As featured in North Hawaii News May 13, 2019

I usually spend little time worrying about fitting in with the expectations of others and prefer to do things my own way. It seemed to me that conformity was for those who were busy trying to perfectly match themselves up to the rest of the world and there was no place in that for me. I now understand that individuality requires its own precise energy, which is where perfectionism snuck up on me.

When we become the primary caregiver for an adult loved one, there are so many combinations of issues to manage that there is no single path one is to follow. Most people bounce around through this river of change, making mistakes and eventually eliminating the awkward edges of mishaps that happen along the way. Trips to the emergency room and emotional outbursts are hard on everyone involved, so caregivers tend to try to narrow their world into their own perfect flow of function.

This desire to perfect every action around us in order to stop getting emotionally bumped and bruised is very normal, but not necessarily healthy for the relationships involved in caregiving. Accepting the way we feel through those rough patches while allowing imperfection is all part of the journey. I personally have a hard time when I can’t please every older adult, family member, employee and agency that I’m involved with.

The challenge with this type of perfectionism is that I can get frustrated toward myself and those working with me if things end up even slightly uncomfortable for those we are trying to help. I have seen this same desire in many caregivers as they interact with their loved one and discuss their needs with us. The perception of being responsible for making the other person’s life experience as perfect as possible is a burden that many of us must let go of.

I recently saw a movie in which the main character said something about not wanting to be considered perfect because that leaves no room to grow. That really struck a cord with my newly self-aware self. Being confident in ourselves and our own actions is far more important than getting it right every time, and is imperative to standing tall in our beliefs. We must honor and build upon the inner voice that truly believes in what we stand for through both the smooth days and the rough patches.

Ideas of perfection can also be pushed on us by those around us. I believe it is critical to set clear boundaries with those in our lives who use intimidation and criticism to try to get us to bend in their direction. These strategies distract from what we value in our relationships and leave us feeling like a disappointment, even when we know we didn’t do anything wrong. This tactic does not create authentic relationships, as we only truly have someone in our corner if they have arrived there out of mutual respect and understanding.

In speaking with a caregiver who had finally had enough of her mother-in-law’s criticism and found inner strength as both an individual and a wife, I got the mental image of her taking the bull by the horns and pushing back against both internal and external pressure to excel at caregiving. Holding firm to the boundaries of how we will allow ourselves to be treated will help us all take the power back. So even if you are like me, and create your own bull’s worth of pressure on yourself, please consider that it is all in our own mind and the only things we can do is give it our very best, every day, and honor ourselves and those around us for showing up.

As featured in North Hawaii News April 8, 2019

Last month I reviewed the past five years of Kupuna Transitions articles and gave some condensed thoughts about some of the topics that had come up over that span of time. There was too much content for one month’s column, so I’d like to zero in on some options for those helping an individual with cognitive challenges.

When someone demonstrates signs of memory impairment, it is often family and friends who do step in and offer help. The individual’s medical professional is usually the first place they start, and I hope loved ones will continue to seek support through organizations like the Hawaii County Office of Aging and local Alzheimer’s Association expert Patrick Toal, as well.

Community resources are critical, as there are choices that need to be made regarding care and living arrangements, along with legal documents that need to be put in place. Many people feel that they are smart enough to be able to tackle these things on their own, but what they may not consider is the power of experience. Therefore, educating oneself through the guidance of professionals can be a great help based on tried and true approaches. Support groups also provide camaraderie and tips to help the person who is helping others.

Collaboration in family caregiving situations is also very important. Being on the same page as many different personalities come together is not simple. Finding common ground based on their love for someone needing help is essential, and supporting each other through this dynamic does improve the whole experience. Even if you don’t always agree on the best course of action, honoring each other’s ideas and gently stating your own reasons behind your choices can be a good starting point.

Often there is a primary care giver who holds on to the reigns of responsibility and has a hard time utilizing the support around them. Sometimes they feel they are the only one who can do it all correctly. Learning how to let go of the idea that they are now scripting the other person’s life story will hopefully help that individual allow others to feel valuable to the situation.

Being in a 24/7 dynamic with a loved one who needs our full attention and support can also shift the balance of the relationship, as there is so much to be responsible for. We often help someone based on meaningful past experiences that connect us to each other, so reflecting upon and discussing those good times will help keep the true nature of the relationship in a positive light. If they get all of the details wrong, avoid confusing them with the facts and join them in their world. They say that ignorance is bliss for a reason, so let their mind take them where it may if it feels good to them.

It is also helpful to remember that the individual did not ask for this and is on a challenging journey of their own. Bad behavior in those with some type of dementia is not personal, but rather a symptom of the disease. If it feels difficult to offer kind and patient support, that is a clear sign that you are in too deep and are doing too much. Time away from the care situation can be very nourishing, and can help you return to the house with a lighter approach.

I hope these words are helpful, and wish you all humor amid the chaos of care!

As featured in North Hawaii News March 11, 2019

This month marks my five-year anniversary of writing this Kupuna Transitions column. I am grateful for the opportunity every month that I get to sit down and share ideas with our Hawaii community about caring for ourselves and the older adults in our lives. Your positive response and comments in the community have encouraged me to continue to create messages that hopefully inspire and support you. I wish I could give each reader a big high five! In reviewing my contributions since March 2014, I noted a few common topics that I’d like to highlight over the next few months.

Communication is the first subject that has come up many times over the past five years. The words we use, and think, can have a powerful effect on those around us. I found that many people use infantizing words around older people like cutie and sweetie. This usually comes out of care and concern, almost a nurturing instinct, yet it may feel condescending or childish to the full-fledged adult they are speaking to.

A great way to utilize communication for good is the ask about the life stories of those older adults in our lives. It helps to validate the whole individual rather than the present tense problems they may be facing, and also opens the door for great advice that can be passed down to the generations following us.

Communication also goes far beyond the actual words that are coming out of our mouths. Irritated tones often break down relationships, and they often come out of burn-out from being responsible for someone else’s well-being 24/7. This leads to the importance of self care in order for the care giver to find resilience amidst the challenges they may face on a daily basis.

There are many tools available to assist us all in finding peace amidst the storms of life. Stepping out and silently appreciating nature is the quickest way to get a shot of perspective. There are also a variety of meditation apps that can bring peaceful sounds or guided meditations to our fingertips and help us breathe through the present moment until we find our emotional balance.

Appreciating what we do have keeps our attention on growth and opportunity and helps limit the amount of time we stay in the dark cloud of misfortune. It is human nature to focus on our shortcomings over our strengths, so we need to be intentional about building ourselves and our situations up. Emphasizing on what we are good at and bringing others into the situation who excel in other areas will likely help create the best case scenario when providing care.

Ultimately, the way we communicate with ourselves and others create our life experience. We make so many small choices every day that we seem to forget that we are in control of the direction of our lives. Believe in your ability to adapt and grow through these experiences and life will be a beautiful mosaic to look back upon.

I personally would like to thank my husband and my father, the two most important men in my life, for supporting me the past five years. My dad sends kind words of appreciation after each article, and my husband helps me to find the exact wording that speaks to my heart when I’m too caught up in the passion to see the light. My 10-year-old daughter has also been an ongoing inspiration, as she is my sunshine, and she says that I am her sky. It doesn’t get much better than that!

As featured in North Hawaii News February 11, 2019

Life presents us with many opportunities to make financial decisions based on emotions, and I’m hoping you’ll consider with me how our money best serves the values we hold dear. It can be used as a demonstration of love, yet can also be used to manipulate love if it becomes a tool for control.

An example of this is the way that inheritance can fracture family relationships, especially when uneven distributions of one’s estate are left behind. On the other hand, if the estate is evenly divided but one sibling provided more physical or financial care of a parent without fair compensation, they could feel frustrated and/or hurt.

When considering a legacy that truly leaves the family in a better position than they had originally been in, we may want to consider other ways to demonstrate love through those funds. Large family adventures or appreciation parties are a lovely way to create memories that keep you vivid in their minds after your departure.

We give much of our lives for the income that serves our basic needs and preferred lifestyles, and spending some of those funds in preparation for future situations is a newer concept for society. The average life expectancy for men born in 1919 was 53. One hundred years later it is almost 80 years old. Due to this shift in the number of years we spend in our bodies, there are evolving expectations of how our income will be utilized.

The above-mentioned desire to leave our loved ones with some sort of monetary gift when we pass away is thoughtful and quite common, particularly for older generations. The ironic thing is, the societal shift has taught us to expect our older loved ones to living longer so many children no longer rely on an impending inheritance. The best way to avoid being a burden to our loved ones is to plan for our financial futures.

I believe a good approach to this preparation is understanding the resources that are out there, as well as the funding sources behind those programs. I would guess that at least one-fourth of the family members who reach out to me, looking for services for their parent, believe that their blue cross/blue shield or Medicare insurances will cover the care. If they had an idea of what out-of-pocket expenses could be expected, creating a step-by-step plan to pay for it would be more beneficial.

We need to take ownership of the precious earnings in our own lives so they can be used as a tool of support for many years to come. Investing in life/long term care insurance and retirement accounts that can grow through the years are wise ways to help our money work for us. A financial advisor can help you plan for the day when you will no longer be heading off to work and, in the meantime, help the compounding effect work in your favor.

Should you be in a situation where someone has prematurely promised you an inheritance, it may be tempting start making plans for that windfall. Chances are, the well-intended money may be needed for care services or other needs. It may be prudent not to mentally spend it until that day actually comes. I’ve seen how the anticipated inheritance spent on the care of an adult loved one creates feelings of resentment that would not have been there if they hadn’t expected it.

Benjamin Franklin said “an investment in knowledge pays the best interest.” May you lovingly grow your own fruitful financial garden of knowledge and wealth!

As featured in North Hawaii News January 14, 2019

Welcome to a new year with fresh possibilities! Let’s look at how we can get set up for success. Many of us completely eliminate a vice or start something new at the beginning of the calendar year with the intent to start with a clean slate, wishing there was an actual reset button in life to help those dramatic shifts in our lifestyle stand firm without that habitual pull back toward the unwanted behavior. Many of our relapses toward old patterns are triggered by the need for comfort or familiarity when outside influences leave us feeling uncomfortable or stressed.

So how do we deal with discomfort or stress?

I believe it is to come to terms with them, accept that they are part of the human experience and understand that the struggle they bring is a part of our full life experience. The choices we make that lead us further from those challenging situations is where we have the greatest power. Being intentional about the commitments we agree to, letting go of unnecessary struggles and keeping our schedules reasonably full rather than overloaded will help us soften those triggers that weaken us in the battle for positive change.

For caregivers, the realization of overcommitment often comes with hindsight, after they have gotten themselves involved in a situation that is difficult to adjust. I noticed a common theme being discussed over the holidays regarding situations where there are multiple generations relying on the primary caregiver in the family. This individual feels taxed by the needs and challenges of their children, life partner and parents, primarily when they all live under one roof. When pressure is coming from different sides, they often feel like they are drowning in responsibility and believe that if they stop, everything will fall apart.

If you are wondering when it will be your turn to have the peace of mind that you work so hard to provide for others, it’s time for a mental reset. You may have the skills, time and desire to be the go-to person for those in your immediate circle, but that doesn’t necessarily mean you should. Primary caregivers tend to have an all-or-nothing attitude about their role in their loved one’s lives. Being all things to all people is not humanly possible and loving them dearly does not mean you will not experience negative consequences upon your health for overdoing it.

Some care situations last five, 10, even 20 years, and raising a child only officially ends at 18 years. Sandwiched caregivers dedicate a large percentage of their life experience to others. This can be exceptionally rewarding and valuable time shared with family. However, if you are sacrificing your own well-being through this process then I suggest re-evaluating the entire structure of your situation. Coming up with ways to set clear boundaries is much better than trying to push through, and there are more friends and services out there to offer support than you may realize.

As the book The Prophet says, we all need space in our togetherness. You may assume that you’re letting others down when they could actually be very understanding and appreciate that your own life needs to be valued as well. Your personal mental health and well-being are critical and you are your own best advocate. Our inner light doesn’t reside in the same place as overwhelm, so find the strength to pull back from excessive commitments and you’ll be set up for positive growth. Now that is a resolution we can all get behind!

As featured in North Hawaii News Dec 10, 2018

Do you believe in magic? This entire season is built upon the magic and power of that which we cannot see, surrounding us with love and cheer. We gather together and sing songs in celebration of the positive energy that created us. Ironically, this is also a time that many people feel in the greatest opposition to peace and merriment. This often comes from the psychology of getting through the holidays, rather than getting to do the holidays.

We are all emotional beings who tend to put extra pressure on ourselves to meet some sort of expectation of being all things to all people. We have friends and family who we want to create holiday memories with, yet we can become so attached to the outcomes of our efforts that we forget to have fun along the way. I encourage you to be aware of how you are feeling and be more responsive to that which keeps your spirit bright.

Decorations, gifts and music are here to lift us up, but trying too hard to make things perfect can result in lower spirits. On top of this, family care partners often feel extra pressure during the holidays as they try to smooth out the rough edges that come with the situation. They aren’t just caring for ailing family members, they’re also trying to keep traditions going that may be better left alone considering the new dynamics at play.

As loved ones unite for festive occasions, this could be a great time to communicate the truth about our life situations. Awareness is the first step towards that which brings us fulfillment. Others can’t help with what they don’t know is a problem and progress is only made with effort. Setting your intention on finding that which would feel good to you will help you figure out what you need to ask for. Help with the caregiving, supportive guidance to help you along the way or other means of support can help you find a path of less resistance.

The lesson that my personal life coach has helped me learn is that it is very important to do less wherever you can when feeling overwhelmed. It’s so simple, yet I personally tend to try to do more in order to get a handle on the chaos when the best thing I can do is ease the pressure to do it all at it’s very best. Then I have the mental space to love myself and allow things to fall into their imperfect places. Running around trying to catch every “ball” tossed my way only leaves me tired, frustrated and unproductive.

During this season, I hope things will come together for all of you. May you open the door to the magic of positive energy which fills life with well-being and optimism. Whatever situation you may be in, please appreciate all of your efforts along with those who lift you up. We may not build many snowmen here in Hawaii, but establishing a personal base of awareness, honesty and appreciation will hopefully lead us to the jolly soul of Frosty and the wisdom of the three kings. Happy Holidays!

As featured in North Hawaii News Nov 19, 2018

Have you ever had somebody get upset with your decisions, even though your actions don’t directly affect them? Having someone become emotionally involved in your life can add extra weight to your own concerns and also break down those trusted relationships. In family caregiving, there are many decisions that need to be made. Some are on a large scale, like choosing what type of living situation the care recipient will be in. Smaller, daily choices about outings and clothing can swirl around in a caregiver’s mind and bog them down.

Outsiders to any situation can easily form opinions and “helpfully” offer suggestions that leave care partners second guessing themselves, once these decisions have been made. When taking on the responsibility for a mature adult, numerous factors create a one-of-a-kind experience for each scenario, from the beliefs of each family member to the recommendations made by the various physicians and the professional caregivers.

Everyone involved is doing the best that they can with the information they have. There will be times when mistakes are made. The caregiver can grow from them and try again. This is how most of us get through our own lives, and assisting with choices for an adult loved one brings on even more difficult trial and error moments. Having the trusted space to experience these lessons without having to defend themselves will aid their development.

If you want to support someone in a caregiving situation, I have been taught an approach to offering advice that can create more receptivity when used sparingly and sincerely. If you would like to hear my advice, please read on. If not, I respect your choice and hopefully we can reconvene in next month’s article. I’ve just demonstrated a bit of what my advice is. Request permission to ask them a question or offer a suggestion. It seems so very simple, yet turns the story around in their mind from one of attack to one of teamwork when you give someone the respect of allowing your perspective on their life, rather than forcing it upon them. This also opens the door to a more heartfelt conversation.

If the roles are reversed, and someone is repeatedly offering you unsolicited advice, it can be awkward to approach them about pulling back. Find a time to sit with them when you are not in an emotionally charged moment and let them know that you appreciate their intention to be helpful. Let them know that while they intend to be helpful, it actually feels like criticism or disrespect, or whatever it feels like to you. If they insist that they must help you with their words of “wisdom,” you can follow this by asking them to give advice in a different format, such as writing it down so you can receive it when you are prepared to take it in. This would preferably be with a professional who can help you weigh the options they are presenting.

The giving and receiving of advice is so common that we do not often recognize the internal damage it can cause. Dr. Michael Aronowitz says that if it feels like criticism, it is criticism. This understanding breaks down all of the rationale we tell ourselves for interjecting our opinions into someone else’s life and allows for a more mutual discussion. I like this quote about advice written by Samuel Taylor Coleridge: “Advice is like snow — the softer it falls, the longer it dwells upon, and the deeper it sinks into the mind.” May your words fall softly and hearts love warmly.

As featured in North Hawaii News Oct 8, 2018

When I boarded the 7-hour flight from Denver to Kona, the last thing on my mind was caregiving. Having been up since a crazy early hour, I was in my own little world and my mind was full of basic logistics like snacks, reading material and getting my seat area disinfected. The woman next to me, however, had far more on her mind than her own comfort. She explained that she was caring for her husband with cognitive impairment and was flying him to the Big Island to see his grandchildren.

I think it was a nice twist of fate that we were sharing a row, as my sensitivity to the challenges they were facing made it easy for me to cooperate with her requests. She asked if he could switch seats in order to take his anti-anxiety medication and rest against the window. He was resistant with his wife and I knew that his response to a stranger would be different, so I pleasantly told him that we were about to take off and we needed to switch seats right away. I stood up, and he followed my lead. Within two minutes we were in our necessary places.

During this adventure, I couldn’t help but think of the changing flight experiences that our society is encountering now that America has over 15 million caregivers assisting older relatives. There are many reasons they would need to travel on a plane with their loved ones, from medical appointments to family reunions, and there is also a need for heightened sensitivity to those who are helping.

I read a study that said people are less irritated with you on a plane if you have a disruption, like a crying child, when you apologize. I tried it when my daughter was young, and the energy around us would soften, so it seemed to work. Acknowledging the challenge that everyone is facing connects us at the human level and we feel less like the person is being inconsiderate.

The tricky thing is that an adult with cognitive challenges isn’t easy to spot. How do you get the message across without putting the person needing care in an uncomfortable situation? Maybe they get a fabric sign to hang over the seat back explaining their predicament. The airlines may want to consider having special companion seating areas for those who are caring for someone with cognitive challenges. Being close to an area where the individual can get up and pace around a bit, or get to the restroom quickly even if there is cart service occurring, would be helpful. That would be very useful not only in consideration of what the person is going through, but also to understand that they would likely need special assistance in an emergency.

I recently heard a keynote speaker from Washington D.C. who has studied public policy in the aging industry for over two decades. He said something I found very surprising: Demographics don’t necessarily drive change.

The number of older adults in our country has risen exponentially, but the services and policies are not keeping up. We actually have fewer geriatric physicians (geriatricians) than we did 10 years ago. How is that possible? I believe that is the most needed area of medical expertise in our country today.

What I have gleamed from this realization is that it is upon us to create the change we want to see. Taking it upon ourselves to notify those around us of the situation we are in is a great place to start. And if any of you have a connection to the airline industry, please encourage them to consider ways to keep our treasured caregivers supported through travel. They are often older themselves, and basic navigation of what seems to many of us to be a simplified check in process may not be so cut and dry when they can’t figure out how to get their phones into airplane mode, let alone get the seats that will make their flight smoother.

Bon voyage!

As featured in North Hawaii News Sept 10, 2018

I utilize this column to discuss various ways to cope with some of the adjustments that maturity and caregiving can require in our lives. It is an honor to reach different members of our community through various lessons and insights learned.

This month, I am reaching out to those of you who may feel isolated by a diagnosis in your life or the life of someone you love, as well as the general public who may not be experiencing that particular challenge. I am addressing a subject that I feel passionate about and apologize if it feels at all like a sales pitch.

There are a number of fundraising events supporting causes, such as cancer, diabetes, arthritis and so on, that you may have considered participating in, but it may not have felt relevant or necessary. It is also possible that you are in the midst of that particular storm, and may feel overwhelmed.

In whatever way you may or may not be affected by the causes that hold fundraising walks or other events, please consider becoming involved any way you can. Whether it’s spreading the word, offering to pitch in on the volunteer side of things or contributing a small donation, every action we make towards these larger causes can have a ripple effect that we can’t possibly fully understand.

I believe that opportunities to feel helpful actually help us as well by lifting our spirits and building on that extra sense of purpose in our life experience that expands beyond ourselves. Each person who contributes can create a magnetic attraction that leads to greater support for those challenged by the source of the charity than was there before.

I personally enjoy assisting with the annual Walk to End Alzheimer’s, as my career in the aging field has shown me the great need for support towards those affected by the disease. As our island has recently seen, this disease can impact an entire community when someone goes missing. On a more intimate scale, families are challenged emotionally, financially and physically on a daily basis when caring for someone with the symptoms of disorientation, paranoia and a sense of slipping away, to name a few.

At 8 a.m. this Saturday, a group of Hawaii Island community members will join me at the Old Airport in Kona to show their support for the fight against Alzheimer’s disease. This walk not only raises funds for research, but also builds a sense of community among those from different aspects of the battle.

We have a new Big Island coordinator who has replaced our longtime Alzheimer’s guru, Chris Ridley, and Patrick Toal wishes to become a support to those of you out there who need an experienced touchstone. I recommend that anyone in this battle come and feel supported by others who are going through similar things.

If you have been through this, you well know that it can feel rather depressive when battling a chronic illness, primarily because it often coincides with pulling out of regular social interaction. It is common for people to feel as though their world has shrunk to the goings on within the care environment.

Please consider taking the step out of the struggle bubble and opening yourself up to the caring arms of your local community. We are out there because we care about you or someone you know. Let’s make a difference, one step at a time.

As featured in North Hawaii News Aug 13, 2018

Conversations about neuroscience can overwhelm me, and medical references to the way our brain works tend to lose me in a cloud of scientific terminology. Personally, I would rather discuss the social aspects of aging issues, yet I also know it’s helpful to grasp the complexities of the brain when caring for individuals with dementia.

Fortunately, I’ve recently come across a neuroscientist who is able to make scientific brain lingo very relatable. Dr. Wendy Suzuki’s engaging and conversational approach to understanding the brain in her book, “Happy Brain, Happy Life: A Personal Program to Activate Your Brain & Do Everything Better,” connects neuroscience with everyday references. I highly recommend either reading or listening to her book, or viewing Dr. Suzuki’s TEDWomen talk about the brain-changing benefits of exercise.

One my greatest takeaways has been Dr. Suzuki’s finding that powerful emotional attachments to an experience can strengthen and create new memories in an individual, even if they have short-term memory loss. More often than not, I have witnessed the frustration of a relative who wants their loved one with dementia to recall a new experience or expectation. I have occasionally seen situations where something new is retained, and didn’t fully understand why.

Dr. Suzuki explains this phenomenon by explaining the power of the amygdala, which processes emotions and “helps boost the memory.” She says this “shows just how interdependent emotion and cognition, or feeling and learning, truly are.” Therefore, our chances of creating a new memory for someone with dementia are increased if we can connect it with a powerful, emotional experience.

Along with resonating at an emotional level, other factors are involved in the retention of a new memory. Something new or unusual is effective because our brains respond to new stimuli as a way to protect us. Give us some new faces or environments to process, and through this novelty our brains will really become activated. Should you add some important associations to the mix, such as hobbies and favorite pass-times, and you may be able to create a lasting memory for someone with memory loss. The reason these connections are so valuable is that strong memory networks build a framework in our minds to retain information about those things we enjoy most.

Dr. Suzuki also helps to clarify the difference between dementia and Alzheimer’s disease. She says that “dementia is a general term that describes a set of symptoms that are severe enough to effect a person’s everyday life. These symptoms most commonly include a decline in memory function, planning ability, decision making and other thinking skills. The term alone does not describe a specific disease, such as Alzheimer’s disease.”

Now that we’ve distinguished what dementia is, how do we do our best to protect our brains and keep them healthy? Let’s grow healthy new brain cells! According to Dr. Suzuki, “exercise is the most transformative thing that you can do for your brain today,” which improves the strength and size of brain cells in our hippocampus, holding off dementia. If you, like me, tend to mix up the function of the hippocampus with the other important parts of the brain, it may help to think of it as our main photo album. It holds our long-term memories and assists with learning and emotion.

All of these factors are involved in memory creation and retention, so let’s be extra good to this powerful little “hippo” and build some happy new brain cells through 30 minutes of movement daily. Protect it with all you’ve got and you’ll be setting yourself up for a memorable future.

As featured in North Hawaii News July 9, 2018

Many family members of an older adult struggle with a guilty conscience about not visiting with their relative often enough. In Hawaii, our guilt can be even greater because it isn’t feasible for the average person to fly over for face-to-face visits on a weekly or monthly basis. Sometimes the weekly phone call can even be a bit challenging due to time difference issues.

On top of the internal guilty lectures we may give ourselves, family members or friends who have more interaction with the older relative may make comments (whether intended as a barb or not) that leave us feeling even worse, as well as defensive. This spiral does not lead to a good place, so by the time the direct interaction with your beloved senior is happening, it may feel like a deep chasm has come between you.

The icing on this dysfunctional cake is the inevitable comment from the older adult themselves, questioning where you have been, or asking why you haven’t called or visited. They may even lay on the guilt as a salve for their own loneliness. My concern for caring individuals in this situation is for the way they may feel emotionally beaten up, which could lead to degrees of anger or depression.

In times like these, positive self-talk is critical. Accept that the choices you have made in the past are part of you simply being human. Let go and choose to take a small step today.

You can start with a simple card, note or phone call. Internally hashing out yesterday’s mistakes only breaks down our spirit and leaves us bound to the same negative behaviors. Focusing on what you value, such as family unity and harmony will lead to small steps that increase positive feelings about that goal.

Here are some tips for closing in that chasm and feeling a greater sense of well-being. Phone calls are tricky, as it can be difficult to find relatable topics that keep everyone interested. Questioning the older adult about health issues may make them feel too vulnerable and put them on the defensive, so simply asking what they enjoy doing these days is a nice, open ended start. Keeping the conversation vague, rather than getting into the specifics of their routine, is also a nice way to keep things light.

Ask them if there’s anything you can do to help out. Offering to help be part of the solution does not mean you are the solution. You are simply finding out where their needs are and seeing if you can help delegate some solutions. I think many people are fearful that they’ll get asked to do too much, but more often than not the individual may just need to feel heard and that someone is in their corner. Sometimes the solutions are very simple, but nobody thought to ask.

When the conversations and visits do come to an end, I highly recommend being very clear about your feelings for that person. That’s truly the main reason you reached out, and they will likely appreciate being left with that fact at the forefront of their mind. Words of appreciation and love will leave your time together on a good note.

Ultimately, if you want to maintain family relationships when an older adult is requiring a bit more care, keep your eye on that which you value and make choices that follow that path. We all just want to be a part of something that makes our world a better place, and we have more power than we often realize in which to make that happen.

As featured in North Hawaii News June 11, 2018

During this past month, hundreds of caring members of the Big Island community have searched for a generous, kindhearted woman who is lost to those who care for her due to her confused Alzheimer’s state. She served our island community as a public health nurse, and in turn her family is now being supported in hopes of finding her in recoverable health.

One of my first thoughts, after that heart-wrenching moment of sadness for the situation, was about the value of a GPS watch. They make them for individuals who are at risk of wandering, in hopes of being able to locate them if this situation should happen. If someone is willing to wear that type of watch or pendant, it is a great way to help prevent these devastating situations from happening. Unfortunately, on the Facebook page supporting the search effort, her son wrote that she would take her tracking devices off.

With this dire situation at hand, I decided to look into alternative ways to help family members keep track of their disoriented loved one. There obviously is not one simple solution to keep someone with severe memory loss away from the risks of danger, especially when no two cases are exactly the same. I call Alzheimer’s the snowflake disease because it affects each person differently, beyond their personality or upbringing. For example, where one person becomes angry when they were always pleasant, another person can start off and stay pleasant. That is why there isn’t one fix to keeping someone with Alzheimer’s confidently safe.

Most importantly, a family member must recognize and accept that their loved one is at risk of wandering away and getting lost. After that, it is absolutely worth the investment of time and money to find a way to get that individual tracked. Technology is rapidly expanding with improved tiny devices that can track the whereabouts of people or things, like lost keys. Aside from numerous environmental tricks such as an elevated lock on a door or black circle that appears to be a hole keeping someone from stepping over a threshold, I think their best bet is trying out a few different devices that can be attached to, or inserted inside of, whatever the individual is always utilizing.

We are creatures of habit and even if habits may change with cognitive shifts, there is usually something that is routine with the person. I think shoes are the best bet, as many older individuals wear the same shoes nearly every day and do not leave home without them. There are a variety of tools like smart insoles and tiny devices that can attach to shoelaces or sandal straps. You could even cut a slit in the sole of their favorite pair of shoes and slip a GPS device in there if they resist the device. Hide their other shoes, claiming they’re lost, so the tracked shoes are sure to be worn. It’s also important to be sure the devices battery is charged, as the last thing anyone needs in this situation is a false sense of security.

It is said that hindsight is 20/20, yet with this type of situation even hindsight can’t say for sure what would have kept our local family from experiencing this traumatic event. Shoes can be slipped off as easily as that tracking watch they tried to give her. Cell reception can get spotty in many parts of our island, so GPS is not a perfect solution for any family in this situation.

I hope that my suggestions at least aid family caregivers when coming up with a family plan to keep their loved one safe. Until this search becomes a rescue, I hold in the highest regard those community members aiding in this cause. It could easily be any of us who care for someone with Alzheimer’s, so it is beautiful to see such a strong, caring community of local citizens. I honor you all.

As featured in North Hawaii News May 7, 2018

The greatest lessons in life often come from our mistakes. Through this perspective my grandma was ultimately my greatest teacher. Her dementia and bitterness destroyed our caregiving relationship. By the time of her passing, I was so hurt that I had already mourned the loss of the amazing woman I had known and loved. Through this past decade, my healing and understanding have fueled the desire for the lessons I’ve gleamed from my late grandma in order to help other family caregivers improve their situations.

I had a wide spectrum of caregiving experience before stepping into the family caregiver role and thought I was the ideal caregiver because of it. I had educational, as well as professional, experience in the field. My grandma had been my inspiration to enter into the gerontology field in the first place, yet it was a very different experience when everything I had learned needed to be utilized in a personal dynamic.

One of the first things that slipped into my subconscious mind was the dangerous word I often hear caregivers use to beat themselves up with: should. I felt that I should be able to not only meet her needs, but also should be able to swiftly anticipate and resolve those needs before they arose. Shoulding myself during and after my caregiving experience influenced my inner dialogue in a detrimental way. I was my own harshest critic because of it.

Now, with years of perspective and healing, I can clearly understand that loving someone does not mean you should be anyone other than their vulnerable and imperfect child, grandchild, sibling or spouse. In fact, the closer you are to the person you are caring for, the more blurred your vision can become. All the tips for caregiving you learn can fly out the window when you find yourself feeling responsible for ruining someone else’s happiness because you think you should have done better.

This is why professional caregivers can be such an important piece of the caregiving picture. It is best to roll with it if someone with dementia is incorrect in their recollection of something. If they think they are still living on Maui, then you pretend you’re on Maui. With that in mind, imagine your mother gave you the family holiday platter, saying she didn’t need it any more, yet the following day she insists you stole the platter. As a family member, this becomes personal very quickly.

A professional will likely assess the individual’s mood and mental status and carefully respond with an apology of misunderstanding the nature of the conversation around the platter. Letting go and moving on is the gift given to someone who does not have a history with the individual needing assistance. They are also a fresh face and personality that may be a breath of fresh air to the person you care for. Just as a substitute teacher was a special treat as a child, a substitute caregiver can bring ease and comfort to the person you are helping.

The cocktail of emotions that I experienced with grandma is very common for family members who mean well, yet beat themselves up for not being good enough. Do not buy into the notion that you are responsible for that person’s happiness. Consider their needs in two categories: comfort needs and true needs. Ultimately, their true needs are the most critical. Should you be so lucky as to reach a number of their comfort needs as well, consider that a bonus. Simply stepping in and helping is an incredible gesture.

As featured in North Hawaii News April 9, 2018

Do you know somebody who’s struggling with the role of caring for a parent, sibling or spouse? I have had an accelerated number of conversations lately with people who are concerned for a loved one who is in a state of chronic stress while providing care for a family member. The caregiver often pushes offers of support aside, feeling either protective of the delicately balanced world they’ve created in order to keep their loved one comfortable, or frustrated by the challenges facing them.

One of the most natural beliefs caregivers establish is that nobody else can provide care they way they can. They’ve been through the ups and downs and learned how to handle all of the variables that may come their way. Since all of those lessons are too difficult to pass on to an alternative caregiver, it simply seems easier to handle all of the care on their own.

I completely understand this way of thinking, as I have had the same issues with my business. I lean on my experience and ability to connect with the kupuna I care for, so it is difficult to let go and trust others to come in and provide the same level of care. I can get so caught up in the small details that make every little thing special for our kupuna that I can’t imagine anyone else doing it the way I feel is necessary.

In my experience, the number one relief that allows me to step back and trust others to my precious charges is to have systems in place that the other caregivers can work from. I’ve written out the daily schedule, created procedures for most tasks and trained them in the hands-on care and the philosophy that surrounds the care offered. I have also seen that alternative ways of doing things can bring positive energy into the dynamic.

In a home environment, family members may not think to formalize the care of their loved one. All of the information swirls around in their heads and they pluck it from their memory when the appropriate situation requires a solution. If you want to be a helpful support to the primary caregiver in your life, I suggest you learn about resources that can help systematize their situation and help set them up.

By getting their caregiving practices clarified and organized, they not only get the mental break of having to re-think it every day, they also know they can step away for a breather. The person receiving care will still get their primary needs provided for, such as medications and eating/bathing routines, so the caregiver can rest more easily.

Another way that you can support your friend or family member is to encourage them to go to the Conference for Family Caregivers that will be held from 8:30 a.m. to 2:30 p.m. April 20 at the Sheraton in Keauhou. The Hawaii Community Caregiver Network is working very hard to make sure that there are numerous resources all in one place to help support the family caregiver.

I am so touched by the number of people in our community who are looking out for their increasing number of friends and family in the caregiving role. Please continue to gently offer your support, without judgment, in a variety of ways. Preparing a meal, staying with their loved one while they go for a walk or sending a lighthearted text may just be the thing they need. Knowing they aren’t alone means much more to them than you may realize.

As featured in North Hawaii News March 12, 2018

Many seniors believe there is safety and quality of care when it comes from those they are closest to. Children are raised to do the right thing and spouses are handpicked, so in a perfect world they are the most qualified individuals to provide TLC. On top of this rationale, news stories of the elderly being abused in care facilities reinforces the idea that we would be better off at home.

According to Hawaii Island Executive on Aging Dr. Kimo Alameda, most of the abuse of our older adults is carried out by family members. When I asked some of the kupuna at my day center about why they believe most financial, physical and emotionally abusing situations are carried out by children and spouses, they had some insightful thoughts.

One woman in her 90s feels that it might come from their familiarity with the older individual. They know their temper and may think they’re getting them straightened out. Another 89-year- old woman also feels that they don’t mean to abuse, in that sense – they are likely doing these things without realizing what it’s doing to the person on the inside. On the other hand, she has also seen a clearly abusive situation with a neighbor in which the caregiver grandson was on drugs. She noticed the son was blind to the grandson’s ways, so the grandma was stuck.

Occasionally the relative willing to help is the one mostly needing a place to stay rather than the one best suited for care. Even in situations when the family member is stable, control issues can slip in. Although the requests upon the recipient are usually well-intended, they can still feel like demands rather than care. The vulnerability of those needing their help must be treated with the utmost respect and patience.

In fact, impatience is often the first step towards an unstable caregiving situation because a good night’s sleep is highly unlikely. One can become short-tempered with the consistent lack of rest, and fatigue also limits the caregiver’s drive to provide an uplifting environment that stimulates the individual’s mind and body. It often takes a clear head space to get an older adult with ailments to feel motivated to get active.

I personally believe that dementia care is the most at-risk dynamic of all, in terms of abuse. Caring for somebody with memory loss brings a greater need for understanding. A family member may assume the older person is intentionally behaving a certain way and react to their actions rather than seeing past them as a symptom of the disease. Understanding limited capacity may not necessarily keep them safe, though, as those gaps create opportunities for bad behavior to occur which may not be recalled by the victim.

I absolutely honor family members who step in, and have seen firsthand how challenging it is to maintain tenderness and understanding as weeks turn into months and years. My hope in shedding more light on this topic is to raise our awareness to the importance of looking out for each other. Putting all of the caregiving pressure onto one family member may be a recipe for disaster. We all need support in adult caregiving and work as a team to keep everyone healthy and well cared for.

As featured in North Hawaii News February 19, 2018

Those who are older than us often demonstrate love through the sharing of wisdom. Many of those words have been repeated frequently and for good reason. They ring true now just as they did centuries ago, when the grandparents of our grandparents were sharing their love through a fresher version of these antidotes. Last week, on Valentine’s Day, it was nice to emphasize our love and appreciation for others. Luckily, these loving expressions of wisdom are offered year round to encourage and inspire us.

First, you must try your best to appreciate every day that you have. None of us have any guarantees that we will be here tomorrow. When I ask my clients what they are grateful for, 95 percent of the time they first say their life. Of course, as you get older you appreciate the beauty of breath and a heartbeat more and more. I also believe that making the most of moments by being fully present in them will bring immense value to each day.

This leads me to the next often shared piece of advice: slow down. Not only does “haste make waste,” but speeding through life only makes the precious moments a blur. Life isn’t a race. Stop to smell the roses, and say I love you every day so you won’t miss the chance to be sure your feelings are clear.

Another piece of advice is to remember that there is a great big world out there, so don’t get caught up in the small stuff. Tunnel vision will only intensify the disappointments in life, rather than emphasize the beauty. Exposure to diverse cultures and connecting to various members of your community will help to keep your perspective open to new opportunities and adventure.

I’ve also been advised on many occasions to only use what is needed. Always be gracious and leave something for the next person. This advice often comes from those who experienced the Great Depression era, where there was little to go around, yet we are also learning about how this applies to our natural resources in this age of sustainability and eco-friendliness. No matter how much we are blessed with in our lives, remember to think of others and the world at large when handling our resources.

A commonly quoted commandment is to “Do unto others as you would have done unto you.” Be kind to your neighbors. Always treat others with the utmost respect. They are the ones who are there for you when the unexpected occurs. It is also wise to always try to help the next person feel good, no matter how you may be feeling. Helping them will most likely help you feel better as well.

I would like to leave you with one of the most powerful expressions of all. No matter what you feel comfortable calling the source of all things, should you follow these words you will be on the right track: Love, as I (the source) have loved you, for the greatest gift is to love and to be loved.

As featured in North Hawaii News January 8, 2018

Beautiful gifts wrapped in pretty paper and bows recently filled our homes and workplaces as we celebrated the holidays. The anticipation of what was hidden inside, as well as the joy of receiving a new treasure, made the season enjoyable for many. Personally, I was also given a very different type of gift. And trust me, “gift” was the furthest word from my mind as I went through a great challenge throughout the holidays.

Running two businesses, in which great care and attention is required in order to maintain the health, safety and quality of life for older adults, requires a number of caring professionals. I have been blessed to be supported by many such angels through the years. However, week by week over the last month and a half, I lost a number of valued staff members for various reasons. As the demands of around-the-clock caregiving fell upon my shoulders, there were moments when I was amazed that I was still standing and capable of handling it all.

While all of this was going on, I happened to be listening to a CD that spoke to my exact situation of being overwhelmed. The given perspective was that the very challenge that we think we do not want in our lives may very well be a gift. Given all that we desire and work towards, suppose the experience is providing an expansion of understanding that will guide us to where we are meant to be. In other words, we are on the right track when we are experiencing unwanted things.

These words made a great impact on my journey, as I had to rely on my inner strength and determination to once again demonstrate just how much I value the path I am on. My patience was stretched and I found myself depending on the good-heartedness of friends and family to help me through the most demanding part of it. I am so grateful for the understanding and care that surrounded me when I found it necessary to call on support.

Family caregivers are in a position similar to that which I have been in, and I hope this unique way of looking at their experience is helpful. They have recognized that their help was needed in the care of a loved one, and may now find themselves struggling with numerous details and unexpected decisions throughout the day. No matter how much they try to stay on top of things, they never know when they’ll be called on to go above and beyond that which was expected.

Should you find yourself in receipt of the gift of expanded understanding, as I recently did, I hope you will take the time to explore its meaning in your life and travel in the direction you may be called upon to follow. Sometimes getting what we want involves getting a clear picture of what we don’t want as well, in order to be certain about the path we need to take. May the light of hope and good fortune shine upon you in adventures to come.

As featured in North Hawaii News December 11, 2017

Christmas and Hanukkah are almost here, and many of us will have the opportunity to do some celebrating in our own special ways. From gift exchanges to baking parties, connecting in a loving way with family and friends is what it’s really all about. I would like to tickle your brain with some thoughts on how valuable it is to really take in the details of those precious gatherings.

Many customs that we will be honoring have been passed down through the generations. Silent Night was written almost 200 years ago in 1818, and it still brings our voices together in peaceful harmony. At the same time, some new traditions are being created right this moment as recent circumstances and relationships expand our lives and open our minds to new possibilities. Regardless of how established these practices are, they leave a powerful footprint on our hearts.

A little over a week ago, my daughter and I joined our friends and neighbors outside in the rain for the Waimea Twilight Christmas Parade. We all layered up in our raincoats, gloves and boots when it was so very tempting to remain cozy at home. The floats and walking groups representing the diverse beauty of our community passed us by that night, and the connection between all of us in this amazing town left me feeling grateful that we upheld our tradition and were not deterred by the moisture.

Maintaining energy and focus these upcoming weeks by emphasizing the relationships that we are ever-building will help us all stay connected to the spirit of the holidays. A grown woman and her grandmother were talking the other day about how, in preparation for a holiday party, the granddaughter had pulled out the special platters that her grandmother had passed down to her. She spoke of how meaningful it was to her to look at them and recall many happy childhood memories. The grandmother got choked up by the tender words of appreciation spoken to her. It was wonderful to witness such a special interaction between the generations. And all it took was a moment to verbally recognize what those dishes represented.

Amidst the holiday season, many of us have days where we feel as though we are dragging ourselves through the motions while our spirits feel depleted. Trying to accomplish too much, along with the pressure of generations worth of expectations, can make this experience something we feel we just need to get through. Please take the time to refresh with some deep breaths and reflection. The one thing we can always count on is change, so taking time to pause and appreciate the people surrounding you may leave an imprint on a moment that could otherwise be unnoticed. Years later as you reflect on loved ones who have grown, or sadly been lost, it is those memories that rise up and fill your heart with joy.

As featured in North Hawaii News November, 2017

Supportive family members often step in to help when an older adult needs family planning and coordination. Care recipients inevitably find themselves exposed through physical care, financial matters and oftentimes legal issues. Considering how personal these life aspects are to each of us, how would it go over if a well-intentioned loved one came into your life right now and started questioning when you last had a bowel movement, how much money you have in investments, or whether your home is the right place for you? Although these questions are often necessary, it can be difficult for someone to give full disclosure of their life without any discomfort or conflicts of interest.

Without sensitivity and preparation, this situation can quickly lead to a relationship breakdown. Adult children, siblings, spouses and other family relations are often forced to juggle changing needs as they arise, and find themselves having conflicting opinions about the best approach in a variety of life areas. Carefully considering how and why these decisions get made will lay the foundation for a more effective experience.

I have teamed up with the West Hawaii Mediation Center to discuss the importance of positive communication in care partnering. We will offer helpful suggestions, such as structured conversations and family agreements, that can assist with this process.

Here is an example of family members effectively working together: Mom’s memory problems were making it unsafe for her to live alone. Her three children lived in three different states and each considered bringing her to live with them. Since mom felt most comfortable where she was, they all came home to seek out a living situation that would keep her close to home, as well as safe. They worked together to get her settled in a home with experienced care. They communicated via group email or text with her caregiver and amongst themselves to make decisions as a collaborative group. Educating themselves on memory loss helped them communicate with mom by letting her live in her own reality, and only sharing necessary details — seeing that too much information caused anxiety for mom.

Suppose one of the children had insisted that mom was fine living alone or that she would have been better off living with them. These types of conversations are often based on individual interpretation rather than well-supported understanding. This is why there is power in writing intentions down. It provides family members with a reference point on which to base decisions.

As varied as each care situation is within each family structure, there are some common disputes that could be avoided thanks to pre-planned conversations and mediation sessions.