August/September 2011 Print - Aging Well Rochester

Making the best use of your time off

Time off from caregiving is precious. But after a break, many family caregivers find they don’t feel as refreshed as they hoped they would.

New research provides insights about how to get the most from a respite break.

Common respite mistakes

Unplanned time. It may sound good to “have no plans.” But that can backfire if you end up simply watching TV. You may feel you “wasted” your time.
Routine tasks. Doubtless, there are chores and tasks to be done. If completing a task will genuinely feel satisfying, great. But you may feel cheated if you use your respite to do “more of the same.”
Obligations. Watch out for self-imposed “shoulds.” Such as, “I should go see my niece in that play.” If theater is not your thing, you’ll end up frustrated instead of rejuvenated.

Tips for respite satisfaction

Reconnect with favorite activities. What have you found pleasant or meaningful in the past? Use time off to resume those activities. Or look for new activities you enjoy. The point is to restore your sense of self.
Address what’s critical. Your physical health and mental health are essential. Follow through with doctor appointments. Meet with a support group or counselor for help with emotional distress.
Improve on the basics. If you must do routine tasks, find ways to make them more fun. Perhaps you and a friend can team up on house cleaning. Or carpool to grocery shopping (coffee anyone?).
Get more from work time. Work is time away from caregiving. Try to weave in personally fulfilling activities. For example, have lunch with friends regularly. Or schedule exercise, or lessons, directly before or after work.

Don’t wait until you’re feeling burned out to take time off. You and your loved one will fare much better if you get frequent, regular, and satisfying breaks.

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Strategies to address urinary incontinence

Last month we talked about how to bring up the subject of urinary incontinence with your relative. Incontinence isn’t a fact of late life. It’s a medical issue. And it’s important to learn why it’s occurring and what can help.

Schedule a doctor’s appointment.

Suggest your family member keep a bladder journal. It’s often easier to hand over a record of symptoms than to say them out loud.
If necessary, contact the doctor separately to report symptoms.

The doctor can determine the type of incontinence. The most common are:

Stress incontinence. When a sneeze, a cough, or laughter puts pressure on the bladder.
Urgency incontinence. When the thought of urinating sparks an urgent need to get to the bathroom.
Mixed incontinence. Features of both stress and urgency incontinence.

Expect the doctor to recommend one or more home-based treatments. “Behavioral” strategies are considered the most appropriate. They are more effective than medication. Behavioral treatments include

pelvic muscle training. Known as “Kegel” exercises. These strengthen the muscles that control bladder release. During examination, have the doctor pinpoint which muscles to exercise.
bladder training. Urinating on a schedule and using self-talk and muscle control to avoid leakage.
urge suppression. Remaining calm and not reacting to the urge. Instead, using muscle contraction to ride out an urge until it passes.
fluid intake management. Reducing caffeine intake. Potentially ending fluid intake after 6 pm to reduce nighttime problems (but still drinking six to eight glasses of fluid each day).

Make sure your relative clarifies his or her goal with the doctor. If behavioral strategies don’t produce livable results, ask about medications and other nonsurgical remedies.

If your relative has memory loss or dementia

take him or her to the bathroom frequently, as in every two hours.
watch for constipation, which puts pressure on the bladder.

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When your loved one is depressed, try exercise

Depression is common in older adults living with a serious illness.

It’s long been known that brisk exercise can help reduce depression. Perhaps as a result of an “endorphin high” or changes in other brain chemicals.

But the exercise doesn’t have to be vigorous, according to new research. Even mild exercise can help combat disease-related depression. This is good news for people who are ill or disabled. Researchers have found that

completing an exercise task yields a sense of achievement
achievement boosts our sense of personal power
increased self-confidence reduces feelings of depression and fatigue

In this case, the purpose of exercise isn’t to increase heart rate. It’s to accomplish an activity-related goal.Because when we’ve achieved something, we talk more kindly to ourselves about ourselves. As our self-talk gets more positive, that lifts our mood.

Help your relative create an activity program that suits his or her physical capacity. Ideally, something that can be practiced three to five times a week for a total of 30 minutes over the course of the day. The options are as broad as your imagination. But check in with his or her doctor first. For example, if your family member

is able to walk: try a stroll around the block or shopping mall, climbing flights of stairs, or even tai chi
uses a walker: take several trips up and down a hallway and/or repetitions of getting up and down from a chair
is in a wheelchair: do repeated bending/lifting/throwing exercises

Consider your loved one’s exercise to be important treatment for you, too. Studies show it can be a “downer” caring for someone whose mood is low. When your relative’s depression lifts, that benefit extends to you. It has the effect of literally lightening your load.

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