Lois Nightingale 6/5/19 Lois Nightingale 6/5/19

Simple Ways to Rekindle Romance

1. Write a paragraph recalling the events, things you noticed and the way you felt when the two of you first met. Leave it on his/her mirror, car seat or pillow.

2. Drive to a quiet place together, pull out 3 or 4 sealed envelopes, have him/her open the envelope of his/her choice and read the agenda for the evening, i.e. dinner and a movie, your favorite juice bar and a comedy club, or Chinese take-out at the park then listening to music at a coffee house, etc.

3. Write 31 things you admire about him/her put them in a decorative container and have them read one out loud every morning for a month.

4. If you don’t have a “your song” choose one, if you, do choose a special one for “Valentines Day 2000” or an “our make-up” song, create an occasion for a special song. Present him/her with the CD or tape.

5. Write a note stating three ways the world is a better place because he/she is in it. Give the note with a single stem flower and say, “you are one of a kind.”

6. Using his/her first name create an acronym with words that describe him/her i.e.; Lisa and Mark:

Loving Marvelous Inspiring Adventurous Sexy Rowdy Adorable Kind

7. Say “Thank you”, express gratitude and appreciation often, be sure to give compliments at least five times as often as criticisms.

8. Create a romantic treasure hunt with loving notes or gifts at each stop and detailed instructions to the next location. Have the final destination be a quiet restaurant, candle-lit bubble bath, or a massage in bed with warmed oil.

9. Remember that intimacy may mean different things to men and women. Read John Gray’s Men Are From Mars Women Are From Venus out loud to each other. Respectfully talk about what makes each of you feel close to the other. Remember, feeling safe and unconditionally accepted lead both men and women to feeling loved and special.

10. Allow yourself to be vulnerable. Gently and directly reveal how you feel and what you want. Comment out loud on the things he/she does that lead you to feel special and important to him/her. Give yourself the right to own your feelings and dreams without justification or providing “evidence.” If you are comfortable with how you feel and what you want others will also be more comfortable with you.

Lois Nightingale 5/16/19 Lois Nightingale 5/16/19

Dating as a Single Parent

What are the qualities that a single parent should look for in someone they are deciding to date?

Playful, light and fun with kids. (Kids have an innate instinct about people. Watch
Doesn’t try to make the kids like activities they “should” like. Will accept a child’s declining to participate in an activity that he/she likes. Open to learning about your child’s activities and interests.
Doesn’t try to discipline kids. Setting rules, boundaries and giving consequences needs to be done by the biological parent.
Not jealous if you need to put the children first or when they need your attention. Childhood goes by very quickly. Give you children the attention they need. Help with homework, the chance to talk about their day, etc.
Willing to be introduced into the lives of the kids slowly.
Will accept your boundaries about how much affection you are comfortable with expressing in front of your kids, and at what pace. Progress slowly in the relationship, at least in front of your children.
Speaks to children respectfully but not patronizingly. Speaks to them in age-appropriate ways about topics of interest to kids not just to him/her. Never uses degrading or belittling language. Never calls anyone derogatory names.
Doesn’t want to exclusively do activities with children or only activities in which kids are excluded. A healthy relationship has a mix of adult-only and child-included activities.
Doesn’t scold, lecture or “should” you about how you interact with the children’s other parent.
Is patient when children express jealous and interfering behaviors.
Sees you as a competent adult and a devoted parent.
Understands all kids are different. Doesn’t compare your kids with his/her kids (or kids seen on TV!).
Able to be flexible with the unexpected and roll with the unplanned events that always seem to arise in a household with children.
Is there to hold you when you are missing your kids. Doesn’t try to talk you out of how you feel or rationalize away your sadness.
Understands that kids do grow up and that life-partners are together long after the kids have left home.
Willing to model respect and adoration for you in front of your children. It is good for kids to see their parent treated well by another adult.
Able to have open and non-defensive conversations about how you feel and what you want about your relationship and your children.
Willing to participate in family established rituals such as birthdays, holidays, etc.
Does not use alcohol to excess or drugs.
Able to apologize and model asking for forgiveness when he/she makes a mistake. Able to easily and quickly forgive when asked for forgiveness.

© 1998 Dr. Lois V. Nightingale, Clinical Psychologist (psy9503) and director of the Nightingale Center in Yorba Linda, Ca. Author of My Parents Still Love Me Even Though They’re Getting Divorced. 714-993-5343

Lois Nightingale 5/13/19 Lois Nightingale 5/13/19

Rights of Children of Divorce

Children have the right to:

1. Continue to love both parents without guilt or disapproval (subtle or overt) by either parent or other relatives.

2. Be repeatedly reassured that the divorce is not their fault.

3. Be reassured they are safe and their needs will be provided for.

4. Have a special place for their own belongings at both parents’ residences.

5. Visit both parents regardless of what the adults in the situation feel, and regardless of convenience, or money situations.

6. Express anger and sadness in their own way, according to age and personality (not have to give justification for their feelings or have to cope with trying to be talked out of their feelings by adults).

7. Not be messengers between parents; not to carry notes, legal papers, money or requests between parents.

8. Not make adult decisions, including where they will live, where and when they will be picked up or dropped off, or who is to blame.

9. Love as many people as they choose without being made to feel guilty or disloyal. (Loving and being loved by many people is good for children; there is not a limit on the number of people a child can love.)

10. Continue to be kids, i.e. not take on adult duties and responsibilities or become a parent’s special confidant, companion or comforter (i.e. not to hear repeatedly about financial problems or relationship difficulties).

11. Stay in contact with relatives, including grandparents and special family friends.

12. Choose to spend at least one week a year living apart from their custodial parent.

13. Not be on an airplane, train or bus on major holidays for the convenience of adults.

14. Have teachers and school informed about the new status of their family.

15. Have time with each parent doing activities that create a sense of closeness and special memories.

16. Have a daily and weekly routine that is predictable and can be verified by looking at a schedule on a calendar in a system understandable to the child. (For instance: a green line represents the scheduled time with dad, and a purple line represents the scheduled time with mom, etc.)

17. Participate in sports, special classes or clubs that support their unique interests, and have adults that will get them to these events, on time without guilt or shame.

18. Contact the absent parent and have phone conversations without eavesdropping or tape-recording.

19. Ask questions and have them answered respectfully with age-appropriate answers that do not include blaming or belittlements of anyone.

20. Be exposed to both parents’ religious ideas (without shame), hobbies, interests and tastes in food.

21. Have consistent and predictable boundaries in each home. (Although the rules in each house may differ significantly, each parent’s set of rules needs to be predictable within their household.)

22. Be protected from hearing adult arguments and disputes.

23. Have parents communicate (even if only in writing) about their medical treatment, psychological treatment, educational issues, accidents and illnesses.

24. Not be interrogated upon return from the other parent’s home or asked to spy in the other parent’s home.

25. Own pictures of both parents.

26. Choose to talk with a special adult about their concerns and issues (counselor, therapist or special friend).

Lois Nightingale 3/14/19 Lois Nightingale 3/14/19

Coping with Alzheimer’s Disease in a Loved One

Today someone develops Alzheimer’s Disease every 67 seconds in the United States. This number is accelerating because the aging population is living longer. It’s projected that by 2050 a new case of Alzheimer’s will develop every 33 seconds. It is more important than ever to get early screenings. Sometimes symptoms are written off to “They’re just getting old,” “There are no effective treatments so why get a diagnosis?” “Everyone their age has memory issues.” Early intervention can make a huge difference in quality of life, for the patient and their family.

Today one in nine people over 65 have Alzheimer’s. One third of seniors over 85 have Alzheimer’s. Don’t be afraid to bring up the conversation. It may change how the next phase of life goes.

This is a scary disease. Even many doctors are hesitant to tell patients that they have the disease. Caregivers report that forty-five percent of Alzheimer’s patients are not given their diagnosis from their physicians. Make sure a reliable car giver attends medical appointments, asks important questions and writes down the doctor’s answers.

Between 2000 and 2010 deaths from all other major diseases have decreased (deaths from heart disease have deceased by 16%, deaths from breast cancer, prostate cancer, stroke and HIV have all decreased) while deaths from Alzheimer’s has increased by 68%.

Very few cases of Alzheimer’s are familial, less than 3% of all cases. These genetic cases include mutations on chromosomes 1, 14 or 21. There is a test for this very rare form of the disease, which only affect s a few hundred families worldwide. The more common type generally starts later in life, progresses very slowly, and is caused by gene mutations that shrink the brain. This is caused by irregular amino acid metabolizing that builds up plaque and kills brain cells. This leads to memory and/or language loss. Whichever shows up first will usually be the worst symptom over the course of the illness.

Normal Aging

Some memory and cognitive functioning is normal s we age. The speed with which we process information slows a little. Working memory shrinks just a little (7 to 5%) and there are mild retrieval deficits, it takes more effort to remember things. Episodic memory, like what you had for dinner last night, may be less efficient, but it still works.

In normal aging verbal reasoning, attention skills, social life, recreation, the ability to recall how to do something and personality all are intact. If there are personality changes it is very likely some form of physical dementia is at play.

Symptoms

Symptoms of Alzheimer’s Disease include loss of short term memory, such as forgetting what one just said, leaving the water on, cooking on the stove, or what they did yesterday. Long term memory is often preserved, even though verbal and visual memory are both usually affected. Another symptom is the loss of the ability to copy simple drawings such as two connected diamonds or a circle and a square touching each other. Naming simple objects or fining words during conversations can become difficult. Words that are used less frequently are often lost first.

Symptoms may appear “patchy” and come and go, or show up at later times of the day when the patient is tired or it has been many hours since their medications. This “Swiss cheese” effect can be very frustrating for family members. They may interpret the fluctuations in symptoms as manipulation on the part of the loved one. Try to be patient and keep a record of these irregularities. Over time it may become apparent that there are some predictabilities in their forgetfulness.

Depression and anxiety often accompany the frustrating symptoms of Alzheimer’s. If psychotic symptoms appear they are often delusions filled with fear such as someone is stealing from them or their spouse is having an affair.

Preventative Measures

There is research that indicates that a healthy lifestyle may optimize aging and optimize functioning should there be dementia later in life. Health during midlife appears to be the most important. Weight control, healthy diet, physical and cognitive exercise, maintaining control of blood pressure, blood sugar, cholesterol, vitamin B12 and homocysteine levels and maintaining good immune functioning are some of the most important.

Genetics appear to not account for all of the predisposing factors. Social activity with face to face interaction engages 70 % of the brain, if you add in a lively conversation 100% of the brain is used. Four hours a day of social interaction appears to minimize the risk of developing Alzheimer’s Disease. Exercise, regular adequate sleep, good nutrition and challenging cognitive activity also give some protection.

A healthy diet consisting of mostly produce with unprocessed protein and low processed grain can help protect your brain. The fruits, vegetables, healthy oils, fish and whole grains of the Mediterranean diet is a good guideline.

As little as 30 min of physical activity five days a week reduces cerebral atrophy, stimulates neuron regrowth and synaptic plasticity (increases hippocampus volume) and reduces stress. Remember, everything that is good for the heart is good for the brain.

Sleep patterns change with age. Seniors may need less sleep and have more disrupted sleep. They may also suffer from REM disorders like restless legs or Apnea. Poor sleep leads to a diminished ability to concentrate and pay attention. Sleep disturbances can also interfere with encoding memories so they can be retrieved later.

Stress is another culprit that negatively affects cardiovascular health, immune system, gastral intestinal functioning, sex drive, sleep and mood. People who are under constant stress have higher death rates for their age group and display poor concentration. There are many ways to decrease stress including exercise, meditation, breathing techniques, spirituality, social support and guided imagery and mindfulness training.

Progression of the Disease

In mild neurocognitive impairment, no symptoms may be noticeable. The brain works hard to compensate for physical changes. Most patients have had Alzheimer Disease for at least ten years before they show symptoms because the brain has worked hard to make up for the diminishing capacity. While this may sound like a good thing, this compensation my hide symptoms. The earlier medication is introduced the more effective it is in delaying the onset of serious symptoms. Often patients know they have mental decline long before it would show on tests or long before their doctor knows.

In major neurocognitive disorder, the cognitive changes become a concern to the family. One or more areas of memory and mental functioning are significantly impaired. And eventually as dementia sets in the cognitive impairment is severe enough to interfere with everyday abilities.

Usually this progression is very slow, subtle and insidious. There doesn’t usually seem to be a defining event where the disease begins. Some exceptions are head injuries from falls or accidents, serious medical illness, surgery involving anesthesia and the death of a caregiver. It can take up to six weeks to get anesthesia out of the body after surgery. If there is a negative cognitive effect from pain meds or anesthesia, it may take time to see if a patient will return to the previous level of functioning.

Support for the Family

Having a loved one with Alzheimer’s takes a toll on a family. The disease slowly steals the person they knew and loved. Each day may be different. Issues of taking away driving privileges, medication schedules, medical decisions, financial responsibilities and obligations, removing power tools and fire arms, all may be overwhelming tasks for families. When out of home placement is necessary the guilt ambivalence and exhaustion can become unbearable.

If possible, divide up responsibilities. Collecting medical and psychiatric records and accompanying the patient to medical appointments can be rotated or delegated between several family members. Don’t be afraid to ask. Even if you get told “No, I can’t help” you’ll neve r know unless you ask.

Type up a comprehensive list of medications and supplements, the dosages, frequency taken and the prescribing physicians and phone numbers. Have this list available at all medical appointments. Also, type up a physical and psychological history including birth issues such as “blue baby,” NICU stays, head injuries, addictions, impulsivity, seizures, family history, work or military history, neurological issues and major illnesses and surgeries and any complications. Include hobbies, religious affiliations, past social life, marital history, job length and satisfaction sleep hygiene, exercise diet and appetite, weight gain or loss, and access to transportation, fire arms, and help with daily needs. Keep these lists current so any caregiver accompanying the patient will have the information to give medical personnel.

Support groups such as Care Givers of Dependent Adults or Alzheimer’s Disease support may offer valuable connection, suggestions and a safe outlet to talk about the challenges at home. Individual or family therapy may be helpful to cope with the feelings of loss, anger, frustration and guilt.

Ask your loved one’s medical doctors about medications that may be useful. Ask about side effects of medications and synergistic effects between drugs.

The more you trust yourself and have good coping skills for your own emotions, the better equipped you will be when it comes time to have difficult family meetings, chose financial plans, cope with the change of personality of your loved one and keep them safe. Therapy may help with identifying situations that trigger the Alzheimer’s patient and provide coping skills for the emotions that come with bathing, changing clothes, moves, change of caregivers or implementing interventions such as hospitalizations.

Coping with the aggression, depression, delusions, disinhibition, anxiety and agitation of a loved one suffering from this progressive disease takes a toll on everyone trying to help. Educate yourself about the disease and resources available. Run your expectations and fears by professionals and those in support groups. Simplify everything you can. Set up systems and calendar all appointments and ask for help before you need it. Set up predictable routines and don’t argue or try to convince the patient of the truth. Be good to yourself and make self care a top priority.

Alzheimer’s Association (2015) Alzheimer’s Disease Facts and Figures.

American Psychiatric Association (2013)

Lois Nightingale 2/16/19 Lois Nightingale 2/16/19

Building Resiliency in Children of Divorce

Resiliency, the ability to overcome serious hardships, has been researched and show to be a trait that can be fostered in children. When resiliency is nurtured and developed in children of divorce, it can reduce the negative effects of not only the disruption of the divorce, but it can also increase emotional strength for future disappointments in their lives.

Dr. Nightingale’s books can be found at amazon.com/author/loisnightingale