Monday, March 28, 2011

Quick & Healthy Dinner Preparation ...

When you spend the day caring for others' needs, it is more than possible to arrive at dinner time exhausted and uninspired. And, if you're like most of us in that situation, you will be strongly tempted to reach for something highly caloric, high fat, highly salted or sugared, refined and fast! And then to regret it until bedtime or beyond.

Caregiving takes a lot of energy and we all need nutritious meals to fuel us as we do our caring work. Here are a few tips for ensuring healthy eating at the end of the day:

1. Cook twice the recipe whenever you make a favourite meal and freeze the leftovers in individual serving bags for another day. Or, alternatively, plan a big cooking day once every couple of weeks and cook several meals at once for stocking the fridge and freezer. (Put a chicken in the crockpot, a roast in the oven, soup or stew on the top of the stove and make a big bowl of quinoa or bean salad and - hey, presto! - meals for the next two weeks. I usually take a 4-5 hour Sunday afternoon to do this kind of cooking and it saves me so much stress during the week.

2. Simplify your meals. Home made soup, salad and a fresh wholewheat bun can make a great dinner. Some of my favourite quick and healthy recipes come from Jules at the Stone Soup website. Here she offers simple, healthy, 5 ingredient recipes that are ready in a flash. She also has a 5 Ingredient cookbook and a virtual cooking school for the less skilled among us.

3. Add your favourite healthy ingredients to a commercially prepared product. For example, add kale and quinoa or pot barley or chopped-up microwaved yam or beets to a healthy canned soup. (Watch the salt content here.)

4. Learn some simple, healthy sauce recipes to dress up leftover meats or pasta. Jaimie Oliver's Basic Tomato Sauce is one of my favourites. It's available in his Jaimie's Dinners cookbook and on the Internet.

5. Ask for help if you are a family caregiver who is too tired to cook. When friends or family ask what they can do to help, ask them to bring a dinner as a once-off or on a regular basis. Be sure to let them know your preferences, dislikes, and any food intolerances or restrictions.

6. Include your family in meal preparation the night before. (You may have a whole house full of little sous chefs!) Get them to chop vegetables, stir pots, wash dishes - whatever is age- appropriate and within their capabilities. You may have to exercise a little patience to begin with, but soon they will become more skilled and they will feel so proud of their newly acquired skills.

If you have any other ideas that work for you, please add them to the list!

Saturday, March 19, 2011

Secondary trauma first aid...

My heart goes out to all people suffering the direct effects of the disasters we are seeing on TV this week.

How much the world can change in just a few days. Even though I was fairly sheltered from newspapers, internet and newscasts while I was away, just the conversations of those around me and my own naturally hypersensitive empathic responses were enough to raise my heart rate, increase my respirations and create a buzz of anxiety. (Witnessing trauma triggers old trauma responses.)

The current disasters, to say nothing of the trauma we encounter in our workplaces and caring situations at home, can combine to cause acute secondary trauma responses in our own lives even though we are not actual survivors of the disasters. What can we do to lessen the effects of the trauma we witness?

Here are a few practical tips:

1. Monitor and limit your trauma exposure through TV, the internet, newspapers, and conversations.

2. If you begin to feel anxious, stop and take a few deep breaths and relax your whole body, particularly your pelvic floor muscles, as you breathe deeply, pause, then slowly release your breath through pursed lips. (If a medical condition contraindicates this type of breathing, please make adjustments to meet your own needs.)

3. Take a walk in the fresh air every day.

4. Talk about your feelings with someone you trust to listen respectfully.

5. Draw deeply upon your spiritual beliefs and practices.

6. Do something to help someone else. It will lessen your feelings of helplessness. For example:

- Pray for them or hold them in your meditation.
- Send a donation to a reliable disaster relief organization.
- Send a note of support to someone who is directly affected by the disaster.
- Help someone in your family or neighbourhood - drive someone to a doctor's appointment, visit someone who is shut in, do someone's grocery shopping, spring clean someone's garden, do a new mom's laundry, buy some flowers for a friend who's struggling ...

7. Be close to the people who love and support you - either in person or by email, Skype/iChat or phone.

8. Ramp up your usual self care practices - trust the strategies that have worked in the past.

9. If none of these things help, consider seeing a counsellor who specializes in trauma work. There are a number of short term interventions that could be very helpful in reducing your stress.

Monday, March 7, 2011

Vacation ...

Hi everyone! Just a note to say that I will be off to Vancouver Island in the early hours of tomorrow morning to spend Spring Break with family and friends. (So, I won't be posting here again until after March 17.)

I've written, before, about how important it is for helpers to take breaks before we need them, so this week I'm taking my own advice and having a brief foretaste of what will be a longer vacation in the summer.

As someone who is self employed, I'm always surprised when salaried folks don't take their full allotment of paid vacation. (As a family caregiver, I was even more amazed!) We need these regular breaks from our caring work or we soon find that the well is empty and we have nothing left to give.

Dr David Posen offers some sage advice about taking time off in his book, The Little Book of Stress Relief:

1. Plan to take all the vacation time your employer allows. If you're self-employed, give yourself at least two to three breaks a year.

2. Spread your vacation time over the year. As soon as you return from a holiday, plan the next one.

3. Organize your work so other people can cover for you while you're away.

4. Don't take work-related material with you. This includes professional reading, laptops and cell phones. If you feel naked without that stuff, it's a chance to break your dependency - an added benefit!

5. Don't call the office and don't tell them where they can reach you. Make it a clean break.

6. Plan a light first day back to work (for catch-up and readjustment).

Now, if you're a family caregiver, some of this may not be possible. But, with some planning, most of us can get away for at least a short period. The problem is that we often wait until we're so depleted that the mere thought of making all those arrangements is more than we can handle. If this is the case for you, ask for help. Ask someone who knows your situation well to help you plan some time away. Ask them to do internet searches for locations, to make phone calls, to arrange a list of surrogate carers, to help you write down all the things that need to be done for your care recipient while you are away.

It may seem a lot to ask of someone, but the truth is that people who care about us want to help and are just looking for opportunities to be able to do something concrete. The first time I went away while caring for my husband, I called everyone I knew who was qualified to help care for him and I actually had people crying on the phone because they were so grateful to be able to do something for us.

So, again, get away before you need to and ask for the help you need to make it happen. (You'll always be ambivalent about going, especially if your loved one objects, but you'll come home refreshed and energized and full of stories that will expand and brighten your loved one's world as well.)

And, if it is truly not possible to leave right now, find a way to take small "vacations" during the day. Set the timer on the stove to remind you to go out and sit on the front steps for five minutes, three times a day. Take some slow deep breaths, notice the warmth of the sun on your face, the shape of the clouds, the sound of the rain on the path, the swelling of the buds in the garden with their promise of hope and renewal.

Sunday, March 6, 2011

Survival Tips for CF Partners...

When a traumatic event occurs, the trauma survivor feels the first impact then a ripple of secondary trauma spreads out to affect his or her family and friends. That ripple then travels on to touch the helpers who have responded to the survivor's pain and on to their families and friends. And thus, trauma becomes the gift that keeps on giving.

This week, I have been asked by three different CF spouses, - two clergy spouses and one partner of a paediatrician - about ways of dealing with the impact their partners' compassion fatigue. To my knowledge, there's not been any research done in this area yet - so I spent some time thinking about my experience of my own husband's CF and that of former clients who had had compassion fatigued partners. I also looked at the literature on spouses of persons with depression, chemical dependency and primary posttraumatic stress. From these sources I've drawn together a list of possible "survival tips", some of which could be helpful to you or your partner:

* Educate yourself regarding your spouse's CF. Remember that your partner's CF is not your fault - you didn't cause it, you can't control it and you can't cure it. Make age-appropriate explanations of your partner's behaviour to your children.
* Consider your own trauma history. It is natural to experience a full range of emotions regarding your partner's CF symptoms. However, if you think you are over-reacting emotionally, if you find yourself medicating your emotions, or if you are tolerating verbal or physical assaults or persistent emotional neglect, these may be signs that the current situation is stimulating old trauma in your own life. If you have not yet dealt with your personal trauma history, consider seeing a qualified mental health professional in order to understand your responses and gain support.
* Recognize symptoms of CF (diminished capacity for empathy, less compassionate behaviour, dreading/ feeling trapped at work, pushing oneself to keep working despite signs that it is proving harmful, nightmares about work, flashbacks, irritability, nervousness, sleep disturbance, exaggerated worry over threats to self or loved ones, avoidance of trauma triggers, physical or emotional withdrawal, emotional and physical exhaustion, self-medicating). Ask your spouse how you can best support him or her when the symptoms are activated.
* Plan undemanding, low stress activities to help the family relax and have fun together.
* Make time for self care. You will probably have to carve out time by giving up something else but you will find it's worth the effort and the loss of whatever you have to put aside.
* Build a support network of family, friends, co-workers, faith community etc for emotional support and occasional help with routine tasks or child care. Teach them about CF.
* Encourage your partner to see a CF or trauma specialist early in the CF trajectory - before CF interferes with daily activities. (Know that it might take several attempts to find the right treatment mode and therapist).
* Find a family therapist if your family finds it hard to talk to each other.
* Be clear when communicating changes you want your spouse to make. He or she cannot read your mind.
eg - Cutting down drinking or other drug use to x amount
  - Caring for the children x hours per week so you have time for yourself
- Acting less irritable with the children and showing more interest in them
- Once recovered physically, bringing in a reliable income, no matter how small
- Scheduling and showing up for date nights
- No physical acting out
* Take a pre-arranged time-out if you or your partner's reactivity begins to escalate.  
* Have a safety plan in place if your partner has a history of aggressive behaviour or if substance use makes his or her behaviour unpredictable. 
* Recognize that you have options. Almost everyone has options. If we don't recognize them, we may begin to feel trapped, which can lead to emotional numbing, depression, self medicating, paralysis, despair or even suicidal thoughts. If you can't see any options,      see mental health professional who can help you to expand your constricted world view.
 * Consider asking a CF specialist to facilitate a support or psychoeducational group for CF partners.

These are just a few ideas. Please add to the list if you know of anything else that might be helpful.