Caring for an elder can be stressful, trying, and time-intensive. Even strong-willed, confident, and optimistic individuals may find that elder care wears on them over time. It’s important to understand that these feelings are natural and can be overcome. You may feel overwhelmed at times, but know that help is available. If you are tasked with caring for a loved one, perhaps a parent or grandparent, these tips and techniques can help relieve any stress or anxiety you may be feeling.

1. Get organized

One way to relieve stress and anxiety is through organization. By organizing your responsibilities into manageable to-do lists, and decluttering your living environment, you can save time and energy, focus on other matters, and have a better sense of your daily tasks, among other things. To help organize your responsibilities, consider an organization app for your smartphone or tablet. Popular options include Asana and Todoist.

2. Join support groups

Major medical organizations (like MayoClinic) agree: Support groups can help people cope with stress, overcome anxiety, and deal with major life changes. If you find that caring for an elder is causing you or your family a great deal of stress, consider joining a support group of individuals going through the same experience. You may find such a group at your local hospital, a YMCA in your hometown, or through a psychiatric practice. You may also find online forums, such as, to be helpful.

3. Enlist available help

Don’t be ashamed to enlist help if you are tasked with caring for a loved one. Elder care is a tremendous responsibility that can challenge even the strong-willed among us; enlisting help will not only be beneficial for your well-being but for the person you’re caring for as well. After all, if you’re feeling depressed, anxious, stressed, or fatigued, you can’t provide the best care possible. If you have family that is willing or able to help, ask them for help. If not, consider using the government’s elder care and respite services.

4. Put technology to use

Monitoring an elder at all times can be difficult, if not impossible. So how can you be sure that your loved one is safe while you’re away? What if he or she were to fall down, or suffer some other type of accident, while you’re out of the house? For just such eventualities, you should consider a medical alert system, like the Lively Mobile by GreatCall. This device, easily worn on clothing for convenience, offers fall protection and emergency response services, in addition to GPS tracking. Should your loved one need assistance while you’re away, they can get it—without having to rely on a telephone being nearby.

5. Maintain a healthy routine

If you don’t care for yourself, how can you be expected to care for someone else? Make no mistake, elder care can be a tiring, even exhausting, especially for long periods of time. Maintaining a healthy diet and exercise routine is incredibly important for caregivers, as it will provide you with the energy and stamina needed to care for your loved one. With a diet rich in fruits, vegetables, and low-fat meats, you can give your body the fuel it needs to work at peak efficiency. And with exercise, you can build muscle and develop cardiovascular strength for all-day stamina.

6. Set aside time for you

Just as it’s important to eat healthily and exercise, it is also important to set aside time for yourself. As mentioned above, respite is a key component of elder care. After all, if you don’t receive breaks occasionally, how can you be expected to provide the best care possible? You have a life of your own, with its own responsibilities, and it’s important that you take time to tend to it. There are practical concerns that demand your attention, as well as emotional ones. Though you may feel an obligation to the loved one in your life, don’t forget that you are important, too.

7. Consider elder programs

Do a bit of research to see what elder programs are available in your area. There may be a social club for seniors, or a swim class (with assistants who can help). Or perhaps there’s a chess club or lawn bowling league that you can join. Even if your loved one is unable to participate, due to mobility concerns or other issues, he or she may still enjoy the camaraderie and social aspects. Joining an elder program can help relieve some of your responsibilities while improving your loved one’s morale and spirits at the same time.

8. Seek counsel if necessary

Finally, if you are feeling stressed out, anxious, overwhelmed, or depressed, don’t be afraid to seek counsel from a doctor, psychiatrist, life coach, or friend. Having someone to talk to can help you deal with your stress and blow off some steam. It allows you to air your concerns and troubles, rather than keep them to yourself. And there are practical benefits to counseling as well. A counselor may help you solve a problem, propose a solution for a specific concern, hold you to task, or simply provide encouragement. Don’t be too proud to seek out a therapist if you feel it may provide some benefit.

The bottom line

Caring for an elder can be hard work and stressful, but human and digital help are available to help out. You don’t have to go through it alone.

An autism service dog is a service dog trained to assist an autistic person to help them gain independence and the ability to perform activities of daily living similar to anyone else. For the most part, these dogs are trained to perform tasks similar to those of service dogs for other sensory processing disorders. Many autism service dogs are trained in guide work/obstacle avoidance (similar to a guide dog) to help the handler with visual stimuli, find specific locations to help with navigation, signal to sounds, and provide targeted deep pressure therapy.

What is autism?

Autism is a complex neurobehavioral condition that includes impairments in social interaction and developmental language and communication skills combined with rigid, repetitive behaviors. Because of the range of symptoms, this condition is now called autism spectrum disorder (ASD). It covers a large spectrum of symptoms, skills, and levels of impairment. ASD ranges in severity from a handicap that somewhat limits an otherwise normal life, to a devastating disability that may require institutional care. These disorders include autistic disorder (autism), Asperger disorder, and pervasive developmental disorder not otherwise specified. Children who have the latter two disorders have fewer and milder symptoms compared with autism.

An autism spectrum disorder affects about 1 in every 110 children in the United States, according to the Centers for Disease Control and Prevention. Studies in Europe, North America, and Asia have noted an approximate prevalence of 0.6 to more than 1%. Children with autism have trouble communicating. They have trouble understanding what other people think and feel. This makes it very hard for them to express themselves either with words or through gestures, facial expressions, and touch.

Recent studies

Dogs are man’s best friend and have also been known to be successful in helping children cope with autism. A study conducted by the Journal of Pediatric Nursing surveyed parents of children who had autism, about the children’s interactions with dogs. Nearly two-thirds of the families owned a dog. Of these, 94% said their child bonded strongly with the pet. Even in the families without dogs, 7 in 10 parents said their child enjoyed interacting with dogs. The study shows children with autism, who also had a family pet from a young age, tended to have greater social skills.

A research team in Canada measured stress hormones in children with autism and interviewed their parents about their child’s behavior before, during, and after introducing a service dog into their home. Overall, the parents in the 42 families who participated in the study reported 33 problem behaviors (e.g., tantrums, anxiety, intolerance of noise) before the dog came into the home and only 25 while the dog was in the home.

Benefits to family and child

Placing an autism service dog can be a long process. “Proper training of an autism service dog, and having the family and child bond with the service dog can take up to a year and a half to two years,” according to Golden Opportunities for Independence Head Trainer Howie Gallagher. Golden Opportunities for Independence is a non-profit that has been training service dogs since 2013. Mr. Gallagher recalled a case where a 7-year autistic child began to bond and cuddle with his new service dog. “I remember his mother crying her eyes out, her child before that wouldn’t even let her cuddle with him.

Renee Tarnutzer, who got her son an autism service dog two and a half years ago explains the benefits she has seen. “One of the things that I never expected was for the dog to also help us with teaching empathy, or understanding the ability to read social signals. For instance, we have used the dog’s body language for him to understand when the dog is happy or sad. In social situations, people do ask about the dog and it gives us an opportunity to push our son to engage in brief conversations—something he never did before.

As it relates to the overall happiness of the family, Renee couldn’t have imagined having an autism service dog making such a positive impact. “Because we had difficulties going out in public with our son, it was always tag-teaming which parent would go and which would stay. Now, it’s not uncommon to go out and about with the whole family. The dog has also helped calm our son when and if he has a meltdown in public. Even things like family gatherings are easier.

This year, the service dog accompanies her son to school for four half days and a full day of school. “Everyone knows who he is because they know he’s the kid with the dog. He feels so much more comfortable, even at school, with the dog.

Related Content:  How Pets Can Help Reduce Bullying

Final thoughts

Parents should consider their children’s sensitivities carefully when choosing a pet to ensure a good match. Bringing a dog into any family is a big step. For families of children with autism, getting a dog should be a decision that’s taken very seriously. For example, a child who is easily agitated or has sensitivities to noise may have great difficulty with an extremely active dog or one that tends to bark.

Trained service dogs can be the link between a child with autism and the world around them. Instead of stares and mutters, a service dog can alert the public that this child is a little different. By showing that interactions with other people are a positive thing, a service dog can help with the gross delays many of these children have in public or crowds. With its unconditional love and inherent patience, an autism service dog can lend far more support than any particular person or parent can offer by themselves.

This was first published on Companion Animals on 01/27/17. It has been republished here with the author’s permission.

All children play. Although you can provide them with toys, a sandbox, or figurines of their favorite cartoon characters, they really don’t need any of those things. They will play wherever they are and with whatever they have. Think, for instance, of all little kids you’ve seen stuck at an airport running around with “toys” such as an empty soda bottle or a plastic spoon. Who knew these things could be so entertaining? It turns out that this type of play, known as unstructured play, has science to support its importance in the brain development of children.

We all want to give our children the best opportunities to learn and to play. We try to make sure they have the best teachers and the best schools — if we have a choice in the matter. We enroll them in soccer, gymnastics, basketball, and other sports and try to teach them the rules and the fine points of the games. It’s only natural to try to guide them. And, that’s ok. But be sure to also allow them enough time to have playtime without guidance, rules, and structure.

The science of play

According to a scientific study, playing changes the neural connections in the front parts of children’s brains, called the prefrontal cortex. This part of the brain helps regulate emotions and aids in problem-solving and planning abilities.

This brain development is accomplished by free play, where children use their creativity and own ideas to come up with a desired game or type of play. Think back to the kid with the soda bottle. No one had to tell her how to play with it. It was the only offering the parents had, and she did all the rest.

Wrestling, making a fort, creating animals out of sticks, figuring out a game with a ball—all these activities help the brain build new circuits to aid in various social interactions and play. Children will find this type of play on their own if parents let them. Giving them the environment and opportunity is essential, but let them play on their own and in their own way.

A structure for unstructured play

Ironically, one of the best ways to induce unstructured play is the play structure. Don’t let the words mislead you. Commercial play structures provide a vehicle for creativity* but your children will do all the playing without instruction or any help from you.

Play can be a source of physical activity and development. Running, climbing, jumping, and other activities will develop strength, agility, and fine motor skills. Play structures offer attachments such as swings, slides, climbing ropes, and bridges. Usually, there is an inside of the structure that can serve as a fort or hideout conducive to social activity and development.

Children build self-confidence through play by meeting challenges from their peers or being able to traverse the horizontal ladder with only their arms or climbing the rope all the way to the top. Natural, unstructured learning will take place as games are created, modified, and played. Children will learn to share and take turns.

Socialization skills are fine-tuned as children learn to play well together, cooperate, and share. Remember some of the yard and playground games of your youth? The rules often changed to offer a new twist, or in some cases, to give scheming children a greater advantage. However, all these things need to be discussed, worked out, and implemented by the children involved.

Animals play, too

Animals are the same as children in their creative, unstructured play. Have you ever seen kittens stalk and jump on each other? Rats do the same thing: jump and pile on each other, chase one another around the cage, and wrestle for food. We often refer to our children as playing like puppies, so we know dogs offer many examples of unstructured play.

Dogs and puppies get in on whatever action there is. You may have had a good pair of shoes that served as an excellent play toy without your prior knowledge. Maybe the new pillows you bought are missing some stuffing from a past day’s play.

Play is much the same across many different species of animals. It is unstructured and looks that way, but they do follow some conventions if not rules. They don’t actually hurt each other on purpose, although it sometimes happens, just like with people. They take turns and usually involve everyone. In this way, play helps both animals and people develop social skills and create bonds among each other.

Play for success

Studies have shown children who play often are better students. An accurate prediction of academic success is how socially skilled children were in third grade. Those who played well with others and played often had a better chance to succeed academically later in school.

Traits like the ability to cooperate, to share, and to show empathy all were developed in the play environment and translated into academic success later in their schooling. Recess is being reconsidered as an educational tool now too, rather than just a break from learning.

Yes, we need balance. No one wants children playing all day, especially unsupervised. Certainly, they need to study, too, and to do their homework. Keep in mind, though, that when children play—especially in an unstructured environment—they are learning and developing many skills that will aid in their future success. Let them play, and let them tell you about how much fun they had and about the friends they have made.

*This is not a paid link, it was included because of the quality of the content.

Despite years of research, understanding contributing factors to ASD, or Autism Spectrum Disorder, is still a guessing game in many respects. Though research does suggest some avenues for lowering a child’s chances of ASD during gestation, there are no absolutes. Many factors, including genetics and environment, likely play a role in whether or not a baby is born with ASD. Genetics are certainly out of a mother’s control and so are certain environmental factors.

According to the Centers for Disease Control and Prevention, 1 in 68 school-aged children are somewhere on the autism spectrum. Many parents don’t realize their babies may have autism until around 18 months when pediatricians typically screen for it. If you are concerned because your baby isn’t hitting milestones, talk to your doctor about testing for ASD earlier.

Being proactive during your pregnancy to avoid ASD may be effective in some cases. Here are some ways that may minimize the risk of your child being born with ASD.


1. Avoid toxins

Though the research is only two years old, one study found that a mother’s exposure to certain pollutants, metals, and several kinds of pesticides increases the risks for ASD. Chemicals to avoid include some plastics, flame-retardants, and even certain cosmetics.

Check makeup labels for unfamiliar ingredients. Consider limiting canned foods, which contain aluminum, and plastic or aluminum water bottles. The blanket term “fragrance” on an ingredient label refers to a variety of substances that aren’t required to be listed individually. They can be found in everything from baby powder to laundry soap. Because some of these substances may be harmful in ways that we don’t yet understand, it might be best to use fragrance-free alternatives instead.


2. Watch medications

Women who take certain prescription drugs during their pregnancy may increase the likelihood of their children having ASD. Many studies have found connections between antidepressants, particularly SSRIs, and increased occurrences of ASD. What remains unclear is whether this is the result of the mother’s depressive disorder or the medication she takes for depression. If you are pregnant and on an antidepressant, do not discontinue taking it without first discussing the consequences with your doctor.

Valproate, a drug used to treat epilepsy, may also increase the risk of ASD, though skipping that medication can put both mother and fetus in danger. Be sure to discuss the pros and cons of each with a doctor before deciding to skip or take any prescription or over-the-counter drug.


3. Increase folic acid intake

Any woman who is actively trying to get pregnant or capable of pregnancy should be taking folic acid to prevent birth defects. Additionally, a mother’s folic acid intake may decrease the chance of her child having ASD. Pregnant women should take 400-600 mcg of folic acid daily. Increasing folic acid will also decrease the chance of a premature birth, another factor that increases ASD risks.


4. Take time between pregnancies

Women who have pregnancies between two to five years apart have the lowest chance of having a child diagnosed with autism. According to a study done in Finland by the Journal of the American Academy of Child and Adolescent Psychiatry, babies conceived less than 12 months after another birth had a 50% higher chance of being on the autism spectrum as opposed to those with larger windows between births, though the reasons are unknown.

Conversely, more than five years between pregnancies lead to a 30% higher likelihood of a child being diagnosed with ASD. One contributing factor here may be the age of the parents at conception. Older parents tend to have higher occurrences of children born with autism.


5. Practice self-care

Very premature babies have a much higher risk of autism. Though ASD is most commonly associated with genetics, new studies are finding birth and weight complications can factor into the equation as well. Doctors have been surprised at this finding, which revealed nearly 30% of children born extremely early are diagnosed with ASD. For babies who are born at term, the corresponding number is 1%.

In most situations, it’s impossible to prevent factors that contribute to preterm birth, but sometimes early labor, which accounts for 64% of preterm births, can be avoided with proper self-care. Pregnant women should eat healthily and avoid that old adage about eating for two.

Other ways to take care of yourself during pregnancy include:

  • Taking prenatal vitamins
  • Avoiding exposure to unnecessary drugs
  • Following medical guidelines for gestational diabetes tests
  • Exercising gently, under a physician’s care
  • Sleep when tired and taking breaks throughout the day


6. Be kind to yourself

Women in the U.S. are now part of a worldview that believes you can do pregnancy right, despite how individual and unique every women’s body is and how differently each responds to pregnancy. Tune out judgmental voices in your head, especially if your own mind is generating them. Such thoughts only increase stress, which can also lead to a difficult pregnancy. Being kind to yourself helps your health and the health of your baby.

The list of things to do to decrease the risk of ASD is equally good for staying proactive during your pregnancy and safeguarding your baby’s health. It’s important to remember, though, even the most careful mother can’t control everything. The majority of the time, ASD—and other birth-related issues—are not something you can plan for or prevent.

I still remember the days when my parents chose my wardrobe. They paid for my clothes and, therefore, I had to wear what they wanted. Needless to say, their selections were less than fashionable, resulting in me getting a healthy dose of teasing on the playground. This helped me learn a valuable lesson: When others get to make decisions on your behalf, it’s really hard for them to set aside their own tastes and motives. I call this the Decision Maker Bias.

Many decades later, I now find myself heavily involved in my parents’ care and often have to decide what’s best for them. Should they move into a facility or live on their own? Do they need a caregiver or perhaps even a geriatric care manager? Should they downsize or keep living in their house with a stairway? I constantly catch myself forming strong opinions on each of these topics. But after some introspection, I realize that there is a trace of my own interest in them. I genuinely want my parents to be happy, so I created a framework that helps me spot decisions where I might be affected by the Decision Maker Bias.



We often try to get our parents to move closer to ourselves, thinking that they will benefit from us being able to spend more time with them. However, we also have to consider the cultural impact on our parents’ lives. Would a culturally conservative 90-year-old from the Midwest feel at home near Berkeley, CA? Will they be able to connect with their neighbors? And will they find a local church that fits their needs? While it’s true that we might be seeing them on weekends, they may experience isolation and depression on all other days of the week. Also, their old friends and neighbors they leave behind are often restricted in their mobility, making it very hard to see each other again. When relocating an elder, we have to remember that this is more traumatic for them than we can imagine.



Safety is the cornerstone argument in almost all elder care discussions; we use it to downgrade houses, move our parents to assisted living facilities, veto long trips and outdoor activities, etc. But what we often forget is that money can buy safety—you can hire caregivers, install home safety equipment, use smart monitors, etc. In other words, the question should not be: “Is it safe?” but instead: “Can we afford to make it safe?” You won’t always be able to say yes, but be aware that being an overprotective adult child is not always in the best interest of your parents—sometimes the extra effort and cost it will take to keep them safe might be worth the happiness they’ll get out of their wishes for autonomy and independence coming true.



I don’t believe that this is happening between me and my parents, but I’ve certainly encountered it as part of my work. As caregivers and elders spend a lot of time together, inevitably, they start forming strong bonds which can make the adult children jealous. Particularly, the topic of oversharing sensitive family stories seems to come up a lot. Caregivers are in a difficult spot; as a companion, a part of their job is to be a great listener, but not all topics are good for their job security. Adult children can get suspicious that the caregivers are being nosy, and it’s hard to determine who initiates such conversations. What’s clear in those situations is that the adult children face the Decision Maker Bias: Their hurt feelings can hinder their parents’ ability to bond with their caregiver.



When encouraging my mom to be more active, I usually suggest that we go for a walk. I just love the outdoors, and it’s one of my favorite ways to bond with her. However, I recently read in the New England Journal of Medicine that dancing trumps all other recreational activities when it comes to mental acuity in aging. Well, dancing is my least favorite activity, and now I face the same dilemma that parents face when helping their kids decide which sports to pursue—should I encourage something that we’ll both enjoy? This just reminds me once again that our personal taste has a real impact on the people we care for.

Are there any other areas where you can spot the Decision Maker Bias? Leave them in the comments so that we can all be more aware, and get better at realizing our bias when we make decisions on behalf of the ones we love.

Related Content: Are Cultural Bias and Prejudice Inherited?