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A publication of Affiliated Employee Assistance Program Nov/Dec 2004
Caring for Those You Love
By Liz Ashe
November 2004 is National Caregivers Month.
Years back I read an article about baby boomers (those born between 1946-1965).
The gist of the article had to do with a large population of folks whose needs
shape much of what goes on in the United States. The only quote I remember
was “When baby boomers sneeze, the country buys Kleenex.” Have
you noticed small appliances are starting to look much like the stainless steel
ones of the 50’s? And Fiesta Ware and Depression glassware are being
reproduced. Auto manufactures are building look-a-like VW Beetle cars, PT Cruisers
and now there is a Chevy Truck that looks like the old ones. All are efforts
to appeal to the nostalgia of the boomers as they age and think of the “good
ole days.”
Well the baby boomers have sneezed again. These folks are facing caregiving
challenges. Our aging society has about 32 million people over the age of 65
and three million are 85 or over. The good news is we have our loved ones longer.
The down side is that half of the elderly require daily assistance or 24-hour
care. Eight percent of all care provided to older people in our country is
provided by family members. Only 5% at any one time are institutionalized.
According to one estimate from the Travelers Group Insurance Company, as many
as 40% of all workers over the age of 30 now care for an aged parent/relative.
And there are an increasing number of grandparents, aunts and uncles (average
age 59) who are raising grandchildren, nieces, and nephews to keep
them out of foster care. Not only are these workers caregivers, but they also
have extensive other family and life responsibilities. More than 40% also care
for children under 18.
Caregivers dedicate on average 18-22 hours per week to provide care for older
persons and even more when the person has multiple disabilities.
WHAT IS A CAREGIVER: Anyone who provides unpaid assistance to an adult family member or friend who is frail, ill, disabled or just needs some help. A grandparent, aunt, uncle, or other family member who cares for children born to relatives.
Caring for someone you love is rewarding, but also presents many challenges
and having the responsibility of caregiving can feel like an emotional minefield.
There may be guilt because you may resent all the responsibilities or decision-making.
There may be anger and/or resentment if other family members aren’t helping.
Problems may surface in a relationship because of the time spent caring for
others. If Alzheimer’s or dementia is present you feel grief because
your loved one is with you physically, but not mentally. And it is painful
to deal with the gradual loss of losing someone you love.
Many caregivers lose time at work or are less productive due to stress or an
inability to concentrate. Some have to decrease work hours, take family medical
leave, or get done entirely, and may suffer financial difficulties.
Juggling work, home, and caregiving can be exhausting. And it can take a toll
on caregivers. Sleep deprivation is common and caregivers may experience personal
health problems.
Psychologist Janice Kiecolt-Glaser, Ph.D. and a team of researchers at Ohio
State University College of Medicine in Columbus monitored the immune system
of 31 men and women caring for relatives with Alzheimer's disease. Compared
to non-caregivers, the subjects' immune responses were significantly depressed,
suggesting they were less able to ward off infectious diseases. No one functions
at their best when experiencing the cumulative stressors involved in caregiving.
Caregivers, especially if caring for a spouse, tend to let their cup get empty
before they ask for help….some never ask for help.
DO YOU:
? Provide transportation for errands or appointments?
? Help with grocery shopping or picking up prescriptions?
? Help manage an adult family member or friend’s money (like bills, medical
insurance matters, and or checking account)?
? Provide emotional support and companionship?
? Help clean, or make household repairs because a family member or friend can’t
do them anymore?
? Check up on someone who lives alone in another state?
? Call a family member or friend once a day to check up on them?
? Stop by a friend’s house to see if they need something from the grocery
store?
? Organize home health care or participate in giving medical or nursing care
at home?
? Help with personal care (like dressing, bathing or feeding) that an adult
family member or friend can not longer manage easily?
? Take care of someone in your home?
? Have medical power of attorney for a loved one?
? Provide meals for a family member or friend?
? Take care of or raise a relative’s child?
? Administer medications or monitor what a person takes?
If you do, you are a caregiver. Caregiving although rewarding, can be very
stressful. and overwhelming.
SELF-CARE HELPS PREVENT BURNOUT
•
Learn ways to balance your caregiving time with your personal, family and work
life.
•
Don’t let your loved one take center stage all the time.
•
Accept any feeling (guilt, anger, frustration, and helplessness) as normal
but try to focus on the personal satisfaction that comes from helping a loved
one.
•
Talk with your loved one about his/her needs and your needs and discuss ways
to balance each.
•
Be good to yourself by exercising, getting enough rest, and eating healthy
foods.
•
Watch out for signs of depression and don’t delay getting help if needed.
•
If you feel trapped or “burned out” take a break from the caregiving.
Hire help when possible or ask others for help.
•
Set priorities at work and home so that you don’t get bogged down.
•
Schedule quality time with the other people in your life who need you. Don’t
put your family or friends on a back burner all the time.
•
Rearrange commitments creatively and cluster appointments if possible.
•
Talk to your employer about your caregiving responsibilities and talk of ways
to balance these with your job.
•
Schedule quality time for yourself. Do something fun and enjoyable.
•
Get help with managing the financial impact of caregiving.
•
Do not increase your intake of alcohol or drugs to cope.
•
Don’t try to do it all. Accept help when it is offered. Ask for help.
•
Get expert advice and support. Call your EAP.
If you are having difficulty as a Caregiver,
EAP can help. Your EAP is a confidential, assessment, short-term counseling
and referral program for you and your family members. It is a free benefit
provided to you by your organization. Call 1-800-451-1834
1-800-451-1834
A publication of Affiliated Employee Assistance Program
May/June 2004
Loving and Losing By Liz Ashe
Like many people, I have read numerous self-help, inspirational, motivational and up-lifting books and articles. I have read books to help heal wounds and emotional scars as well as holistic remedies for just about every ache/pain and mood swing. I’ve listened to tapes and prayers and spiritual lessons. I have watched movies about horrific life stories some with miraculous happy endings and many with tragic endings. And I have had bad things happen to friends, neighbors, family members and myself.
But one thing is very clear to me…..you can’t predict how you will feel or act until “it” happens to you. And a situation that you handled well (or badly) in the past does not predict how you will handle a very similar situation in the future. For example a broken relationship may seem like the end of the world in one situation, but at another time, reason to celebrate. A job loss in one circumstance may be crippling, but at another time an opportunity for something bigger and better.
A few years ago, a friend of mine, a very positive, upbeat person who usually turns upsets around quickly, fell in love. She at the time was writing a book, You Are One Minute Away From Feeling Better and as a “Well-Being Coach,” was giving motivational speeches throughout New England. My friend spoke to audiences about positive thinking and moving on.
Everything in her life seemed beautiful and she was gloriously happy and she expected to make a lifetime commitment with the man she loved.
But it didn’t work out that way. He left her to return to his ex-wife. Her world turned upside down and her grief was overwhelming. Months and months of pain, tears, anger, depression, feeling listless, not eating, and prayers led into two plus years of healing.
She told me, “The concepts I taught are all great in theory. But in the middle of pain and grief and loss, it isn’t so easy to do. I didn’t want to do things, like exercise, I knew would help. All my recipes for joy and stress free living seemed farfetched. Nothing seemed to work in the midst of my intense emotional pain. Oh I sometimes found something to distract my thoughts or ease my feelings for a moment, but the thoughts came back and the pain and anger returned.”
TIME
Time seems to be the operative word to healing. Time changes the look of almost everything….it may sound simplistic, but it’s true. The hurts we suffer fade after awhile and our energy and zest for life returns. I’m not saying you forget; I’m saying you eventually move through the pain. We’ve all been hurt or have lost someone we love. It’s not horrible to have loved and believed in someone. You may think you have been taken in (even used) but trusting and loving means you allow for some unknowns. The world isn’t neat – it’s kind of messy when you think about it…But kind of messy means life has many possibilities and lessons. We learn from bad or painful experiences and if lucky, we become stronger. Most self-help gurus espouse to this same concept and often our toughest times do teach us something valuable, eventually. My friend believes there are no accidents in this universe and over and over she said, “There has to be a life lesson in this for me.” I spoke with her recently and she said, “I think I finally know my lesson and that is to be more patient with people who are grieving. I used to think people should just get over it and be happy. I now know it isn’t always so simplistic or easy.”
GRIEF
Loss can burst into the best of relationships, either through death, divorce or breaking up. The grief from this can be one of the most excruciating pains a person can endure. When we lose someone whose life was lovingly and thoroughly enmeshed with ours, we are engulfed by something far deeper than daily normal disappointments or frustrations.
The pattern of our world is shattered. We feel the solid earth under our feet crumbling and we feel we have nothing to hold onto.
Bereaved persons do not function in their usual manner. When our feelings receive a cruel blow, we react any number of ways. With such sorrow we can’t expect to function normally. When stricken by grief, we suffer from a disease of the emotions. And it is extremely important to feel the feelings…. Too many people want to run away from their pain or mask it.
Before healing can take place, we must allow ourselves the luxury of falling apart. By fully experiencing our feelings, we can then accept the loss, face it and eventually move back into life again. Loss and recovery doesn’t have a neat and tidy end. It is never over. You never forget; and reoccurring moments of pain, especially when faced with a trigger such as a song, a sight, sound, or anniversary, are normal.
What we all learn is that the loss is permanent but the immobilizing grief isn’t. The pain relieves itself eventually but it takes its own course and the time frame of that course differs from person to person. Just remember that loss is an emotional amputation. It takes time to heal. The scars will never entirely disappear, but time does make us whole again.
As we return to our duties of living, we make adjustments to the circumstances we did not choose, but have to accept. Our world isn’t the same but eventually new interests, new friendships or love, new experiences and a new life emerges. And most of us become restored with time.
Normal Recovery Time Frames After a Loss
0-24 hours: You are only looking to survive. You don’t eat or sleep and you feel shock.
2-10 Days: You feel intense pain. You need lots of support and handholding because you feel hopeless and helpless.
2-8 Weeks: This is the adjustment period. Life isn’t okay. Your world has fallen apart and you are grieving when the rest of the world thinks you should be back to normal. But this is the reality stage. The loss becomes very, very real and you can’t sleep. You don’t function well and you don’t want to do normal activities. You are not anywhere near being over the heartbreak; you may pass into various stages of depression. Many people fall into denial or get angry and resentful. Many tenaciously try to hold onto the past and the way things were.
3-9 months: This is the resolution phase. You finally start to see that life isn’t ever going to be the same. You begin to face the fact that your identity has changed, even your friends may have changed. The pain is still strong and very much there, but you aren’t bumping into it on a daily basis. You start to do things again and you enjoy activities more and more. You still have thoughts and feelings, but you aren’t as obsessed or taken over by them.
1-2 years- recovery: It takes at least a year to find a new life identity and it may take up to 2 years to reestablish a sense of self, balance and wholeness. After two years, you still have scars but life no longer seems hopeless and you begin to see a new future.
A critical point to remember is that humans do not get over a loss, it leaves scars. You don’t ever forget, but you do move beyond it eventually.
If you are struggling with the loss of a loved one, EAP can help. Your EAP is a free, confidential, assessment, short-term counseling and referral program for you and your family members. It is a benefit provided to you by your organization. Call 1-800-451-1834
A publication of Affiliated Employee Assistance Program
March/April 2004
Alcohol – Use, Abuse, Addiction - Part 2
By Liz Ashe
I never realized my mother had a drinking problem until she retired. She was
always very professional and poised. She was a full time saleswoman, a respected
board member and volunteered for multiple civic groups. She drank on weekends
and embarrassed me now and then, but when she retired she began drinking daily.
She never passed out, binged or was irresponsible to her family, but embarrassing
episodes increased. I remember begging her to stop drinking. Numerous times
I said to her, “If you love me, you will stop for me.” But she didn’t.
I couldn’t understand why she wouldn’t stop. But back then, I just
didn’t understand the disease of alcoholism and that her stopping or not
stopping had nothing to do with loving me or not loving me.
Is Alcoholism A Disease?
Yes, alcoholism is a disease. The craving that an alcoholic feels for alcohol
can be as strong as the need for food or water. An alcoholic will continue to
drink despite serious family, health, or legal problems. Like many other diseases,
alcoholism is chronic, meaning that it lasts a person's lifetime; it usually
follows a predictable course; and it has symptoms.
Is Alcoholism Inherited?
If you are among the millions of people in this country who have a parent, grandparent,
or other close relative with alcoholism, you may have wondered what your family's
history of alcoholism means for you. Is your risk for becoming an alcoholic
greater than for people who do not have a family history of alcoholism?
Some people develop alcoholism even though no one in their family has a drinking
problem but
many scientific studies, including research conducted among twins and children
of alcoholics, have shown that genetic factors do influence alcoholism. These
findings show that children of alcoholics are about four times more likely than
the general population to develop alcohol problems. Children of alcoholics also
have a higher risk for many other behavioral and emotional problems.
But alcoholism is not determined only by the genes you inherit from your parents.
Research shows that many factors influence your risk of developing alcoholism.
Your environment, friends, the amount of stress in your life, and how readily
alcohol is available to you are factors that may increase your risk for alcoholism.
The risk may be higher, but remember: risk is not destiny. Just because alcoholism
tends to run in families doesn't mean that a child of an alcoholic parent will
automatically become an alcoholic too. In fact, more than one half of all children
of alcoholics do not become alcoholics and many children of alcoholics, from
even the most troubled families, do not develop drinking problems.
Knowing you are at risk is important though, because then you can take steps
to protect yourself from developing problems with alcohol.
If you are worried that your family's history of alcohol problems or your troubled
family life puts you at risk here is some common–sense advice to help
you:
• Avoid underage drinking. The risk for alcoholism is higher among people
who begin to drink at an early age.
• Learn more about the disease and talk to an EAP counselor or healthcare
professional about your concerns.
• Drink moderately as an adult (no more than one drink/day for most women
and the elderly and no more than two drinks a day for most men). People with
a family history of alcoholism and thus a higher risk for becoming dependent
on alcohol, should approach moderate drinking carefully. Maintaining moderate
drinking habits may be harder for them than for people without a family history
of drinking problems.
Can Alcoholism Be Cured?
No, alcoholism cannot be cured at this time. Even if an alcoholic hasn't
been drinking for a long time, he or she can still suffer a relapse. To guard
against a relapse, an alcoholic must continue to avoid all alcoholic beverages.
Can Alcoholism Be Treated?
Yes, alcoholism can be treated. Alcoholism treatment programs use both
counseling and
medications to help a person stop drinking. Most alcoholics need help to recover
from their disease. With support and treatment, many people are able to stop
drinking and rebuild their lives.
Alcoholism treatment works for many people. But just like any chronic disease,
there are varying levels of success when it comes to treatment. Some people
stop drinking and remain sober. Others have long periods of sobriety with bouts
of relapse. And still others cannot stop drinking for any length of time. However,
with treatment, one thing is clear: the longer a person abstains from alcohol,
the more likely he or she will be able to stay sober.
Concerned About
Someone’s Drinking?
Alcohol abuse or addiction of a family member or close friend can affect you. The following screening test was adapted from “Al-Anon: Is it for you?” in Codependent No More: How to Stop Controlling Others and Start Caring for Yourself, by Melodie Beattie.
1. Do you worry about how much your loved one drinks?
2. As a result of alcohol, do you ever have money problems?
3. Do you ever tell lies to cover up for someone’s drinking?
4. Do you ever feel that drinking is more important to your loved one than you
are?
5. Are mealtimes frequently delayed because of the drinker?
6. Do you blame the drinker’s companions for his or her drinking?
7. Do you make threats (out loud or to yourself) like, “If you don’t
stop drinking I’ll leave?”
8. Have you lost sleep because of your loved one’s drinking?
9. Are you afraid to upset someone for fear it will set off drinking?
10. Have you ever been embarrassed by your loved one’s behavior when he/she
was drinking?
11. Do you worry about holidays being ruined because of drinking?
12. Do you ever have to take over chores or duties of your loved one because
their drinking interferes with them getting it done?
13. Do you ever search for hidden liquor and/or dump it?
14. Do you feel that if the drinker really loved you, he/she would stop to please
you?
15. Have you ever refused a social invitation out of fear or anxiety?
16. Have you ever had to cancel or bow out of a social obligation because of
the drinker?
17. Are you ever afraid of your loved one’s driving when they drink?
18. Does your loved one make promises that he/she didn’t keep related
to their drinking?
19. Has your loved one ever promised they will stop if you give them one more
chance and they didn’t stop?
20. Do you ever think that if the drinking stopped, your other problems would
be solved?
21. Do you feel there is no one who understands you?
If you answered yes to four or more of these questions, a self-help group like Al-Anon, Alateen or Children of Alcoholics may be helpful. For more information about these groups, consult you local telephone directory, talk to your healthcare professional or call EAP 1-800-769-9819.
If An Alcoholic Is Unwilling To Get Help, What Can You Do About It?
This can be a challenge. An alcoholic can't be forced to get help except under
certain circum-stances, such as a violent incident that results in a court-ordered
treatment or a medical emergency. But you don't have to wait for someone to
"hit rock bottom" to act. Many treatment specialists suggest that
you begin by stopping all "cover ups." Family members often make excuses
to others or try to protect the alcoholic from the results of his or her drinking.
It is important to stop covering for the alcoholic so that he or she experiences
the full consequences of drinking.
Also extremely important: find ways to set boundaries and take care of you.
EAP CAN HELP.
Your EAP is a confidential, assessment, short-term counseling and referral program
for you and your household members. It is a free benefit provided to you by
your organization. Call 1-800-451-1834
A publication of Affiliated Employee Assistance Program
January/February 2004
Alcohol - Use, Abuse, Addiction -
Part 1 By Liz Ashe
Most of us can look at ourselves and/or into our pool of friends,
family or coworkers and see, past or present, alcohol use, abuse and addiction.
No person taking his or her first drink says, “I hope this first drink
makes me an alcoholic or gives me cirrhosis of the liver or kills me.”
People take their first drink for any number of reasons such as they want to:
be part of the crowd and accepted relax and unwind be more fun, outgoing and
uninhibited experience a “buzz”
seek relief from intense emotional or physical pain
try it because they are curious
Alcohol Alters Brain Chemistry Alcohol belongs to a class of chemicals known as sedative-hypnotics which depress the central nervous system, affecting all sensory-motor functions (vision, hearing, smell, taste, movement, memory, reaction time). Impairment in judgement, self-control and coordination can be objectively measured with as little as two drinks in the body.
Alcohol also puts the brain to sleep. An area about the size of a pea called the brain stem controls breathing and involuntary life functions. If the alcohol concentration is more than the brain stem can handle, you nod off and feel sleepy. The stem also sends electrical signals to wake the brain. Alcohol has to wear off before signals can be sent out. Time is the only factor to sober a person. Coma and death can result if the brain stem quickly becomes saturated before the body can eliminate the alcohol (alcohol poisoning).
Experimenters People who try their first drink are called experimenters. They don’t know their limits or how they will be affected. They discover alcohol provides a “feeling” or “buzz.” They then learn they have that same reaction every time they drink. And eventually the experimenter learns how to control the degree of mood swings by regulating the quantity of alcohol intake. Some experimenters may not like the taste, hangover, and/or do not like the sensation of losing control and having their feelings and actions determined by alcohol and may never drink again.
Users People who regularly or occasionally drink are users. For most people who drink, alcohol is a pleasant accompaniment to social activities and there are no adverse consequences or trouble as a result. Users violate no social norms and are not preoccupied with drinking. For most adults, moderate alcohol use--up to two drinks per day for men and one drink per day for women and older people--causes few if any problems. (One drink equals one 12-ounce bottle of beer or wine cooler, one 5-ounce glass of wine, or 1.5 ounces of 80-proof distilled spirits.).
Moderate users know when to stop before they become intoxicated or tolerant to large amounts of alcohol. Tolerance As a person continues to drink, the body adapts to or tolerates the original amount of alcohol consumed. To achieve the same effect the drinker must increase the amount of alcohol ingested. As time goes on, there continues to be a need to drink greater amounts of alcohol to get "high."
Dependence With continued tolerance and use, the body may become
dependent on the alcohol and without it will react to its withdrawal. People
increase their use of alcohol because they want to avoid the adverse withdrawal
reactions such as nausea,
sweating, shakiness, and anxiety. Eventually life activities begin to focus
around the substance. A large number of people get into serious trouble because
of their drinking.
Currently in the US:
Nearly 14 million people, (1 in every 13) adults abuse alcohol or are alcoholic;
Several million more adults engage in heavy and risky drinking (i.e. binge drinking, funneling, short-gunning, etc.) on a regular basis;
Six percent (6%) of heavy alcohol users admit to going to work high or a little drunk;
Fifty-three percent of men and women in the United States report that one or more of their close relatives have a drinking problem;
Nearly 1 adult in 5 lived with an alcoholic or problem drinker as a child; Alcohol-related problems cost society about $185 billion per year; and Harmful or hazardous drinking is involved in about one-third of suicides, one-half of homicides, and one-third of child abuse cases.
Alcohol Abuse Alcohol abuse differs from alcoholism in that it does not include an extremely strong craving for alcohol, loss of control over drinking, or physical dependence.
Alcohol abuse is defined as a pattern of drinking resulting in one or more of the following situations within a 12-month period:
Failure to fulfill major work, school, or home responsibilities;
Drinking in situations that are physically dangerous, such as while driving a car or operating machinery;
Having recurring alcohol-related legal problems, such as being arrested for driving under the influence of alcohol or for physically hurting someone while drunk; and
Continues drinking despite having ongoing relationship problems that are caused or worsened by the drinking.
Although alcohol abuse is basically different from alcoholism, many effects of alcohol abuse are also experienced by alcoholics. Addiction / Alcoholism Alcoholism is a chronic, progressive illness that includes tolerance, dependence, an intense craving for a drink, and loss of control (i.e. not being able to stop drinking once drinking has begun and the loss of control over the use of the alcohol and the amount used). Reliance on alcohol becomes obvious to others, giving rise to denial, hiding, and sneaking; and the drinker continues using even if he/she experiences negative consequences. The disease is a downhill spiral that can lead to potentially fatal internal organ damage.
What Are Signs of a Problem? Not everyone who takes a drink is destined to become an alcoholic. According to the Institute of Medicine of the National Academy of Science, 15 percent of people who try alcohol become dependent.
How can you tell whether you may have a drinking problem? Check the statements, if any, that apply to you.
‚ I have felt I should cut down on my drinking .
‚People annoy me by criticizing my drinking .
‚I have felt bad or guilty about my drinking .
‚I have had a drink first thing in the morning (as an “eye opener”) to steady my nerves or get rid of a hangover.
‚Drinking makes me careless of my family’s welfare
‚I crave a drink at a definite time daily .
‚I have had complete losses of memory because of drinking .
‚ Drinking makes my home life unhappy .
‚ I drink to escape from worries or problems.
One “check” suggests a possible alcohol problem. If you “checked” more than one statement, it is highly likely that a problem exists. In either case, it is important that you evaluate your relationship with alcohol. Even if you answered “no” to all statements, but you have gotten into financial difficulties due to drinking or encounter drinking-related problems with your job, schoolwork, relationships, health, or the law, you should seek professional help.
The effects of alcohol abuse can be extremely serious, even fatal, both to you and to others. EAP can help. An EAP counselor can help you determine whether you have a drinking problem and if so, can recommend the best course of action.
Your EAP is a confidential, assessment, short-term counseling and referral program for you and your family members. It is a free benefit provided to you by your organization. Call 1-800-451-1834. References: U.S. Department of Agriculture, U.S. Department of Health and Human Services, National Institute on Alcohol and Abuse, John Hopkins Medical School, www.samhsa.gov