How To Let Go

with Melissa Smith-Wilkinson &
Teepa Snow
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Teepa Snow is an Occupational Therapist with over forty years of rich and varied clinical and academic experience. Her experiences led her to the development of the GEMS® State Model, for understanding the progression of dementia, and the Positive Approach® training strategies. Her company, Positive Approach to Care® (PAC) provides online and in-person education and products. Teepa presents with extraordinary expertise and humor to audiences throughout the world.

Website: Positive Approach To Care

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The GEMS: Brain Change Model

Melissa Smith

Welcome to Caregiver Wellness podcast, we're really glad that you joined us today and I am incredibly excited to introduce you to Teepa Snow. Now, most of you that are tuning in are probably already aware of her reputation for her positive approach to care. Teepa is an occupational therapist. She has more than 40 years of experience and clinical and academic. But what's really fabulous about Teepa is that she tends to marry this idea that it is not about changing the person, it is about being flexible and adaptable, about the person we are caring for. So in essence, it's really about being open and curious. And how do we figure out this challenge of caregiving and so keep our sanity. So the ideas that she brings together with her occupational therapy, in addition to just years of wisdom that she pours into you with, as you will see, an extreme amount of animation in her voice. It is just so inspiring, much like our podcast with Jennifer Bute. If you haven't listened to that, I highly encourage you to go back one episode. Dr. Jennifer Bute has dementia, and the conversation absolutely flipped and changed my perspective on dementia. This conversation is no less enlightening for me. I am truly honored and excited to share Teepa Snow advice for you and me. And there is even a section in there about, well, you'll see how she gives me some tips.

 

Melissa Smith

I also want to encourage you that if you enjoy these episodes, would you just take a moment to on Apple, write us a review. You can also Google us at CaregiverWellnessRetreat.com and add a Google review. These kinds of things really help other caregivers like you find us. Super important for a nonprofit to have a little more visibility so that we can continue this kind of programming. In addition, if you are willing to share any resources, whether that's your time by sharing this episode with someone else or if you want to forego your five-dollar coffee today, maybe consider giving us a donation in response to today's episode.

 

Melissa Smith

We're glad you're here. We're excited. And I want you to. Hear the wisdom and the experience and just sit back and enjoy. Take time for you.

 

Melissa Smith

Welcome Teepa I can't tell you how excited I've been to host you. I think it was months ago, actually, that we had this originally scheduled. And actually, I think every timing is perfect because we are again now in a new transition, everything transitioning once again. And just when we think as caregivers that we sort of get things sorted out. There's another surprise, a little new, something exciting to figure out and to kind of unravel and be a part of. So welcome. And I'm not sure that you even need an introduction for those that have joined us. Well, I know you roll your eyes, but it's really true. You have really made. I think, in my opinion, the approach to dementia care, tangible, relatable and most importantly, human.

Teepa Snow

Well, that's huge, because that's why I do what I do, because if we are human, what are we I mean, the whole purpose of the point of this is we are humans trying to humans. I mean, wow. I mean, it's hard work, but it's really important work. And there's joy in it when you finally get over that idea that I'm the boss of you.

 

Melissa Smith

Well, and we're going to dove deep into that, I think a big part of this conversation for me today is really understanding the role of caregiver and context to dementia, which I think you defined so well. So I will say, you know what? What Teepa Snow has brought to dementia care is a background in occupational therapy. And I think there's some confusion about what exactly occupational therapy is. Do you want to briefly say how that bridge you know.

 

Teepa Snow

The tricky part is occupation is a job or career or what you do for work. But an occupational therapist is actually somebody who's trained in the health care arena. But to help you do that, would you want to do in your life whether it's take care of yourself, like how to give yourself a bath after you've had a stroke or how to be able to do something one-handed if you have lost the use of your other hand or maybe how to live now that your vision is so impaired due to glaucoma or cataracts. And it's not a vision specialist, it's a function specialist. And so my background is in function. How do we help people continue to live life that has value, that has pleasure, that has wellness and has rest and restoration as part of it? When we know that you're going to really be confronted by lots of challenges and living and some of them are obvious, like you have a head injury and now you're recovering your status post head injury or you've you have diabetes and it's affecting the sensation in your hands and your feet, even in the site and in your ability to manage your battling bladder. And so I get real. I get real intimate, because if you live in a human body, there's stuff that goes in there, stuff that comes out and there's in-between stuff. And being able to live life like you like it is hard for one human being. And then as a OT another part we take on is I'm only here for a window of time. I'm an expert and I'm here for a window of time. But in fact, human beings have other human beings that live around them and with them and that they may be caring for supporting.

Teepa Snow

And so not only do I want you to look at how you want to live, how do you do the thing you want to do with other people, with animals, with what is it you want to do with yourself for your life? And how can I be supportive of that? Or how can we modify or change things that you could be successful with that?

 

Melissa Smith

I love that explanation. And almost to simplify, I think so many times we think of our mind and our body as separate. And what I see that occupational therapy does and also this perspective of looking at dementia is it pulls it all together. We are a body, we are mine, and it's all integrated.

 

Teepa Snow

We have the spirit stuff because the stuff that's sort of intangible, that connects us to each other, there's something about being with another human being that calls forth in me, things that I wouldn't have if I weren't with that human being. And so it lifts me up or it drags me down. And so I want to look in the mirror at me and go, what's coming for me and what's coming from you and what's the interaction? Because what can I be in charge of shifting? And it's me and the interaction. It's not changing you. As soon as I start thinking I can change you, that's where we get in trouble.

 

Melissa Smith

Oh, oh. Does everyone do that again? It's so true because we because as. Right. So so you have that role and that of an occupational therapist or the role of caregiver or that role. We have all of these labels and definitions of ourselves. And so how do we still fully embody and live that? But we have to remember that it's not our role that is over another person. It's integrated with them.

Teepa Snow

Yeah, yeah. I mean, and so we talk about partnerships. We've got to somehow form this partnership because it's truly another human being's body and brain and spirit. And my goal is to connect. And and if I'm not liking what's happening, I need to look at me and go, OK, what can I modify? Or I need to look at the environment or maybe the task or maybe the timing of the task. And what can I shift? Because if I don't shift, maybe I need to say I'm not a good match for this. I mean, it's not a good match. And I, I say quite openly, there are numbers of people who love individuals who are living with dementia who should not be their care provider. I mean, they are not a good care match, what they are is a great friend, spouse, whatever, but I can love you, but I can't be your care provider because I'm having a really hard time with this.

 

Teepa Snow

And so, I mean, I have people in my life that will not be my care providers. I know that for a fact. But I know that I love those people, that I know that who I am and who they are. It's not going to be a good match for us if we try to do this.That way.

 

Melissa Smith

Wo and so well, that speaks to to several different avenues, because there are some people who have no choice. They have no financial or monetary or or agency. And that responsibility and there are some that do. And so then I would be curious and the circles really around our overall topic seem today, which is really the care of the caregiver. And so how do we prepare ourselves to care for someone else? How how do you take care of yourself?

 

Teepa Snow

So one of the things I try to put things in groups of five because there are things I know about human brains and human brains can classically if they're in decent shape and they're not dramatically impaired, hold on to about five things at a time before I start dropping stuff. So if I were to say what are five categories of things I need to do for me so I can do for others, what is it I need to be thinking about doing here?

Teepa Snow

And so, first of all, for me, it's I need to be curious enough about my excitement level, my stress level, and my distress level to realize that if I want to be a healthy care partner, I need to go from stress to OK. I don't want to be in distress because when I start finding myself in distress, I will need help to get out of distress. Human beings to have a hard time coming out of distress on their own.

 

Teepa Snow

I will need space. I will need time. I will need to breathe. I will need some strategies. I might need some support if I am in distress, being a care partner in that moment. Probably not a good match because I'm having trouble with me, I am inactive brain distress, I am in body distress. So if I'm physically hurting, if I'm emotionally hurt, or if I am exhausted as an example, that is a really bad time to have a situation on my hands where I have to give care when the last thing I can do right now is one more bout of trying to figure something out because my brain's not working. So my stress level, how stressed, distressed. If I'm bored because I keep doing the same thing and all I see is the same thing day after day after day. Oh, that's not a healthy place either, because my brain isn't finding anything positive to engage in. So how are you doing? So the simple question is ask yourself or think about excuse me. How are you doing? I'm doing great. Cool. You're doing like this. I'm doing OK. I'm, I'm stressed, but I'm OK. I'm not doing well. And finding somebody or do it for yourself, how am I doing today, Look in the mirror, because self-evaluation of how you're doing turns out to be really, really important. And if you're down here. It's vital to know that about yourself, I mean because it means you're empty and we need to kind of figure this out, how are we going to get you out of there?

 

Melissa Smith

Well, that's it. That's my next question. How do we pull it out?

 

Teepa Snow

The first thing I would do is they said, Melissa, you say you're down here. You really are. All right. I'm going to ask you for something really, really hard. I want you to give me two things. Two things that are not as bad as they possibly have been or could be. What are two things that you can come up with that are not absolutely black and awful? What do you got?

Melissa Smith

I have my husband and my son.

 

Teepa Snow

So you do spend time with your husband and your son? It sounds like it's too little, but you are getting some of it.

 

Melissa Smith

Yeah, definitely.

 

Teepa Snow

Yeah, that's huge. Well, that's one thing. What's another one

 

Melissa Smith

I've become really good at ping pong lately.

 

Teepa Snow

Yeah. So ping pong is you've gotten really good at it. Tell me about that.

 

Melissa Smith

I, I still can't win yet, but that's not important. It's, it's really exciting. And also my husband actually told me a secret that if I aim for the far back corner that he can't get it. I think you can hear me. So now I'm working on my serve to that corner.

 

Teepa Snow

And working on actually shooting to that corner because he gave you an inside scoop. Cool. So what did you notice about your face and your emotions when I had you dig into those two areas that weren't as bad as the others? What happened?

 

Melissa Smith

I think I just lit up. Right. Did you guys see my smile? Yeah, my face down probably turned red, admitting to you that I was secret about his serve.

Teepa Snow

So when I got you to do for just a few seconds, there is let go of the distressed state and realize this is not a crisis in the moment. Yes, the day is crappy. You're having a hard, awful day. But this moment that you're with me, this is not a dangerous moment. This is not a moment when the tiger is about to bite you in the butt. This is not a moment that there is an active crisis right there. It's it's yucky. It's nasty. And, you know, you're going to go back to it. But I just got your brain to relieve itself of the burden of everything is awful for just a few seconds. And that difference, what we actually literally did is release chemicals into your brain. And they are dopamine, serotonin, oxytocin. I mean, Norbert mean, we just did a little chemical rush for you that helped your brain go, oh, I do have some coping strategies now.

 

Teepa Snow

And what it tells me is you have a hard time holding on to them in the life you're living. So now all the things that are going crappy. And you're really down here was the tell me one thing you would like to focus on that you think you would like to ship for yourself, what is the one thing that would make you not feel like things are down here all the time and it's got to be an eye statement.

 

Melissa Smith

I would like to step away from my computer.

 

Teepa Snow

Yeah, so you're getting really locked into this relationship, huh, huh? It's like you're in it, feel like you're having sex all the time or something different.

Melissa Smith

Not related at all

 

Teepa Snow

No orgasms going on here. This is sort of like this relationship that never seems to find a moment. And it's like

 

Melissa Smith

I'll be right back. No kidding. Yes!

 

Teepa Snow

It's that kind of thing where you're spending so much time looking at this thing, you feel like you don't have another life. Yeah, OK. Well, that's really so you do have something you'd like to work on. So now we get to the second thing that we want to look at, which is argue each day getting decent amounts of rest. In other words, six to eight hours of good quality self-maintenance called sleep, where you can literally go inside yourself, know that the world out there is not going to collapse while you do it. You don't have to sleep with your ears open because she might make it out the door. This might happen. That might happen. So you literally are cleaning your brain and cleaning out your organs. So you're going to be able to go again full out tomorrow because it turns out that that process of cleaning ourselves out, we are not cognitively aware of it, but it happens in a twenty-four-hour cycle through the sleep cycle. It is really vital that we give ourselves those time zones. And if we can't know that we're working at a deficit and you can add that up after a while, but it starts counting against you, if we can't, it's really an important phenomena to explore. But then on the other side, we have Melissas's issue of, oh, if I sit in front of the screen all day, how physically active? How many feet have you got, Melissa?

Melissa Smith

Last I check still two.

 

Teepa Snow

How many behind's do you have?

 

Melissa Smith

Well, it's grown over the pandemic but I'm sure one.

 

Teepa Snow

Covid 20 or the Covid 10, Covid 5 or the Covid 50. How many vacuums? You only got one of those. And you've got two feet you should spend twice as much time moving about on these things and using these things as you do using this thing because it's made for resting, but it isn't made as a permanent base. I mean, we have feet at the bottom because it would be good if we use them. That kind of idea. And then the third one is how well are you eliminating? I know that seems like a really intrusive question. How well are you putting things out there? And I mean things like balen bladders, certainly because we tend to what do we do as caregivers without even realizing it? What do we do? Oh, my God, I've got to get three more things done before I make it to the bathroom that I can hold it. Can I hold it a little longer?

 

Melissa Smith

I should like it's a badge of honor. It's not.

 

Teepa Snow

It's s really bad habit. The little tiny sphincter and it's a tiny muscle, guys, and this bladder is going like man I should squeeze. I'm telling you, I need to squeeze and all it takes is uh. There it was. And now you got changing yourself and the added into the mix of what else you need to do but output in other ways, like are you giving yourself a chance to output laughter to output CO2? Are you holding your breath?

Teepa Snow

Are you outputting, are you getting rid of are you building up enough work that you actually sweat? I mean, in good sweat? I'm talking about healthy sweat, like aerobics, sweat, not stressed that, you know the difference. You know, you smell different, you feel different. It's like, oh God, is she going to say, oh, what's going to happen?

 

Melissa Smith

I watched a Facebook live with you. And you would you come in and you were drenched in sweat.

 

Teepa Snow

Sure enough because I fit it where I can. And so it's like, man, I'm not going to have time for a shower. They get what they get. Here you go. I'm coming on.

 

Melissa Smith

But I loved it because, you know, I think it was such a great reminder of living what you're saying. And I just thought, kudos to you. You know, here we go.

 

Teepa Snow

Yes. Sometimes it's a wash-up, not a shower. I mean, I'll be honest, I don't always get to the thing I thought I would because I figure out what I'm going to wear. What do I care more about getting a shower or doing a quick wash up and then grabbing a ginger, make my ginger tea. What am I going to do? Well, then no wait, what do we have these two over here? OK, so we could go more on output. I mean, there's all kinds of output. We could talk about the elimination. This is being socially connected. This is getting socially connected with somebody you like and it's really getting yourself connected with people you like. So what's cool about being here right away? Recognize Laura and I know Laura. I saw people. It's like you guys, Mary Ellen, I recognize you from somewhere. I mean, and Melissa's here and being connected to humans that you enjoy being with. This doesn't mean getting with people. You don't like it spending more time with people you don't like, doing stuff you dont like. Finding a place where you do get something that fills you up because it turns out social connections are vital, they really are, but they've got to be the right ones for the right length, for the right reasons, and so you can start with baby bites. And then finally, really taking care of your physical and spiritual and intake.

Teepa Snow

And I put it over here last because guess what we tend to do. Yeah, yeah, I'm going to grab something quick. Yeah, yeah, I'm going to just let me get a cookie, that will hold me over, let me have a cracker. You know what? I'm going to grab this. I'm going to get that. I overdo this because I'm now I need comfort. And so really physiologically recognizing spirit, self, physical, self, emotional self, they are so interwoven that taking things in for us is really important. And as a carer, so easy to just like unless you serve everybody else and then finally grab something. It's cold, it's been heated twice. You throw it back in the microwave, it's like I'll just have what I did it the other night. I just said, you know what? I'm just going to get one of those noodles from college. One of those things called their off noodles and noodles. And I'm doing ramen noodles at eleven because I never got dinner. I never did this. And it's like kind of happened. Yeah. Should it become a habit? No, not if you want to stay fit for caring. I mean, like once once in a great while. Yeah. And you did it. I went did it and I went. That was a bad plan.

 

Melissa Smith

You know, it's always that sort of like post ice cream binge regret kind of thing. But this reminds me of your you have a system that you call the Gem's Model and you talk about, you know, the stages of dementia in a positive way. But one of the gems is what you talk about, right, Sapphire, which is true blue, just true blue flecks and sky and. Yeah, supporting one.

 

Melissa Smith

Yeah, supporting life. And that that really the qualities of a caregiver is a sapphire. And I love I love that it's a separate hand because you talk about it. Yeah. So I don't know if you want to talk about the quality of a sapphire and how that relates to caregiving.

Teepa Snow

Yeah a sapphire has to be able to support life. And so I said ocean and sky and lake and water because all of those are background pieces, but they're essential to life. I mean, they are let's support life, but it's incredible flexibility. So if we look in the sky and we see birds, I mean, wow, Sky has characteristics, but then we see trees and sky has characteristics, support trees. And being a carer really does give us that capacity only if we are well ourselves to truly be so curious about the life of everything we have out there. It's it's my job to offer support when I can not to take over the life of. And so we have diamonds who are rigid in and they have shine, but they also can cut. We have emeralds who are caught in episodes and they're on the go, but they're flawed, but they're absolutely beautiful. But they want to go home or they I need I need to do something. And it's like what. I don't know. I just need to get it done in your life. Yeah. And if I could figure out how to support you so that desire and need to really be that that sapphire and ambers who get caught in a moment of time and it's all about sensory need or sensory intolerance. I don't care what you like or what. I can't because I'm overwhelmed by my own sensations. And so a sapphire has to be able to go, OK, not right now. All right. We were doing the show. We're not doing the show. We were doing it right. We're not doing it. I would take a step back because you're not in danger. And I need to figure this out before we try anything else. You like music? Not now. OK, that's that brief is really hanging low. Yeah, it's hanging low. So, yeah, it's coming off. OK, good. Well, maybe before we get you to walk down the hall and let me just see if I put my hand out and take my hand. No, not doing it. And it's really it's a dance art form to work as a sapphire with an amber and not to lose it. And there'll be moments but oh jeez, you know, you can think you're there and then you lose it.

Teepa Snow

And then Ruby is this beautiful deep red. We're all fine motor stops and I've got big strength, but not me. But or maybe it is me, because I've got to be careful that as a sapphire, I don't have my ruby moments for I got to have my ruby moments when I'm not going to be caring because that's when I'm strong and I'm not thoughtful and I'm not skilled. And so these gem states, although with people living with dementia, go through them as part of developing dementia. We also have them as part of living life. There are moments when I'm in a purple state and to be a healthy being, we need sleep. We need to be inside that shell and quiet. But with dementia, the reality is they get trapped in Shell at the end of this disease and finding a way out the. The only way to have a way out is to have a really skillful Sapphire to create the safety net when it's going to be possible and to create the reason to come in and to be present.

 

Melissa Smith

I just think that's so beautiful because it's such a again, it's a positive approach to all of this instead of sort of thinking I have to suffer through all the changes. One thing that you talk about a lot is, so how is your life really going to be? Because this is it. This is your life. Welcome to your life. So how do you. Yeah, so how do you want it to be?

 

Teepa Snow

I mean, how do you want to be on a roller coaster with a merry-go-round every now and then, because that's probably what you got. Can you see it, though, as this roller coaster? Whoa, whoa, whoa. And then we go around sometimes, just like I thought I was on a roller coaster. No merry go round now. Same old, same old. Oh, wait, let's change horses. I'm going to get on the one that goes up and down for a bit because I'm tired of the one that I'm tired of, the lion that doesn't I'm going to switch up because I need to switch up to stay here. It's two of us experiencing this and I've got to figure out how I'm going to stay because I want to stay. But I got to figure out what I need so I can stay and not become somebody you don't want in somebody I don't want to be with.

Melissa Smith

Well, I think that's almost two sides of the coin. So we figure out how we can stay and how we can be more adaptable and amenable and flexible. But then there's this whole box of guilt and backpack that we carry.

 

Teepa Snow

Yeah. And what's that doing for you? I mean, you carry all that crap around her, as I call it. I'm pretty blunt. I carry all this shit going to use it again. I mean, it really is. I mean, it's excrement. You're just carrying it around. Guilt doesn't have I mean, I am. So I know the feeling of guilt. I wish I had I only I had you know, I shoulda, woulda, coulda I mean, I could have, but I didn't. So where I mean, now look at what I've got in front of me because that's what I can do some of that and I can say I am so sorry. You're absolutely right. I could have done something different and I didn't. And I hate it for us. We are where we are now, though. Can we move forward? Because that's all I got. I mean, I we don't have do-overs in the same way plus of dementia. Sometimes you get a do-over. And sometimes we're tired of those do-overs. It's like, no, no, no, not again. It's like do-over, OK, what am I going to do different this time? Because last time I didn't like how deep the continent's brief change went. I'm going to try something different because I really didn't like how I behaved. I really had a hard time with it and I felt guilty afterward. We'll stop feeling guilty. What was the one thing you didn't like about it that you want to try differently? What were two things you did pretty well, because let's repeat those again. For me, it's about becoming more skillful, more confident or to realize time out I, I am not getting more skillful, more confident. I need help. I get a call, not surrender. But I just I need help. I need different eyes on this. I need different years on this. I need somebody who gets it differently because I'm when I'm in it man I can't see the other side of it. I need some help. I'm stuck.

Melissa Smith

I love that you said that because I think I think that's carryovers from what I can see and from what I've served with my father, wait until it's too it's either over it or no.

 

Teepa Snow

Many times we pushed on that wall and we pushed it. We pushed. And the one that comes up most often in my world is often bathing or showering. I mean, by the time people ask for help with getting someone, helping someone get clean to get the sweat off, to get the excrement off because they're starting to not recognize it for what it is and acknowledging. Their brain is not seeing it that the way our brain is seeing it, it's not smelling it the way we're smelling it. You know, if I had started or started thinking a little earlier, this is doesn't seem to be working for me. We might have been able to not have such a hard, solid brick wall for the person because we've made so many attempts. Anybody else making an attempt can really have a hard road to go because we've created this boundary. No, no, no. And we're familiar with that word. People not in dementia are surprised that I just went to just go and that arguing that we sometimes will get into because we're so frustrated and it's like, well, where's the sky in the ocean?

 

Teepa Snow

I don't know. I don't. And it's like, OK, probably need a break. And I don't mean you can walk away, but I do mean you're unlikely to be successful in the moment doing what you were going to do. So you might as well let it go in the moment. And letting go is something is real different than giving up on something. And I think learning the difference between letting something go in a moment and giving up on someone or something in the long run, it's a very different thing. I mean, it's just hard to remember that you're in the middle of it, so.

Melissa Smith

Absolutely. Well, I think I think that's pretty sage advice throughout the entire day, no matter what season of life you're in can.

 

Teepa Snow

Have grandkids. If you've watched Sunday morning, you can see me sometimes with two of them thinking, what was I thinking? This bad plan.

 

Melissa Smith

I love it. But and when one thing that I am also talking about sort of that sapphire quality and flexibility. Because I've always resisted the word letting go, because when someone tells me to let go, I hold on tight, tighter.

 

Teepa Snow

Oh my.

 

Melissa Smith

Yeah, I know a little little little bit of control issues.

 

Teepa Snow

Well, I to note that one of the very last skills children learn with their hands is the art of letting something go. Children learn how to hold on to things much sooner and more skillfully than they will be able to let things go, because letting go requires a whole different set of muscles and skills. And it's actually the opposite side of your arm that and the forearm that allows you to let something go, because to open your hand up means I'm not in control. You're absolutely right. But it turns out when you let go of something that you can be in control again.

Melissa Smith

Oh, I love that analogy. That's amazing.

 

Teepa Snow

And I'm just go hard to put as long as you're thinking if I let go, I'll lose control. It's like, yeah. Only by letting go can you gain control because now you have your hands free to do something different.

 

Teepa Snow

Wow. Well I, I what I've done is I've replaced the word letting go with allow what can I allow for, for someone who likes to control things that seems a little softer and like I have more agency.

 

Teepa Snow

Yeah. You have more agency. And so my usual question follow up on that is a curiosity with what did you learn when you allowed that to happen? What did you learn when you allowed that?

 

Melissa Smith

I love that you said that a few minutes ago instead of thinking about all the things that I did wrong so that I can pile more guilt on myself. What are the two things that you did right now so that you could do them differently?

Teepa Snow

Yeah. I mean, what did you like about what? I mean, what was one thing? It was hard. It didn't work. I mean, you didn't get where you wanted to and you had to allow the person to say, no, not now. But what did you take away from that? What was your learning? What was the moment when you knew that it wasn't going to happen? When was that moment? When did that make it happen?

 

Melissa Smith

But I think we can pinpoint that moment no matter the situation by also a feeling. You know what? I tend to know it in my body, like I have like my shoulders or gut feeling or like a sadness or, you know, or an anger or whatever it is. It shows up in my body or in my emotions.

 

Teepa Snow

Yeah. And some people get it internally and some see it externally. So I watch them and if they break eye contact, the person grabs their pants. They took a step back. They, they type, they tense their mouths. I mean, whatever it is, I may be an external person that picks up on cues, or I may be internal picking up on cues and whichever cues I'm picking up on it's like, OK, so their mouth tensed.

Teepa Snow

Do you do you happen to remember at all who was talking when that happened? Well, since their mouth tends to I suspect it was me. Huh. I wonder how much you were talking. Or maybe the words I mean, can you recall it all, what they said? And sometimes it's really just exploring the situation with you to help you look at something you might not have seen or listen for something you might not have heard or physically try something that you don't remember. So were you facing them or were you turned sideways to that? I mean, and so sometimes talking through it with a caregiver really helps the caregiver, whether it's allow or let go of the idea that you did something wrong, you did it. But what happened was the way you did it was that person didn't feel supported in a way. And it's like, OK, well, that didn't work. Yeah. And you've tried some other things. Well, typically we can change who does it, where we do it, when we do it or how we do it. What do you want to shoot for next? Because, you know, once I get you to back away from the idea that I can't get it to work, quit beating yourself up. Let that go. Because beating yourself up is not going to get anything done. It's just going to get you committed to. I can't I can't make this work. It's like, well, it didn't work that time, that's for sure. And it sounds like you've tried lots of different opportunities, so which of these possible shifts do you want to try? Change the person, change the place, change the timing, change how it's done? You know, maybe even look, it doesn't actually need to get done. Really? Right now, I mean, in so asking yourself really hard questions, is it coming from me, is it coming from them or is it coming from an old old story? Well, mom says it's like, yeah, mom's not here right now. You know, that your grandma this is what you're supposed to do. And it's like, is she here? Nope. Well, what are we going to do? And it's not that I don't value my mom's life experience. I did. But there was a time when she wasn't necessarily the best partner for a person that I was caring for. And she would have opinions. You just need to show her in the shower. That's what you need to do. I'm going to tell you right now, she's not going to cooperate with you if you don't shove her in the shower. It's like, yeah, I hear your mom. So for you, you would just shove her in the shower? Yeah, I'm thinking I'm going to try that. Well, you do what you want, but I'm going to tell you what you got to do just like this. Would it be helpful for my mom to stay around while I try whatever I'm going to try? What do you think, Melissa? You sometimes saying, Mom, I'm going to ask you for a huge favor. Give me 15 minutes. Just give me 15. I know I'm not doing what you would like me to do. And this is particularly important if I'm sharing this care responsibility with another person because I think I'm caring for one person. Guess what? I'm not. I'm caring for two people because I'm having to care for this other human that really has an opinion about how my grandmother's care should go. But her opinion, in my opinion, that's not the same thing.

Teepa Snow

And so when we have a care role and we have other carers involved. That's not stress-free, that's like a lot of additional potential for issues and that need to really go, wow. Yeah. So you're thinking I should check. I will tell you that I was not as skillful back in those days. That was when I was much younger. And I would say, mom, I'm not doing it, OK? I mean, that was not a healthy thing because then when my mom developed dementia later, that replayed itself. So I got a second chance at coping with somebody who was really needed to be in control. Not saying anything. I'm not. Right.

 

Melissa Smith

ell, I think. It's so valuable for us to examine our relationship to ourselves, which circles this back to how do we care for ourselves and see how that mirrors how we're caring for others. And I just think this is such a valuable conversation that we've had. I, I love how, you know, you make everything sort of physical, your gems, you're using your tips with your hands. I think it helps us remember and recall things I would love for you in closing to share one thing that you do for yourself that you feel. Just gives you or equips you to do what you do.

Teepa Snow

Yeah, so I do, I have to move when I meditate, I am not that nice, still quiet person. I have way too much energy and I drink only half caf at most and mostly switch to decaf and then switch over to ginger stuff or herbal stuff because I don't need more chemicals on board. I was born with a lot apparently. So what I do need though is I need to move with some purpose and so I need some outdoor.

 

Teepa Snow

It has to be outdoor. It absolutely. I have to be treadmill. Time is work, outdoor time is pleasure. And even if it's raining, even if it's cold being in the world and I don't have headphones on and I don't have I mean, I want to be present in the world as I'm doing this meditation work and I always am running or I'm walking, mostly running that I do walking meditation as well. And it has to be a surface that I don't have to focus too much on. And it has to be a pathway I'm familiar with because there are so many things to be aware of and to enjoy and to experience, even in a familiar space, because you get to hear birdsong, you get to see the flight, you get to see the cows in the pasture, whatever it is. And when I'm in an unfamiliar place. I'll try to pick a space that gives me something that I can see from the world around me that I can bring in and rejuvenate myself, so I'm ready to do the things I need to do.

 

Melissa Smith

I love that. And I think everyone listening, you could probably think of something you should do, like exercise, like I know I should. But then we can reflect on what do you really enjoy and how do you connect those two together. And that's a beautiful example Teepa of connecting the way what you know is good for you. But yet, here's what I prefer and here's how to do it.

 

Teepa Snow

Yeah I mean push comes to shove. I know that it's good to exercise the value of being outdoors. So if I get my druthers, man, do I really want to be in that space? And it allows me to do some heavy thinking if I need to figure something through, think it through, allow there to be time for things to come in, and to take something that comes in that I didn't really anticipate and figure out how it fits with what's going on in my day because there's I believe in connections beyond connections. And so sometimes it's nothing that has anything to do. But then suddenly a mama and a baby can start talking to each other and it's like, OK, what does that have to do with my life? And so sometimes you get opportunities to explore the world in a different place and space in your brain and it opens your brain up again to flexibility.

Melissa Smith

Yeah, yeah. Hits the reset button. Well, Teepa We are going to say thank you, but not quite yet. So those of you that are watching on Facebook, you want to make sure next time that you subscribe to our newsletter because then you'll get the invitation to join us actually in a meeting setting. So where you can ask the guests a question. So I'll say goodbye to our Facebook folks and you can catch the rest of this on our podcast.

 

Melissa Smith

So thank you for those of you that were on Facebook. All right. So they're off. And so I will say thank you to those of you who joined us live here. I know. And also, Laura, thank you for being willing to answer some questions. And I will say, I know some of the I knew some of the questions. Steve and I were talking earlier that would be really specific about behavior, which is what Teepa does so well.

 

Melissa Smith

I would love to invite any questions that are maybe specific to your own care and the care of the caregiver if you have any of those as well. And I see I don't know your first name, but it's Espace that you're up quite a bit and you tried melatonin with your loved ones to no success and had no dose of low dose sleeping pills. And your time is very difficult and worried about your own health that you've cut out caffeine, you get them out for walks.

 

Melissa Smith

What suggestions do you have? What would you suggest to them?

 

Teepa Snow

So when is your prime sleep time would be when did you used to sleep? Let's just look in the past. When did you sleep and when did your person sleep? Was it a match before? Was it a great match before? So this is really different or this is the same kind of issues but in like Technicolor. So that would be one of my very first questions is is how much is sleep always invaded this other person and how much is this part of your pattern or not? First. And when you. So that's sort of my very first one, so tell me how you're restoring yourself if you're not getting. So if that person doesn't get a solid sleep cycle, you still are going to need solid sleep or your risk of having accidents, of making mistakes, of depleting your emotional energy and physical energy is so high. How are you restoring yourself? And if the answer is, I don't have any way to do that, we are really approaching a critical mass here of finding a way for you to do that. And you could be saying, help, I need help. I need someone to at least spell me a couple nights a week. I need someone who is willing to be. So when the person is awake versus I'm awake, are they awake and distressed or are they awake and doing OK? I mean, even though you're wanting to sleep and they're not wanting to sleep at night, is it an OK awake or is it not? Can you rest with them being awake?

Teepa Snow

Because sometimes that desire to be awake when somebody is awake, why are they napping in the day? Is that an option? So, I mean, looking at what you can do, sort of like what we look for, new moms and new moms classically will need a support person because otherwise we lose a lot of new moms to postnatal depression, very significant condition that was very rarely talked about. We're just now starting to wrap our heads around. It's true depression.

 

Teepa Snow

I mean, clinical depression, clinical anxiety and dysfunction and these high risk. And so really recognizing. Yeah, maybe for the short term, but breathing might be helpful, oxygenating as a short term both. I found sometimes for me and my partner. La la, la, la, la la la la la la la la la la la la la la la la la la. If they tell me to shut up, I'm not sure I know I have got a little more hold on to that I need to eliminate before I suck more in.

 

Teepa Snow

I mean, really, to be playful, I mean, the idea of using the chemistry of your brain to override the chemistry of your brain, sometimes laughter can then ultimately trigger sleep if we can get to a different place. So rather than trying to get to sleep, really look at things that change the chemistry of the brain in another way. So whether it's funny little YouTube videos or whatever music that might be uplifting, but getting out of the sleep, trying to go to sleep until you quit worrying about trying to go to sleep and then suddenly find both of your sleeping.

 

Melissa Smith

Sleep is huge. There is there's no there's so much. And we get into some really disruptive bad patterns. And I really appreciate your first advice. Are you trying to do this all in your own. And how sleep deprived are you, so if you if you're not getting some relief, when you're able to get some nights some full night's sleep on your own as a caregiver.

 

Teepa Snow

I mean, and again, we can do it for short-range on the long haul, though, and this is often a long haul situation.

Teepa Snow

If I don't wait before I get to that stop sign, I'll get to a stop sign, and then there's nowhere to go. And I'm exhausted. I cannot stay awake. I just can't do it. And I'm also my health, my immune system. I'm very susceptible to so many things. And the idea of accidents, any really significant, serious accidents can happen. And now how would the person be cared for if you weren't even available? And I'm not being dramatic. I'm just I've been there. I've been in lots of situations. I mean, I was at a gas pump one time and pulled away with the gas nozzle still in the car.

 

Melissa Smith

Sorry to disappoint you in that.

 

Teepa Snow

I mean, I heard a clicking of shit. Oh, my God. No, I totally. And so I go into the store carrying this gas nozzle and hose in the store. And it was when my mother-in-law was in the hospital for three months and I was there every night and worked during the day. That's how dumb I was. I just didn't know.

 

Melissa Smith

What makes you feel any better nowadays? They actually make them to come off because people do that.

 

Teepa Snow

They had just replaced it with a breakaway. And she said lady, you are so lucky. It was a breakaway. And I'm like, what does that mean? He goes, it's fine.

 

Melissa Smith

It's not the only one.

 

Teepa Snow

Apparently not. But I think I was one of the few that was due to staying all night with my mother, with mother in law, with dementia in the hospital. Well, they made mistake after mistake, which. Yeah, couldn't take your eyes off her because she'd pull something out. And it was like they would just say, she'll be OK. I'm just going to be right out here. No, I can't tell you get so that was that what did I need to do. I had to quit working during the day. Who is I working with.? The Alzheimer's Association. I'm so sorry I wasn't there for you for a while.

Melissa Smith

I well I think I really appreciate your story because it normalizes it. I mean, we what we do is we try to do too much, even if they're for really great reasons, really. We have to evaluate what's what is in the best interests of ourselves and the best interests of the person we care for. And so I will say there is one more question that will answer here. And I think, you know, I think we can all relate, Stephanie, to your question, even though your question is very specific, you know, the emotional capacity to step back from any situation. And I feel like we've covered so many ideas how to step back from things. But if you had one more nugget of wisdom of when things get incredibly tense like that, how do we pull away from a high-intensity situation?

 

Teepa Snow

The first thing that I would suggest is break eye contact. Make yourself look down, because by looking down, you need to ground yourself. You literally don't look down and recognize. This is not working, and then the next thing is if your shoulders have drifted, which they often will, and if you find yourself leaning. And I will use a really important word for me. I will go. Wow.

 

Teepa Snow

Wow, that's the F word now, and I say, wow, because, well, forces me to breathe out. It forces me to let go of what I'm holding onto in that moment. And wow this is hard. This is really hard. And so breaking eye contact, doing a weight shift. Wow. This is really hard. Is often what you need to say, OK, I'm letting go of the idea that this is moving forward. I mean, truly, it's not it's not going to go the way I want. I'm going to take this opportunity to go, wow, this is really hard.

Melissa Smith

Wow, I think we can all practice that.

 

Melissa Smith

I am so glad that you chose to join us today, and as you can hear, this has some bonus material on it that wasn't in our Facebook lives. So if you joined us there on the video portion, you didn't quite get everything that you got on this podcast. In addition to that, if you were listening to the very last drop of this today, perhaps you should join us live.

 

Melissa Smith

That's how we record these. They're called Community Gatherings. We record the episodes live with our guest, and we give opportunities off-camera, off-record to ask questions so that you feel comfortable. And our guest is so happy to do that. It is an incredible and valuable resource. I really hope that you'll consider doing that. In fact, you could go to CaregiverWellnessRetreat.com, click on our podcast and you'll see right there underneath the latest episode what you can sign up for.

 

Melissa Smith

We have them either once or twice a month and we have some incredible guests coming up. So we look forward to welcoming you into our caregiving family. The best way to be notified about those upcoming episodes is to sign up for our newsletter. Everything that we offer is absolutely free and there's no catch to that at all. It is truly an honor and a gift to be serving this kind of community. As I watched the toll that it took on my dad as a caregiver.

Melissa Smith

We do need your help to survive, though. So if you are willing, leave aside Google Review, Apple Review or take a minute to consider donating at CaregiverWellnessRetreat.com, click on Donate. Even five dollars is perfect. Whatever you would have spent maybe going out for coffee, we would love your support. So thanks again for joining us today and we look forward to welcoming you into our family on the next episode.