Tag Archives: stress

How To Start A Keto Diet

A ketogenic or a Keto diet is a high fat, low carb, and moderate protein diet that helps you burn all of your fat efficiently.  Studies say it has enormous benefits in terms of robust performance and weight loss.

 This is the reason why most doctors recommend it. But first, 

 What exactly is a Keto diet?

It’s a diet that involves few foods that are low in carbs and moderate in proteins. This can also increase your fat intake, but, eventually, with the correct diet, you can lead a healthy life.

The reduction in carbohydrates places your body in a metabolic state known as ketosis when the fat from your body and your diet gets burned in the form of energy. 

Why should you start a Keto diet?

A ketogenic diet’s benefits might seem similar to that of other diets which reduce fats and carbs from your body, but it does that more effectively than other diets. If followed properly it will give amazing benefits. 

 

  • Weight loss

Quite simply, if you turn your body into a fat-burning machine you can quickly lose weight. The advantage is that you can lose weight without feeling the need to eat more or feeling hungry. More than 70% of studies show that a ketogenic diet is comparatively more effective and greater for weight loss.

  • A calm stomach

A proper Keto diet results in less flatulence and pain, fewer cramps, and a calmer stomach. It improves the symptoms of irritable bowel syndrome as well. 

  • Treating Epilepsy

Since the 1920s, the ketogenic diet has been proven in treating epilepsy effectively and is a registered therapy.  

The Keto diet hardly has any side effects but offers loads of advantages. It’s a LCHF (low carb high fat) diet process that eliminates carbs and helps keep away hunger pangs and craving for processed foods.

So, if you are here thinking about adopting a Keto diet, here a few simple, effortless tips to get you started!

  • Reduce carbs but add lots of veggies

It is extremely important to eat clean and add more protein portions to your diet. Eat fewer or limit your carbohydrate intake. Add vegetables like broccoli, spinach, beans, legumes, nuts, tofu, and cottage cheese, to meet your body’s expectations for vitamins, minerals, fiber and protein. Various products are available in the market to make this diet easy, ( Keto Atta, for example)

  • Decrease stress

While following a Keto diet make sure you keep a continuous check on your stress levels. Low sugar levels in your body could trigger the release of stress hormones like cortisol, and result in a non-effective Keto diet. Therefore, it is extremely important to keep your stress at bay by adopting good habits like exercising, meditation, saying no to negativity, and changing your daily routine. Take naps more often.

  • Increase healthy fat

With a LCHF diet such as Keto, it is essential to eat the right amounts of harmless fats. Include products like cheese, tofu, vegetables, mushroom, fish, and egg, as well as fruits like avocado, oils like olive oil, coconut oil. Vegetarians can opt for vegan foods that are easily available in the market.

  •  Drink lots of water

Water is undeniably a vital element of life that supports your metabolism and helps the body function correctly. Low carbs like a Keto diet have little diuretic effect on the body. Drink enough water to keep  constipation, cravings, and dizziness at bay.

Diet chart

Start with this menu:

  • Breakfast: Eggs scrambled with sautéed onions and cheddar cheese.
  • Snack:  Vanilla Shake.
  • Lunch: Grilled chicken over baby spinach, tomato, and avocado salad.
  • Snack: 1 cup sliced red bell pepper with 2 tbsp ranch dressing.
  • Dinner: 5 oz hamburger, 1 oz pepper jack cheese, 1 small tomato, ½ Hass avocado, 2 romaine lettuce leaves.

What are you waiting for? Start a Keto diet today and give yourself a healthy and great body!

REFERENCES:  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2367001/

                          https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1819381/ 

                          https://pubmed.ncbi.nlm.nih.gov/11581442/

                          https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2633336/

                          https://pubmed.ncbi.nlm.nih.gov/17332207/


Ananya Ghoshal  loves writing about healthcare at Healthcareinsides.com and can be found on Facebook, Instagram, Twitter and Pinterest.

Disclaimer The information presented in this article is offered for educational and informational purposes only and should not be construed as personal medical advice. You should consult with your personal physician/care giver regarding your own medical care.T

 

 

Finding the Silver Lining: Stories of Strength and Struggle

As the global COVID-19 crisis has continued well beyond initial predictions and precautions, the response of the community at large, especially across the Indian diaspora, has been startling. Some have embraced the changes, calling for society to adapt and accept the circumstances as “the new normal”; others have lamented the lockdown as a pestilence to be endured. For many in the Indian community on a global level, questions and concerns about when the global pandemic will end remain unanswered.

However, some have managed to find a platform to voice their stories during these difficult days, especially through a younger audience. This has shed light on the experiences of many who have previously have encountered limited responses from peers and the wider community.

We the Young, a positive, youth-driven Indian media platform, has responded to the COVID-19 crisis by assisting young people to find the silver lining during the uncertainty of these times. As an online portal, the virtual community has developed a safe space that welcomes the voices of youth to share their story and find inspiration from others’ shared experiences. Many Indian youth have been able to voice their personal outlook on life from a mental health perspective as a way to engage with young people across the internet.

As a way to facilitate this further, this initiative also collaborates with mental health experts, advocates, and those with lived experiences to engage and explore approaches to coping with various mental health issues through their weekly initiative, the Mental Health Dost.

Udita was one such youngster who found it difficult to keep her emotions in check early on, especially when it came to her relationship. Diagnosed with clinical depression and borderline personality disorder, she found it hard to handle the pressures life threw her way, and she wished to end it all. A random Google search led her to get connected to a helpline, where she found herself pouring out her emotions to the person on the other end of the line; who gave her both the assurance and hope that she was looking for. Now with professional intervention, Udita has found help and is coping with her mental health issues. “For me, now, Udita says, “it’s one day at a time”. 

Many young people just like Udita have began to share their stories as part of the Instagram live series, #DearZindagi; which, with the help of We the Young, has been turned into a mini-documentary series which has been promoted online and has received thousands of views and responses from young people with shared experiences who also are empowered and able to share their voice as a result.

As We the Young continues its campaign to engage others, including through their social media campaign, #InItTogether, as well as their weekly live sessions with artists and advocates who share their tips during isolation, and the blog online which is updated regularly – the story continues. The voice of youth has continued to empower others to do the same, and as the platform continues to impact others, many more youngsters are inspired to join this growing community.

Commenting on the need of the hour, Charit Jaggi, the founder of We The Young said, “We need to create more platforms and safe spaces for people to come and share their vulnerabilities and problems..so many of us are battling with loneliness, anxiety, and depression alone. No one deserves to suffer alone. There is an urgent need for us to come together as a generation, right now more than ever.”

For young people across the global Indian diaspora, strength in solidarity is the best way forward.


Joseph Kolapudi is a young writer, currently serving as Editor-in-Chief for ProvokeWoke, a youth-driven, online platform. He also contributes to several print and online publications. He has been recognized as a Global Shaper by the World Economic Forum for his work locally and internationally. 

Nexts Steps to Reduce Anxiety

Are you feeling anxious during these troubled and difficult COVID times? Anxiety starts to affect our mental and physical status. We worry about our families, friends, and ourselves. What if something happens, what next? Fear, and anxiety, come from thinking of the future.

Maslow’s hierarchy of needs is a motivational theory in psychology comprising a five-tier model of human needs. In the traditional Maslow pyramid, we see that the basic physiological ( food, water, warmth, rest) and safety needs ( security, safety) are not met for many of us. Many have lost their jobs, do not have a roof over their heads, or even food to eat. This causes immense anxiety, frustration, anger, and fear. However, even for those whose primary needs are met, there is still a tremendous amount of anxiety. To help understand and cope with this feeling in these unusual times I have redefined the upper part of the pyramid.

In these uneasy COVID times, it is necessary to ease our minds. What are our emotional needs during a difficult time like this? Here is a simple diagram that helps explain it. During this time it is good to go within us.

Let’s look at this diagram. We need to accept this situation as it is. It may not be what we anticipated or wanted, but with Acceptance, it will be easier to deal with the situation, rather than fight against it. 

Routine is a sequence of actions regularly followed. In these times it would be beneficial to create a healthy routine. Pick things that you have control over and make them an integral part of your routine.  When new things show up that are not in your control, let them go, and don’t let it affect your routine. In this process of not being able to be always in control of happenings, anger, and frustration arise, which need to be slowly released. 

Would you like to connect with others? We have been asked to social distance. The effects of this have brought about sadness and a feeling of loneliness. Even though you are social distancing, you can nurture your relationships with emotional Connections. Go on, pick up the phone, and speak with a friend, text, or use social media. Share your feelings and know that you are still connected even though you are physically apart. This is not forever.

The world has slowed down so that you can discover yourself. Think about taking a pause and figuring out what is the new normal.  When you Reset, what you thought meant something important to you may have changed. What seemed normal no longer seems useful to you. 

For many of us, it is hard to concentrate on our emotional needs when we are filled with anxiety and fear.  Use these next steps to reduce your anxiety first so that you can take care of yourself and the needs within.

  1. Reduce watching and listening to negative news.
  2. Enjoy family time with a feeling of gratitude. I understand it is difficult at times being under the same roof. Cooking, cleaning, teaching kids (homeschooling), video conference meetings, loud music, dogs barking. Once this is over you will realize that this was an opportune time to bond with each other. So make it happen now.
  3. Be in the present. Anxiety, worries, and fear come from thinking of what will happen in the future. Just live for the moment as life is precious and should not be taken for granted. 
  4. I find yoga, meditation, and most of all a good night’s sleep valuable to calm my mind.  Many apps and sites offer meditation sequences. 
  5. Practice gratitude. Gratitude for being you, for having the smallest of things. Gratitude for the frontline workers, researchers and so much more. 
  6. Exercise helps release your feel-good chemicals. If you are allowed to and it is safe then, walk, run, cycle with 6-foot social distancing in a non-crowded area while wearing a mask. Come home and wash your hands. 
  7. It is time to take on a new hobby, or even learn a new language. All the things you always wanted to do but didn’t have time for. 
  8. Charity is giving. Giving makes you have a feeling of purpose and control. Donate to an organization, assist the elderly, support those who need your help. 

I keep asking myself what is troubling me. Is it the fear of my fragile life, that my loved ones or I am locked down at home? So many things keep flitting through my mind causing anxiety, but the best approach is to look at what I have and be thankful. Be in the moment. 

Geetanjali Arunkumar is a writer, artist, life coach. She is the author of ‘You Are the Cake’.

Corona Casts Dark Shadow Over Mental Health

Dr. Madhu Bhatia, a psychiatrist in Washington D.C., finished setting up her home office a few days ago, two weeks after the Metro area began to sit up and take notice of COVID 19.

“I’ve already seen an uptick in anxiety among my patients,” she says, “and now, more than ever, I need to stay in touch. I’m expecting an increase in cases, and more Post Traumatic Stress Disorder (PTSD) type symptoms.”

“This is the first time I’m practicing telepsychiatry on this scale,” she adds wryly. “It’s going to be a new experience for me and many of my colleagues – but it may be the future, for a long time.”
The suddenness and speed of COVID19’s onslaught has sent our health care and our social systems into shock. Equally important, (but in danger of being underplayed as all our attention focuses on the battle with the virus), it has been a massive, invisible shock to our collective psyche.

As we live this in real time, health professionals all over the world are getting more concerned about the long-term emotional fallout from the pandemic. The complete cessation of normal activity in lockdown, a constant ticker tape of rising numbers of those infected and dying on TV, and economic insecurity associated with the shutdown is the perfect formula for creating a sense of suppressed panic and helplessness, which, in turn, is a perfect breeding ground for anxiety disorders and depression.

We can look to China, which was ahead of the curve, for the trajectory of anxiety and anxiety related disorders. Early studies on the effect of the pandemic indicate an enormous, lingering impact on mental health. In the first few weeks of the lock down in China, there was mostly worry about contracting the virus and the safety of loved ones. As more time passed in quarantine, financial strain and more stress with family relations piled onto the general worry for safety.

In an ITV report, Dr. Peng Kaiping, the head of Psychology at Tsinghua University in Hubei province (where the epicenter, Wuhan is located), says they are now increasingly seeing symptoms of PTSD among the population.

“It’s important to remember,” says Dr. Bhatia, “that even something as innocuous as more enforced time at home with the family can become a source of great anxiety, if it isn’t handled correctly. There can be something like too much togetherness. Time has to be managed carefully, especially in families which already have underlying stresses in relationships.”
She advises setting up strict daily routines, especially if there are children at home.

“Children need the security a routine provides. However, they also need social interaction with their peers and a sudden cessation of contact with friends creates anxiety. If they are young, set up facetime playdates for them.”

“For teenagers, try to give each individual enough time on their own and permission to retreat into their own space if they want to, but designate a family time where you come together, especially for meals. Make that a pandemic free space, where things like homework or activities are discussed and optimism about the future is restored.”

“South Asian families are often not very good at expressing their feelings, and there is a sense of shame, specifically in the older generation, in admitting that they are fearful. This is a time when parents should reassure their children (and sometimes their own parents), that it’s important to talk frankly about one’s fears and be supportive of each other.”

Therapists and providers are increasingly adapting their practices to technology to get their message out.

Pallavi Surana, a resident of Herndon, Virginia, and a meditation therapist, has guided a group meditation session every Friday for the past 10 years.

With Virginia’s COVID restrictions, she has now taken it to Facetime (the group dials in from home and meditates together) and increased its frequency to an hour every day.

“Daily Meditation is more important than ever during this crisis,” she says. “We are locked in at home, with our fight or flight responses highly aroused. Calming our minds has an enormous impact on our immune systems, and doing it collectively is even more beneficial. Even a short 20-minute session has an impact.”

Alice Walton in a recent Forbes article suggested important ways to preserve sanity and maintain optimism during these trying times.

Gratitude is a therapeutic emotion. Take time to be grateful for family and friends, and for all the things which are working for you in life. In a Harvard health study, it was found that writing down even 5 things you were grateful for, just once a week, had an enormous positive effect on emotional well-being.

Exercise and meditate daily. Treat these activities as necessary, medicinal doses of stress relief and give them priority. There are several online sites offering free exercise routines and meditation. Mindfulness based stress reduction (MBSR), developed by Jon Kabat Zinnat at UMass, has been shown, through many studies, to be very effective. Several organizations now offer this online. Meditation is a proven stress buster and is especially good for our immune systems.

If you aren’t into meditation, studies have shown that just calming your breathing – taking a few minutes a day to sit quietly and breathe deeply – can greatly reduce daily stress. Simple breathing exercises, like those taught in Yoga, (check out these top rated apps), are also great at soothing the mind and producing a sense of well-being.

Your daily exercise routine should be supplemented by “quality time” outdoors. The Japanese concept of “forest bathing,” which means spending as much time in nature as possible and mentally “bathing” in its beauty, is now backed by science. Being around greenery doesn’t just calm the mind – it has a proven effect on our immune system and lowers the levels of the stress hormone, cortisol. Consider positioning your home office where you have a view of the greenery outside.

And last, but not the least, connect to friends and family daily through whatever means available. Social isolation is like a punishment for our species, because we are wired with a strong need to interact. A recent article in the Washington Post by social scientist, Arthur C. Brooks, emphasizes the importance of social interactions which allow eye contact. Looking directly into a person’s eyes while talking releases oxytocin, the pleasure hormone, and is the most beneficial for our social needs. So, choose a medium like Skype or Zoom or Face Time where you can see your friend or family.

Stay safe, dear reader, and remember to hug your family often! Human touch is a proven therapy for anxiety.

Jyoti Minocha is an DC-based educator and writer who holds a Masters in Creative Writing from Johns Hopkins, and is working on a novel about the Partition.

Edited by Meera Kymal, contributing editor at India Currents.

Building Resilience

In this fast-paced society, we are increasingly stressed for longer periods of time. Dr. Sanjay Gupta – neurosurgeon and Chief Medical Correspondent for CNN – describes an epidemic of chronic stress in the HBO documentary “One Nation Under Stress, with 8 in 10 Americans experiencing stress daily. Stanford neuroscientist Dr. Robert Sapolsky explains that while stress response originally evolved as a life-saving and coping mechanism to deal with external threats or dangers, we now generate stress responses to non-life-threatening situations including interpersonal conflict, deadlines, health concerns, jobs and finances. The United States of Stress 2019 reports that chronic stress affects people of all gender and ages, particularly younger people, exacting a stunningly toxic toll on the body, brain, mind, and soul. Its ongoing assault wears us down, measurably aging — or “weathering” — our insides, for some of us much more than others. Chronic stress zaps brainpower by damaging neural pathways and skewing judgment. It compromises the immune system. It taxes the heart, kidneys, liver, and brain. Multiple studies show that high stress adversely impacts physical and mental health leading to higher levels of chronic pain, addiction and suicide. Learning to deal with stress can be a powerful addition to our personal-wellbeing arsenal.  

The American Psychological Association defines Resilience as the process of adapting well in the face of adversity, trauma, tragedy, threats or significant sources of stress … It means “bouncing back” from difficult experiences. This article explores the relationship between stress and how your brain functions, and simple techniques to “bounce back” to – to build Resilience.  

Dr. Amit Sood tells us how. As a physician and professor of medicine at Mayo Clinic he created their Resilient Mind Program. Now executive director of the Global Center for Resiliency and Well-Being, he’s an internationally recognized expert on proven resilience techniques. “Cognitive and emotional loads we carry have increased progressively over the past two decades” he says; our brains possess a finite ability to lift these loads and get overloaded, “just as our ancestors’ backs were when manual labor was predominant.” This excessive load decreases quality of life, so we have to find ways to increase our lifting capacity if we don’t have ways to reduce it. “Resilience is our capacity – the core strength – to lift the load of life,” he says. It has several components: physical, spiritual, cognitive and emotional. Cognitive resilience relates to the amount a person can remember and handle, while emotional resilience measures the amount of negative emotion one can manage before getting stressed. Research led by Dr. Sood and several others shows that higher resilience correlates with better emotional and physical health, better relationships, success at work and the ability to handle adversity and grow despite downturns.

Our body hosts resilience in the brain and heart, our two main active organs. Heart health impacts physical resilience while cognitive, emotional and spiritual resilience are centered in the brain. “We understand how exercise, diet, sleep and sometimes medications keep the heart healthy and strong,” Dr. Sood explains, “with recent advances in neuroscience we are just learning that how the brain operates is critical to cultivating resilience.”

The evolution of the human brain has given it some operational vulnerabilities which predispose us to chronic illness and premature death. These can be traced back to the instinctive suspicion about everything around them that our ancestors developed in a quest for survival. Suspicion was their means to deploy attention, and is the genesis of our negativity bias today. Their need to constantly scan their environment for external threats has led to our wandering, jumpy attention. Although we have since collectively created a completely different world where the cause of death has shifted from external injury to heart disease and cancer, these brain vulnerabilities persist. Dr. Sood points out that while our brains tire after 90 minutes of cognitive work, we work 12-14-hour days, enabling emotional and cognitive vulnerabilities to manifest and influence our actions. “Nature gives us ‘baseline’ brains and hearts, and we have to keep ‘upgrading’ them through training,” he says, “resilience boils down to becoming aware of how our brain operates – particularly its vulnerabilities – and learning how to overcome them.”  

How can you do this? Dr. Sood has developed a structured approach in the Resilient Option. At its core is an integrated three-step process to develop awareness, attention and attitude (positive mindset). First, become aware of the brain’s vulnerabilities and take charge to train its attention and attitude. Second, develop an intentional attention that is strong, focused and immersive. Third, cultivate a resilient mindset or attitude through practices that best resonate with you such as meditation, prayer, music, or working out. This approach enables you to view your world in a broad context instead of a short-term one that could frighten or stress you. The resilient mindset is built around five guiding principles: gratitude, compassion, acceptance, meaning and forgiveness that reframe your perspective, integrating teachings of several disciplines including psychology, cosmology, spirituality to develop your unique model of self, life and fulfilment. You start by assigning one day in the week to each principle, and develop short specific practices that are emotion- and relationship-centric. Short practices are key for success – Dr. Sood refers to the ‘two-minute rule.’ We all struggle to sustain lengthy practices because of inherent weak attention and the tugs and pulls of our daily lives. In time, you integrate the three steps and five practices into your daily life, pre-emptively experience more joy by the practice of gratitude and compassion, and recover quickly from negative experiences or moments of negative emotion because you are able to more easily find gratitude or compassion through that experience and have learned to accept, find meaning and forgive. You live a life of your choosing, and are not reactive but responsive and intentional. Your energy increases and you develop better relationships. Fifteen years of research and over 30 clinical trials have proven that this approach is easy and powerful, enabling positive changes with little time investment. Find out how resilient you are.  Get your resiliency score, and start building it with these tips from Dr. Sood.

With sincere thanks to Simon Matzinger at Unsplash for the use of his beautiful photograph.

Sukham Blog – This is a monthly column focused on health and wellbeing.  

Mukund Acharya is a co-founder of Sukham, an all-volunteer non-profit organization in the Bay Area established to advocate for healthy aging within the South Asian community.  Sukham provides information, and access to resources on matters related to health and well-being, aging, life’s transitions including serious illness, palliative and hospice care, death in the family and bereavement. If you feel overcome by a crisis and are overwhelmed by Google searches, Sukham can provide curated resource help. To find out more, visit https://www.sukham.org, or contact the author at sukhaminfo@gmail.com.  

 

The Sandwich Generation

The elderly Indian man wanders through the neighborhood, talking to himself and pausing uncertainly every now and then. His clothes are soiled and his eyes are vacant. A neighbor, observing him from behind the blinds of her living room, sighs. This is the third time in 10 days that she has seen him outside, unaccompanied and obviously disoriented. The old man lives next door. His son and daughter-in-law are away at work, their children in school. The neighbor knows that no one will be around till 5:30 p.m. She reaches for the phone to call the police.

Ill and aging parents. A heartbreaking reality that most of us will have to cope with sooner or later. The inevitable reversal of roles, as the hands that once deftly buttoned our shirts and led us confidently across a crowded street, now reach out to us for help in perform­ing the basic tasks of daily living.

It is estimated by the U.S. Administration on Aging that a full 25% of all households in the country are involved in caring for a family member, usually a parent. While the number may not be quite that high in the South Asian community, it is nevertheless increasing rap­idly, as more and more families are choosing to bring aging parents and relatives from their native countries to live with them permanently.

Four generations of an Indian-American Family
Four generations of an Indian-American Family

Typically, the caregivers are adult children with kids of their own, often known in the media as the “sandwich generation”—caught between childcare and elder care. Research has shown that almost 65% of women in this country will have to deal with extensive or partial elder care issues.

 Chandra Deshmukh, a Marin County resi­dent thinks that “sandwich” is an apt descrip­tion of a person in her circumstances. “I have two little kids and a father who is often in hospital with complications from diabetes,” she says. Her father lives in Houston, Texas with her older sister, and Deshmukh has already flown to Houston three times this year to help with his care “dropping into my husband’s lap the kids, their homework, din­ner and piano lessons.” She says she has learned to live with a constant sense of guilt, feeling inadequate at work and incompetent at home. “There is this nonstop worry in my head that I am not doing enough for anyone—my kids, my husband, my employer, or my father, whom I am very close to,” she adds.

According to Rita Ghatak, a Palo Alto­ based psychologist and specialist in elder care, guilt is a very common feeling among adult caregivers. “The feeling of helplessness and guilt can be overwhelming at times and in trying to take care of everything themselves, these women, (and most of the caregiving is done by women aged 35 to 50), fail to look after their own needs,” she says. Ghatak knows, because she has been there herself. For 14 years, she was a long distance caregiver to her parents who lived in India. In that time she flew to Delhi 16 times to take care of, first, her father who suffered from Parkinson’s disease, and then her mother who suffered a stroke in 1995. “I was completely stressed out,” she remembers ‘There were times when I was so tired and worried that I could not think straight. I wanted to be in both places at the same time.”

Ghatak is also CEO of Older Adult Care Management (OACM), a private organization founded over 15 years ago, and considered a pioneer in the field of elder care. The organiza­tion provides a comprehensive care program for adults through quality home care services like trained health aides, family counseling, case management services, and elder care education. OACM has virtually no South Asian clients, because, Ghatak says, they are largely unaware of the variety of elder care resources available in the community. “It is not that they want to be ignorant, it is just that they do not know where to go for the informa­tion. Sometimes a parent’s illness catches us unawares and we are unprepared to handle it,” she says. Lack of information led to less-­than-desirable situations like the one de­scribed at the beginning of this story. In this case, the elderly man was referred by the police to the county-run Adult Protective Ser­vices. In turn, OACM was contacted and Ghatak ended up sending an information packet in the mail to the caregivers. She never heard from them but she hopes that the family was finally able to get some help and take care of their father.

When it comes to taking care of one's parents, most adult children are lost in a maze of emotional and logistical issues
When it comes to taking care of one’s parents, most adult children are lost in a maze of emotional and logistical issues

When it comes to taking care of one’s parents, most adult children are lost in a maze of emotional and logistical issues. Some dis­eases like dementia (a common form of which is Alzheimer’s disease) or Parkinson’s disease, both of which are on the rise worldwide, according to the World Health organization, make home-based caregiving especially diffi­cult. Still, how can one send a parent to an outside facility? Will that not amount to aban­donment? How would the parent take it? What about the cost: emotional and financial? Decisions like these are hard to make and even harder to justify to relatives and siblings who are watching from the outside.

Using trained help, strangely enough, is one of the last options considered by many South Asian caregivers. “It is expensive but more importantly it could be seen as pawning off your responsibilities,” remarks Deshmukh, whose has just succeeded in persuading her reluctant sister to hire a door-to-door service to take their father to the doctor for regular appointments. However, using trained help could ward off potentially dangerous situa­tions. “If I had to do it again, I would definitely use trained help,” confirms Inderpal Grewal, a full time professor and mother of two little girls living in El Cerrito. Grewal had just given birth to her second child when her mother, who suffered from acute rheumatoid arthritis came to live with them. To Grewal, it was spotting the little things that could prevent the bigger things from happening that drove her crazy. “I was always worrying about things. Are the bars in the bathroom safe? Is the house too cold? Is the bed okay?” she says. “In spite of all this my mother caught pneumonia, be­cause we had not kept the house warm enough. Old people are more fragile than they appear.” Subsequently, her mother went to live with another sibling in Connecticut where a home health aide came to look after her needs several times a week.

Taking care of a parent can create stress and awkwardness between siblings.

Rashmi Rustagi is a stay-at-home mother of four in Palo Alto. Her children range in age from 5 to 15 and take up much of her energies and time. Rustagi’s parents live with her. Last year, her mother suffered a stroke and became almost bedridden, needing con­stant care. The subject of who would be the main caregiver came up often at family dis­cussions with the other siblings. Though each of them make financial contributions towards their mother’s health care, Rustagi feels that she was chosen because “most often it is the sister who stays at home or is the wealthiest who gets to take care of the parents. The others plead work pressure, or lack of space or money.” Rustagi feels a little taken for granted because she ends up putting in so much more effort and time than her sisters and brothers do. Lately, she says, she has taken to keeping a log of the time she spends looking after her mother’s needs like taking her to doctor’s appointments, or the physical therapist. “Not the expenses, mind you, just the time,” she hastens to add. “And one of these days I am going to show it to my siblings just to let them see for themselves how much effort it takes to just keep things going.”

To many South Asians, taking care of a family member might mean flying half way around the world several times a year. As Ghatak testifies from her experience “it takes a heavy toll on your family life.” Even so, bringing the family member over to the U.S. may not be a logical solution because of the high cost of health care and the emotional cost of uprooting the person from her native cul­ture. In addition to this, says Grewal, the person often finds herself confronting a racist health care system in America, “one that believes that most immigrants are out to rip off the system.”

Pradeep Joshi, a co-founder of the Indo­American Community and Service Center (IACSC), and a commissioner serving on the Senior Care Commission of Santa Clara, agrees that seniors who come over from India have to deal with isolation and a loss of empowerment. “And without MediCal, healthcare is prohibitively expensive,” he stresses. “A recently passed immigration law states that those seniors who immigrated to the U.S. after October of 1996 are not eligible for Supplemental Security Income (SSI) or MediCal. This will definitely have a negative bearing on family decisions to bring a parent over.”

All too often, the “sandwiched” adult, torn between making time for the kids and the parent, feels like the rope in a tug-of-war game. Ghatak suggests a few simple guide­lines to make the task easier. Planning ahead is the essential key to elder care management. Confront the situation and talk about it and if the parent is capable, involve him or her in the decision. Scope out the services available in the community, clubs, recreational centers, senior centers, and groups that the parent might be interested in joining. If the parent is handicapped or suffering from a debilitating disease, look into the possibility of hiring home care aides. And above all, make time for yourself, to exercise, socialize, rest and main­tain recreational outlets. Lack of proper care of oneself might lead to stress-related illnesses like chronic headaches, ulcers and depres­sion.

With over 200,000 South Asians in the San Francisco Bay Area, it is inevitable that senior support networks are springing up within the community. Apart from sporadic activities organized by the local temples, mosques and gurudwaras, the Icse in Santa Clara runs an excellent senior program that stresses independent living. The Center hosts lecture programs, yoga classes, computer and writing courses and a variety of social activi­ties for South Asian seniors from day outings to cultural programs.

Looking after a relative or parent can be an enriching experience and the ultimate expression of love and compassion from one human being to another. Deshmukh’s children are learning this valuable truth as their mother packs her bags for yet another trip to see their grandfather. In the Rustagi household, life is just a little richer, as grandparents and chil­dren learn to share their living space and their experiences with each other. “It finally boils down to this-there really is no right or wrong way to do things. Accept your limitations and just do the best you can,” states Ghatak.