Caregiver Advice: GO OUTSIDE!

Today is Sunday and it’s a beautiful day. Don’t hate me if I’m inspired to preach. My sermon will be short: GO OUTSIDE! While you think of all the obstacles that could keep you from doing that, here are some good reasons why you must.

Between the Pond and the Woods

Butterfly garden at Nescopeck State Park

A nice stroll and the smell of grass will go a long way to helping you feel good if you don’t have time to do more. This can be accomplished even if you need to cajole someone else to go with you — or push a loved one’s wheelchair. The Alzheimer’s site recommends the following joint outdoor activities to promote caregiver health:

  • Take a walk together outside to enjoy the fresh air
  • Go to the mall and stroll there
  • Garden or do other routine activities that you both enjoy

Do you need more reasons to go out and move around?

  • Research like the Evercare study shows that caregivers’ health suffers due to their lack of time and energy to prepare proper meals or to exercise. In this national survey, 60% of caregivers said that their eating (63%) and exercise  (58%) habits were worse than before.
  • A study by Haley, et al, showed that caregivers are at risk for increased mortality, coronary heart disease and stroke, particularly under conditions of high strain.

I’m ending the list here since almost everyone knows the bad news already. Instead, let’s consider the good news. The Mayo Clinic says that just a regular brisk walk can help you:

  • Maintain a healthy weight
  • Prevent/manage heart disease, high blood pressure, type 2 diabetes
  • Strengthen your bones
  • Lift your mood
  • Improve your balance and coordination

If that isn’t enough to get you off the couch, consider these sage words from Ralph Waldo Emerson:

“In the woods, a man casts off his years…I feel that nothing can befall me in life — no disgrace, no calamity, which nature cannot repair. In the woods we return to reason and faith.” [from his essay on Nature]

I may be old fashioned, but I love reading Emerson’s tributes to nature and its power to transform the way we feel. Since I am a bit modern, too, I can also condense the forty pages of Emerson’s essay to one excellent idea: GO OUTSIDE!

Curative vs. Palliative Care for Dementia Patients

Years ago, at a gathering of writers, someone told me I should look into hospice services for my mom. I was rather offended. Apart from her dementia, my mom was pretty healthy and I expected her to live for a long time. But I confess that back then I knew very little about the different models of treatment families can offer their loved ones at any stage of the disease.

Between the Pond and the Woods

The topic came to mind again this week when I came across a research brief on palliative care, which incorporates many ideas used by hospice providers. The article in European Journal of Public Health Advances by Lieve Van den Block — an award-winning research psychologist – suggests that since there is no real cure for Alzheimer’s or dementia, “curative” care alone may not really meet the complex needs of elderly patients. Her work, published by Oxford University Press, doesn’t suggest that we abandon the idea of seeking a cure for dementia. What it asks is that we re-focus our attention to include the range of physical, social, and psychological problems an older person faces — then plan care options so they can choose what makes them most comfortable in the final years of their lives.

Van den Block explains that the term “palliative care” used to refer to mainly to cancer and end of life situations. Now the idea is broadening to include support for patients with all types of life threatening diseases. It is an approach that encompasses the “physical, psychosocial and spiritual problems” that can affect the quality of life of the patient and their family.

At first it may seem that, given all our duties, this question is too complex for us to consider. But as my mother’s state becomes ever more precarious, I ask myself if we took enough time to discuss everything with her so her care would address deeper needs that lie below the surface checklist of her living will.

Hospice is still a scary word for me. It sounds like the end of the road. But the palliative care model uses many of the same ideas without making any judgement about how long the patient is likely to live. It is a patient-centered approach that focuses on quality of life and dignity, patient autonomy, and compassionate care.  My goal now is to learn more about what that would mean in a real life family setting.