Your Aging Advocate
Helpful tips for family caregivers

Stress relief: only a breath away

As a family caregiver, you may often feel frazzled as you juggle responsibilities to your loved one and everything else in your life. The good news is that you carry a tool for stress relief with you everywhere, all the time. It’s your breath! Specifically, how you breathe. It sounds almost too simple, but research has shown that certain breathing practices can help calm both body and mind, particularly when you are overwhelmed.

How it works. When stress takes over, it triggers a “fight or flight” response and keeps your body in overdrive. It can lead to a racing heart, tense muscles, and anxiety. Controlled breathing helps shift your body into a calmer “rest and digest” state—like pressing a reset button for your nervous system.

By slowing your breathing, you’re signaling to your body that there’s no crisis at hand. Studies show it can lower blood pressure, reduce anxiety, and even strengthen the immune system. Best of all, you can feel the results in just a few minutes. You are calmer and your thinking is more focused. Try it out when you’re frustrated with your relative, on endless phone “hold,” or just need to wind down for sleep. It’s a practical tool for getting grounded.

There are many breathing techniques. The basic rule is to deliberately slow your breathing and exhale longer than you inhale. Here are two protocols to try:

• Box breathing
  • Inhale for four counts, hold for four counts, exhale for four counts, and hold again for four counts.
  • Repeat for one to two minutes.
• Cyclic sighing
  • Take a deep inhale through your nose, followed by a second short inhale to fill your lungs.
  • Exhale slowly through your mouth for twice as long as the inhale.
  • Repeat for five minutes.

While breathing exercises are safe for most, if you have heart or respiratory problems or any severe condition, consult your doctor before starting a new practice.

What is the Platinum Rule?

Did you say “yes” to being a healthcare decision maker for an aging loved one? It is an honor and a sign of trust to be chosen! And it is a powerful responsibility. As healthcare power of attorney (or proxy), your role is to make medical decisions for them if they cannot make them on their own due to illness, injury, or incapacity.

In this role, your job is to follow the Platinum Rule: Treat others the way they want to be treated. The decisions you make on your loved one’s behalf should match their values and priorities, even if they differ from your own. Even if doing so is emotionally challenging. Your choice should be the choice they would make if they could. For example:

• Your relative with advanced dementia now has pneumonia. If they indicated in their advance directive “don’t treat infection,” then you must refuse treatment with antibiotics—even if medical staff or family members press for it.
• Or perhaps your loved one is in a late stage of cancer that has relegated their life to bed-bound dependence. If they want to continue with treatment, it’s your duty to support them to that end.
• Or your relative has a major stroke. Would they want to be kept alive no matter what? Say “yes” to a feeding tube? What would they say makes their life worth living?

Talk with your relative about their wishes before a crisis occurs! Make sure you understand their priorities. You might ask, what does “quality of life” look like to them? What would be worse than death? These are big, sensitive topics worthy of several discussions. Take your time and get details. There are various programs online that can help facilitate these conversations.

Check in with yourself, too. Be sure that you can honestly commit to advocating for the priorities your relative has identified, no matter what.

Finally, ensure that your loved one’s advance directive is up to date. Make sure it names you as the healthcare agent or proxy, if that is their intention. Then let the Platinum Rule be your guide.

Essential tremor: the basics

Are you noticing a persistent shake in your loved one’s hands, head, or voice? They might be dealing with essential tremor (ET), a common neurological condition that affects millions and typically appears after age sixty. The good news is that ET progresses slowly and isn’t life threatening. Tremors are usually the only symptom. But they can make daily tasks, such as eating and dressing, challenging for your family member.

Diagnosis
Diagnosing ET involves ruling out other conditions, such as Parkinson’s disease. Parkinson’s generally causes tremors when someone is at rest, while ET is more noticeable during action. Parkinson’s also causes slow movements and trouble with balance or walking. ET does not.

There is no one medical test that proves ET. To get a proper diagnosis for your relative, it’s best to see a neurologist. Ideally one who specializes in movement disorders. They’ll evaluate physical symptoms and may have your loved one perform simple movements. They’ll also review family history, because the condition is heritable. If you are unsure about the diagnosis, seek a second opinion. ET can be tricky to diagnose.

Treating symptoms
If your relative has ET, talk with their healthcare provider about options. In the early stages, learning what brings on tremors may be all that’s needed. As time goes on, the frequency of tremors may decrease, but their strength may increase. That can make it hard to hold objects. You might ask the doctor for a referral to occupational therapy. An occupational therapist can show your loved one techniques and devices to make their daily life easier.

If needed, the doctor may prescribe a medication, such as a beta blocker or antiseizure drug. Botox injections can also be effective. If these options aren’t enough, there are more-advanced treatments. In a future article, we’ll talk more about helping your relative live well with ET.