Host Sebra Barcuis continues to speak with Jenna Dion, Geriatric Care Manager at Clear Guidance LLC. Learn even more techniques you can utilize remain calm when caring for a loved one with Alzheimers.
WBCA Podcasts
The Mindful Aging Show
You're listening to WBCA 102.9 FM Boston's Community Radio Station. I have the pleasure of having this be my part two show. This is the first time I've ever done a part two, but I thought that it was so important to continue the conversation with my previous guest, Jenna Dion, who is a geriatric care manager, because we were talking about November being celebrating caregiver month and honoring caregivers, and Jenna was really just giving us some helpful tips in terms of how to relax when you are in a moment with someone that you are a care partner for, when it could be a little bit stressful, and you really, really need to focus on what's happening. So I want to pick it up right away, and thank you again, Jenna, for participating with me in part two, and to really kind of move right into some of the helpful hints, helpful, I'm not going to say tips and tricks, because it's really not a trick. It's centering, and it's really getting to know who you are and how you can change the vibration of the environment that you're in with the person that you're caring for. So thank you again for just giving us all of this wonderful information about mindful dementia care. Well, thank you for having me, and I'm grateful for part two, because I have a lot to say. And when we were talking last time about being mindful in the window of tolerance, and sort of just the recap of the window of tolerance, it's emotional regulation when we're feeling centered. And then hyper arousal is more of the anxiety and hyper-vigilant state. And then our hypo arousal is our burnt out state. So, and I like to explain it this way, because it just allows us to know when we're centered. And I talked a lot about box breathing, and I talked a lot about just kind of being able to take that moment to look around the room and just say, okay, you know, what's blue in here, or what's red in here, you know, just to pull yourself away from getting triggered when you are in a stressful environment. And there's, like I was saying, it's kind of like a marathon that you have to practice. Because the more we practice breathing, or other forms of mindfulness, say body scans or tapping, or, you know, participating in things like, you know, yoga or Tai Chi or Chigong, you know, it doesn't even have to be that, it can just be even if you look on Google breathing exercises, there's just, there's so many ways to get there. Another thing may be walking meditation, you know, where if you type in YouTube walking meditation, you put your headphones on, it's someone that's, you know, walking you through maybe counting steps or counting your breath, or again, using the colors to look, you know, in your environment, so that basically you're telling your body, I am safe, there's not a tiger in the room that's going to attack me. And I'm using tiger in the room as, you know, an evolutionary times where the limbic system in our brain, you know, this, that reptilian brain that's, you know, very reactive in a fight or flight mode, you know, is that we didn't have the front part of our brain, which is our frontal cortex, to tell us we are safe. We don't need to run from this tiger, you know, like when we're caring for our loved one, and they're saying, you know, they start saying I need to go home, you know, and you're at, you know, eight o'clock at night and it's cold out and you're like, you are home. And then they're like, I'm not home, and you're starting to feel that, you know, you get upset and maybe try to re-explain, you know, that sometimes when you're in that hyper around state, your brain is like, Oh, big trouble, I'm going to fight or flight or whatever your system does and stress is that the breathing exercises come, they also almost turn on the logic parts of our brain. When we're centered and we're like, okay, what is going on here? What is in my environment? Our front part of our brain is able to turn back on and say, okay, I need to pause some more, or I need to walk away and come back 10 minutes later, or how important is getting mom into the shower right now? Can I wait? You know, so it's, you know, using our breath to sort of make our brain turn on to be more logical in that moment. And one thing with dementia that's really tough is that in dementia, you're losing the function of your frontal cortex part in your brain, okay? So that's our planning, our logic, our organizing, our, do I really need to yell at my daughter right now? You know, it helps kind of, it's like the governor of our brain, you know, so when people with dementia are, you know, you know, sort of in that fight or flight place, that's kind of the space they live in. They're not able to say, you know, I probably shouldn't get upset about this because they're living very much in their limbic system. So they, they're losing the ability to kind of calm themselves down. So it's then puts even more responsibility on the caregiver and I hate putting all that responsibility, but it's kind of like to build that muscle of your prefrontal cortex to say, okay, I need to pause right now and I need to not fly off the handle. And that's when, you know, walking, breathing, tapping, yoga, you know, different meditation apps like calm, head space, insight, timer, just googling on YouTube or YouTube being like mindful walking, mindful breath. And yeah, so those are kind of some more tips and there's even more things we can do, but well, I want to sit there for just a minute because you made me think about something, you know, as I look in, in retrospect with my relationship with my mom, which was a very loving relationship, but I would at those times, when we would sort of have that back and forth, it really became sort of a battle of the wills in a sense. And after every single time when I realized I wasn't going to win, and I had to retreat into the bathroom and shed tears and take a breath and I would always say, why did I do that? Why did I push her? I know she's not going to do this. I know that she's not necessarily understanding me. And once again, in hindsight, to have been able to take that moment and not feel like I needed power rather than to sort of be introspective to say, what's really the goal here? Is it for her to do as I'm saying, I'm telling her to do, what really is the goal? And I think a lot of caregivers can relate to that whole power struggle that happens. And then you feel guilty, you know, and then you're crying. And then your loved one feels that they may not be able to express it in a way that we understand, but even their behavior changes. So you know, that's just so important for you to help us with some of the things that we can do to be in the moment, but be away from the moment, if that makes sense. Yeah, I think, and I think that's a really good question, is like, what is the goal? And sometimes you have to ask yourself that before you pause. And sometimes you have to pause and then ask yourself that. And I think, you know, one of a word that I like to use is, you know, grace, because I bet you the Dalai Lama would yell at their parent if they were in this position, you know? Like, just giving yourself grace to say, okay, why is this so stressful? Why did I just yell? Because, you know, my best friend, I'm losing a lot of her, and it's really, I'm really sad or I'm really angry or I'm really scared. And maybe I just need my mom right now and I don't feel like she's there right now. So and then, you know, so then it goes back to a lot of, like, you know, self-soothing in a way. It's like, do I need to give myself a hug or a little, you know, do I need to have my spouse or my best friend, like, kind of give me a word of affirmation or, you know, have more people check in on me? Because I've heard people say sometimes that it can be, you know, you're in a room with your loved one who has dementia and maybe they're more advanced, that it has this essence of a deeper loneliness because there's such a deep grief associated with a lot of it. And then also I say is that sometimes not everyone has the most loving relationship with their parents or their spouse that has dementia. And so that Alzheimer's isn't just in like a siloed or a dementia, it's not just a silo. It's maybe resentment that you have of the past or you have things that you need to work through in that relationship. So then, you know, they won't get in the shower. So then it's, you know, it is affecting so many different pillars and so I just like to use that word grace because, you know, we're not perfect, but we can try to pause a little bit more or we can try to take care of ourselves a little more so that we don't fly off the handle and then feel guilty. And even if we do fly off the handle and feel guilty, that mindfulness can also get us back to being, you know, to maybe forgiving ourselves for doing something and not carrying that anger that, you know, we're such a terrible daughter or, you know, just allowing yourself to say, I'm trying my best, you know. So a lot of this, I think, it's helpful, you know, to, you know, have these resources and then maybe, you know, outward resources as well of like a good friend system or if you can, you know, if insurance or, I don't know, like for therapy or community resources or, you know, calling the Alzheimer's Association or, you know, care management where you can get, you know, like it takes a village, you know, so you have your friends and family, you have maybe professional resources, you have just kind of ways that you can maybe co-regulate, so I talk about self-regulation, there's also co-regulation where maybe you can talk to a friend and they can give you a hug and you're like, okay, you know, so there's so much of your relationship with yourself, your relationship with the person living with dementia and then your village at large. And one other thing I want to say, even though I have a lot to say is, you know, people living with dementia and I said that there can be like a loneliness for caregivers but I also said in the first episode is the person living with dementia is feeling those changes and that grief and loss of identity is that, and I talked about kind of losing that ability to control emotions and with that, I also think people living with dementia can do breathing exercises and, you know, listen to music and help them feel less anxious. So that's where we talk about, you know, what strengths do you still have, you know, what can you still access to help yourself feel more regulated? So I just wanted to put that out there that I think people living with dementia, these tips are also useful, you know, so whether you're doing them on your own or you're doing them with your loved one, or you're doing them with, you know, a caregiver that comes in the house, you know, so I just wanted to preface that, that this is for everybody. I think that is so important, especially once again since we're talking about mindful practice and with this being the mindful aging show and with this being the show that I'm dedicating to a family caregiver month, supporting family caregivers, I think it's really important to stress like you have that this is an exchange, it's not about one person, which is so wonderful. I wanted to let everyone know that they are listening to WBCA 102.9 FM Boston's Community and Radio Station. This is the mindful aging show and I am Sabra B, your host. My guest is Jenna Dion, a geriatric care manager. She's also a dementia care practitioner, a certified dementia care practitioner, and a certified dementia care partner. I wanted to just pivot a little bit because with your bringing up how we need to be mindful of what the person living with dementia is going through, just talk to me a little bit about and also with you saying that sometimes we do have to seek professional help. Talk to me a little bit about what a geriatric care manager does and a certified dementia care practitioner and especially a certified dementia care partner because I know that we do have dementia care partners, but just in looking at the three of them, what's similar and what's different. I think that as a care manager, it's almost like all my experience over the years is sort of packed into this description of, as a care manager, you're looking at the care partner, you're looking at the person living with dementia, you're looking at the health systems, you're looking at the environment, you're looking at all of these different things that go into the system. So looking at the person living with dementia, what's their personality, what gets them up in the morning, are they on the right medications? It's kind of like looking holistically at the whole picture and I think that's what all of those certifications have taught me. They've taught me just disease education, like what's the difference between dementia and Alzheimer's, which is such a common question. Where I like to, I've learned over the years that dementia is just an umbrella term. So if I were to say, what virus do you have, you could say, well I have, do you have strep, do you have mono, virus is an umbrella term and then dementia is an umbrella term. So what dementia do you have, is it Alzheimer's, is it vascular dementia, is it Louis body, Alzheimer's is the most common, 60 to 80% of all dementias. And so it's taught me to understand the disease pathology. It's taught me, okay, if the disease pathology is affecting this part of the brain, this is the behavior that you're going to see. And then that allows me to say, okay, that's not the person, that's how the disease is affecting their brain, that's their behavior, what is their behavior trying to tell me? What is the emotion underneath, what can maybe I do differently or the care partner do differently with our behavior, it's affecting the person living with dementia, is it, it just allows me to look at the whole system. And I think that sometimes when you're in it, you can't look at the whole system because you're in it. Yeah, yeah. So that's why sometimes having a professional like a care manager or the Alzheimer's Association or just, you know, PCP or your neurologist, they can help you look outside the system a little bit more, you know. And so that's where I think all of those certificates and I think, you know, most of my, where I've been has been experience, you know, I've worked in memory care assisted living and I've done support groups for 10 years and I've done, you know, I've befriended people with dementia to really understand what their experiences. And the last thing I'll say about, you know, sort of my work is the most important for me is to understand grief, to learn about grief, is to learn about how people are when they feel like they're losing someone they love or they're losing themselves. Because the more I understand about that, the more compassion it gives me and the more empathy it gives me to then be able to, you know, have grace for the people I'm working with or to maybe even teach the concept of grief, grace, excuse me, for the care partners, the medical team or the person living with dementia. In all of that, full circle, I have to have mindful practices for me to be better at my job. And I've been practicing for 20 years, sometimes I don't think I breathe for like a month and then I say, okay, Jenna, maybe we should start breathing again and so again, it's just coming back, coming back to a more centered space. So I admit that I'm not always perfect in that regard, but yeah, so that's kind of what I do in a nutshell and I feel grateful to be in that space and I'll admit that it can be very difficult at times for my own heart, but I remind myself, like, if I can hold that space for someone, maybe me holding that space can cause the other people to maybe be a little more calmer and be a little bit more able to pause. So yeah. Well, you just brought up something that I think in another episode, we want to talk about grief because we sometimes look in the rear window of grief and don't really understand that we're going through that as we're caring for or with the person living with dementia. So I want to make sure that we make that a future, you know, a future presentation because I think that's so important. But I wanted to just share something with you in our last few minutes. According to the Institute on Aging, mindful meditation and dementia have one very important thing in common, they're strongly linked to the present, the present moment. In fact, mindfulness practice can help our aged loved ones. Yeah, mindfulness practice can help our aging loved ones and body. There's, okay, Sabra, you know, this is like we're talking at the kitchen table, but essentially what it's saying is that mindfulness practice can actually help our aging loved ones and their bodies focus on their strengths rather than their perceived weaknesses. And when I read that, I also wanted to share with you and with the audience that, you know, my mother passed away in 2021 and I'm still finding things. I'm still finding notes. I'm still finding affirmations. I'm still finding little things that she wrote to herself that let me know what was happening with her in the disease. And I recently found a prayer that she would keep in her Bible. I never knew about this. So like I said in our last few minutes, I'm going to read this. I'm going to read this quickly and I'd like your comment on it. I quote John in the Bible that says, you know, my peace I give unto you, dear Lord, I believe in your goodness with all my heart. You are ever wise and caring. There is never a reason for me to hold back anything when I talk with you in prayer for you understand every worry and every wish of mind. How grateful I am to have you to confide in one of your greatest blessings, Lord, is peace of mind. It is this wonderful blessing I'm seeing as I come before your presence now. Today's world is very rushed and hectic with a lot of confusing things going on. Often I get an awful feeling of unrest, a feeling of inner turmoil, please help me. Yes, help me to rid myself of unsettling thoughts that make me tense and ill at ease. I so want to be able to face the pressures of daily living by thinking in peaceful terms about any problem which might arise. I pray you will answer my plea and send me blessed peace of mind. Let me soon feel a new calmness, a new peace within. My faith in you is a strong faith and it comforts me to know that no matter what may ever happen in my life, I'll always have you at my side to guide and love me. Thank you, Lord. Amen. I recently found that and just looking back with my mom, I know that this is something that she as a prayer probably was saying every day all day for many years. So with that, I'd like your last little piece of wisdom for us. Yeah. What a beautiful prayer and apropos of this conversation of a peaceful mind that sometimes we can be in almost feeling like the depths of a dark place when we have these scary thoughts of confusion or there's so much going on in the world that I think when we're connected to our breath and just being centered that regardless of religious beliefs or however you practice that we all want peace of mind and that we can get that through breath. We can get that through meditation. I think prayer is a form of meditation. I think it just allows us to just center and listen and get into the window of tolerance, which is equal to peace of mind. So I think it's all interconnected of just, I just want to feel okay, like just. And I think with when we're living with dementia and even being a caregiver or just a human in this world is we're living in a scary time. We don't quite know. We feel maybe not safe or protected or there's chaos. And I just think if we can just go into ourselves to breathe, to ask for peace to maybe even go to what we're grateful for, because I think our brain is a very strong machine and that if we can sort of veer it back to being centered and peaceful and maybe some gratitude that it can help us stay centered rather than going down rabbit holes or you know, and that does happen. You've been listening to WBCA 102.9 FM Boston's community radio station. You've been listening to the mindful aging show and my guest today was Jenna Dion. Thank you, Jenna. Thank you, Sabra.