Margery Pabst is a nationally acclaimed author, speaker, and facilitator.  Her fourth book, “Enrich Your Caregiving Journey” won the 2010 “Caregiver Friendly Award”. Margery uses storytelling to engage readers and to explain useful tips and tools for caregivers.  “Caregiving was the hardest and most rewarding role of my life”, she says.  “When I was a caregiver, I wanted something comforting and helpful all at once.  I wrote this book to fill that need.”

Ask the Caregiving Coach offers you specific tips with doable actions suggested for enhancing your caregiving experience.  According to Margery:  "We hope the outcome will be more time for you to care for yourself while providing quality, enriching care for your loved one or friend."

This is your forum!  We invite you to submit questions for the Caregiving Coach or your responses to the questions and answers provided.  We will post new questions every other week.  The dialogue created between you, the Coach, and your fellow caregivers will provide a rich learning experience for all as we learn from each other.

To ensure this column is useful to as many caregivers as possible, we encourage your questions be submitted in a 2-3 sentence format.  With this format, we can post more questions, answers and feedback to the Caregiving Coach.

Email your question or comment for Ask the Caregiving Coach to This e-mail address is being protected from spambots. You need JavaScript enabled to view it .  Thank you in advance for all your questions!  All questions will be archived so your issue may be featured at a later time.

Learn more about Margery Pabst and Enrich Your Caregiving Journey at www.pivotalcrossings.com.

See parts of Margery's keynote address at our 2011 Spring Symposium by clicking here: Margery Pabst Spring Symposium

Ask The Caregiving Coach

November/December 2011

This month, I am responding to questions concerning making transitions from health care facilities to home.  As more and more families bring their loved ones home, many due to economic pressures, the issue of transition is critical.  Thanks for your questions and comments.

Question:  If you could name the most important tip when bringing a loved one home from the hospital, what would it be? - Meryl

Caregiving Coach:  Thanks Meryl.  You’ve really made me think about the one that can make all the difference in your loved one’s well being.  Talking to each of the medical team about your loved one and asking the question, “What medical tasks do I need to do each day to keep my loved one safe?” heads my list.  Then COMPARE the answers you get about medication, diet, supplements, etc.  If you receive conflicting information, get it resolved before you take your loved one home.

Question:  I’m taking my sister from a rehabilitation facility back home next week.  What do I need to think about? - Tom

Caregiving Coach:  First, use my answer in the first question to begin and begin right now so that by next week, you have medical issues confirmed.  Second, ask that an appropriate professional come to your home and assess it for potential risks, given your loved one’s condition, that need to be addressed.  For example, throw rugs may need to be put away, a special walker may be needed, or a special bed for easy access may need to be rented or acquired.

Question:  I just brought my mother home a month ago from a nursing home, and I’m feeling a lot more stress with her being here.  What steps can I take for myself personally? - Leona

August 2011

Like January, September is often a month when people and organizations make plans.  With this theme in mind, I’ve selected some questions that relate to planning ahead.

I hope they prove useful and, as always, I appreciate your feedback and continuing engagement as we take the caregiving journey together.

Question:  It just occurred to me the other day:  What will I do when I need care? Marina G.

Caregiving Coach:  You raise a critical issue and one that, as we care for others, becomes paramount. As caregivers, we witness the amount of time and resources that caregiving requires.  As you begin to think about your own future caregiving needs, consider your values.  Are you a more private person or do you like seeing friends and family often?  What about hobbies?  What are your interests and skills?  As you consider a care plan for yourself, think of your personality, values, and interests.  The answers will take you down your unique path.

Question:  I live in a flood prone state and area.  How to I begin to think about a plan? - Quentin R.

Caregiving Coach:  Always be prepared.  Identify the amount of time authorities believe you have to evacuate your home and community.  During months of high risk, make sure your vehicle has food, clothing, blankets, etc. available for you and your family.  Natural disasters seem to be on the rise, so consider how ambulatory or not your loved one is.  As a caregiver, consider that additional supplies/medicines should be at the ready to take. (Note that each type of natural disaster requires a few different points of preparedness, so do research about your location.)

Question:  I feel guilty that I’ve begun planning about what I will do once my husband has passed on.  Is this a good thing to do at this time? - Judith A.

July 2011

This month, our focus is Family Dynamics.  Not only did I hear many comments about family dynamics at the Spring Symposium, but I’ve also read and heard so many comments about the “family feud” wherever I go.  Sometimes the feud is at a low boil, sometimes the heat is up.  Here are some questions and comments related to your family and my family.

Question:  My sister, Alice, lives in another state.  She’s stopped questioning everything I do, but now she calls my mother to check and see if I’m providing all the facts about mother’s illness.  What do I do? -  Jo

Caregiving Coach:  Be sure you are providing complete information to your sister.  I know that’s hard, so become a diligent note taker.  Have the doctor or nurse provide information to support your efforts.  You can’t stop your sister from checking on your communication skills; you can be responsible for yourself.

Question:  It seems that my family disagrees about most everything.  Where do I begin? - Smokey

Caregiving Coach:  Begin by writing down those things you can agree on.  Focus on agreement.  Often, disagreements occur around HOW TO ACCOMPLISH A TASK.  Go back, and ask, “WHAT is it that we all want?”  If you can agree on WHAT (the outcome), then it may be easier to sort out how to make it happen.

Question:  I just can’t relate to my father.  If I say “black”, he says “white”.  We’ve never been close but now that he’s sick, I’d like to know him better. - Millard

Caregiving Coach:  This is one of the toughest areas for me too and it relates to the fact that, even though we are in the same family, we may have very different VALUES.  Ask yourself, “What does my father value?”  He may like solitude and you may like parties.  He may love biscuits while you avoid carbohydrates.  As with the last question, is there something you both value and can agree on?  I suggest you confirm his values even if they’re not your own.  Confirming his values and tastes does not mean you agree with them.

June 2011

Thank you for your questions.  I choose three that were a direct result of our time together at the Spring Symposium.  The questions reflect issues that many of you voiced.

Question:  How does caregiving affect spirituality? - Roberta S.

Caregiver Coach:  Caregiving is an intensely spiritual pursuit.  It forces us to face what it means to love and care for others.  Caregiving forces us to take a hard look at both our strengths and weaknesses as human beings, the result often being a confirmation that we need a higher power to help us.  As for me, my spirituality and faith was strengthened by the experience.

Question:  How do I support my mother emotionally as she endures a chronic illness like Parkinson’s? - Harriett W.

Caregiver Coach:  Your question reflects so many concerns caregivers have.  I felt exactly the same.  Was I up to the task of providing emotional support?  What I discovered was right in front of me!  I gave time every day to sitting with my mother, asked her to talk to me about any and everything, listened to her, and even wrote down her comments in a journal.  It became a storytelling hour, and provided her with the emotional support she needed.  Emotional support really means showing and expressing understanding for the ill person’s concerns; caregivers who make time to listen will provide that support.

Question:  How can siblings work together in supporting their aging parents who live in another state? - Quentin P.

May 2011

Seeing and meeting so many of you at the Spring Symposium was inspirational and delightful!  Energy in the room was palpable; your engaged participation made it so.   Many of your comments and questions centered around the issue of responding to your care partners, family, friends, and medical professionals.  So I thought that I would highlight three questions--two from family caregivers and one from a professional caregiver.

At the Spring Symposium, we explored why skillful responses are so important for caregiver well-being and balance.  As always, please provide some options to my answers as none of us has all the angles on caregiving issues.

Question:  How do I keep my thoughts together when I visit the doctor with my mother?  I always seem to forget something. - Angela

Caregiving Coach:  I recommend having a medical resume which includes the medications your mother is taking, any allergies or interactions she may have, and a history of her medical condition.  Have a list of questions that you keep altering and adding to with each doctor visit.

Question:  What can I do as a long distance caregiver to get more engaged with my father’s care?  My sister lives in the same town as he does; she just tells me she’s taking care of everything. - Max

Caregiving Coach:  First, tactfully ask your sister to keep you informed and why that is important. (i.e. you want to provide support)  If that doesn’t work, explain that you want to be ‘in the loop’ in the event that she cannot provide care for your father.  As a last resort, contact your father’s doctor and request the information, explaining that you want to be kept informed.

Question:  One of the most difficult tasks I face is how to respond to a caregiver who constantly questions what I’m recommending and doing.  What can I do? - Alicia

Caregiving Coach:  Ask yourself, “Am I proactively explaining what is being done/recommended and WHY THE PROCEDURE or MEDICATION is important.  Today’s patients and caregivers want to know the WHY as well as the WHAT.  By explaining that up front and perhaps even providing the information in writing, you will put the caregiver at ease and fewer questions will be the result.

April 2011

The Symposium meets a central need for many caregivers by providing an opportunity to network and to discover tools for taking care of yourself while caring for others.  By the end of the conference, you will have an opportunity to explore many questions relating to your personal resiliency as you provide care for another.  Some of the questions I've received lately are about personal resiliency, including:

• Why do I feel so tired?
• What can I do to maintain my personal worth?
• What will happen if my role as a caregiver continues for a long period of time?
• How do I make sense of the caregiving role?
• How do I learn from this experience?

March 2011

The Spring Symposium is only a little over a month away, so to provide a preview of one of the sessions, I’ve selected questions related to a very hot topic, “How to Get Quality Time With The Doctor?”  We’ll be exploring this question and others related to meaningful discussions with your health care professionals.  As always, please send me other questions and responses to this topic.  We hope to see you at the Symposium.

Question:  What can I do when the doctor appears preoccupied and doesn’t seem to be listening? - Margo

Answer:  Here’s what I say and it usually helps to redirect the conversation.  “I can see you’re busy today, but I do need your attention for the next 5 minutes on an important issue.”

Question:  My loved one’s doctor often speaks by using big medical terms.  I don’t understand what she is saying, so I can’t determine the severity of the problem. - Pam

Answer:  As in the first question, it often helps to change the conversation by saying, “Dr. _____, I don’t understand what you are saying.  Can you explain what is happening in terms that (name of patient) and I can understand?”  Remember, you need to change the conversation when you’re not getting what you need in the doctor’s office.

Question:  I frequently get flustered at the doctor’s office.  My attention is usually directed at my doctor, but I still forget the questions I needed to ask.  What can I do? - Woody

Answer:  Write down your questions.  I always kept a “running list” from one doctor visit to the next, with the most pressing questions at the top.  Also remember, there’s nothing wrong with going back to the office or clinic (especially if you are still nearby or in the parking lot) and letting the nurse or receptionist know you still have questions.  Ask that the doctor call you back.

February 2011

In this month of love, I’m listing questions from you related to listening and empathy--one of the best ways to demonstrate that you care.  I appreciate your questions and hope the answers assist you in being great Caregivers with a capital C.  As always, I appreciate your questions or responses to my answers.

Question:  When my Dad starts complaining about something we can’t change for him, I worry that if I listen, he will think I agree or can do something about it.  What should I do? - Caren

Caregiving Coach:  When we listen to others, we are not agreeing but rather seeking to understand.  Simply listening goes a long way to easing tension and calming the other person.  Saying, “I understand your frustration, but there is nothing I can do” will let the person know you share the concern.

Question:  How can I tell when a person is not sharing their real feelings with me? -Gavin

Caregiving Coach:  One tip off is language.  There are one word ‘red flags’ all of us use to mask our real thoughts and feelings.  A couple of those ‘red flags’ are words like “fine”, “great”.  When you ask, “How are you?” and the response if “Fine”, be sure to follow up with another question like, “What’s on your mind today?”.  I find this question to be particularly helpful in encouraging real thoughts and feelings.

Question:  How can I remind myself to listen more? - Marcus

Caregiving Coach:  How about a visual reminder?  I have an old coffee pot from my Mom.  When I was still at home and then into my middle age, Mom and I sat down and drank coffee from that pot.  Coffee making was slow in the old drip pot, but that was good because we spent quality time at the table waiting for the coffee and then drinking it.  That pot will always remind me to slow down, listen, and attend to friends and loved ones.

January 2011

Happy New Year!  For January, I’ve selected questions that pose issues related to getting 2011 off to a good start.  Thanks for your submissions.  I hope my answers help bring you joy in the New Year.

Question: Now that the holidays are over and all the anticipation for the holidays are past, what can I do to fend off the winter doldrums? - Tisha

Caregiver Coach: Try creating something new to anticipate for January.  Make it an event, meal, or experience that will happen in this month; something too long range will defeat the purpose.  Discuss the planning or simply how wonderful “IT” will be everyday with your patient/loved one.  Often something that can be researched adds more interest as well.

Question: My sister seems so depressed now that the holidays are over.  How can I keep the spirit going? - Samuel

Caregiver Coach: One possibility is to “regift” the presents you each received to one another by sharing and enjoying them.  For example, read a book you received to your sister or encourage her to wear an article of clothing she may have received and then do something interesting and fun together while she’s wearing it.  Enjoy your presents yet again in January in one another’s presence!

Question: The dreary weather has such an emotional effect on me.  It’s hard to keep my spirits up when caring for another person.  What can I do? - Meghan

Caregiver Coach: One of the mistakes we all make, especially during bad weather, is to not exercise.  Exercise does demand more effort when it’s cold and the desire to brave the elements on the way to the gym or Y become daunting, BUT PERSIST.  You’ll feel much better and more energized once you get your body moving and breathing harder.  When you get home, light a candle with your loved one.

November/December, 2010

I, again, received many responses to the topic “Asking for Help”.  The issue continues to be at the top of any caregiver’s issues.  Here are three responses/questions that I thought demonstrated what is on your collective minds.

Question: I could really relate to Lorna who was frustrated because medication was forgotten in her absence.  Do you think a big chart listing medication times is a good idea? - Tisha

Caregiver Coach: Absolutely a terrific idea.  I would add that in addition to a large chart that color and pictures be added for extra emphasis and clear communication.  When colors and pictures are added to words, the retention of a communication/message more than doubles.

Question: I answered your poll on “Why is Asking For Help So Difficult” and was surprised that I will more often ask for friend’s help rather than family.  Why is that? -Bertie

Caregiver Coach: Go back and look at what tasks/issues you more often ask for a friend’s help.  For me, I found that I asked friends more often to help with errands, specific tasks around the house, etc.  However, when larger issues like seeing a new doctor, changing medication, or moving to a different care facility, I depended on my family’s opinions and input.

Question: The reasons listed in the survey gave me food for thought.  Reviewing what prevents me from asking for help and what encourages me to ask for help were useful.  How can I use these lists going forward? - Kathleen

Caregiver Coach: Post them somewhere (maybe the refrigerator) to remind you about asking for help.  Color code each list (red for what prevents you from asking for help and green for what encourages you to ask for help).  If you use a journal, make notes on how you feel what you ask for help and when you don’t.

September/October, 2010

I’ve received several questions about the topic “Asking for Help”.  All of us know it is one of THE most difficult actions for a caregiver.  So this month, I’m sharing only two of the questions with all of you because I found the answers had to be longer.  I guess that confirms how difficult asking for help is!

The topic also prompted an idea:  to end this month with a poll that will give us an even better idea about asking for help.  The poll questions are to your left.

Question:  Last week, I asked my sister-in-law to keep my husband company for two hours while I went to a movie.  When I returned she had forgotten to give him his medications.  What should I do?  Lorna

Caregiver Coach:  Make a decision based on the following:  “Was it acceptable that your husband received his medications a little late or did this error impact his health?”  If it was acceptable, then identify if your sister-in-law learned from her mistake and will not make it again.  If you believe that she learned from this, then I would have no problem asking her to help you again.

Question:  I always feel so guilty when I leave my mother with another caregiver.  What can I do to alleviate my guilt and take time for myself?

Caregiver Coach:  Who is making you feel guilty?  You or your mother?  Has your mother always laid a “guilt trip” on you at other times, or is she encouraging you to take time for yourself?  You need to FIRST IDENTIFY THE SOURCE OF YOUR GUILT.

If the guilt is an ongoing family pattern, then you must respond to her with love but with firmness.  For example, “Mom, I am going to a movie with a friend and we’ll have dinner together later.”  If the guilt is coming from within you, then focus on what you are gaining from being away from the caregiver role, and identify a caregiver who will use the time with your Mom for creative and stimulating activity.

August, 2010

Thanks to all of you who submitted questions.  I am hoping to hear from many of you as you respond to my answers.  I know you have great ideas and I look forward to hearing from you!

Question:  I seem to be riding an emotional roller coaster since I became a caregiver.  The ups and downs are really driving me crazy!  What can I do? - Victoria

Caregiver Coach:  Share your feelings with others on a regular basis.  For some of us, sharing feelings can be difficult.  One suggestion is to write your feelings down each day, beginning with the words, “I feel_____”.  Once you’ve written them down, it may be easier to share them.  I find that sharing relieves much of the emotional burdens caregivers often keep to themselves.

Question:  I really liked your comments on collaboration and sharing responsibility with loved ones.  Now I just have to do it.  How do I get started?  - Hank

Caregiver Coach:  Start small with a few tasks you trust another person to do.  Begin delegating to just one trusted person who has the skills needed to complete the tasks to your satisfaction.  Once you see how well it goes, your confidence will build and you can then reach out to others.  Good luck!!!

Question:  My sister may need to go into the hospital for a few days.  What should I think about and plan for? - Jaclyn

Caregiver Coach:  Here are three key questions to ask your doctor or other healthcare professionals:  “Why is a hospital stay needed?”, “Who do I need to contact besides you?”, and “Do I need to prepare anything at home for her return like additional equipment?”  If you don’t get specific answers from your first contact, ask the questions until you get the answers you need.

A special thanks to Hank for his response to collaboration and shared responsibility!

July, 2010

A Note from the Caregiver Coach:

Thanks to those of you who submitted questions!  I appreciate Beverly, Sam, and Vivian for their submissions.

For this month's column, I’ve selected questions related to one category:  Collaboration.  One question asks about shared responsibility while another is concerned about the care partner’s loss of self esteem.  In each instance, the gateway to involving your loved one in his or her care, and thus maintaining a sense of self esteem and empowerment , is your ability to develop a collaborative style.  While there a many ways to develop collaboration with your care partner and with your wider caring community, I hope my short answers begin the awareness and dialogue for sharing your role as caregiver.  Some benefits for you are freeing up time and seeing your care partner achieve the best quality of life possible.

Question:  I notice that my husband is becoming more apathetic as the days go by; his illness is not progressing but his attitude is more and more one of disengagement.  What do I do? - Beverly

Caregiver Coach:  I’m reading between the lines and sensing that your husband is losing self esteem, feeling more disengaged and unworthy as the days go by.  If this is the case, and you are making ALL THE DECISIONS about his care, engage him and ask for his help in developing care options.  Some of the best general questions you can ask are:  “How would you like to spend the day?”   “If you could customize your day exactly as you want, what would it look like”?  I know it’s scary to open it up like this because some impossible things will be mentioned; however, there will be surprises at what you can do that are new and exciting.

Question:  I read an article in a magazine about “shared responsibility”.  It sounded great but how should I start trying to accomplish that? - Sam

Caregiver Coach:  Start small with one thing your care partner can do.  I like to think about the following categories for collaboration/shared responsibility:  physical needs (eating, bathing toileting), medical issues (planning doctor visits, medications, etc.), environmental issues (making beds, cleaning), and recreational (picking out movies, books, researching on computer, etc.).  Choose one category or ask your care partner to choose one to begin with and then identify specific tasks for sharing responsibility.  What often happens is the responsibilities will expand once your loved one has initial success.

Question:  I have a next door neighbor that I care for 2 days a week.  Both she and her son moved to our neighborhood about a year ago, so I don’t know her that well.  I have been a caregiver for another person in the neighborhood, so that’s probably why I was asked. I’ve tried to get her to take on some things.  She is capable but just sits and watches television all day.  What can I do? - Vivian

Caregiver Coach:  It sounds like you need to start at the BEGINNING of any collaborative effort and that is having TRUST with your neighbor.   Start by engaging her in conversations about what is meaningful to her, what she likes to do.  Then ask some in-depth questions and really listen for the person inside.  For example, if she mentions her life raising 6 children, ask, “How did you do that?”  “How did you plan your day”? followed by some “why” questions like, “Why did you feel you could not take vacations?”  Often the “how” and “why” question engage people to talk about the meaningful areas of their lives.  Once you’ve gotten to know your neighbor better and established trust and understanding, then try again for some shared responsibility.

June, 2010

Question: I have one family member, a sister, who is always disruptive when we are having a family meeting.  What can I do?  Harvey

Caregiving Coach: My first answer is a question:  Does your sister have a specific role or set of duties?  Sometimes a person is disruptive when he/she feels removed from doing anything helpful for the situation.  Think about your sister’s skills.  What could she do for you that would keep her occupied?  If she does have a role, then take her aside before the next meeting and ask for her help in contributing positive ideas.

Question: I am a new caregiver (just 5 days) and I’ve felt sick to my stomach ever since my husband was diagnosed.  What can I do?  Sarah

Caregiving Coach: Find some additional help if you can, so that you have an opportunity to take care of yourself in these early days.  Get plenty of sleep (if you have some help, your mind and body will be able to relax) and eat nutritious foods, staying away from spicy food especially.

Question: How can I make sure that I’m doing the best I can?  Should I ask my father’s doctor?  CeCe

Caregiving Coach: The first person to ask is your care partner, your Dad.  Ask him to be honest and let you know if there’s anything else you could be doing.

May, 2010

Question: Even though I am the primary caregiver, I have three siblings who need to stay in touch with the situation.  I think it's important to keep them updated about Mother, but is there such a thing as too many meetings with the family?  Lauren

Caregiving Coach: Dear Lauren, No.  With today’s technology, meetings have no borders and staying in touch is easy and vital.  I would designate meetings as formal or informal, the formal ones being those in which urgent or important decisions need to be made.

Question: Tell me a quick way to relieve physical stress.  Tony

Caregiving Coach: Dear Tony, Sit down in a quiet place.  Breathe in deeply and then take each part of your body, beginning with your toes and feet, and tell that part of your body to relax.  As you tell your toes, feet, legs, etc. to relax, take a deep breathe in and out.

Question: Is it natural for caregivers to feel resentment?  Bill

Caregiving Coach: Dear Bill, Yes!  I hear this concern from many caregivers.  It is normal and natural to feel resentment, even toward those we love.  When we are tired and our emotional resources are spent, resentment is one of the normal responses.  It’s a signal for the caregiver to find some time for him or herself.

April, 2010

Question: My mother lives in another state and has advancing dementia.  I believe her care is excellent but I often feel nervous about not knowing what is happening day to day.  What can I do?   Deborah

Caregiving Coach: Dear Deborah, One way to keep in closer touch is to REQUEST A DAILY UPDATE via e-mail from her caregiver or care facility.  Develop a consistent format that ensures information for you and ease of use for the primary caregiver or facility.  For example,  3 questions like “How did the day go?”, “Did anything change from the routine?”, and  “What is Mom’s mood”? could be answered every day or in a timeframe suitable for everyone.

Question: I always thought it would be good to establish a routine while caring for my dad who is 89.  We go to the doctor once a week and he takes 5 different medications.  It seems that the same routine depresses him because on the day we go to the clinic, he is more lethargic and depressed.  What can I do?  Allen

Caregiving Coach: Dear Allen, We do depend on routine but we all get frustrated by it too, including our loved ones.  Variety, as they say, is the spice of life, so change the doctor’s visit to a different day of the week or include a different activity before or after the visit (like a visit to a restaurant or favorite store) that your loved one looks forward to.

Question: I am at my wits end.  When I suggest an activity to my husband, he usually disagrees with me even when it is something fun like going to a movie.  He has difficulty moving around, but I think he just wants to disagree with anything I say.  Should I just wait for him to make a suggestion?  Shirley

Caregiving Coach: Dear Shirley, I think you have a very good idea.  Why not try some open-ended questions to encourage suggestions from your husband. Questions might include: “What do you feel like doing today?” or “What’s the plan for Saturday?”, or “Do you think we need a plan?”.  Your husband will either give some ideas or will ask you for your thoughts.  Either way, fewer frustrations will be felt on both sides.