Laura Jalbert, LCSW, CIMHP, Owner of Mindful Transitions and Lisa Kaufman, MS, CTRS, CMC, C-EOLD, Owner of SeniorCare Options recently participated in the Women’s Retirement Radio Podcast with our friend and financial planning colleague, Russ Thornton, Owner of Wealthcare for Women. We had such fun chatting about how to support family caregivers of older adults. Listen in for some of our wisdom. 🙂
Spring is around the corner. In most cultures, spring is synonymous with beginnings. At a certain stage of life, “beginning” may seem like a thing of the past. But I would argue that beginnings are as much the domain of a 90 year-old as that of a 90-second old. And well they should be.
Think of an arrow flying through the air. It would seem to be the epitome of movement. And yet, at this very second, were we to freeze time, it would be still. In this frozen second, there is no past and no future for the arrow. Only now. And that is true for all of us. We have a tendency to merge what has happened and what will happen with what is happening now. But we are not guaranteed a split-second more of this life and, as a wise woman once told me, “the past is gone–give up all hopes of changing it.”
In this light, every second of our lives is a beginning. Every second is a chance to change direction, let go of the illusion that we can rearrange the past, and focus on all that we can truly influence: this moment. This is not to say that we are not accountable for the past; but we can change our perspective of it. Make amends. And it’s not to say that we cannot shift our trajectory as a means of influencing future moments. But make no mistake: influencing the future is not the same as controlling it.
There is a Buddhist concept called, “Beginner’s Mind.” It tells us that every moment is an opportunity to experience the wonder and awe of a child who is experiencing the world as new. That is because every moment is new–as much for anyone else as for a child. One major difference is that the child has less “past” to project onto the future. What if we experienced this moment without judgment, without assumptions, and with openness to having our hearts and minds experience the world from a fresh perspective?
Carl Jung says the symbol of the spiral suggests that we do come back around again, but not exactly to the same place. Therefore, while we can see the past when we pass a familiar spot on an inner ring, and while our remembrance of that past moment informs our thinking, we are not in the past. The rings of the spiral expand into infinity with every new second.
This year, when the beginning that is spring comes, remember that it might as well be the first spring of your life. The first tulip you see is the first time you have ever seen that very tulip as the person you are right now. The first baby bird, a wonder. And yourself, a mystery unfolding.
But how do we do this? How can we adopt beginner’s mind? Mindfulness is the key. Jon Kabit-Zinn says “…mindfulness means paying attention in a particular way: on purpose, in the present moment, and nonjudgmentally.” This type of awareness can be honed through a meditation practice. And it is a practice–awareness grows through the practice of meditation just like muscles grow by being challenged through resistance training.
There are many ways to build a mindfulness meditation practice. Perhaps the simplest way is to download an app to your smartphone or google “meditation” and choose a YouTube video to guide you.
If you would prefer to learn in a class setting, there are many opportunities for that in Atlanta. The Atlanta Mindfulness Institute and The Shambhala Center are two excellent options in the Atlanta area, but there are many, many more to be found.
One of my favorite mindful awareness practices is called the “Three-Minute Breathing Space.” There are three steps:
Become aware of what is happening in your experience of this moment. Observe it, but if you find yourself making judgements (too big, too cold, not ____ enough), notice it and let that go. Come back to just observing your experience.
Turn your attention to your breath. Your focus was initially broad, but narrow it now to just noticing your breath. Again, do this with curiosity, not judgment.
Finally, let your focus expand again to include your whole body, noting any sensations that are present. If you find yourself commenting on the goodness or badness of anything (too tight, too tingly, the wrong size, etc.) come back to just noticing the sensations without judgment.
You can take three minutes to do this practice at points in the day when you feel overwhelmed, stressed, or detached. This practice will help you find your way back to a more vivid experience of this very moment. The only moment there is.
Funny how we spend our first 12ish (okay, maybe more like 25ish) holiday seasons thinking about presents. Yes, the holiday is multifaceted–love, family, food–but let’s face it: the presents were the focal point.
And then we mellowed a bit. We expanded. Presents were, well…just things. We had jobs—we could buy things. So what were the holidays about, then? Maybe there were kids and then we spent the next 12ish (okay, 25ish) years thinking about presents again. And then maybe there were grandkids. More presents. And by then some of us may have wondered, “is that all there is?”
Because, by then, life had given–and taken–much more. Over time we had come to see that it was not about stuff. It was about the other things…the bony hug from Mom, the way the cat went after the same shiny ornament every year, the scent of apple cider, the solemn, sacred silence of an icy winter morning.
Life has changed us and made us richer, more appreciative of what cannot be bought. And so here we are, aware of the profundity of it all, and yet, despite all this awareness, sometimes the “big moments” feel like a thing of the past.
But that is an illusion. There are memories, and those are treasures. But they are artifacts. All that truly exists is what is happening now.
What do you see? The austerity of the bare branches–how many delicate shades of brown and gray?
What do you feel? The warmth of winter layers, comforting in their softness.
What do you hear? Perhaps the sound of your own breath, a sound that has been with you longer than any loved one.
What do you taste? Maybe traces of your most recent meal–the spice, the richness lingering on your tongue
And what do you smell? The metallic tang of cold winter air? The absence of things blooming, dormant in their generative rest.
This year, perhaps “the present moment” can be your greatest gift. Perhaps your presence–full, focused, unhampered by distraction, can be the gift you give yourself and those you come into contact with. This moment is all we have—we have no sway over what has passed and no access to what has yet to come.
What the anger iceberg does not explain, though, is what to do when someone you love is directing their anger at you. Being around an angry person is very difficult. That anger can jeopardize that ability to maintain a loving relationship and have closeness. You want to get to what is under the anger.
Here are tips on responding to someone’s anger:
Do not take it personally. Their anger is usually not about you. Try taking a curious or investigative approach to the anger. This shift in perspective, from defensive to inquisitive, may help you to really see what is going on. Remember, there is something beneath the anger. Is it fear? Loneliness? Frustration?
Do not try to fix their feelings. The goal here is not to change or fix their anger. You may not be able to calm the person down, but you can hear them. You can abandon any attempts to reason or defend yourself. Just listen. When a person stops trying so hard to convince you why they are justified in being angry, they may be able to move through their anger and access the feelings underneath.
Restate what they need. There is usually some unmet need that is going unheard and unmet. Can you identify that and bring the focus to that unmet need?
Leave. If their anger is harmful, threatening, or destructive to you, leave.
Anger is usually an attempt to cover up some kind of pain or vulnerability—listen for that pain.
is never an easy task, but to salvage meaningful, fulfilling
relationships, it may be necessary. If you and your loved one are
experiencing frequent, unresolved anger issues, consider getting help.
Trained mental health professionals, like the Clinical Social Workers at
Mindful Transitions, can help you work through the anger and salvage
your relationship. To learn more about our service, please call us
at (678) 637-7166.
Original Medicare offers mental health benefits to beneficiaries needing mental health services. Here is a quick overview of those benefits:
Medicare Part B will pay 80% (once the Part B deductible is met) for outpatient counseling services. The remaining 20% would be the co-insurance paid by the patient (or a MediGap plan, if the patient has a supplemental plan).
Medicare allows its beneficiaries the option of getting treatment through a variety of mental health professionals such as psychiatrists, psychologists, clinical social workers and clinical nurse specialists. Most of our clients prefer to find a provider who accepts Medicare and takes assignment. If a provider doesn’t accept assignment then Medicare will not pay for the services or reimburse a beneficiary for amounts paid to non-participating providers. The Licensed Clinical Social Workers at Mindful Transitions are all certified Medicare providers and take assignment.
Mental Health Screenings
In addition to psychotherapy, Medicare covers yearly depression screenings that must be done in a primary care doctor’s office or primary care clinic. This can help with appropriate diagnosis, treatment and follow-up. There is no cost for this screening. If your doctor hasn’t talked to you about your mental health, you can always request a screening.
Inpatient Psychiatric Services
The benefits for inpatient psychiatric services are paid by Medicare the same way that general hospital services are paid. There is a $1,340 deductible for each benefit period, $0 coinsurance for the first 60 days, and $335 co-insurance for days 61-90. Medicare pays for 80% of all mental health services provided while the patient is in the hospital. Medicare limits the number of psychiatric hospital stays to 190 days per lifetime; after those days are used up, the patient must pay for inpatient psychiatric care privately.
Partial hospitalization programs (PHPs) are structured programs provided as an alternative to inpatient psychiatric care. They are more intense than traditional therapy, are provided during the day, and do not require an overnight stay. Medicare helps cover partial hospitalization services when they’re provided through a hospital outpatient department or community mental health center (assuming that the doctor and the partial hospitalization program accept assignment).
Medicare usually covers medications used to treat mental health conditions under the Part D prescription drug benefit. The Part D formularies may limit which medications are covered and should be checked. Each Part D plan creates its own list of approved and covered drugs. The open enrollment period is a great time to review your plans’ formulary and to possibly switch to a new plan.
Medicare Advantage Plans
Medicare Advantage Plans also offer mental health services, but there are limits to their services. They have a narrow network of providers. Each plan has to be explored individually to learn what they will provide.
To locate a provider in your area that accepts Medicare assignment, use Medicare’s online tool at medicare.gov/physiciancompare. Type in your zip code, or city and state, then type in the type of profession you want locate, like “psychiatry” or “clinical social worker” in the “specialty” box.
The Licensed Clinical Social Workers at Mindful Transitions are Medicare providers and take assignment. In addition to providing psychotherapy, we also provide comprehensive clinical social work services to each of our clients, ensuring that they are connected to important services in the community and that their care is coordinated between all providers. Taking this holistic perspective that incorporates the whole system is important for the well-being and optimal functioning for each of our clients. We provide psychotherapy and so much more!
It is uncomfortable for us to be around someone that has just experienced the death of a loved one. What do you say? Do you say anything about the death or the loss? Do you act like nothing happened? What if you make it worse? What if he starts crying? What if I start crying?
Mindful Transitions’s last Mindful Minute (our monthly e-newsletter) offered tips for grieving the loss of a spouse. Our follow-up to that newsletter is a list of tips for supporting a grieving friend, co-worker or loved one.
Acknowledge your discomfort and let it be—witnessing someone’s pain is hard.
Be patient, empathetic, and understanding.
Be an active listener.
Allow silence; listen without giving advice.
Know that nothing with “fix It.”
Accept the tears, rages, and silences as normal and healthy.
Acknowledge birthdays, death dates, anniversaries, etc.
Accept that you cannot make them feel better.
Avoid talking about the loss or death.
Force the grieving person to talk about the death or loss.
Claim to fully understand by saying, “I know exactly how you feel.”
Minimize the loss by saying, “Think of how much worse it could have been,” or, “At least…”
Offer cliche sayings such as “She’s in a better place now.”
Try to fill the empty space with chatter.
Let your sense of discomfort and helplessness keep you from reaching out.
Talking to a friend, neighbor, co-worker or family member after a death can be uncomfortable and intimidating. Nothing is gained, though, by avoiding them or the topic. Remember, by reaching out and letting the person know you care and can be there through the discomfort along side them, you ARE doing something to help.
Please See Me Through My Tears by Kelly Osmont
You asked, "How am I doing?" As I told you, tears came to my eyes... and you looked away and quickly began to talk again. All the attention you had given me drained away.
"How am I doing?"...I do better when people listen, though I may shed a tear or two. This pain is indescribable.
If you've never known it you cannot fully understand. Yet I need you. When you look away, When I'm ignored, I am again alone with it Your attention means more than you can ever know.
Really, tears are not a bad sign, you know! They're nature's way of helping me to heal... They relieve some of the stress of sadness.
I know you fear that asking how I'm doing brings me sadness ...but you're wrong.
The memory of my loved one's death will always be with me, Only a thought away.
My tears make my pain more visible to you, but you did not give me the pain...it was already there.
When I cry, could it be that you feel helpless, not knowing what to do? You are not helpless, And you don't need to do a thing but be there.
When I feel your permission to allow my tears to flow, you've helped me You need not speak. Your silence as I cry is all I need. Be patient...do not fear.
Listening with your heart to "how I am doing" relieves the pain, for when the tears can freely come and go, I feel lighter.
Talking to you releases what I've been wanting to say aloud, clearing space for a touch of joy in my life.
I'll cry for a minute or two... and then I'll wipe my eyes, and sometimes you'll even find I'm laughing later.
When I hold back the tears, my throat grows tight, my chest aches, my stomach knots... because I'm trying to protect you from my tears.
Then we both hurt...me, because my pain is held inside, a shield against our closeness...and you, because suddenly we're distant.
So please, take my hand and see me through my tears... then we can be close again.
The majority of our clients have a concerned family member either living with them or living nearby to help with emergencies, errands, doctor appointments or even day-to-day care. Caregiving is a tough job, and every caregiver deserves a break. If you are caring for an aging or disabled loved one, you know how easy it can be to become overwhelmed, tired, and burnt out. We encourage all of our family caregivers to take some time off from caregiving to recharge and rest, but we also know that it can be so hard to get away even for a long weekend. Just in time for the holiday travel season, we wanted to share some information about caregiving and vacationing.
A Vacation Involves Too Much Planning
As a caregiver you have so much responsibility on your shoulders. You have your own health, your own household, maybe even a job or business and a family of your own to be concerned about. On top of this, you have an aging or disabled loved one that depends on you so much. Sometimes getting through the day takes more energy and time than you have; so doing that AND planning a vacation seems impossible!
Vacations do not have to be exotic, far away or fancy. “Staycations” where you simply stay home, unplug, order in food, and watch movies all day can be rejuvenating and restoring. Staying at a bed and breakfast a few miles away can give you the break you need. And if you truly want to get away, let a travel planner, your credit card company, or even Costco make your arrangements—so many businesses now offer travel booking as a special perk. You may not get the vacation of your dreams, but you will get some time away to get a break. It doesn’t have to be a perfect vacation in order to give you the break you deserve.
You Deserve a Life, Too
Many caregivers feel like they need to put their life on hold while they are caregiving. Even though they may have grandchildren they rarely get to see or dreams of their own yet fulfilled, they resist giving themselves permission to travel out of state to see other family members or to see the parts of the world they long to experience. Caregivers deserve a life, too, and looking after yourself is not selfish or self-centered. Taking care of yourself, investing time in what you want and need may not be appreciated or approved of by others, but you do not need their permission to live your life. You can spend time on yourself and meet your caregiving responsibilities.
The Fear of What Will Happen While You’re Away
“There’s no way I can go out of town. Everything seems to fall apart as soon as I leave.” This is a common reality for many caregivers. After MONTHS of stability and calmness, a caregiver may feel like it’s an okay time to travel or leave town for just one week. Without fail, it seems as if that’s when the emergency happens! Mom ends up in the hospital, constant calls start coming in with high anxieties, a fall occurs, the list of possible emergencies never ends. Or what if the worst happens—what if your loved one dies while you are away? Could you ever forgive yourself?
The fear of emergencies happening while you are away is real. You can make contingency plans for this. Assign someone else to be the primary contact. Is there another family member that can be the emergency contact? You can hire an Aging Life Care Manager to be the main contact while you’re away if there is no family. You could also decide to provide care remotely, traveling only to places that allow you to be accessible. You can hire a certified nursing assistant to provide companionship for your loved one while you’re away or consider a respite stay at an assisted living community. You may have options to help your loved one while you’re away. It will be hard work to get the plans in place, but it will likely be well worth it so that you can get a break.
And although you can make great contingency plans, there is the chance that you will not have everything planned out perfectly. An emergency may occur, your loved one’s anxiety may be higher, or the worst may occur. Making the decision to not vacation or travel because of this is making a fear-based decision. Being a caregiver can often put some of your wants and needs in conflict—you may find yourself wanting to be a good caregiver to someone you love and also needing to have a break from caregiving or just time away to do something else. It’s not easy to prioritize your own needs, but taking time for yourself is not selfish or self-centered. You will likely be a better caregiver once you get a break.
This holiday season, we wanted to share this encouragement with all the caregivers out there. Caregiving is hard. We know what you are doing day in and day out, and we believe that you deserve a break, too. For our clients, we work closely with the individuals and their families to help make the times the caregivers are away to be calm and stress-free. Whenever possible, the therapists at Mindful Transitions try to meet with our clients during the caregiver’s absence, and we provide our clients with extra tools to handle their stress and anxiety during those times. We also often act as extra ears, eyes, and hands for the caregivers, relaying back important information while they are away.
To find out more about the Clinical Social Workers at Mindful Transitions, please call us at 678-637-7166 or visit us at https://184.108.40.206/
We have officially started seeing clients in Gainesville, GA!
This month, we started accepting and seeing clients in the Gainesville area. This is one of our biggest territory expansions, and we couldn’t be more pleased to be able to serve more seniors. Our clinical social worker, Lynn Lane, is currently accepting new clients in the Gainesville area.
Mindful Transitions is committed to providing quality clinical social work services to Medicare beneficiaries. Mindful Transitions is a team of Licensed Clinical Social Workers (LCSWs) who are extensively trained to provide clinical social work services on site to seniors living in assisted and independent living environments.
What do you do?
-Provide individual therapy for older adults in their homes -Conduct mental health assessments
-Treat depression, anxiety, bi-polar disorder, etc. -Provide counseling to older adults through difficult transitions (e.g., a move to an assisted living community, the death of a spouse, the loss of physical functioning, etc.)
Who Can Qualify For Therapy? Anyone who: -Is over 65 years old,
-Receives Medicare, -Wants psychotherapy in their home, and -Lives within our service territory (which now includes Gainesville).
How much does this cost? Usually $40-60/session: -Medicare pays for 80% of our sessions. -Most secondary insurance pays for the remaining 20%. -There is a $40 house call fee/session for the in-home visit. (Medicare Advantage Plans pay $0 of our services)
What would you do if your spouse became suicidal in the middle of the night? What if you started having thoughts of suicide? Who would you call if you found your elderly mother disoriented and acting bizarrely one afternoon during a regular visit? How would you help your uncle with a substance use problem that continues to get worse? Knowing what to do in a mental health crisis goes beyond common sense—you must know the resources in your area that you can trust in such tough situations. Our clinical social workers work with individuals in one-on-one or group therapy during normal business hours. Our sessions are scheduled and not usually in response to a crisis. It is our goal to avoid any mental health crises from occurring through ongoing treatment, but we are prepared to connect with crisis teams when needed. Here is a list of the mental health emergency resources in Georgia:
Georgia Crisis and Access Line— A free 24/7 helpline providing mental health crisis assistance and access to mental health resources throughout the state of Georgia 1-800-715-4225 mygcal.com
9-1-1-For emergencies in which law enforcement may be called, ask for a Crisis Intervention Team (CIT) officer
Bookmark this information and share with others. It’s important to know who to call when a crisis occurs. If you have questions during business hours, please contact us at (678) 637-7166 or email us anytime at email@example.com
In February of 2018, our owner and Clinical Director, Laura Jalbert, shared some insights into our practice and the unique aspects of our work with older adults on Caregiver Connection, a radio program on NewsTalk AM1160, with Aysha Cooper. You can hear the interview by clicking the link below. It’s a quick listen and very informative.
Updated February 2019: The radio show is no longer available.