The Caregiver’s Manifesto

1. Care for yourself first

Caregivers routinely make their first priority taking care of someone else–which is why they often need to be reminded to take care of themselves. Caregivers ignore their own needs not just at their own peril, but at the peril of the people for whom they care. Figure out whatever you need to do to maintain balance – a daily walk by yourself, a good book to enjoy at the end of the day – and do it.

2. Preserve whatever you can of your original relationship

Just because your spouse/sibling/child/friend requires care doesn’t mean either of you want to change the nature of your relationship – but that is still often what happens. It is extremely difficult when your spouse, for example, requires help with basic self-care tasks for the balance of power that exists in all relationships not to shift toward the caregiver. But both of you retain the power to create moments in which your old ways of relating are captured.  Exhaust your creativity to retain whatever elements of the way you previously related to your loved one. The way you used to connect isn’t the only way possible. Find new ways that work for you both.

3. Laugh at everything you can

Some psychologists consider laughter an adaptive defense mechanism that helps us withstand unpleasant experiences. Seek to create experiences designed to make you and your loved one laugh. Seek humor in even the most grisly circumstances.  Never forget that most important of equations: humor = tragedy + time.

4. Get as much help as you can

Most caretakers only think to ask for help long after they actually need it. Additionally, most caretakers lack sufficient training for the care they are required to provide. Learn what you need to learn to be a good caretaker however you can and seek professional support as early as possible.

5. Know your limits

If you constantly allow your limits to be exceeded without sufficient rest between episodes you’ll almost invariably become used up. Often this state is reached without the caregiver’s even realizing it, their loved one’s needs often growing slowly like grass–without being directly recognized. It is neither selfish nor weak for a caregiver to acknowledge their limits and act accordingly.

6. Embrace your new life

Life is change. Everything is impermanent, the original Buddha taught. Everything, and there is nothing we can do to change this fact. Rather than rage against a change we don’t want but can’t stop, we must embrace it, fully discarding our old lives and seeking to create meaning and value out of our new ones. It’s amazing how simply accepting adverse circumstances we can’t change can free us from some of the pain of experiencing them.

7. Value yourself for the care you provide

Even if your loved one doesn’t express their appreciation, or expresses it so often it ceases to have meaning, recognize and value your own achievement in committing to the care of another person. It’s a great gift to give–perhaps even the greatest–and it makes all who chose to give it truly worthy of the word noble.

Dr. Alex Lickerman is a general internist and former Director of Primary Care at the University of Chicago and has been a practicing Buddhist since 1989. His blog is called Happiness in this World, published on Pyschology Today.

When I saw the movie Avatar, one of the (many) things that fascinated me was the Na’vi language, created just for the movie. In 2005, while Avatar was still in scripted form, James Cameron decided that the residents of Pandora should have their own complete and consistent language. He contacted Paul Frommer, who holds a PhD in linguistics from University of Southern California, to take on the task of developing the language of Na’vi. Here is some information about how the language of Na’vi was developed, and what the language is like.

According to Frommer, the first step in the creation of the language was to develop its sound system. Frommer created three sets of meaningless words for James Cameron to choose from: one with tonal distinctions, one with varying vowel lengths, and one with ejective consonants. It turned out Cameron loved the ejectives, so the sound system was further developed based on that choice. Once he determined the phonetic inventory (e.g., which sounds would be included/excluded), then he determined what combinations of sounds would be allowed.

Next, Frommer created the language’s lexicon, syntax and morphology. James Cameron already had created some vocabulary, mostly names of characters. The lexicon was then expanded upon based on those words/names, and now contains about 1,000 words. The syntax of Na’vi is characterized by an extremely flexible word order. Verbs are conjugated for tense, but not for person – which makes me wonder if this was done intentionally to enhance the central theme of interconnectedness between all beings.

In an interview, Paul Frommer stated that despite his strong awareness of the language Klingon, which was similarly developed for Star Trek, he deliberately did not look at Klingon in order to avoid subconsciously creating similarities between languages. Though Frommer is the only person at the moment with a complete understanding of the Na’vi grammar, he has hopes that it will catch on, and perhaps someday be more widely spoken and understood by Avatar fans around the world.

If you’d like to learn more about Na’vi and the process of its creation by Paul Frommer, here are some links:

This is an interview with Paul Frommer, linguist who created the Na’vi language:  http://www.pbs.org/newshour/art/blog/2009/12/usc-prof-says-youre-speaking-my-language.html

Here is the Wiki page, which contains lots of detailed information about the morphology, syntax, and phonology of Na’vi:  http://en.wikipedia.org/wiki/Na’vi_language

This website has information about the vocabulary, grammar, and sound system of the Na’vi language:  http://www.learnnavi.org/

Abstract

Title. Bedside screening tests vs. videofluoroscopy or fibreoptic endoscopic evaluation of swallowing to detect dysphagia inpatients with neurological disorders: systematic review.

Aim. This paper is a report of a systematic review conducted to determine the effectiveness and feasibility of bedside screening methods for detecting dysphagia in patients with neurological disorders.

Background. Dyspaghia affects 22–65% of patients with neurological conditions. Although there is a large variety of bedside tests to detect dysphagia, it is unknown which have the best psychometric properties and are feasible for nurses to use.

Data sources and review methods. An electronic database search was carried out using Medline (PubMed), Embase, CINAHL, and PsychLit, including all hits up to July 2008. The search terms were dysphagia, sensitivity, specificity, diagnosis, and screening. The methodological quality of included studies was assessed.

Results. Thirty-fiveoutof407studieswereincludedinthereview. Eleven studies with sufficient methodological quality revealed that trial swallow tests using water had sensitivities between 27% and 85% and specificities between 63% and 88%. Trial swallow tests with different viscosities led to sensitivities ranging from 41% to 100% and specificities of 57% to 82%. Combining water tests with oxygen desaturation led to sensitivities between 73% and 98% and specificities between 63% and 76%. Single clinical features, such as abnormal gag, generally had low sensitivity and specificity.

Conclusion. A water test combined with pulse oximetry using coughing, choking and voice alteration as endpoints is currently the best method to screen patients with neurological disorders for dysphagia. Further research is needed to establish the most effective standardized administration procedure for such a water test, and to assess the value of pulse oximetry, in addition to a trial swallow to detect silent aspiration.”

Recently I had the opportunity to join a team from various hospitals in San Diego who go to Mexicali, Mexico twice a year to perform surgery and offer treatment for children with craniofacial disorders.

From a perspective of speech-language pathology, we were involved in many parts of the process from beginning to end. Starting with assessment, we helped determine whether a child (or adult) was a candidate for surgery. Therapy was provided to children who were not candidates, and families of those who did receive surgery were educated and provided with tools to help their children practice post-op. There was a wonderful talk provided by a speech language pathologist for any parent who wished to attend, with the focus of how to facilitate language development in young children. A question and answer period at the end allowed parents to inquire about suspected speech and language delays/disorders in their children or others that they know, and ways in which they can take action.

This trip taught me not only specifics about cleft lip/palate and the many related disorders, but also about compassion within the medical field and the joys of seeing young adults who have come back each year since they received surgery with this team as an infant. Also amazing was to see the adults who received a surgery they have waited their whole lives for, or families who have traveled across Mexico for these services. It was a powerful experience, and one that I hope to be a part of in the future!

“Every year, thousands of middle- and upper-class American children study a foreign language for enrichment. These children, their parents, and their teachers are guided by the belief that knowing another language “is good for you.” At the same time (and sometimes in the same schools) thousands of other children—usually from immigrant and lower-class backgrounds—are discouraged from and sometimes forbidden to speak their native language. Their families are told that communication in their native languages will prevent them from mastering English and that raising children with more than one language will “confuse” them and have long-lasting, detrimental effects.

Given these two contradictory perspectives, what does research say about the consequences of bilingualism?”

[Read more via ASHA]

Marian, V., Faroqi-Shah, Y., Kaushanskaya, M., Blumenfeld, H., Sheng, L. (2009, Oct. 13). Bilingualism: Consequences for language, cognition, development, and the brain. The ASHA Leader, 14(13), 10-13.