A to Z Challenge: Z for Zeitgeber

The last letter of the alphabet! This was an interesting and challenging experience, as always, and I am so grateful for all the connections and comments. Thank you all for reading and encouraging me, and other caregivers.

Zeitgeber

I ran across this interesting word as I was studying a book called “The Paleo Approach” by Dr. Suzanne Ballantyne. Zeit means “time” in German and geber means “giver”. A “time giver” is “anything that influences your circadian clock”. Your circadian clock is all about your body’s routine. And routine is one of the most important tools of caregiving.

Examples of zeitgebers are the light and dark cycle, food intake and activity. Regular times for meals, for exercise and for sleep are beneficial to all of us, but especially for the very young, the elderly and for those with dementia. Being able to depend on a routine gives the impression that things are under control, and having any sense of control is comforting.

Routines

Routine is not the easiest thing for me as a caregiver. I am the queen of spontaneity, and will usually go out of my way to break up a routine. But now, I have things I do pretty regularly. One of the most important reasons I’ve developed routines is because they help me not to forget stuff I would otherwise probably forget. Routines also cut down on decision making because we have already decided what and when. And of importance, the routines help my husband know what to expect at various times of the day.

Circadian Rhythms and Sleep

The light/dark cycle is probably the most important zeitgeber, and the one I have the most trouble with. Being outdoors in sunlight during the day, and in the dark at night greatly affects circadian rhythm, which in turn affects the immune system, mental ability, mood, alertness and energy level. Ideally, the husband and I should get as much light exposure as possible during the day. We both should cut down on our screen time at night as well. Blue light from our computers, phones, TVs, and LED fixtures signals our bodies much like daylight does. It suppresses melatonin production. Blue light not only signals through the retina of our eyes, but even our skin has sensitivity to it. In contrast, low light and darkness signal the production of melatonin and bring on relaxation and sleep.

It is dark outside. Due to my circadian rhythms, I am getting sleepy. Take care of yourselves as we go through these strange times. Good night to all.

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This evening Dennis, my husband, came out where I was sitting and apologized. Not knowing what he was apologizing for, we talked and I discovered he had read the X post. He was saying that he was sorry for making things hard for me. I was surprised that he had not read other posts this month, even though he was aware that I was writing on the subject of caregiving. He was sweet, and humbly aware of the impact that his illness has had on me and on our relationship. It’s moments like this that make me know that he is more than just my patient. He is still very much my husband.

Forty-seven years and counting…

A to Z Challenge: R for Rest, REM Sleep Disorder and Respite

Caregivers struggle to get their rest. Often those they care for also struggle to get good rest. But sleep is essential for healing, and for maintaining circadian rhythms that work in the body’s favor. Times of rest are when the body repairs itself physically and mentally. Everything goes better when all are sleeping well. But there are some enemies of good rest. Here are a few I know about.

It used to drive me insane. I traveled with a client who made me go around our motel room pinning the drapes shut with clothes pins, putting tape on the LED lights on any appliance that had them, covering up the clock, and putting towels at the bottom of the door to keep out the hall light. She insisted she could not sleep when there was any light in the room. In my mind, I was telling her my solution – shut your eyes and the light goes away.

Turns out she was right. We are programmed to become sleepy when it’s dark. We need to get light exposure during the day. It actually plays a part in keeping us alert and awake. But as evening comes, a hormone our body produces called melatonin, increases and we get tired. But even ordinary indoor lighting can interfere with our melatonin production. LED lighting is probably the worst kind and that is why having a lot of evening screen time – TV, computer, and cell phone is counterproductive. Ideally, you and your person should try to get out during the day, keep lights low in the evening, and avoid screen time the last few hours before going to bed.

Our short winter days make it hard for us to get light exposure. We have a light box to help with that and keep it next to the treadmill. Kind of like a walk in the sun?

One of the most common problems I read about in the caregiver support chats is the condition called “sundowning”. People with Alzheimer’s or other dementias might have the experience of getting more anxious and upset in the late afternoon or evening. It’s a kind of confusion that keeps them thinking that they should be up when you think they should be asleep. It can be exhausting for everyone involved. Having good routines with activity during the day (less napping), relaxing time before going to bed, not eating too late in the day and possibly boosting melatonin levels with a supplement, can all help.

It’s also just common sense to not try to get the whole day’s fluid intake in the evening (when you finally remember…) because frequent bath room trips do not make for good sleep.

For many years before his diagnosis of Lewy Body Dementia, my husband had vivid dreams. He would talk, shout, run, peddle his bike and fight with kicks and punches during his nightmares, scaring himself and me. We didn’t sleep very well and we have stories about that. We learned that this was called REM (rapid eye movement) Sleep Disorder, and it is one of the symptoms leading to the diagnosis of LBD. I was fascinated to learn that most of us are somewhat paralyzed when we sleep, which is why we don’t act everything out. Not so with this kind of dementia. Again, supplementing with melatonin before bedtime has helped Dennis to avoid most of this and sleep quietly.

Caregivers, there is another important R word that you should know about. If you are at your wit’s end, exhausted and nothing is getting better, you might need respite care for your loved one. Respite is a short period of rest or relief from your difficult situation. Sometimes it can be as simple as asking a relative or friend to help for a night so you can get some sleep. Respite care is also a common feature of hospice care, so inquire if you need this kind of help. Your person depends on you to stay well and take care of yourself.

I am reminded of the scary statistic coming out of one caregiver study – death rate of caregivers was 63% higher than that of the control group. After six years of the study 70% of the caregivers had died before their person and had to be replaced. Stress can do that to you. I’m hoping to stay well and be here for my people until they don’t need me anymore. Just sayin’…

#AtoZChallenge: My Favorite Things Z

Zzzzzz’s (okay, sleep)

I used to think that missing sleep was not a big deal, if I could make it through the next day all right. I’m learning differently, and it’s a little scary.

A good sleep pattern, something that’s habitual, can make the difference between being healthy and active or falling prey to (are you ready for this?) brain fog, memory loss, diabetes, obesity, cardiovascular disease, cancer, depression and Alzheimer’s disease. Prolonged poor sleep habits are a factor in all of those things THAT YOU DON’T WANT!

I’m especially concerned about my brain as I age, specifically I want to avoid dementia of all kinds. Good sleep enables the brain to clear out damaging proteins and carry out several other physiological chores that cut inflammation and bolster the immune system. Sleep apnea,  a common condition these days, has been shown to be a factor in the cognitive impairment that can precede Alzheimer’s disease. I’m not saying that my husband is cognitively impaired yet but he says he’s worried that he is.  What I hear, a few minutes after he falls asleep, is snoring. After he is fully relaxed his airway closes and he doesn’t breathe for a much longer time than normal – which rouses him suddenly just enough to start the cycle over again. Neither one of us sleeps very well through this.

The good news is that he has finally gotten around to visiting a sleep specialist for his sleep problem. Yay! I have been telling him that it could be causing some of his other complaints, and after getting the explanations from this doctor, he is starting to believe it. He’s eager to get on with his night time sleep study (polysomnogram). There is a whole field of medicine devoted to sleep disorders, and it’s about time since we spend nearly a third of our lives sleeping, or trying to.

Sleep, good sound sleep that leaves me feeling refreshed, is a memory from younger years I’m afraid. I usually look forward to getting off my feet and lying down, but after a few hours of hunting for a position that doesn’t hurt something, somewhere, I’m am looking forward to getting up again.  Tried a “sleep number” bed. It didn’t help. Tried “My Pillow”.  Didn’t help either. I’m defying the odds. But every once in a while I hit the jackpot and get a really good sleep. It is so sweet, and definitely a favorite.

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The kind of ridiculous, good sleep I’m waiting for…

 

I’m addressing my sleep deprivation from several angles, trying lots of lifestyle alterations that help. There’s lots of interesting information out there! How are you sleeping these days?

Where in my mind am I?

I was very tired last night.  I fell asleep in the chair watching tv and decided it was crazy to waste sleepiness on a chair.  I would go to bed where I so often wish I was sleepy and am not.  I got ready for bed and got in, turned out the light.  As I was lying there and my body was getting numb to it’s surroundings, as I lay quietly behind my closed eyelids waiting for sleep, I suddenly could not remember whether I was in the chair thinking about being in bed, or in bed thinking about being in the chair. Weird things happen in that space between awake and asleep.

The worst part was, I had to get up and go write down what it was like because I knew I’d forget it if I didn’t.  By then I was wide awake again and stayed up too late like usual.  The mind is a crazy place, just sayin’…

Anything like that ever happen to you?

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It started here, in my chair.

A to Z Challenge: K is Kicking

The really strange thing about dreams is that they turn people into unrecognizable variations of themselves. They think and do things while dreaming that they probably would never do in real life – and I don’t mean that they dream they are doing those things. They actually do those things.

To preserve anonymity, I’m not going to say who did this, but the other night someone was dreaming that they were being threatened by a huge bad guy. The dreamer (not saying who) knew that they couldn’t get away by running. The only good strategy they had was to lie on their back, wait till the bad guy was above them, and then swiftly and decisively, kick their head off (the solution, of course!). This they proceeded to do, followed by several loud noises and the sound of breaking glass.

This woke me up, searching for a light and looking to see if the husband was in bed and okay. The dreamer (anonymous) was rubbing his ankle and surveying the damage. Somehow the bedside lamp had totally lost it’s lampshade and was hanging from the wall on a strange angle. On the marble top bedside table was a broken pitcher vase with it’s flowers all awry.

There are two points to this story. The first is this – if you sleep with a dreamer make sure his feet are pointing away from you and sleep lightly. The second is, if you are a bad guy, don’t sneak in our house at night unless you want your head kicked off. Seriously.

Alas, she is broken
Alas, she is broken