Host Sebra B speaks to Jenna Dion, Geriatric Care Manager at Clear Guidance LLC. She shares her experiences and advice from 17 years in the dementia care field. Learn how you can remain calm when caring for a loved one with Alzheimers with techniques such as box breathing and body scans.
WBCA Podcasts
The Mindful Aging Show
(upbeat music) - You are listening to WBCA 102.9 FM Boston's Community Radio Station. Welcome to the Mindful Aging Show, where we explore the connection between health, mindful aging, and aging gracefully to give you information to make choices that educate and empower you to be your best advocate and live your life fully. My name is Sabra B and I'm the host of the show. The goal of the Mindful Aging Show is to identify and define mindful aging from your perspective and put it into action for you to live the life that you value. With this show, I want to explore mindful aging and find out what we really mean by that and how do we really do that. I also want to talk about education, empowerment, and advocacy and how you can take action. You know, when we talk about being mindful, the first thing that people think about is focusing. They think about being in the moment, meditating, or just slowing down. And today, I want to highlight a very important reason why we need to take that action of being mindful. For those of you who don't know, November is National Family Caregiver Month and it's a time to not only recognize and honor family caregivers, but also to raise awareness of family caregiving issues. So who are caregivers and what do they do? Well, according to the website caregiver.com, family caregivers provide enormous value to society. Their services often make it possible for their loved ones to remain at home. It usually fills a gap that would be astronomically expensive otherwise and it goes on to say that caregiver, caregiving, the process of caregiving, can be tedious, it can be repetitive, it can be physically challenging and emotionally straining for many caregivers. They sacrifice their own wellbeing to take care of their loved ones. And I'll briefly share that I was a caregiver from my mother who had Alzheimer's dementia and some other chronic illnesses and I can attest that it was very difficult for me. And of course it was during the time of COVID where I didn't feel like I had any support and I really didn't know where to turn. I didn't know who to reach out to until one day in the middle of a lot of stress with caregiving for my mom, I took a minute to sit quietly and ask myself, where will I find resources and how can I find resources? And I thought about how I used to call the Alzheimer's Association early in my mother's disease process and so I did reach out to them and I called them and I actually got a lot of support in real time to help deal with a lot of my caregiving strain I'll say. I also started watching YouTube and like most of us did during the pandemic, I started searching for information about caregiver stress and caregiver burnout when you're taking care of someone who has Alzheimer's disease. And what I found was the need to take a minute from me but I still didn't know how to do that. You know, I really had to learn what that would look like for me. So taking five minutes to take a deep breath sometimes was all that I could do for myself to recharge and renew my spirit and as I said, it was quite challenging. So today we're gonna honor Family Care Giver Month by talking about mindful dementia care. My guest today is Jenna Dion who is a geriatric care manager at Clear Guidance LLC. She is a certified dementia care practitioner and a certified dementia care partner. She's worked in the dementia care field for over 17 years and has held positions as a dementia care consultant at the Alzheimer's Association of Massachusetts in New Hampshire. She has consulted with thousands of families to help navigate the diagnosis and help persons living with dementia focus on their purpose and what they can still do well. Welcome Jenna. - Thank you for having me, Sabra. - I am so happy that you're here. You know, I told the audience about you professionally but I'd like for you to share with us who you are and what you want us to know about you. - Well, you did a very good introduction and said a lot of things that I would say about myself. I would add that during my journey in this profession is that it really did come from my maternal grandmother had Alzheimer's disease when I was about 11 to 20 and she really, I loved her so much and I was good with her. That kind of led me to a path that I didn't know I was gonna be on and now I'm just turned 35 and I'm grateful for her guidance to be here even though I wish that she didn't have the disease. So that and just, you know, being a steward somehow for caregivers and those living with dementia has been a really beautiful gift even if it's challenging at times. So thank you for having me here, Sabra. - Oh, you're welcome. So, you know, when I was talking about you, I was really struck by the fact that you help families to navigate the diagnosis and help persons living with dementia focus on their purpose and what they can still do well, which to me also defines mindfulness. Talk to us a little bit about that. - You know, what I've heard from people living with dementia is that, you know, they go to a neurologist or they go to their doctor and they're given a diagnosis and it's like, okay, go get your affairs in order. You know, basically there's not much we can do a few medications and good luck we'll see you in a year. And both the person living with dementia and the caregiver is like, well, what? What do I actually do? So, you know, with that process, I really learn like, okay, you know, what gets us up in the morning? What makes us, you know, wanna keep going if you have that diagnosis or, you know, you have to, you know, help your parents or whatever it is, it's finding something that gets you up in the morning. And so, I've helping people with dementia think, okay, what do I love to do? What makes me feel alive or gives me purpose? And that could be, you know, talking to your grandkids that could be helping like the local, you know, food pantry, you know, obviously there's some roadblocks, say, you know, if you can't drive anymore, it's like, okay, if you can't drive anymore, what other opportunities can we look at? Can we do like Uber? Can we see, you know, what the town has for transportation? Can we get maybe your kids or your community to help? So, it's kind of looking at like, okay, what can I still do in the context of my strengths and limitations? So, that's kind of how I like to talk with people with dementia because I've heard from so many like, okay, well, I'm just gonna give up, you know, and giving them that sort of like empowerment, but also allowing them to grieve with their diagnosis because I don't wanna be a Pollyanna and say, well, you know, just keep doing great things when there's a lot of sadness involved with losing some of that individuality and personhood that, you know, the changes throughout the disease. I also think with caregivers, you know, if you're putting your whole entire, you know, drive and personality into your loved one, you're kind of burning the candle at both ends. - Absolutely. - Instead of like kind of maybe finding, you know, little ways around that to give you purpose, to talk to another caregiver, to, you know, feel like you're contributing in some way. And the last thing I'll add to that, even though I'll talk more about it, is David Kessler, who worked with Elizabeth Kubler-Ross, who created like the, well, she defined the stages of grief, which are like denial, anger, bargaining, depression, acceptance, which none of those are linear, you know, you don't just like graduate to acceptance. But David Kessler talks about the antidote being purpose. So we have these, you know, these stages of grief. And if we think of the six stages purpose, you know, it's almost like putting the energy of into that grief that there's like an output to help, you know, kind of navigate the ups and downs if you're putting like this radio show, you know, like giving, you're giving back to the community, something like that. And it's all, you know, depends on who you are as a person. So, yeah, so that's kind of where that purpose comes from. - Well, even when you talk about purpose, you know, relating it to being mindful, it still is focusing on something in the moment. So share a little bit more about that with us. - I think, you know, when we're thinking about purpose, we have to think, we have to have internal self-reflection of, you know, kind of sitting down with ourselves and saying, you know, what is important to me? You know, what gives me what makes me wake up in the morning like I was saying? What, you know, what makes me happy? Even if it's just like sending a text message to a friend in the morning when you wake up or watching a funny Saturday Night Live, you know, video or something that just kind of gets you, like your brain flowing or you're like, you know, okay, you know, what is important to me? Is it giving back to people? Is it like maybe, you know, you know, helping people, you know, you know, like, for instance, I'm not that great with organization of like maybe finances or something, but that's somebody else's strength. So, you know, just talking to maybe a younger person on, you know, what they can do. And with that being said, and going back to mindfulness, so if you are caregiving and giving, you know, 24 hours a day or, you know, however that looks for you, you're at the same time if you're having trouble with mindfulness and you're just an autopilot, which is very common, it's hard to even think, like to have the space to think about purpose. - Yeah. - So mindfulness is not only about, you know, it's kind of like every step of the way you have to have a mindfulness practice and that doesn't mean sitting and meditating for hours and hours. There's many different ways to be mindful, but you also have to have a mindfulness practice to clear out your mind so that it's not like, I've got to do laundry, I've got to get mom's medicines, I've got to, you know, that laundry list that tends to happen when we're in that fight or flight anxiousness doesn't even give us space to think about our purpose, you know, 'cause like even being like, well, we have to find your purpose. People are like, well, yeah, I don't have time for that right now, you know. So, and I can speak more to that kind of, you know, mindfulness around caregiving, we're stressed too, but I want to check in with you and see where we're at. - Okay, well, I just wanted to let everyone know you're listening to WBCA 102.9 FM, Boston's Community Radio Station, and this is the Mindful Aging Show. I am Sabra B, your host. And today, in honor of National Care Government, we're talking to Jenna Dion, who is a geriatric care manager about mindfulness as it relates to dementia. So, Jenna, you said you were gonna go a little bit more into that, let's do that. - Okay, great. Being in this career for so long and having my own grief journey, you know, having my own story around grief, I tend to, when I'm working with people, think about, okay, what, in the larger scale, what are people struggling with, what is happening to them in this process? - And in my own research, there's this term called window of tolerance by Dr. Dan Segal, and he talks about, our window of tolerance is when, you know, we're in a regulated state. So, I talk about the word emotional regulation. And so, when we're in like kind of a calmer state, our brain maybe is not as like, you know, like the laundry list is what I was saying. I think about an example, like say, you know, today I drove from New Hampshire to Boston, and there was many parts of traffic. And today I felt fairly regulated, felt like the window of tolerance, like somebody cut me off, I didn't, you know, honk my horn, I didn't do anything that I would have regretted. You know, I was kind of like, oh, they probably have somewhere to go. Or, oh, that's annoying, but, you know, in the scheme of things, I'm fine. So, if I was not in my window of tolerance, and I was in, you know, you kind of think of a ladder, what's the next step up is hyper arousal. So, hyper arousal is when we're in a state of, you know, fight or flight we have, you know, are we angry? Are we resentful? Are we, you know, fly off the handle? So, if I'm in a hyper arousal and someone cuts me off, what, you know, we think about how do we express anger, or like that sort of trigger, like, you know, mine might be beeping my horn or yelling at someone, and then, you know, that feeling of like, you can either, you know, like, I'm so upset. So, that's like that hyper arousal. And when you think about it with caregivers, you know, it's, I think there's a lot of hyper arousal, because you're in that state of hyper vigilance, okay? So, like, am I gonna get a call that, you know, my mom fell, or, you know, did I get all the right medicines, or how am I gonna pay for this? You know, when's the shoe gonna drop? It's that you're revving, you know, you think of a car and RPMs, like, you're revving your engine so high all the time, okay? So, in that window of tolerance, or in that hyper arousal state, okay? And then, you think about, okay, if you're in hyper arousal and you're revving hard, and you're burning yourself out, there's a state called hypo arousal. And that's where you, you know, that term play possum, where, you know, you're like, kind of apathetic, you don't wanna get out of bed, you don't, at this point, you don't care if you get a call, 'cause you're like, well, here I am. It's like a defeated feeling, okay? So, ideally, we wanna be emotionally regulated to be in that window of tolerance. And the question is, how do we do it? Yeah. So, you know, that's where some of this mindfulness stuff comes in, it's like, I kind of use window of tolerance to like, you know, maybe even when I'm in traffic is like, I mean, it's kind of better maybe, before I'm in traffic to be like, what's my state right now? You know, am I, you know, feeling like I'm holding my breath? Am I feeling like jittery? You know, so sometimes those feelings of like, the hyper arousal is, when we're stressed, is like, what are we feeling in our body? 'Cause a lot of times, we're stuck in our head, okay? So, the mindfulness with the, you know, putting with the window of tolerance is kind of allowing us to check in with our state of being. You know, so it's kind of, you know, we, I don't know if you've heard of like a body scan. It's like, you know, checking in with your head down to your shoulders, you know, if I'm in a hyper arousal state and I'm doing that, I'm gonna feel my shoulders, you know, near my ears. So, you know, you can do the body scan to kind of see where you are. And when we're in a hyper arousal state, you know, it might be, we might wanna use things that, you know, calm us down, so breathing, you know, kind of slowing down, you know, using our senses, okay? You know, looking at what's around us, what can I hear? You know, kind of just like breathing to calm down all of those neurotransmitters that we produce when we're stressed out. Like everyone's heard of cortisol. You know, we're in hyper arousal. We're constantly producing cortisol. And that's keeping us in a fight or flight. So sometimes if we just say, okay, where am I right now? Am I safe? Am I okay? You know, in this moment, okay? And then we can use our breath to anchor ourselves. We can use like even, you know, tapping, which is, you know, you tap the top of your head. You can kind of look this up on Google that you type in tapping. It kind of helps us get away from this stream of consciousness that we sometimes don't even know we're in because we're just an autopilot. So I like to do that. I like to check in with myself. I like to just say like, okay, am I anxious? Am I hyper vigilant? And then if I'm in hypo arousal, sometimes it's like, how do I get myself back up the ladder? You know, sometimes it's like putting ice cubes on our wrist or, you know, maybe even singing or just kind of doing that more like invigorating stuff. - Well, can I give you an example of a caregiver? Yeah, that's in that moment with the person that they're caring for that has dementia. And it is a moment where there's something like you said, you're always trying to think of what's happening next. And the person that they're caring for or a care partner with is feeling like they don't want to either go somewhere, eat something or, you know, from the caregiver standpoint, not be quote unquote agreeable. Where we know that the person living with dementia is really just responding to their environment. But in that moment where the caregiver really wants to scream, wants to rush them along, how do you, how do you think of centering yourself? How do you think of taking that second or 30 seconds to say, what do I do? - All right, well, I have a lot of thoughts when I have about this because this is, you know, common like, you know, okay, mom, you got a shower. I already showered last night, knowing that, you know, they haven't showered for a few days or whatever it is. And you're like, get in the shower. Like when you're in that hyper-arousal, sometimes you can't, you know, in my career, I've been trying to teach people all these communication, you know, you know, say yes, agree, you know, be kind. But if you're in a hyper-arous state and you've been in that state for a long time, when your mom says, no, I'm not showering. In that moment of that fire flight, you click on and then you feel guilty about it 'cause you're like, I don't wanna yell at my mom because that makes me feel bad and her feel bad. So I think a lot of this in an ideal world would be every day we're practicing to try to get into, you know, window of tolerance. It's kind of like, if I wanted to, you know, tomorrow, if I wanted to run a 5K, you know, it's gonna be really hard. But if I'm doing like the couch to 5K where I'm, you know, gearing myself up and training, that's the ideal. But, you know, if you don't live in an ideal world, necessarily, and especially with caregivers or care partners, is that I love the power of pause. P-A-U-S-E, pause, and breath, okay? So I hope if you get anything out of this talk is my favorite thing called box breathing. - Box, B-O-X? - B-O-X, box breathing. - Okay. - So say, you know, you're in this situation with your mom and she's, you know, you're starting to feel her rev, you're revving up, you're getting it, you're in that hyper arousal state and you feel that your heart rate, a box breath, and you don't have to be anywhere else, you know, you can be right there, is you're gonna breathe in for four seconds. So you're breathing in, one, two, three, four, you're holding for four seconds, and then you're blowing out your mouth for four seconds. And what that's actually doing is it's taking, I don't know the exact science, but I've, you know, heard and listened to a lot of podcasts and read a lot about it and practiced myself, is that it actually pushes cortisol out of your heart. So if you're really stressed, you're having cortisol run through your bloodstream. If you're breathing like that and you're doing that consistently, it's, you know, pushing oxygen into your heart and sending that blood out with cortisol. And then that helps our blood pressure that's helping us get down to the window of tolerance. You know, so sometimes that pause and you don't have to do it for too long, but it's just enough that when you're about to go into that hair trigger of, you know, whatever it looks like for you, sometimes a pause, a breath, or you know what, I really have to go to the bathroom right now, I'll be right back, that is permissible so that when you're in that hyper-arous state, you're not just, sorry for the, you're not going zero to 60. You're able to sort of pause, see if you can get back in a regulated state. And that could just mean that instead of flying off the handle, you're saying, yes, I understand. And then, you know, I could teach all the communication tips, but you can find those. But basically what I'm saying is that emotional regulation and nervous system regulation is really the state we have to work on to do any of those things that are successful in caregiving. So there's a lot of practice, but it's, some of these things you can just practice within yourself, like the breathing, you know, sometimes even just, I like to do, okay, look at everything that's blue in the room, you know, and so your eyes are scanning the room, am I safe? Yes, 'cause you know, your body's looking, a lot of this comes back to evolutionary times, okay? There was like a threat, like a tiger in the room. You know, our fight or flight, we had to go in this to like run away as fast as we could. So when we're scanning the room, that's our body's way of saying, there's no tiger in the room right now. You're safe, take a breath. And then try, try again. I don't know where that quote comes from, but it's basically like, try, try again, you know? It's like, okay, if it doesn't work, pause, breathe, maybe go and even have some gum or something so that you're concentrating on something else. So, you know, there's a lot of things that are in this world of emotional regulation, but sometimes to just start with pause, breathing, you know, scanning the room for colors. But yeah, so that, and then that opens space to maybe respond the right way and have your loved one or your mom or whoever maybe feel that centeredness in you. Because if people with dementia are sponge, they can, if you're going, all right, get in the shower, they're gonna feel that little raise in your voice. And then all of a sudden they're like, I don't think so. And then you're going back and forth. Where if you're a little more centered, they may be responding to your center itself. So, you know, that's my, I could probably go on for hours, but long winded. - That, you know, I think for caregivers, we need one thing. - Yeah. - And I think that's the one gift because it starts with, as you say, being centered. And I want to just remind everyone that you're listening to WBCA 102.9 FM, Boston's Community Radio Station, and this is the mindful aging show. Now, Jenna, as we're talking, I know that we're gonna have to have a part two and most likely a part three because there's so much information that I know that you can share. But I know that our listeners have been able to at least take that one thing away, you know, to just pause. And as I'm thinking, I do want to make this probably a continuing series because it's so, it's so very important. So I want to be able to invite you back for part two. And in our last, like five seconds or so, if there's one thing that you would like to share with our audience about just being mindful, especially as a caregiver, what would it be? - I think being mindful as a caregiver, I want you to, if you're able, to look into box breathing, to just follow that four seconds in, four seconds out, or four seconds in, four second hold, four second out, and to just put your hand on your heart. To just, when you do that, just say the words, I am okay. 'Cause sometimes we need a reminder that I am okay as you breathe. So anyone can do that. I have to do that, you know? - I will be doing it. - So just pause, breathe, and then affirmation, I am okay. So that's what I want to leave with you today. And thank you, you're wonderful. I'm glad I could be here. We all need a little help from our friends, sort of speak. So thank you, Sabrina. - Thank you, thank you, Jenna. You have been listening to WBCA 102.9 FM, The Mindful Aging Show.