Tips for Talking to Children about Aurora Shooting

By David Fassler, M.D.

Parents and caretakers are faced with the challenge of discussing the recent tragic shooting in Aurora, Colorado with children. Although these may be difficult conversations, they are also important. There are no “right” or “wrong” ways to talk with children about such traumatic events. However, here are some suggestions that may be helpful:

• Create an open and supportive environment where children know they can ask questions. At the same time, it's best not to force children to talk about things unless and until they're ready. 

• Give children honest answers and information. Children will usually know, or eventually find out, if you're “making things up.” It may affect their ability to trust you or your reassurances in the future.

• Use words and concepts children can understand. Gear your explanations to the child's age, language, and developmental level.

• Be prepared to repeat information and explanations several times. Some information may be hard for them to accept or understand. Asking the same question over and over may also be a way for a child to ask for reassurance.

• Acknowledge and validate the child's thoughts, feelings, and reactions. Let them know that you think their questions and concerns are important and appropriate. 

• Remember that children tend to personalize situations. For example, they may worry about their own safety or the safety of friends when going to the movies or other public areas.

• Let children know that lots of people are helping the families affected by the recent shooting. 

• Children learn from watching their parents. They are very interested in how you respond to local and national events. They also learn from listening to your conversations with other adults.

• Don't let children watch too much television / news coverage with frightening images. The repetition of such scenes can be disturbing and confusing. 

• Children who have experienced trauma or losses in the past are particularly vulnerable to prolonged or intense reactions to news or images of violent incidents. These children may need extra support and attention.

• Children who are preoccupied with questions or concerns about safety should be evaluated by a trained and qualified mental health professional. Other signs that a child may need additional help include ongoing sleep disturbances; intrusive thoughts or worries; recurring fears about death, leaving parents, or going out to public areas. If these behaviors persist, ask your child's pediatrician, family physician, or school counselor to help arrange an appropriate referral.

• Although parents may follow the news with close scrutiny, most children just want to be children. They may not want to think about or discuss violent events.  They'd rather play ball, climb trees, or ride bikes.

A senseless, violent crime is not easy for anyone to comprehend or accept. Understandably, some young children may feel frightened or confused. As parents and caring adults, we can best help by listening and responding in an honest, consistent, and supportive manner.

Fortunately, most children -- even those exposed to trauma -- are quite resilient. However, by creating an open environment where they feel free to ask questions, we can help them cope with stressful events and experiences and reduce the risk of lasting emotional difficulties.

David Fassler, M.D., is a child and adolescent psychiatrist practicing in Burlington, Vermont.  He is also a clinical professor in the Department of Psychiatry at the University of Vermont College of Medicine.

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National Caregivers Month: Alzheimer's Disease

By Felicia Wong, MD

Alzheimer’s Disease is a progressive, irreversible brain disease. The cause is poorly understood, and there is no known cure. Symptoms of Alzheimer’s include memory loss, confusion, impaired judgment, personality changes, disorientation and loss of language skills. It is the most common form of irreversible dementia.

Watching someone you love slowly lose their memory, thinking and reasoning skills can be heartbreaking. Caring for a person with Alzheimer’s Disease is a difficult task and can become overwhelming at times. As Alzheimer’s patients gradually lose their memory and their skills , each day brings new challenges to the caregiver. This is why I wanted to recognize caregivers for Alzheimer's patients in November, which is National Family Caregivers Month and Alzheimer's Disease Awareness Month.

Over time, communication diminishes, rewards decrease, and without strong support from family, friends and the community, caregivers of Alzheimer's patients face challenges to their very own well-being. Maintaining emotional and physical fitness while providing care for a loved one with Alzheimer’s Disease is crucial. Preparing and protecting yourself, understanding your loved one’s experience, and accepting help from others can reduce the stress associated with care-giving, and maximize the joys of being there for a loved one.

Here is a link to tips to help caregivers of loved ones with Alzheimer’s cope.

Additional support for Alzheimer’s and Dementia Caregivers, including warning signs of caregiver burnout, and tips on how to plan your own self care can be found on Helpguide.

Find additional information on Alzheimer's and other issues affecting mental health in seniors on the American Psychiatric Association's Healthy Minds website.
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National Family Caregivers Month: Self-Care for Caregivers

By Felicia Wong, MD

I love helping others. That is why I became a doctor, and why I love my job as a psychiatrist. But when I was a pre-medical student in college, my mom shared the following words of wisdom with me:  “In order to take care of others, you need to take care of yourself first.”

It took me a moment to understand the importance of the point she was making. I had taken a break from my community service projects due to a sports injury, and was eager to return to them. However, at that time, I was not fully recovered and was often in pain, and would tire easily. My mom encouraged me to take some more time off in order to focus on my own recovery and healing. Initially, I felt guilty taking the time out for myself. But in the end, I realized mom was right. Once I became strong and well again, I had so much more to offer to others.

Caregivers tend to be selfless, and expect a lot of themselves without recognizing their own need for self-care. Studies have found that caregivers have higher levels of depression and stress than non-caregivers. Sometimes caregivers are so committed to helping others that they forget to take care of themselves. They fail to recognize that if they drive themselves to exhaustion or sickness, they may not be able to help at all.

Warning signs of caregiver burnout from the non-profit Helpguide.org include:

• You have much less energy than you used to
• It seems like you catch every cold or flu that’s going around
• You’re constantly exhausted, even after sleeping or taking a break
• You neglect your own needs, either because you’re too busy or you don’t care anymore
• Your life revolves around caregiving, but it gives you little satisfaction
• You have trouble relaxing, even when help is available
• You’re increasingly impatient and irritable with the person you’re caring for
• You feel overwhelmed, helpless, and hopeless

Key strategies to prevent burnout include getting the help you need, seeking emotional support, and taking time out to care for yourself.

• Learn and use stress-reduction techniques.
• Attend to your own healthcare needs.
• Get proper rest and nutrition.
• Exercise regularly.
• Take time off without feeling guilty.
• Participate in pleasant, nurturing activities.
• Seek and accept the support of others.
• Seek supportive counseling when you need it, or talk to a trusted counselor or friend.
• Identify and acknowledge your feelings.
• Change the negative ways you view situations.
• Set goals.

For additional strategies for self-care for caregivers, visit the Family Caregiver Alliance, and watch for my next post on caring for someone with Alzheimer's. 

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National Family Caregivers Month

By Gariane Gunter, M.D.

November is National Family Caregivers Month and what a worthy group to stop and recognize. Those who are caregivers for family members or friends with mental illnesses need support and encouragement just as those caring for loved ones with other illnesses. There are many groups and resources available across the nation that are available to help. I would like to tell you about one of them.

The National Alliance on Mental Illness is a grassroots organization that was started in 1979. I have had the wonderful opportunity to work with them in my area and have seen firsthand the difference they make in the lives of those suffering from mental illnesses as well as their families. One special program they offer for family members is called Family-to-Family. The NAMI Family-to-Family Education Program is a free 12-week course for family caregivers of individuals with severe brain disorders (mental illnesses). NAMI recognizes that family members of people with serious mental illnesses need information and support to cope with the considerable stresses they experience.

The Family to Family Education Program is a structured, peer-led, 12-week information and support self-help class for such individuals. Research shows reduced subjective burden and increased empowerment among graduates. Family-to-Family classes are offered in hundreds of communities across the country. You can find more information on this program as well as many other resources available in your area by visiting NAMI online at www.nami.org. There you can find a support group, connect online in NAMI's discussion groups, contact your state or local NAMI and more. Caregivers please take the time to take care of you this month.
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