It’s happening in large numbers. We aren’t alone. We’re having to take care of our aging parents. More people are living longer. Unfortunately that doesn’t mean they are healthier. Maybe it’s the medications and procedures that help keep our parents alive. While the ages, and reasons might be different, the issue of “keeping your mind” while you assist someone who is slowly “losing” theirs, looms before you. I’d like to share my thoughts.

First remember that if your heart is in it, then no decision is “wrong.” Few people, even those who daily help others make these types of decisions, can know exactly what is best each step of the way. If you’re having to make decisions that could have been made long ago by the parent, then realize that this was their choice…for someone else (you) to decide instead of them.

At some point you will have to make a decision that is only the best of choices. There might not be a “good” choice available. Odds are, your parent will reach a point when no decision you make will be satisfactory to him or her. If they already had a habit of disapproving your actions, it will be an even tougher path. If they are also in denial about the level of care they need, it will often feel like the parent-child roles have been reversed. It’s almost too easy to fall into the scenario of them stomping their feet that they don’t want to, and you, stomping your feet that you don’t want to either but have to.

There are books available. They deal with the issues of making the home safe; how to help with choosing medical care; how people act when they age; how to talk with someone with dementia. Having many resources will assure you that you are doing it all “right.” I even found (on the Internet) a professional listing of items that comprise the home assessment for determining how much and what kind of help the senior needs so that decision becomes easier.

What might not be so readily available is how to take care of yourself while you are caring for an elderly parent. We tend to forget about ourselves. We might be very concerned about whether a parent is eating properly, yet skip a meal so we can rush to run an errand for them. We will call the doctor for a sleep medicine for Dad because we know how important a good night’s sleep is, yet fail to safeguard our own sleep time.

What’s behind this? Maybe it’s because we were taught not to be “selfish.” We might have been taught that being selfish is a bad thing, and that we must always put others first. That could be true if there’s a choice of sharing a whole cake or keeping it all for yourself. I don’t believe it’s true if being “selfish” is to help keep yourself healthier. Maybe you are working through the idea of “honoring our Mother and Father.” If that is a basis for your care giving, I think you might be surprised at what a clergyman would advise you about limitations.

We can’t give if we are tapped out ourselves. We must take care of ourselves, and our basic concerns, before we can begin to adequately take care of another. It’s been estimated that such responsibility will add 6 years to our own aging process. (It makes us 6 years older than we really are.)

I guess what I want you to take from this article most of all is the permission to “only” do your best for right now. That isn’t your best of all time in your life, that isn’t your best all the time forever — it’s your best for the moment given. We can all second guess ourselves, and do. Take into account your own situation at the time — your own health, your own issues, the resources available, your own knowledge and learning time (for few of us have done this before!)

Think of the decisions you’ve already made. Did you do your best at the time? I bet you did. I doubt you were confronted and decided, “I’m not going to do the best I can.” Be gentle with yourself. Try not to despair. Not all decisions will be crisis interventions.

Some decision making will have to be done quickly, without much time to mull all the options over very long. “Mother fell, she won’t go to the hospital.”

Some decisions can wait till you can call the doctor and wait on a response. “Dad doesn’t want to take the anti-depressant.”

Still others require much more angst in the making. “ Dad won’t go live with anyone, yet his doctor thinks he probably shouldn’t be living alone.”

No article can give anyone all the answers, for this is such a personal area of concern. Your own family dynamics will orchestrate what happens, how decisions are made, and people’s reactions to them. At times you might find the sequencing of actions and decisions rolling right along, all according to how things went when you were all growing up in that household. Maybe it’s supposed to be that way?

If you don’t wish things to be that way, realize that you have the power to change it. As an adult, no one can make you do things. You have intelligence and feelings and logic enough to know what you want to do for your own peace of mind within your own capabilities.

Do your best. Give a good effort. Make the decisions that are foisted upon you. Then step back and tell yourself, “You’re doing a good job.”

When you find yourself overwhelmed — and you will — remind yourself that you aren’t responsible for the way things turned out. Certainly if you could prevent parents from becoming old, you would! (And would become quite rich in the process of selling the secret!) Make sure you shelve any guilt you have from not doing everything you, or another family member, think should be done. You are working with what is now.

Realize that part of what you are feeling is your own mortality. Add in that you might be grappling with the idea of what could have been, and any opportunity of that happening now is quickly fleeing before your eyes. Perhaps you begin thinking about how you want to be cared for when you are in that same situation. If that prompts you to make long-term health care decisions, then it served its purpose. But guilt over not being the all-giving, all-answering, all-energy, always correct, sweet child? No.

It helps to have someone to talk with about these things. While you may hear a good idea to try, you will most certainly hear that you aren’t alone in this. Taking care of an aging parent is one of the most difficult activities a child will engage in. Maybe it’s a rite of passage.

We generally crave foods due to external prompts and our emotional state, rather than actual hunger. We tend to be bored, anxious, or depressed immediately before experiencing cravings, so one way of explaining cravings is self-medication for feeling miserable.

Chocolate is the most frequently craved food in women, and many women describe themselves as ‘chocoholics.’ Chocoholics insist that it is habit-forming, that it produces an instant feeling of well-being, and even that abstinence leads to withdrawal symptoms.

When we eat sweet and high-fat foods, including chocolate, serotonin is released, making us feel happier. This partly explains the cravings common in seasonal affective disorder (SAD) and pre-menstrual syndrome.

In many women, the craving occurs on a monthly cycle, which suggests a hormonal basis. A recent report in the New Scientist magazine suggests people can become overly dependent on the sugar and fat in fast food. Princeton University researcher Dr. John Hoebel found that rats fed on sugar became anxious when the sugar was removed. Their symptoms included chattering teeth and the shakes – similar to those seen in people withdrawing from nicotine or morphine. Dr. Hoebel believes high-fat foods stimulate opioids or “pleasure chemicals” in the brain. This theory is backed up by many other studies.

Chocolate contains several biologically active ingredients, all of which can cause abnormal behaviors and psychological sensations like those of other addictive substances. Researchers at the University of Tampere in Finland found that self-proclaimed chocolate “addicts” salivated more in the presence of chocolate, and showed a more negative mood and higher anxiety. The researchers state that chocolate addicts show traits of regular addiction, because they exhibit craving for chocolate, irregular eating behavior, and abnormal moods.

Although there are similarities between eating chocolate and drug use, generally researchers believe that chocolate “addiction” is not a true addiction. While chocolate does contain potentially mood-altering substances, these are all found in higher concentrations in other less appealing foods such as broccoli. A combination of chocolate’s sensory characteristics — sweetness, texture and aroma — nutrients, and chemicals, together with hormonal and mood swings, largely explains chocolate cravings.

Chocolate is seen as “naughty but nice” — tasty, but something which should be resisted. This suggests that the desire is more likely a cultural phenomenon than a physical one. The inability to control eating may be a result of inborn traits and today’s environment.

“Humans used to have to search for food,” according to Baylor College of Medicine researcher Dr. Ken Goodrick. “Now food searches us out.”

We are overwhelmed with advertising, large-scale grocery displays, plenty of high-calorie foods, and an obsession with thinness. The stress of modern living often makes us turn to food for comfort, then return to a restrictive diet. The attempt to restrain ourselves before we are satisfied increases the desire for chocolate.

Tips to Curb Chocolate Craving

If you can satisfy a chocolate craving with only two chocolate peanuts, then go for it. If you’re not so lucky:

• Discover if the craving is emotional – there are all sorts of reasons why people crave foods. It can often be related to feelings of low self-esteem or depression. If you can identify your reasons, then try another approach to tackling the problem.
• Incorporate small portions of chocolate into your usual diet, rather than restrict yourself. Moderation is the key. A research trial found that people who limited eating chocolate to within half an hour of eating a meal gradually weaned themselves off their craving.
• If you are feeling bored and craving chocolate, go for a walk, run errands, call a friend or read a book. If you can take your mind off food for a short time, the craving may pass.
• Make sure you always have healthy food nearby, so you can replace chocolate with fruit a few times a day. Eat an overall balanced diet, eat regularly to avoid hunger, and eat more slowly. When your blood sugar levels are stable, cravings are less likely to occur.
• If you think it’s necessary, do not allow chocolate in the house. Ask friends and family not to buy you chocolate, or even not to eat it in front of you!
• Finally, it is a good idea to increase your level of exercise, to burn off excess calories and increase your metabolic rate. Exercise also releases endorphins, which counteracts stress, anxiety and depression.

With this is mind, I would like to take a look at assertiveness, how it works and how we might achieve it if we are not coping well at the moment.

Our right to exist

Most people think of being assertive as an external thing, as facing up to difficulties with other people in a strong manner. The reality is that the problem goes deeper. To be assertive, we must first learn to face up to some core beliefs about ourselves. We need to see what we are doing to ourselves by being unassertive, and how this is affecting us.

The chronically unassertive person is a doormat, available for everyone to walk over, and unable to do anything about it. An unassertive person might eventually burst into a fit of anger at what they see as ‘the last straw,’ but this is not being assertive — it is a symptom of the problem. To change we must look at the feelings we have about ourselves. Why do we feel so pressured by others? Why are we so easily pushed around? Why do we let them in? Why can’t we stand our ground?

I believe that the core of unassertiveness comes from low self-esteem. Because we have a low view of ourselves, we are apt to believe that other people’s beliefs about us automatically are correct. We see everyone else’s point of view as stronger than our own, because we are not secure in our ownership of our own mental space. We are like squatters when everyone else is a landowner.

Before we can be confident in defending our mental space, we need to realize that we are landowners too. We need to know that no one can come into this place unless we invite them, that no one can make us think anything unless we allow them to. The unassertive person does not know this truth, and grants almost magical powers to those who wish to control them. It is like giving the keys of your home to everyone you meet, and then hoping that they won’t move in!

The first change is to realize that we are each owners of our own mental space, we have absolute title to that place, and that is where we must live. That is where we will learn to stand our ground, and so we had better get used to living on our own land. I use the metaphors of ‘land’ and ‘ground’ deliberately, to remind myself of the solid fact of assertiveness, and where it is drawn from. Assertiveness comes from our own awareness of our right to exist.

Instead of always looking at what other people think, comparing ourselves to and worrying about how we measure up to them, let’s take a look around our own space. It’s a refreshing exercise, and sometimes we have almost forgotten how to do it. I like to look at my bookshelves at home, and remind myself that these are the books that I have chosen for myself, or take a look at my wardrobe and my favorite clothes, or my favorite foods in the kitchen cupboard. These things are an expression of me. Other people may have different tastes; that’s fine for them, but they are not me.

This is a good place to start, with just a quiet reminder of the physical fact of our existence in our own space. I don’t expect anyone to come into my home and change the books on my shelves, and I have gradually learned to trust my mental space in just the same way. These days, if I find myself having conflicting feelings about another person, I take a look at these feelings, to see what’s going on. Invariably I find that the feelings are just some old insecurity about my own position and not about the other person at all. Other people will behave in whatever way that they wish, and that is their responsibility, not mine. I have my own space to look after, and that’s what I have learned to do.

Sometimes I look at a small statue of a seated Buddha, resting happily on my desk. Buddha sits there content, smiling at the world, just – being. It’s a nice inspiration.

Next month I’ll have a look at practical assertiveness, building on the strength of occupying our own mental space, and of the ability to say ‘No.’

Now, besides deciding whether to talk to your employer, your colleagues need to be taken into consideration as well.

You have no obligation to disclose your illness to your co-workers. That said, some issues may arise. For example, if you take time off every week for appointments, or even a leave of absence, your work gets distributed and your co-workers will have to take on your share. They may wonder why you get ‘special treatment’ and may either be concerned for you, or resentful. People may get anxious and talk among themselves. They know that something is amiss.

To set the record straight, and to keep possible rumors from spreading, as well as to maintain collegial relationships, you might want to talk to them about what is happening with you.

This talk should take place behind closed doors. You do not have to tell them everything. You can just say that you have a medical problem that you need treatment for. If you feel comfortable with them, you may give them more specifics. If they know what is going on, they may be understanding and be part of your support group. Tell them how they can help you. Give them some information about your illness.

Keep in mind though, that some people still harbor stigma about people with mental illness, and those misconceptions and fears make their way into workplaces.

As an alternative to talking to your co-workers, you may ask your manager to talk to them on your behalf. Remember, the decision to inform your colleagues is yours. If you don’t want them to know, then don’t tell them, and tell your manager, if he or she knows, to keep everything confidential (which he or she should anyway).

In the next segment, I will discuss prevention and various proactive ways to handle mental illness in the workplace.

Then my knees would almost give out on me while I was just standing still. Sometimes it would happen when I was walking or just from going from a sitting position to standing. Pretty soon after that, my knees started hurting so bad I couldn’t walk the mall.

Then I couldn’t finish my grocery shopping without leaning heavily on the basket.

Then my arms wouldn’t support my weight.

I bit the bullet and started riding the electric carts that had just come on the scene.

Soon, it started interfering with the only fun I had — going out with my best friend two or three times a week. We stopped going out as often and we wouldn’t go to the mall anymore. This went on for a while until it started making me angry. I used a cane for a while, but that didn’t stop the pain. I took anti-inflammatory drugs and while they helped my knees, they did inflame my stomach. I’d had enough by this time. It took all I had to climb the stairs to my second- story apartment.

One day, or maybe it took several days, I was musing, thinking about and analyzing my life. I didn’t like it one bit!

Throughout my childhood, my mother wouldn’t allow me to do much in the way of fun because she didn’t trust me. I jumped from the frying pan into the fire when I married the first time; stiffer control and no trust.

I divorced and remarried and was a stay-at-home mom for 20 years. Then I was legally separated and left with an empty nest. My mom, my constant authority figure, had passed away. For the first time, I realized that I could do anything I wanted. There was no one to answer to.

Did I want to sit at home and spend most of my time on the computer? No. There was a life outside of that screen. Life was there to be lived and by golly, I was going to live it! Everything inside me screamed “Live Life! You’re too young to give up and do nothing but sit and wish!”

The first thing I refused to give up was going out with my best friend. I had never been so in tune with someone else as she and I were with each other. The second thing I wasn’t about to do is let someone else do my grocery shopping, even if it was my best friend that offered to do it. Another activity I wouldn’t give up was spending time with my kids and grandkids. I missed being able to walk down my four steps to do my gardening. I love “playing in the mud.”

So what was I going to do about it? Was I going to let my depression and my physical state get the best of me? At 60, was I going to give up, fold my hands on my lap and say “that’s it?” Judging from my grandmother’ss and mother’s longevity, I still had a good 20 years left. Was I going to spend it wishing to myself “if only,” or was I going to say, once again “Full speed ahead and damn the torpedoes?” I chose the latter.

My doctor confirmed that some knee injuries had caused quite a bit of degenerative arthritis in my knees. I also had it in my shoulders and my hips. That’s when I found out about the degenerating vertebrae, also from a past injury. I slapped myself on the forehead and said “no wonder!”

So now what was I going to do about it? What were the possibilities? What were my options? To this day, I haven’t taken another anti-inflammatory drug. I’d rather my knees hurt than my stomach get upset. The pain in my knees doesn’t bother me as much as my stomach hurting and having everything I eat turn sour. Two vertebrae, I don’t think, is enough to have surgery on. Besides, I had a friend that had degenerative disk disease and was always under the influence of painkillers that made her even more irrational than she was normally or she was in pain, anyway. She’s had several back surgeries. She’d also had some gizmo implanted where she could pump morphine to the painful site. That much suffering wasn’t for me. No surgery.

Given that I was already on disability, I broached the subject of a power chair with my doctor. He was willing to write a prescription. There was quite a bit of hassle with my insurance but in the end, Medi-Cal paid for my chair.

I had accepted the fact that I live with depression, but I don’t “suffer” from it. I had accepted the fact that I couldn’t walk for more than just a few steps, but I wasn’t going to “”suffer” from arthritis and just two degenerative disks. I decided that depression, arthritis and degenerative disk disease did not and would not define me as a person. First and foremost, I am a living, breathing human being. Secondly, I am a woman with a few passions and various interests still left in my life.

I also know that everything has a purpose and things will happen when we are not following that purpose. It is also a strong belief of mine that obstacles are put in our way for a reason — to strengthen our spirit and our resolve, and to give us experience in dealing with life’s circumstances. From experience comes wisdom.

The fact that I have accepted my lack of physical mobility has made it possible for me to run my new dog, breathe fresh air and feel the breeze in my face and hair. From that has come the benefit of making new friends throughout my neighborhood. This in turn, has become a natural medicine, if you will, in my fight against depression. I can now outlast my best friend when we go to the mall. I can go into every single store and look at and touch everything if I so choose, because, by golly, she won’t be outdone. At the moment, I’m on the brink of taking a large step, the biggest in my life, and that is to start my own small business. At my age, I’m on my way! It’s never too late and unless we are on our death bed, it’s not over!