2. HOSPICE AND PALLIATIVE CARE CONFERENCE: CARING FOR THE CAREGIVER When Ways to Relax Become Too Much of a Good Thing: Medication, Alcohol, and Gambling

3. Session Objectives To identify mood altering methods of coping To determine when coping activities become addictions To map out the addiction process and its impact on caregiving and grieving To describe the process of change

4. Worden, 1991 The Tasks of Grieving To accept the reality of the loss To work through to the pain of grief To adjust to an environment in which the deceased is missing To emotionally relocate the deceased and move on with life

5. Substances/Activities that can be addictive Benzodiazepines Opiates Stimulants Hallucinogens Cannabis Non-prescription drugs Alcohol Gambling Food Exercise Work Shopping Sex Internet Etc…

6. Negative habits vs. Healthy habits Pleasure develops quickly Negative consequences appear later Self esteem and reputation suffer Narrowing of focus Impulsive problem solving Relationships suffer Eventually becomes unpleasurable Pain first Deprivation Self-esteem gradually increases Goal reached after extended period Brings balance to life Life becomes more pleasurable Leads to other positive involvements Coping skills are improved

7. Stages of Change Model Prochaska,Norcross and DiClemente 1995

8. Pre-contemplation Individuals who are pre-contemplative, have not connected problems to their use or do not realize that there are any problems. There’s no problem.

9. Contemplation Individuals who are contemplative, are aware of the connection between their behaviour and the problems it is causing, but they are not ready to make any significant changes. Yeah, maybe it’s a problem but I’m not sure I want to do anything about it.

10. Preparation The costs of using have begun to outweigh the benefits and they are now ready to make changes. It’s very important to take the time needed to make an effective realistic plan. Okay, it’s a problem and I need to do something about it now!

11. Action Individuals are eager to put their plans into action and start making changes. Get out of my way… I’m ready to put plans into action!

12. Maintenance Individuals are maintaining changes now with little effort and feel very comfortable with their new lifestyle. Wow, now that I’m making changes, I have to do a lot of things differently!

13. Termination The individual no longer needs to make a conscious effort to maintain the change. Hasta la vista baby – I won’t be back!

14. Resources Responsible Gaming Information Center Club Regent: 985-0419 & McPhillips Street Station: 985-1240 Salvation Army – Booth Center 946-9400 Self Help Communities A.A., C.A., Al-Anon, F.A., G.A., GamAnon Provincial Problem Gambling Helpline 1-800-463-1554 Addictions Foundation of Manitoba 944-6200