How to Recognize and Manage Caregiver Stress

Quote from “How to Recognize and Manage Caregiver Stress” by Alzheimer’s Association.

I also like to listen to this beautiful music “George Frideric Handel – Music for the Royal Fireworks”.

10 COMMON SIGNS OF CAREGIVER STRESS
1. Denial about the disease and its effect on the person who has been diagnosed.
I know Mom is going to get better.
2. Anger at the person with Alzheimer’s or frustration that he or she can’t do the things they used to be able to do.  He knows how to get dressed — he’s just being stubborn.
3. Social withdrawal from friends and activities that used to make you feel good.
I don’t care about visiting with the neighbors anymore.
4. Anxiety about the future and facing another day.
What happens when he needs more care than I can provide?
5. Depression that breaks your spirit and affects your ability to cope.
I just don’t care anymore.
6. Exhaustion that makes it nearly impossible to complete necessary daily tasks.
I’m too tired for this.
7. Sleeplessness caused by a never-ending list of concerns.
What if she wanders out of the house or falls and hurts herself?
8. Irritability that leads to moodiness and triggers negative responses and actions.
Leave me alone!
9. Lack of concentration that makes it difficult to perform familiar tasks.
I was so busy, I forgot my appointment.
10. Health problems that begin to take a mental and physical toll.
I can’t remember the last time I felt good.
***
10 WAYS TO MANAGE STRESS AND BE A HEALTHIER CAREGIVER
Are you so overwhelmed by taking care of someone else that you have neglected your own physical, mental and emotional well-being?  If you find yourself not taking care of your own needs, you may be putting your health at risk.
1. Find time for yourself.
Consider taking advantage of respite care so you can spend time doing something you
enjoy. Respite care provides caregivers with a temporary rest from caregiving, while the person with Alzheimer’s disease continues to receive care in a safe environment. Visit alz.org/care to learn more.
2. Know what community resources are available.
Contact the Alzheimer’s Association® or use our online Community Resource Finder
(alz.org/CRF) to locate dementia care resources in your area. Adult day programs, in-home assistance, companions and meal delivery are just some of the services that can
help you manage daily tasks.
3. Become an educated caregiver.
As the disease progresses, it may become necessary to adopt new caregiving skills. The Alzheimer’s Association offers programs to help you better understand and cope with common behavioral and personality changes that may occur. Visit the
Alzheimer’s and Dementia Caregiver Center at alz.org/care to learn more and access care training resources, including free online workshops.
4. Get help and find support.
Our online Care Team Calendar (alz.org/carecalendar) helps you organize friends and family who want to help provide care and support. Our 24/7 Helpline (800.272.3900),
ALZConnected® online social networking community (alzconnected.org) and local support groups (alz.org/findus) are all good sources for finding comfort and reassurance.  If stress becomes overwhelming, seek professional help.
5. Take care of yourself.
Try to eat well, exercise and get plenty of rest. Making sure that you are healthy can
help you be a better caregiver.
6. Manage your level of stress.
Stress can cause physical problems (blurred vision, stomach irritation, high blood pressure) and changes in behavior (irritability, lack of concentration, change in appetite). Note your symptoms and discuss with a doctor, as needed. Try to find
relaxation techniques that work for you.
7. Accept changes as they occur.
People with Alzheimer’s disease change over time and so do their needs. They may require care beyond what you can provide on your own. Becoming aware of community resources — from home care services to residential care — can make the transition easier. So will the support and assistance of those around you.
8. Make legal and financial plans.
Putting legal and financial plans in place after an Alzheimer’s diagnosis is important
so that the person with the disease can participate. Having future plans in place can
provide comfort to the entire family. Many documents, including advance directives,
can be prepared without the help of an attorney. However, if you are unsure about how to complete legal documents or make financial plans, you may want to seek
assistance from an attorney specializing in elder law, a financial advisor who is familiar with elder or long-term care planning, or both.
9. Know you’re doing your best.
Remember that the care you provide makes a difference and that you are doing the best you can. You may feel guilty because you can’t do more, but individual care needs change as Alzheimer’s progresses. You can’t promise how care will be delivered, but you can make sure that the person with the disease is well cared for and safe.
10. Visit your doctor regularly.
Take time to get regular checkups, and be aware of what your body is telling you.
Pay attention to any exhaustion, stress, sleeplessness or changes in appetite or behavior. Ignoring symptoms can cause your physical and mental health to decline.
CAREGIVER STRESS CHECKUP
Do you experience any of these signs of stress?
» Denial
» Exhaustion
» Anger
» Sleeplessness
» Health problems
» Irritability
» Social withdrawal
» Lack of concentration
» Depression
» Anxiety
Call 800.272.3900or visit alz.org for caregiver information and support.

Keep the talk and act consistent: 「說時似悟,對境生迷」,如何能對境界不動心?

The following quoted article in traditional Chinese is one of the advices for life that I shall frequently remind myself of.  I quote the entire article by the Venerable Master Hsing Yun (星雲大師) in the following.

Short quote:

偈云:「風吹疏竹,風過而竹不留聲;雁渡寒潭,雁去而潭不留影。」故君子「事來而心始現,事去而心隨空」。參禪修道的人,永遠活在當下,所謂「逢山開路,遇水搭橋」。事情過去了,心裡面也不必再留有痕跡。

◆ 不要把仇恨帶到明天。今天有人對不起你,對你不好,明天就把它忘記,修行人不要有「隔宿之恨」。

Entire article:

《六祖壇經講話》第四定慧品
文/星雲大師
◎「說時似悟,對境生迷」,如何能對境界不動心?

一般學佛修行的人,平時聽經聞法,對於佛法的道理好像有所認識,有所體悟。但是,境界一來,就迷惑了,這就是「說時似悟,對境生迷」。因此,佛教主張「解行並重」,不僅要「說時似悟」,尤其境界來的時候,要能不動心。

  過去有一個總經理,老是發脾氣,自己也知道脾氣不好,後來為了改脾氣,製作了一塊木牌子掛在身上,上面寫著「戒瞋怒」。

有一天,無意中聽到部屬私下在談論他:「我們總經理甚麼都好,可惜就是脾氣不好。」

他一聽,忍耐不住,隨手拿起了身上的牌子,就往那個幹部頭上砸去,邊砸邊說:「你胡說!我脾氣已經在改了,怎麼還要說我的脾氣不好呢?」

雖然口說改、改,但是修行的功力不夠,境界一來,又被迷惑了。所以,禪宗所謂「八風吹不動」,就是說,我們遭遇利、衰、苦、樂、稱、譏、毀、譽八種境界時,都能不為所動,都能如如不動。

有時候,在生活裡面,我們常為痛苦動心,為快樂動心,為人我是非,為別人的一句話而動心,這都是修行不夠。所以,我們能夠苦樂不動心,貧富也不動心,榮辱也不動心,不動心就是自主、自由、自在的生活。

偈云:「風吹疏竹,風過而竹不留聲;雁渡寒潭,雁去而潭不留影。」故君子「事來而心始現,事去而心隨空」。參禪修道的人,永遠活在當下,所謂「逢山開路,遇水搭橋」。事情過去了,心裡面也不必再留有痕跡。

在日常生活中,常見有一些人,三個月前被人罵過,三個月後,他還是耿耿於懷;十年前受過人家的欺負、侮辱、傷害,十年後他還是銘記在心。這樣的人生,負擔也實在是太重了。因此,「耳根是空谷投響,過而不留,則是非俱捨」。參禪悟道首先要學不動心,這是非常重要的。

著名的哲學家方東美博士,平生喜愛游泳。有一次在游泳時,忽然身子往水底下沉。在求生的本能下,他拼命的掙扎。但是愈掙扎,愈是往下沉,眼看著即將遭到滅頂。這時他平靜一想:「我是個哲學家,對於生死應該看開才是,如此求生怕死的樣子太難看了,一個哲學家,死也要死得灑脫一點啊!」

如此一想,心情輕鬆許多,四肢也自然放輕鬆,結果反倒浮出水面而生還。所以,不動心是一種力量,不動心是一種至高的修行境界。

修行不但要能不為外境動心,同時更要不時的返觀自照。

如何才能做到對境不動心呢?

◆ 不要把煩惱帶到床上。今天遇到任何煩惱生氣的事,到了睡覺的時候,就不要再去想它,不要把煩惱帶到床上。

◆ 不要把仇恨帶到明天。今天有人對不起你,對你不好,明天就把它忘記,修行人不要有「隔宿之恨」。

◆ 不要把憂鬱傳染給別人。在生活裡,自己的心頭縱有一些傷心事,不要再把自己的憂鬱傳染給別人,不要把自己的情緒寫在臉上,表現在行為上。

過去的禪師們在參禪修行的時候,總是先觀照自己的心,觀照自己能不動心嗎?能無心嗎?印光大師在他的房間到處張貼「死」字,觀「死」就是警惕自己,生死當前,還有甚麼好計較的呢?所以,一個死字,我們記在心上,就會離欲。

過去,有一個出家人問曹山本寂禪師:「有一個人通身害病,醫生要替他治療,要不要給他醫治呢?」

本寂禪師說:「不要,不給他看病。」

「唉喲!禪師!你怎麼這麼不慈悲呢?怎麼不讓他去看病呢?」

曹山本寂禪師說:「我要他求生不能,求死不得。」

所謂「求生不能,求死不得」,就是能夠不生不死,生死不動心。所以,我們能不為榮辱動心,不為得失動心,不為好壞動心,不為是非動心。不動心就能做到「說時似悟,對境也不迷」。

──摘自佛光文化出版《六祖壇經講話》

Tzu Chi Tea Preparation & Flower Arrangement: A brief slides report

I begin to understand that Tzu Chi Taiwan’s trainings in tea preparation and flower arrangement provides a great approach for pursuing a calmer mind, meditation (meditating via tea preparation and flower arrangement) and mind/heart/spiritual connection the Buddhist way.  The following attached slides is a brief report (in traditional Chinese language) to Tzu Chi’s venerable master Cheng Yen prepared by a member on the training of Tzu Chi Tea Preparation & Flower Arrangement class; the class was conducted in Taiwan in November 2016.  I particularly like the photos of the flower arrangements (in the second-half of the slides): some of them show simplicity, grace and elegance.

The attached slides in PDF format:

A brief slides of reporting Tzu Chi Taiwan Tea Preparation & Flower Arrangement Trainings in November 15, 2016

Eye complications caused by diabetes

An entire article quoted from the American Diabetes Association’s web page here: Eye Complications [caused by diabetes]

Brief quote:

Retinopathy

Diabetic retinopathy is a general term for all disorders of the retina caused by diabetes. There are two major types of retinopathy: nonproliferative and proliferative.

Nonproliferative retinopathy

In nonproliferative retinopathy, the most common form of retinopathy, capillaries in the back of the eye balloon and form pouches. Nonproliferative retinopathy can move through three stages (mild, moderate, and severe), as more and more blood vessels become blocked.

Macular edema

Although retinopathy does not usually cause vision loss at this stage, the capillary walls may lose their ability to control the passage of substances between the blood and the retina. Fluid can leak into the part of the eye where focusing occurs, the macula. When the macula swells with fluid, a condition called macula edema, vision blurs and can be lost entirely. Although nonproliferative retinopathy usually does not require treatment, macular edema must be treated, but fortunately treatment is usually effective at stopping and sometimes reversing vision loss.

Proliferative retinopathy

In some people, retinopathy progresses after several years to a more serious form called proliferative retinopathy. In this form, the blood vessels are so damaged they close off. In response, new blood vessels start growing in the retina. These new vessels are weak and can leak blood, blocking vision, which is a condition called vitreous hemorrhage. The new blood vessels can also cause scar tissue to grow. After the scar tissue shrinks, it can distort the retina or pull it out of place, a condition called retinal detachment.

Entire article quote:

Eye Complications
You may have heard that diabetes causes eye problems and may lead to blindness. People with diabetes do have a higher risk of blindness than people without diabetes. But most people who have diabetes have nothing more than minor eye disorders.

With regular checkups, you can keep minor problems minor (see our Eye Care page). And if you do develop a major problem, there are treatments that often work well if you begin them right away.

Eye Insight

To understand what happens in eye disorders, it helps to understand how the eye works. The eye is a ball covered with a tough outer membrane. The covering in front is clear and curved. This curved area is the cornea, which focuses light while protecting the eye.

After light passes through the cornea, it travels through a space called the anterior chamber (which is filled with a protective fluid called the aqueous humor), through the pupil (which is a hole in the iris, the colored part of the eye), and then through a lens that performs more focusing. Finally, light passes through another fluid-filled chamber in the center of the eye (the vitreous) and strikes the back of the eye, the retina.

The retina records the images focused on it and converts those images into electrical signals, which the brain receives and decodes.

One part of the retina is specialized for seeing fine detail. This tiny area of extra-sharp vision is called the macula.Blood vessels in and behind the retina nourish the macula.

Glaucoma

People with diabetes are 40% more likely to suffer from glaucoma than people without diabetes. The longer someone has had diabetes, the more common glaucoma is. Risk also increases with age.

Glaucoma occurs when pressure builds up in the eye. In most cases, the pressure causes drainage of the aqueous humor to slow down so that it builds up in the anterior chamber. The pressure pinches the blood vessels that carry blood to the retina and optic nerve. Vision is gradually lost because the retina and nerve are damaged.

There are several treatments for glaucoma. Some use drugs to reduce pressure in the eye, while others involve surgery.

Cataracts

Many people without diabetes get cataracts, but people with diabetes are 60% more likely to develop this eye condition. People with diabetes also tend to get cataracts at a younger age and have them progress faster. With cataracts, the eye’s clear lens clouds, blocking light.

To help deal with mild cataracts, you may need to wear sunglasses more often and use glare-control lenses in your glasses. For cataracts that interfere greatly with vision, doctors usually remove the lens of the eye. Sometimes the patient gets a new transplanted lens. In people with diabetes, retinopathy can get worse after removal of the lens, and glaucoma may start to develop.

Retinopathy

Diabetic retinopathy is a general term for all disorders of the retina caused by diabetes. There are two major types of retinopathy: nonproliferative and proliferative.

Nonproliferative retinopathy

In nonproliferative retinopathy, the most common form of retinopathy, capillaries in the back of the eye balloon and form pouches. Nonproliferative retinopathy can move through three stages (mild, moderate, and severe), as more and more blood vessels become blocked.

Macular edema

Although retinopathy does not usually cause vision loss at this stage, the capillary walls may lose their ability to control the passage of substances between the blood and the retina. Fluid can leak into the part of the eye where focusing occurs, the macula. When the macula swells with fluid, a condition called macula edema, vision blurs and can be lost entirely. Although nonproliferative retinopathy usually does not require treatment, macular edema must be treated, but fortunately treatment is usually effective at stopping and sometimes reversing vision loss.

Proliferative retinopathy

In some people, retinopathy progresses after several years to a more serious form called proliferative retinopathy. In this form, the blood vessels are so damaged they close off. In response, new blood vessels start growing in the retina. These new vessels are weak and can leak blood, blocking vision, which is a condition called vitreous hemorrhage. The new blood vessels can also cause scar tissue to grow. After the scar tissue shrinks, it can distort the retina or pull it out of place, a condition called retinal detachment.

How is it Treated?

Huge strides have been made in the treatment of diabetic retinopathy. Treatments such as scatter photocoagulation, focal photocoagulation, and vitrectomy prevent blindness in most people. The sooner retinopathy is diagnosed, the more likely these treatments will be successful. The best results occur when sight is still normal.

In photocoagulation, the eye care professional makes tiny burns on the retina with a special laser. These burns seal the blood vessels and stop them from growing and leaking.

In scatter photocoagulation (also called panretinal photocoagulation), the eye care professional makes hundreds of burns in a polka-dot pattern on two or more occasions. Scatter photocoagulation reduces the risk of blindness from vitreous hemorrhage or detachment of the retina, but it only works before bleeding or detachment has progressed very far. This treatment is also used for some kinds of glaucoma.

Side effects of scatter photocoagulation are usually minor. They include several days of blurred vision after each treatment and possible loss of side (peripheral) vision.

In focal photocoagulation, the eye care professional aims the laser precisely at leaking blood vessels in the macula. This procedure does not cure blurry vision caused by macular edema. But it does keep it from getting worse.

When the retina has already detached or a lot of blood has leaked into the eye, photocoagulation is no longer useful. The next option is vitrectomy, which is surgery to remove scar tissue and cloudy fluid from inside the eye. The earlier the operation occurs, the more likely it is to be successful. When the goal of the operation is to remove blood from the eye, it usually works. Reattaching a retina to the eye is much harder and works in only about half the cases.

There are two types of treatment for macular edema: focal laser therapy that slows the leakage of fluid, and medications that can be injected into the eye that slow the growth of new blood vessels and reduce the leakage of fluid into the macula.

Am I at Risk for Retinopathy?

Several factors influence whether you get retinopathy:

  • blood sugar control
  • blood pressure levels
  • how long you have had diabetes
  • genes

The longer you’ve had diabetes, the more likely you are to have retinopathy. Almost everyone with type 1 diabetes will eventually have nonproliferative retinopathy. And most people with type 2 diabetes will also get it. But the retinopathy that destroys vision, proliferative retinopathy, is far less common.

People who keep their blood sugar levels closer to normal are less likely to have retinopathy or to have milder forms.

Your retina can be badly damaged before you notice any change in vision. Most people with nonproliferative retinopathy have no symptoms. Even with proliferative retinopathy, the more dangerous form, people sometimes have no symptoms until it is too late to treat them. For this reason, you should have your eyes examined regularly by an eye care professional.

  • Last Reviewed: June 7, 2013
  • Last Edited: November 1, 2013

“Amazing Grace”, John Newton, Olney Hymns, 1779

This song “Amazing Grace” always raises up my spiritual side.  Click on the picture below to play the video.

 

. Also this video by Celtic Woman (appearance order in this song year 2010: Lisa Kelly, Chloë Agnew, Alex Sharpe, Lynn Hillary) https://www.youtube.com/watch?v=HsCp5LG_zNE

CelticWoman2010.jpeg

. Click on the following link for another recording Amazing Grace (My Chains are Gone) – Chris Tomlin (with lyrics)

. Additionally, another video link: “Amazing Grace (My Chains Are Gone) | BYU Noteworthy”

My personal thought: In this imperfect world, freedom is still a privilege – not yet a birth right in general; and quite often we don’t set ourself free.

“Amazing Grace”, John Newton, Olney Hymns, 1779

Amazing grace! (how sweet the sound)
That sav’d a wretch like me!
I once was lost, but now am found,
Was blind, but now I see.

‘Twas grace that taught my heart to fear,
And grace my fears reliev’d;
How precious did that grace appear
The hour I first believ’d!

Thro’ many dangers, toils, and snares,
I have already come;
‘Tis grace hath brought me safe thus far,
And grace will lead me home.

The Lord has promis’d good to me,
His word my hope secures;
He will my shield and portion be
As long as life endures.

Yes, when this flesh and heart shall fail,
And mortal life shall cease;
I shall possess, within the veil,
A life of joy and peace.

The earth shall soon dissolve like snow,
The sun forbear to shine;
But God, who call’d me here below,
Will be forever mine.

John Newton, Olney Hymns, 1779

About “Amazing Grace” from https://en.wikipedia.org/wiki/Amazing_Grace

Quotes:

Amazing Grace” is a Christian hymn published in 1779, with words written by the English poet and Anglican clergyman John Newton (1725–1807).

Newton wrote the words from personal experience. He grew up without any particular religious conviction, but his life’s path was formed by a variety of twists and coincidences that were often put into motion by his recalcitrant insubordination. He was pressed (conscripted) into service in the Royal Navy, and after leaving the service, he became involved in the Atlantic slave trade. In 1748, a violent storm battered his vessel off the coast of County DonegalIreland, so severely that he called out to God for mercy, a moment that marked his spiritual conversion. He continued his slave trading career until 1754 or 1755, when he ended his seafaring altogether and began studying Christian theology.

Ordained in the Church of England in 1764, Newton became curate of Olney, Buckinghamshire, where he began to write hymns with poet William Cowper. “Amazing Grace” was written to illustrate a sermon on New Year’s Day of 1773. It is unknown if there was any music accompanying the verses; it may have simply been chanted by the congregation. It debuted in print in 1779 in Newton and Cowper’s Olney Hymns but settled into relative obscurity in England. In the United States, however, “Amazing Grace” was used extensively during the Second Great Awakening in the early 19th century. It has been associated with more than 20 melodies, but in 1835 it was joined to a tune named “New Britain” to which it is most frequently sung today.

With the message that forgiveness and redemption are possible regardless of sins committed and that the soul can be delivered from despair through the mercy of God, “Amazing Grace” is one of the most recognizable songs in the English-speaking world. Author Gilbert Chase writes that it is “without a doubt the most famous of all the folk hymns,”[1] and Jonathan Aitken, a Newton biographer, estimates that it is performed about 10 million times annually.[2] It has had particular influence in folk music, and has become an emblematic African American spiritual. Its universal message has been a significant factor in its crossover into secular music. “Amazing Grace” saw a resurgence in popularity in the U.S. during the 1960s and has been recorded thousands of times during and since the 20th century, occasionally appearing on popular music charts.

Critical analysis

The general impact of Olney Hymns was immediate and it became a widely popular tool for evangelicals in Britain for many years. Scholars appreciated Cowper’s poetry somewhat more than Newton’s plaintive and plain language driven from his forceful personality. The most prevalent themes in the verses written by Newton in Olney Hymns are faith in salvation, wonder at God’s grace, his love for Jesus, and his cheerful exclamations of the joy he found in his faith.[26] As a reflection of Newton’s connection to his parishioners, he wrote many of the hymns in first person, admitting his own experience with sin. Bruce Hindmarsh in Sing Them Over Again To Me: Hymns and Hymnbooks in America considers “Amazing Grace” an excellent example of Newton’s testimonial style afforded by the use of this perspective.[27] Several of Newton’s hymns were recognized as great work (“Amazing Grace” was not among them) while others seem to have been included to fill in when Cowper was unable to write.[28] Jonathan Aitken calls Newton, specifically referring to “Amazing Grace”, an “unashamedly middlebrow lyricist writing for a lowbrow congregation”, noting that only twenty-one of the nearly 150 words used in all six verses have more than one syllable.[29]

William Phipps in the Anglican Theological Review and author James Basker have interpreted the first stanza of “Amazing Grace” as evidence of Newton’s realization that his participation in the slave trade was his wretchedness, perhaps representing a wider common understanding of Newton’s motivations.[30][31] Newton joined forces with a young man named William Wilberforce, the British Member of Parliament who led the Parliamentarian campaign to abolish the slave trade in the British Empire, culminating in the Slave Trade Act 1807. However, Newton became an ardent and outspoken abolitionist after he left Olney in the 1780s; he never connected the construction of the hymn that became “Amazing Grace” to anti-slavery sentiments.[32] The lyrics in Olney Hymns were arranged by their association to the Biblical verses that would be used by Newton and Cowper in their prayer meetings and did not address any political objective. For Newton, the beginning of the year was a time to reflect on one’s spiritual progress. At the same time he completed a diary – which has since been lost – that he had begun 17 years before, two years after he quit sailing. The last entry of 1772 was a recounting of how much he had changed since then.[