
Dr. Martha Garmon, author of the book, I Am Not Alone, will be blogging on A Caregivers Journal, every Monday, beginning April 22.
The blog will follow the format of the book in which a Caregiver will answer questions about his or her experience with caregiving.
If you would like your story considered for the blog, simply download, or copy, the questions, write your añswers, fill out the Interview Release form, and email both to, Martha@ACaregiversJournal.family.
Because of limited space, not all submissions will be used. However, all submissions, that are used,will be edited, without changing the meaning of your story.
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Here is a link to a form you can fill out to answer the questions and sign the release online.
“I Am Not Alone” interview form and release
Nation:
Email:
Caree name and relationship:
Age at diagnosis:
Diagnosis and date of diagnosis:
INTERVIEW QUESTIONS:
- Where do you find hope? Comfort?
- What is one thing about caregiving or you or others – that surprised you most?
- How do you take care of yourself?
- What do you do when you hit bottom?
- What is the best/worst piece of advice you have ever been given?
- What is the best/worst thing you have learned about yourself?
- What would you most like to tell someone who has become a caregiver?
- What would you do if someone handed you 100 thousand dollars?
- What would you do with three extra hours a day?
- What do you wish you had more of?
- What are five easy things you do to relax or find joy?
- What is the best/worst question you have ever been asked?
- What are three things someone could do to help YOU (not your LO, but you)?
- When was the last time you cried?
- Do you like yourself?
- What is the hardest thing you have faced?
- What is the one thing that no one can understand about your situation?
- What is it that everyone should know, but no one wants to talk about?
- Do you have support from family? Friends? Church? Others?
- What do you miss the most?
- Do you have a humorous story you would like to share?
- Anything else you would like to add?
- List any resources that you have found helpful in your journey.
INTERVIEW RELEASE FORM
I understand that Martha Garmon, (the Author) is preparing, writing, and will publish work on the subject of caregiving for persons with dementia. The book is currently titled “I Am Not Alone” (the Work).
In order to assist the Author in the preparation of the Work, I have agreed to be interviewed and to provide information and other materials to be used in connection with the Work, including my personal experiences, remarks, recollections, and photos.
I hereby grant permission to the Author to quote or paraphrase all or any portion of the interview in her book or future works. I ( ) do ( ) do not grant permission to use my name. Permission granted is for world rights in all languages and editions of the book, including electronic editions and all future works or publications.
I understand and acknowledge that the Author, and possible future publisher, will be the sole owner of all copyright and other rights in and to the Work.
I acknowledge and agree that I am not entitled to receive any form of payment from the Author or future publisher.
Agreed and confirmed:
_____________________________________ Date: _____________
Signature
_____________________________________
Name (print)