February Wellness Update
Self-Care is not a luxury.

“Many of us are not practicing self-care, we are practicing after-care.
After-care is the thing that we do once we are diminished, 
once we are depleted and we can’t take anymore…
[With] after-care you will constantly be managing crisis after crisis. 
It is so important that as a preventative measure 
you lean into continuous and constant self-care practices.” 

~ Nedra Tawab
This month’s wellness update features New York Times best-selling author, Nedra Tawab. As a therapist, she has built a successful career helping others establish and maintain personal boundaries for better health and wellbeing. While her book was not written exclusively with family caregivers in mind, the themes in her 2021 release, Set Boundaries, Find Peace: A Guide to Reclaiming Yourself, offer compelling parallels and helpful strategies for caregivers. Though it can be uncomfortable and challenging work, feeling equipped to identify and prioritize our needs helps us protect space for self-care and can be truly transformative. This challenging, yet fascinating process often liberates years of behavior patterns which have unintentionally impeded our peace of mind and overall health. I appreciate how her work aligns with healthy caregiving strategies by offering short-term, long-term and self-manageable skills.

When caring for others, particularly adults with dementia whose needs require more time and oversight, establishing healthy boundaries can offer substantial benefits for everyone surrounding the caregiver. Before experiencing all the benefits of healthy boundaries, the steps to identify and honor one's own needs must first be securely established. This is no small feat and where family caregivers often need ongoing support and reminders. In dementia care, this is a moving target. We all make compromises for the people we love and yet the balance of our needs vs. others can generate instability within ourselves. This internal battle is how resentment and burnout take seed. 

“Neglecting self-care is the first thing to happen 
when we get caught up in our desire to help others.”

Contrary to how it initially sounds, the work of creating and maintaining boundaries is not about controlling outside stressors, walling-out the world, especially those who care about our health and best interests. While we’ve all done this before to cope with intermittent feelings of overwhelm, doing so as a long-term strategy is harmful to relationships as well as exhausting. Attempting to manage things outside of our control is one sure way to feel even less stable internally. Instead, this approach is about radical self-care and preservation where accountability is firmly rooted in managing ourselves while letting go of managing conditions (and the people) around us in order to feel secure. Sometimes the people we love the most will unintentionally challenge our capacity to show up for ourselves. This makes sense when we consider years of conditioning and cultural expectations to be supportive at all costs as one (unhealthy) definition of love. What we actually discover through boundary work is how the thief of our peace is often no other than…ourselves. Oftentimes, we’re the biggest threat to protecting and preserving our own mental health and wellbeing. 

It’s human and natural to turn away from ourselves from time to time, particularly when what we are experiencing is painful or confusing. The trouble rests in how easily this can become habitual, when we dismiss our immediate discomfort by looking for something else (or someone else) to soothe our distress. This is precisely where healthy boundaries (for self and others) can show up and help us through, like following a roadmap back to our peace. This also fosters self-trust and it becomes easier to ask for help and receive it when we’re clear on what we need. While the word boundaries can be misunderstood as a barrier or a closing around emotional or physical availability, in this sense, it is self-care in action and approached as an opening to our health. Boundaries are built and reinforced through honest dialogue, beginning with how we speak to ourselves and then with others. One simple boundary expressed skillfully, such as our capacity to say No, can compassionately protect our health and our relationships. It also goes a long way toward protecting the finite resources we have: our time, availability and energy. 

"The ability to say no to yourself is a gift. If you can resist your urges, change your habits, and say yes to only what you deem truly meaningful, you’ll be practicing healthy self-boundaries. 
It’s your responsibility to care for yourself without excuses."

Boundaries are not invisible walls, they are flexible and responsive to present conditions and function best when communicated, regularly and clearly. In the spirit of Valentine’s Day, located in one of the most dreary months of the year in Michigan, this is a loving act which flows in all directions. And this also happens to be where things get interesting. It’s easy to forgo important agreements when the agreement maker is also the agreement editor and the agreement breaker. While we can get away with treating ourselves poorly, the cost will likely show up in our peace, happiness and the quality of our relationships. Look around. If any of these things feel particularly strained, a healthy boundary may be helpful. While there are no quick fixes in caregiving and no easy routes through decision making, there are simpler and less harmful ones!  

For your consideration, here’s a simple list of clarifying questions. See what resonates, challenges or interests you.

“To determine if your expectations are reasonable, consider this:"

  • Whose standard am I trying to meet?
  • Do I have the time to commit to this?
  • What’s the worst thing that could happen if I don’t do this?
  • How can I honor my boundaries in this situation?

Boundary work has been an essential inclusion in our wellness programming over the years and Nedra Tawab’s work offers exceptional insights for navigating the discomforts of saying No to what does not align and the counter-intuitive discomfort of also saying Yes to ourselves. The practical and deep-cutting skill building underscores an essential point and mindset for all caregivers to embrace: Self-care is not a luxury.  

“Remember: there is no such thing as guilt-free boundary setting. 
If you want to minimize (not eliminate) guilt, change the way you think about the process. 
Stop thinking about boundaries as mean or wrong; start to believe that they’re a nonnegotiable part of healthy relationships, as well as a self-care and wellness practice.”
—Laura Rice-Oeschger, LMSW
Managing Director, Wellness Initiative
New Wellness Programs
Cultivating Creativity 
 
April - December, first Tuesday of each month, 10 a.m. - 12 p.m. 

Cultivating Creativity is a monthly arts program for persons living with memory loss and their family caregivers. Participants will enjoy an instructed and dementia-friendly art activity together. Projects include painting, print making, ornament and coaster decoration, and cardmaking among other activities. The program is currently offered in person.
Mitten Minds Education Series
 
April - May, dates to be announced 

The Mitten Minds Education Series offers a series of educational presentations for individuals who are newly diagnosed with mild cognitive impairment or are in the early stages of a dementia. The series provides important information, provides a space for questions to be answered, and to connect to other resources and support services available.
CALM Conversations 

April 28, 1 - 2:30 p.m.

Conversation Topic: Coping with the grief that arises after securing additional support, such as in-home care, respite or a relocation

CALM Conversations is a series of facilitated discussions exploring topics related to change and loss throughout the caregiving journey. Recognizing the presence and impact of losses while developing ways to include grieving in wellbeing practice is integral to connection, healing, and growth. The program is currently offered virtually.
Upcoming Program Registration
Catching Your Breath

February 14, 10 - 11:30 a.m.
 
Catching Your Breath is a monthly program focused on learning and practicing stress resilience skills for continued health, balance, and well-being. The program is for family caregivers of adults living with a dementia.
Mitten Minds Support Group
 
February 15, 3 - 4 p.m.
 
The Mitten Minds Support Group is a monthly support group for individuals with mild cognitive impairment or early stage dementia. The support group provides a space for individuals living with memory loss to meet and learn from others going through similar experiences.
Have a Seat

Thursdays from 12 - 12:30 p.m.

Have a Seat is a weekly guided meditation program. Would you like to receive weekly email reminders to join the program? Subscribe here to receive.
Soothing Word of the Month
Hooly or Huly
(Adverb) To proceed gently or softly, with steadiness or caution. Scottish/Irish.
This Month's Virtual Events
Caring for Caregivers 

February 22, 10 - 11 a.m.

Paula Duren, PhD, Founder of Universal Dementia Caregivers will present as part of our monthly speaker series. Tune in, or find a recording available afterwards on our YouTube page.
The Future of Alzheimer’s Research and Treatment

February 24, 5 p.m. 

Early detection and accurate diagnosis are key to developing strategies to treat Alzheimer’s disease. Learn about the latest advancements in those areas and the range of treatments and lifestyle interventions being explored to help reduce one’s risk or slow the disease. Rebecca M. Edelmayer, Ph.D., Senior Director of Scientific Engagement for the Alzheimer’s Association, will lead a panel of researchers, including our Associate Director, Dr. Bruno Giordani.
Research Looking for Caregivers
New Study!
Stress and Well-Being in the Everyday Lives of Caregivers (SWEL) study

The Institute for Social Research at the University of Michigan is looking for participants interested in the Stress and Well-Being in the Everyday Lives of Caregivers (SWEL) study. The purpose of the study is to learn about the daily experiences, well-being, and cardiovascular health of family members or friends living with someone with dementia in an effort to understand the impact that this has on family caregiver heart health. Family caregivers of any age who are living with and helping a family member or friend who has Alzheimer’s or a related dementia are invited to participate, and the study is completed in the home. Participants can receive up to $400 for taking part in this study. For more study details and contact information for the study team, visit the link below. 
Family Dynamics and Influence in Dementia Care (FDI-DC)

This study investigates how the availability and circumstances of family members influence the type and level of care over time. The study’s focus is to learn the social, financial, and health circumstances of family members of persons with dementia and how the care availability changed due to the COVID-19 pandemic. It also aims to learn about dementia care transitions influenced by changes in family circumstances. The study is recruiting spouses or adult children of an adult who received a dementia diagnosis at least one year ago. For more information and to participate, contact Bona Park at parkbo@umich.edu or 734-985-0526.
COVID-19 Coping and Resilience Care Partners Study (CARE)

This study investigates experiences among couples living with dementia during the COVID-19 (coronavirus) pandemic to learn more about ways to help both partners live well together. The study is looking for couples (married or living together) residing in Michigan in which one partner has received a diagnosis of dementia within about 5 years or has early symptoms of dementia. For more information, contact the study team at C19carepartners@umich.edu or 734-232-4565. 
Identifying Factors Predicting ACcurately End-of-Life in Dementia with Lewy Bodies and Promoting Quality End-of Life Experiences (PACE-DLB)

This study aims to understand what changes might predict the end of life in people living with dementia with Lewy bodies (DLB). This information will help patients, caregivers, families, and health care professionals know what to expect in later stages of DLB. Study is enrolling individuals with at least moderate stage DLB and their main caregiver, and the caregiver must be able to answer questionnaires related to the DLB and caregiver experience. Study is conducted via Zoom or by phone. Contact Kelly Mattingly at mattinke@med.umich.edu or 734-223-9297 for more information.
The Wellness Initiative at the Michigan Alzheimer's Disease Center