-by Jill Ruff

Being a caregiver of some one can be challenging. What can be helpful to caregivers is to create a support network to assist you in caring for your loved one. Your network can include healthcare providers, family members, neighbors, friends, vendors who provide in-home care or adult day care services, or a local church if you belong to a specific religious denomination. 

Informal Support

Think about people who may be willing to help or have offered you help in caring for the patient.  Sometimes family and friends are not able or willing to help, but others in your extended groups of friends or your neighborhood are willing to become involved and are happy to help.  You just need to ask and you might be surprised as those who step up to the plate to offer assistance.

• First make a list of what needs to be done and post it prominently in the house.  Visitors who see the list might offer to help out.
• Ask for help.  Most people want to help but just are sure how so let them know.
• Request practical help with tasks like shopping, driving to appointments, going to the pharmacy, making meals and housework including laundry, lawn/gardening.
• Find out when people are available to help and select a task that works on their timeline.
• Your community or church may have volunteers that will visit, come over to read or play cards, make meals, or offer other types of support that you and the patient need.

Formal Support

Your formal support network is more structured than the informal one.  You can ask your family doctor for help finding services, the social workers at the hospital where the patient is discharged from or go to the Internet and find lists of resources.  Your formal support network may include:

• Home care nurse, personal care workers or a home health aide who can provide baths, feedings and care, and can offer you a break for a few hours from your care giving duties.
• Pharmacy that offers home delivery
• Community agencies that offer services for a fee including grocery shopping, house cleaning, gardening and transportation services.
• If your loved one is on hospice, a hospice care team which may include a nurse, social worker, chaplain and other members

Do not be afraid to ask for help in your caregiving responsibilities.  If you do not ask, you may never know what is available.  Just reach out. And if your loved one is resisting help from others or is reluctant to have “strangers” in the home, explain to them that you need the help and would like to at least give it a try. It’s not always easy getting used to unfamiliar faces in your home.  It will take some adjustment but ultimately you will get used to this and will find it tremendously helpful.

Source: A Caregiver’s Guide - K. Macmillan, J. Peden, J. Hopkinson and D. Hycha

*This post is part of San Diego Hospice’s series of healthy recipes for patients. This series will be updated monthly. Feel free to let us know if there is a type of recipe you’d like to see more of.

When caring for someone who is battling cancer, it is important to find recipes that are full of healthy ingredients. The plant Thyme has a long history of use in natural medicine in connection with chest and respiratory problems including coughs and chest congestion. Because of this, the use of Thyme as a culinary herb can provide nutritional value that can be especially beneficial to cancer patients.

According to the Cancer Treatment Centers of America, a dash of thyme can add disease-fighting power to your cooking. In addition to its respiratory benefits,  thyme (and other spices such as hot paprika, curry powder and Worcestershire sauce) contains salicylic acid. This acid is believed to have anti-inflammatory properties that may help protect against diseases such as colon cancer and hardening of the arteries. You’ll find the use of Thyme in the following delicious chicken recipe. Could be a great option for Labor Day weekend:

Balsamic-Glazed Roasted Chicken Breasts

Serves 4
Ingredients:

• 4 bone-in chicken breasts, trimmed, skin removed
• Salt and pepper
• 2 teaspoons dried thyme leaves
• 1/4 cup red currant jelly
• 2 tablespoons balsamic vinegar

Directions:

Preheat oven to 400º. Line a baking sheet with foil and lightly oil or coat with nonstick spray. Season chicken on both sides with salt and pepper, then rub with 1 1/2 teaspoons thyme. Place chicken bone-side up in a single layer on prepared baking sheet. Roast for 15 minutes. Meanwhile in a small saucepan, heat jelly, vinegar and remaining thyme over medium low heat until jelly is melted. Season with salt and pepper and remove from heat. Turn chicken meat-side up. Brush liberally with jelly glaze. Continue to roast, brushing twice with the remaining glaze, until the chicken is cooked through, about 15 minutes.

Source: Cancer Treatment Centers of America

-by Melissa DelaCalzada

For those of us caring for seniors, elderly parents or aging loved ones (call yourself caregivers or family members), communication can oftentimes be a challenge. Although we all understand that changes do come with aging, for family caregivers, it can be difficult to watch, and deal with, your loved ones growing old.

In my role as family caregiver, I have noticed the “communication gap” that has developed between my father and I and the challenges it poses. Not only do I find myself repeating the same answers, as he asks the same questions, sometimes I feel like I am the “interpreter” between my father and the rest of my siblings or anyone that my father interacts with – oftentimes explaining to him what is being stated and explaining to others what my father’s needs are.

Factors can affect the way we communicate with seniors and the elderly such as physical, visual, sensory, cognitive and emotional abilities that aging loved ones and the elderly experience on a more profound scale. Understanding what seniors are faced with can help in communicating with them appropriately and avoid the occasional flare-ups that may occur.

Caring.com suggests that the way we communicate can help avoid conflict in talking with aging loved ones, seniors or elderly parents and suggests the following communication techniques:

• Listen to what elderly parents or aging loved ones are saying and try to understand what is important to them.
• Do not rush the conversation. If pushed too hard too soon, many seniors will respond by what can be perceived as being stubborn or non-compliant.
• Pose questions and offer more than one acceptable solution. Ask your parents which choice they think is best. By doing that you not only give them control and independence, but you also involve them in the decision process and make it work for everyone, regardless of the choice.
• Keep it simple. Raise a single issue at a time rather than a complex group of ideas or subjects all at once.
• Be patient. Talking with your elderly parents or aging loved ones should not be a race or a contest of wills to see who wins. It is a series of communications where both parties have to feel that they have benefited from the outcome.

Using these communication techniques and taking the time to understand the changes that seniors are faced with can help caregivers and family members close the communication gap and create conversations that are more effective, empathetic and meaningful to all involved.

-by Melissa DelaCalzada

Hospice volunteers in San Diego provide an invaluable service to the patients and families they serve. At San Diego Hospice, volunteers are a vital part of the fabric of the area’s original non-profit organization. Volunteers can come from diverse backgrounds and fill a variety of needs. Some work directly with patients; others answer phones, assist with clerical duties, speak in the community, take photos, deliver medical supplies to patients, help with data entry, and perform a multitude of other tasks to support the agency. Each one is unique but they all have one thing in common – a heart of service.

San Diego Hospice is currently seeking volunteer haircut stylists. Prospective volunteers must:

• be at least 18 years of age;
• hold a valid license to offer their services in the San Diego area;
• be able to attend a special orientation and training on Monday, September 20 from 8:00 a.m. to 12:30 p.m.

Rhys, owner of Jet Rhys Salon, is a San Diego Hospice volunteer and talks about the experience of being a volunteer.

“I’ve always had a desire to help others. I’ve found a way to do that here. By making the patients feel better, I feel better. It’s fulfilling to know that I can make such a big difference by doing something as simple as giving a great haircut.”

Members of the Volunteer Resources team at San Diego Hospice advocate that something as simple as a haircut can mean the world to hospice patients, and providing this service would not be possible without skilled volunteers.

For more information call 619-278-6451 or send email to volunteer@sdhospice.org. Volunteer applications and more information about many volunteer opportunities are also available online on the San Diego Hospice website.

While there is no ‘right way’ to grieve the loss of a loved one, there are several strategies to help cope with the healing process. One healthy way to express your grief is to create a photo memorial. Many people find that pictures help keep their memories fresh and their loved one in their heart. When creating a photo memorial you have many options but here are a few unique ideas:

An imemory book is an album created online and passed among family members and friends. Multiple people are able to add to the book and share their specific memories and photos of the individual that has passed. The then album permanently lives online and can also be printed as a hard copy. This option can be good because the physical hard copy can be handed down through generations and the online copy will always be accessible should something happen to the hard copy. It is also unique in that it helps more than one person through the healing process as anyone can share their story and add to the album.

Another creative way to pay tribute through pictures is to create a quilt with photographs of a loved one. There are multiple companies that easily incorporate select pictures and even favorite pieces of clothing into a quilt, pillow, or blanket so that you can have the memorial piece completed quickly.

One of the more popular ways to remember a loved one through photographs is with a shadow box. The three-dimensional picture frame allows you to post pictures alongside items that remind you of the person who has passed. The memorial piece is also referred to as a “Remember Me” box as it is personalized with the name and birth-death dates of the family member or friend being honored.

Ultimately, finding a safe and healthy way to express strong emotions after a death is a major part of the grieving process. Using photography to remember a loved one who has passed away is a helpful strategy to help cope with the pain of the loss.  We’d love to hear about some of the ways you’ve used pictures to help you cope with your grief. Please let us know in the comments section noted as “Leave a reply”.

- by Susan Griswold

Driving safely is a priority at any age, but it is important to realize that as we get older, our body reacts more slowly. Our judgment can be impaired more quickly and our physical abilities are limited, which can significantly impact driving skills. However, being able to drive helps us feel independent and therefore a large part of maintaining a high quality-of-life. As a caregiver, you can help your aging loved one maintain their independence as long as possible by passing along these driving tips from AAASeniors.com.

Driving Tips for Seniors

1. Move into an intersection only after checking the area for pedestrians, cyclists, hazards and other motor vehicles. Don’t allow other drivers to pressure you into sudden moves.

2. Limit conversation and keep the radio volume low to minimize distraction.

3. Don’t drive when you’re tired or depressed and avoid more dangerous times such as rush hour or late at night.

4. Never drink and drive. Metabolism changes with age, and even one drink can make driving unsafe at any speed. In addition, avoid driving until you are aware of how new medications may impair your driving.

5. Ensure your windshield is clean and visibility is clear. If you smoke, refrain form lighting up inside the vehicle.

If your loved one still seems to have difficulty driving, it might be time to discuss their safety and driving. AARP has wonderful resources on knowing what to look for and how to prepare for the driving discussion. Whether your loved one still has the ability to drive, or has reached the point where they need other transportaion options, communication is key. Ensuring that they play an active role in the discussion, as well as the decision making, will make them feel they still have control over some aspect of the situation and help them understand that you have their best interest in mind. Although it isn’t easy, being sensitive and understanding of their situation can go a long way.

-by Carol Lovci, RN, MSN

The physical demands of caregiving are challenging, especially when you are experiencing your own stress due to changes in a loved one and the duties that come with suddenly becoming the primary caregiver. You may be worried about how you will provide home care and not cause harm and how you will give them what they need. You may also wonder how you will find down time to take care of yourself. Here are a few tips to consider when giving physical care in the home:

• Start by getting as much information from the health care professionals about what your loved one will need and resources they may have to assist you

• Once you are at home, remember to always practice universal precautions. This rule applies to everyone, everywhere, everyday. This precaution simply protects you and the person you are caring for from infection. Hand washing is key — use warm soapy water before and after every activity.

• When bathing or positioning your loved one, be sure to be aware if movement causes pain and, if so, provide their pain medication 30 minutes before beginning the activity. This will provide time for the medication to work prior to the activity starting and make the experience more comforting.

• If you need to provide the oral care for your loved one, be sure you do not do this while they are lying flat as this can lead to choking. If they are unable to raise their head, turn them to the side. Check their mouth daily for sores and never put your finger in their mouth, as someone who is confused or sleepy could inadvertently bite down.

• If there are wounds and dressings/bandages are involved, be sure to wear gloves and dispose of any products with blood or bodily fluids inside of two plastic bags. This is intended to keep all bacteria/infectious material contained.

• If your loved one has medication that requires the use of needles and syringes, be sure to dispose of them by placing the used objects into a hard plastic or metal container that has a lid. Place the lid on the container when it is full and tape it shut so the needles will not fall out and stick anyone.

If you are a family member / caregiver of someone in need of your assistance, please know that there are resources available to assist you. Check with your healthcare provider for referrals or learn more about in-home care assistance for family caregivers.

-Carol Lovci, RN, MSN has worked in hospice care for the past 18 years and has been in healthcare for more than 25 years. She is the mother of five children and a grandmother of three grandchildren with a love of family, animals and the river.

-by Melissa DelaCalzada

*This post is part of San Diego Hospice’s series of healthy recipes for patients. This series will be updated monthly. Feel free to let us know if there is a type of recipe you’d like to see more of.

Whether in your own backyard or at a park, summer in San Diego is the perfect time for grilling. In addition, if you are a caregiver to someone who is home-bound, grilling can provide an outdoor activity without travel. The following healthy recipe features ingredients that include Tryptophan, an essential amino acid that brings feeling of calm and relaxation, and Magnesium, a nutrient essential to good health that helps regulate the absorption of calcium for healthy bones and teeth.

Turkey Burgers with Avocado Salsa
Recipe by Karin Lazarus

Avocado Salsa
1 ripe avocado, finely chopped
2 tablespoons fresh lemon juice
2 tablespoons fresh lime juice
2 tablespoons chopped fresh cilantro
1 teaspoon minced fresh garlic
1/2 tablespoon plain low-fat yogurt
1/2 small red onion, finely chopped
1 teaspoon ground cumin
Dash of hot pepper sauce
Salt, to taste

Turkey Burgers
1 pound ground turkey breast
2 tablespoons wheat germ
2 tablespoons fresh lemon juice
1 teaspoon minced fresh garlic
1 medium egg
1/2 teaspoon salt
1/4 teaspoon black pepper

1 large red bell pepper, quartered and seeded
4 cups arugula or mixed greens
2 tablespoons extra-virgin olive oil
1 tablespoon fresh lemon juice
4 teaspoons unsalted sunflower seeds, toasted

Grilling tip: Turkey tends to be more fragile and may stick to the grill due to its low fat content, so oil the grate before heating, or use foil.

Directions:
1. Thoroughly mix all avocado salsa ingredients in a medium bowl;
set aside.
2. In another medium bowl, combine ground turkey, wheat germ, lemon juice, garlic, egg, salt, and pepper; mix well. Form mixture into four patties.
3. Oil grill grate (or lay a piece of aluminum foil on grill) and heat.
Cook turkey burgers and red pepper quarters for about 4 minutes on each side. Remove; cut grilled red peppers into thin strips.
4. Toss arugula or mixed greens with olive oil and lemon juice; divide among four plates.

Top each with a burger and avocado salsa; garnish with grilled red pepper strips and sunflower seeds. Serve right away.

PER SERVING: 342 cal, 48% fat cal, 19g fat, 3g sat fat, 102mg chol, 32g protein, 15g carb, 6g fiber, 397mg sodium

Source: Delicious Living Magazine

-by Noreen Carrington, LMFT, FT

It is often difficult to parent children when you are experiencing your own stress, loss and grief. You may be worried about how you can talk to your children about what is happening in your family. You may be anxious that you won’t give your children what they need. Here are a few points to help you with parenting during times of stress and loss:

• Keep the rules the same. Setting limits and keeping your house rules in tact help children to know what is expected and maintains the structure they rely on.
• Show your children that they are important. Set aside some time, one on one, where you can have uninterrupted interactions with each child.
• Maintain routines and consistency as much as possible. Routines help children feel safe and secure when other changes are taking place.
• Communicate openly and honestly. Keep your discussion age appropriate and always honest. Children often fill in the gaps when omissions are made. Children also will ask for more information and you can continue to provide as they ask.
• Allow your children to express their thoughts and feelings. Encourage, but don’t pressure, children to express themselves over time. Allow for many kinds of expressions including drawing, writing, talking and playing.
• Accept and respect the feelings of your children. Stress and grief bring many feelings and some, such as jealousy, ambivalence, relief and guilt may be difficult to hear about and understand.
• Express your own feelings openly and appropriately. Modeling healthy expressions of your feelings helps your children know that it is ok to share their feelings with you.  Keep your level of expression to one that ensures your child does not begin to take care of you. Sharing your feelings combined with reassurance that “we will be ok” and “we will get through this” is most beneficial for children.
• Repeating your message over time. As children develop and change their need for expression and understanding will increase and change as well.

It is important to realize and normalize for your children that their feelings are a normal reaction to the loss. Although grief is a natural reaction and expression of a loss, parents often find themselves wondering if they are doing or saying things that are most beneficial to their children. Inviting the support of others, including grief goups, talking it over with a counselor, or enlisting the support of your child’s school guidance counselor, can often be just the reassurance you need.

-by Susan Griswold

For patients or anyone visiting their healthcare provider, talking with a doctor may not be an easy or comfortable task. In addition, a visit to the doctor’s office can cause the patient or caregiver to feel overwhelmed with the information provided during the visit.

However, research shows that patients and/or caregivers who act as a healthcare advocate for patients, who have a good relationship with their healthcare provider, are happier and more confident with the care they receive. The following suggestions can help build that relationship and make sure you get the information you need from your visit with your doctor.

Here are some tips to help you talk with your doctor:

• Consider bringing a friend or family member. They can help remember information, bring up questions you might not have thought of yourself and help keep you company.
• Bring a notepad and pen (or a tape recorder if you doctor is comfortable with this). This will allow you to keep a copy of the information covered and allow you to go over the information later yourself or with your caregiver.
• Bring a list of your symptoms and try to be as specific as possible when describing them.
• Bring a list of all medications you take.  Be sure to include all over-the-counter medications — including vitamins, herbals and other supplements – these are medications, too.
• Bring all your insurance information and any healthcare directives.

Educate yourself ahead of time and prepare a list of questions beforehand. This way, you won’t forget to ask about something that was important to you.

Depending on your needs, health-related websites such as WebMD provide health information to patients, caregivers, and healthcare professionals. These websites offer a list of health topics to choose from, including everything from stress to disease-specific information like Alzheimer’s, and provides suggested questions that one can use to ask his or her doctor on their next visit.

When talking about your healthcare needs with your doctor, if something is unclear, try repeating it back to your doctor or ask your doctor to draw a picture or show you a chart, if that is easier for you to understand.

Take control of your healthcare needs and share your concerns, questions, and healthcare goals with your healthcare provider.

Susan Griswold is part of the marketing team at San Diego Hospice and The Institute of Palliative Medicine team. She enjoys teaching herself how to cook, traveling, and trying new things.