ADLs

Taking pills when it’s difficult to do so

arrowhearts said to realsocialskills:
I was wondering if you knew of any tips or resources for taking (pill-based) medications daily when for a variety of reasons (anxiety, forgetfulness, bad taste, fear, etc) it is difficult to do so? Also thank you so much for the time and thought you have put into this blog! It has been very useful and informative to me!

realsocialskills said:

There are some potentially useful reminder/tracking apps for iOS, Android, and Apple Watch:

  • Mango Health, which is gamification-based and offers rewards/badges for taking your pills every day. (It’s not very flexible.) It also has notifications and reminders.
  • (If you like gamification, HabitRPG may also be helpful).
  • Medisafe, which is in no way gamified and isn’t trying to make you have fun or like anything. It’s just an app that tracks medications, gives reminders, and has a few other features. 

Getting help remembering from someone else:

  • Some people find it helpful to have someone remind them to take pills.
  • Or ask them whether they’ve taken a pill.
  • Or to bring them the pills.
  • (Both medication apps allow you to link another person to your pill-taking records, if you want to.)
  • This can also backfire, and isn’t the right option for everyone.
  • (One way it can backfire is that if you ask people for help remembering, they may think that it’s their job to *make* you take it, whether you want to or not.)
  • (Needing help with the logistics of pill-taking doesn’t mean that you need someone else to take over your medical decisions, but a lot of people think it does).
  • Some people also find that their anxiety skyrockets when others pay attention to their pill-taking.
  • Sometimes this is less of a problem if it’s mutual (where you remind someone about their pills, and they remind you about yours.)

Help can also be more occasional:

  • Some people need occasional help figuring out the logistics, or overcoming anxiety or other barriers. It can help to have people you can ask for occasional help, along the lines of:
  • “I need to take my pill, but I need to eat before I can take it, and I have no food. Can you help me figure out how to eat?”
  • “I can’t make myself take my pill, can you tell me to go do it?”
  • “Can you remind me that it’s ok to take pills and that I’m not being lazy or something?”
  • “I’m having trouble with the pharmacy’s online refill system, do you know how it works?” 
  • tl;dr: Needing help doesn’t mean needing others to take over, and it doesn’t necessarily mean needing supervision or ongoing daily assistance. 

If the problem is that the pills taste disgusting or are hard to swallow:

  • Sometimes this is a problem that goes away over time.
  • Sometimes if you keep tasting a particular taste regularly, it become less disgusting.
  • Similarly, many people who initially find swallowing pills difficult find it much easier as they get more practice.
  • You can also put the pill in a spoon of something like applesauce, yogurt, or pudding. That can mean that you taste and feel the pudding and not the pill, which can make swallowing easier for some people.
  • Some people find it helpful to chase pills with a liquid they like.
  • (A caveat about that:
  • If  the taste/sensation makes you feel sick to your stomach or like you’re going to throw up, it may not be a good idea to drink/eat something you really like right after. 
  • Because you can end up associating that feeling with the thing you like, and then develop an aversion to that too.
  • But if the nasty-tasty pills *don’t* make you feel sick, washing the taste away with something you do like can work really well.)

If the problem is irrational or mostly-irrational anxiety:

  • Reminding yourself that the anxiety is irrational can help.
  • Reminding yourself what the pill does and why you want to take it can also help.
  • And once you get used to taking the pills regularly, the anxiety may go away.
  • Some people find it helpful to think things like “This is scary, but I can do it, and it won’t always be this scary.”
  • One reason that taking pills can be scary is that it can be an unpleasant reminder that you need the pills. 
  • If that’s a barrier, it might help to remind yourself that you need the pills whether you take them or not. 
  • Or you might know that it causes side effects you hate.
  • It also might help to complain about this to yourself, along the lines of “I really !#$!$# hate having to take this pill”.
  • (Having to take pills can suck, and it’s ok to have feelings about it.)

If the issue is reluctance or reservations about the pills:

  • I’m somewhat uneasy about mentioning this, because logistical difficulty is often dismissed as unwillingness to take pills.
  • That said — sometimes the problem really is that someone is trying to force themself to take pills that they don’t really want to take.
  • Everything is harder when you don’t want to do it.
  • There are all kinds of reasons that people might not want to take medication. (Some good reasons, some bad reasons).
  • Eg: Some people feel ashamed of needing medication, or feel like they should be able to somehow will themselves to not need it.
  • Eg: Sometimes the side effects really suck. Sometimes side effects mean that a given treatment needs to be reconsidered.
  • Eg: Sometimes people take pills that don’t seem to be working, and that can be demoralizing.
  • Eg: Sometimes people are misdiagnosed, and prescribed medication that isn’t appropriate, (or suspect that they were misdiagnosed).
  • Eg: Sometimes things that seem like a good idea in the doctor’s office don’t seem like a good idea in day-to-day life.
  • Eg: Sometimes when people have been taking a pill for a while, they forget what it was like without the pill — but keep noticing the side effects. This can make it hard to feel that the pill is still worthwhile.
  • Eg: Sometimes people come under intense pressure from others to believe that a particular pill will fix things. This can get complicated if the pill isn’t actually the right solution.
  • (And there are any number of other reasons).
  • Sometimes the solution to this is changing your attitude towards your medication, and sometimes the solution to this is changing your treatment plan. (And sometimes it’s a combination of both). 
  • So it might be worth asking yourself: How do you feel about taking this medication, Is this a pill you want to take?
  • Why are you taking it? Why was it prescribed? Do you agree with the reasons?
  • Are you having side effects that suck? Are you questioning whether the side effects are worth it? 
  • Is there another option you want to consider, or does this seem like the best choice for now?
  • If you really are reluctant, err on the side of taking that seriously. You may have a good reason, and it may lead to needed changes.
  • If you think about it and decide that your reluctance is irrational, that can also be very helpful.
  • Either way, if the problem is reluctance, thinking through things and getting to a point where you feel confident that you’re making the right choice can help a lot.
  • *All that said*, it’s important to remember that taking pills can be hard for all kinds of different reasons.
  • Some reasons it can be hard to take pills have absolutely nothing to do with how you feel about them. 
  • Wanting to take pills doesn’t always make it possible to take pills.

Sometimes pills are easier to take if you associate them with an action you do every day rather than with a time. Eg:

  • If “take nighttime pill at 11pm” doesn’t work, “take nighttime pill when I brush my teeth” might.
  • If “take morning pill at 8am” doesn’t work, “take morning pill after I eat breakfast” or “take morning pill when I get into my car/bus to go to work/school” might work.
  • Or “I’ll take my pills when my kids come home from school and I’ve given them theirs”.

Sometimes changing where/how your pills are stored can make a big difference, for instance:

  • Keeping pills in the medicine cabinet can make it easier to take them when you brush your teeth
  • Keeping pills next to your bed can make it easier to take them when you get up and/or when you go to bed
  • If you frequently forget to take your medication, keeping some in your purse/ backpack/etc can make it easier to take it once you realize you forgot.
  • If you need to take medication when you eat, keeping the pills near your food might help.
  • Some people find pill sorters really helpful. They’re clear box-things with a box for each day, and at the beginning of each week you put a week’s worth of pills in them. This can also be a way to tell whether you’ve taken a given dose or not.
  • Sometimes you can get pills packed in blister packs, with a compartment for each day. 
  • (Birth controls are usually packed this way, and some pharmacies can pack any kind of pill this way).

If part of the issue is privacy:

  • Sometimes not wanting other people to know can complicate taking medication.
  • This is a common issue for birth control pills — and there are cases you can get for birth control packs that look like little makeup cases. (So you could keep it in your purse and it would just look like you have makeup).
  • (If you’re in a situation in which it’s unsafe for others to know that you’re using contraception, birth control pills may not be the best option. An IUD or Depo-Provera shots might be better. Planned Parenthood can help you consider options.). 
  • Similarly, it might help to keep pill bottles inside little containers that don’t look like pill things (eg: Claire’s has coin purses that are a good size for this).
  • Or to get a lockable toolbox and keep the key on your keychain.
  • Or to keep pills in your gym back if you have one — most people are going to assume there are gross sweaty clothes in there and be reluctant to look.
  • If you’re in college and don’t want your roommate to know about your pills, it might work to keep your pills with your shower stuff, and take them when you shower.
  • Or to keep pills in your backpack, go to the bathroom after class, and then take the pills there

If part of the issue is that they’re hard to afford:

  • If you’re taking a name-brand drug, look online for a coupon. A lot of companies offer them.
  • If you’re taking something insurance isn’t covering, GoodRx can often save you a LOT of money. (It tells you about coupons, and shows you which pharmacy near you has the lowest price.)

Anyone else want to weigh in? What are some strategies you know of for dealing with pills?

Shower prompts?

Anonymous asked:

Do you or your followers have any advice for focusing in the shower? Or for a good blog to ask this question? My mental illness makes it hard, so a 10 min shower sometimes takes me more like 40 min. Then I feel exhausted afterward. I’ve found lots of techniques to focus in other situations, but for some reason the internet seems to have no advice on this. It’s hard to use post-it notes or affordable electronics in a wet space.

realsocialskills said:

If notes or visual symbols work for you, there are options for using them in a shower. hygiene 

If it’s your shower, the right way to do it might be to write the steps on the shower wall. You can do this with a bath crayon. (It’s also possible to wash off the bath crayon after, but it might not be a good idea to count on being able to do that without getting distracted.)

You could also write instructions on a shower curtain.

You could also try bath stickers. Baths stickers are these plastic things for kids that stick the walls while they’re wet. You could look around for what kinds there are, and see if there are some that might work as prompts. 

You can also make a laminated note sheet that tells you the steps. Which you could hold in your hand attach to the wall with a suction cup. You can make your own and laminate it. (There are also a lot of activities of daily living sheets on Pintrest; but they’re mostly created by parents and therapists and may or may not meet your needs). Stores like Office Depot and copy shops usually have laminators. You can also use a page protector and tape. That doesn’t work as well. 

If you use timers to help you notice the passage of time, an hourglass sand timer might be a good solution. There are some with suction cups, so you could get one of those and put it at eye level in a place where you will notice it.

In terms of higher tech solutions, there are also shower lights you can install that change color over time. 

You also might try audio prompts. If you have a way of making your phone loud enough to hear in the shower, you could try recording yourself describing the showering process then following your instructions. You could also try putting on a song that you know has a specific length in order to help yourself keep track of time.

Anyone else want to weigh in? What have you found helps you keep focused in the shower?

Showering

anonymous asked:
do you have any tips on personal hygiene/showers for someone with both chronic pain/mobility issues and severe depression? often i shower the very least i can and still get away with it, it’s disgusting how long i’ve gone without showers just spotwashing in the sink and applying deodorant etc. i don’t understand what makes showers appealing to other people. all they do is put me in pain and take an immense amount of energy out of my day. this might be out of the reach of your blog though, sorry.
 

realsocialskills said:

I’m posting this mostly because I think many of y'all probably have advice on this.

A couple of things I can think of to suggest:

Is your soap hurting you?

  • For some people, certain kinds of soap and shampoo hurt
  • If you find showering painful and you’ve only tried one kind of soap, it might be worth trying another kind.

Is showering exhausting because standing is painful?

  • If so, using a shower chair might help
  • Or, if you have a tub, maybe sitting in the tub and using one of those flexible shower heads would work?

I don’t really know. Have any of y'all found solutions that make showering work for you, or that allow you to be clean without showering?

comfort in a new flat

Anonymous asked realsocialskills:

This may be a strange question and isn’t really related to social skills, so I apologize if it’s a wrong place to ask. I’m autistic and recently I moved flats. I lived in the old one for 15 years. No matter how much I try, I don’t feel at home in my new flat. I can’t relax, it doesn’t feel like my safe place. I feel alien and it makes me stressed and tired. Do you (or your followers) have any idea what I can try to do to get used to it? It’s a new place, new furniture, and nothing feels right.

realsocialskills said: 

 It might be a matter of time. If you wait long enough, things might start seeming more familiar.

 But in the mean time: I wonder if it would help to do some really familiar things? 

  • Like, do you have a go-to TV show that you’ve watched over and over? Or a book you’ve read a zillion times? 
  • Reading/watching that a whole bunch of times in your new place might help it to feel comfortable and familiar. 
  •  Are there foods that smell or taste like comfort to you? 
  • Like, do you like the smell of cookies baking? Did you bake in your old place? If so, baking here might help too.
  •  Or ordering a kind of food you ordered a lot. 
  • Are there stim toys or blocks or anything that feel comforting and familiar to you? If so, using them might help.  (I never really feel at home in a new place until I’ve made a pattern with my pattern blocks.) 
  •  Do you have the same blankets you used to have? If not, it might help to get some that are similar.

 Also, it’s worth checking around your place to see whether something is actually bothering you. It might feel like unfamiliarity when it’s actually that you’re physically uncomfortable, for instance:

  • Are the lightbulbs in your new place bothering you? Some people find florescent bulbs intolerable. If your old place had incandescent bulbs and your new place has CFLs, changing the lights might help.
  • How is the temperature? If the air is uncomfortable, you won’t feel as good in a place. Turning the temperature up or down, or getting a fan, might help.
  • Are there noises that bother you? Or is it too quiet? If so, wearing headphones or turning on background noise that you like (music, white noise, TV, etc) might make you more comfortable

 

When food is too hard (my reply to an objection)

Content warning: This post is my reply to someone who reblogged calling some of my low-spoons food strategies lazy and unhealthy. Some of y'all might be better off skipping this one.

watsonly:

realsocialskills:

Anonymous asked realsocialskills:

Related to the remembering food exists thing, do you have any advice for what to do when your depression is making preparing food seem so hard that you’d nearly prefer to just go hungry?

A couple of suggestions:

Order a pizza, or some other form of food that gets delivered to you

  • Hunger feeds on itself and makes everything harder
  • If you’re in a state of mind where preparing food seems too difficult to be bearable, ordering food can often break that cycle
  • So can getting takeout or going to McDonalds
  • This is not a frivolous expense
  • And it’s not necessarily more expensive than preparing your own food. McDonalds has a dollar menu.
  • When you’re starving from not eating, it is not the time to worry about health food. Making sure that you eat comes first. Eating anything (that you’re not allergic to) is healthier than regularly going hungry because you can’t bring yourself to eat.

Keep stuff around that’s easy to eat and doesn’t require any preparation or only need to be microwaved, for instance:

  • A box of cereal
  • Chocolate
  • Granola bars
  • Ice cream
  • Popsickles
  • Protein shakes
  • Rice cakes
  • Peanut butter
  • TV dinners
  • Frozen chicken nuggets
  • It can also help to keep around disposable plates and utensils so the thought of having to wash dishes doesn’t deter you from eating

Get someone else to tell you that you need to eat:

  • Sometimes it’s easier to remember that eating is important if someone else tells you
  • For instance, if you text a friend saying “remind me that I need to eat” and they do, that can sometimes make it more possible

Get someone else to talk you through the steps of making food:

  • If there’s someone you can ask how to find/make food, that can be helpful
  • Sometimes what’s really exhausting is not so much doing the steps, as it is anticipating them, or figuring out what they are
  • If someone can help you through that, it can make it much more possible

watsonly said:

okay, this is a really good post but i do think someone should mention that defaulting to eating chocolate, ice cream, and tv dinners is really unhealthy and will probably only make you feel worse in the long run. i don’t know about you guys but eating a bag of chips feelings great in the moment but then 30 minutes later i just feel worse than before

so i give you a list of super fast and easy snacks that are inexpensive, yummy, and best of all will make you feel great (◕‿◕✿)

  • cucumbers. seriously, just cucumbers. maybe some salt on top
  • rice crackers oh my god they are so cheap and mmmmmm
  • apples, peaches, pears, grapes, any fruit really :)
  • plain yogurt with some warm honey drizzled on top
  • flavoured yogurt + granola
  • SMOOTHIES MAN LIKE RLY JUST BLEND UP SOME BANANA’S, YOGURT, COCOA POWDER AND JUICE AND YOU’VE OPENED A FUCKING BOOSTER JUICE
  • toast. everyone likes toast.
  • chickpeas! yeah, those weird things you always pass in the supermarket. mix ‘em up with whatever diced veggies you have in the fridge and put a splash of olive oil on top ;)
  • NACHOS. IT IS SO DARN EASY TO MAKE NACHOS. SERIOUSLY. DO IT. (tortilla chips + salsa + cheese + oven + 3 minutes)
  • some lovely campbells soup with soda crackers ^.^
  • eggs! fry ‘em, boil ‘em, mix em with some cheese and omelette them!
  • really just eat whatever makes you feel happy and healthy yo <33

oh, also, let’s not engage in any of this paper plate crap - WASH THOSE DISHES! seriously. rinse out your plate/bowl/cutlery when you’re done eating and do it later if you like. bUT DONT MAKE BEING LAZY AND ACCESSIBLE OPTION. PUT ON SOME MUSIC IF YOU LIKE. DANCE AROUND. USE WAY TOO MUCH SOAP SO THE WHOLE KITCHEN SMELLS LIKE SUNLIGHT. PRETEND YOU’RE ON A COOKING SHOW. DO WHATEVER YOU NEED TO DO, JUST HAVE FUN WITH IT!

FOOD IS DELICIOUS AND AMAZING AND SOMEONE EVERYONE SHOULD WANT TO ENJOY, AND SITTING AROUND EATING JUNK FOOD ALL DAY IS NOT THE WAY TO GO ABOUT DOING THAT! 

realsocialskills said:

There are some major problems with your advice. My post was for people who have trouble eating because the food logistics are very difficult for them. The problem here isn’t how to do what’s nutritionally ideal. The problem is how to make sure you eat and don’t starve, even when you’re so low on spoons that the thought of eating makes you want to cry.

Enjoying food is great. But avoiding starvation is more important. So is eating regularly enough to avoid cognitive side effects of hunger.

Most things that you have suggested are not viable for people who are having this degree of trouble eating. Here are some reasons:

Low calorie snacks are not a good solution for people who are having trouble eating enough food:

  • Defaulting to low-calorie foods is a great strategy for people who compulsively overeat and consume too many calories
  • But people who have trouble eating have the opposite problem.
  • What’s a healthy food choice depends on what your needs are
  • People who find it so difficult to eat that they’d often rather go hungry need strategies for making sure they get enough calories
  • For people who have that problem, defaulting to low calorie foods can actually be dangerous
  • Ice cream contains a lot more nutritionally essential things than cucumbers and rice cakes do

In a similar way, many of your suggestions are too difficult/exhausting/complicated for people who have this problem:

  • A lot of your suggestions call for fresh perishable ingredients. In order to eat that way, people have to be either capable of keeping ingredients around, or capable of going out and getting the ingredients whenever they need to eat. That’s often not possible.
  • Using a blender to blend something takes a lot of steps. And then you have to clean the blender, or it will make your kitchen disgusting. That can be a major deterrent to eating.
  • This is also true of making omelets and other things that require cooking. You have to have the energy and executive functioning to cook safely, and then you have to wash the pans.
  • Drizzling warm honey on top of yogurt is only viable for people who can heat honey and put it on something without making an exhausting mess.
  • Putting something in the oven and keeping track of it for three minutes *and successfully cleaning it up afterwards* isn’t easy or possible for everyone.

Some of your suggestions don’t actually make nutritional sense for anyone:

  • TV dinners are expensive, but they’re not necessarily unhealthy.
  • A lot of them are way more nutritionally balanced than a plate of nachos
  • And just about any TV dinner is better for most people than eating nothing but fruit and cucumbers

Paper plates and other disposables are necessary and important for some people:

  • Disability is a real thing
  • Not everyone can handle washing dishes
  • Trying to wash dishes can seriously damage some people’s health
  • Because it can deter them from eating to the point that they become malnourished
  • And it can also make it impossible for some people to maintain a sanitary living environment
  • Calling people who have this problem lazy doesn’t make the problem go away
  • But using disposable dishes does, for some people
  • People with disabilities have the right to eat and living in sanitary conditions

Fun and a light hearted positive attitude do not actually generate spoons or solve sensory problems:

  • If people are too exhausted to move and can barely handle getting up to make a sandwich, no amount of music is going to make it possible for them to wash dishes or make nachos
  • If the texture of water and dish soap makes someone want to scream, no amount of pretending to be on a cooking show is going to stop having to wash dishes from deterring them from eating
  • If someone finds almost all food unbearably repulsive, having an attitude that food is meant to be enjoyed is not going give them the ability to eat. Having access to the things they *do* find reliably edible will.
  • Sometimes people have good reasons for needing certain things to be really, really easy. That doesn’t mean they’re bad people. It just means they need to find easy ways to do things.

If you don’t have this level of difficulty with food, and you can handle eating more complicated and difficult things regularly, that’s great. But I wrote this post for people who need food to be as easy as possible so that they are actually able to eat it.

When food is too hard

Related to the remembering food exists thing, do you have any advice for what to do when your depression is making preparing food seem so hard that you’d nearly prefer to just go hungry?

 

A couple of suggestions:

Order a pizza, or some other form of food that gets delivered to you

  • Hunger feeds on itself and makes everything harder
  • If you’re in a state of mind where preparing food seems too difficult to be bearable, ordering food can often break that cycle
  • So can getting takeout or going to McDonalds
  • This is not a frivolous expense
  • And it’s not necessarily more expensive than preparing your own food. McDonalds has a dollar menu.
  • When you’re starving from not eating, it is not the time to worry about health food. Making sure that you eat comes first. Eating anything (that you’re not allergic to) is healthier than regularly going hungry because you can’t bring yourself to eat.

Keep stuff around that’s easy to eat and doesn’t require any preparation or only need to be microwaved, for instance:

  • A box of cereal
  • Chocolate
  • Granola bars
  • Ice cream
  • Popsickles
  • Protein shakes
  • Rice cakes
  • Peanut butter
  • TV dinners
  • Frozen chicken nuggets
  • It can also help to keep around disposable plates and utensils so the thought of having to wash dishes doesn’t deter you from eating

Get someone else to tell you that you need to eat:

  • Sometimes it’s easier to remember that eating is important if someone else tells you
  • For instance, if you text a friend saying “remind me that I need to eat” and they do, that can sometimes make it more possible

Get someone else to talk you through the steps of making food:

  • If there’s someone you can ask how to find/make food, that can be helpful
  • Sometimes what’s really exhausting is not so much doing the steps, as it is anticipating them, or figuring out what they are
  • If someone can help you through that, it can make it much more possible

remembering that food exists

It can be hard to remember that food exists, or notice it while it’s there.

I know a few things that work for some people to mitigate this problem:

For some people, cooking for other people regularly makes it easier to notice that food exists:

  • Sometimes remembering to cook for other people works as a reminder that you need to cook and eat
  • Sometimes the motor/sensory/tactile experience can make it easier to remember that you have food
  • Because for some people, motor memory works better than visual memory

For some people, asking other people for direct help is useful:

  • If you feel like you need to eat, asking a friend to tell you to eat might help
  • Or asking them what you should eat
  • Or how to find the food
  • Some people who can’t figure out food for themselves, *can* tell other people how to find food
  • So if you and a friend both have this problem, you might still be able to help one another

Stashing food in places where you’ll see it can also help:

  • Keeping a box of cheerios or granola bars or something else that lasts a while by your computer might work as a reminder that food exists

These are strategies I know about. Do any of y'all know about others?