Incontinence in children is called "training". In adults, it's often called embarrassing. Without understanding the problem, people may jump to the conclusion that their loved one is suddenly getting too lazy or simply doesn't care. This is so rare, that it should be the very last consideration when seeking a cause. Although incontinence is usually not an emergency, problems with incontinence should be reported to the doctor. The gynecologist and the urologist are the specialists who are most familiar with incontinence and can evaluate the causes and recommend several treatment approaches.

There are a number of reasons your loved one may be experiencing incontinence, thus, while it may not seem like a medical emergency, it is wise to inform the doctor when problems are noticed. The specialists more familiar with incontinence are gynecologists and urologists. Depending on the cause of the incontinence, there are several recommended treatments. These should be discussed in detail with the doctor. The following possible causes are not arranged in order of likelihood of occurrence. Such predictions are based on the individual and aggravating or contributing factors.

Dementia, mental confusion or psychological factors.
Cancer.
Restricted mobility.
Urinary tract or prostate enlargement or infection.
Side effects of medications.
Impaired nervous system.
Pelvic muscle weakness.
Nerve or muscle damage after pelvic radiation.
Developmental problems of the bladder.
Pelvic, prostate, or rectal surgery.
Bladder spasms.

When you do speak with the doctor, give the doctor the most appropriate and applicable information. Here is a checklist of things the care recipient should share with the doctor.

Describe your problem.
When does this occur?
How long has incontinence been a problem?
How much of a problem has this condition become?
How many times does this happen each day?
Are you aware of the need to urinate before you leak?
Are you immediately aware that you have passed urine?
Are you wet most of the day?
Do you wear diapers in case of accidents? Occasionally? All the time?
Do you avoid social situations in case of accidents?

History and factors

Do you have a urinary tract infection now? In the past?
Is it more difficult to control your urine when you cough, sneeze, strain, laugh, run, jump or walk?
Is the incontinence worse when sitting up or standing?
Do you suffer from constipation?
Is there anything you can do to reduce or prevent accidents?
Have you ever been treated for this condition before? Did it help?
Have you tried pelvic floor exercises (Kegel)? Did it help?
What surgeries have you had?
What injuries have you had?
What medications do you take?
Do you drink coffee? How much?
Do you drink alcohol? How much? How often?
Do you smoke? How much each day?

Expect and prepare your loved one for the likelihood of a physical exam. For both men and women, expect an abdominal, rectal and neurological exam. Additionally, men are given a genital exam and women a pelvic exam. The doctor will also run a number of diagnostic tests, which will include urinalysis, cystoscopy (checking the bladder) and procedures to check urinary functioning.

You should encourage your loved ones and/or clients to avoid items that irritate the urethra or bladder. Check with your doctor for more specific information. Some of these items include liquids that tend to increase urination (coffee, alcohol), diuretics (water pills), some anti-spasmodic medications, antidepressants and antihistamines, cough/cold medications (they should also avoid coughing, so this may be a tricky one), ventolin (albuterol) or other beta agonists.
 

It is universally recognized that elderly people with dementia lose their short term memory first and their long term memory last. For example, they often remember people and events from their earlier years, but have difficulty remembering what they ate for breakfast the day before. Here are a list of activities that you can do with a loved one who can not carry on a normal conversation due to this memory loss.

1. Reminisce! Everything you do together lends itself to reminiscing. If the person can still speak fairly well, say, “Tell me about...” If his vocabulary is more limited, you may have to facilitate the story. “Do you remember when...” As you bake cookies together you can talk about their favorite cookies, meals, etc.
2. Read aloud and use visual aids such as memory poems, family pictures, or stories about "the days gone by" stimulate reminiscences.
3. Make music. Sing, hum, whistle, dance. Singing brings oxygen to the brain to help you think more clearly. Dancing exercises other parts of the body. Both increase your own sense of well-being as well as the well-being of the residents! Have music activities and entertainers visit. Choose the residents' favorite music or CDs.
4. Sensory stimulation activities could include the following:

Making lap quilts.
Painting.
Talking books.
Scrap books.
Walking!
Flower arranging.
Tutoring, or visiting with children.
Baking.

Keeping the mind and body active are important for everyone, but especially your loved one with dementia. Do something that is enjoyable for both of you, and it makes it that much easier.

I recently read this article on a caregiver based web site. Asks the interesting question about what we do when the one that we cared so much for is no longer there.

As a caregiver, we totally commit ourselves to caring for another person who no longer functions as they once did in the normal scheme of life. We move in with them or move them to us. We give up our jobs, our own independence, and very often our family and friends. We become so involved with the care of that person out of love that we ourselves are removed from normal day to day living. Our entire life revolves around comforting and making our loved one feel loved. We protect them at all costs. In a very real sense we have given our life for another.... not out of obligation but out of LOVE! The ultimate test of LOVE for another! Then one day we wake up and our commitment has been released to a far greater LOVE in a place of no more pain or suffering! We grieve and then the process of finding our way back into the world begins anew. 

How do we pick up the pieces and start to live again? I guess there is no so-called normal pattern that each of us has to follow. It seems to come down to taking one step at a time...some walk slower than others and some speed their way back out into the world! Often we take one step forward and two backwards ... it is not an easy process but there is a life after caregiving! We just have to look forward and find opportunities that are once again there for us. Renew old friendships, find a job that you feel good doing, do volunteer work (we already know you are a caring concerned person!), find a new or renew an old hobby.... but begin to take a few small steps towards living again! One of the best therapies is finding a friend you can talk to...one who will listen and support you as you ease back into the world! Soon you will find that life does still exist and you are a part of it! Butterflies are still flying and the birds are still singing. The light of another day is showing through the clouds, and all that you gave up was well worth it in the end! We are better than ever for our commitment. We are forever changed in a good way.... no one can ever take that total love away from us as we again join the world! 

February brings the celebration of "Black History Month" in the United States and Canada. Originating in 1926, Black History Month was chosen to be celebrated in February as it marks the birthdays of two men who greatly influenced the lives of African-Americans, Abraham Lincoln and abolitionist Frederick Douglas. During this month when we celebrate African-American history and culture, it is important to realize and recognize the increased health risks that are prevalent in the black community. Here is a list of several illnesses and health issues that continue to specifically challenge the African-American community.

- African-Americans have a 50% higher prevalence of hypertension than the overall population

- Diabetes related death rates have increased in our society across the board. The rise in mortality rates has been greater among African-Americans when compared to the rest of the population.

- Due to the above problems with high blood pressure and diabetes, African-Americans develop kidney failure four times more frequently than Caucasians.

- Immunization rates among the elderly in the African-American community is behind that of the total elderly population.

- The risk of coronary heart disease remains higher than the rest of the population, despite a decrease in recent years.

Researchers from the University of North Carolina has found that hugging your partner can reduce your heart rate. For women, the release of the hormone oxycontin was found to be higher in those who are regularly hugged, casuing a lowering of their blood pressure. Results of the research also show that women with happy marriages have fewer risk factors for cardiovascular disease than single women or women in unhappy relationships.

Keeping this in mind, here are other ways that you can enhance your health through the power of love.

1. Hug somebody - As mentioned above, hugging is benefical for a lower heart rate and blood pressure. Make it a goal to give at least five hugs a day to your spouse, family members or even friends.
2. Call a Friend - Take a few minutes to call somone and ask them about their day. Giving someone a listening ear could be more helpful than you realize.
3. Be Kind - A simple act of kindness can make someone's day. Keep an eye open as opportunities to be kind are abundant.
4. Compliment People - Complimenting people will make them feel good and, in some cases, give them confidence. Reciprocation will come by doing so which will, in turn, make your feel good yourself.

As a caregiver, there are a lot of things that you are responsible for. From feeding to cleaning to transporation, you are relied upon for a multitude of tasks. One important thing that may or may not fall on your shoulders is the organization and scheduling of the medications for the one that you are caring for. Learing to manage medicines properly is important for your loved one's health. A new brochure by the Eldercare Locator and Consumers Union, the nonprofit publisher of Consumer Reports, outlines some simple steps to help make sound health care decisions concerning prescription drugs:

• Maintain a medicine record

• Share any change in side effects with your doctor

• Keep your health care professionals informed of all the medicines you are taking

• Find out about different options to pay for your medicines.

Another option for tracking medications can be found at Fenway Medical's Product section, http://www.fenwaymedical.com/products.html. The Personal Healthcare Journal can be used to monitor medications as well as schedule and track doctor's appointments, allergies and emergency contacts.

For many people with dementia, a worry for the family is the health and safety of their loved one leaving the home and forgetting where they are. Wandering is a common symptom of Alzheimer's and dementia patients and the proper steps need to be taken to assure that we doing what we can to keep the enviorment safe for people with this condition. Here are some practical tips offered up from the Alzheimer's Foundation of America and professionals at the Mayo Clinic to keep a wanderer safe.

• Reduce hazards. Throw rugs and extension cords are both tripping risks. Utilize gates at stairwells and nightlights to help with fall prevention.
• Have a “safe” zone for walking and exploration. Offer a loved one a place for exercise that also instills a sense of freedom they may have lost. A fenced backyard or three-season patio are good options.
• Reduce environmental stimuli like loud music or overcrowding, which might initiate wandering behaviors.
• Set a daily routine that includes recreational activities.
• Hide essential items such as coats, keys, wallets, and shoes that may spark a desire to leave home.
• Increase safety by using camouflage. A coat of paint, curtains, or some wallpaper can cover a door and blend it in with the surrounding wall. A mirror also works to deter a dementia patient from entering rooms that are off limits or not safe.

A recent edition of the Readers Digest had a wonderful story that focused on caregiving and the bond forged and needed between the caregiver and their "patient". These stories range from adults taking care of their parents to friends taking care of friends to spouses taking care of each other. The caregivers in these stories put together a list of things that they wish that they had known sooner in their caring process. This list is designed to help caregivers who are new to their current (and future) situation. It allows these new caregivers to understand that they are not alone and helps them to realize that someone has done this before and that there is assistance out there.

1. It's OK to Push - You decide what is right for the one that you are caring for. Make your voice heard.

2. Don't Take It Personally - There will be personality changes with your loved one. Come to terms with these changes.

3. It's Easy to Over-Share - Do not share too many details of your loved one's private life with care groups or even loved ones. Respect their privacy.

4. Protect, but Not Too Much - If your loved one has the ability to do something on their own, don't hinder their process and progress.

5. Love Goes Through Changes - Changes in your loved one's conditions can actually help you to gradually create some distance and cope easier.

6. Divvy Up the Work - Don't try to do everything all on your own. Delegate responsibilities to other siblings or friends when you can.

Many of us started new work out programs as a part of our New Year's resolutions. If you already were going to a gym or doing personal workouts at your place of employment, you surely witnessed an increase in the amount of people that were in the facility with you. Now that we are five weeks into the new decade, maybe the amount of people have already decreased back to numbers that you were used to prior to the big ball dropping in Times Square. Should some of these new people still be sticking to their resolutions, you may notice that few of them actually take an important step in their workout routine. That step is stretching before and after a workout. Regular stretching can lengthen your muscles, increase your range of motion and improve your flexibility. Here are some do's and don'ts of stretching that you could use yourself or that you can pass along to these new members of your workout group.

Do : Warm up before stretching to reduce your risk of injury

Don't: Stretch to the point of pain. Discomfort and pain are two different things.

Do: Stretch for 20 minutes at least three times per week

Don't: Bounce while you stretch

Do: Stretch all of your muscle groups, including the back, chest, shoulders, neck, legs and arms.

Don't: Hold your breath while stretching

Today, we conclude our three days series on the different types of conditions that can cause incontinence. Incontinence is a disease that affects millions so if you or someone you know has incontinence issues, realize that you are not alone and do not be embarassed to speak with your physician about your particular condition. Information for these blogs was taken from Health.com.

Sex

Women with incontinence can also experience urine leakage while having sex, Dr. Shah says. Since this discharge is caused by pressure on the abdomen and bladder, it’s a sign of stress incontinence.

You can reduce your chance of leakage by going to the bathroom before sex, avoiding fluids an hour before sex, and trying certain positions (such as being on top).

Mixed symptoms

It’s common for a woman to have mixed incontinence, or a combination of stress and urge incontinence, especially after menopause.

"Sometimes it’s clear-cut, but it’s not uncommon for patients to have both components,” Dr. Shah says. However, one type of incontinence is usually more severe or annoying than the other.

“One should see an expert to determine which conditions are present and then decide which therapy would be best,” Dr. Shah says.

Amount of urine

Volume of leakage alone doesn’t necessarily tell you what type of incontinence you have, Dr. Shah says.

The amount leaked completely depends on the severity of the condition. Although people with stress incontinence are thought to leak less than people with urge incontinence, they can still release quite a bit if their condition is severe.

Yesterday's Care Blog was the first of a three series entry that explores nine different types of health conditions that can cause some type of incontinence in adults. Today, we look at another three conditions. Millions are affected by incontinence so chances are that your or someone you know has one of these problems. Information for these blog entries have come from Health.com.

Running water

This is not a myth. Some people have an increased urinary urgency—which can trigger incontinence—when they hear the sound of running water.

Other noises or daily rituals can also cause problems for people with urge incontinence.

“Running water or thoughts of approaching home—as one waits for the garage door to open or unlocks the door—can actually exacerbate the symptoms of overactive bladder,” Dr. Shah says.

Exercise

Leaking urine when lifting weights or performing other exercises is another sign of stress incontinence.

"Anytime you exert yourself, increase pressure on the abdomen, and leak urine, that would be considered stress incontinence," Dr. Shah says.

Exercising with a full bladder makes you even more vulnerable, so try to schedule bathroom trips before and during your workout. If this still doesn’t give you a handle on your incontinence, talk to your doctor before giving up on exercise.

Can’t hold it

People who experience urge incontinence have a hard time reaching the bathroom.

"They know they have to go, but feel they don’t have enough time to get there," says Dr. Shah. "They can’t stop the bladder, and their underwear is wet before they get to the bathroom or they are dripping on the floor.”

Anxiety can worsen urge incontinence, as can having uncontrolled diabetes and taking diuretics, which are blood pressure-lowering drugs that work by clearing your body of water and salt.

There are several types of incontinence that affect millions in our population. Here are three of nine symptoms or problems that can help determine the type of urinary incontinence. We will also post three symptoms in both tomorrow and the following day's Care Blog to complete the ist. Information for these articles was taken from Health.com.

Standing up

If you leak urine after simply standing up from a sitting position you may have stress incontinence.

This type of incontinence isn’t due to emotional stress, but rather physical stress—meaning increased pressure in the body or straining can force urine past the neck of the bladder and out through the urethra.

Stress incontinence is more common in women than in men, and is typically caused by factors that weaken the bladder muscles, such as aging, childbirth, excess weight, and surgery—particularly hysterectomy in women and prostate surgery in men.

Sudden urge

If you feel the need to urinate frequently and often have a sudden, urgent, and uncontrollable need to urinate, you may have overactive bladder, which can cause you to have urge incontinence. The feeling can occur even when the bladder contains only a small amount of urine.

Urge incontinence typically occurs when the bladder contracts at inappropriate times, and these bladder spasms result in incontinence. Bladder contractions can be the result of damage to the nerves or muscles of the bladder.

Laughing, sneezing, coughing

Urine leakage when you laugh, sneeze, or cough is a common symptom of stress incontinence.

Depending on the severity of the problem, you may leak small to large amounts of urine when this pressure on the abdomen occurs.

Doing Kegel exercises can help you tone the pelvic floor muscles, which hold in urine, and tame your incontinence.

For women and elderly adults, there is a silent disease that needs to be learned about and addressed. Osteoporosis gradually steals mass and strength from bones and makes them porous and weakened. It targets the hips, spine and wrists and damage to these bones can dramatically boost the risk of dying for adults over 60 years in age. In an Australian study published in the Journal of American Medical Association, a look at more than 4,000 elderly people over a period of 20 years produced the following results.

• After even a minor bone break, the risk of death increased by 42% in women and 33% in men.
• After a hip fracture, women were twice as likely to die than before, and men, three times as likely to die.
• These increases in death risk were present for years: 5 years for all fractures and up to 10 years for hip fractures.

Osteoporosis is not an inevitable part of aging. Around the age of 30, bone reaches a peak of density and strength and after that, bone loss occurs at a faster rate than it is created. The bone loss rate increases more in women after menopause. To help prevent this bone loss and slow down the process, there are every day steps that can be utilized.

• Increase your calcium - This is the mineral that is vital to bones. If you do not get enough over your life time, you are increasing your chances of getting osteoporosis. Eat foods like low dairy products, dark green leafy vegetables and calcium fortified food.
• Get plenty of vitamin D - Vitamin D hopes your bones to absorb calcium. You can get Vitamin D through egg yolks, supplements and mostly through exposure to regular sunlight.
• Exercise, exercise, exercise - Weight bearing exercises improve your bone's health and helps improve muscle tone, strength and coordination. Walking, hiking, jogging and even dancing can help your bones remain strong against the "silent disease".

An alarming problem in Asia shows how important it is for caregivers to know that help is available for them before it gets to the point of despearation.

Singapore is facing an aging population problem. Caring for the elderly is the responsibility of many family members and it is estimated that by the year 2030, there will be at least 300,000 caregivers in the community. The problem is that today many of these caregivers are not aware of the resources that are available to them to help with this responsibility and the results of this lack of knowledge are somewhat disturbing. Patients are being admitted to hospitals when no medical need is required. These patients are admitted by the caregiver to give themselves a break and the caregivers are sometimes unable to be contacted for days after the patient is dropped off.  Social workers often have to intervene to convince the caregiver to take back their elderly loved one. About 700 cases a month that are addressed by hospital social workers are related to care issues. For the caregiver, fatigue often sets in when they are unable to cope with the financial, emotional and physical stress of looking after a patient. Depression can also be a problem and in extreme cases, suicides are the result.

If you are a caregiver, know your limitations. You must care for yourself before you can care properly for any one else. Know where your help is and take the time to research what resources you have available to you in your community. It will be better for both you and your loved one.

We just had our first snowfall of the year last weekend. Though, not significant for my part of the world, it was snow and covered the ground. Each year, you hear on the news of people who over-exert themselves while shovelling snow and suffer from a heart attack. In the back of my mind, I think of my family history and wonder if this fate will ever befall me as I try to make a path for my car to get out of the garage. If you also worry about heart disease due to family history or lifestyle choices, here is a checklist released by The National Heart, Lung and Blood Institue that shows a variety of risk factors to look for.

• Family History - Risk increases if your father or brother was diagnosed before the age of 55 or if your mother or sister was diagnosed before age 65.
• High Blood Cholesterol
• High Blood Pressure
• Diabetes & Pre-Diabetes
• Obesity & Overweight
• Smoking
• Lack of Physical Exercise
• Unhealthy Diet
• Stress
• Age - Risk increases for men over 45 and women over 50 (or post-menopause)

I have written this Care Blog for over three years now. My audience includes baby boomers, generation X'ers, senior citizens, males and females. The common thread that we all have in common is that we are caregivers. Former First Lady, Rosalyn Carter, once wrote the following passage. "There are only four kinds of people in this world. Those who have been caregivers, those who are currently caregivers, those who will be caregivers and those who will need caregivers."

Here are some caregiver statistics and numbers that I have run across that I find astounding. Based on these, the words of the Former First Lady were prophetic and true.

• A new study says that 66 million Americans provide care for an elderly parent, family member or a disabled child, and that caregiving has become an unpaid, part-time job. On average, caregivers provide 19 hours of help a week.?
• Approximately 50 million Americans provide the majority of the help needed by relatives or friends who are elderly, ill or disabled.
• The number of people 65 and over is expected to double in the next 40 years.
• The number of those over 85 will more than triple.

Those last two facts are not caregiver stats but the aging of the population is definitely going to directly effect how we see and provide caregiving in our society in the future.

Doctor appointments that must be scheduled; the constant care and attention your loved one needs, both physically and emotionally; the back and forth to grocery stores, drug stores, physical therapy sessions and, most of all, the need to know you are doing the "right thing" for loved one in need of your care. We all know the daily challenges we face as caregivers and that we seldom have time for ourselves.

But we need time –time to reflect, relax and rejuvenate for at least few hours each week. This "private time" gives us a renewed strength to carry on. It's important to take that time. You deserve it. AND, should not feel guilty about it.

There are ways to allow yourself time away. For an hour, a day or even a weekend to collect your thoughts and get back on track. It's okay to do that. Listen, you've got a very important role to play - if you do not care for yourself, who will step in to care for you AND your loved one.

Take the time to read through this "guilt free" list and we hope you'll be a better caregiver for it...

• Accept the help others offer. Suggest specific things they can do for you and your loved one. This is rule #1 for a reason. No one is a Super Hero. Don't feel like you're the only one that can take dad to the doctor or your wife to her physical therapist. REACH OUT and ask another family member -- or close family friend -- to assist you occasionally so you have time to yourself. Trust in their willingness to help. Many times they do not know how to reach out and help unless you are able to communicate your needs.

• Ask for and accept favors such as; a friend staying with your loved one while you are able to get out of the house for a while, a dinner being cooked for you and your loved one once a week, an offer to go to the supermarket or drugstore in your place. Respite can be achieved on a daily basis with the smallest of kindnesses.

• Know your limits! If you wear yourself out caring for your loved one, who will step in to care for the both of you? Remember, caring for yourself is not selfish, it’s the greatest gift you can give your loved one.

   

Here at the Care Blog, we often talk about ways that you can try to fight and eliminate stress. In today's entry, we're going to try a different approach. Here is our tongue-in-cheek advice on how you can maintain, and even increase, your current stress levels.

1. Don't exercise and stay overweight. If you watch what you eat and exercise, you are sure to feel more energetic, your endorphins will be all over the place, and you might start to think clearly. Then you'll get things accomplished, feel better and, ugh...relax. Forget it, stay tired. 

2. Avoid fun and get rid of your sense of humor. Doctors have proven that laughter and enjoyment are good for you and your heart. You can't be properly stressed if you are enjoying your life. It just doesn't work that way. 

3. Eliminate your support systems and never ever ask for help. The best way to stay stressed is to make sure no one else can do anything for you or your loved one. You have to be responsible for everything and everyone. How else can you make it all your fault when schedules crash or things don't go well? 

4. Avoid hugs and comfort whenever possible. Those same meddling doctors who keep telling us to laugh more, also found out that there is some kind of measurable healing power in soothing, comforting physical contact like when you are hugged. If you let anyone hug you, practically all that great stress you've been building up all day goes right out the window. Your heart beats more evenly, your blood pressure comes down, you probably even forget to yell at the next person you see. Hugs are just the worst thing you could do if you are trying to stay in an over-stressed mode.

5. Eliminate all time management practices. Procrastinate! Procrastinate! Procrastinate! Poor time management helps to increase your sense of being overwhelmed and out of control. Trying to do everything at once, with no plan in sight is the perfect way to get nothing done. That way you can continue to blame yourself for everything that went wrong and of course, your stress level will go through the ceiling

Deaths from heart disease fell 28 percent between 1997 and 2007 and deaths from stroke fell 45 percent in the same period but the number of heart procedures performed in hospitals rose 27 percent during the same period, according to the report published in the journal Circulation.

"The mortality rate going down is good news; however, the fact that the burden of disease is so high indicates that we may have won a battle against mortality but have not won the war against heart disease and stroke," said Dr. Veronique Roger of the Mayo Clinic in Rochester, Minnesota, who led the study.

"We can attribute much of that to improved quality of care, with heart and stroke patients getting the care and treatment they need to live longer. But unfortunately the prevalence of these diseases and their risk factors are still high," Roger said in a statement.

The team said the cost of treating heart disease and stroke topped $286 billion in 2007, a figure that includes both health costs and lost productivity at work.

That outstrips the cost of treating cancer and benign tumors, which in 2008 was estimated to exceed $228 billion, the researchers said.

"We need to energize our commitment to strategies that can prevent disease in the first place," Roger said.

According to the report, 33.5 percent of U.S. adults 20 and older have high blood pressure, and while 80 percent known they have high blood pressure, less than half have it under control.

The team also found that 23.1 percent of men and 18.1 percent of women smoke; 5 percent of adults 20 and older have high cholesterol, and more than 67 percent of adults are overweight.

The data was part of the American Heart Association's annual report on heart health.

The AHA said in figure reports, it will focus on progress toward its goal of improving heart health for all Americans by 20 percent while cutting heart-related deaths and strokes by 20 percent.

Being a caregiver makes demands on your body, mind and spirit. Failure to take care of ourselves results in a failure to be able to care of others.

Caregivers commonly explain that there never seems to be enough time. Ironically, though, the more we take time to take care of ourselves, the more time we will have for what we need to do for ourselves and for others. If you don't believe it, consider this experiment. Try to consistently apply the things talked about in this article for two or three months and see what happens. At worst, nothing will change. At best, you may find everything changes, and life can be filled with abundance.

Over the last 20 years, extensive research, at Harvard and other prestigious universities, has shown that only 20 minutes of daily meditation has dramatic effects on physical health. Meditation has been shown to lower blood pressure, cholesterol, and the occurrence of heart disease, while it improves the immune system, and enhances physical response to chronic diseases such as diabetes and multiple sclerosis.

Learning how to meditate on a periodic basis throughout the day is most effective. Five or ten minutes here or there--or even one-minute "monastic moments"--can be the most effective way to handle stresses and time limitations. The key is to learn how to turn the mind off and tap into the wellspring of limitless time and energy.

Try this:

1.Find a space where you will be free for a few moments from distraction. It may need to be when other people in your home are asleep or out of the house. Make an agreement with yourself that you will try to meditate for a specific amount of time, at first usually for no longer than 10 minutes.

2.Sit in a comfortable spot. It is better to sit up than lie down. While sleep is good for you, it is not the same as meditation.

3.Now, simply notice your breath. Don't try to control it or think about it. Just notice it. Are you breathing? Is it shallow? Is it fast? Is it punctuated with heavy sighs? That's right. . . whatever it is. . . just let yourself breathe!

4.If thoughts come into your mind don't try to stop them, just let them go. See your thoughts as you might look into the sky and see clouds passing. They come and they go. Thoughts come and go the same way--it is only for a few moments.

5.Stay focused on the breath going in and out of your body. Just breathe. In these few moments, all you need to focus on is your breath.

Do this 5-10 minutes a day. Eventually you will be able to expand to longer periods of time. You may choose to meditate for 10 minutes in the early part of the day and 10 minutes before you go to bed, or in the afternoon. There is never a wrong or bad time to meditate.

It sounds very simple and like such small thing. But it is the first step in a lifelong process that will have a profound impact on your ability to care for yourself and others. Meditation does take practice, and there is never a wrong way to do it. As you become more experienced, it gets easier and easier to find that exhilarating and peace-filled silence.

If you care for someone in the home setting, here are some tips for the caregiver on how you can prepare your home and make it a safer place for your loved one.

Improving support and safety throughout the home:

Have smoke detectors installed near kitchen and bedrooms
Have safety rails in showers and tubs
Install handrails up stairs and in bathrooms
Use non-slip flooring in kitchens and bathrooms
Remove any loose rugs
Move furniture around to create less confusion
Remove any dangling telephone cords
Mirrors can distort the loved one’s view when walking, and should not be placed where they can easily be bumped into
Ways to correct visibility and lighting problems:
Use bright, vivid colors to light up rooms
Make sure hallways and stairways are well lit
Lighted switch plates make finding switches at night easier
Have night lights in between bedrooms and bathrooms
Use easily reached cords that can turn a light on and off in closets
Basements should be very well lit considering the steepness of stairs going up and down

Methods to improve movement and sight throughout the house:

Some of you may be caregivers. Others who read this may just know someone who is a caregiver or in a position to potentially become a caregiver. If you are in this latter group, it is important that we also look out for our caregiver friends and family and make sure that the caregiver is still taken care of themselves. Here are some tips from a registered RN that you can also utilize to provide care for the caring ones.

TAKE TIME TO LISTEN TO THE PRIMARY CAREGIVER

Many times in our busy day, we hurry through our conversations with the caregivers. I have learned that caregivers have a wealth of information to share with you about their loved one. Why reinvent the wheel if you don’t have to?

ASK THE CAREGIVER FOR THEIR INPUT WHEN DEALING WITH UNIQUE ISSUES.

Remember the primary caregiver is oftentimes with the patient 24/7 and they face and have found creative ways to deal with many issues such as toileting, bathing, dressing, etc.

BE SURE THE CAREGIVER IS TAKING CARE OF HIMSELF OR HERSELF 

Studies have shown that the stress caused by caregiving leads to depression, poor health, and even death. By giving the caregiver permission to take care of themselves, and at times insist they do, could literally be the difference between life and death.

TAKE TIME TO GUIDE THE CAREGIVER TO THE PROPER ASSISTANCE

Many caregivers are willing to do the leg work if they only knew what direction to turn. The Area Agency on Aging is a great first step. Our agency has many contacts, and assessors that will come into the home and inform the caregiver of the options available to them. The assessment is free. This may be different in your area, but every Area Agency is a good place to start.

ALLOW THE CAREGIVER TO VENT THEIR CONCERNS

I have found that many caregivers just need to vent and not be judged. Allowing the caregiver to openly express their concerns and desires is of utmost importance. Remember, their concerns may not be a personal attack on the care being received, but a way for them to release stressful feelings, etc.

LAUGH WITH THE CAREGIVER

Finding the humor in a situation is such a stress reliever. Remember there may be times where humor is not appropriate. Give the caregiver permission to laugh, help them see the humor, let them know that it is ok to laugh at a situation not at the person. There’s a big difference.

GIVE THE CAREGIVER THE PROPER TOOLS/ TRAINING

Caregivers become frustrated when there is improper training and tools. Be sure they understand the procedures, equipment, who to call if there is a problem, how to problem solve. Provide or develop resources to help caregivers learn more about services, issues and techniques.

GIVE THE CAREGIVER PERMISSION TO SAY “I’ve had enough”

At some point the caregiver has given all they can, their own health has declined, or their loved ones health as declined. Assist them in the process of what to do next; give them options, allow them to talk through their concerns.

Stress is a topic that we seem to write about alot here on the Care Blog. Being a caregiver can create a lot of stress and many changes. The fact is that change is an expected part of our daily lives today. Dealing with it so that you control it rather than vice versa is an important and positive force in controlling your life. Here are some more tips on how to deal with caregiver (and every day) stress.

1. Accept what you cannot change. Take a tip from AA. Change what you
    can, if it bothers you. But, if you cannot change it, learn to live with it.

2. Face up to your problems. Sort them out, and see which ones are real
    and which are simply imagined. Deal with them as they are, and not
    what you think they are.

3. Deal with one problem at a time. Sort out your priorities, and deal with
    them in the order of their importance to you.

4. Be flexible. Give in once and a while. If you do, others will too.

5. Don’t hold all of your worries inside yourself—talk it out. Frequently we
    swallow our unhappiness (along with candy, cake, ice cream, etc.)
    because we can’t let the problems out. Talk to someone. A burden
    shared is much less of a burden.

6. Work off Stress. Physical outlets for stress help your body to fight off
    many of the negative results of stress.

7. Get enough rest/relaxation/sleep. Give your body a chance to recover
    from day to day. Lack of sleep and rest will only make matters worse for
    you.

8. Avoid “self medication.” A “spoonful of sugar” may make the “medicine
    go down,” but it does your body no good. Sugar, alcohol, nicotine, and
    ice cream may all feel good going down, but they make matters worse—
    from the inside. They add to your body’s physical stresses, thus making
    dealing with external stresses much harder.

9. “Take time to smell the roses.” Have some fun. Relax.

10. Think about and do something for others. A little altruism never hurt. It
      even makes people feel better about themselves.

11. Be the “captain of your ship.”  If you are not happy with your life, think
      about what’s wrong or missing, and then plan the necessary actions to
      change it to coincide with your needs and desires for your life. 

12. Work on your relationships with those who share your life. Don’t hold
      back your feelings. Share them with your family and friends and co-
      workers. It can help to decrease tensions.

Some of us may be experiencing a post-holiday letdown. Others may just have a case of the winter "blahs". Whatever it is that may be ailing you, here are some tips that will help you to maintain optimum emotional wellness.

• Allow "me" time - Try to give yourself time, space and moments of silence from the every day distractions. Take deep breaths and try to relax for at least 20 minutes a day.
• Get plenty of sleep - A good night's sleep is essential for good, emotional health. Try for 7 1/2 to 9 hours of "peaceful" sleep each night.
• Stay hydrated - Drinking eight glasses of water a day help to flush the toxins from stress out of your body. Hydrating with water has also been found to elevate your mood.
• Eat healthy - This may be a big change for many of us, considering our lack of control with diets during the holiday season (I know that I took down a few extra appetizers). Try to load up on green salads, fruits and vegetables that you probably missed at the holiday parties.
• Exercise - Many of us set New Year's resolutions that include excersize. 30 minutes a day on the treadmill or outside will not only help you emotionally, but will also help you to burn extra calories.
• Ask for help - Don't feel like you have to do it by yourself. Ask for help if you feel overwhelmed. It will release a burden and make you emotionally feel better.

The saying is "as the days get longer, the cold grows stronger". Right now, in my section of the world, this is definitely holding true. The days are gradually getting longer but we haven't seen the worse of our winter yet. As we looking longingly towards the longer days and warmer weather, we need to make sure that we are protecting ourselves from Old Man Winter. Help your budget by making sure that your home is winterized, using weather stripping and insulation over exposed water lines. You can also protect yourself by preparing for weather-related emergencies. Keep extra supplies of non-perishable foods and water as well as an up-to-date emergency kit should you lose power or become stranded. Most importantly, be careful when you need to venture out in to the cold. Look at the following:

Injuries due to ice and snow:

• About 70% of injuries are due to vehicular accidents
• About 25% of injuries occur in people caught out in a storm
• The majority of these injuries happen to men over the age of 40

Injuries related to cold:

• 50% happen to people over 60 years old
• More than 75% happen to males (see the ice and snow injuries above)
• About 20% of the injuries occur in the home

So, dress warm and stay safe. Spring is about 10 weeks away!

Here are 10 things that you can do as a caregiver as we start the new year.

1. Keep records of all medications and reactions: make notes about what works, what doesn’t and when you informed the physician of any problems.

2. Keep records of all doctor appointments: the reason for the visit, the doctor’s responses to our concerns, any procedures performed, etc.

3. Start or continue to maintain copies of medical records for your loved one, and for yourself, as well. These will be beneficial should a grievance arise or if there are questions about medical histories.

4. Plan for the unexpected: discuss plans and wishes of everyone involved in the caregiving family. Talk about final resting places and what arrangements your family will want.

5. Have an Advance Directive filled out and given to the primary physician and all relatives who may need the form.

6. Have a Last Will and Testament completed or updated: without a signed Will, the courts will decide how to distribute the possessions of your loved ones.

7. Keep a record of where all-important documents are kept. When an emergency or tragedy occurs, locating information should not be where we spend our thoughts and energies.

8. Record all monetary involvements: investments, resources creditors, debtors, business transactions, etc.

9. Have an insurance analysis done: is your home, life and health insurance still appropriate for your family’s needs? What about the insurance policies for your loved ones? Do you all have enough coverage to take care of any eventuality? Do you have provisions for Long Term Care? For respite care? Is your house adequately covered given the state of the weather patterns?

10. Clean out the medicine chest. Look for expiration dates on all medicine, and check with your doctor about previous medications which will either be harmful with current prescriptions or which are no longer effective for your or your loved one. Not only will you save space, you might also save a life.

When caregivers take on the responsibility of caring for a loved one, we expect our lives to change. What is unexpected, and often goes unnoticed, is the forfeiting of our own well-being in order to become a primary caregiver. 

Ask yourself the following questions. If you answer, “Yes,” to any of them, you need assistance. Support groups, your loved one’s social worker, your physician, counseling or therapeutic centers and a number of other community resources can help you in providing greater balance between your caregiving responsibilities and your well-being.

Have you stopped communicating with friends you had before you became a caregiver?

Do you lack time to participate in activities that make you feel good?

Is your caregiving role negatively affecting your personal relationships?

Have you failed to have a check-up lately or find you do not follow the doctor’s recommendation for you own health?

Does your loved one need, but not have, a monitoring device?

Has your loved one become abusive towards you?

Have you noticed you are becoming verbally, physically or emotionally abusive to your loved one?

Are you drinking or taking drugs to cope with stress or distress?

Has your sleeping pattern changed since becoming a caregiver? 

Do you feel you are not getting enough sleep?

Do you refuse to let others assist you, or give your respite, for fear something will happen if you leave you loved one in another’s care?

Feet are one of the most important yet maligned parts of the body. They are our little chauffeurs, getting us where we want to go. They’re twin fashion statements, getting squeezed into trendy shoes no matter how high the heel or how narrow the toe. And they are our little scapegoats, because even as we try to do something good for the rest of the body, like walk or run, our feet still bear the brunt of abuse.

While we should all give our feet better than they get, people with diabetes should be particularly concerned about foot care. According to the American Diabetes Association, one fifth of all people with diabetes who enter the hospital do so for foot problems. Diabetes creates havoc on the circulation system, clearing the way for a variety of foot problems that can lead to more serious complications for the rest of the body.

Here’s how it works: Increased blood sugar levels cause decreased circulation. Poor circulation means that the blood doesn’t move sufficiently to the feet. Without proper circulation, the feet become more vulnerable to infection and injury.

Another potential problem for diabetics is diabetic neuropathy, or nerve damage. When nerve damage occurs, the ability of the feet to register pain, hot or cold is diminished, and therefore at greater risk of injury. Because of this decreased sensitivity, damage to the feet may go unnoticed until infection has actually occurred.

People with diabetes have a higher risk for calluses, which, if untreated, can turn into ulcers. A pumice stone can be used daily on calloused areas to gently soften the skin. Lotion may be used for extra moisturizing, but do not use moisture between the toes. Infections thrive in moist, dark areas such as between the toes, so that area should be kept as dry as possible.

If the skin on the feet becomes very cracked and dry, it is an indication that the nerves that control sweating have been damaged. Because cracked, peeling skin is an invitation for infection, dry feet thoroughly after bathing.

Diabetic ulcers are sores on the surface of the skin, which do not heal. Ulcers are more common for people over 40, and for people with diabetes related kidney damage or eye changes. Your doctor should treat any breakdown of the skin immediately. Common places for ulcers to develop are the ball of the foot and below the big toe. Ulcers can also develop on the side of the foot, often due to bad fitting shoes. Ulcers that go untreated can develop infection and lead to amputations.

Here are some foot care tips for diabetics:

Keep blood sugar under control. High blood sugar makes it difficult to fight infection.

Don’t smoke. Smoking can assist in poor circulation and therefore cause problems. According to the ADA, most diabetics who have limb amputations are smokers.

Thoroughly inspect feet daily for sores, calluses, dryness, or redness. If necessary, have someone help examine the feet or use a mirror.

Don’t wear anything that constricts circulation, such as tight hose or garters..
Clean feet daily. Lotion is okay on cracked skin, but never use between the toes.
Do not soak feet or use heating pads. Because of decreased sensitivity, diabetics can burn themselves without realizing it. The safest way to make the feet warm is by wearing extra socks.

Always protect the feet. Diabetics should not walk barefoot.

Always check with the doctor before using over-the-counter remedies on calluses or warts. The chemicals in such products may be too severe for diabetics.

Be careful when choosing footwear. Make sure shoes fit properly. Socks should be soft and comfortable, not tight. Diabetics should not wear socks with seams or rough spots. The doctor may be consulted about footwear for the diabetic’s special needs.

Diabetics should have their feet checked by their doctor at least once a year