San Diego Elder Answers
Expert advice for people caring for a loved one

Psychological first aid

Anxiety and stress commonly accompany family caregiving. The ongoing pandemic and its stream of variants are only adding to that. Perhaps you could use a little “psychological first aid.” These are skills or techniques first responders are trained to teach or apply to distressed persons after urgent physical issues have been addressed.

The goal of psychological first aid is to help people feel safe (physically and emotionally), calm, and hopeful. Connected to others. Sound good? Try these strategies on yourself.

• Maintain healthy basics. This means good nutrition, good sleep, and daily physical activity. Avoid leaning on sugar, alcohol, tobacco and such for coping.
• Practice deep breathing. When you feel anxiety mounting, practice slow, deep breathing. A few minutes of deep breathing can reduce stress hormones and blood pressure and get you quickly back to your emotional balance.
• Establish a daily routine. Structure is reassuring in a time of uncertainty or upheaval. It also allows you to save vital mental energy for other tasks since a routine can be done a bit more on autopilot.
• Avoid further harm. Recognize that what you are feeling is normal. Especially with the pandemic, it’s easy to feel hopeless in the face of new surges. But that doesn’t mean you let your guard down. Stay vigilant! Continue to protect yourself and your loved one.
• Prioritize. What is urgent? What can wait? What is within your control? What is not? Focus on the things you can control, addressing the urgent before the nonurgent. It will counteract feelings of powerlessness.
• Give yourself a media diet. Limit your intake of the news to once a day. Ideally, avoid TV news. Too many vivid pictures.
• Cultivate hope. Admittedly, this may feel difficult. Start by mentally identifying the things that are going well, however small. Be on the lookout for positive moments and savor Keep a gratitude journal.
• Stay connected. Whether by text, phone, video chat, or visiting safely in person, stay in touch with people who make you feel better, people you can confide in.
• Consider past coping strategies. How have you gotten through challenges? What worked and is worth repeating? Anything you want to be sure you don’t do this time around?

Caregiving apps

Juggling multiple schedules, keeping other relatives informed, ensuring prescriptions are filled … these are but some of the many duties you may face as a family caregiver. In some instances, a simple spreadsheet can do the trick. But an app makes it easier to coordinate with others.

Admittedly, every app has a learning curve and may feel like “one more thing” to do. But if you have a smartphone and are so inclined, you may find these apps ultimately save you time and distress. (They are free, but there may be ads or other trade-offs.) All are available on the App Store or Google Play.

We are not endorsing any of them. Rather, we are naming apps that have been reviewed by organizations such as AARP (American Association of Retired Persons) and seem generally well rated. They are grouped here in terms of common features. Not all features are in each app named in a group. Conversely, apps are frequently updated to include new features. This review can give you at least a sense of the range of applications. Maybe there’s an app for what you need!

Updating others; asking for and scheduling help
Two apps that have stood the test of time are Lotsa Helping Hands and Caring Bridge. You invite others to join an online community so you can send out group updates, upload recent photos, display a calendar with needed tasks, request help, etc.

Medication management
Common features include tracking prescriptions and refills, sending reminders to your loved one, and receiving alerts if a dose is missed. Most support quick lookup of instructions and side effects. Some deliver discount coupons. Check out Medisafe, CareZone, and MyMeds.

All-in-one app
Consider Caring Village if you want to facilitate communication, scheduling, and medication management using just one app. It includes options for uploading and storing documents (for example, an advance directive).

"Chemobrain"

People who go through chemotherapy for cancer often complain about “chemobrain.” If your loved one is under treatment and is having trouble with memory, thinking, and concentration, it is likely from the chemo drugs. The fuzzy thinking may not go away right when chemo stops. But it usually recedes over time.

Encourage your loved one to

• plan the day. Do the most challenging tasks at their “best time,” when they feel most mentally sharp. Get a large calendar/planner.
• create routines. Habits help because they don’t tax the brain. Keep the same daily schedule. Store essentials (keys, wallet, phone) in one spot.
• do one thing at a time. Remove distractions. Turn off the TV or radio. Avoid multitasking.
• use memory aids. Put lists on the refrigerator or smartphone. Use audio reminders from Google, Alexa, or Siri. GPS in the car.
• reduce mind alterants. Meet with the pharmacist to ask about substitutions for any noncancer drugs that cause mental fog. Stop/reduce use of alcohol or recreational drugs.
• move, eat, sleep. A daily walk gets essential oxygen to the brain. A diet high in vegetables brings vital nutrients. And getting a good night’s sleep gives the brain time to rid itself of the daily natural sludge that builds up.
• keep a sense of humor. “There goes that chemo brain!” Remind yourself—and everyone—that your loved one is not stupid. Just experiencing a bodily reaction to the assault of chemo drugs.
• let others know. Encourage your loved one to be open and to ask for help. Also, to join a support group of others undergoing chemo. There is relief in knowing you aren’t alone!

If your loved one also has insomnia, sleep apnea, depression, or anxiety, seek treatment for these conditions as they can also add to the fog.