Category Archives: exercise

30 Tips for Coping with Holiday Grief

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candle lightThe holidays can bring up all sorts of emotions: joy, anxiety, depression and grief, especially if you’re missing a loved one, or if a loved one is a shadow of their former self.

You are entitled to feel any and all emotions as they arise. If you’re at a holiday party and the tears well up, simply excuse yourself until you’re ready to rejoin the group. If you’re overcome with fatigue and grief and simply can’t make it to a party, it’s okay. Make yourself a bowl of popcorn and watch a movie or read a book. But keep in mind that socializing might do you a world of good. The most important thing is that you do what’s best for YOU. So whatever you need to do in order to get through the holiday season, do it in a healthy way. Please don’t rely on alcohol or drugs to numb your feelings.

Here are some suggestions for feeling your emotions and feeling your best, while remembering your loved ones during the holidays and beyond.

  1. Be honest with yourself and with others. Tell them what you’d like to do and what you’d prefer not to do.
  2. Create a new tradition in honor of your loved one, i.e. if you typically hosted a dinner, set a place setting and serve your loved one’s favorite dish.
  3. Decide where you want to spend the holidays. Maybe go to a new place or take a trip with another widow or widower whom you met in a support group.
  4. If you’ve had a hard time discarding your loved one’s clothes, think about donating them to a homeless shelter, etc.
  5. Start journaling. It’s a wonderful way to express your feelings and get things off your chest.
  6. Write a letter to your loved one and express your love, your sadness, grief, guilt, etc.
  7. Place two chairs facing one another. Sit in one and speak out loud the words you would like to express to your loved one. Tell him or her how much you miss them, or express your anger and guilt, etc.
  8. Watch what you eat. You should definitely enjoy your favorite foods, but don’t use grief as an excuse to overindulge in foods that aren’t good for you.
  9. Splurge on a gift for yourself!
  10. Help out at a shelter or food bank, or make a donation in honor of your loved one.
  11. Don’t overcommit. You don’t need to make the holiday meal, if you’re not up to it.
  12. It’s okay to be happy. It’s the holidays! Don’t feel guilty for enjoying yourself. It won’t diminish the love you have in your heart for your loved one.
  13. Read a book that will help identify your feelings and cope more easily with grief. I recommend these two: The Empty Chair: Handling Grief on Holidays and Special Occasions by Ed.D Zonnebelt-Smeenge, Susan J. R.N. and Robert C. De Vries | Sep 1, 2001. The Secret Life of Grief: A Memoir by Tanja Pajevic, 2016, 2016
  14. Get a massage.
  15. Use aromatherapy. Citrus oils are generally refreshing and uplifting for the mind and emotions, relieve stress and anxiety.  Consider: bergamot, grapefruit, lemon, and orange. Floral oils are often used as a personal fragrance and are useful to relieve anxiety, depression, and irritability. These oils are useful as an inhaler, in a body lotion, and for the bath. Consider: clary sage, geranium, lavender, rose, and ylang ylang.
  16. Get the sleep that you need.
  17. Make an appointment with a professional therapist if you need help.
  18. Eat a serving of high-quality protein with every meal and snack
  19. Focus on complex carbohydrates (whole grains, veggies and fruits), and eliminate junk foods (refined carbs).
  20. Enjoy unlimited amounts of fresh veggies.
  21. Eat a good breakfast!
  22. Eat 3 balanced meals and 1-2 snacks/day.
  23. Magnesium, B complex, fish-oil, walnuts, flax seeds, dark leafy greens, and high quality all help reduce stress and uplift mood.
  24. Meditate, light a candle, or find some quiet time for yourself.
  25. Take a multi-vitamin mineral supplement to support your overall health, well-being, and immunity.
  26. Exercise! At least take a short walk every day.
  27. Put on a CD, vinyl record or the radio and listen to your favorite music. Dancing as though no one is watching. There is nothing like music or dance to uplift the spirit.
  28. Put on a funny YouTube video and laugh.
  29. Meet a friend for a chat over coffee. Having a good chat and/or laugh, either via telephone or in person does wonders.
  30. Do the best you can. Try to relax and enjoy your family and friends.

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Barbra Cohn cared for her husband Morris for 10 years. He passed away from younger-onset Alzheimer’s disease in 2010. Afterward, she was compelled to write “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s & Dementia”–winner of the 2018 Book Excellence Award in self-help– in order to help other caregivers feel healthier and happier, have more energy, sleep better, feel more confident, deal with feelings of guilt and grief, and to ultimately experience inner peace. “Calmer Waters” is available at Amazon, Barnes & Noble, Boulder Book Store, Tattered Cover Book Store,  Indie Bound.org, and many other fine independent bookstores, as well as public libraries.

10 of the best nutrients for men that you may not know about

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Man eating salad

Calling all men, and the people who love them. June is Men’s Health Month, and a perfect time of year to evaluate your diet. There are no more excuses for being a couch potato. It’s time to get up, go outdoors, have fun, and get some exercise!

It’s also a great time to boost your nutrition with antioxidants found in fruits and vegetables, and learn some easy ways to cook them on the grill. Here’s a list of some of the important nutrients to add to your health regimen for a boost in overall health, energy, uplifted mood, brain support, and, yes, your sex life.

  1. Lycopene offers the best antioxidant protection of the 600 naturally occurring carotenoids. Carotenoids are the pigments found in colorful fruits such as watermelon, guavas, and tomatoes.  Thousands of articles have been published discussing lycopene’s potential as a protectant against prostate, lung, breast, skin, and pancreatic cancer. There is even a new study indicating that because of the strength of its antioxidant ability, lycopene has the potential to be developed as a clinical nutrient supplement for the prevention of AD –Alzheimer’s disease. The best way to get the benefits of lycopene is by eating tomatoes cooked in olive oil or tomato sauce.
  2. Did you know that if you are a man living in the United States it’s almost inevitable you’ll eventually have to face prostate problems? The prostate gland begins to grow in most males after they reach 40 years of age because DHT (dihydrotestosterone), a potent form of the male hormone testosterone, increases in the body. Testosterone is produced by the testicles and the adrenal glands and DHT accumulates in the prostate, causing prostate cells to rapidly divide. This overgrowth of prostate tissue compresses the urethra and slows or even stops the flow of urine in a similar way that a bent garden hose inhibits the flow of water. This occurs in 75 percent of men over 60 and sometimes the enlargement is the result of something more serious. Numerous studies have found that saw palmetto contains fatty acids and sterols effective in balancing male hormones, supporting testicular functions, and relieving prostate discomfort. Saw Palmetto helps reduce the level of dihydrotestosterone (DHT) by blocking its receptor sites in the prostate, and by inhibiting enzymes necessary for DHT conversion. It also helps shrink over-grown prostate tissue without bothersome side effects.
  3. B6, B12, and folic acid are important for reducing homocysteine levels, which is considered a major culprit in heart disease. Medical professionals are learning that homocysteine—a by-product of the amino acid methionine—is often a better indicator of your cardiovascular health than cholesterol. High levels of homocysteine indicate inflammation within the arteries, which can increase injury to the arterial wall. Consequently, this causes plaque to form, inhibiting blood flow, which increases risk of a blood clot from forming. Scientists and physicians have observed that most people with a high homocysteine level don’t get enough folic acid, vitamin B6 or B12 in their diet. In fact, in 1969 Dr. Kilmer S. McCully of Harvard Medical School discovered that patients with heart disease had nearly 80% less vitamin B6 in their blood serum than healthy individuals. Supplementing with these vitamins helps return the homocysteine level to normal. B6 also helps support healthy blood pressure.
  4. Resveratrol is a super antioxidant found in red grapes and wine. It has also been shown to reduce the inflammation and damage in the blood vessels that results from homocysteine. Hundreds of studies have shown that it supports cardiovascular health and may even provide anti-aging benefits.
  5. CoQ10 (Coenzyme Q10) is a co-enzyme that is called the “spark plug” of your cells. It is essential for electron transport within the mitochondria, and the production of adenosine triphosphate (ATP), which is responsible for energizing the 70-100 trillion cells in your body. The highest concentration of this important antioxidant resides in the heart. Without it your heart wouldn’t be able to beat 100,000 times a day, and some experts believe that if deficiency levels reach 75% your heart would stop beating. As we get older our levels of CoQ10 naturally start to decline. Our body needs vitamins, trace minerals and the amino acid tyrosine in order to produce CoQ10. If you are deficient in any of those nutrients because your diet is inadequate then your body will not be able to adequately produce CoQ10.Also, statins (cholesterol-lowering drugs) block CoQ10 production by blocking cholesterol synthesis, which is necessary for the production of CoQ10. So if you take Lipator or another statin drug it is crucial that you take a CoQ10 supplement. An 8-week study of 59 men already taking medications for high blood pressure found that 120 mg daily of CoQ10 reduced blood pressure by about 9% when compared to placebo.  Recent studies have shown that CoQ10 supplementation can save the lives of patients with congestive heart failure, and that 91% of heart attack victims improve within 30 days of adding CoQ10 to their list of daily supplements.  CoQ10 supplementation has also been found to support numerous cardiovascular illnesses, including atherosclerosis, ischemic heart disease, heart failure, and hypertension.
  6. Siberian ginseng is an adaptogen or substance that normalizes and balances all of the body’s systems, increasing your ability to handle physical and mental stress. It also helps support the adrenal glands, which help regulate energy levels.
  7. Multi-vitamin mineral supplements for men are formulated to address the unique nutritional needs of today’s man and to insure your  health. Look for one that is iron-free, since iron can negatively affect heart health.
  8. L-Arginine is an amino acid that is involved in the production of nitric oxide (NO), a chemical released by the blood that helps the muscles in the penis to relax. This, in turn, allows healthy blood flow in order to sustain a healthy erection. Without arginine in the diet, there would be no NO, and without NO men would not be able to have erections. And without erections there would be no . . . . Get the picture? But beyond sex, L-arginine helps build muscle mass, enhance immune function, improve blood pressure, increase memory, and speed wound healing. Arginine-derived nitric oxide has also been found to play a supporting role in the cardiovascular, immune, and nervous systems and has been validated by hundreds of studies. Foods that include arginine include meat, legumes, nuts and seeds, and turkey breast, chicken, and pork.
  9. Omega-3 fatty acids are essential acids, meaning your body does not manufacture them. You must obtain them through diet or nutritional supplementation. They are vital to supporting cardiovascular health, including blood flow to your heart and brain, and numerous other body functions. EPA and DHA, the long-chain omega-3s support healthy function of the brain and retina. DHA is a building block of tissue in the brain and retina in the eye. It is important in the production of phosphatidylserine, a neurotransmitter vital to brain cell communication. Studies show that omega-3s are also important to supporting an uplifted, even mood, and that a deficiency can lead to depression. It is also beneficial to creaky joints. Omega-3 fatty acids are the healthy fats that you can’t live without. To make sure you are getting adequate amounts, eat cold-water fish such as salmon, mackerel, cod, herring, sardines, at least twice a week. It is also found in freshly ground flaxseed or flaxseed oil; dark, leafy greens, hemp seed, soybeans, canola, walnut and flaxseed and oils made from those beans, nuts and seeds. To play it safe, my advice is to take an omega-3 fatty acid supplement.
  10. Chromium Picolinate is a first class blood sugar and insulin regulator. Nine out of 10 American diets fall short of this trace mineral, which is essential for the transfer of sugar from the bloodstream to muscle cells, thereby giving them the fuel they need to work.  Chromium is involved in maintaining cholesterol and triglyceride levels, and it is also necessary for our muscles to function properly. Chromium is believed to help build new muscle and act as a fat burner. When combined with an exercise program, chromium supplementation has been shown to produce significant weight loss.  Research suggests that chromium may help those with diabetes II and hypoglycemia. In a recent study, participants with a binge-eating disorder who took chromium picolinate supplementation, had improved glucose regulation.

Happy Father’s Day to everyone who is involved in the life of a child.

You are appreciated!

 

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Barbra Cohn cared for her husband Morris for 10 years. He passed away from younger-onset Alzheimer’s disease in 2010. Afterward, she was compelled to write “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s & Dementia”–winner of the 2018 Book Excellence Award in self-help– in order to help other caregivers feel healthier and happier, have more energy, sleep better, feel more confident, deal with feelings of guilt and grief, and to ultimately experience inner peace. “Calmer Waters” is available at Amazon, Barnes & Noble, Boulder Book Store, Tattered Cover Book Store,  Indie Bound.org, and many other fine independent bookstores, as well as public libraries.

 

Why are U.S. Pregnancy Deaths up?

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belly of pregnant woman monochrome on dark backgroundHappy Mother’s Day! I don’t normally write about pregnancy, but I feel compelled to address the fact that more U.S. women are dying from pregnancy-related causes. According to Dr. Neel Shah, a Harvard Medical School obstetrician, an American mother today is 50% more likely to die in childbirth than her own mother was.  Possible reasons include the high rate of C-sections, high blood pressure which can lead to preeclampsia, diabetes, and obesity. Although these deaths are rare, there are about 700 of them each year and according to the CDC (centers for disease control) more than half of them are preventable.

I taught the Bradley Method of Natural Childbirth thirty years ago. Back then, I warned my students that there was a possibility that their doctor might want to schedule a delivery around a vacation or tee time. I taught ways to have the healthiest outcome possible with the least amount of intervention.

Here we are three decades later and the percentage of C-sections has nearly doubled globally since to 2000, according to a study published in The Lancet, Oct. 13, 2018. In the U.S. 32% of all babies are now delivered by C-section.

Globally, maternal mortality fell about 44% between 1990 and 2016, according to the World Health Organization. That’s good news. But in the U.S., 17 out of every 100,000 new moms die. That’s up from 12 per 100,000 25 years ago. And black women in the U.S. are three times as likely to die from a pregnancy-related health issues than others. This could be due to lack of medical care, racial bias, and/or poor health to begin with (high blood pressure, etc.).

If you or a loved one is pregnant or plans to get pregnant

  • Please see a physician as soon as you suspect you are pregnant in order to get the best medical care possible.
  • Get a comprehensive heart-risk evaluation 12 weeks after delivery.
  • Eat a healthy, whole-foods diet and monitor you salt and sugar intake.
  • Practice a stress-reducing technique such as yoga, deep breathing, meditation.
  • Take a birth preparation class—these are usually offered at hospitals throughout the county.
  • Practice a relaxation birth technique with the person who will be your support during delivery and labor.
  • Keep your fitness up or strive to improve it. Walk or swim.

There are many articles posted on this blog on ways to reduce stress, eat well, and exercise. Even though many of them pertain to caregivers, there’s a lot of general information that applies to everyone.

Best wishes for a Happy Mother’s Day, a happy pregnancy, and a happy baby!

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What happens to your body when you’re a stressed caregiver?

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Woman having a headacheStatistics show the stress of care giving can result in chronic disease for the caregiver and take as many as 10 years off one’s life. In comparison to caregivers of people in all categories, caregivers of Alzheimer’s patients in particular rate their health more poorly, take worse care of themselves, and spend more money on their health care. Feeling more tired and depleted, they evaluate themselves as less healthy, engage in fewer health-promoting behaviors, and use more health services.

Given the demands on caregivers’ time and energy, they may neglect their own self-care by sleeping less, eating too much or too little, not exercising, or not managing their own health problems. Neglect of their own health may worsen pre-existing illnesses or increase vulnerabilities to new stress-related problems.

The Physiology of Stress

Walter Cannon described the fight or flight response in 1929.  Adrenaline is the fight-or-flight hormone: It causes cells, especially muscle cells, to speed up energy production so that the body will be ready to fight a foe or run away. It is needed for short blasts of stress.

  • Pupils dilate to sharpen vision.
  • Heart rate and blood pressure increase to accelerate the delivery of oxygen to fuel the muscles and critical organs.
  • Blood flow is diverted from non-critical areas such as the gastrointestinal tract to the critical areas such as the heart, skeletal muscles and liver.
  • Liver releases glucose and fatty acids into the bloodstream. Glucose is for immediate energy; fat is needed when the fight-or-flight response lasts longer than expected.
  • Bronchial tubes dilate to maximize the exchange of oxygen and carbon dioxide.

Cortisol bolsters us in long-lasting stress situations. But when the body is dealing with chronic stress, the adrenals get “stuck” in the on position and the whole system goes into chronic “fight or flight.”

  • Glucose that is dumped into your bloodstream goes unused, so your body has to produce an enormous amount of insulin to handle it. Eventually, this may result in hypoglycemia or diabetes.
  • Fat that is dumped into your blood also goes unused, so it clogs your arteries, leading to cardiovascular disease.
  • If you drink caffeine, the stress hormone cortisol becomes elevated, which can set you up for countless health problems including: poor quality of sleep, impaired immunity and age-related deterioration.

Adrenal exhaustion–The adrenal glands produce or contribute to the production of about 150 hormones. When they are stressed, they become exhausted. Once the adrenal buffer is gone, you become a prime candidate for asthma, allergy, fibromyalgia, chronic fatigue syndrome, autoimmune disorders, hypoglycemia

Alcohol, caffeine, sugar and salt put added stress on the adrenals.

Stimulate, such as caffeine increase the effects of your body’s own stimulating neurotransmitters: norepinephrine and dopamine, which are similar to adrenaline in their effects. Caffeine and these natural stimulants provide short-term energy, focus and even a lifted mood. But in the long-term, caffeine depletes your stores of norepinephrine and dopamine, leaving you more tired, sluggish and down than you were before the caffeine habit.

Psychological stress can impact cardiovascular function and lead to cardiovascular disease, and possible stroke/heart attack.

Stress and sleep

Adequate sleep repairs your body, sharpens your mind and stabilizes emotions. Lack of sleep triggers the body to increase production of cortisol, which makes it harder to fall asleep and stay in a deep sleep because on some level your body and brain think they need to stay alert for danger.

  • Loss of sleep as a result of caring for a loved one can lead to serious depression.
  • As little as five nights of poor sleep can significantly stress the heart.

Weight gain and insulin resistance

  • Increased cortisol production leads to weight gain. The adrenals increase gluconeogenesis, which provides the body with glucose from protein, rather than carbohydrates. This decreases serotonin and melatonin, which results in poor sleep and leads to food cravings for carbohydrate-rich foods in order to uplift mood, which releases more serotonin and insulin. This leads to more stress and insulin production to regulate glucose, which may lead to fat storage, weight gain and insulin resistance. It becomes a vicious cycle.
  • Insufficient sleep is also associated with lower levels of leptin, a hormone that alerts the brain that it has enough food, as well as higher levels of ghrelin, a biochemical that stimulates appetite. Consequently, poor sleep may result in food cravings.

Exercise

  1. Insufficient sleep may leave us too tired to burn off extra calories with exercise.
  2. When your body is stressed and prepared to fight or run it’s full of stress hormones. If you’re sedentary, those hormones will continue to circulate and cause damage to your body. Vigorous exercise, however, burns off those hormones. Exercise also releases the neurotransmitter serotonin and endorphins, the body’s natural pain relievers.
  3. Doctors from Nottingham Trent University suggest the chemical phenylethylamine is released during exercise and could play a part in uplifting mood as a result of exercise. Phenylethylamine is a naturally produced chemical that has been linked to the regulation of physical energy, mood and attention.

Impact of food on mood and physiology

Hazards of caffeine

  1. Caffeine stresses the adrenal glands and can contribute to anxiety, insomnia, depression, irritability, anxiousness—not good for caregivers. In fact, studies show that those who drink the most coffee often suffer from chronic depression. It depletes the body of B1, biotin, inositol, vitamin C, calcium, potassium, and zinc. It increases thirst because it is dehydrating, over stimulates and weakens the kidneys, pancreas, liver, stomach, intestines, heart, and nervous system.
  2. Can increase production of cortisol, leading to stronger cravings for fat and carbohydrates. This increases blood glucose, release of insulin and fat stored in the abdomen.
  3. Increases dopamine levels, making you feel good until it wears off
  4. May interfere with restful sleep
  5. Try not to drink coffee after 2pm
  6. Simple carbohydrates increase insulin production.

People who are stressed often crave and overeat sugar and simple carbohydrates, like chips, cookies and white bread or pasta, because those foods provide a fast release of the feel-good chemical serotonin. But eating this way causes a blood-sugar crash a couple of hours later, leaving you tired and moody. The more of these foods that you eat the more you crave. Although these foods are high in calories, they contribute few nutrients and deplete the body of essential vitamins and minerals, raise triglycerides, and contribute to inflammation and excess weight.

  1. Lack of water/fiber can rob the body of nutrients because of problems with digestion and assimilation
  • HFCS and other artificial sweeteners can interfere with your natural production of neurotransmitters. Aspartame (NutraSweet and Equal) competes with tryptophan by blocking its conversion into serotonin. Artificial sweeteners contribute to numerous adverse symptoms, as compiled by the Food and Drug Administration and include everything from menstrual changes, weight gain, and headaches to severe depression, insomnia and anxiety attacks.

High fructose corn syrup (glucose and fructose) can lead to a decrease in leptin production leading your body into thinking it’s hungry so you eat more, especially processed foods. HFCS can lead to insulin resistance and higher levels of triglycerides, as well as obesity, hypertension and cardiovascular disease.

Bad habits, i.e. forgetting to eat, eating on the run, not eating breakfast all contribute to unstable blood sugar and adrenal exhaustion, which makes you grab foods that aren’t good for you, so you end up feeling irritable, moody, and even more stressed.

You get the picture? It’s important to take care of yourself, especially when you are taking care of someone else. I don’t want to overwhelm you with information or preach to you. Here’s a short checklist to help you stay healthy and balanced.

  • Eat a serving of high-quality protein with every meal and snack
  • Focus on complex carbohydrates (whole grains, veggies and fruits), and eliminate junk foods (refined carbs).
  • Enjoy unlimited amounts of fresh veggies.
  • Eat a good breakfast!
  • Eat 3 balanced meals and 1-2 snacks/day.
  • Magnesium, B complex, fish-oil, walnuts, flax seeds, dark leafy greens, and high quality all help reduce stress and uplift mood.
  • Meditate or find some quiet time for yourself
  • Exercise! At least take a short walk everyday.
  • Put on a funny YouTube video and laugh.
  • Use aromatherapy.
  • Do the best you can.

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Barbra Cohn cared for her husband Morris for 10 years. He passed away from younger-onset Alzheimer’s disease in 2010. Afterward, she was compelled to write “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s & Dementia”–winner of the 2018 Book Excellence Award in self-help– in order to help other caregivers feel healthier and happier, have more energy, sleep better, feel more confident, deal with feelings of guilt and grief, and to ultimately experience inner peace. “Calmer Waters” is available at Amazon, Barnes & Noble, Boulder Book Store, Tattered Cover Book Store,  Indie Bound.org, and many other fine independent bookstores, as well as public libraries.

Calmer Waters: Spring 2019 book signings and events

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Especially for folks in the Denver-metro area: You are warmly invited! Please drop by at a book signing to say hello, or attend the caregiver symposium or conference (or both!) for lots of great information, networking and support. Respite care is available for both events. Click on the links to find out more.

10 New year requirements for all caregivers

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You’re tired, you’re stressed–You and 45 million or so American caregivers. So what are you going to do about it? Don’t say that “I don’t have time to take care of myself.” I’ve been there and done that. But I always promised myself that I was not going to be a martyr and sacrifice my health for my husband’s illness. Because if both of us went done that wasn’t going to serve any purpose, least of all our children. They were barely adults when my husband was in the throes of Alzheimer’s disease. They needed at least one healthy parent. And whether you are taking care of a spouse, parent or child, there are other people in your life who love and need you, not necessarily to take care of them, but to love and support them emotionally.

When you are a caregiver, it’s hard to find the time to go to the gym or even take a shower, somedays. But it’s absolutely vital that you take care of yourself or you will end up getting sick and then who will take care of your loved one? Who will take care of YOU?

Here are 10 easy ways to take the edge off your stress and fatigue so you feel some relief.

  • Say a positive affirmation before you get out of bed. “This day is going to be a good one.” “I am grateful for my friends and family.” “I am healthy and full of energy.” “I am strong and competent.” Say something positive to set the tone of the day.
  • Before you reach for a cup of coffee, drink a glass of hot water with lemon. It hydrates your body and brain, the lemon helps to alkalize the system (yes, it’s counter intuitive), which is usually too acidic, and it helps with regularity.
  • Ask for help! You don’t have to do it all by yourself. No one is going to think badly of you if you take some time for yourself. If your loved one resents your going out, it’s okay. Don’t become a slave to their wishes and rants. If you can’t leave your loved one alone, please ask a neighbor, friend or home care professional to help at least a couple hours a week. Some social service programs provide free respite care.
  • Many cities throughout the U.S. offer volunteer snowbusters (volunteers who will shovel your walk and driveway), fix-it volunteers who will help with easy home repairs, and yard maintenance volunteers.
  • Meet a friend for a chat over coffee. Having a good chat and/or laugh, either via telephone or in person does wonders.
  • Find a walking partner in your neighborhood and try to walk at least once a week (preferably 3 times a week).
  • Put on a CD, vinyl record or the radio and listen to your favorite music. If your care partner is mobile, ask him/her to dance. There is nothing like music or dance to uplift the spirit.
  • Use essential oils to immediately diffuse feelings of sadness, depression, anxiety, etc. Lavender oil is the most frequently used fragrance. You can also try bergamot, grapefruit, lemon, orange, clary sage, geranium, rose, and ylang ylang, frankincense, and myrrh. Put the oil in a diffuser or spray bottle to mist your collar or pillow. Find a fragrance that is pleasing to your care partner. It’ll help him/her also.
  • Take a multi-vitamin mineral supplement to support your overall health, well-being, and immunity.
  • It’s important to get at least 6 hours (preferably 7 or 8) of sleep every night. Of course, this isn’t always possible if you are caring for someone and need to get up at night, or are worried about paying the bills, taking care of the car, getting a new stove, etc. If you can’t get in the hours at night, put your feet up for 10 minutes during the day when your care partner naps. Or take a power nap. It really helps.

Wishing you and your loved ones a healthy, happy New Year! And remember that “this too shall pass.”

Barbra Cohn cared for her husband Morris for 10 years. He passed away from younger-onset Alzheimer’s disease in 2010. Afterward, she was compelled to write “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s & Dementia”—Winner of the 2018 Book Excellence Award in Self-Help—in order to help other caregivers feel healthier and happier, have more energy, sleep better, feel more confident, deal with feelings of guilt and grief, and to ultimately experience inner peace. “Calmer Waters” is available at Amazon, Barnes & Noble, Boulder Book Store, Tattered Cover Book Store,  Indie Bound.org, and many other fine independent bookstores, as well as public libraries.

20 energy and stress fixes to use now!

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The holidays are stressful for everyone, but especially for caregivers. Here’s a list of some of my favorite stress relievers and energy boosters.

Soak in an Epsom salt bath and put in a few drops of lavender oil.
Soak in an Epsom salt bath and sprinkle in a few drops of lavender oil.
  1. Start the day with an affirmation. Before you get out of bed say something such as: “I am happy for the beautiful day.” I am grateful for my family and friends.” “I am cherished.” Make it yours, make it sincere. It’s amazing how it can set a positive tone of the day.
  2. Breathe! When we are stressed we tend to hold our breath. Take a 5-minute break and sit down in a comfortable chair. Close your eyes and take a deep breath, in and out. Then focus on your breath and watch how your mind quiets down and your muscles relax. Then remember to breathe throughout the day. Whenever you feel yourself getting anxious or tight, take a deep breath and let it go.
  3. Drink water. We’ve heard it a million times but it’s always good to be reminded. Forget about sodas and limit the wine and alcohol. Staying hydrated, especially at this time of year, is vital to supporting the immune system and reducing inflammation. It’s also important to support healthy cognitive function and memory.
  4. Make lists, including a meal plan for the week. It helps eliminate the last hour panic of “what am I going to make for dinner?” and unhealthy last-minute food decisions like ordering pizza.
  5. “Me time” is important! Get respite care if your loved one needs full-time attention. Ask a neighbor, relative or friend to come over for an hour or two so you can take a walk, go to the gym, or meet a friend for lunch or coffee.
  6. Eat walnuts. A daily dose of about 9 whole walnuts or 1 Tbs. walnut oil helps your blood pressure from spiking during stress. Walnuts contain L-arginine, an amino acid that helps relax blood vessels, which in turn helps reduce hypertension.
  7. Drink green tea. L-Theanine is the main chemical constituent in green tea. It is an ideal nutritional aid for stress because it produces alpha-wave activity that leads to deep relaxation and mental alertness. This is especially important because in order to mitigate stressful situations, it’s important to remain calm and alert. Theanine also stimulates the release of the neurotransmitters GABA, serotonin and dopamine, which help us feel happy, motivated and calm. Green tea extract is available as a nutritional supplement, which might be easier and quicker to take, and it’ll save you a lot of trips to the bathroom.
  8. While we’re on the topic of “green,” be sure to eat green leafy vegetables for vitamin B and magnesium, both of which help your body cope with stress.
  9. Two handfuls of cashews (make that a small handful, please; one ounce of cashews contains 157 calories.) provide a mood-boosting effect because they are one of the highest natural sources of tryptophan, the precursor for serotonin, the feel-good neurotransmitter.
  10. Did someone mention dark chocolate? It reduces cortisol, the stress hormone that causes anxiety symptoms. Just a couple of pieces should do the trick.
  11. Stretch! It’s important for everyone, not just runners and athletes. Stretching keeps your muscles flexible, strong and healthy. Without it, muscles tighten and weaken, which puts you at risk for joint pain and strain.
  12. Walk around the block. Just getting out into fresh air will instantly relieve stress, and moving your body gets your blood pumping and will clear your mind.
  13. Light candles and play relaxing music while you eat. It will change the mood instantly.
  14. Aromatherapy is a miracle cure for stress and anxiety. Use a wall plug-in to diffuse the aroma of lavender oil to uplift mood, or place a few drops on a handkerchief and tuck it into a shirt pocket or on a pillow. Other oils to try: vetiver, frankincense, myrrh, orange, lemon, bergamot, and grapefruit.
  15. Sit down, close the door and meditate. If you don’t have a mantra use the word OM. Repeat it silently and when you realize you are not saying it, then gently come back to it. Do it for 10 to 20 minutes every day and yoyu will notice that you are much more relaxed.
  16. Music is the universal language, and it is also the universal stress reliever. Whether it’s jazz, classical, or hard rock that makes you feel better, by all means, play it loud, play it soft, dance to it, drive to it, go to sleep to it. It will definitely help.
  17. Take a multi-vitamin mineral supplement to help with stress, energy and immune support.
  18. Warm up with warming herbs and spices such as ginger, turmeric, cumin, oregano, cayenne, black pepper, cardamon, garlic.
  19. Take an Epsom salt bath and put in a few drops of lavender oil. Light some candles, turn down the lights, put on some music, and relax!
  20. Getting the proper rest is vital to staying healthy and reducing stress. Prepare yourself for a deep night’s sleep by unplugging from electronics at least an hour before bed, taking an Epsom salt bath (put several drops of lavender oil in the water for added relaxation), and making sure the room temperature isn’t too warm.  Good night, sleep tight!

If you, or someone you care about, tend to suffer from stress, anxiety, or depression, these recommendations might just “take the edge off” and improve your quality of life … without the risk of side effects. May the holiday season begin!

Best wishes for a happy, safe and relatively stress-free holiday season!

Barbra Cohn cared for her husband Morris for 10 years. He passed away from younger-onset Alzheimer’s disease in 2010. Afterward, she was compelled to write “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s & Dementia”—Winner of the 2018 Book Excellence Award in Self-Help—in order to help other caregivers feel healthier and happier, have more energy, sleep better, feel more confident, deal with feelings of guilt and grief, and to ultimately experience inner peace. “Calmer Waters” is available at Amazon, Barnes & Noble, Boulder Book Store, Tattered Cover Book Store,  Indie Bound.org, and many other fine independent bookstores, as well as public libraries.

The best gifts for people with Alzheimer’s and dementia

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Christmas gift or New Year with blue ribbon and greeting card on wood table on bokeh background. Tiny and Handmade gift box concept.Instead of worrying about what to give a friend or loved one who suffers from Alzheimer’s disease or dementia consider this. What that person really wants more than anything is to just be with you. So here’s a list of things you can do together.

  1. People with dementia love ice cream. Share a pint of his or her favorite. Bring the toppings and arrange them on a table in little bowls—sprinkles, chocolate chips, chopped fruit, whipped cream, butterscotch or chocolate sauce, etc.
  2. Watch a comedy together. It doesn’t matter if your loved one can follow the plot or not. If you laugh, he or she will probably join in the merriment. Laughter triggers the production of endorphins; the brain chemicals that reduce the sensation of pain and make you feel good.
  3. Bring a dog to visit your loved one. If you don’t have one, borrow one. There’s nothing like a friendly pup to cheer someone up and add some excitement. Listen to music together.
  4. Put on a CD and sing together. Big Band Music is usually a hit with most 70, 80 and 90 year olds. If your loved one is younger, you can try classic rock.
  5. Get out the paint brush, paper and water colors. You don’t have to be an artist or art teacher to have fun with your loved one. Painting and drawing is a great way to share time together, and to even express feelings of frustration, irritation and fear—on paper.
  6. Dance to the music. If your loved one is still mobile help him or her get up and move. The exercise will enhance memories, even if temporarily. A short surge of condensed exercise boosts the compression of memories in both elders in good mental shape as well as those with slight cognitive impairment, according to new research by a team of scientists from UC Irvine’s Center for the Neurobiology of Learning & Memory.http://www.cnlm.uci.edu/
  7. Go for a drive and get some fresh air. Just getting out of the house or memory care home does a body good.
  8. Hold hands, give a foot massage. Use aromatherapy oils (see chapter 18 “Aromatherapy” in The Caregiver’s Journey Through Alzheimer’s and Dementia
  9. Create a book of photos that depict your loved one’s life and share memories without saying “remember when. . .”
  10. Just breathe together and be still in the silence. It’s the greatest gift of all.

Treat yourself to the perfect gift for all caregivers to help you feel healthier and happier, less stressed, sleep better, deal with feelings of guilt and grief and find inner peace. The Caregiver’s Journey Through Alzheimer’s and Dementia

BarbraCohn__

15 self-care strategies to reduce holiday stress

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Hand writing text caption inspiration showing Self Care. Business concept for Taking caring for own Health Written on sticky note paper, wooden background with folded pink paper meaning thinkingIt’s National Family Caregivers Month and the perfect time to consider how you can reduce the stress of the holidays by taking better care of yourself.

  1. First, pat yourself on the back. If you are a caregiver you’re doing an incredible service of giving of yourself and your time. Whether your care recipient verbally expresses appreciation or not, know that you are a bright light in that person’s life and in the world.
  2. Before getting out of bed in the morning repeat an affirmation several times to set the tone of the day. Some ideas: “Today is going to be a good day,” “I am a loving, kind person,” “I am grateful for my family and friends.”
  3. It’s especially important to eat well at this time of year when colds and flues are rampant and the stress of the holidays taxes the immune system. Focus on warming foods such as soups and stews, mineral and bone broths, and ginger tea. Citrus fruits are in season and offer vitamin C, important for immune support. The winter squashes offer beta carotene and vitamin A, which are also excellent antioxidants. Please listen to my interview with Mary Collete Rogers on her podcast “The Healthy Kitchen Companion” for ideas about how to include healthy foods into your diet and how to organize your kitchen. Caring for yourself and others with good nutrition.
  4. Make a food plan for the week and bring a shopping list with you so you don’t have to make a repeat run to the grocery store.
  5. Calm yourself with calming foods. Studies show an association between the levels of the neurotransmitter serotonin and mood. The good news is you can naturally increase your serotonin levels with food such as these: sweet potatoes, brown rice, oatmeal, amaranth, buckwheat, millet and quinoa allow your brain to process more serotonin. Eating protein and healthy omega-3 fats, found in fish, walnuts and flax, will also improve mood. B vitamins, which are abundant in fresh leafy greens and in chemical-free, pasture-raised meat, are another important factor because they’re needed for serotonin production. Leafy greens, such as spinach, kale, collard greens, are high in folic acid, a B vitamin. Low levels are linked to depression. Bananas contain vitamin B6. They are high in potassium, an important electrolyte for a happy and calm mind.
  6. Reduce stress by supporting your adrenal glands with supportive supplements. The adrenal glands sit on top of your kidneys and produce adrenaline and cortisol, the stress hormones. If you press on your kidneys and they hurt, there’s a good chance your adrenals are working overtime due to stress. Stress may hit us as a headache, backache, insomnia, anxiety, irritability, respiratory, illness, or the flu.  If we really become overwhelmed, stress may accumulate to the point where our entire immune system is compromised and we end up fighting a serious illness. The good news is that adaptogens and nervines —two categories of herbs—can help your body adapt to stress, creating a state of homeostasis.

Recommended adaptogens:

  • Ashwagandha – is an Ayurvedic herb that has also been called “Indian ginseng.” It raises energy levels, enhances immunity, helps the body cope with stress, and reduces the stress hormone cortisol.
  • Cordyceps – is a revered Chinese nourishing tonic used to build strength and stamina, support the immune system, combat fatigue and the effects of aging, and invigorate the elderly and those weakened after serious illness.
  • Gotu kola – is an important brain and nervous system restorative in Ayurvedic medicine. It is also used as a mild diuretic and for insomnia and gastric complaints.
  • Rhodiola – also called golden root, stimulates and protects the immune system by supporting the adrenal hormones. It boosts immunity, improves concentration and stress resistance, and increases physical performance and uplifts mood.  It is also a remedy for sleep difficulties, poor appetite, irritability, hypertension, headaches, and fatigue from intense physical or intellectual strain.

Nervines

According to David Hoffmann, a leading herbalist and spokesperson for a return to herbal medicines, a nervine is a plant remedy that has a beneficial effect upon the nervous system in some way.  Nervines are especially useful during times of stress because they have a strong relaxing and calming effect without producing a dulling, “hang-over” side effect.  They also tone and restore the nervous system to a more balanced state.  Some nervines are also anti-spasmodic, meaning they relax the peripheral nerves and the muscle tissue, which in turn has a relaxing effect on the whole system.

Recommended nervines:

  • Passion flower- is beneficial for anxiety, insomnia, tension headaches, muscle aches and spasms, pain, hyperactivity, epilepsy, and to alleviate anger and help lower blood pressure.
  • Skullcap – is antispasmodic and relaxing and is recommended to relieve headaches, mood swings, insomnia, premenstrual syndrome, and nervous tension and exhaustion

The next time you’re feeling nervous, agitated, restless or hyped up, calm your nerves with a nervine herb. If you want to rejuvenate your adrenal glands and boost your entire immune system, take an adaptogen.  You’ll have more energy, feel happier and less stressed, and your overall health will improve too!

7. Move! Exercise is vital to staying healthy and strong. The days you feel “stuck” or stiff are the days it’s most important to put on your walking shoes, sunglasses, and a hat, and go for a walk. Chat with/walk with a friend or with your pet dog

8. Take a bath. Hydrotherapy has been used for thousands of years as a healing modality throughout the world to relieve stress, release aches and stiffness, and refresh the mind and emotions. For an added benefit, add Epsom salts and/or essential oil.

9. Dance is an amazing healing aid that can instantly enhance your mood and create joy. Put on your favorite Motown, R & B or salsa music and dance in your living room as though no one is watching. A twenty-one-year long Einstein Aging Study, completed in 2001, found that dancing is the best physical activity to help prevent dementia when compared to eleven other activities including team sports, swimming, and bicycling. The study was summarized in an article that appeared in the New England Journal of Medicine in 2003.

10.Breathe deeply. Most of us breathe shallow breaths that restrict oxygen flow to the lungs and throughout the body, resulting in fatigue and depletion of our vital energy. Breathing is not only free, but it will set you free. Try this simple exercise: Sit on a chair with your back straight and focus on your breath. Take a deep breath, and then let it go, exhaling all the stale air out of your lungs. Continue for several minutes. Notice any sensations in your body. Eventually your body and thoughts will settle down, and you’ll emerge feeling more relaxed. Try to do this at least five minutes on a regular basis.

11. Stay hydrated! It’s important to keep your brain hydrated as well as the body. Have non-caffeinated, unsweetened beverages throughout the day, particularly water and tea. The rule of thumb is to have 48 to 64 ounces of non-sweetened, non-artificially sweetened drinks. Hydration keeps the body in proper pH (how acidic or alkaline your body is) and protects it from getting dehydrated, which is a cause of inflammation and other kinds of imbalances.

12. Meditate, pray, take a walk in nature. Take a walk around the block, even for 15 minutes.

13. Listen to some classical music, meditative music, religious music, etc.

14. Use aromatherapy essential oils such as lavender for an instant relaxing effect.

  • Use essential oils (lemon, peppermint, lavender, frankincense, bergamot, thyme, sandalwood, vetiver, myrrh) to boost immunity. For more information about the use of aromatherapy to reduce stress, improve immunity, reduce agitation, and to promote relaxation read chapter 18 “Aromatherapy” in “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s & Dementia” by Barbra Cohn

15. Practice good sleep hygiene. It’s hard to function at your best and to stay healthy when you aren’t sleeping well. Here’s a quick reminder of how to improve your sleep.

Don’t drink caffeine after 1:00 pm. Limit your fluid intake after dinner so you don’t have to pee during the night. Turn off all electronics at least 30 minutes before bed. Cool your bedroom, but make sure you don’t feel. Or, warm your bed with a heating pad. Get black out curtains. Eat a banana; it contains potassium and magnesium which help reduce risk of muscle cramps. Or, have a protein snack such as a slice or cheese or tsp of peanut butter on a cracker to help maintain balanced blood sugar. For more suggestions read 16 ways to sleep better . . . so you can be a better caregiver. 

Best wishes for a happy, safe and relatively stress-free holiday season!

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Barbra Cohn cared for her husband Morris for 10 years. He passed away from younger-onset Alzheimer’s disease in 2010. Afterward, she was compelled to write “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s & Dementia”—Winner of the 2018 Book Excellence Award in Self-Help—in order to help other caregivers feel healthier and happier, have more energy, sleep better, feel more confident, deal with feelings of guilt and grief, and to ultimately experience inner peace. “Calmer Waters” is available at Amazon, Barnes & Noble, Boulder Book Store, Tattered Cover Book Store,  Indie Bound.org, and many other fine independent bookstores, as well as public libraries.

 

Have you tried any of these natural ways to combat depression?

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St. John's Wort capsulesOctober 11 is National Depression Screening Day. If you are feeling overwhelmed, depressed or have a hard time getting out of bed in the morning because you don’t want to face the world it’s time to evaluate your emotional health. You can take an anonymous screening online here: Select a state to find a screening.

If you are suicidal please call the national suicide prevention lifeline: 1-800-273-8255.  The Lifeline provides 24/7 free and confidential support for people in distress, prevention and crisis resources for you or your loved ones.

If you have mild to moderate depression, there are a number of proven natural supplements and modalities that can help.

While I cared for my husband who had younger-onset Alzheimer’s disease, I lived behind a persona of forced cheerfulness because I didn’t want anyone to know that my private world was being deconstructed bit by bit. I went through bouts of depression and grieving periods. I took the supplement St. John’s wort, danced and meditated. I met with girlfriends and did yoga. I also used essential oils and tried to eat well. It all helped.

I gave St John’s wort to my husband, too, until he was in late-stage Alzheimer’s disease. By then he needed a pharmaceutical anti-depressant. But the St. John’s wort worked well for mild to moderate depression.

  1. Here’s what we know about St. John’s wort
  • It is a safe and effective way to treat mild to moderate depression over long periods of time
  • Is similarly effective as standard antidepressants
  • It has minimal side effects when compared to standard antidepressants

One study done on laboratory animals found that St, John’s wort (Hypericum perforatum) has antidepressant properties similar to standard antidepressants. The antidepressant profile of H. perforatum is closely related to the selective serotonin reuptake inhibitors class of antidepressants.

A Swiss study evaluated 440 patients suffering from mild to moderate depression and treated them with 500 mg. of St. John’s wort for up to one year. Although mild side effects such as upset stomach were reported—which may or may NOT have been related to the treatment—the researchers reported that is a safe and effective way to treat mild to moderate depression over long periods of time. They also found that it is especially suitable for preventing a relapse.

A meta-analysis at the Centre for Complementary Medicine Research, Technische Universitaet Muenchen, Munich, Germany analyzed 29 trials (which included 5,489 patients), comparing St. John’s wort with placebo or standard antidepressants. The evidence suggests that the hypericum extracts tested in the included trials a) are superior to placebo in patients with major depression; b) are similarly effective as standard antidepressants; c) and have fewer side effects than standard antidepressants.

2. Support serotonin levels. Omega 3 fatty acids are rich in DHA, the major unsaturated fat in the brain. Your brain is 60% fat and depends on the fat you ingest from food. Healthy fats found in cold-water fish such as salmon, mackerel, sardines, and in olive oil, walnuts, flax and avocado will improve your mood. It is important to cook with a healthy fat such as olive oil, walnut or avocado in order to feed your brain! Canola oil, peanut oil, and safflower are not able to provide you with the fat your brain needs.

As a nutrition educator, I also like to recommend foods that increase the “happy” neurotransmitter serotonin. Whole grains, sweet potatoes, brown rice, oatmeal, buckwheat, millet, quinoa, support your brain’s ability to process more serotonin.

3. Drink water. Your brain needs to stay hydrated. Make sure you drink at least six tall glasses of water every day. When my mom went into the hospital for severe dehydration, among other things, she began hallucinating. A psychiatrist called to tell me “your mom has full-blown dementia.” I said, “No she doesn’t,”  and refused to allow the doctor to prescribe an anti-psychotic prescription. Sure enough, several days later my mom sounded completely normal. Her body had been dehydrated, as well as her brain. The simple habit of drinking water is sometimes all we need to maintain mood and mental health.

4. The Canadian Network for Mood and Anxiety Treatments published a report in the “Canadian Journal of Psychiatry” in 2016 with this conclusion: For the management of mild to moderate depression it says exercise, light therapy, St. John’s wort, omega-3 fatty acids, SAM-e, and yoga are recommended as first- or second-line treatments.

5. A recently published study in the “Journal of Clinical Medicine” concluded that individuals who engaged in a meditative movement practice of Tai Chi, Qigong, or Yoga showed significantly improved treatment remission rates. The researchers conclude that emphasizing the therapeutic effects of meditative movements for treating MDD (Major Depressive Disorder) is critical because it may provide a useful alternative to existing mainstream treatments (drug therapy and psychotherapy) for MDD. Given the fact that meditative movements are safe and easily accessible, clinicians may consider recommending meditative movements for symptomatic management in this population.

6. Music is the universal language as well as one of the most common ways to affect mood.  My husband was never without head phones as he listened to music and wandered through the halls of the memory care home where he lived the last two years of his life. Music made him happy. It makes toddlers spin until they’re dizzy, teens hand bang until their necks get sore, and adults drum their car’s steering wheel. Music also helps decrease anxiety and improves functioning of depressed individuals as found in a meta-analysis that concluded music therapy provides short-term beneficial effects for people with depression. 

Other natural ways to combat depression

7. Create a calm environment. Light candles at dinner, play classical music, have a vase of fresh flowers on the table.

8. Get some physical exercise every day; even just a 20 minute walk helps tremendously.

9. Use aromatherapy oils. For more information about the use of aromatherapy to reduce stress, improve immunity, reduce agitation, and to promote relaxation read chapter 18 “Aromatherapy” in “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s & Dementia” by Barbra Cohn

10. Vitamin B complex optimizes cognitive activity and brain function, has a positive effect on memory, learning capacity and attention span, and supports a healthy nervous system and a stable mood. Vitamins B6 and B12, in particular, play a role in the synthesis of serotonin, the neurotransmitter linked to improving memory, lifting mood and regulating sleep.

11. Maintain your social connections. Loneliness can actually lead to health problems and mental decline. Join a group—any kind of group: worship,  hiking, scrabble, table tennis, knitting, discussion group or book club. Volunteer at a food bank, soup kitchen or animal shelter. It’s important to stay connected and to feel as though you are a contributing member of society.

12. Sleep well by getting to bed before 11:00 pm, eating your last meal before 8pm, turning off your electronic devices, and eliminating light in your bedroom. If you have trouble sleeping consider using a lavender essential oil spray on your pillow or a sachet of lavender inserted into the pillowcase. There are lots of natural sleep aids available at your local health food store, such as melatonin, calcium/magnesium, valerian, hops, etc. Consult with a nutritional consultant about what might work best for you.

“Surround yourself with people who are only going to lift you higher.” anonymous

 

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Barbra Cohn cared for her husband Morris for 10 years. He passed away from younger-onset Alzheimer’s disease in 2010. Afterward, she was compelled to write “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s & Dementia”–winner of the 2018 Book Excellence Award in self-help– in order to help other caregivers feel healthier and happier, have more energy, sleep better, feel more confident, deal with feelings of guilt and grief, and to ultimately experience inner peace. “Calmer Waters” is available at Amazon, Barnes & Noble, Boulder Book Store, Tattered Cover Book Store,  Indie Bound.org, and many other fine independent bookstores, as well as public libraries.