Photo Credit: iStock

Dear Candid Caregiver: My dad is in the middle stages of Alzheimer’s disease. Meanwhile, my mom is recovering from cancer surgery, and the prognosis isn’t good. I’m trying my best to be a good caregiver for both of them and stay positive while doing it, but it’s hard.

I recognize that we’re fortunate in that my parents are able to hire an agency that supplies a rotation of in-home caregivers. The other side of it is that I have a brother and a sister, both living hundreds of miles away from our parents and me, so they can’t help out much. They try to be sympathetic and appreciative of what I’m doing, but their suggestions usually feel like criticism. It’s never overt, but they simply have no understanding of what it’s like to have the responsibility that I have, so their attempts at “helping” by offering simplistic, sometimes insulting, advice hurts me.
I love my parents and I want to help them but I have a hard time not sliding into general negativity. How do others stay positive when they see caregiving going on for years? – Gloomy Suz

Dear Gloomy Suz: I’m sorry for what’s happened to your parents and for your own understandable struggle. Two parents who need care at the same time is difficult, and your mom’s poor prognosis must color each day that you have together. Nearly anyone in your situation would be struggling to stay positive, but I can suggest some tools that might help.

Let’s start with the fact that it’s unrealistic to expect yourself to be a positive caregiver every minute. You are trying to help your dad live well with his Alzheimer’s diagnosis as well as looking at the fact that your mom may not survive her cancer for any length of time. Give yourself credit for persevering under these difficult conditions, and even striving to make caregiving a happier time.

The National Institutes of Health (NIH) maintains that caregivers have both positive and negative responses to their role. This shouldn’t be surprising because most of us do experience both emotions. Their goal seems to be to show that family caregiving isn’t just a burden; it’s worthy and can also be uplifting.

I feel that while well-meaning, this data might best be ignored by individual caregivers who are going through a hard time. It would be easy to take this information to heart and simply feel more burdened and guilty for not being “positive” about your caregiving experience all the time.
Taking steps to care for yourself is key and can improve your outlook.
 
That being said, one aspect that is highlighted by the NIH is how much difference perceived social support received by the caregiver can make. This is an absolute truth. Thus the effectiveness of both online and in-person caregiver support groups.
AARP offers an article on positive caregiving by clinical psychologist Dr. Barry J. Jacobs. In his article titled Repeat After Me: I Am A Good Caregiver, Dr. Jacobs offers some suggestions such as guarding against shame and eliminating old messages that we torture ourselves with. His tips are timeless and guilt reducing.
I’ve found some additional methods helpful for refreshing my own caregiving attitude, so I’ll offer these ideas to you as a potential way forward:

• Learn to cope with negative input from outsiders by seeking support from other caregivers. Yes, I touched on this above but it bears repeating. Having the loving support of other caregivers can help you learn steps that work for you when you have to face down ignorant or cruel input from outsiders. Search out a support group, or in your case, you might benefit from two; one for cancer caregivers and one for Alzheimer’s caregivers. Time-consuming, yes, but even online groups can be an enormous help and they are quite convenient.
• Absolve yourself of the need for perfection. Caregivers seem to be repositories of unearned guilt. In my mind, one of the most effective ways to have a more positive attitude toward caregiving is to understand that guilt is counterproductive. If necessary, see a counselor. It’s important that you work at erasing that burden from your thought process.
• Adjust your expectations to reflect reality. We can’t fix our loved ones who are living with terminal diagnoses. We can only try to make their lives as good as they can be given their circumstances.
• Learn to say no to outside demands that add to your burden. If your friends don’t understand that you can’t drop everything to meet for coffee, that is their problem. It would be nice if they could learn to be a better friend to a caregiver, but if they can’t, it’s their loss.
• Create a journal. It’s a way to make order out of chaos. For some people that just seems like more work. A formal journal can be, but my approach to journaling is broad. If you love the idea of a beautiful book to write in, please splurge and buy yourself one. However, for many, a Word document on their computer desktop works fine.
• Structure your journal as you’d like it, but keep that structure fluid to reflect your own growth. I’d suggest at least two categories. One is to list and explore your frustration, depression, and, yes, anger (your parents’ health struggles are bound to make you angry). Then, make a page where you can list each positive emotion about caregiving. These might include noting a rare, beautiful moment of clarity experienced by your dad, or his joyful reaction to your offering of music. Quality time making memories with your mom would certainly qualify, as well.
• Engage in outside activities that you enjoy. Your last statement led me to believe that you are looking at the future as solely one of caregiving. I understand the feeling of being too exhausted to even think of going out, but you do need to work on finding a balance. Look for activities that you enjoy, whether they are solitary, such as reading or taking a walk in a park, or social such as lunch with friends. You are high risk for caregiver burnout so self-care is vital. Part of self-care is finding something in life outside of caregiving that is satisfying to you.

It’s admirable and even sensible to try to find the positive in most situations, Suz. Considering the fact that you’ve spent years as a caregiver and are likely looking at more years of the same, taking steps to care for yourself is key and can improve your outlook. Everyone's mental and physical health can benefit from finding a more positive outlook, however, no one can stay in that place constantly, so don’t put that expectation on yourself. If you find yourself becoming too negative, please do see a counselor. If anyone can use some compassionate guidance, caregivers can.
 
The Candid Caregiver

The Candid Caregiver (TCC) is a safe place for all caregivers, of any condition area or caregiving level, to go for candid yet professional guidance. Questions will be answered, tough topics will be discussed, and the caregivers will ultimately have a place where they, themselves, feel cared for. No topics are off the table. Ask your questions and share your stories on social media using the hashtag #TheCandidCaregiver.

​TCC's lead caregiver and author is Carol Bradley Bursack, a veteran family caregiver with more than two decades of experience.


 
 

As we get older it is normal that our vision changes. Our eyes may find it harder to read small print, take longer to adjust from light to dark and be more sensitive to glare from sunlight or unshielded light bulbs. There’s a decline in depth perception that can make it hard to judge distances, and perceiving contrasts and colours may become more difficult. Sight provides much pleasure, but it’s also an important part of staying safe and independent. Because our eyes do so much for us, they deserve good care and attention. Be kind to your eyes!
 
Turn on the lights. Seeing better can sometimes be as easy as changing a
light bulb! Putting 100 or 150-watt bulbs in your lamps can reduce eye strain
(but make sure your fixture is designed for that wattage!). Brighter lighting in stairways can help prevent falls.
 
Don’t smoke. Studies show that tobacco smoking is an important risk
factor in the early onset of an eye disease called age-related macular
degeneration (AMD). This disease causes serious and permanent loss of
central vision.
 
Reduce glare. There are many ways of reducing glare, including good
lampshades, glare shields on computer monitors, and sunglasses. Wear
sunglasses that provide 99 to 100% UV-A and UV-B protection when you
go outside during the day. They will protect you from UV rays that can harm
your eyes even on a cloudy day.
 
Protect yourself. Many people suffer vision loss because of accidents in the
home. Here are some ways to prevent damage to your eyes:
• put a grease shield over frying foods
• make sure that spray cans and bottle
nozzles are pointed away from you
• wear safety glasses in the workshop
and when opening and using
chemical products like ammonia
• when using bungee cords, be careful of recoil
Eat your carrots. Studies show that a daily dose of the vitamins and minerals found in melons, citrus, carrots, spinach and kale may help slow the progress of age-related eye diseases such as macular
degeneration, glaucoma or cataracts.
 
Get an eye examination. Many changes to vision happen so slowly that you may not realize you have a problem. If you are over 45 years of age, the most important thing you can do to protect your vision is to have an eye exam on a regular basis. Finding problems early may make the difference between maintaining good vision and vision loss.

Vision changes
 
 Here are the most common changes that come with age:
 
Presbyopia is the inability to focus on close objects or small print. Reading glasses usually solve the problem. The usual age of onset is 40.
 
Cataracts are a gradual clouding of the natural lens of the eye that prevents light from reaching the retina. If the central part of the lens is cloudy, you may not be able to read or drive unless the cataract is removed. This is one of the most successful surgeries done in medicine today.
 
Floaters are tiny spots or specks that float across the field of vision, that are often normal. If a floater appears right in your line of vision, sometimes moving your eye around will make it shift out of your central vision. If you notice a sudden change in the number or types of spots you see, or if they come with light flashes, see your eye doctor as soon as you can. These may be signs of a serious problem.
 
Dry eyes are a common problem, especially with aging. Your eyes may feel gritty, itchy or burning. Your doctor may suggest using a humidifier in your home, or special eye drops that act as tears. In a few serious cases, surgery may be needed to correct the problem.
 
Tearing (watery eyes) is another common problem. It may be because you are more sensitive to light, wind or changes in temperature. Simply protecting your eyes by shielding them or wearing sunglasses may solve the problem. The condition can also be a result of an eye infection, eye irritation or blocked tear duct, all of which can be appropriately treated. See your doctor to find the exact cause and treatment.
 
Vision loss
 
Here are the most common reasons for age-related vision loss:
 
Glaucoma is an eye problem that develops when the pressure within the eye starts destroying the nerve fibres within the retina. If not treated early, glaucoma can cause vision loss and blindness. Because most people have no early symptoms, it is very important to have regular eye exams. Treatment may include eye drops, medication or surgery.
 
Age-related macular degeneration is an eye disease that occurs when the macula (the central part of the retina responsible for sharp vision) is damaged. This damage can be the result of many factors, including aging, and causes permanent loss of central vision. Regular eye exams can detect the disease early on and laser treatments can slow down central vision loss.
 
Diabetic retinopathy is an eye problem linked to diabetes. Changes to blood vessels can cause the retina to become oxygen starved. Symptoms include cloudy vision and seeing spots. This condition goes through many stages and can result in blindness. If you have diabetes, have regular examinations and inform your eye specialist that you are diabetic. Treatment can slow down vision loss. Laser treatment in the early stages often proves successful.
 
Visit your eye doctor (ophthalmologist) if you or someone else notices that you:
• squint – you may have a greater sensitivity to light and glare
• choose bright over dull coloured objects or clothing
• spill food or drinks because you misjudge where objects really are
• find it hard to copy from written texts
 • are getting “clumsy” – you have a hard time threading a needle, buttoning a shirt or finding food on your plate
• see flashes of light or rapid movement from the corner of your eyes
 • experience difficulties with sharpness and contrast while driving at night
• experience uncontrolled eye movement
 • make driving mistakes – you miss street or traffic signs. This is important for your safety and the safety of others. Older drivers with vision impairment are more likely to be involved in a car accident
• have fallen because of a missed step or an object on the floor that you didn’t see.
 
For most seniors, normal age-related vision loss can be corrected or stopped
with glasses, medication or surgery. For others, using vision aids and making changes to their homes and routines help them stay safe and independent. For those who have more serious vision loss, there are many services available to help you through this difficult period of adjustment.
 
For more information...
If you want to have your eyes checked or treated, look under Optometrists in the Yellow Pages or ask your family physician if a referral to an ophthalmologist is suitable.
 
To learn more about eye problems, falls prevention, vision and driving, or on how to live an active life with vision loss, call the following organizations or visit their web sites:
 
Eye conditions and vision loss:
Canadian Ophthalmological Society
www.eyesite.ca
 
Canadian National Institute for the Blind
(416) 486-2500; www.cnib.ca
 
Canadian Association of Optometrists
www.opto.ca
 
Falls prevention:
Public Health Agency of Canada Division of Aging and Seniors
(613) 952-7606 www.phac-aspc.gc.ca/seniors-aines
This web site offers publications on home safety, assistive devices, falls prevention, etc.
 
Driving:
Contact your provincial ministry of transportation, who can provide tips and advice to improve driving safety. The following Ontario web site provides excellent information:
www.mto.gov.on.ca/english/pubs/ yourdriving.htm
 
Our thanks to the Canadian Ophthalmological Society and the National Institute for the Blind (CNIB) for their help in the preparation of this info-sheet. Division of Aging and Seniors Public Health Agency of Canada
www.phac-aspc.gc.ca/seniors-aines
 
Link to online publication:
http://publications.gc.ca/collections/Collection/H30-11-8-7E.pdf
 
 

September is Prostate Cancer Awareness Month
 
Every day, an average of 58 Canadians are diagnosed with prostate cancer. It is the most common cancer among Canadian men. If detected early, survival is now close to 100 per cent. It is important to spread awareness about this disease as men over age 65 account for nearly 60% of all prostate cancer diagnoses. (Prostate Cancer Foundation: Patient Guide) 
 
About Prostate Health:
Men have prostates, which are small glands located near the bladder. Prostates can develop problems like infections or inflammation. Cancer cells can also form in the prostate, which can develop into tumors. Prostate cancer is a disease where some prostate cells have lost normal control of growth and division. They no longer function as healthy cells.
A cancerous prostate cell has the following features:
•    Uncontrolled growth
•    Abnormal structure
•    The ability to move to other parts of the body (invasiveness).
 
Symptoms of Prostate Cancer:
Symptoms are not always present especially in the early stages of the cancer. If detected and treated in its earliest stages (when cells are only in the prostate), your chances of survival are greatly increased. Early detection is key. For many men, having to experience a rectal exam is the main reason for avoiding prostate cancer screening. Remind senior men that their health (and genes) can affect their loved ones. Any temporary discomfort is worth it and could save a life. 

Common signs and symptoms of prostate cancer may include:

• Difficulty urinating
• Urgent need to urinate
• Frequent urination, especially at night
• Burning or pain when urinating
• Inability to urinate or difficulty starting or stopping urine flow
• Painful ejaculation
• Blood in the urine or semen

Screening for Prostate Cancer:
There are two main options for screening for prostate cancer. Men can receive a blood test, which is called a prostate-specific antigen (PSA) test. A physical rectal exam may also be conducted. If a doctor suspects a patient has prostate cancer, a biopsy is almost always involved in the diagnosis. 
 
Treatment of Prostate Cancer:
 The most common treatments for prostate cancer include radiation, surgery to remove tumors, and drug-based therapies. (Prostate Cancer Foundation: Patient Guide)
 
No studies to date have definitively proven a prostate cancer prevention strategy. However, some prevention strategies are believed to reduce the risk of cancer overall, and may improve the body’s ability to fight any kind of cancer. Try:
• Eating a healthy, anti-inflammatory diet • Maintaining a healthy weight • Staying active • Attending regularly scheduled doctor appointments (Mayo Clinic)
 
 The obvious reason for screening older men for cancer is that early detection increases the odds of survival. There are other reasons for getting screened, though: • Men with prostate cancer may have genes that predispose both their sons and daughters to forms of cancer. • Data about prostate cancer, even if it is non-aggressive, can be used by researchers to prevent and treat all cancers. • Early detection can reduce the intensity of treatment required, as well as the side effects. • Doctors may be able to begin with the less invasive blood test if a senior’s risk level is low. (Prostate Cancer Foundation)
 
For more information, speak with your Physician.

​To find a local support group or for more online information visit: www.prostatecancer.ca/ and www.cancer.ca/en/cancer-information/cancer-type/prostate/prostate-cancer/?region=on 
​