Tag Archives: anxiety

Is Palliative Care Right for Your Loved One?

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Woman comforting her unwell husband

When most people think about palliative care, they visualize someone who is suffering from pain, advanced cancer, COPD (congestive heart failure), or another fatal illness. Palliative care is specialized medical care for people also facing serious illnesses like dementia. The goal is to support the patient and the family on all levels, including physical, psychological, and spiritual.

What’s the difference between palliative care and hospice care?

Palliative care aims to ease pain and discomfort, reduce stress, and help patients —and their families— have the highest quality of life possible. Hospice care comes into play when a cure is no longer viable or when the treatment negatively outweighs the benefits. You can have palliative care at any stage of illness, along with other treatments.

Typically, with hospice curative medications or aggressive treatments for a patient’s illness are stopped. But not all medications are stopped. Medications that help relieve pain, nausea, anxiety and help a person breathe are an important part of hospice care.

In an article that appeared in Alzheimer’s TODAY (Volume 19, Number 1), Ann Wyatt, MSW, a leader in palliative care for people with dementia, says that people with dementia express their comfort and discomfort through their actions. It’s the caregiver’s responsibility to figure out the cause of the discomfort and help the person become more comfortable.

But that’s tough because dementia may prevent a person from communicating the source of distress. It’s usually not dementia that causes the distress, says Wyatt. (Although from my experience with my husband, his dementia caused frustration, anger, and irritability.)

Wyatt, says, “Most of the time it means that somebody is in pain or has some other discomfort. Dementia just means they can’t explain what it is.”

In a care facility, a resident might be given an antipsychotic drug to manage or misdirect behaviors that are perceived as aggressive. But the behavior might be a reaction to the person’s discomfort of being in a setting where schedules are instilled to provide efficiency and ease for the staff without considering the individual needs. For instance, a person who finds it hard to get up in the morning may exhibit “difficult behaviors” because they are woken early for breakfast or a shower, when they’d rather sleep in.

A personal anecdote

In my husband’s case, another resident occasionally, and mistakenly, walked into his room thinking it was his. My husband would shove him, and sometimes they got into a physical altercation. The situation was resolved when the other man was moved to the opposite side of the facility. This was a good example of palliative care. The caregivers removed the source of discomfort and stress for both residents (and families) by simply moving one resident to another area.

Simple ways to provide palliative care

  • 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.
  • Play soothing music, and sing.
  • Speak softly.
  • Read to your loved one.
  • Use dimmed lights and/or battery-operated candles.
  • Beautify the environment with flowers.
  • Massage and/or physical touch is a wonderful way to ease everyone’s tension.

Getting palliative care

A palliative care team helps patients and families find ways to improve their quality of life whether that means moving to a skilled nursing facility or getting good home care. To find palliative care in your area visit https://getpalliativecare.org/howtoget/find-a-palliative-care-team/.

Download the free booklet Palliative Care for People with Dementia at caringkindnyc.org for excellent information about a comfort-focused care approach

For dozens more tools and techniques for reducing stress, uplifting mood, supporting your immune system and finding ways to connect on a spiritual and emotional level with the person you care for, read Calmer Waters: The Caregiver’s Journey Through Alzheimer’s and Dementia.

Keep your cool this holiday season and all year long

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The holiday season is stressful for everyone, but especially for caregivers. Here’s a list of my favorite ways to destress any time of the year.

  1. 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.
  2. 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.
  3. 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.
  4. 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 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.
  5. 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.
  6. Two handfuls of cashews (make that a small handful, please; one ounce of cashews contains 157 calories.) provide the equivalent mood-boosting effect as a therapeutic dose of Prozac because they are one of the highest natural sources of tryptophan, the precursor for serotonin, the feel-good neurotransmitter.
  7. Did someone mention dark chocolate? It reduces cortisol, the stress hormone that causes anxiety symptoms. Just a couple of pieces should do the trick.
  8. 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.
  9. Light candles and play relaxing music while you eat. It will change the mood instantly.
  10. 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.
  11. 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.
  12. 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!

Have a safe, healthy, and fun holiday season, and many blessings for a year filled with ease and peace.

For dozens more tools and techniques for reducing stress, uplifting mood, supporting your immune system and finding ways to connect on a spiritual and emotional level with the person you care for, read Calmer Waters: The Caregiver’s Journey Through Alzheimer’s and Dementia.

15 Ways to Help You Deal with Caregiver Guilt

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You spend countless hours taking care of your loved one and have given up so many things. So why do you still feel guilty about not doing enough? Why do you continue to second-guess yourself?

You may ask yourself Am I doing enough? Did I make the right decision? What if… what if…? Here are ways to recognize your feelings, tips for accepting them, and ways to forgive yourself.

Why do you feel guilty?

  • Do you feel that you aren’t doing enough for your care recipient? Make a list of everything you do for the person you care for. Preparing a meal, shopping for groceries, driving to appointments, making a bed, doing laundry, making a phone call, sitting next to the person, even just giving a hug: the list adds up! You are doing a lot more than you think you are!
  • Are you guilty about your negative feelings? Resentment, anger, and grief are all normal. They are just feelings and they aren’t wrong. Feelings are complicated and you are entitled to them. You probably love the person you are caring for but the time you spend is precious and you might rather be outside gardening or hiking or traveling.
  • Do you feel bad about taking time for yourself? Don’t! If you don’t stay well, including eating and sleeping well, there’s a good chance you will get sick. And that is not going to help anyone! Please take some time for yourself. If you are a full-time caregiver, at least take a 15-minute walk every day. Get some respite care. Your local county social services department can most likely provide you with some options for help.
  • Are you feeling inadequate as a caregiver? The Alzheimer’s Association offers free classes on caregiving. “The Savvy Caregiver” is an excellent five-session class for family caregivers. It helps caregivers better understand the changes their loved ones are experiencing, and how to best provide individualized care for their loved ones throughout the progression of Alzheimer’s or dementia.
  • Do you resent losing personal time for meeting with friends, exercising, painting, playing an instrument, or traveling? It’s normal and natural to feel like you’re missing out on the things that bring you enjoyment. Try to carve out at least an hour or two a week where you can do whatever you want to do.
  • Do you have unresolved issues that stem from your childhood that get in the way of your feelings for the person you’re caring for now?
  • Are you comparing yourself to other caregivers? For instance, if you’re in a caregiver group you may be in awe of the amount of time another caregiver spends taking care of a spouse or how many hours she sits next to her husband in a memory care home. You are YOU, you’re unique and have different needs, a different history, and a different relationship with the person you’re caring for. Don’t compare yourself with anyone.
  • Do you have past unresolved issues with the person you’re caring for?

Tips for easing guilt

  • Ask yourself what’s bothering you. Talk with a close friend who will not judge you, or with a professional therapist, clergyperson, spiritual teacher, or intuitive guide. Talk about your guilt until you feel your body release the tension that is stored in your muscles and cells.
  • Remember that you are human and not perfect. No one expects you to perform with absolute clarity and grace all the time.
  • You cannot control everything all the time. You are doing the best that you can with the information, strength, and inner resources that you have.
  • Join a support group. Caregivers share many of the same problems and issues. A support group meeting can be a safe place where you will not be judged.
  • Have an “empty chair” dialogue by speaking out loud and pretending that your care partner is in the chair next to you. Express your feelings openly and wholeheartedly. Ask for forgiveness if you feel that you wronged your loved one in any way.
  • Write down your thoughts and feelings. Journaling is a wonderful, inexpensive way to release your concerns and worries on paper. It’s available when your therapist and best friend are not, and you can do it anywhere at your leisure.
  • Strong feelings of guilt, remorse, and grief will diminish over time.  If they continue to haunt you, seek professional help.

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.

When surgery is recommended for a person with Alzheimer’s

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Caregiver holding elderly patient’s hand in hospital bed

Surgery is scary for everyone. But when the patient has Alzheimer’s it can be traumatic. Someone with Alzheimer’s may feel frightened and confused by a new environment and by people they don’t know. They may not understand what is happening to them. Their normal routine will inevitably change, as well as their diet. The list goes on and on.

If your loved one’s doctor is recommending surgery, you’ll want to ask a lot of questions because being in a strange environment will likely cause anxiety (although some patients with dementia might enjoy the special attention). And getting general anesthesia can cause dementia to worsen.

A study published on the Fishman Center for Alzheimer’s Research Foundation’s website found that about half of the patients undergoing surgery at the Marques de Valdecilla-IDAL University Hospital in Spain showed declines in cognitive skills after their hospital stays. https://content.iospress.com/articles/journal-of-alzheimers-disease/jad191229 But those who had high levels of beta-amyloid, consistent with an increased risk for Alzheimer’s disease, fared the worst on measures of memory. All the patients were older than 65, and none had dementia before their surgery. https://www.alzinfo.org/articles/prevention/major-surgery-may-accelerate-the-slide-into-alzheimers-disease/

However, Duke University researchers recently found that “in over 100 patients undergoing a wide variety of major surgery types under general anesthesia, we found no correlation between post-operative changes in thinking/memory and in Alzheimer’s disease-related biomarkers in the fluid surrounding the brain and spine . . . This should be a reassuring message to anesthesiologists, surgeons, older surgical patients and their family members,” said lead author of the study Miles Berger, M.D. https://corporate.dukehealth.org/news/no-link-between-cognitive-changes-alzheimers-markers-after-major-surgery

Things to consider

  • Plan a consultation with the doctor to discuss the specifics, and have an honest discussion. Is the surgery absolutely necessary? What might happen if your loved one does not undergo surgery? Will the surgery provide a better quality of life, i.e. reduce pain and increase mobility? Prolong the person’s life? What is the worst-case scenario if they do not undergo surgery? Is there an alternative solution to the problem, i.e. complementary medicines and/or modalities such as acupuncture or biofeedback? Ask if you can record the discussion in order to review it later. Consider getting a second opinion.
  • If your family member plans to go ahead with the surgery, look for a hospital that has adopted the ACS Geriatric Surgery Verification Program. The medical community is starting to recognize that a routine surgery for an adult may be very different for an older patient, especially one who has dementia. The Geriatric Surgery Verification (GSV) Program has 32 surgical standards (two of which are optional) designed to improve surgical care and outcomes for older adults. Optimizing surgical care for older adults is critical, as patients 65 years and older account for more than 40% of all inpatient operations (and increasing).https://www.facs.org/quality-programs/accreditation-and-verification/geriatric-surgery-verification/
  • Before surgery make sure all the legal papers are signed and in order such as a DNR (do not resuscitate), POA (power of attorney), etc., and that you hand over the appropriate signed documents to the medical facility or doctor.
  • If your loved one falls and breaks a hip, or is injured in an accident, you will have to make swift decisions. Keep a copy of the important documents mentioned above in your glove compartment. Be prepared for the patient to experience “delirium” afterward. This is common among people with Alzheimer’s who need general anesthesia. Stay calm. There’s a good chance the patient will recover and revert back to their usual state. However, as mentioned above, 50% of older patients who undergo surgery show cognitive decline afterward.
  • If the surgery is pre-scheduled do everything you can to make the hospital experience as easy as possible. Bring favorite “toys”, music, clothing, foods, etc. Have someone who is comfortable with the patient, and whom the patient is comfortable with, stay overnight, if possible.

Patient delirium

Delirium after surgery is common for older people and those with Alzheimer’s disease. It’s a byproduct of anesthesia and the stress of being in an unfamiliar environment where there’s a steady flow of nurses and care providers coming in and out of the room. Remind the nurses to introduce themselves when they come in to care for your loved one. This will help make the experience less stressful.

Your loved one may not remember that they had surgery. Let them know what it was for and that they’ll get better. Tell them where they are, who will visit or already visited, and how long they will be in the hospital.

Try to distract your loved one if they don’t understand what is going on, and if they try to get out of bed. If they normally watch TV, watch it together. Put on their favorite music, or read to them. Aromatherapy essential oils are wonderful for calming down someone with anxiety and agitation.

Aromatherapy

Aromatherapy can be a resource of comfort to you and your care partner by providing an easy, natural way to reduce stress and anxiety and uplift mood. To make sure you are buying a pure essential oil and not synthetic fragrance oil, look for the botanical name of the plant and the phrase “pure essential oil” on the label. Essential oils can be used in a wide variety of ways, but the most common methods are by inhalation or topical use, such as lotion, body oil, or in a bath. My favorite method which I used for my husband is an electric micro-mist diffuser, and available by mail order or at health food stores. These disperse essential oils into the air in a cool mist or can be gently warmed in a candle-heated aroma lamp that releases the aroma into the air. Another easy way is to add 30-40 drops of essential oils to a 4-ounce water spritz bottle. Favorite oils for reducing stress and anxiety include: lavender, Holy basil, clary sage, geranium, rose, and ylang ylang. Citrus oils uplift the mind and emotions, relieve stress and anxiety, and are useful for appetite support: bergamot, grapefruit, lemon, and orange.

Aromatherapy is also great for caregivers!

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 ways for caregivers to reduce holiday stress

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Happy holidays! Thanksgiving is almost here! It’s almost inevitable that most of us feel more stressed during the holiday season. There’s always so much to do if you’re planning to get together with friends and family. And for those who are grieving or alone, the stress can be debilitating. If you’re a caregiver, you’re undoubtedly even more stressed.

The most important thing is to take care of YOU. If you get stressed and exhibit anxiety, those around you are going to feel it. It becomes a vicious cycle. You get stressed, and then the person you care for may get irritable, nervous, or anxious.

Make this your mantra: eat healthily, drink water, take a daily walk, and sleep well. It sounds easy, but how do you do that when your time is limited and you feel stretched in every which way.

Or how do you take care of yourself when you’re so depressed it’s hard to get out of bed? (This is a huge topic that I won’t address here, but you might want to read: Have you tried any of these natural ways to combat depression? https://barbracohn.2018/10/03/have-you-tried-any-of-these-natural-ways-to-combat-depression/

  1. Make a pot of soup that will last several days. Lentil, split pea, vegetable, chicken, butternut squash, and tomato soups are chockful of goodness. See below for a yummy recipe.
  2. Do you really need to drink 8 glasses of water each day? According to an article that recently appeared in the New York Times, the answer is no. It depends on a lot of things: how big you are, how active you are, and how much liquid you’re getting through foods and other drinks such as tea and coffee. I had always thought that caffeinated tea and coffee dehydrate you. But according to this article they don’t. Juicy fruits such as oranges, melons, and pears (not to mention summer fruits), contribute water to your total intake. Just make sure that you’re drinking enough so that you don’t get to the point where you feel thirsty or where your lips feel dry.
  3. Exercise is vital to overall health and stress reduction. Whether you live in a cold or hot climate, dress appropriately and find at least 15 minutes a day to get outside and walk.
  4. Show your care partner (the person you care for) a bit of extra attention if you’re able to. Take them for a drive to see holiday lights. Have an afternoon tea in a charming café. Visit your care partner’s best friend, or have them come for a visit. Buy a new CD of their favorite music and play it for them. Light candles at dinnertime. Have them help you with decorations, if possible.
  5. Plan a visit from a music therapist or animal-assisted (AAT)therapist, or find out where you might find them visiting facilities.
  6. Aromatherapy can be a resource of comfort to you and your care partner by providing an easy, natural way to reduce stress and anxiety and uplift mood. To make sure you are buying a pure essential oil and not synthetic fragrance oil, look for the botanical name of the plant and the phrase “pure essential oil” on the label. Essential oils can be used in a wide variety of ways, but the most common methods are by inhalation or topical use, such as lotion, body oil, or in a bath. My favorite method which I used for my husband is an electric micro-mist diffuser, and available by mail order or at health food stores. These disperse essential oils into the air in a cool mist or can be gently warmed in a candle-heated aroma lamp that releases the aroma into the air. Another easy way is to add 30-40 drops of essential oils to a 4-ounce water spritz bottle. Favorite oils for reducing stress and anxiety include: lavender, Holy basil, clary sage, geranium, rose, and ylang ylang. Citrus oils uplift the mind and emotions, relieve stress and anxiety, and are useful for appetite support: bergamot, grapefruit, lemon, and orange.
  7. Making art can help you regain a sense of balance. If you’re feeling out of control, and are inclined to create art, set aside a table just for art and make it sacred. Gather your materials and have them easily accessible so that the space is prepared for you to focus on the “now” without a lot of distraction. It’s amazing how making art can melt stress once you get into the creative zone. The same goes for playing an instrument. It doesn’t matter what is going on in the world or how I feel, when I sit down at the piano, everything becomes part of the past and I’m able to enjoy the moment. It actually becomes a meditation.
  8. Speaking of meditation, the buzzword these days is “mindfulness.” There are numerous apps and classes that can teach you how to stay present and act with kindness and compassion. You can also take a meditation class such as Transcendental Meditation, where you learn how to meditate twice a day for 20 minutes. TM has been proven to reduce blood pressure, and help the body recharge by reducing stress. It’s easy and anyone who can think a thought can do it.
  9. Keep it simple. You don’t have to make an elaborate feast (unless you’re a cook and love to do that) to make the holidays special. If you want to make it really easy on yourself, order a meal for the number of people at your table. Grocery stores like Whole Foods provide dinners that are yummy and healthy (and yes, a little expensive). Or make the essentials and buy a pie.
  10. This holiday season stop and smell the flavors and enjoy the little things: a walk in the woods, a new baby’s smile, a toddler’s romp, a new sweater, or a pair of socks. Get out the photo albums and reminisce. Watch funny YouTube videos of animals and children. Watch a comedy together. Borrow your neighbor’s dog to take on a walk. Walk in the snow (please wear treaded boots so you don’t fall). Enjoy the moment because time passes quickly and what’s here this year may not be here next year.

While most families are hoping to get together for the first time in a couple of years due to COVID, it’s important to keep abreast of the latest health and safety directives in your area. The number of COVID cases is on the rise again. Please wear a mask when flying, traveling by train or bus, and when you’re in crowded places such as a grocery store. Get a COVID booster and seasonal flu shot. If you feel sick, please stay home! There’s nothing like exposing your loved ones to an illness and having them get sick to make you feel guilty and everyone stressed.

One of my favorite soup recipes to enjoy throughout the winter

Pasta y Fagioli—a one-pot meal, 4 servings

  • 2 tbsp olive oil
  • 1 large onion, chopped
  • 3 carrots cut into 1/4 inch pieces
  • 2 stalks of celery, cut into 1/4-inch pieces
  • 1 leek, peeled and cut into 1/4-inch pieces (discard the top, tough stalk or keep to use when making vegetable broth)
  • 1 zucchini, cut into 1/4-inch pieces
  • 1 yellow squash, cut into 1/4-inch pieces
  • 2 large garlic cloves, finely chopped
  • Herbs of your choice: basil or thyme
  • 1 28-ounce can of chopped tomatoes
  • 1 quart of stock –vegetable or chicken. Add water if needed to cover the veggies
  • 2 cans of white beans (navy, butter, or cannellini)
  • 8 oz of pasta of your choice
  • salt and pepper to taste
  • Grated parmesan cheese

Heat the oil in a soup pot on medium. Add the onion and cook for about 5 mins., occasionally stirring. Add the other vegetables, until they begin to soften, about 8 minutes. Stir in the garlic, and cook for 2 minutes. Add the broth and tomatoes and their juice.

Separately, cook the amount of pasta you want to put in the soup. Keep the pasta separate or it will turn to mush. Add a serving of pasta to the soup and top with grated cheese. Serve with bread and salad. Delicious!

Happy Thanksgiving!

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.

How to increase GABA, your brain’s calming chemical

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Everyone is stressed out these days. But caregivers are dealing with pandemic stress on top of normal caregiving stress. And if you live in the West, you may be dealing with the stress of being evacuated because of wildfires, or smoke that is hampering your ability to breathe. Ask yourself this:

Are you feeling stressed and burned out?

Are you unable to relax or loosen up?

Do you feel stiff? Are your muscles tense?

Do you have a hard time falling asleep because your mind keeps racing?

If you answered yes, you could use of a boost of GABA.

What is GABA?

Gamma-Aminobutyric acid (GABA) is an amino acid that is produced in the brain and acts as a neurotransmitter, communicating information throughout your brain and body. GABA inhibits nerve cells from firing, and helps us to feel balanced, calm and relaxed.

GABA also:

  • Reduces mental and physical stress
  • Reduces anxiety
  • Eases muscle tension
  • Creates a calm mood
  • Supports balanced blood pressure
  • Promotes restful sleep
  • Regulates muscle tone
  • Uplifts mood

What are neurotransmitters?

Neurotransmitters are the brain chemicals that communicate information throughout your brain and body. The brain uses neurotransmitters to tell your heart to beat, your lungs to breathe, and your stomach to digest. They can also affect mood, sleep, concentration, weight, and can cause adverse symptoms when they are out of balance. Neurotransmitter levels can be depleted many ways. It is estimated that 86% of Americans have suboptimal neurotransmitter levels. Stress, poor diet–protein deficiency, poor digestion, poor blood sugar control, drug (prescription and recreational), alcohol and caffeine can deplete them. (Emmons, The Chemistry of Joy, 2006).

What depletes GABA?

Too many carbs and refined foods, and certain drugs and medications deplete GABA. If you rely on tobacco, marijuana, alcohol, Valium, sweets or starch, you probably have a GABA imbalance

A GABA deficiency often results in:

  • High anxiety, panic, worry
  • “Monkey mind” or a racing mind.
  • Difficulty falling and staying asleep

5 Ways to Boost GABA

  1. Eat these foods

The best foods for helping your body produce GABA, according to a May 2018 review published in Nutrients, include:

  • Cruciferous vegetables (broccoli, cabbage, cauliflower, Brussels sprouts)
  • Soy beans
  • Adzuki beans
  • Mushrooms
  • Spinach
  • Tomatoes
  • Buckwheat
  • Peas
  • Chestnuts
  • Sweet potatoes
  • Sprouted grains
  • Rice (specifically brown rice)
  • White tea

Fermented foods including kefir, yogurt, tempeh, sauerkraut, kimchi, and pickles help increase GABA levels. These foods may also boost GABA: whole grains, fava beans, soy, lentils, and other beans; nuts including walnuts, almonds, and sunflower seeds; fish including shrimp and halibut; citrus, tomatoes, berries, potatoes, and cocoa.

2. Meditation and yoga have a positive effect on GABA levels.

3. Passion flower, lemon balm and valerian help support GABA, and help you fall asleep if your mind is on overdrive. Infuse them in hot water for a soothing herbal tea.

4. Nutritional supplements support GABA. Make sure you let your physician know which supplements you take, since some may interfere with medications.

L-theanine is a relaxing amino acid found in green tea. It’s available as a nutritional supplement, or get it by drinking green tea.

Magnesium is the most important mineral for the heart, It supports healthy blood pressure, decreases food cravings, balanced blood sugar, nourishes and calms the nervous system, and protects the body from damage of stress. Besides food, Epsom salt baths are another way of getting magnesium–absorbed through the skin. Magnesium is found in dark, leafy greens, dark chocolate, avocados, nuts, legumes, tofu, seeds, whole grains, bananas, and some fatty fish.

Taurine is an amino acid that activates GABA receptors and encourages the release of GABA. It is found in dairy food, shellfish, and the dark meat of turkey and chicken. It is also taken as a dietary supplement.

GABA is available in amino acid from as a dietary supplement. It is questionable, however, if it is able to cross the brain barrier.

5. Exercise, and being outdoors, paying attention to your personal needs are important.

How to boost all your neurotransmitters

  • Eat a serving of high-quality protein with every meal and snack. Focus on complex carbohydrates, and eliminate junk foods (refined carbs).
  • Enjoy unlimited amounts of fresh veggies.
  • Eat a good breakfast!
  • Eat 3 balanced meals and 1-2 healthy snacks per day.

Complex carbohydrates, such as sweet potatoes, brown rice or oatmeal, allow your brain to gradually process more serotonin, the neurotransmitter that keeps us happy. 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.

For more information about how to prevent caregiver burnout and ways to boost your neurotransmitters, visit: https://barbracohn.com/2019/07/03/preventing-caregiver-burnout-with-good-nutrition-and-foods-that-support-neurotransmitters/

Recommended Reading

  1. The Mood Cure, Julia Ross, MA
  2. The Edge Effect: Achieve Total Health and Longevity with the Balanced Brain, Eric Braverman, MD
  3. The Chemistry of Joy, Henry Emmons, MD
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.

Should you move a family member back home from a care facility?

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I'll have to learn to walk againAccording to the New York Times (April 17, 2020), about a fifth of U.S. virus deaths are linked to nursing homes and other long-term care facilities. That’s about 7,000 people.

It’s an extremely difficult time for families who have a loved one in a care facility. You’re not able to visit, and you and your loved one might be missing the physical touch that we as humans crave.  You might be too overwhelmed with caring for others at home to make the drive to the care facility, only to be allowed to peer through a window and touch hands separated by glass.

Two of my friends recently lost a parent who was in a nursing facility. Their parents didn’t die from Covid-19. One died from Alzheimer’s (yes, Alzheimer’s is a fatal disease) and the other had dementia and was recovering from a broken pelvis. Neither friend was able to get to the facility in time to say good-bye, partly because of the imposed lock-down on these facilities.

You might be worried that your loved one will contract Covid-19. What should you do?

Should you move your loved one home?

  • Consider why you moved your loved one to a care facility in the first place. Are you able to safely care for him/her at home?
  • How is your health? Have you been sick? Do you have a chronic condition that prevents you from taking on added stress?
  • Are you overwhelmed caring for children who are doing online schooling?
  • Are you working from home?
  • Is your loved one mobile? Continent? Can you bathe and dress him/her? Do they need a two-person transfer?
  • Can you hire in-home care? This option comes with the risk of having an outsider who has possibly been exposed to Covid-19 come into your home.
  • A person with dementia might have compounded anxiety during the pandemic. Anxiety increases when a person with dementia has their routine disrupted. The individual may not be able to understand what is going on, but pick up on the stress of those around him/her. Would you have the patience and time to devote to caring for such an individual?
  • Be honest with yourself, and consider your own health, psychology and emotional well-being.

If moving your loved one is out of the questions, consider these tips from The Alzheimer’s Association.

If your loved one is in a care facility:

By now, almost all care facilities are not allowing visitors through the door. 

  • Check with the facility regarding their procedures for managing COVID-19 risk. Ensure they have your emergency contact information and the information of another family member or friend as a backup.
  • Do not visit your family member if you have any signs or symptoms of illness.
  • Depending on the situation in your local area, facilities may limit or not allow visitors. This is to protect the residents but it can be difficult if you are unable to see your family member.
  • If visitation is not allowed, ask the facility how you can have contact with your family member. Options include telephone calls, video chats or even emails to check in.
  • If your family member is unable to engage in calls or video chats, ask the facility how you can keep in touch with facility staff in order to get updates.

What if the care facility has or had Covid-19 incidences?

  • Ask the facility about their quarantine procedures. What is your level of confidence that CDC guidelines are being followed?
  • How many people in the facility have been impacted by COVID-19? Are those affected staff, residents or both?
  • Is your family member able to follow social distancing procedures (with or without help)?
    • In some cases, the person may not be able to walk or move about on their own. This could help maintain social distancing.
  • Does the facility have and use personal protective equipment?
  • How many staff members interact with your family member on a regular basis? Is the facility able to limit the number of staff who work with your family member?
  • Is the facility adequately staffed to provide the level of care your family member requires?

The Centers for Disease Control has issued these guidelines for nursing home visitation in the wake of the COVID-19 outbreak:

Limiting Visitation: For facilities that are in counties, or counties adjacent to other counties where a COVID-19 case has occurred, we recommend limiting visitation (except in certain situations as indicated above). For example, a daughter who visits her mother every Monday, would cease these visits, and limit her visits to only those situations when her mom has a significant issue. Also, during the visit, the daughter would limit her contact with her mother and only meet with her in her room or a place the facility has specifically dedicated for visits.

Facilities should actively screen and restrict visitation by those who meet the following criteria: 1. Signs or symptoms of a respiratory infection, such as fever, cough, shortness of breath, or sore throat. 2. In the last 14 days, has had contact with someone with a confirmed diagnosis of COVID19, or under investigation for COVID-19, or are ill with respiratory illness. 3. International travel within the last 14 days to countries with sustained community transmission. 4. Residing in a community where community-based spread of COVID-19 is occurring.

Be kind to yourself, and try not to feel guilty about not being able to visit your loved one. Caregiver guilt is complicated, but you are probably doing the best that you can.

This pandemic lock-down is unprecedented. Hopefully, the restrictions will lift soon and you’ll be able to be with your loved one again. Until then, take extra good care of yourself.

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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.

Gardening as therapy for caregivers and their care partners

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Senior couple gardening in the garden

Clipping vegetables and watering flowers can do wonders for the soul and have a profound effect on a stressed physiology. Horticultural therapy is a health-care specialty that uses gardening to promote physical and emotional health by creating a peaceful oasis amid the challenges of Alzheimer’s disease, or any other caregiving situation.

Therapy gardens encourage memory-impaired people and their caregivers to take a moment to smell the roses and perform tasks that magically momentarily take away their cares and worries. You might already being working in the garden, which is a natural balm for these anxiety-filled days.

If you are caregiving for a loved one at home, gardening is a great opportunity for you and your care partner to spend time outdoors, connect through memories that might arise, and de-stress. You’ll also gain the satisfaction of accomplishing something that will, hopefully, provide you with beauty, sweet scents, and/or food!

Here are some ways to include your care partner so that you both benefit—from the “Horticulture Therapy by horticulurual therapist Pam Catlin, chapter 17 in my book “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s and Dementia.

Throughout the ages people have connected over food and the garden setting provides an abundance of taste experiences through edible flowers, herbs, and vegetables.  Not all non-poisonous flowers are tasty or have a pleasing texture, however.  Some tried and true edible flowers are nasturtiums, lavender, day lilies, roses, tulips, pansies and violas.  The flowers can be used in salads, baking, decorating cakes and so much more. In caring for these flowers, chemical pesticides must be avoided.

Herbs and vegetables are a great addition to a garden and they provide another taste experience for the gardener.  Examples of easy to grow herbs are basil, chives, mint, oregano, parsley and rosemary.  Some are even perennials that will come back each year. These herbs might be enjoyed by being mixed into plain yogurt or softened cream cheese to create an easy dip to spread on a cracker.  When selecting vegetables, keep in mind that all of the solanaceous family (tomatoes and eggplant) have toxic foliage.  With close supervision, they can still be planted as most gardeners love a beautiful ripe tomato.

For those who have retained their olfactory senses, just running hands over herb plants provides a fragrance to inhale and enjoy.  Scented geraniums, grown for their foliage and not their bloom, date back to Victorian times and are now available in most nurseries in a variety of fragrances including but not limited to citrus, chocolate and rose. Particularly fragrant flowers to include in your garden are sweet alyssum, heliotrope, pansies and cosmos.

When selecting plants to stimulate the visual senses, it is important to remember that bright colors such as reds, pinks and yellows are more easily seen by older eyes than subtle, pastel colors or white.   Don’t forget interesting leaf patterns when looking for visual stimuli.  Unusual leaf patterns and colors can be found in coleus, Rex begonias and some grasses, such as zebra grass.

Consider adding some auditory elements to the garden.  Wind chimes near the patio door can assist in orienting an individual to the door’s location.  Grasses, trees, plants with seed pods, water features and bird feeders can all add a variety of pleasant sounds to the garden.

As the other senses fade, tactile stimulation becomes an important part of the gardening experience.  Selections that are surprisingly soft to the touch are dusty miller, African fountain grass and lamb’s ears.  Smooth skinned succulents provide tactile interest and can be grown indoors and (weather permitting) outdoors.  Placing plants with texture near the edges of containers or beds is an invitation to garden visitors to touch and feel as they move through the outdoor space.  If the gardener with cognitive issues is not responsive to the stimuli when touching with their fingers try running a fuzzy leaf across the cheek.  The apple of the cheek is filled with tiny nerve endings that will often be more receptive than the nerve endings in older fingers.

What you need to set up a therapy garden in your yard or porch

As the person with memory loss advances in his or her disease process, physical balance tends to become a challenge. an effective way to create a safe gardening experience is to elevate the growing areas either through raised beds or large ports. For those able to stand for short periods of time, a variety of planter heights would be ideal to support gardening while standing or sitting. rEcommended dimensions for planter height is 2′ – 2 1/2′ for sitting or 3′ – 3 1/2′ for standing. Acceptable dimensions for widths are 2′ if accessible from only one side or 4/ if accessible from all sides.

If the gardener has limited reach, avoid building materials such as bricks or block as it would be difficult to reach the soil to plant. It’s a good idea to measure what would be comfortable for the user before constructing the garden. Growing in pots or raised beds requires good planting mixes (combination of peat moss, topsoil and sand or perlite or a good quality soilless mix), regular fertilizing and plants that are no taller than 3′.

These days, many large pots are lightweight and easy to move andn place prior to filling with soil mix. Pots can be placed on rolling saucers, provided the wheels have brakes, or on pavers to help raise

Successful Plants

There are a number of tried and true plants that are safe for the garden.  For cool weather gardening, calendulas, pansies/violas, and stock add bright color.  Cool season vegetables are broccoli, cabbage, cauliflower, kale, lettuce, peas, radishes and spinach. Suggested plants for the warm season shade garden are coleus, impatiens, begonias and mint.  Good plants for warm season sunny locations would be alyssum, dusty miller, geraniums, marigolds, purple cup flower, petunias, portulaca, snapdragons, zinnias, most herbs other than mint and most vegetables other than those mentioned for cool season planting.   Bush varieties of squashes and cucumbers are best suited for raised beds and pots, as are some varieties of tomatoes.

A piece of advice when creating a garden space is to start small.  The primary purpose of this growing area is to provide peace of mind and an avenue of connection for the person with memory loss and those providing care, not food production.  A garden that provides a balance of physical activity and just being in nature is a perfect addition.

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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.

Easy art projects to do with your care partner when you’re both going nuts

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Brush point in watercolor paint closeup

If you’re a caregiver taking care of someone at home, you probably feel like pulling your hair out. It’s tough, especially if you or your care partner, or both of you are experiencing anxiety or stress.

Here are a few things you can do by yourself and with your care partner.

“Art Exercises for Caregivers” by Meg Carlson, chapter 11 in my book Calmer Waters: The Caregiver’s Journey Through Alzheimer’s & Dementia.

  1. Making an Inside/Outside Box

Materials:

  • Boxes-shoe box, tea box, metal tin, etc.
  • Mixed media-crayons, paint, markers, glue, feathers, felt, rocks,

Decorating a box allows the artist to reflect his/her persona or face that is shown to the outside world on the outside of the box. Decorating the inside of the box is an opportunity to express the internal feelings and conflicts that are private or feel too big to find words to express. Use whatever materials that are available to decorate the outside of the box, and then the inside of the box to express these feelings.

Outside Box: How do you experience being around others with your loved one? What do you share with the outside world about your process/how do you share?

Inside Box: What is really going on inside of you each day? What isn’t shared with others that have an impact on you?

What has this process, or your imagery expressed to you? What kinds of responses are you having?

  1. Daily or Weekly Mandalas

A mandala is a circular image. It begins with a circle drawn on a page. It can be any size and any media can be used.

Materials:

  • Paper: Bristol, Watercolor, or mixed media (6×6 is a great size)
  • It is small enough to be done in a brief sitting, and large enough to have room for several images or areas of focus.

Pencils, markers, watercolor, colored pencil, pastels, or crayons are all great.

A version of mandala exists in many spiritual traditions (rose windows in Cathedrals, Navajo and Tibetan sand paintings, Buddhist imagery, etc.) Mandalas can be used to support focusing attention, as a self check-in tool, to express emotions in a contained space (circle), for establishing a sacred space, and to aid in mindfulness and mediation. Carl Jung, through his own art process, came to realize that mandala paintings enabled him to identify dysfunctional emotional patterns and work towards integration and wholeness. 

  1. Color-Texture-Pattern Feelings Portrait

         This process is about awareness of how much is going on in each of us at any given moment. It is an opportunity to just GET IT OUT through color, movement, and expression. The imagery is usually abstract. It is the process of expressing that is beneficial here, not the finished product. Feelings are difficult to have, and when they are expressed visually they can be difficult to look at. But that is okay. If you use this process, when you are finished, take a moment to witness it like a loving friend. Then just set it aside. If your image invites a redo or edit, you can come back to it and work with it, even tear it up and re-create it. If not, let it go. The materials will support you to express emotions and that is their purpose sometimes …. to help you create something that is not necessarily pretty, but honest. That is their gift to you.

Materials:

  • Small to medium paper, mixed media paper is sturdy. Taped to surface is best. When you prep ask yourself, What size is my expression today? That will tell you what paper size to use.
  • Pencils, markers, watercolor, colored pencil, pastels, or crayons are all great.
  • This can be done between 5 and 25 minutes. It is simply the process of choosing colors and making textures and patterns that express the layers of feeling present. Let the speed and movement be an extension of your expression. It will be unique every time.
  1. Two Inch Window Drawing

The goal is to work with detail and discernment to create a bird’s eye view. Another way to use this tool is one of magnification, to zoom in to one aspect of something larger; examples could be to feel a single sensation, filling a small (contained) space with just what is magnified. Used as a daily or coping practice it may serve to redirect concentration or focus energy and attention, provide containment while titrating an intense sensation. They take between 1-10 minutes to complete. Think Macro and Micro… what would be most helpful, to step back or lean in?

Materials:

    • Paper: Bristol, watercolor, or mixed media (2×2 or 4×4)
    • Card stock scraps come in several colors, and can usually be found at craft stores.
    • This drawing is small enough to be done in a brief sitting, and can even be a single set of colors.
  1. Process: Journey Drawing

Materials:

  • Paper: Bristol, watercolor, or mixed media (6×6 or larger)
  • Collage materials, or a material you enjoy (fabric, craft papers, natural materials, etc.)
  • Chalk/oil pastels, pencil, watercolor

Where are you in this journey? Emotionally … physically . . .personally . . . socially? Is there stuckness . . . is there movement? What colors, shapes, textures represent where you are right now? What colors feel supportive of your journey or give you strength? What emotions are present for you about your current life, about being a caregiver? Can you think of any supportive guides/helpers that you have met along the way? How has your identity or personality been challenged or changed in this process? Who in your life is accepting these changes, who in your life are having difficulty accepting the changes?

What has this process, or your imagery expressed to you? If you had a chance to respond to it, what kinds of responses are you having? Are you in a different place in your journey than you assumed/thought/hoped? What are the qualities of where you feel you are in your journey as a caregiver? As you have moved through different stages, what has each stage offered you?

Lastly, choose a color that feels strengthening, a color that will help you move into the next stage of your journey. Now create a final piece of you drawing that will offer you strength and power when you look at it.  Be one of the helpers for yourself in this moment of your journey.

6. Process: Breath Drawing

Materials:

  • Oil pastels or chalk pastels
  • Large paper
  • Your breath
    With one color in each hand, draw your breath. Notice the qualities of your in breath (short, stunted, deep, long, interrupted, fast, shallow) and allow your hands and the colors to express it. Same with the exhale. What are the qualities present in your out breath? Move each hand/arm in a circular motion with the expression, notice how the lines change over time. Notice similarities and any shifts. Follow your own breath with soft awareness.

What has this process, or your imagery expressed to you? What kinds of responses are you having?

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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.

16 ways to help you get through the anxiety and fear of the pandemic

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Empire of the sunWe’re all experiencing some level of anxiety during this crazy time. And if you’re a caregiver, you’re dealing with your own stress and the anxiety of the person you are caring for. Watch for a blog next week about calming the person that you care for. Or, search through the archives on this site.

Here are some practical things that really work to help create order and calm.

  1. First thing in the morning when you wake up say an affirmation or prayer. “This will be a beautiful day,” “I will do the best I can,” I am strong and healthy,” ” I can get through this.” “I am strong and confident.”
  2. Create a schedule and try to stick to it. For example:
  • Shower
  • Make breakfast
  • Do an online yoga or cardio class
  • Wash clothes, clean house
  • Clean your office
  • Work on a creative project, i.e. write, knit, paint, etc.
  • Have lunch
  • Walk outside, if the weather permits
  • Etc.

It seems very simplistic, but it helps. And when you check each item off the list it adds to a sense of accomplishment.

3. Include a self-care ritual in your day. Take a bath, call a friend, do a manicure. Wash and style your hair. Whatever makes you feel good.

4. When the negative thoughts start flowing, stop them in their tracks. I heard about this technique recently from a friend, who got it from her therapist. Change the mental dialogue in your head by replacing the worst case scenario you imagine with a best case scenario. Instead of dwelling on doom and gloom, think hopeful thoughts. Of course, this technique only goes so far. If the person you are caring for has mid- to late -stage Alzheimer’s, for instance, hoping for a total recovery isn’t very likely. But you can still think positive thoughts that focus on what you cherish about the person instead of  what you dislike about his or her behavior. Or when you start to panic about what will happen to your loved one if you get sick, replace that thought with a visualization of being strong and healthy.

5. Watch a funny movie or YouTube video. There are tons of movies online, and as of today, March 20, Hulu is currently offering a free 30-day trial. The Metropolitan Opera is offering Free Live Audio Streams. Vocal artists are offering online concerts while you’re stuck at home.

6. You can work out in your living room thanks to fitness studios that are live-streaming workout classes for yoga, meditation, cardio, etc. free during the coronavirus outbreak.

7. Create a ritual of lighting a candle and playing classical music at dinnertime.

8. Use aromatherapy to calm the nerves and uplift the mood. 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. Check online for ways to order 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.

9. 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.

10. If you’re lucky to have a caring partner, give each other a massage. It’s a wonderful way to tune out the world and relax. Or do a self massage with warm oil. Olive or coconut works perfectly.

11. Avoid an excess of alcohol, caffeine and sugar. These will just make you feel more jittery in the long run, and add extra calories.

12. Avoid listening to the news before bed. When the coronavirus outbreak first occurred, I found myself glued to the news and I suffered the price. My sleep was restless and I had nightmares. Limit yourself to tuning in 2 or 3 times a day at most, for a limited period of time. Don’t keep the TV or radio on all day, and certainly not while you’re eating or before bed.

13. Limit your social media time, too. There are a lot of scary things on Facebook, etc. While it’s important to stay informed, too much information can overwhelm us and make us even more frightened.

14. Stay in close contact with family and friends. Reach out to those you haven’t been in touch with for a while. Laugh about old times.

15. Do some volunteer work, unless you are a caregiver. Your spiritual/religious community has things you can do to help others like calling congregants to check-in and see if they need anything. Or donate money to a food bank or emergency assistance organization. It’ll make you feel good.

16. It’s officially spring! Get outside and do some yard work. Plant some seeds for a spring garden and watch as the seeds sprout into nature’s gift of flowers and greens.

Stay positive and healthy. We will get through this together.

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.

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