like any normal adult would do, and while some may thrive on being “cared for” like a child others begin to resist and respond with anger. This creates confrontation and stress for everyone. The older family members have to change their schedule to suit whomever it is they are living with, and this is not always easy – years or decades of habits may be in conflict with what you as the caregiver feels is correct.

Equally, the caregiver has their privacy, independence, work schedule and life altered. Often times the caregiver is a family member in their early fifties, they were planning for retirement and all the things they have always wanted to do; or they are at the peak of their career and soon feel overwhelmed by the addition of care responsibilities – these responsibilities often come hand-in-hand with those already involving college-age children.  As modern adults, we have a lot going on, sometimes too much, and it is impossible for us to wish for the good ol’ days because we don’t really have the same history as a different generation like that of our parents. My Aunt Linda shared with us the following – “Your memories are not the memories of those you are caring for”.  If they are not correct by your recollection, it is ok; you can still enjoy them”. Frustration is not just reserved for the caregiver. However, there are times you will want to pull your hair out or wring a neck.

No matter how much you may love those in need, there are times the situation or person may be “toxic” to you; not everyone can be a care provider, and it is important to know and be willing to ask for help. My Aunt and Uncle have always been very independent and in charge of their life journey. Today may be a good day, or it may be a bad day, but it is their day just the same. It isn’t one I have to fix; it is one I am willing to share with them and help them through. As appointed caregivers we help family members find a compromise – whether it is in regards to the amount of support they need or finding the right place for them as individuals to live were full-time care is available. They need to feel they can trust, just as much as you need to feel you are doing the best for them. Be willing to allow your elder family to settle be involved with making the decisions in regards to their care and personal routine; don’t assume you know best and forced them to your will.

Our own fears over our family members wellbeing and safety will cloud our thought process and as care providers if we are not careful; irreparable damage to our relationship with our family may occur.  I tell my clients; Consider carefully how you want to be remembered and remember your loved ones. The choice is all in your hands.

To a peaceful life transition.