As our society now shifts toward a prominently aging baby boomer demographic, more studies are underway to better understand how we age, and the choices we make for aging well.  Approaching 45? Time to review alcohol consumption and low carb meal options. Nearing 60 (like me) and it’s time to start pumping iron and build up muscle. Each person being unique, it’s really about self knowledge at every age, and self knowledge is a good thing.  Those of us working in dementia care, would add steps to take for brain health.  Knowing that brain health is connected to heart health, our purpose in life, and our social connections, we can make conscious choices to support ourselves and loved ones at any age. This morning it was all about being outdoors, under a canopy of redwood trees with three residents whose average age is 90. It was spontaneous, beautiful, and supportive of…

In the early 1990s I worked in skilled nursing facilities doing therapeutic activities with frail elders, and about a third of the population I assisted were recovering from a stroke. Much of my training and experience was focused on how to improve post stroke conditions that included partial paralysis, contractures, speech and communication impairments, delayed auditory processing and muscle weakness.  During that nearly 10 years of working in a nursing home setting, public health and medical communities were making solid strides toward decreasing incidence of stroke through medications for hypertension, statin medications, changes in dietary guidelines and smoking laws. The goal was to decrease levels of disability associated with aging — stroke being one of the biggest culprits.  As I started researching materials this month to prepare for a staff training on how to respond to signs of stroke, I realized that we are headed in the wrong direction. Since…

Self-care is essential for caregivers to regain the inner strength and energy it takes to do our jobs well. We hear it all the time. And yet, many of us find ourselves initiating steps for self-care when we are already depleted or completely drained. One of the underlying ideas behind a truly supportive self-care routine is to incorporate it into daily life, and hopefully avoid reaching that maxed out state-of-being.  Each person’s version of self-care is unique because self-care is all about what you want it to be. A supportive self-care routine needs to be based on your own interests and what makes you feel wellbeing at your core once again. And self-care has nothing to do with pleasing others! Self-care time is stress and pressure free. It can be just a few minutes or several hours. Time spent in nature can be incredibly restorative but maybe a spontaneous trip…

When we became licensed in 2011 to operate our first dementia care home, I quickly realized that developing solid caregiving skills was the most important thing I could do. My law degree, framed beautifully and hanging on the wall of our living room, didn’t mean anything to the frail elders in my care. Like many caregivers, I unexpectedly gained more than I could have imagined.  And my esteem for caregivers everywhere has only grown.  I have asked myself many times why caregiving is not yet fully appreciated in our society? First, we have been told for generations that for one to be viewed as valuable to society a college degree is required. Yet, the incredibly important skills of a caregiver, like many essential tradesmen and artisans, are not found on any college course syllabus.  Second, our society creates mixed messages about what skills and jobs are important — ie, if…

ROSHI’S POEM Whenever I hearThe edgeless soundIn the deep nightO Mother!I find you again. Whenever I standBeneath the lightOf the seamless skyO Father!I bow my head. The sun goes downOur shadows dissolveThe pine trees darkenO Darling!We must go home.— Leonard Cohen This morning I walked around my backyard and heard, first, the sound of a California Oriole calling out to claim he has returned to his California home. Then, looking for him among the plum blossoms, I could see his bright yellow feathers and regal black hood. He and his mate have returned home to nest and raise their next generation. Home is a universal and instinctual desire to have and create. Trying to include some important elements of what each resident feels is home for them is a calling of ours. What are the important elements needed to call a place home? There are many. I thought of a…

Families are made up of different generations; making life inherently more interesting. Visiting residents in assisted living and dementia care can be multigenerational too. I have witnessed the many kinds of changes that residents experience with dementia and have tremendous sympathy for their families. Diagnosis and treatment for Alzheimer’s or vascular dementia continue to pose a great challenge. And we know that a truly viable treatment is decades away while early prevention is somewhat of a guessing game.  Sounds daunting, yes. Yet, we are left with many choices on how to move forward — first and foremost is to not give up. We can work together to create an environment and routine filled with family, friends, and joyful moments. It’s not possible of course to create a perfect world for loved ones, however there is so much we can do to help during this journey.   I have witnessed families face…

A hospice nurse recently reminded me that each person will have a unique way of dying, and that dying is a sacred time for them.  I believe that those tending to the dying person are presented with the honor of applying care practices that support this sacred process.  Since I work with people who have Alzheimer’s, Parkinson’s or vascular dementia, I have already witnessed the brain failing before the body is fully ready.  As I have come to say, this leaves us with heart centered work. So the sacred piece of the puzzle at end of life has become an important part of my learning and sharing.

The labels and language we use around dementia affect how we experience caregiving. The words we choose affect how we feel about it and how we understand the problems to begin with, as we try to solve the many puzzles that dementia creates just navigating daily life.  Our expectations around caregiving are shaped by the words and labels we use. These expectations are incredibly powerful and impact how we think and experience our work. An insightful study, famously called the Milkshake Study, from Stanford University demonstrates this truth. The study measured ghrelin levels (the hormone that tells our brain we are full during mealtimes). They conducted lab tests with two groups of participants who drank the exact same milkshake mixture. The only difference was the expectation created by the words used to describe the milkshake. One group was told their milkshake was high calorie and the other was told their…