Be RESTORED & EMPOWERED This Season Through Caregiving: By Dr. De Leon

In keeping with the spirit of Thanksgiving season and Care GIVER month;

I want to personally say thank you to all the unsung heroes who give of themselves daily to make someone else's life better especially to my husband who is my rock and without whose loving support I would not be able to survive a single day and be able to be a caregiver to everyone else in my family!

Since, none of us are islands to ourselves and are in need of one another for support and encouragement to carry on, there are a few words I would like to say to everyone this week : 

 be a giver, a hugger, a listener, a greeter, a smile maker, not withholding words of praise, encouragement, thanksgiving and kindness.

Sharing blessings with others is a choice- so choose to make a difference TODAY and experience the power of giving and in turn BE INSPIRED, EMPOWERED, RESTORED, and CURED!

Although we are all waiting anxiously for a cure to PD, is what we do with our time while we wait that counts. We must count our blessings and learn to not only  lean on one another for moral support but also lift one another up when the load gets heavy. For those of us who are the care partners, and Parkinson patient Advocates let us continue to be the voice in the desert of the less able (the ones devoid of support whether it be moral, spiritual, or financial) and champion the PD cause so all patients and caregivers alike can obtain support, be lifted, and find fulfillment in their journey.  

Happy Thanksgiving everyone!!!

6 Survival Strategies to Help Ease the Holiday Stress: By Dr. De Leon

               When I was young the Holidays were something to be cherished. I looked forward to helping pick out a Christmas tree ( the biggest one on the lot of course!) to decorate it with my family as we listened to Christmas music. We frequently burst out in a familiar chorus making it so much more fun. But, the biggest joy was to sit in the dark just staring at all the twinkling lights and fall in to a daze. Life was simple then. I am not really sure when life started getting more complicated and started losing some of its magic. Especially as I began my practice, I started to notice an increase in strokes during the Holiday seasons particularly Christmas. Strokes were usually caused by an increased blood pressure caused by stress, sadness, and  loneliness.

Over the last few years I have lost 3 of the most important people in my life and I, too, for a while began to feel extremely sad and detached which only contributed to a 'sense of futility' in the whole festivities especially compounded by Parkinson's disease making every ordinary activity like decorating or traveling that much more challenging. Then I remember, what Holidays are truly about FAMILY! Even though, I could not go back in time, I could certainly make new memories for my daughter and let her enjoy the wonders of a boisterous family laughing by the fire place telling stories and eating great food; while all the kids stay up late enjoying their own games and staying up late.

However, once again I find myself with guarded expectations for the upcoming Holidays thinking about the fact that my dad may not be around any longer.

 I thought there must be a better way to survive the Holidays then worrying about what might happen. Will my Parkinson's cooperate so I can continue decorating home for my family and cooking their favorite meals? Should my dad pass before then will we be to devastated to celebrate?

So instead of Panicking or living in pain due to a loss of a loved one, or feeling numb because of the new Parkinson's diagnosis or some other chronic illness, here are a few tips which might help you survive:

• Prepare- don't let the roller coaster of emotions take over- prepare before hand by talking to your doctor about getting counseling or adding a temporary antidepressant or anxiety or increasing your PD meds.  If you think your loved one may not be around ( like my dad so we are planning an earlier thanksgiving to enjoy him while he is still able to eat and talk) or you might not be up for the challenge so plan an earlier festivity where you can have control.

• Accept- the difficulties of this time of year- family drama and all- tell your self this too SHALL PASS so go ahead and pass the plate around -dessert first- life is too short after all.

• Socialize- it is not good to retrieve into your shell during this time will only make you more sad, upset and could land you in the hospital. Force yourself to go out, mingle talk to people. Laughter is a great medicine for the soul and body.

• Lower your expectations- this way you wont be disappointed and you might even be pleasantly surprised.

• Coping Strategy- Take care of yourself first, have phone numbers readily available to people that can support you and get you out of a crisis should you have one (close friends, counselor, pastor, doctor etc.)

• Set boundaries- explain to others like family and friends that you may not be capable of keeping all commitments, that you need breaks, rest frequent meds, tell them what you can or cant do in regards to party planning or hosting. DONT ever let others guilt you over doing more than you can physically or emotionally handle. Also shop on line - this will eliminate a lot of stress of driving and fighting crowds, gift wrapping, shipping. you can do all this in one sitting. this is why the last few years on line shopping for the holidays has become my go to mode. 

references :
Petherbridge, Laura. Survival Tips for Handling the Holidays.

Depression as a Manifestation of Neurological Diseases like Parkinson's disease : By Dr. De Leon

“You treat a disease, you win, you lose. You treat a person, I guarantee you, you’ll win, no matter what the outcome.” Hunter – Patch Adams ( one of the best performances by R. Williams)
In the advent of Robin Williams untimely demise, a great deal of spark and conversation has ensued around the topics of mental illness including depression anxiety and bipolar diseases well as their connection to Neurodegenerative diseases like Parkinson's.

Let me begin by saying first that although there is news of Robin Williams’s early diagnosis with PD -we do not have any details on his actual neurological condition or whether he was on treatment or not?

Furthermore, we must recall that it has been said that he battled with bipolar disease most of his adult life. Bipolar disease is more likely to result in a higher suicide risk and suicidal ideation and behavior compared to Parkinson's. Nevertheless, we should not underestimate the severity of depression in any patient no matter the cause. And anyone suffering any type of mental illness like depression, anxiety, bipolar disease, etc. should seek immediate attention and get under the care of a specialist.
But we do need to be aware of some of the facts.

Depression is found to be more common in certain diseases like Parkinson's, Alzheimer's, multiple sclerosis, epilepsy, migraine, and stroke.

This depression is not caused by the fact that patients are given chronic progressive mostly incurable diseases; although, certainly the notion of having these illnesses has sometimes a negative impact on an individual and can accelerate or worsen symptoms. Furthermore, some of the medications used in the treatment of these illnesses themselves can cause depression, anxiety and other mood disorders. (e.g. amantadine, L-dopa, baclofen, bromocriptine, etc. while some meds that are used to treat pain in PD like those in the seizure class-depakote, lamotrigine, carbamaepine, etc.; and of course SSRi’s-Cymbalta, Zoloft, Lexapro, Effexor, etc. can be beneficial)  in the majority of neurodegenerative diseases, the depression precedes the neurological deterioration as a harbinger of  things to common.

In the case of PD, and Alzheimer's these can be the very first clues of something amiss especially when there has never been a prior history of mental illness, depression or family history of such problems. According to the National Institute of Mental health roughly 18 million Americans suffer from depression yearly with a 12 month period. Depression is characterized by loss of appetite, although sometimes can be the opposite, loss of interest In things that used to bring pleasure and happiness, poor sleep or too much sleep, lack of energy, suicidal thoughts, poor concentration, feelings of guilt, and low self esteem these symptoms last longer than 2 weeks and the key is that the interfere with activities of daily living.

Women are twice as likely to suffer from depression than men which already puts PD women at higher morbidity this compounding effect maybe one of the reasons are now finding out that women with PD have more negative effects (meaning non-motor symptoms) like depression as opposed to men with PD who have more tremors (positive symptoms)...roughly about 50 % to 60 % of all PD patients suffer depression at one point during their illness and about 1/3 of patients present with depression as an early symptom before diagnosis. Yet despite this knowledge, the overall risk of suicide in PD is somewhat controversial.

One study, in 2001 in the U.S. including more than 144,000 people with PD found the rate of suicide in general population to be 10 times greater than in the Parkinson’s population while another study done in 2007 in Denmark found the rate of suicide among PD patients to be equal to those in the general population. Another in 2009 said PD patients although appearing to be at higher risk for depression, they truly were not at higher risk for suicide compared to general population of Denmark. Yet, one thing this study highlighted was the  increase in suicidal ideation (thoughts); this was found to be much greater among those with PD than in the general population. This last piece of information is vital to help us remember and keep in mind of the potential for a slip for those suffering from PD. The possibility of suicide is ALWAYS there and given the fact that some of the medications can trigger or worsen or even cause mood disorders, we have to be extra vigilant as patients, caregivers, and health care professionals to discuss this subject at every visit especially when there are concerns before symptoms get out of hand.

 There are many treatments for depression including medication. I have discovered that in PD patients, the first step is often a matter of adjusting medications if discussed early. In severe cases (ECT) electroconvulsive therapy has been instituted. Treatment of depression and other mood disorders often requires a team approach including a counselor, therapist (behavioral), psychiatrist, psychologist, and neurologist. (Don’t forget about caregivers too- they also have high rate of depression correlating with extent of care)

It is also extremely important to realize that the highest risk and higher than expected rate of suicide noted to date among PD patients has been among those that have undergone DBS particularly in those that had depression or were single. This is why is crucial if you are considering this treatment that you do not partake if you have no social support or have history of mood disorders like depression. (unless absolute last resort and are under strict supervision by a team of specialist as I described above throughout entire life-this is my opinion) Make sure that you seek opinion of an expert that has done thousands of DBS to get best outcome.

So, even though, we have lost a great entertainer and we mourn his loss, his passing although uncertain as to the cause which led him to his final acts of desperation has provided us with a stepping stone to a new beginning of discussions to remember to treat the person and NOT just the disease- no matter if its Parkinson’s, Alzheimer’s, Multiple sclerosis, Bipolar disease or another chronic illness.
Let us remember to keep in mind  all those that suffer mental illnesses like depression …..
If you have questions regarding your Parkinson’s or think that you might have Parkinson’s and depression

… I invite you to call the National HelpLine of the Parkinson’s Disease Foundation at (800) 457 6676 or email us at info@pdf.org.
Otherwise contact
www.Samaritans.org  or www.suicide.org/hotline/texas-suicide-hotlines.html or www.suicidepreventionlifeline.org/
www.Speakyourmindtexas.org

Tips for Making Life Easier for Both Caregivers & Chronically Ill Alike : By Dr. De Leon

Last month I have been dealing with my dad's terminal illness. I have had my moments of frustration as many of you have in taking care of loved ones with chronic illnesses like PD because sometimes what we think is best for them is not what they think is best for them.

So how do you decide when to step in and when to watch from the side lines (cautiously holding your breath).
This question is extremely complicated of when to override their needs and desires for safety sake?
For example my dad is very frail getting extremely weak and has fallen twice but still insists in using a walker instead of wheel chair which makes me cringe.

It is important not to fall into a trap as a caregiver of assuming what the person with chronic illness or PD needs or wants. It would be best to ask that person what their wishes are. An honest and frequent dialogue can go a long way in maintaining the personal dignity of the care recipient or patient as well as that of the care partner who will not come across as a tyrant but rather truly caring individual.

Learn to compromise- avoid disputes and old issues from getting in the way!
During chronic illness especially as a loved one reaches end of life; this is the time to stick together! So as to make him or her feel like he/she still has some independence ...so instead of forcing wheelchair in the case of my dad, I explain my concern for him of falling again. You must Reiterate your concerns in a compassionate manner – I explained to him that we had been lucky until now not to have broken any bones thus far. But, as his bones are frail and weak any small apparently insignificant injury even a simple bump from sliding off the bed can lead to a hip fracture or wrist fracture. However, if we are to not use wheelchair, then we must have a safe plan in place. So, he was instructed to call someone first prior to getting up either from bed or sitting to alert them of his intentions of wanting to be mobile. He then was to Sit at side of bed if reclining for few minutes rather than  jumping up from laying ( although  this is more theoretically purposes just so that he remembers to take it easy because in all honesty he is not jumping anywhere when movements are extremely slow, deliberate and  laborious); these recommendations are meant to safeguard him from getting orthostatic, dizzy and avoid subsequent falls. Furthermore, I again instructed him on appropriate safe use of walker and asked for him to carry safety belt around so if he does slip it would be easier for me or my mom to catch or lift him up.

Learn to coordinate: some of us are better at this than others. If you are good at delegating and seeing the big picture- this is your calling. Nothing is more important than having a game plan! For instance, I am good at this …
While my mom tends to daily needs of my dad I can step back and see what needs to be done so I can guide my mother and assist her in getting things done. For instance dealing with matters of insurance, are documents in place?  Are Wills done?  Over see funeral arrangements if dealing with end stage disease and terminal as is my dad’s condition? Are other legal documents in order?
Because, as we know when we are dealing with the task of caring for someone 24/7, we can become so overwhelmed we sometimes can't see the trees for the forest. This is especially the case when death is imminent, our judgment can become clouded and we may become paralyzed with grief! Be the one that initiates conversation and steers it in a positive direction to get things that need done taken care of.

Learn to facilitate: emotions tend to run ramped when dealing with a chronically ill loved one.  It is hard to step outside your situation and see things objectively. This is when a friend, pastor, social worker, healthcare professional or in my case a relative that does not live there all the time comes in handy. They will ( I-you can ) provide valuable insight into the situation, give impartial advice to diffuse a stressful situation by offering prayer and even referring to other counseling services, support groups and other resources on line and to other community organizations that may be able to assist with specific needs. (i.e. Help find a sitter)

Learn to listen: this is the most difficult task of all! Some of us hear but don't really LISTEN. Listening takes special skills understanding and putting one in the other person’s shoes. When we are in a stressful situation we all desperately need to be heard so everyone talks but No one LISTENS!
Often times no words need to be uttered to have truly listened and made the person you are caring for feel special, unburdened, understood and loved.
The same rules apply for the caregiver ... ask them to tell you their story. This simple act can allow them an outlet to relieve their stress and open the door of communication and a way for you to offer assistance in the area of their specific need. (E.g. My dad still wants to maintain some semblance of dignity and independence/ mom wants not to have  him break a bone and hurt herself in the process if he falls). So, we came up with specific compromises on how to do things like grooming in a manner that is safe and convenient for everyone.

Lastly but not least learn to socialize: again if you are a leader or a take charge kind of person or event planner, this would be right up your ally... After all we are social beings ...most of us even the shyest of us (we) thrive when we are in bonding with others either individually or as a group. Therefore, it is important to plan social outlets to get the caregivers out of their stressful situation from time to time to avoid depression, loneliness, feelings of helplessness, spiritual exhaustion which might lead to suicidal ideation but also to remind them they are individuals that have unique talents and gifts. It is important to Do the same for the patient - (to avoid same type of feelings) the social activities can be done together or separately-best if done separately from time to time.  Help organize activities for family, individual etc. Put your imagination to work. Even if it means taking them out for an unexpected " ice cream " run or whatever their favorite activity may be like in my dad's case fishing (even if it's just in a pond, bucket, or fish tank because he is now too sick to go outdoors far away from home fishing as he would like) and my mom -shopping! (Of course don’t forget to get someone to watch patient while care giver goes out).

Defeatparkinsons: Practical Tips for a Long Distance Caregiver : By ...

Defeatparkinsons: Practical Tips for a Long Distance Caregiver : By ...:             Recently with my dad's cancer rapidly escalating, I have had a crash course on being a long distance caregiver which I ...

Practical Tips for a Long Distance Caregiver : By Dr. De Leon

            Recently with my dad's cancer rapidly escalating, I have had a crash course on being a long distance caregiver which I was not entirely prepared for. Although, we knew his cancer was very aggressive and only diagnosed at  the beginning of the year, we were all very hopeful for a good prognosis and successful outcome. Since he was diagnosed being the eldest and physician of the family, I was automatically relegated the role of medical decision maker. 

Sometimes, when dealing with a loved ones chronic illness like Parkinson's or other medical or neurological disease, the choice of who will have medical power of attorney is not always as clear cut. In such cases a family meeting needs to take place as to who has time, understands  the patient’s wishes, and who will be available when the time comes to make necessary decision concerning health care issues concerning the loved one. The best person for this job, preferably will be someone who lives in  the same town or nearby and has a connection or bond with the patient already. However, is not always possible to appoint someone that is nearby or to be near our loved ones due to work or other professional and family responsibilities including our own illnesses.

As, I have learned  over this last year, taking care of someone from a distance can be extremely stressful for all involved, especially for the caregiver. I should know! I have gone back and forth to Houston at least a dozen times in the last month since father took  a turn for the worst. And even when I was not there physically, I was handling doctors calls at all hours trying to make decisions for my dad.

So, what can you do to prepare yourself should you be called upon to be the caregiver of a parent or loved one with a chronic illness like PD?

Here are a few tips to help make things easier for yourself and your loved one who is suffering from  a chronic illness and needs your support and help because they are too frail to care for themselves, or to sick to be effective advocates for themselves or have some other impediment like old age preventing them from achieving the best health care possible.

First, realize that this self less job is NOT going to be easy but well worth your time!.....

As the one in charge of my father's care, I have found that the hardest job of all is being his primary caregiver when I live far away especially when I, too, have a chronic illness to deal with (which is frequently the case for many caregivers....) or worst because we are living longer some of us senior citizens are being called upon to take care of  our even older more frail relatives ( parents, etc.). If this is the case take care of yourself first so that you can continue to care for others- you will be no good to anyone if you are ill yourself! After 2 weeks straight in the hospital, I had to take a small break to be able to recharge and be more effective at taking care of him and my mom. Learn to take needed rest to be more effective caregiver.

Being far away causes a type of inner turmoil deciding whether to move back closer, move your loved closer ( which is always the ideal but not always feasible due to many factors including socio economic and fact that person we are caring for mat simply be too sick and unstable to travel) to you. The other option is for you, the caregiver, to  travel back and forth  (as I have done)frequently to care for ailing loved one. Most often because of established family settings and careers of caregivers it is impossible to move closer to person in need. Learn to schedule time to spend one- on- one with loved one.

At same time, although  the patient maybe in need of  greater assistance they may be unwilling to admit and you must find a way to provide for them without insulting their pride or hurting their feelings. An open communication is the best policy in this case. Nevertheless, if they are of sound mind you have to respect their decision to stay in a familiar environment where they are comfortable and feel valued, even if you feel they might be better elsewhere. For instance, I thought my dad needed to go to  and would benefit more from a quick rehab stay to try to get stronger since he got so week during his nearly 15 days of  hospital stay. But, he refused and wanted only to convalesce at  home so we compromised and found a way for him to get the appropriate care that he needed at home so that he would be safe. Learn to compromise for betterment of loved one.

Being far away can sometimes be more overwhelming in dealing with a loved one’s chronic illness than being closed by. In many cases, the guilt and frustration of being far away and disconnected from the care of our loved ones leads to demanding and unreasonable expectations, advice, and demands for those that are around close to patient.(i.e. the team of health professionals and ancillary care staff).  These strong opinions as to what to do with mom or dad at times can only be counterproductive as well as serve at times to alienate those who are trying to offer help close by hurting the very feelings of the loved ones we are attempting to care for. So avoid walking in like a hurricane dictating changes to care plan established. This will only cause hard feelings and confusion in care. Learn to keep emotions in check and act on patients behalf always -portraying their wishes while addressing your concerns.

Also, try to be realistic in your promises. Don't promise things that might be impossible to keep like promising to maintaining them in their home  when they are alone, demented, or too weak to even perform normal activities of daily living. Express empathy and discuss concerns directly with loved ones. Learn what promises to make.

Being away sometimes does provide wisdom to see the big picture ...use this to your advantage. Be an advocate for your loved one. Sometimes they are too sick to speak for themselves or know what is going on around them.
Establish routines to help the infirm realize not only that you care but you are available when it is important. Learn how to be an effective advocate.

1) call home regularly- if  loved one is getting demented or elderly it helps to call them at  the same time -do it at  least once a week but should call more often if possible 2-3 x when people are chronically ill because things can change from day to day very quickly!
2) if possible, especially if live within driving distance at least a day's time visit at least a couple of times a month more often if possible. If farther away that requires long distance driving or flying think about going at least every 6 months.
3 )  help as much as possible; when you do visit, do not burden loved one by staying with him or her if struggling financially -stay at a hotel, buy food, try to pay some bills, perhaps they need extra supplies like pads if incontinent, ensure or meds that are not readily covered by Medicare etc.; if they have another caregiver there give them a respite while you take over.
4) when you visit loved one - make a point to go and meet with the physicians caring for your sick relative, establish rapport and encourage communication with you so they can let you know should there be any changes, questions or concerns. Make sure you have all the doctors’ phone numbers on speed dial and they should have yours in case of an emergency! if possible schedule doctors visits during your visit.
5) learn your loved ones needs and medication regimen as well as routine tests and doctors appointments so you can enquire about them to make sure they ( loved ones) are following through with care plan designed by their providers.

In the end remember, do what's best for your loved one...spend time with them and do not let cash flow or dysfunctional family dynamics get in the way of doing what is right for you & your loved one. The time you spend with them is priceless.
Handle with care- remember as Jim Rohn said; “ One person caring about another represents life's greatest value.”

No Se Aceptan Devoluciones : By Dr. De Leon

"...Two roads diverged in a wood, and I-
I took the one less traveled by,
And that has made all the difference."  Robert Frost

Creo que tal vez la mayoría de ustedes están familiarizados con la tierna y conmovedora película que lleva por título "No Se Aceptan Devoluciones."
Yo, al igual que Valentín, desde mi niñez aprendi que la vida no es tal y como me la imaginaba. Hay que luchar y aveces es necesario ser lanzado contra nuestra propia voluntad desde lo alto para aprender a volar. También yo, como el, me he dado cuenta que hay golpes más duros y más  difíciles que enfrentar en la vida que el ser impulsado de un barranco como cuando tuve que cuidar de mi abuela porque le dio el mal del Parkinsons o velar por mi abuelo por que despues de varios infartos cerebrales le cobraron la memoria. Pero al igual he tenido la gran fortuna de ser guiada por mis dos más grandes amores en esta vida. El primero ( mi abuelo) "me enseño  como estar preparad(a) para enfrentar la vida." Mi abuelo siempre me instruyo acerca de Dios, las artes, y las ciencias. El apesar de que nunca tuvo escuela formal su filosofia de “primero Dios y despues la sabiduria y el conocimiento” me ha servido en gran manera durante mi trayectoria en este mundo. Sus enseñanzas también fueron reenforzadas cuando me lanzo de un barranco hacia el fondo del río para que aprendiera a vivir sin miedo al igual que el padre de Valentín lo hiciera.
El segundo amor de mi vida y mi más grande amor "me enseño como enfrentar la vida sin estar (aún ) prepared(a)."

Mi amor me enseño a creer en mi misma, en mis sueños, en mi pasión por la medicina y la neurología, y en el poder de la determinación. Compartimos el mismo fervor y gracias a el es que tuve el valor de empezar a escribir.
Ambos me dieron alas y me ayudaron a conquistar ( alcanzar) mi meta de ayudar y trabajar con los pacientes del Parkinson's. Los dos no sólo dirigieron mis pasos hasta este momento pero continúan definiéndome en mi lucha cotidiana tratando de entender la ironía de la vida. Pues siendo aún especialista de desórdenes de movimientos y  mal del Parkinson's ahora soy yo la que necesito la ayuda, los doctores y las medicinas. Pero toda la experiencia hasta este momento ha sido en preparación para compartir mi vida con ustedes mis estimados lectores que al igual que yo han sufrido de algún contratiempos en sus vidas -vidas interrumpidas. Pero les dijo que aveces en medio del caos, uno puede encontrar paz. nuevas amistades, nuevas pasiones, salud interna, descubrir nuevos talentos, y hasta encontrar fuerzas y amor para cuidar y velar por alguien más.
A fin de cuenta, los 8 años de estudio de medicina resultan haber sido una inversión más grande y más valiosa de lo que yo misma me imaginaba. Y gracias a Dios que en esta vida no se aceptan devoluciones por que aunque tuviera la oportunidad de cambiarlo todo no lo haría. Porque gracias a esta jornada con la enfermedad del Parkinson's he descubierto que como una de las flores más fragantes y más hermosas de este mundo -una Flor distinguida por su hermoso aroma y su color blanco como plumas de espuma- la “reina de la noche”  o “cereus de la noche” como es conocida.  Las personas puden vivir desapercividas de ella toda la vida pero solo en medio de las tinieblas y la obscuridad a la media noche  la  pueden apreciar y disfrutar de su belleza incomparable  al igual que su aroma que puede llenar varios pisos con solo una flor. Y aunque sólo florean  por un breve instante su impacto es incalculable para aquellas personas que disfrutan de su fragancia mientras duran.

Instructions not Included: By Dr. De Leon

 “Be shepherds of God’s flock that is under your care- serving as overseers, not because you must but because you are willing….and when the Chief shepherd appears you will receive the crown of glory that will never fade away.”  I Peter 5:2-4

About a month ago, my mother called me in a panic not knowing what to do with my dad who was not “acting right,” worst he was “not being reasonable!”

As I proceeded to tell my mother how to handle my psychotic and confused father hearing the fear in my mother saying “you need to come over quick. Only you know how to calm him down.”  It occurred to me that the reason I can be so calm and able to handle my dad and most any psychotic individual is not any particular or unique talent that I posses. Aside from experience is thinking about and anticipating the other person’s needs where the goal is to maintain peace & serenity in the midst of a waging storm.

So, how do you do this when a loved one is hallucinating, aggressive, and even belligerent?

Although, our loved ones do not come with instructions on how to handle when they become psychotic it may serve you well to remember these simple rules to weather the storm unharmed.

First, rule take a deep breath and remain calm with a soft voice. Do not be confrontational, angry or frustrated this will only make matters worse since your loved one has no control of his behavior and may often not even know who you are. Thus, if you try to be too assertive they may perceive this as a personal attack and be “forced to defend” themselves which can result in trauma to either you or your loved one.

Second, be patient. Sometimes, particularly if your loved one is demented or has memory loss simply walking away for a few minutes will diffuse the problem. When you return you will often find your loved one in a peasant disposition. This may be a good time to administer their medication to help prevent further outbursts.

Third, be prepared. Discuss with your physician medication changes or additions and also have a plan should they become aggressive. Have emergency contact numbers handy or call 911 particularly if you or your loved one is in danger. This includes keeping dangerous objects or weapons out of sight as well as keys. Maintain open spaces to avoid falls and maintain a soothing environment. Safety is a priority for everyone involved.

Fourth, get help if you don’t feel up to the challenge. Caring for anyone with a chronic illness whether it be Parkinson’s or dementia can be both physically and emotionally exhausting. Therefore, if you cannot take care of yourself how you can take care of a loved one who depends on you physically and emotionally. If this is the case, you must ask for help from family, friends and or consider alternative care like nursing home. Make sure you tap into all resources available. Speak to your loved ones physician or provided for referral to social worker or home health agencies. You would be glad you did and your loved one would be best suited to have your love if not your time.