Wednesday, 30 December 2015

Care Partner Wednesday--Five Myths about Alzheimer's



When you begin your journey as a care partner, there is so much to learn. This is especially true if your loved one is suffering from Alzheimer's or another form of dementia. You are full of questions.

"What will happen? How fast?"
"What can I expect?"
"How do I handle________?"
"What does it mean when____?"

Because it is all new and you are thirsty for information, you may look to all kinds of sources, including some that aren't credible. (But how do you know?) You also want to talk to others who are coping with the disease, and although this is valuable, their experience isn't your experience, and anecdotal truth isn't necessarily true.

Five Myths About Alzheimer's Disease

5. When someone is diagnosed with Alzheimer's disease, you lose a little of them every day, until there is nothing left. Their body is there, but the mind, spirit and emotions are gone and you are left with an empty shell.

I find this myth particularly disturbing, because it is so prevalent and because it is so wrong. There will be losses, there is no denying it. The person will change. But isn't that what we do as humans? We grow and change. I am not the same person (inside or outside!) that I was at 20. And I have had losses. There are things I can't do any more. Things I will never do again. But I am not defined by what I can or can't do, or remember. I am more than that.

Daily, I see people in the last stages of Alzheimer's laughing, telling jokes, dancing, singing, playing the piano, visiting with friends...the list goes on. What are they doing? They are living. People with Alzheimer's have purpose and value.

4. People with Alzheimer's can't learn anything new.

I used to believe this, but I've seen it disproved over and over again. When people move to our care sections from living independently in an apartment, it is a tremendous upheaval for them. I can take up to six weeks to fully adjust. In the first few weeks, they may end up back at the door of their apartment, wondering how to get in, or looking for their room in an entirely different section of the building. But they adjust. Eventually, they learn that it's a right turn down the hall to the dining room, and that  this room contains all their treasures, is indeed theirs. It usually takes heaping portions of patience on the part of care partners, but it is possible.

3. People with Alzheimer's lose their personality.

Again, not true. Aspects of personality may change, and you may see behaviours you haven't seen before. Some may loose the social mask that kept them from saying whatever they were thinking, leading to funny, or sometimes insulting comments. Others may become angry when they never were before (or didn't show it.) But the essence of who they are remains. You might see the sarcastic edge, or the emotional side, anger or anxiety, but the person is still there. They may be changed and there may be times when you have to search for the best way to connect, but it a search worth taking.

2. People with Alzheimer's aren't aware of what is happening around them.

The opposite of this is true. It seems that, as the faculties of speech, memory and other abilities fade, the sense of people's emotions is heightened. It is difficult, if you are upset when coming in to work, to hide it. Residents with dementia sense it without a word being spoken. It's incredibly touching to me that, when they sense there is a problem, they try to solve it. A word, a smile, a touch, a hug. People with dementia are the most loving and caring, and being among them is therapy.

1. Being a care partner is all about giving 24/7.

You will have times of exhaustion, and the demands can be great. But you will receive. You will laugh, you will be hugged, and you will have times of incredible fulfilment.

Seventeen years ago, when I started in elder care, I worked exclusively with people with dementia. I was as green as they came, and stumbled around (figuratively) trying to find my way and make a difference. A woman called Florence had Alzheimer's and an anxiety disorder. She always looked as if she was going to burst into tears, and I searched for ways to help her. One day, as she rested on her bed in the afternoon, I sat with her for a few minutes, holding her hand. She opened those faded blue eyes, looked at me and smiled. "I feel safe with you," she said. All these years later, I remember her, and how she gave back to me that day.

If you are a care partner of someone who has been diagnosed with Alzheimer's disease, I urge you to contact the Alzheimer's society in your area for hundreds of valuable, credible resources.


Wednesday, 16 December 2015

Care Partner Wednesday--A Different Kind of Care Partner


Care comes in all different forms.

Professional care partners, such as personal support workers, give one level of care, and they are needed for the hands-on care for people who can't perform the activities of daily living on their own.

Not everyone who needs care is unable to brush their own teeth or dress themselves. Today, I am thinking about a person who has lost a loved one recently. For at least the first year, and often much longer, they need special care that is sensitive and understanding. Ministering to someone who is grieving is not acting as a traditional care partner, but the care is at least as important. And you may be the only person who can give it.

When my first husband died, I felt lost. I had been a wife for thirty years, and I had no idea how to be a widow. The tax office asked me questions. I had no answers, and started to cry. The bank wanted to know things. I didn't know what they wanted, and started to cry. The insurance company...well, you get the picture. I functioned at work, but when I came home, I wandered aimlessly through the house, not able to focus. I could see what needed to be done, but I had no idea how to start.

I'm not normally like this. I am organised and have lists, both in my head and on paper. I accomplish things. At that time, my head felt like it was full of quilt batting, and pushing it aside to accomplish my daily tasks required tremendous effort. Beyond the normal activities, there are mountains of assignments associated with death. Cards and social insurance numbers and driver's licences and a multitude more need to be cancelled and government departments informed. In my case, money was tied up and bills needed to be paid, and that was a worry. Each day, I felt like I was slugging through heavy mud, just to stay in the same place.

But I had care partners. Two friends decided together to go out to dinner with me around all the "firsts." My birthday, his birthday, Christmas, Valentine's Day--every date that might be significant and difficult, we got together in a local restaurant. Sometimes I wanted to talk and sometimes I didn't, and both were fine.

One friend took me with her while she did errands, so I wouldn't have to spend every night alone. Both of them took on the monumental task of helping me organise a garage sale. They were there, even when they weren't physically in the room. There came a time when I needed the support less, but by that time, we decided meeting for dinner was great for all of us, and it became a monthly event.

Years passed. I remarried, and with the help of another friend, they organized my wedding. We continued to meet every month. Then this year, in the spring, the unthinkable happened. The husband of one of my friends fell down a set of stairs and, after five days, he died. Not having any warning that life was going to take this tragic turn, she was stunned. Several months later she said, "I'm just beginning to believe this isn't a bad dream I'm going to wake up from."

So, we meet each month. Sometimes she wants to talk, and sometimes not, and both are fine. Last Saturday, we put up her Christmas tree (a job her husband always did) and ate pizza together. We laughed at the antics of her new puppy, because even in the midst of intense pain, laughter is possible.

I have been called to be both the cared for and the care partner. It's made me aware of those around me. As Christmas nears, take stock of those you know. Are there people who need you to come alongside--to have dinner together, to listen or to organise a garage sale?

Are you being called to be a different kind of care partner?

Wednesday, 2 December 2015

Care Partner Wednesday--Facing the Fear part 2




In it's most extreme form, fear:

  • cripples
  • consumes
  • limits
  • empties life of it's quality and joy
  • takes
  • diminishes
Fear makes your world small and confusing. For the care partner, especially one new to the job. or facing a change, fear  can lead to wrong information and wrong choices. When you are afraid, you tend to reach for whatever lifeline is thrown, without considering all the choices.

So how do you handle fear? Here are some ideas.

1. Learn as much as you can. At the beginning of your journey, this can be overwhelming. Not only is there information about whatever disease you are dealing with, the health care system has it's own language, and probably you don't speak it. There are forms and processes and medications and protocols. Ack! Too much. Read what you can about the disease, and make notes. If you don't understand something, write it down. Later, you can...

2. Ask questions and keep notes. With doctors, it is best to prepare as many questions as you can think of ahead of time, and then prioritize them. Nurses are also a great source of helpful information, and may be more willing to spend time with you. If a word comes out in conversation that you don't understand, ask.  As time passes, you will begin to get a picture of what is happening and your options. You will come to a place where you can make better decisions.

3. Find a friend. Another care partner is ideal, as you can share your journey. However, what you need is someone who will be willing to listen when you need to talk. This can be anyone. Even if they don't know what you are going through, a compassionate friend who will let you vent is a valuable resource. You aren't looking for answers from them, but support and comfort.

4. Realize there are many things you have little control over. Medical changes, cognitive changes, and the dreaded "what happens next?" are all out of your control. Spending your precious energy worrying about tomorrow and what it may bring, is foolish. You can't change it by worrying about it, but it can change you. If you dwell on what might happen, you might miss what is happening today. I'll say it again--focus on today. You have today with your loved one. Look for the joy in what you have.

5. Being a care partner can be all-consuming. Even when you aren't with your loved one or dealing with things that involve them, you're thinking, thinking thinking. You are trying to solve problems in your head and worrying and thinking some more. The reality is, though, that some day you will have to say good-bye. Not only will you no longer have this all-consuming job of care partner, but you will not have this significant person in your life any more.

Probably you don't want to think about this. You should. Spend some time today thinking and praying and planning for that day. For today, make sure you say all the things you want to say while they are alive. You have this opportunity. Take it. Then, spend a little time thinking about what your life will be like when they are gone. Make a plan, even if it's only partially defined, of how you will spend your time when your role as care partner is over. I have seen people who have no idea how to live their lives when the person they gave every minute to, is gone. Don't make that mistake.

Without realizing it, you can allow fear to steal parts of today that should never be his. Recognize that possibility, take control and take back today, and tomorrow.



Wednesday, 25 November 2015

Care Partner Wednesday--Facing the Fear



"How's you mother doing?"
"Oh, she's just amazing. She's 91, you know, and she still lives in her own house and does all her own cooking and cleaning. We bought her one of those monitoring things, where she can push a button if she gets in trouble, but that was more for our peace of mind. She never uses it. She just astounds us all."

That was last week. Then things changed.

Mom felt light headed, so she pushed the button. It's a good thing, too, because that was the start of a major stroke. Now her left side is paralysed, she's in the hospital and they aren't sure how much function she will recover. She'll never be able to live independently again. Physio, assistive devices, long term care--there's a whole world of new things for you to learn, and you need to know them yesterday.

There are aspects of being a care partner that can lead to a lot of fear. Here are a few of the most prominent ones.

1) Fear of a sudden change. Even if life wasn't as perfect as the situation described above, you may have reached some sort of "normal," only to have everything change in an instant. A severe medical condition, a fall with a broken bone, or a sudden decline can change everything. We are seldom prepared for how life changes when this happens, and there are no guarantees of recovery.

2) Fear of decline. Even when the changes are small and incremental, a few of them can add up to a major decline, and it can be frightening. Perhaps there is a loss of appetite, leading to weight loss, lack of energy and loss of muscle and fat. As a care partner, you are looking for ways to solve this, but in a short time you realise there has been a major change. It's frightening.

3) Fear of the unknown. The whole medical field speaks a strange foreign language, and you may have no idea how it relates to your loved one.

4) Fear of devastating change. Do you think about the day your father won't know you, or your mother keeps calling your son by your name? Lack of recognition from someone you love is a fear that lurks in the minds of many who deal with dementia.

5) Fear of death. When your mother has always been there, you can't imagine life without her. You know it is inevitable, but can't fathom it.

All these fears and more plague care partners as they walk (sometimes stumbling) this journey. Next week, we'll look at some practical steps toward dealing with the fear.

Stay tuned.


Wednesday, 11 November 2015

Care Partner Wednesday--When Family Lives Far Away



We call it the "daughter from Florida syndrome" where I work. This is not to disparage daughters, and is certainly not about Florida (one of my favourite places in the world!) It's a known fact that most care partners are women, and Florida is far from where I live. Hence the name.

Just to make sure I make me point and don't offend anyone, imagine a family member of either sex arriving from out of town for a week to visit their loved one who is in care. Almost before their suitcases hit the ground, they begin to find fault. Soon there is a list, and staff members scurrying to fix, explain and follow up. Review the medications, change the mattress, get a different hairdo. "The laundry destroyed her socks, and why isn't my mother up, it's after ten o'clock?"

At the end of the week, the family-member-from-out-of-town leaves, and the staff collectively sighs with relief. Whew. Until next time.

Let me qualify what I'm saying with this:

Not all out-of-town family members are like this. I'm sure you aren't. But over the years, we've seen more than a few.

I have been "the daughter from Florida." But that's a story for another day.

Having a family member in care when you aren't there is difficult, heart-wrenching and sometimes confusing. You wonder what is really happening, and you worry. Perhaps you get a disturbing phone call from your loved one, and you struggle with how much to believe.

Here are some thoughts as you visit your loved one:

1) If you have a sibling who lives in town and handles most issues--tread carefully. If you say this or that is wrong, it is easy for them to feel you are criticising the job they of doing of caring for your loved one. Make sure you discuss issues with them, and do it in a non-threatening way.

2) Establish relationships. Get to know your loved one's nurses and care partners. Thank them for the job they are doing. A small "thank you" in the form of a fruit basket or other treats means so much to those who work hard every day.

3) Find someone (possibly a nurse, but even better might be a team leader, activation staff, or any staff member who stays in touch with families. Ask if you could email them every two weeks to get a feel for what your mother is doing. (Make sure it's not more often, although it might be tempting.) You could also send pictures of your family events, and the right person might send some back to you.)

4) Ask questions, and then listen. Sometimes an issue is only an issue because you don't have the whole story. Perhaps the socks needed to be replaced, the hairdo is the one Mom asked for and she's in bed because she wanted to sleep in this morning. Not everything is a negative.

5) On the other hand, if you believe you have a serious issue, go to the top with it. Make sure to involve your siblings in town (if they exist) but ask to speak to the nurse, the doctor or the Director of Care. Keep talking and listening and asking questions until you are satisfied.

6) Use technology. Is there a family member or friend who could bring in a laptop or tablet once a week? All it takes is the wifi password and an arranged time, and you are Skyping with your loved one. I see this more and more, and it's lovely to see the delight on the elder's face as their daughter-from-out-of-town appears on the screen. Set this up while you are visiting and enjoy it when you go home.

All of these tips have one goal: to bring you closer to your loved one. As problems are solved, relationships fostered and technology used, you can connect to the one you love.

Which is what it's all about.


Wednesday, 4 November 2015

The small miracle of little things.


I have a tiny screw in my glasses that keeps working itself loose. I'm not sure why, because I've never had to tighten the one on the other side. But every month or so, I have to grab a kitchen knife with a sharp edge and secure the screw.

Except when I forget.

If the screw comes loose enough to fall out, it can easily be lost. Without that screw, the lens oops out and I can't see. Without that lens, my life screeches to a halt. I can't drive, I can't work, and I can't get to the optician by myself to get a new screw. This minuscule object, less than an inch in size, has the power to bring my entire life to a standstill.

As I tightened the screw, I thought about other "little things" that drive me nuts and can ruin my whole day if I let them. Here is my (not comprehensive, by any means) list:
1. People who are late.
2. Being late myself.
3. Bad grammar.
4. Arrogance in any form.
5 Being taken for for granted.
6. Not being taken seriously.
7. My own awkwardness. (I am the original klutz, and it's embarrassing.)
8. Missing the train (see #2)
9. Loud, flirty people.
10. Uncontrollable tears. (When I realise I am going to cry and I can't stop it from happening at a completely inappropriate time.)

These "little things" (and many others) can set my teeth on edge and put me in a bad mood. Like the tiny screw, they have the power to ruin my day if I let them.

The thing I noticed about little things, is that they can cloud my vision. When that screw falls out and rolls away, and my lens won't stay in my glasses, I can barely see. Every other action, thought and response my life is affected by it.  Like living in a fog, I am paralysed, squinting to see what is in front of me.

Attitude does that. The "little things" are all about attitude.

If I am focused on the irritating events or people in my day, I miss everything else. I don't see the sunrise because I'm fussing about missing the train. I miss a friendly smile because I am listening to the grammar. I don't care about any other small miracle God has put in my pathway. I miss it all.

Even worse, I become someone I don't want to be. If I allow "little things' to cloud my vision, I become sarcastic, grumpy and negative. Lovely.

So today, Lord, (and all the days that follow) I give You permission to poke me when I slide into letting "little things" control my day, my attitudes and who I am.

Remind me that You call me to humility, patience and love. Oh yes, and thankfulness.

"In everything give thanks, for this is the will of God in Christ Jesus concerning you." I Thess. 5:18

These are the little things that matter.

Wednesday, 21 October 2015

Care Partner Wednesday--When A Crisis Changes Everything



I was at work, and my husband, a victim of cardiac myopathy (enlarged, inefficient heart) was at home on short-term disability. It had been that way for several months, with several interruptions for hospitalisations. Since he had gone on disability, we had been looking for the new normal. We hadn't found it yet.

In the afternoon, I received a call from the visiting nurse who made daily visits to dress the wounds on his elbows and legs because his skin was breaking down without proper blood flow. Her voice sounded close to panic.

"Mrs. Peachman, your husband is on the brink of cardiac arrest, but I couldn't convince him to go to the hospital. He all but threw me out of the house."

I blinked in shock, having no idea what to do next. I assured her I would handle the situation.

After a quick prayer, I phoned my daughter, told her the situation and asked her to meet me at the train station. She had a two-month-old baby, and I thought the presence of the baby would help soften what I had to do.

When we arrived at the house, my husband was in the basement in his easy chair (his usual hangout.) His ankles were grossly swollen to the knee, and pills lay all over the carpet around him. "Oh, hi!" he said with pleasure at seeing me home early. My daughter and the baby followed, and he was delighted.

"I got a call from the nurse. We have to go to the hospital. There is no choice." All pleasure disappeared, but I was right, and the presence of my daughter and the baby tempered his reactions. Slowly, painfully, we got him up the stairs and into the car. He'd had so many hospital stays that no part of him wanted to go back. I was not the forceful one in our relationship, and that was one of the hardest days of my life. As it turned out, he never came home from that hospital stay.

The next few weeks were gruelling. I worked all day, went to the hospital at night and then came home. (We lived in a different city from where I worked and where the hospital was.) I'd get home about 10:00 at night, and be up at 5:00 am to do it all again. Sometimes, my kids would meet me downtown and drive me home, and sometimes I took transit. Every day was a marathon.

How does the care partner look after him/herself in crisis? There is no easy answer. 

I did a few things right and a few things wrong, but here are my suggestions:

1. Get help. A crisis can feel isolating, but it doesn't have to be. You have friends and family who support you and care about you. Call them. If ever there was a time to garner all the troops, this is it.

I did this right. My family knew immediately, and after all, it was their dad, so they were there whenever they could be. The situation was critical, and as it turned out, the last days of his life, so it wasn't actual relief for me. I was there as well. But their presence was an incredible support. I also had a few key friends who kept in touch with both me and everyone else. I knew there was a group of people praying for us, and willing to help in any way, and it was a huge support. My boss and others at work would have done anything for me, and that held me up. They listened. They let me cry. They gave me space. 

2. Look at options. All things might be possible. I worked until the last day of my husband's life. The Friday they called us in the middle of the night to say they were turning off the machines, was the only day I missed until my compassionate leave after he died. Of course, I didn't know the end of the story. I didn't know this was the end, or how many days it would go on. What I did know, quite clearly, was that I couldn't sustain this pace forever. My friend told me that, and I answered her, "What option do I have?" At the time, I felt there were no options, because I presumed I knew what the answer would be if I went to human resources and asked for some time off. I didn't ask, and I should have. Looking back, they probably would have worked something out for me. I should have at least asked.

3. Savour every moment. Does that sound weird? Here's what I'm saying. As horrible as the situation was, it was my last days with him. During the first week and weekend, he was conscious, and we had some critical conversations. I didn't know it was the end, and I didn't think he did either, but as he initiated the conversations, perhaps he suspected more than he let on. We talked. I shared with him a scrapbook I had made of emails we were receiving from people who were praying. We played a game where I slipped ice chips in the holes in his oxygen mask and he caught them in his mouth. I shared with him my dream to be a writer. He assured me I would. 

I look back on those moments now as an incredible gift that no one can take away. I wasn't making a conscious choice (I'm not that smart) but I believe the prayers of those who cared for us both were guiding me. I am so thankful.

Crisis changes everything. On rare occasions, things go back to the way they were. Sometimes, the crisis establishes a new normal. 

Inevitably,  crisis changes the care partner. 




Wednesday, 7 October 2015

Care Partner Wednesday--Do you speak dementia?















Imagine you are in grade seven or eight. At school, you are at the top of the heap.
You have worked your way up from frightening Kindergarten days to the confidence and coolness 
of the oldest kids. In reality, you are probably far from confident, but on your home turf 
and with your friends, you exude it. 
You know stuff. You definitely know a lot more stuff than your parents.

Your school has this relationship with a seniors' residence. When you were a little kid in grades one and two, you used to go over there, and it was okay. You sang with your classmates and showed your drawings and got fed juice and really tasty cookies. Then you all trooped back to school following your teacher like a family of ducklings.

But now...Now you are older, and the school expects you to talk to the seniors and actually do things with them. In the place in your heart that you won't reveal to anyone but yourself, you admit that you are scared. Terrified, actually. Some of them have dementia and you don't know what to say to them. You're afraid of what they might say. Or do.

In a few weeks, we are hosting just such a group of kids. The school within walking distance has a long standing relationship with us. Over the years, we've learned a few things. We are beginning with an orientation, mostly with the kids by themselves, to set some ground rules and teach them the basics of walkers, wheelchairs dementia and communication. For some, it will come naturally to speak respectfully and make eye contact, but others will have to learn.

Below is what I have prepared to teach them about how to communicate with someone with dementia. Although written to kids, there is truth for everyone.

Dementia is a huge umbrella term.
Because “dementia” is a part of so many diseases, it looks a little different for each person. Also, each person has a different background, different life experiences, different health challenges and different medications. Lots of differences!

The point is, because there are so many factors, there is no way to say, “A person with dementia will look like this. This is the way to talk to them.”

Here are some thoughts and suggestions:
1. The person with dementia is a person. Like any other person, they have a personality, and they can feel emotions and enjoy life.

      2.  Enter into their reality. What does this mean? It means, in their world, “home” might be the place where they grew up, and they think they can go there and see their parents. In their world, they might still have a job, they might be 43 and they might have a cottage up north. Because this is their world, their reality, they might say things like, “I want to go home.” “I have work to do.” “I’m taking a cab and going to my parent’s place.” Don’t panic, and don’t argue. Enter their world by saying things like, “What is your parent’s house like? Where do they live? What kind of a job do you have?” This not only gets them talking, but validates them as a person. It’s not lying, it joining them in their world.

    3. Like all people, they have good and not-so-good days. If they aren’t having a good day and seem sleepy, or angry or unresponsive, move on to another person.

      4. Avoid distractions. It’s hard for a person with dementia to process information, but if you meet with them one-on-one and maintain eye contact and SMILE, it is often a great experience.  If there are a lot of other people in the room talking, or a television or music, they can only process one of these things at a time.

   5. Talk about one thing at a time. Same as above, their minds move slower than yours, but they do move.

   6. Share yourself. They love to hear what sport you are playing or where you went on vacation (and what you thought of it.) Ask their opinion of things. They have lots of opinions!

    7. Speak clearly and naturally. Remember these are adults, and never talk down to them (as in “good girl!” or the like.)

   8. Identify yourself.” Hi, Mrs. E., I’m Sheryl. We had fun talking together a few weeks ago, so I came back to visit you again.”

    9. Listen. Even if you have no clue what they are talking about, listen and nod, smile and respond. (“Uh-huh.” with an interested look works fine.)

   10. Have patience. You might hear the same story several times, or have to answer the same question over and over. Listen and answer as if it was the first time.

SMILE

Have fun!

Get to know these incredible people who are our residents






Wednesday, 23 September 2015

Carpenter Wednesday--Letting go

I apologise for not posting for two weeks. My computer went on strike!



The day you realised you could no longer be a full-time care partner, you set out on a journey. You researched and toured and talked to others, looking for the best place for your loved one. You looked at finances and wrote "what ifs" on pieces of paper and counted the cost. You agonised and made the best decision possible.

Moving day came, and you didn't sleep the night before. You worried how it would go. Would they resist? Would the staff be kind? Would they have patience with incessant questions and unpredictable moods?

Now, several weeks have passed. Your loved one is settled in, and although life isn't perfect, there are positives. Mom seems to like her full-time care partner and is going to the dining room for meals. She's attended some activities, and even brought the fancy napkin home from a tea party and posted it on her bulletin board. When you walk in the room, she seems happy. When you walk out, she goes on to other things.

How are you doing?

It's a question I often ask family members. Many times, there is the answer they give (I'm fine. I'm so glad the transition is over. She seems happy.) and the real answer (I worry about her all the time. I wake in the night wondering if she's okay. The staff is great, but...)

It's hard to let go, isn't it?

What does letting go mean, anyway? Here is what it's not:
1) It doesn't mean you aren't a care partner any more. You have more support in the care of your loved one, but you make the decisions and control the outcomes. You are the most important member of the care team.

2) It doesn't mean you aren't needed. Instead of focusing all your energies on care needs, you can now spend time on fun things with your loved one. Is there an ice cream cone or a walk outside in your future?

3) It doesn't mean you shouldn't visit. Sometimes, depending on the person, it's wise to stay away or not visit too often in the first few weeks during transition. This isn't the case with everyone, but for some people it makes the transition easier. But after those first few weeks, your visits are important and needed.

4) It doesn't mean you love them any less, or you are less loving and caring as a care partner.

So what does it mean to let go?

It means you get to know the care team, find out who they are as people, and begin to trust them. Until you can trust that your loved on is getting good care, you will never sleep well at night.

It means you give the care team as much information as possible about your loved one: their background, things they like to eat and the little ways they like things done. You make sure they have all the information they need to do a good job. Then you back off. If something important to your loved one's care and well being isn't being done, you address it, but you don't sweat the small stuff. You look into your heart and ask, "Is this bothering Mom, or is it just bothering me?"

It means you set boundaries and don't feel guilty. This is a tough one. Boundaries are one thing ("I will visit three times this week and not every day. I will go away this weekend. I will consider a vacation.") but the "not feeling guilty" part takes practise. As you learn to trust the staff, and you can gradually open your hand and loosen the tight grasp that was necessary when you were on your own.

Letting go is freeing. You will always love and care, and, let's face it, you will probably always worry. But letting go lets you enjoy your loved one in new ways. It gives you the freedom to be with them without focusing on the minutia of their care.

Today, if you are in this position, open your hand--just a little.