Part memoir, part self-improvement text, part professional advisory, this often-moving book by Professor Lawrence T. Force implicitly and explicitly delivers for caregivers what its subtitle promises: key tips for survival, strength and patience. Pay attention: many (perhaps most) of us will be in the caregiver role, if we are not there already.
I first met Larry Force at a symposium on alternatives for care for seniors, held at local library. His keynote talk was impressive in its wisdom and its obvious caring. As a gerontologist, Dr. Force has decades of experience in the field, with particular emphasis on victims of Alzheimer’s, including his dear mother. His doctoral study, almost four decades ago, centered on the behavior of family members in accessing adult day care for their relatives. I was flattered to be invited subsequently to speak to his class about being an advocate for patients and about being a caregiver myself.
Dr. Force has written numerous professional articles, including one in which he described, as he does here, four styles of caregiving: the Hero (who does it courageously and without complaint), the Martyr (who grudgingly supplies help while bemoaning being a caregiver), the Snake (who slithers away from the situation) and the Devastated (who can barely help, due to overwhelming grief over the predicament of their loved one). The case histories he summarizes make the reader hope to be in the Hero category, while recognizing what that may entail.
Subsequently, he and his colleagues have also identified the Wolves (who swarm in, take control and isolate the patient from the family) and the Liquidators (whose concern is not the patient but the patient’s assets).
Dr. Force notes that every day, in the USA, 10,000 people turn 65, many of whom will need a period of prolonged care before they die. That care is likely to be provided by a spouse or a child and eventually a nursing home.
On the subject of nursing homes, it encouraged me to learn of the excellent experience Dr. Force and his family had regarding the care for several years of his mother in a Catholic facility New York, and his thank-you letter to that organization is a model of its genre.
It’s all about you, he emphasizes. “You cannot take care of someone else or be present for someone else if you aren’t taking care of yourself.” Caregiving includes paying attention to your own well-being.
Part of his experience was nearly dying, “a yearlong odyssey that would change my life.” Bedridden for months, he was urged by a friend to change his thinking radically, to view himself as “competent, in control, healthy, strong….” He had been introduced to the healing power of mental imagery, a power that can benefit both the cared for and the caregiver. It led to his becoming certified in hypnotherapy and re-orienting his practice to include cognitive, wellness, and exercise elements. Often, diet and exercise produce big improvements in well-being.
Mentally, we are at our best when we are neither dwelling in the past nor worrying about the future, but experiencing and observing and being mindful of the present. Dr. Force discusses mindfulness and exercise (including structured breathing) and imagery/visualization. We want to establish beneficial habits and eliminate harmful ones. If we are aware we are repeating self-defeating habits, we are on the way to erasing them. He offers a detailed how-to guide to enhanced relaxation and imagery.
The book includes several short pieces by other caregivers, emphasizing the variety of situations and experiences, yet reinforcing the point that if the caregiver is not careful of self, he or she will not be able to continue to supply support when it is needed.
In his practice, Dr. Force applies “Holistic triage…natural supports to enhance cognitive (thinking and imagery), energy (nutrition, wellness and spirituality), and movement (exercise, strength building, yoga, Pilates, and breath work)… [and] internal reflection.” This discussion takes the book beyond do-it-yourself, but we are encouraged to do much of this on our own: “Change what can be changed.”
While upbeat in tone and prescriptions, the book includes some very touching material, including M.J.’s story, about the nearly impossible situation she has been managing at home, trying to keep from having to put her cognitively impaired husband into a nursing facility. Declining health aggravated by medical errors have put their lives into a tailspin. There may not be a solution to her situation, but we read it and think, “I wish her well. Thank God, I’m not M.J.”
Chapter 10 discusses nutrition and exercise, with input from registered dietician Louise Turino. To have a sound mind in a sound body, you have to eat right and exercise. Lots of information is presented, though I skimmed it, as I think I already know how to eat and exercise. I did particularly like this quote from the Mayo Clinic, “Exercise is meditation in motion.”
The book ends with a helpful “Resource Section,” giving annotated links to organization web sites, with descriptions of what each contains.
As a long-time caregiver myself, I strongly recommend this book for others who rise to this sometimes-herculean challenge.