Lori Larson | Larmax Homes

Life during the coronavirus pandemic has created an emotional maelstrom across the world. For people with older adult loved ones, either at home or quarantined in a senior living community, these emotions can be felt exponentially as families are bombarded with news reports of the devastating toll the virus is taking on older people. Being shut off from loved ones, family members may experience unbearable uncertainty, fear, anxiety, despair, and guilt. As social work clinicians, we have helped our clients navigate the emotional fallout of the pandemic, and we have also been privileged to share in their astonishing ability to find a sense of hope and optimism in the midst of despair.

Optimism may seem an incongruent or jarring concept to think about right now. But In fact, the ability to maintain a sense of hope and optimism is crucial for strong mental health. At its core, optimism is about having hope and confidence in the future, even in the middle of bleakness. It doesn’t mean ignoring reality or sticking your head in the sand. And it doesn’t mean you won’t continue to feel those negative emotions. Fear, anxiety, and despair are normal, appropriate and useful responses to this pandemic. They spur us to take appropriate safety precautions like social distancing. But creating emotional balance is key. Finding ways to feel hopeful and optimistic brings balance and can make the uncertainty bearable.

Much advice has been written to help people cope day-to-day during the pandemic: eat right, get regular exercise, maintain social contacts, reach out, maintain routine, limit news watching. In the same way, it is possible to take steps to cultivate optimism and hope.

Practice Gratitude. Being grateful seems hard right now. But the research is clear that taking time to focus on the blessings, really noticing them, expressing them, can lift our mood. Being grateful for front line workers is an obvious place to start. Plus, when you are in the act of being grateful, it is the opposite of anxiety. Anxiety involves worrying about the future. When you take time to recall the 3 or 4 or 5 things you are grateful for, it keeps you grounded in the present.

Do Acts of Kindness. Self-care is critical right now and we have to take care of ourselves. But research also shows that reaching out to others in need to lend support contributes to our own wellbeing. Call a neighbor, check on an old friend, donate to a charity that is feeding the unemployed, bake brownies for nurses at your local hospital. Then, feel the good of doing good. Acts of kindness sow the seeds of a greater purpose and meaning, which is key to feeling hopeful and optimistic.

Consider the Positive Outcomes. During uncertain times, many of us tend to focus on all the possible negative outcomes. Take the time to remind yourself, make a list, of all the many positive or probable outcomes. The negatives won’t seem so certain.

Know your resilience. Resilience is built out of adversity, how we respond to it. You have surely experienced some suffering, whether personal, (death, illness, family strife) or societal (9/11, natural disasters, the 2008 recession). But you survived those, and you are likely stronger because of it. Remind yourself that you did it, identify the strengths you drew on then, and draw on them now.

Even as the sun finally shines, and many states and senior living communities start loosening restrictions, hope may naturally emerge, but uncertainty will persist. Making room emotionally for optimism can help make the uncertainty bearable.

Our thanks to Robin Mansfield, LCSW-C, of Aging Network Services in Bethesda, MD for this excellent advice. Aging Network Services has been providing geriatric care management and psychotherapy since 1982. Our clients are people who feel a strong sense of responsibility to parents who can no longer function independently. They are determined to keep their parents safe and as high-functioning as possible, and they also want to retain the joys and routines of their own lives. They rely on us to help them succeed at the difficult, emotion-laden balancing act they face.

VIRUS WARS! and COVID-19

Molly Gee was sitting in the coffee shop on a warm winter day. Others were gathering late in the afternoon. She didn’t even hear the cough, so unknown to her, she had inhaled a virus that causes the corona virus infection. Her mouth and nose and even her eyes were the portals for the virus. Viruses are much smaller than bacteria: they can’t even be seen by a regular microscope. Like all viruses, they can’t be killed by antibiotics. Amazingly, they are not even really alive. We call them half alive. A virus is composed of either DNA or RNA inside a protein coat. Some are further enclosed by an envelope of fat and protein. They are parasites and they have to get to a living cell to continue to exist and reproduce.

As Molly quietly sat enjoying the day, she was unaware that a war had started within her body. The virus might have been trapped by mucus and expelled by the body, but in her case, it made it past the this first line of defense, and now the virus was ready to invade. The spikes seen around the 2019-nCoV’s cell are the keys to the castle and a protein, ACE2, on human cells, is the lock. The virus’ spike protein attached to her cells, piercing through, and then the virus injected its DNA or RNA (in COVID-19 it is RNA) into the cell. Now inside, it could make a slave of that cell, using the cell’s own machinery to reproduce its genetic material. When each infected cell was filled, the new COVID RNA was released into her body to invade other cells. Some viruses burst the cell and sometimes genetic material is released, leaving the cell alive to become a virus factory. It is not clear which type COVID-19 is but either way, the number of infected cells grew exponentially.

In COVID-19 millions of body cells are infected. Molly’s immune system launched a defense. The innate system detected that something was an invader and phagocytes were sent in to devour foreign cells and release interferon that warns surrounding cells of trouble. Interferon may not work this way in COVID 19. When the phagocytes could not destroy the invading force, it notified the lymph nodes that called in killer T-Cells and B cells. If these cells had ever fought this particular virus before they would have retained the memory. The body knows how to fight off viruses with antibodies previously formed: this is how vaccines work. The problem with this corona virus is that it is novel, and Molly’s cells did have any weapons already prepared to fight it.

In the corona virus infection, Molly’s immune cells poured into the lungs. The corona virus then invaded some of the immune cells causing confusion that sent them into a fighting frenzy. As the immune cells continued to flood into the lungs, they killed as many healthy cells as virus cells: friendly fire. The immune cells sent in way too many cells, killing healthy lung tissue. Molly’s immune system slowly regained control, killed the infected cells, intersected the virus trying to impact other cells and cleaned up the battlefield. In some people, the damage to the lungs makes them very susceptible to pneumonia and the immune system can get overwhelmed leading to the need for life support ventilators, and even death. Molly recovered.

It is much more dangerous than the flu and much is not yet known. Two things we can do to fight the war is to not get sick and to keep others from getting sick. It is a very complicated problem with a couple of simple solutions. The very best thing that we can do is to wash our hands. Remember the fatty envelope around the virus? Soap is a powerful tool that dissolves this fatty layer and makes the virus unable to infect us. It is also slippery and keeps the virus from clinging to our hands.

The other method is to socially distance. This reduces how many people are infected and gives the scientists time to develop medications and a vaccine. It is not fun but the solution is up to us. Molly plans to go back to the coffee shop, sometime.

Thanks to THE MEDICAL TEAM for providing this excellent post. THE MEDICAL TEAM Home Health and Hospice is fighting with a dedicated team to care for people who have tested positive for COVID-19 and a team that cares for people’s health who do not have the virus. Private duty aides help people care for themselves maintaining nutrition, hydration, hygiene and company. The Hospice team gives comfort and support to people in the final part of the journey. THE MEDICAL TEAM recognizes the everyday heroes in our senior communities who are working to protect and care for their residents. THE MEDICAL TEAM

The hustle and bustle of the holiday season is upon us, and we think about finding the perfect gift for everyone on our list. But, what do we give to the older members of the family, especially those who are frail or disabled? Gift-giving for older adults can be a challenge.

The most valuable gift is your time. Set aside time during the holidays to visit with the older family member. This will provide an opportunity to engage in conversation and reminisce about the past. You might even learn something new about your relatives! Take your family member for a walk, play music or bring food to share. Giving of your time can be a special gift for both of you.

In addition to time, everyone enjoys unwrapping a holiday package. For the person who is confined to a chair or wheelchair, consider a small blanket to cover her lap and legs. Warm slippers or comfortable socks are always appreciated, as are cozy pajamas. In addition, there are many varieties of wheelchair cushions that can be purchased on-line or at a medical supply store. A cushion for the chair or wheelchair can provide a whole new world of comfort for an older adult.

Items that encourage participation and engagement are beneficial not only for the older adult, but also for those who provide care. Such gifts include magazine or newspaper subscriptions, large print playing cards, or talking books. Recorded music is always a hit, especially tunes from the individual’s younger years.

Consider awakening the senses when providing gifts for older individuals. Lotion or scented soaps help the individual to feel special. Remember that the lavender scent can be calming, while the smell of citrus may improve mental clarity. Dry shampoo is a helpful gift for those who are physically limited. And lip balm is always needed in colder weather.

Other gift ideas include:

A new calendar with large pictures and family dates clearly marked.
A dry erase board to hang in the person’s room for messages and instruction.
Gift cards for a massage or a haircut and style
Blooming plants
Favorite foods. Always check with family or facility staff prior to offering food, to assure that there are no restrictions. For the individual who lives in his own home, consider making arrangements to have meals delivered on a regular basis.
A photo album or framed enlargements of family pictures. If the person has memory issues, label the pictures with individual names.
A bird feeder to hang outside the window
A large clock
An adult coloring book with a container of colored pencils
A Scrapbook filled with memories from the person’s life
A night light
Colorful mobiles to hang in the window
Comfortable, easy-to-remove clothing

The holidays are a special time to recognize and honor the older members of the family. A personal gift from the heart will have special meaning for those who are frail or isolated this season.

Kate Caldwell, Gerontologist

Founder of ElderTree Care Management Services

ElderTreecare.com

According to the Institute for Dementia Research & Prevention, there are at least 5 million individuals in the United States with age-related dementias (other sources put the number much higher). Of these, Alzheimer’s accounts for approximately 70%, with vascular dementia counting for the majority of the remaining cases. Living with dementia is not only difficult for people who receive this diagnosis but also for their families. Understanding the complex and often misunderstood cognitive losses associated with dementia can leave all of us wondering what to do to ensure that our loved ones can LIVE with dementia, not succumb to its challenges and even the myths associated with it.

As part of our broader commitment to this field of study, Larmax is partnering with the Dementia Action Alliance to bring one of the world’s renowned experts in the field, Dr. Gayatri Devi, to Washington on September 24, 2018 for a program designed to help both those diagnosed with dementia as well as their care partners understand how to have a positive perspective and impact on their lives while living with this disease. Her recent book, The Spectrum of Home: An Optimistic and New Approach to Alzheimer’s Disease and Other Dementias, was featured on CBS This Morning. If you would like to hear Dr. Devi speak, visit https://www.cbsnews.com/video/neurologist-on-alzheimers-spectrum-treatment-myths/. I encourage both those diagnosed with dementia or their support partners to read this book as it will give you hope.

While it is impossible to share the wisdom found in Spectrum of Hope in a blog, several points cannot be overlooked:

Dementia is unique to each person, presenting different symptoms, progress and treatments. In fact, the progression of dementia in even the same person can vary over time.
The majority of people with Alzheimer’s disease are living functional lives in their communities.
Attending to the emotional needs of a caregiver is as important as those of the patient. Without personal time, burnout will happen, whether you are a family member or paid caregiver.

Understanding the real story, not the myths and the emotion, about dementia is critical to successfully navigating the journey – either as a support partner or patient. Decisions should be made on facts, not fear. One thing is clear from Dr. Devi’s work, with the right perspective, knowledge and professional assistance, people can LIVE with dementia. The road might not look like the one you planned to take; nonetheless, there can be joy and successes. We will, in future blogs, offer some tools to make the journey a little easier. In the meantime, we encourage you to come hear Dr. Devi speak and read her book. It’s enlightening!

Click here for more information on the September 24 event.