Socialization Help People with Dementia

People with dementia often have trouble in social settings.  The noise and activity of others is distracting and can even be scary.  Even those with early stage dementia are starting to notice they can't as easily follow conversations when more than one person is involved,  It can be confusing or stressful to know your role in a social setting.  As a result many people with dementia and their caregivers end up isolating themselves, going to less and less social settings.  Isolation can lead to depression and less physical activity.

Social interaction is one way to keep the brain active and may even help prevent the progress of dementia.  So how do we find social settings for people with dementia?  It's best to look for groups especially designed for people with dementia.  For example, Rhodes Respite care in Anderson (http://www.fpcandersonsc.com/serving/rhodes-respite-care-2/) provides socialization especially for those in early or middle stage dementia.  Participants enjoy attending the group where they make crafts, enjoy music, and get to know staff and other participants like themselves.  The Alzheimer's support group in Seneca offers a socialization group during it's meetings for people with early stage dementia.  Participants enjoy music, activities with pleasant aromas, board games such as Qwirkle and Rummykub, and interaction with college students and other participants.  The group avoids expectations or competitiveness so that participants feel welcome and comfortable no matter their mood or abilities on a particular day.  Trained college students from Clemson University provide one-on-one interaction to make participation active and enjoyable.  If you would like to join one of the groups led by Clemson students contact Dr. Cheryl Dye at tcheryl@clemson.edu for a list of current offerings.  The next sessions are Feb. 20 and April 17 at 11:30 am at Oconee Memorial Hospital.

Look for social activities where the expectations for your loved one and for you the caregiver are low.  But be sure to pick activities that you both would enjoy.  Consider a walk in the park where you observe children or families, attending a local church service, visiting a small store with few customers, going to a local walking trail on a sunny day, or playing a board game with one or two non-competitive accepting people.  Use your loved one's former interests as a guide.  If they always enjoyed playing cards look for simple card games.  If they enjoyed working out, find a place where you can use simple exercise equipment.  As you are interacting with others provide your companionship and support for your care receiver in case they feel confused or afraid.  Be accepting of their moods and interactions and offer praise during and after the outing, even if everything wasn't perfect.

Going to a social activity can take a lot of preparation and energy.  So be sure to plan some quite time or a nap afterwards.  Remember to praise your loved one for going and for being with you.

Note: See the previous post for another opportunity for socialization.

Dementia Dialogues

Do you work with or take care of someone with dementia?  One of the most effective ways to treat the care receiver is to provide help, education, and support for the caregiver.  Come to this free course...

Dementia Dialogues

Thursdays, February 12 - March 12, 2015

1:00 pm - 2:30 pm

at St Mark's United Methodist Church

616 Quincy Rd., Seneca

Dementia Dialogues is a 5 part learning experience designed to educate individuals who care for persons who exhibit signs and symptoms associated with Alzheimer's Disease or related dementias. Each session is approximately one and one half hours in length. This program is offered at no cost to participants through the Arnold School of Public Health at the University of South Carolina and the South Carolina Department of Health and Human Services.

Below is a list of what we cover in each of the five sessions:


1. The Basic Facts, and introduction to dementia


2. Keeping the Dialogue Going: Talking to people with dementia


3. Environment and safety issues, eating, bathing


4. Challenging Behaviors: wandering, incontinence, sundowning


5. More Challenging Behaviors: repetitive behaviors, yelling, agitation, rummaging, etc.

The class is free. Registration, although not required, is recommended. Email name and phone number to elehmacher@gmail.com.

Participants can attend only one (or a few) of the sessions. Previous sessions are not a prerequisite. Caregivers who need care for a person with dementia may call the Alzheimer's Association to request a free caregiver at: 800-272-3900. (Please call at least 2 weeks in advance.)



During class, another group will be offered for care recipients offering activities for people with early or mid-stage dementia led by Dr. Cheryl Dye and Clemson University students. Board games, drawing, and music will be used to stimulate brain function and improve mood. Room for 10 participants is available. Email tcheryl@clemson.edu to reserve a spot in the care recipient group.

Not So Happy Holidays

 When many people are enjoying celebrations with friends and family, people who lost a loved one recently may be dreading facing holiday traditions, family gatherings, music, and memories.  Sadness, loneliness, anger, preoccupation, envy, and yearning don’t seem to fit the holiday mood and can crop up at a moment’s notice.  What can you do to make survive this "happy" season?

     First, consider what’s most important this holiday.  Is it being with family, taking time off, creating a beautiful home, celebrating spiritual beliefs, exchanging gifts, being a peacemaker, or helping others?  Let your top values help you choose which traditions to celebrate this year.  A recent loss gives you permission to make changes in holiday traditions.  Rabbi Dr. Earl Grollman, certified Death educator and counselor, offers the following suggestions of for new traditions after a loss:  ceremoniously place an ornament/decoration that recognizes the loved one’s favorite hobby/interest, ask the youngest family member sit in the loved one’s seat at the holiday dinner, have family members stuff her stocking with written memories of her throughout the season (later read when all are together), share memories of him around a the holiday meal, play her favorite song, look through past photo albums, encourage family to "give him" a donation to his favorite charity, or serve one of her favorite foods for the meal (even if it’s jelly beans or bratwurst). Although one can’t predict how one will react emotionally during the holidays, having a plan and a new tradition can help reduce worry and even create excitement about something new. Just before holiday events, think ahead so there’s a place you can retreat to for privacy and a designated person (ask them ahead of time) to step into your role in case you need some time alone.  For help, call in “anything I can do” favors.  Your friends will welcome a chance to help you decorate, cook, write cards, visit, or shop.   Pay extra attention to self-care:  accept your feelings and let them out, get enough sleep, eat healthy, drink sensibly, and exercise (aerobic exercise improves mood).  Finally, consider doing something for someone else.  Research shows that we often feel better when we help others.

      What if you’re helping someone grieving? Instead of saying “let me know if I can help,”  offer specific help. Consider inviting them to your home for a holiday dinner or offering to help decorate or address cards.  Suggest a visit and ask specifically about how they are doing after their loved one’s death this season.  Be sure to use their loved one’s name (too often after death we stop using the name and this becomes almost a second loss for the griever).  Then be a listener.  Don’t offer advice, instead say things like “that makes sense” or “that must be hard.” Be flexible allowing your friend to decline offers now, but remember to check in later.

     Sadness and tears may be part of this holiday, but happy memories can be as well.  Focus on what is best for you and your loved ones, be spontaneous and flexible, and allow the feelings to flow whatever they may be.  Need extra help with your grief?  Consider joining a grief support group.  Groups are offered throughout the year at GHS Hospice of the Foothills (390 Keowee School Road, Seneca).  Call 864-882-8940 for more information. Or Google a support group on line.  For example, if you lost a child check out Compassionate Friends where others write about how they handle the holidays. If your grief seems to complicate all aspects of you life even months or years later, talk about it and consider making an appointment with a counselor.  

New Alzheimer's Support Group

By the year 2050, two-thirds of people over age 85 will have Alzheimer’s or related dementia.  Currently, more than 5 million people* in the US are living with Alzheimer’s disease. Someone in the US develops Alzheimer’s approximately every 67 seconds.* Alzheimer’s disease leads to memory loss as well as changes in thinking and behavior.  Research suggest that teaching caregivers more about their role helps both the caregiver and the person with dementia to live healthier happier lives.

In honor of Alzheimer’s and Caregivers awareness month this November, a new support group for caregivers of people with dementia will start Nov. 21 at 11:30am.  Caregivers will meet monthly to learn new skills, focus on self-care, and share coping techniques with each other.  Speakers with expertise in dementia care will come to the monthly meetings to share tips.  In November we’ll learn about non-medicine ways to prevent and treat dementia.  On December 17 Kathy Birkett, a local dietitian with specialty in senior care, will talk to us about how diet can help.   Participants are encouraged to bring a brown bag lunch and drink along to the group each month.

On November 21 at 11:30 (during the Alz. support group) Clemson University students, under the direction of Dr. Cheryl Dye, will provide activities for people with early or mid-stage dementia.  Board games, drawing, and music will be used to stimulate brain function and improve mood.  Room for 10 participants is available.  Email  tcheryl@clemson.edu to reserve a spot in the care recipient group.

Both groups will meet in neighboring conference rooms at GHS Oconee Memorial Hospital.  Participants for both groups should park in the front parking lot and enter together through the tower front door where people at the information desk can direct participants to the 2nd floor conference rooms.  No pre-registration required for the Alzheimer’s support group.  For questions about this new group please contact Eunice Lehmacher, LISW-CP at 864-643-8449 or elehmacher@gmail.com.  Eunice is a local counselor and geriatric care manager in Seneca and a certified dementia specialist.  Dr. Cheryl Dye is a professor in the Department of Public Health Sciences at Clemson University and the Director of the Institute for Engaged Aging.

For information on other Alzheimer’s support groups in the area contact the leader listed below:  In Seneca:  2nd Monday of each month 7pm, Jane Thomas (864-882-1202)

Clemson: 1st Wednesday of each month 2pm, Gail Marion (864-356-1174)

Easley: 1st Thursday of each month 7pm, Jim Vaughn (864-414-2378).

For more information on Alzheimer’s and for support call  the Alzheimer’s Association at 1-800-272-3900 or see www.alz.org.

Participants in an Alzheimer’s support group who would like to have a caregiver stay with their loved one when they attend the support group can call 800-272-3900 at least two weeks in advance to arrange for an free in-home caregiver for their loved one with dementia.

*data from Alz.org

Medications Seniors should Avoid

The American Geriatrics Society has a list of medications not recommended for senior citizens.  To see the list of medication seniors should avoid check out their website here.

What causes people to be healthier?

Dr. Kelly Turner, author of Radical Remission, discovered that cancer patients who experienced radical remission of cancer had the following factors in common:
1.  Radically changing your diet
2. Taking control of your health
3.  Following your intuition
4.  Using herbs and supplements (under doctor's supervision)
5. Increasing positive emotions
6. Embracing social support
7. Deepening your spiritual connection
8. Having strong reasons for living
Dr. Kelly interviewed numerous cancer survivors and identified more than 75 factors that they used as part of their healing journey.  The eight above were listed by nearly all survivors, making them the most significant.  (See her book for more information on each factor and her research.)

Whether or not you have cancer, the above factors may be a good way for you to be healthier and happier.  Consider writing a list of them and hanging it somewhere you'll see it often (your computer's desktop or screen saver, the bathroom mirror, over the kitchen sink).  Then start to notice which areas you need most to work on.  And begin to make changes.

For example, #6.  In a world increasing dominated by the media, social networking, and technology, some people feel isolated.  Family support and friends from younger years often live many miles away. We need to generate our own base of support locally and find ways to reconnect with those who live further away.  Finding friends who will support you includes being able to share with people who are safe your struggles, hopes, dreams, problems, and fears.  Choose people who won't judge you or solve your problems, but will rather listen to you and support your choices.  And be a support system for them as well.  Before tragedy strikes you or your family, accept support of friends, be willing to be vulnerable (with safe people), and provide support to those in your community.  In so doing you create for yourself a healthier community.

Why Did it Happen?

It is normal when something bad happens to wonder why it happened.  And why it happened to you in particular.  It can be good to analyze the whys.  Sometimes through, understanding the whys we come to a greater acceptance of the situation and are able to move on.

But...

and this is a big BUT...

...sometimes there isn't a single why that we can find.  Or sometimes even if we understand the why, it doesn't lead to any relief in the feelings (hopelessness, grief, sadness, pain, depression,...).

Most of us believe that if we could just understand what is happening and why, then make changes based on the understand, everything will be better.  But that's just not always true.  For example, when an accident that hurts or kills someone we love, no amount of understanding/thinking/reconsidering of the event will change that we feel sad (and angry, in pain...).  It's normal to go through lots of what-ifs and if-onlys (and it's not wrong to do so), but that process of thinking doesn't make us feel better.  When we feel pain and sadness there's a drive to find anything that will make us feel less in pain or sad.*  Thinking comes easier than feeling at times like this, and we can sometimes go into over-thinking or ruminating on the same what-ifs and if-onlys incessantly. When ruminating has taken over from thinking, we need to release the need to have logical explanations and move into acceptance of the loss and pain.

"But HOW" you say....

Yes, easier said than done.

It is a daily practice of accepting the now.  Accepting does not mean that you are glad this thing happened. Certainly not thinking that you (or anyone) would have chosen this painful now.  But accepting it as here now:  "I am in pain.  I am sad.  I can't make it go away, no matter how much thinking I do...."  Just noticing, "I'm trying to find an explanation again to make me feel better, but I still feel sad (angry, hurt...)."  Paddle past the pain and hurt onto calmer waters of accepting the feeling.  Perhaps you wouldn't have chosen to be in this boat.  But since you're in it, float, ride, perhaps paddle and move forward.

Try this exercise on releasing thoughts several times each week when ruminating or over-thinking has taken over.  And be accepting of yourself as you try it.  It takes practice to release obsessive thoughts, so the first time you try it, it will only work part of the time.

Take a deep breath and notice the motion of the breath.  Take 5 more deep breaths.
Notice a feeling you find unpleasant.
Notice what body sensations the feeling is causing (tension, hot, restless, lethargic, headache...).
Notice the thought that go with the feeling.
As much as possible observe the thoughts instead of thinking them.
Now accept the feeling.  Say to yourself, it makes sense I am _________.
Allow the feeling to express itself.
Say:  I'm in pain.  I can tolerate this.  I don't like it, but it won't kill me.
Continue to accept.
Take several more deep breaths.
On the breath out breathe out pain, tension, and ruminating thoughts.
On the breath in bring in healing, wholeness, acceptance, and (perhaps) peace.
Breathe.
Then notice if you feel any different.  Accept the change (or lack of change.)


*Sometimes we go to substances (like alcohol) or other addictions (like computer games) as a way to avoid the pain.

The Ten Absolutes for Caregivers

Jo Huey, a nurse, wrote these 10 absolutes for caregivers taking care of someone with dementia:

1.   Never argue, instead agree.
2.   Never reason, instead divert.
3.   Never shame, instead distract.
4.   Never lecture, instead reassure.
5.   Never “remember,” instead reminisce.
6.   Never say “I told you,” instead repeat.
7.   Never say “you can’t,” instead say “do what you can.”
8.   Never command or demand, instead ask or model.
9.    Never condescend, instead encourage or praise.
10. Never force, instead reinforce. 

Caregivers find it hard to stop using reason with their loved one, especially if the person with dementia was an engineer, lawyer, planner or was always very reasonable before dementia.  But once the disease starts, no amount of reasoning or logical discussions will convince them that their version of reality is not real.  In fact, being reasonable, a skill that works well in most other situations, can actually escalate arguements when talking to someone with dementia.  Just like we often can't reason with a toddler, we also can't reason with someone who is now losing skills they learned as a child.  (Note that we unlearn things in the same order we learned them before as a child).

Here's a place where Lily Tomlin can help us:  "Reality is the leading cause of stress of those in touch with it." 

Allow your care reciever to have their own reality.  Let them enjoy it, and don't talk them out of it.  Your job as the caregiver is to eliminate conflict and provide saftey and purpose in life when you can.  And of course, your job is to take care of yourself.  Cut down the arguements, and enjoy the moments that you are given with your loved one.

Consider posting Huey's 10 Abolutes in a place you see daily to remind you.

Living Humbly

We live in a culture of sacristy. Thousands of advertisements tell us we need to get something to be happy and fulfilled. Implied is the idea that we do not have enough or that life is is always about getting more. The idea of scarcity and advertisements do help businesses sell products and help companies grow.  But does it help people, our culture, or our mental and physical health?

If we believe the notion that we don't have enough, we spend our lives striving to make more money, get a better job or home, find the right friends, ....   In other words we focus on the future, improvement, and what we want.  There's nothing wrong with improving and changing.  But if it becomes our only focus, and we forget to enjoy the present, this culture of scarsity can lead to a life of busy-ness, striving, a life with few margins or room for spontaneity...a life with little gratitude or joy.

If you've noticed yourself rushing, having few times of contentment or gratitude, or constant fatigue, perhaps you need a vacation (or stay-cation) from the culture of scarsity. Take on week (day, hour, year) to be fully in the culture of plenty.  Spend time each day being grateful for what you already have, don't go shopping (even on-line shopping), avoid advertisements, use the time you normally shop or watch to do something you really enjoy.  Do something spontaneous. Live simply during you stay-cation. Instead of going out to eat, cook from the things in your home. Play a card game instead of watching TV. Call or visit a friend whom you enjoy being with. Have unplanned time each day. End each day making a list of what is plentiful and joyful in you life. Think of simple activities you enjoyed when you were younger and do one.  If you have a child or pet allow them to set the agenda for some play time and learn from them how they take pleasure.  Kids and pets are great teachers in living in the present.

Stop trying to work things out before their time has come. Accept limitations living one day at day at time. Enjoy each moment. Just be.


“You must live in the present, launch yourself on every wave, find your eternity in each moment. Fools stand on their island of opportunities and look toward another land. There is no other land; there is no other life but this.”  H. D. Thoreau

Thank Goodness for Problems!

“It is in the whole process of meeting and solving problems that life has meaning. Problems are the cutting edge that distinguishes between success and failure. Problems call forth our courage and our wisdom; indeed, they create our courage and our wisdom. It is only because of problems that we grow mentally and spiritually. It is through the pain of confronting and resolving problems that we learn.” ― M. Scott Peck

All of us prefer to avoid problems.  But when we think back on the important things we learned in life, we realize that most of our strengths today come from handling problems in the past.  The challenge  is when we face a problem to day we to be able to be grateful for the problem.  Unfortunately, we don't know what we're learning as we're tackling the problem, and we may face some uncomfortable feelings.  But facing the problem with acceptance instead of avoiding the problem may help us to solve it and grow.

Pain cannot be avoided.  But suffering (pain - acceptance) can be avoided.  Face your pain.  Accept your problems.  Take a deep breath and live yourself into the answers to the problems you face.  If you're in a dark tunnel at present, and the light at the end is small or even invisible, keep hope alive that there is light at the end.  And keep walking until you see it.  Hope will walk with you.

"Hope, like a stranger, came to my door


I was afraid, I was rude
"What are you coming here for?
Have you come to stay
Or are you just passing through?
I've seen your face
But I do not know you"
And he said, "You know me,
But I've had to remain
Hidden in the shadows
Of your sorrow and pain
For you have lived your life
As a slave, so it seems
Believing your nightmares
Instead of your dreams."  Bob Bennett

Be the Change

Marketers suggest that we can buy a certain item can make us happy.  When you go to a doctor you can get a pill to help you solve almost any problem.  Insurances promises to make you secure.  Advisers promise if you use their services you will become rich, healthy, ...  But unfortunately many problems continue even after buying the item, seeing the doctor, or taking the medication.  Although it's true insurance, pills, people and things can help us, often it takes an investment of our own time and effort into a problem before it gets better.

"Be the change you want to see in the world" Gandhi said.  Instead of hoping for others to solve our problems (or the world's problems) we need to learn to see how we can make a difference for ourselves (and others) now.  So next time you have a problem that you thinking shopping, medicine, government, or some expert can fix, consider first what you can do to be the change you want.

Most of us would benefit from getting more exercise.  It would help us pay attention, have more energy, be less depressed, decrease the likelihood of getting dementia and heart disease, and if we walked in our own neighborhood we might improve our relationships with neighbors or make new friends.  Almost everyone I work with knows that exercise would help them, but few people are willing to make the changes necessary to make exercise a regular part of their lives.  Why?  The answer is different for everyone but inertia, or the tendency to stay where we are, is often a large part of the reason.

Most of us could eat better.  If we ate less that was bad for us (sugar, fatty foods, alcohol, etc.) and more that was good for us (fresh fruits and veggies, homemade items, etc.) our hearts, minds, and bodies would be healthier, have more energy, and if we cooked with friends or family it might even improve our relationships.  If we started growing some of our own food, we have the chance to exercise while we're eating better.  Again, most people know that they need to improve their diet, but they resist the messages their body is sending regarding foods.

Eating right and exercising take more time than just taking a pill.  Many skills or techniques like meditation for example take an investment of time and effort on our part before we can reap the benefits.  The benefits often outweigh the effort, but you only notice the benefit after many hours of practice.

“Make the most of yourself....for that is all there is of you.”  R. W. Emerson

Quick fixes are attractive because they are so simple.  But the key to our health and well being lies in our own hands.  We need to decide what is needed to be healthier and happier.  So long as we assume someone else (be that a doctor or family member) holds the key to solving a problem we are facing, we can't really make changes.  So accept what your are, define what you need to change, and then start the hard working of being the change you want to see in your world.

“The curious paradox is that when I accept myself just as I am, then I can change.” Carl R. Rogers

What is FEAR?

What is F E A R to you?

False Evidence Appearing Real
Failure Expected And Received
Forget (or F...) Everything And Run
Frantic Efforts to Appear Recovered (Real)
Feeling Everything's Really Awful
Few Arrive Ever Rejoicing
False Expectations (Egos, Evidence, Emotions, Experiences..) Appearing Real
Feelings Every Alcoholic Rejects
Forever Escaping And Retreating
Fools Every Alcoholic Repeatedly
Forgetting Everything About Reality
Future Events Already Ruined
Forgetting Everything's All Right
Forgetting Everything About Reality

Notice that many of these acronyms have a focus on the future.  We are thinking about the future and we become afraid.  

Try choosing to be in the present instead.  Notice I said choose.  Fear will arise.  It's unclear if we have the power to stop fear from coming into our bodies and awareness.  It's pretty clear that when fear has arrived it will affect our physical bodies, our experience of the present, and our hopes, feelings, and awareness.  Fear changes us.  So when it arrives.... notice it... and...

CHOOSE to BE in the PRESENT....

Breathe...now...this one moment...notice what fear does to your heart rate, breathing, temperature, thoughts, feelings, hopes, awareness....

Now choose to be present....instead of thinking the thoughts that fear brings on...just be... breathe...notice...be aware....

Take this moment to notice something in the present and fully experience it.  Perhaps use beginner's mind to notice some object near you.  Afterwards, notice how your fear and your awareness has changed.

There's enough energy right now to handle the present, not all that might come in the future (and has happened in the past).  So CHOOSE to stay in the present....

Breathe....

Chronic Pain Relief

Although you might not think so at first, pain is a helpful trait of your body.  It lets you know that something is wrong and needs to be changed.   If you touch a hot stove, it's the pain that makes you move your hand.  Pain is the main reason people visit their doctor, since it is often the first sign of many diseases.  Because of pain many people have found out what disease processes were happening in their bodies and got needed treatment.

But let's face it, we don't like pain.  We especially don't like pain that stays around. Chronic pain is sometimes lasts weeks, months, or years.  It is not uncommon for people to continue to suffer from pain even after having a medical treatment for the problem.  For example, most people know at least one person who had back surgery but still suffers from chronic back pain.  Chronic pain is the reason Americans are buying more pain killers than ever before.  46% of Americans say they suffered from pain in the last 2 weeks.  20% of Americans say physical pain disrupts their sleep one or more nights a week.

All pain and illness is probably a result of both physical and mental causes.  Physical causes for pain are numerous and include physical illnesses, inflammation, tissue damage, medication side effects, and chemical changes in the body.  Mental causes for pain can include worry, stress, fear, and faulty belief systems.

Pain cannot be avoided.  Unfortunately all of us will experience pain in life at some point.  But suffering, which is pain minus the acceptance of the pain, can be avoided.   To avoid suffering one must learn to accept pain or learn to resist pain less.  We can know we are suffering if we are grimacing, teeth grinding, having self-punitive thoughts, seeking to avoid thinking about pain, wishing constantly for relief (e.g. attachment to finding a cure), or feel depressed, angry, or afraid of our chronic pain.  Everyone suffers when they experience pain.  Suffering leads to tight muscles, and perhaps a fight/flight/freeze stress reaction.  This stress reaction changes the way our bodies work and may even increase the pain.

So what's the solution?  First of all go see a doctor and get medical help.  If the only medical solution you've found after trying several treatments is pain medication, and you would prefer not to take so many pills, consider steps you can take yourself.  Learn to accept the pain (not the suffering).  Radically accept the pain.  Allow yourself to experience the pain as it is in this present moment.  Instead of letting the pain be a distraction from your work or relationships, give the pain a few moments of undivided attention every day.  Accept the pain of the moment and let go of the pain from the past and potential pain in the future.  For just a moment, allow yourself to experience the pain without thinking about a potential cure or wishing for a solution.  Don't think punishing thoughts about why you are having pain, simply experience it or describe it to yourself.  Notice ways your thoughts are making the pain worse (do you catastrophize, worry so much you get tense in your shoulders and neck or get a headache?).  Just accept the thoughts you have without judging them.  Then go back to observing the pain:  the sensations, the throbbing, the minute by minute changes in the intensity and location of the pain.  Watch.  Observe.  Allow.  Accept....

Although this mindfulness exercise won't take away the pain, it may reduce the suffering.  And with practice you may be able to reduce the level of chronic pain and enjoy your life more.  Try googling mindfulness for pain relief and try a few meditations.  One from my website is here.  For more on this method see www.backsense.org.

Other methods you can use to reduce suffering include changes in diet, behavioral therapy, exercise, physical therapy, evaluation of sleep habits, reduction of substance use, acupuncture, energy therapy, EFT (emotional freedom technique), chiropractic care, and changes in lifestyle and habits.  When you visit your doctor, ask them to give you more than pain killers.  Ask them for what lifestyle changes you can make that would reduce the suffering and pain.  If your physician doesn't know wholisitic methods, look for other health care professionals and/or health coaches in your area that can help you.  Don't forget to ask your friends what methods they have used and which professionals have helped them.  (Note: licensed professionals for whom you have several positive references are your best source of alternative care.)

Cures for Depression

Depression affects approximately one in 10 Americans (Centers for Disease control), although it affects everyone at different levels.  Depression is costly and debilitating for many, a passing nuisance for others, or a recurring down experience.  No matter how it affects you, you have probably looked for an antidote or "cure" for depression.

Medication is one of the most common treatments for depression, and is pretty easy often only requiring taking one or two bills per day.  Talk to your doctor about which medication is best for you.  Remember you may need to try several before you find the one that works best for your body.  If medication is not working for you or not providing enough relief, remember it's only one antidote.  Try some of these depression killers:

Counseling:  Talking out what's hurting can help you develop new ways of thinking and new ways of coping.  Many people find after effective counseling they can decrease or end their use of medications.

Exercise:  Instead of (or in addition to) taking medications, take your body's medication for depression.  The way to activate your body's chemicals is aerobic exercise.  I recommend 30-90 minutes aerobic exercise 5 days a week.  You're looking for exercise that makes your heart rate go up.  For example, swimming, jazzercise, aerobics classes, walking fast, running, playing soccer, etc.  Find something you enjoy doing and consider varying the activity from day to day.   Strength training is also beneficial.  Although you won't see an immediate benefit in the first week of exercise, over time you'll find adding the body's chemicals will counter depression (and has no side effects, except perhaps weight loss).

Sunlight:  If you lived in Alaska or Norway, you'd notice how many people get depressed in winter when full sunlight is available less than 4 hours a day.  If you're feeling down go outside on sunny days.  If you add a walk or a visit with a neighbor, you're doing two depression busters at once!  If you tend to get depressed in the winter, notice how sunset gets later each day after Dec. 21.   Consider getting a "sun" lamp for in your home.

Diet:  Eat some depression busters.  Foods that nutritionists suggest may counter depression include  cashews, brazil nuts, whole grain oats, brown rice, cabbage, raw cocoa, foods with Omega-3 fatty acids (like salmon and tuna), brewers's yeasts, hot peppers, and other whole grains like quinoa, kamut and spelt.  Talk to a health coach or nutritionist for advise specific to your body and/or medical conditions.  Or do a web search on foods that have helped others.  Don't forget to avoid foods that can lead to depression like foods high in sugar or fat, excessive coffee or alcohol.

Thankfulness leads to Increased Joy

Do you remember how happy you could be when you were a child?  Most adults, on the other hand,  approach joy with some foreboding.  When something good happens, we are waiting for the other shoe to drop.  When we notice our happiness, we sometimes fear losing the source of happiness.  Ah, what we can all learn from children....

How to we learn to fully experience joy again?  Researchers has begun to find some clues.  In one study* three groups were asked to write a few sentences each week on the following topics:  what they were grateful for, daily irritations that displeased them, or events that affected them (no emphasis on positive or negative).  After 10 weeks, those whose assignment was to write about gratitude were more optimistic, felt better about their lives, exercised more, and had fewer visits to the doctor that those who wrote about sources of irritation.  In another study**, participants were asked to write a letter of gratitude to someone they had never thanked for their kindness and deliver it to the person.  Participants who did this reported huge increases in happiness scores.

Making a practice of gratitude can increase your happiness and make you more able to experience joy in your daily life.  And perhaps focusing on the negatives can decrease your ability to experience joy.  After Thanksgiving day, we are all more aware of the practice of thanksgiving.  Why not resolve to make the practice of gratitude a daily or weekly practice in your life.  Consider the following approaches:

1.  Start of list of 1000 things you are grateful for.  Add more to it each day or week.  (see more on this in the book One Thousand Gifts by Anne Voskamp).  Monthly read through what you've written in the past.

2.  Each morning as you're waking yourself up, name 5 things you're thankful for.  Don't forget to include a warm blanket, a comfortable pillow, and running water.  Remembering things we take for granted can help us experience more joy.

3. Write a letter to someone who you are grateful to and mail it.  Consider taking the time to handwrite the letter to make it more personal.  Or look up the person and give them a call.

4.  When a sales person, colleague, or neighbor is efficient and helpful, thank them on the spot.

5.  If you have a spiritual practice such as prayer, consider including thanksgiving more often.

6.  Notice people who you know that are happy and consider if they are practicing gratitude regularly.  Or even ask them?

7.  Start a gratitude board on your wall or your computer.  Add to it when you see it.  Encourage others in your family to do the same.

8.  When you write a Christmas card or birthday greeting to a friend, consider including what you appreciate about them in your note.

9.  Make appreciation part of your relationships.  Make a special time (perhaps at meals) to have everyone in the family share about what they appreciate about one member of the family.  The next day/week, choose someone else.

10.  When you do need to correct or disciple someone, start with what you appreciate or what they did right before explaining what they can do better.  Research on criticism suggest that children should hear 10 positives/praise for every one negative/correction they hear.  So start with 3-5 things they did right before providing correction.  If you're a teacher or manager, see how you can incorporate praise into your feedback.  Here's some ideas on feedback from Brene' Brown:  http://brenebrown.com/wp-content/uploads/2013/09/DaringGreatly-EngagedFeedback-8x10.pdf
11.  Start a file folder (actually or on your computer) of thank you notes.  When you get one or a letter that talks about how you helped someone, add it to the folder.  When you feel down or just randomly when you're digging through your files, go read through the folder.

*Dr. Robert A. Emmons of the University of California, Davis, and Dr. Michael E. McCullough of the University of Miami, have done much of the research on gratitude.

**Dr. Martin E. P. Seligman, a psychologist at the University of Pennsylvania, tested the impact of various positive psychology interventions on 411 people.

Letter to your Future Self

When you feel good and strong consider writing a letter to yourself that you will read at times you feel vulnerable.  Give yourself advise on how to cope and get better from your strong self to your vulnerable self.  You know best what it feels like to be depressed, anxious, or discouraged.  Here’s some things to include in your letter:

•  Validation or acceptance of your vulnerable self’s feelings.
• What things the strong-you does that make you feel better (exercise, positive thoughts, healthy diet, mindfulness, supportive friends…).
• What helped you leave behind depression or anxiety in the past.
• Affirmations that you need when feeling weak (others care, every day is a new day, you’ve done this before, it will pass, I love you,…).

·      Advise on what to NOT do as you know from experience (drink, isolate, overeat, negative self-talk).

·      Your personal resources and strengths (intelligence, empathy, energy, caring…).

·      Be supportive, compassionate, caring, encouraging, and understanding of your vulnerable self.

·      Say something hopeful (but believable, remember in dark times no one believes euphemisms)

Helpful thoughts?

"As a single footstep will not make a path on the earth, so a single thought will not make a pathway in the mind.  To make a deep physical path, we must  walk again and again.  To make a deep mental path we must think again and again the kind of thought we want to dominate our lives."  D. Thoreau

When you catch yourself saying "I'm not good enough" or "I never do anything right" and any other destructive thought, take note of this unhelpful path in your mind.  Don't be judgmental about this thought, just notice the thoughts that don't help.*  And then start walking down the path you want to make instead.  Tell yourself "I'm doing the best I can" or "I've handled problems before and I can do it again."  Repeat phrases that you want to hear over and over again.  Maybe you even want to write a card to remind yourself of these positive thoughts or put a reminder on your phone or computer to read the thoughts to yourself.  Negative thoughts may have become a habit, but you can make positive thoughts become a stronger habit (or path).  If you work on this every day, within one month you could notice the more positive path becoming a habit (or at least being "louder" than the unhelpful thoughts).  Below are some suggested coping thoughts.  Choose and adapt the ones you like best.  Better still, write your own.

Today is a new day and I can live it fully.
I can be anxious and still deal with ________.
This isn't an emergency.  It's ok to think slowly about what I need to do.
This isn't the worst thing that could happen.
There is no need to push myself.  I can take as small a step forward as I choose.
I can figure out what I need right now.
I have the time to spend on taking care of myself.  I'm important.
I don't need these thoughts.  I can choose different ways of thinking.
I've survived this before and I'll survive this time too.
I can take all the time I need to relax and let go.
I deserve to feel ok (or ______) right now.
I'll just let my body react to this.  I know it will pass.
Don't worry.  Be happy.
I'm special.  I'm loved.
Fighting and resisting isn't going to help.  So I'll just let it pass.
This moment is special and I'm going to enjoy the present now.
I'm doing my best and I'm taking care of myself.


*Unhelpful thoughts were often "intalled" in our brains in childhood and come without us wishing for them.  By resisting them or scolding yourself for them, you may not help yourself.  But by simply noticing and accepting them as something our mind does, you can move past them to more helpful thoughts.

How To Get Back to Sleep

If you sometimes wake up in the night and can't get back to sleep, you're in good company.  Approximate one-third of Americans wake in the night, and about half of those have trouble falling back asleep.  Sleep experts tell us it's normal to wake sometimes during sleep.  If you wake, roll over, and go back to sleep, you don't have a problem.  But if you are awake for 20 minutes (or longer), you  might need some help.*  What can you do when you want to go back to sleep?  Here's a couple ideas:

1.  Body Scan:  Starting at your toes, finger, or head, scan through your whole body, noticing each part and asking it it relax.  Here's a link to a body scan you can use:  http://www.mindfulmomentsinsc.com/files/Exercises/BodyScan.mp3
2. Noticing texture:  Put your hands on two different textures in your bed (e.g. sheet and blanket or skin and cloth).  Notice the difference between your two palms (rough, smooth, cool, warm, soft, hard...).  Then move your hands slightly and notice the difference.  Then be still again and notice the difference. Move one hand to another object with a different texture and notice the difference again.  This exercise helps pull you into the current moment helping you appreciate your bed and perhaps taking away your thoughts from worry or racing thoughts.
3.  Counting your breath:  Count your exhale length and inhale length. (Ideally the exhale should be as long as or longer than the inhale.)  Then add a number to each inhale and exhale making the breath longer and deeper.  Keep adding numbers until your breath is quite deep, perhaps reaching 10.  Don't go so deep that it hurts.  Then make the breath shorter again, going down in length from 10 to 9 to ... to 2 to 1.  Now breathe normally again, enjoying each inhale and exhale.  Or try this meditation:  http://www.mindfulmomentsinsc.com/files/Exercises/ObservingYourBreath.mp3
4. Neuromuscular Relaxation:  Tighten your fist and hold it tight for 10 seconds.  Notice how tight it gets and perhaps even notice how your arm and shoulder feels tense.  Now relax it and notice the difference.  Repeat twice.  Leave arm still as relaxed as you tighten your other fist.  Relax.  Repeat.  Now tighten your foot, or forehead, or upper arm.  Always holding contraction for 10 seconds, then releasing and noticing the difference.  When you move to a new area, keep the other parts of your body still.  Relax your whole body this way until you fall asleep.
5. Going to a relaxing place:  In your mind go to a place that is very relaxing for you (the beach, forest, a special bedroom, with a loved person...).  Describe to yourself all you see there.  Then describe the sounds, touch, taste and smell.  Really go there and relax.  Breath out tension and breathe in peace.
6.  If you've tried these and other ideas and still can't sleep after about 20 minutes get up and do something else.  It might even be good to have a sofa or comfy chair all set up (with an extra blanket and pillow?) before going to bed.  Go and do something relaxing in another room (ideas below).  And if you fall asleep there, allow that.  Or once you feel sleepy go back to your bed.

Staying in bed when you can't sleep and worrying about not being able to sleep is unlikely to lead to sleep (and gets into the habit of not sleeping when in bed).  So get out of bed to do something else to stop the worry and the tension associated with worry.

Ideas of what to do when you get out of bed in the night because you can't sleep:
1.  Drink chamomile tea which is soothing and can make you sleepy.  Avoid caffeinated teas.
2.  Have warm milk or hot chocolate.  Milk has tryptophan which can help you sleep.
3.  Read something boring (textbook?).  Exciting stories can have the opposite effect.
4.  Listen to quiet soothing music.
5.  Pet your dog or cat.
6.  Think about something you like to do that's relaxing.
7.  Watch someone else sleep.
8.  Develop a relaxing ritual to use before you want to sleep.

Everyone has some nights when it's hard to sleep or stay asleep.  If this is just occasional, there's no need to seek further medical assistance.  But if you regularly find you can't sleep more than 2 hours at a time, you probably should consult a sleep doctor to determine what you could do to get more sleep.



*As we grow older, waking in the night becomes more common for lots of reasons like needing to go the the bathroom, pain in joints, and seniors tend to sleep lighter than younger folks.  As long as you're getting enough sleep (7-8 hours in normal), it's ok if part of you sleep is during the day).

Start the Day Well

Do you ever start the day lying in bed and dreading what is to come?  How we get ready for our day can really set the tone for the whole day, and can make each day more enjoyable.  Tomorrow consider starting you day with one or more of these tips:

1.  As you're waking up name 5 things you are grateful for.  Include things you like about your bedroom, body, family, house, job, neighborhood, state, country,....  Try to think up new things each day.  When things you don't like come to mind, notice the distraction and tell yourself you will work out problems later in the day but this moment is for gratitude.  Then go back to being thankful.

2.  Have 2 cups of water when you wake up.  We wake up dehydrated from not drinking all night.  Drinking water first thing in the morning will make you feel better and help your appetite be more appropriate at breakfast.

3.  Plan to pamper yourself at some point during the day.  Choose something you would really like to do that takes only a few minutes and plan to do it sometime time later today.

4.  As you are showering, bathing, and/or dressing do a body scan, noticing what parts of your body feel good and what parts you can't feel or feel a little tense.  Each day notice any differences since our bodies are different every day.  Let the tension wash out into the water and down the drain.  Or let deep breaths take out the tension/pain and breaths in bring in refreshment and new life.

5.  Eat breakfast.  Myriad health problems (such as heart disease) have been found to be less likely if you eat a wholesome breakfast every day.  Include protien and fresh fruits and/or vegatables.  If you're not hungry when you wake up, pack a breakfast to eat when you get to work or school.

6.  Include peppermint in your morning such as a mint tea, mint gum or candy, or an infuser with mint.  According to a study in the N. American Journal of Psychology people who were exposed to mint before driving had more energy.  Wheeling Jesuit University found that peppermint increase alertness and decreases fatigue when driving (Dr. Bryan Raudenbush, PhD).  So pop a stick of peppermint gum in your mouth before driving to work.

7.  Think of something in your life that you are glad happened to you (e.g. meeting your partner or friend, having children, moving to your town, or having a certain skill or job).  Now imagine how your life would have been different if this had not happened.  This exercise can help you appreciate something that you otherwise take for granted and give your an optimistic start to your day.

8.  Do some exercise outside.  Nature sounds and sights boost our mood, and exercise helps in many ways.  So before you climb on the bus or in the car walk for five minutes (or more) in your neighborhood, pull some weeds, pick a flower, or visit with your dog.

9.  Smile!  Smiles brighten our moods even when we're thinking about something we are dreading or when we're worrying.  So include several smiles in your morning routine.  Give yourself a reminder by posting a picture of someone or something that makes you smile near where you brush your teeth or eat breakfast or on the dashboard of your car.

For more ideas see:  http://www.webmd.com/balance/features/morning-mood-boosters

The Aging of America

In 2056, for the first time in US history, the population of people older than 65 will outnumber younger people according to the US Census bureau.  The Census bureau also tells us that baby boomers are living longer than their parents did even though they tend to be less healthy than their parents were at the same age.  Advances in medicine and medical technology are allowing people to live longer, even if they have poor health habits.

What changes will need to happen as a higher percentage of our population is older?  Time will tell.  But mostly likely we'll need to rely on each other more.  Our health care system will need to focus more on staying fit and healthy and less on curing illnesses.  And each of us will need to care for older neighbors, family members, and friends.  Probably a higher percentage of the population will be employed in the elder care and health care fields.  And we may all work well past the age of 60.

As changes come to our society each of us needs to make sure we are ready for the future.  Staying physically, socially, and mentally active will help each of us as our bodies grow older.  No matter what your age now, consider ways that you can become more engaged in your community, keep your body fit, and use your brain more.  Consider adding the following habits to your life:

*At least once a week call or visit a friend.
*Exercise daily, sometimes aerobic, sometimes stretching.  If you don't have time for a whole work-out, add a longer walk to the car when you park at the office or store or take the steps instead of the elevator.
*Look for ways to learn daily.  Make a list of things you want to learn on your computer or in your journal.  Check this list at least once a year to notice what you've learned and pat yourself on the back for keeping an active brain.
*Learn habits that help you relax and feel good.  Include leisure in your weekly and daily routine.
*Consider your next doctor visit as a time to learn about yourself and your health.  After your check-up resolve to try new ideas that you learned from the doctor or nurse to improve your health.  Enlist a friend to encourage you to keep your goal by telling her/him of your new resolution.
*Notice (but don't condemn yourself for) your bad health habits and make small changes to be more healthy.  For example, if you put three spoons of sugar in your tea, try to cut back to 2 spoons over the course of one week.  If you walk one mile slowly, pick up the pace once a week or add a bit of length.  Small changes makes big differences over time.
*Learn about organizations that help others and consider volunteering.
*Talk with your family members and friends about how you want to be cared for when your are older.  Get your will ready and prepare ideas for your family to commemorate your death once you have pass on.

We'll all need to work together as our society ages.  Please add your comments on how we can all prepare in the comments below.