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Information and resources for today's family caregiver."The most important things to say are often those which I did not think necessary for me to say - because they seemed too obvious." ~ Andre Guide
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"Setting Goals and Making Action Plans"
Above all, try something. ~ Franklin D. Roosevelt
The cornerstone of the six-week Powerful Tools for Caregivers (PTC) course is setting long-term goals and carrying out weekly action plans. Initially, this can seem impossible. During the most challenging of my caregiving experiences, my morning prayer was, "Lord, give me the strength to make it through this day." I couldn't imagine adding anything more to my plate..
The difference is that the goals and action plans advocated in PTC are aimed at putting pleasure back in our lives. Those who feel they can never do enough for a spouse, parent or other care receiver will also never feel they can take time for themselves. And they will eventually burnout. Whether you are a caregiver 24/7, work part-time and other family obligations tugging at you, or doing your best to be helpful from a distant city, failing to care for yourself will eventually lead to deterioration of yourself and your relationships. Care of oneself is not about selfishness, but about self-preservation.
A goal is something you hope to accomplish in the next three to six months. It can be general, i.e., "I'm going to take better care of myself," as long as you list specific objectives below it. For example:
- I will take more outdoor walks
- I will meet with at least one friend once a week
- I will only watch TV programs that make me laugh
Notice that the above list does not include things like going on a diet, losing 10 pounds, or jogging two miles a day. The key is to identify things you want to do -- what gives you pleasure? I was once at a workshop where we were asked to list 25 things that we enjoyed doing. I couldn't get beyond two. If that's true for you, too, be gentle with yourself. Start slowly and simply.. Then take one of those objectives and turn it into an action plan. The elements of a successful action plan are to choose something:
- You want to do.
- Realistically reachable during the next seven days.
- Behavior-specific (Not, "I'll take it easy," but "I will listen to my favorite music.")
- That answers what, when, how much and how often?
- That you have a high confidence level of achieving.
It's also important to state your action plan in absolute terms: "I will," not "I'm going to try to," or "I hope to" or worse, "I should." Here is an example of a well-stated, realistic action plan: I will walk (what) outdoors after lunch (when) for 20 minutes (how much) twice (how often) in the next week.
The reason for being so specific, however, is to first help you identify what may need modifying (Does a different time of day work better?) and second to see what might become a self-care habit. Walking outdoors can offer enormous health benefits. By proving you can do it once, and figuring out when and how far and how often works for you, you will want to try it again the following week. Habits come from adding specific actions to our routines.
The final step in writing an action plan is to state your confidence level. If I were to say, "I will walk 2 miles after breakfast for the next 7 days," my confidence level would be zero on a scale of 1 - 10. I know I'm not going to get there. My confidence level for "I will walk outdoors after lunch for 20 minutes twice in the next week," is more like 9 or 10. It seems achievable. If you create an action plan and give yourself a confidence level of 6 or 7 or less it generally means that either this is something you don't really want to do, or that you have set a too rigorous standard for achieving. Look for ways to modify the plan, or scrap it and decide on something else with a greater chance of success.
Many people struggle with making action plans that bring them pleasure. In our PTC classes some people begin with what seem like "shoulds" to the rest of us - hanging a chandelier, going through boxes of papers that need filing. By the end of the six weeks, however, they tend to be having as much fun as the others. And that is the final guideline for action plans: They work best when shared with someone. Peer pressure is an enormous motivator. If you are not part of a group that meets regularly and to whom you could report your success, share your action plan each week with a good friend or favorite relative who can be an encouraging coach. Ask him or her to call you during the week to see how you are progressing with your action plan, and then at the end of the week to give a report on your achievements.
Accompanying this article is a form for you to download and fill out each week with your personalized action plan. We wish you success. Remember the words of Thomas Crum: Change does not take time. It takes commitment.
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"Choosing the Right Physician"
by Daniel Kuhn, MSW, Mather LifeWays Institute on Aging
Caregivers deserve the help of competent and compassionate health care professionals. A physician is essential in providing a range of services from
conducting a diagnostic evaluation to prescribing treatment and recommending options at the end of life. Finding a physician who is well versed in the medical condition affecting your loved ones and its impact on you and your family must be a top priority.
Medical care of older persons, known as the field of geriatrics, is not a favorite specialty of the vast majority of physicians. After all, they are trained to identify and cure illnesses and promote health. They are often frustrated, like most of us, by conditions that do not respond to medical intervention. At best, physicians can help improve the quality of life for individuals with irreversible medical conditions and can support family caregivers. At worst, physicians can inadvertently create problems for all concerned. The caregiver is in a key position of judging the physician's effectiveness and choosing who serves the best interests of both the individual and the family.
Fortunately, there is a growing number of physicians who are oriented to the psychosocial needs of those affected by chronic conditions such as Parkinson's disease, stroke and dementia. First of all, these physicians recognize that the family is the main provider of care and accept that their own role is limited to being an expert consultant. This approach is not only realistic and practical but helpful too. Second, these physicians make a point of communicating with families by listening to their needs; they take the time to teach them and explain treatment and non-treatment options. They enable families to participate fully in decision-making.
While physicians should take the lead in weighing the risks and benefits of interventions, they should emphasize a conservative approach. They are mindful of the limits of medicine. For example, they caution against aggressive treatment and take into account the physical, emotional, and spiritual needs of all concerned. Finally, these physicians stress the need for caregivers to take of themselves and encourage the use of respite services. In short, helpful physicians understand their role in working with families as partners in care.
Dissatisfaction with health care is growing in the United States for a variety of reasons. Good care is no longer taken for granted by most of the consumer-oriented public. However, some people remain loyal to their physicians despite consistently poor service. Since chronic illnesses may last for many years, it is necessary to have confidence in a physician who can be trusted over the long haul. It may be necessary to "shop around" for the right physician. A long-term relationship with a knowledgeable and sensitive physician will ease the burden of care while someone without these qualities will complicate matters.
Caregivers and persons who are cared for benefit by having a physician whose experience and expertise are used in their service. Caregivers do themselves and their chronically ill loved ones a favor by choosing a physician who knows how to be a true partner in care.
Do you have questions or need more information regarding Mather LifeWays Caring with Confidence or Powerful Tools for Caregivers?
Email: askdan@matherlifeways.com or call (847) 492-6775.
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