Boston Aging Well
Helpful tips for family caregivers
In this season of thankfulness, it’s important to keep gratitude in moderation. And, while we’re thinking of eating, here are some overall dietary strategies to help with several difficult symptoms of Parkinson’s disease. Last, during your holiday visit, you may notice memory or thinking changes in your loved one. This is a tender subject. We offer suggestions for bringing it up in a way most likely to be well received.
November is National Family Caregivers Month. We’d like to take this opportunity to thank YOU for all you do to help your loved ones in need of support.
Too much gratitude?
The benefits of gratitude are well understood.
Studies show, for example, that approaching life from a grateful stance yields a stronger immune system, lower blood pressure, and better sleep. Plus, people who report more gratitude also report greater feelings of joy, aliveness, and optimism.
Those who tend toward gratitude experience less loneliness and isolation and greater compassion.
So why hold back on giving thanks?
At its heart, gratitude helps us maintain perspective. We see the larger picture. We avoid getting fixated on small annoyances. Saying “thank you” reinforces our sense of interconnectedness. It helps us recognize that we are not alone with our problems.
But forced or misplaced gratitude can undermine our overall well-being. For instance:
- Stretching to feel grateful about a person who is taking advantage. Dysfunctional relationships abound in family caregiving. There’s crankiness in the person you care for. Or siblings who don’t share the load. Don’t force yourself to “find some gratitude” when your true feelings are otherwise. In some situations, it is important to set limits and say “no.” Listen to your gut. Are you just making excuses for another’s disrespect? Gratitude can help you get by in the short term. And may be appropriate even for small things. But don’t let it mask a larger problem that needs addressing.
- Mistaking gratitude for indebtedness. We all keep something of a scorecard to assess the give and take in relationships. The closer to center one is in the rings of intimacy, the less appropriate “keeping score” may be. (Think of a business relationship vs. a spousal relationship.) Within families, if someone does you a good turn, it’s appropriate to show genuine appreciation. It is equally appropriate to acknowledge to yourself that you are deserving of help. Dashing to “repay” them—or their behaving as if you should—can inadvertently devalue your contributions.
Diet and Parkinson's
Dietary habits make a big difference in quality of life for people with Parkinson’s. Eating-related symptoms often crop up. For example, difficulties with swallowing. Also, problems with constipation as a result of slow muscle response. And problematic food–drug interactions. On the plus side, some foods can reduce the free radicals common in Parkinson’s.
Here are some tips to discuss with your loved one.
- Constipation. In the morning, a glass of warm fluids such as hot water, tea, or warmed prune juice helps kick-start the bowels. A high-fiber diet and 6–8 ounces of fluid per day is a natural remedy. High-fiber foods include vegetables, legumes, and whole grains. Also fruits with the peel left on. There are prescription medicines that can help. And certainly, exercise helps all aspects of Parkinson’s.
- Swallowing problems. Coughing or choking can be relieved by sitting upright at a 90° angle while eating and “tucking the chin” down toward the neck when swallowing. Also try drinking from a wide-rim glass or cup. Taking smaller bites and chewing thoroughly can help. (Plan for longer meal times. Also, smaller, more-frequent meals.) Talk with a speech therapist or dietitian about other solutions.
- Medication-related issues. A key Parkinson’s drug, carbidopa/levodopa, works best when taken in the absence of protein-rich foods. Ideally, about an hour before or two hours after meals. This timing can be challenging. Other Parkinson’s drugs may conflict with certain foods and minerals or cause dehydration. Consult with your loved one’s doctor and ask for a session with a dietitian or nurse to create a workable plan.
- Antioxidants. Your relative with Parkinson’s has more free radicals than their same-age peers do. Antioxidant foods help mop up these toxic elements. The best foods are deeply colored fruits and vegetables. Blueberries, strawberries, raspberries, and red or purple grapes. Red cabbage, spinach, kale, and sweet potatoes.
Talking about brain health
Are you concerned a loved one may have dementia? If so, be careful how you bring it up. It’s a scary subject!
Before jumping to conclusions, gather some information. Ask family members and close friends what they have observed. Have others noticed changes?
Think of the issue as one of “brain health.” Brains change as we age. Using words such as “Alzheimer’s” or “dementia” is premature. There are many—over 70—changes in brain health that can affect memory and thinking.
Consider these talking tips:
- Ask if he or she has noticed changes. They may not have noticed or may deny it. They may have forgotten. Or they may have noticed and are also wondering (and scared!).
- Emphasize there are many things that can contribute to fuzzy thinking – and ways to address them. Dehydration. Depression. Medication side effects. Not enough sleep. Isolation and lack of social stimulation.
- Make it clear you are a team. It’s their body and brain. Your role is one of support. “I love you and I’m worried about you. Let’s explore this together.”
- Approach the issue with curiosity. It’s not about proving you are right and they have a problem. It’s about learning if their brain needs some extra support, much the way a sore knee may do better with medication and a brace.
- Remove barriers. “Medicare pays for an annual exam that includes a review of brain health.” “I can take you to the doctor. Even go in with you if you want. Or you can go in by yourself.”
- Get a full evaluation. Ask the doctor for a referral to a specialist who can do a complete assessment. Not all thinking problems are Alzheimer’s. It’s good to get a firm diagnosis.
- Be patient. This conversation may need to happen several times over weeks or months.