STACY PHILLIPS: Good morning. And welcome, everyone. My name is Stacy Phillips. I am the project coordinator of educational leadership development. Thank you for joining us today for our Families First training series. Today's session is Entitled Filling Your Cup: A Holistic Approach to Caring for Yourself While Caring for your Children with Disabilities. Families First is a Philadelphia interagency coordinating council activity, which is funded by Philadelphia's Department of Behavioral Health and Intellectual Disability Services and Elwyn Learning Services. 

Today, I have the great pleasure of introducing Raquel Mangual who is our research project manager at the Institute on Disabilities and holds a master's in social work. So I am going to turn it over to Raquel. She will share her slides. And thank you for being here today. 

RAQUEL MANGUAL: Thank you so much, Stacy. Good morning, everybody. My name is Raquel Mangual. And I'm going to be sharing a presentation with you all today. And hopefully, something that you hear or find here might be helpful to you today or someone you know. So I'm going to start sharing my screen and my slides. OK. So today's presentation, Filling your Cup: A Holistic Approach to Caring for Yourself While Caring for Children with Disabilities. 

Just going to give a bit of the agenda and then a brief introduction. So today, we're going to discuss the eight dimensions of wellness and holistic approaches, self-care, building community, seeking out support, some suggestions for surviving the holidays, and tying that all together. And then we'll have time for questions and answers, Q&A part of the presentation. So like I mentioned, my name is Raquel Mangual. 

I am a social worker by training. I worked in direct supports and supports coordination for people with intellectual disabilities and their families for several years. Prior to that, I worked in behavioral health, supporting people who are experiencing substance use. I have a master's degree in social work that I received from Temple University. Honored to say, I am a sibling of a person with a disability. 

My brother has an intellectual disability. I was previously his long-term caregiver after our parents passed away. And while he does not live with me currently, we are a big part of each other's lives. Now I do research at the Institute on Disabilities, but social work remains a very important part of my life. Fun fact. In my free time, I'm an artist. And last year, I became a mother. So you'll see on the slide a couple images of my little one. 

I dressed him up as Gizmo for Halloween. That photo is a picture of me and my brother. And then the other is a symbol of Temple's logo. And then the last one is a photo of a watercolor painting I did. So today, I'm going to talk a little bit about the Eight Dimensions of Wellness. Some of you might already be familiar with this. And if you're not, that's OK because we're going to dive a little further into that. 

So the Eight Dimensions of Wellness were developed by SAMHSA, which is the Substance Abuse Mental Health Services Administration. The Eight Dimensions of Wellness include emotional, social, physical, spiritual, intellectual, occupational, environmental, and financial wellness, which represents the interconnected aspects of life that contribute to overall health. 

It's particularly focused on people's behavioral health needs and how they relate to finding fulfillment and purpose in life and building healthy habits across all the areas in life. This is a holistic model that aims to build a healthier and happy life, which can support improving each dimension that was mentioned from stress coping, which relates to the emotional dimension, finding meaning in life, which relates to spiritual, and managing finances, which relates to the financial dimension. 

So you might wonder, why do these matter and why are they important. So these dimensions highlight that wellness isn't just about physical health. A problem in one area, like being stressed about money and finances or being unhappy with your occupation can affect other aspects of your life. And this framework emphasizes a holistic approach to well-being, so looking at the bigger picture and all the areas that encompass us as individuals. 

So just to expand a little bit on what each dimension looks like, emotional wellness relates to how we cope with life and manage feelings, self-acceptance, and building satisfying relationships. Social wellness refers to how we develop connections, how we have and develop a sense of belonging and foster a strong support system. Physical wellness relates to recognizing the need for things like exercise, nutrition, sleep, and overall physical care. 

Spiritual wellness relates to finding purpose and meaning in life and integrating some of the values that we have from those things with action. And people often form this and sustain this by practices like prayer, meditation, or even just being out in nature. Intellectual wellness refers to engaging in creative abilities, expanding knowledge, and finding stimulating mental activities. 

Occupational wellness has to do with achieving personal satisfaction, enrichment, and balance from work or chosen activities as it relates to occupation. Environmental wellness relates to creating or occupying a pleasant, safe, and stimulating surrounding that supports well-being, which could be inside of your home, where you live. 

And financial wellness is feeling satisfied with current and future financial situations and how you can be supported to manage finances in a way that's supportive to you and your family's life. So what is a holistic approach? A holistic approach views people as complex and interconnected systems. 

And this viewpoint, addresses both the biopsychosocial and spiritual needs, environment of the person, like family, community, and even at a larger, more macro social work level, things like policy for comprehensive well-being. So it can address the factors that contribute to isolated problems and not just addressing the problems itself solely. And this is a big part of social work. 

And this is one of the reasons why social work is-- I'm so passionate about it, because micro or clinical social work helps us address maybe some isolated personal challenges that we might have in life. They call it meso, like the middle ground of where we can address things within the family structure or larger groups. And then macro social work has to do with larger systems. 

So that can be done through research and policy, advocacy and at the level of larger structures like community and government. So the holistic view helps recognize that people are multifaceted and want multiple approaches to meet our needs and wants in life. One size fits all approaches are not very helpful or sustainable often for people. 

And parents and caregivers tend to just be seen in that specific role in their life and not really acknowledged for all the other roles that they have in their life and aspects of their identity. So a holistic approach really supports caregivers in a sustainable way, so that they can meet responsibilities that they have as a part of that part of their life, whether you're a parent, grandparent, or just a caregiver of a person who has a disability. 

And all of this supports us while we try to meet these responsibilities and needs of others to maintain our own well-being. So many of us might be familiar with the phrase, you can't pour from an empty cup. And there's several aspects to that phrase that sometimes aren't very clear or maybe get misconstrued because of that. So breaking that phrase down, the cup refers to personal capacity. 

So that is like the person's total energy that they have, emotional resources that they can share with others, being emotionally present, tending to the needs of others and overall well-being. The pouring aspect refers to giving or caring. And that's not just like giving of resources, but giving of time, energy, and support to other people. And this can be in a professional capacity, like for someone who's a therapist or a social worker, a person in the medical field or on a personal level with family and friends. 

And the empty state that the phrase refers to is when a person consistently gives without replenishing their own resources. So then their own cup, so to speak, becomes empty, which can lead to burnout, and resentment, anxiety, and depression, and a whole slew of other experiences and emotions. So it's not that we give out of ourselves everything we have until our cup is completely diminished and empty again. 

The concept really is talking about your cup needs to remain full. And what spills out of that full cup is what we have available to offer to others. And that is only after we have continued to maintain and refill our own cup, our own emotional resources and energy and well-being. And this is a daily practice. This is not an overnight transition. There's a lot of different viewpoints about this concept, about how it might be perceived as being selfish. 

But the truth is if we're not able to sustain our wellness and take care of ourselves, meeting the needs of others becomes incredibly challenging. So how do you keep your cup full? Or how do you fill it? And the truth is this is unique and individual to every single person. 

But some suggestions that could be helpful in getting started if it's not something that is a practice that you already have is to start setting healthy boundaries with people in your life, whether that's family, friends, community members, colleagues, and learning to say no. No Is a complete answer that doesn't require an apology or an explanation. Another thing is engaging in regular health maintenance. And that can look different for other folks. 

So that includes sleep, nutrition, regular exercise, carving out time for personal fulfillment, hobbies, and relaxation. And sometimes as a new parent, I recognize now, that's not always easy. And I think one aspect of my personal and professional experience is that when you're in a caregiving role, pivoting and remaining OK with things having to become a little more fluid really is important to being able to meet those things. 

I'm an artist. And art is very fulfilling and supportive for me. And I used to be able to do it whenever I wanted prior to being in a full-time caregiving role for my brother or now prior to becoming a parent. And I've had to adapt that. Now it's sometimes when my son is taking a nap or after he goes to bed. Those are the times where I get to practice those things that I find really supportive in maintaining my own cup full. 

And another suggestion is seeking out professional help, so things like therapy. And there's a variety of therapeutic models that people find supportive for the challenges that they might be experiencing daily and also support groups where you can meet other people who might be in similar circumstances, and develop that sense of community, and even get suggestions of new things, new approaches you could try or maybe just identifying with others about how certain things used to work and you don't really work that much anymore. 

And how do I find a new way to care for my family and care for myself at the same time? But I do recognize that this can feel like a heavy lift when you're in a caregiving role. But it is important in being able to stay well while you take care of others, whether that's children, adults, or maybe aging people in your family or community. So self-care is very individual to each person. 

Some people, when they talk about self-care, they might think of someone going to a yoga class or getting pampered and doing things like getting a massage. But the truth is that it's individual to whatever feels supportive for that person. So there is no one size fits all approach. But there are some activities that you can do to support your health and wellness. And some of those include getting regular exercise. 

So it could be things like doing yoga, light stretching, going on walks, just being out in nature, which sometimes, this time of year can be a little challenging, balancing and supporting your nutrition, so eating more supportive meals. I'm not a big fan of naming foods as good or bad. I think it's a more supportive perspective to look at things as what's supportive for your wellness and what's maybe not as supportive, but not restricting those things. 

Sorry. I'm just going to take a drink of water really quick. Sorry. And also, getting enough rest. That can be challenging when you're in a caregiving role. That can be challenging when you're caring for small children. But a little further in the presentation, I will go over maybe some ideas where you can help maintain good, what they refer to as sleep hygiene, so maybe getting a consistent sleep schedule. 

And then therapy. A lot of people find that really supportive, but I do recognize that it's not always accessible for people in the way in which it should be. But just as important as focusing on our physical health and wellness is important to make time for things that support personal fulfillment, hobbies, and relaxation. And that's individual to each person. It could be reading, nature walks, mindfulness activities, which you could build as a family practice, or as an individual, or both. 

Art, music, dancing, puzzles, whatever speaks to you as an individual and feels supportive. And the best approach I have found and have found from other people I've supported is including things in your life that work for you and are easy to come staples and feel more effortless and not something that you're really straining and working hard to fit into your life. So another thing is finding community. 

It's ideal when we can get support from our immediate and maybe immediate family and nuclear family, so parents, siblings, aunts, uncles, cousins. But sometimes, we don't all have that available. And that's OK. So this is where finding community can be really helpful when you're caring for somebody else or a child and trying to care for yourself at the same time. 

So one approach, something that is talked about a lot as it relates to children with disabilities and even adults with disabilities that is helpful in building community is called a circle of support, which some of you might be familiar with or heard that term before. And one of the ways to build a circle of support is through person-centered planning, but also just looking around at what is already accessible and available in your life, so maybe looking at what resources are available in your surrounding community where you live. 

So those could be things like community fridges and food pantries, recreation centers, libraries, parent or caregiver meetups, support groups, and also free or low-cost community events that you can do as a family or even as just yourself. Also, sometimes, physically accessible events and spaces may not always be available or work with your schedule. So can you access like virtual support options? 

And those can include online support groups, even FaceTiming or video calling with friends or family. There's a lot of Facebook groups where people can exchange resources about what's available in the community, what they personally have available, and even just providing additional support and connection and that sense of being able to identify with having a similar experience. 

And then who are people you could connect with for support and spend time with? And that could include neighbors, friends, coworkers, colleagues, and if it's something that's a part of your life, even faith-based groups in your area. And the list really can go on from there. So what could be supportive, not just during the holidays, but in life in general? 

A couple suggestions that I have is leaning in to others for help and support. And I recognize that that's not always easy. I know in my own experience and the experiences of people I've supported professionally, sometimes we don't want to-- we may not feel like we have those people available in our life. Or we may feel-- we don't want to be like a burden asking of others. 

But there are things that we can seek out support with that make a big difference, even if they don't seem like they're large things. So some of those things could be asking for help with running errands. Maybe a friend, or an extended family member, or even a neighbor could go to the pharmacy for you and pick up medication if you feel comfortable with that, support you with cooking, even finding activities in the community that are available for you and your family and childcare and many other things, like whatever would be helpful to have additional support in your life with. 

Something else that's really helpful that you can often ask for and a lot of people love doing is prepared meals being brought to you, whether they're fresh and you can eat them for dinner or lunch right away or even meals that can be frozen. So if you're having a day where you're very busy or maybe you're not feeling that inspired to cook or have a lot of time to, there's things that you can organize, a meal train, where-- or even someone could organize one for you, where folks can sign up and bring meals to you, whether it's for an isolated event like someone is in the hospital. 

You just had a child. Whatever the circumstances are. And people can bring you meals. Another thing that can be really helpful, things like DoorDash or Grubhub, they often have coupons. And people can send those to you even through a text message. And then if you download the app, you can upload the coupon there. And then you could order something, a meal or also things like grocery store delivery. 

People could do that for you. You could offer it as a suggestion if someone asks like, hey, what could I do to be helpful to you today? Parent and caregiver meetups can be really helpful for fostering that sense of belonging and identifying with others, which is a big part of building community, so meeting up with people in the community that are in similar situations and might also have shared interests. 

And this supports forming relationships, forming new relationships, maintaining relationships. And this also provides additional opportunities for the children you might be caring to meet new friends, meet other children, and work on play. Another thing could be focusing on your rest and relaxation and being supported in that process. 

So that could look like a lot of different things like family mindfulness activities, maybe leaning in on a loved one or a neighbor that you feel comfortable with to watch or babysit your children for even just an hour so you could just relax or rest, whatever if that means literally taking a nap, or just sitting on the couch and curling up with a blanket or even being able to engage in an activity that you enjoy and feel supportive to you and being able to really dive into that and not have to be tending to someone else's needs while you're trying to do that. 

And lastly, maybe getting support with household chores and tasks and. That could be getting groceries delivered instead of going to the grocery store and going through that process. I personally hate going grocery shopping because it's not about just going there and buying the stuff because then you got to bring everything home and unpack and everything. And it's a really time consuming process. Even help with laundry or dishes. 

I found it really helpful. People really wanted to help-- my son was born at 28 weeks and six days. And a lot of people really wanted to support my husband and myself. And it was incredibly difficult to let people help me. But even things as simple as a friend coming over to sit with me while I set up things for my son because he was in the hospital for two months or even just letting someone do one load of dishes or laundry made a huge difference in not just getting that task done, but feeling really supported in that experience. 

Another thing could be if you don't have a car or a way to accessibly get errands done, someone giving you a ride or even just-- even if you have a means of transportation, going with you to the store because that sometimes makes an experience a little bit more enjoyable. And also, it could be supportive if you're maybe having to run a lot of errands with your child and going into stores can be really overstimulating. 

So just having that additional support can really help make that task a lot smoother of a process. And then I recognize it's not always financially accessible, but if it is outsourcing certain services to help with household chores and tasks-- and that could be getting hiring a cleaning service that comes once a month, biweekly, to do those deep cleans. So you're just maintaining the day-to-day tasks. 

And things like laundry mat delivery. You can drop off your laundry at a lot of laundromats. And you pay by the pound of the clothing. And they wash everything, fold it up very nicely, and bring it to your house. And that's amazing, another task I do not enjoy, but I do, anyway. So some of the suggestions that I have for getting through the holidays, if you're taking care of a child with a disability, even if you're caring for an adult with a disability and supporting them. 

And I think even this could be applicable if you're supporting an aging adult in your life. But specifically for children with disabilities, preparation and planning can be really helpful. And that can look like a lot of different things. So I'm just going to name a couple of them. Sharing details with your children ahead of time can be very helpful. 

This really can support their own sense of independence, but also create a sense of security and calming for the child and for yourself, so letting them know ahead of time, where are we going? Who are we going with? When are we going to this place? And what are we going to be doing there? Finding some sensory friendly activities or plan ones you can do at home. 

That can be super helpful in the colder winter months where there's not a lot of light outside. It's very cold. It's not very ideal for doing outdoor activities. So those could be things like baking, creating games with different maybe art materials or household materials that can be sensorially pleasing, creating a calm space that if you're maybe hosting a holiday get together at your living place, that if your child does start to feel overstimulated, even if you start to feel overstimulated because hosting can be very stressful sometimes, it can be really helpful. 

And that could be just creating an area where there's low lighting, it's a little more quiet, there's access to fidget items, blankets, pillows, whatever brings comfort to your child when they are feeling overstimulated and even things that feel comfortable and supportive to if you start to feel overstimulated. And if you're going to an extended family member's house, maybe checking in with them ahead of time and asking, is there extra room or a part of a living room that won't be used if they have more than one living room that we could set up a space like that? 

And then packing all the necessities. Sometimes we need a lot of stuff for kids when we're leaving the house. And it can be really stressful to make sure you don't forget anything, so maybe taking your time and packing the day before or a couple hours before you actually need to leave and making sure you have your children's and your own needed items. 

So those could be things like medications, snacks, or safe foods because there while there might be a lot of options available at a holiday get together for items that they can eat, those might not include safe foods for your child that aren't texturally or even taste like things that would be unpleasant or overstimulating for them and then bringing like extra fidget items, devices if they use tablets, noise canceling headphones, even earbuds like the plugs you put in to limit that sensory overstimulation if those are things that your child uses or might find helpful. 

So during celebrations, trying to stick to routines with sleep and meals as much as you can be really supportive. So if you can plan things around when your child takes naps, maybe not go to activities that are really close to bedtime. That would mean that your child's going to go to sleep a lot later than they need to, timing things around when your child usually eats meals, or bringing snacks so they don't have to go a long period of time without eating, giving advance notice to your child about transitions or even changes in plans If something comes up and things are going-- the plan that you let your child know about ahead of time has to adjust at all. 

Giving them notice about that as soon as you can be really helpful to prepare them for another transition. Another thing, like offering choices to your child, this not only supports their autonomy and independence, but it helps support their self-determination and ability to make choices. And a good way to do this without becoming overwhelming for them is to give two options. It could be like, we're at a family event or an event in our community. 

And it's like, there's a wait period. And it's like, would you rather play a game on your tablet or maybe work on some coloring pages or in a coloring book? Showing up to events a little earlier or even leaving a little earlier to limit the overstimulation. That can sometimes happen when we're around a lot of people. Sometimes extended family can get really excited to see your children and maybe want to give a lot of hugs and physical affection. 

But that might not be as supportive and could be a little overstimulating. And communicating that to people ahead of time can be really helpful. But the showing up early and leaving early, whichever is a better option, can help your child transition into different spaces and give them more time to be able to do that, whether it's the transition of getting to the event or destination or preparing to go home. 

And also, it's OK to decline invitations to events or gatherings that might not be as accessible for you and your family or even just seeking out more accessible events and gatherings. I always like to tell people no, we can't make it this year is a complete and justifiable response and doesn't require an apology or any further explanation to the people who have invited you or are hoping that you may be able to come. 

Having kids and caring for children and other people, sometimes we need to be a little more flexible. And also, going back to the Eight Dimensions of Wellness, maybe going to an event might not be as supportive for your own physical or emotional wellness as maybe pivoting and doing a smaller event or activity for yourself and for your child. 

And suggestions for yourself specifically, some things that could be helpful are managing expectations. So that can look like doing what works for you and your family specifically. Holidays and celebrations don't have to look what other peoples' and other families' experiences are. And that's OK. We're individuals. Not everything has to be like a Hallmark event. And another thing is asking for support from your friends, and family, and community, like I talked about a little bit ago. 

I recognize that it's not always an easy thing to do, but it's like any practice. The more you exercise that muscle, so to speak, of becoming comfortable with seeking out support and then asking for it, it does become easier over time. Another thing like prioritizing your own wellness, so that can look like a slew of other things, so making sure you eat consistently and rest, not going like hours and hours in between meals, taking breaks. 

Sometimes breaking down household chores, tasks, and things that you need to do that are a part of holidays, whether that's going to gatherings or events, prepping for gatherings and events that you might be hosting, breaking things off into smaller tasks, and taking breaks in between those can help not only make things less overwhelming, but a little bit more sustainable. 

Even though it's chilly outside right now, sometimes there's a five minute walk around the block can really help with doing something that can keep you calm, keep you feeling motivated. Phoning a friend, big fan of that one because community is so important. And sometimes we might not always be able to spend time with our friends and loved ones as much as we would like to. But even just having that little bit of connection, and hearing someone else's voice, or FaceTiming with them, or video chatting, and seeing their wonderful faces can make a world of a difference. 

And also, doing something that helps calm you and keep you balanced and even keeled before you feel like you're at 100%. And those could be things like breathing exercises, so box breathing, counting breathing, like four, six, eight. So you'll inhale for four, hold it for six seconds, and then exhale for eight seconds and doing that until you start to feel your heart rate decrease, your breathing slow down. 

Even things like a five-minute guided meditation on YouTube, you can search that term exactly. And so many videos will come up. And picking something that feels engaging, something that you can relate to or feel comfortable doing can make a world of a difference, even things like light stretching. It doesn't have to be like a whole yoga flow or anything like that, but just getting a little bit of activity in your body can help release some of those stress hormones, but also increase your energy a little bit or even the opposite, decrease energy if you're feeling overstimulated. 

Staying connected to others in your life, really leaning into that support and connection of friends and loved ones like other parents and caregivers of disabled children, whether those are direct friends you have or friends people you've met through a meetup, and most importantly, being kind and patient with yourself. At the end of the day, we're all just doing our best. And that varies from day to day. And it's all we can do. 

We can't do more of what's in our capacity, as much as we may want to, especially during the holidays, where it can be a really overwhelming and sometimes emotional time of year. Being kind and patient with yourself in that process not only helps sustain your own wellness, but it can make meeting the needs of others a lot easier when you're not feeling overextended because holidays can be challenging. 

There could be strained relationships with others in your family. There could be people who've passed away and who are no longer a part of your life or your family celebrations. And that can all be really difficult to adjust to. But I am a big fan of making your own memories, and your own new memories, and your own new practices, and things that you do to celebrate the holidays, so adapting and pivoting to what's realistic for your life and your family's circumstances presently. 

So tying everything together and coming full circle in some of the ways in which you can approach the holiday season, thinking about the Eight Dimensions of Wellness. What are some parts of those aspects of yourself could use a little extra attention during the season? And that could be like establishing a mindfulness routine, maybe before your children wake up or after they go to bed, taking a few minutes for yourself to do some deep breathing or a guided meditation, any practice that helps you ground and center yourself. 

Listening to your physical needs before you go in, what I like to call the red zone, the danger zone. So that can look like making sure you eat regularly and enough, not over caffeinating. I am guilty of doing that on a regular basis. Taking breaks, whether those are emotional breaks. And I call it giving myself a timeout where I need just a few moments so I can respond to situations as opposed to reacting to them, which all of that ends up leading to feeling very depleted, which makes caregiving sometimes feel more challenging and be more challenging. 

Exploring creativity. There's tons of things that you can get creative with during the holidays, which can be fun activities. And even if you find suggestions for different crafts or ideas, making them adaptable and accessible to the needs of your child and yourself and leaning into social networks. I might sounds like a broken record with that one, repeating it frequently. But it's just so important in sustainability and really feeling supported. 

And being able to look at your family and yourself from that holistic approach, from that ability of acknowledging and honoring all the multiple parts of us that make up who we are and doing the same for your family members and your children. Keep pouring into yourself. And keep your cup full. It is not selfish. You can't care for other people if you're not also cared for. Identifying support when you need it and asking for it. 

Oftentimes, people really want to help. But sometimes they don't know what to say. They don't know how to help. They don't know what to ask for. And they don't want to overstep boundaries and impose upon others or even just making people feel that way. So being specific with what you need or what could be helpful to you really can open a lot of doors. 

And then lastly, preparing and managing expectations for yourself and for your children or whoever you're caring for, but also remembering to enjoy the experiences that come with the holiday season. Being present in them can not only be helpful in making your child feel safe and calm, but it can also do the same for you. So that is the last part of my presentation. This will be the Q&A, the questions and answer part of the presentation. 

So this is the opportunity where you can ask questions. You can even provide a reflection on some of the things we talked about today. You can ask me anything. But I just want to thank you all for spending this time with me today and being open to listening to what I shared today. And I hope that something you heard today might be helpful to you. So I'm going to stop sharing my screen and turn it back over to Stacy. 

STACY PHILLIPS: Thank you so much, Raquel. At this time, I am going to stop recording. So that'll end our session for the day on the recording. That way, we'll have time to chat and ask questions.