Supportive Care Bulletin
Helpful tips for family caregivers
A little knowledge and foresight can go a long way toward easing your worries, including worries about worrying! Here’s to the benefits of planning and prevention.
- Is your relative at risk for a hip fracture?
- Look ahead when downsizing
- When the worrying won't stop
Is your relative at risk for a hip fracture?
Bone fractures are more common than you might think. According to the National Osteoporosis Foundation, “a woman’s risk of breaking a hip due to osteoporosis is equal to her risk of breast, ovarian and uterine cancer combined. A man age 50 or older is more likely to break a bone due to osteoporosis than he is to get prostate cancer.”
Hip fractures are serious injuries that often result in an older adult’s inability to live independently.
People most likely to fracture a hip due to osteoporosis are:
- Women over age 50 and men over age 75
- Naturally slender, small-boned individuals
- People who smoke or drink or have an inactive lifestyle
- Individuals on medications that leach bone mass
If you recognize your relative (or yourself!) in this list, the news is not all grim. Throughout life, we’re constantly making new bone. What we eat and how we live affects bone building even into our later years. Here’s what to do:
- Eat for bone health. Load the grocery cart with dairy products or other high-calcium foods. Fatty fish, such as tuna and salmon, are good for vitamin D, another bone-builder. If your relative is a poor eater, ask the doctor if taking a supplement makes sense.
- Increase physical activity. Weight-bearing exercise, such as dancing, fast walking, and aerobics, adds to bone mass. Aim for 30 minutes at least four times/week. Strengthening exercises, such as weight lifting or routines with elastic exercise bands, are also important.
- Limit caffeine, alcohol, and smoking. Smoking is bad for bones. So is drinking more than three cups of coffee per day or more than 2 to 3 oz. of alcohol.
- Review medications. Ask the doctor about the risks and benefits of existing medications as they relate to bone loss. Also ask about a calcium and vitamin D supplement or a bone-building prescription.
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Look ahead when downsizing
It’s a big decision to have Mom or Dad move into a smaller living situation.
Often more emotionally challenging, however, are the many little decisions your relative must make.
What should they keep?
What should they let go of?
- Possessions, from furniture to garden tools, hold many dear memories.
- Giving them up forces recognition that one day your loved one’s life will come to a close.
The first step to reduce emotional strain is to allow plenty of time. Senior move experts recommend a minimum of three months lead-time. Consider these steps:
- Talk with your family member. Approach the subject carefully: “While we have the luxury of time, Mom, let’s begin to plan how things will fit in your new space. Only you know what’s most important to have with you.”
- Know what space is available. Obtain measurements or, better yet, visit the new residence and measure the floor space (and the closet space!). Create a layout to help your relative visualize what furniture will fit. Likewise, plot space for books, clothing, hobby materials, and other personal items.
- Be sensitive. That set of books may never have captured your interest, but they may hold beloved memories for Dad. This is your opportunity to learn the history of treasured possessions. Such sharing helps your loved one say goodbye, and it provides a way to “pay last respects” to parts of his or her past. What you hear may also change your mind about what to keep!
- Take time. Go at your parent’s pace, even if it seems tortoise-slow to you. If you rush, you’re likely to run into resistance or exhaustion.
If your parent has been a habitual collector, our articles on hoarding may provide more tips and insight.
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When the worrying won't stop
Worry is useful when it calls us to action.
But it’s a problem when it becomes an ongoing state of mind.
Worry can become a habit, bringing tension and stress. It is a frequent cause of insomnia. It can seem to take over all of your thinking.
If you’re a worrier, you know the many ways it makes your life harder. But you may also feel like it “helps.” It’s common, for instance, to have mixed feelings since worry does seem to keep you on your toes. And just maybe, you hope, all that time spent worrying might eventually uncover a novel solution to a thorny problem.
Relieving the stress of worry doesn’t mean you have to stop worrying. Here are some strategies to harness the positives of worry and keep the rest in balance:
- Don’t try to give it up. Instead, do it consciously and take notes! Schedule a 45-minute “worry time” for yourself every day. If a worry pops up at another time, write it down for review during your next worry period.
- Clarify what is fact and what is emotion. Hint: Facts are in the present tense. (“Dad seems tired and is coughing a lot.”) Emotional concerns often have a “future” component involving a problem that might happen (“What if it’s lung cancer?”)
- Create a strategy for action. Unproductive fears are usually based in uncertainty. Create a list of action steps to answer the unknowns. (“Look up the symptoms of lung cancer. Find out how many risk factors he has. Make an appointment with the doctor.”)
- Write out a balanced perspective. While completing the action steps, your mind is unlikely to just “let go” of the worries. For each worry, write down evidence in its support, and evidence against it. For instance, “Dad spent the afternoon in bed today. Then again, just last week he played a full round of golf with his buddies, and no coughing.” When the worry reappears, you can respond to it with this alternative, fact-based thought.
Seek professional help if your worrying feels unmanageable.
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