Archive for November 2011

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Hospice Care for Alzheimer’s Patients near the End of Life

Wednesday, November 30th, 2011

It’s Not Just for Cancer Patients: When we think of hospice care we often associate it with cancer patients, but it’s also valuable for advanced stage Alzheimer’s patients. In that stage the person is unable to walk, dress or bathe without help; has trouble controlling urine and/or bowel functions; and only rarely speaks meaningful sentences.

 More Specific Signs that You Should Consider Hospice Care: According to Gregg Warshaw, MD, Director of Geriatric Medicine at the University of Cincinnati and Past President of the American Geriatric Society, if your loved one with advanced Alzheimer’s is exhibiting any of the following symptoms, it’s time to talk to his or her doctor about considering hospice care:

      1.  Two or more episodes of pneumonia or other serious infections during the past 6-months

      2.  Difficulty eating and swallowing, even with feeding help, that results in weight loss of 10% or more over the preceding 6 months

      3.  One or more skin pressure ulcers that are not healing

 Although starting hospice care for a loved one is a somber and painful experience, just remember it will help both you and your loved one have the highest possible quality of life during the precious time that is left.

Where to Find Additional Information: The Hospice Foundation of America (www.hospicefoundation.org) is an excellent source for more information on this topic.

 

 

 

 

“Silly Saturdays” Story: Bring Me Vodka!

Saturday, November 26th, 2011

Alzheimer’s is a deadly serious topic, but sometimes laughter is the best medicine. So I’m posting  a humorous story weekly, giving us a chance to smile in the midst of our somber life situation. Please send me your own “silly” stories and I’ll post them, too.

As I was walking with Ed to the front door of the Alois Center on my way out the third day he lived there he sweetly said, “Kitty, please. Bring me two bottles of Popov tomorrow.”

“Kitty, I can’t,” I said. “You’re not allowed to have vodka here.”

“What do you mean, I’m not allowed vodka to have?” he asked incredulously. He stopped walking and stared at me. “This is America! I’m allowed anything I want to have!”

“I’m sorry, Ed,” I said. “I can’t bring you any. That’s the rule here.”

He became upset and told me, “Fine. I will find someone else to get it for me.”

I had no idea how he’d find anyone to buy it for him, but despite his dementia he tricked me into helping.

A few hours later he called and cheerfully asked me the address of “this place where I am ‘leev-ing.’” I was pleased. I thought it was a good sign that he wanted to be oriented and know where he was.

I told him the address and he repeated it one letter and number at a time, leading me to think he was writing it down, which I also thought was a good thing.

The minute I hung up I got it.

Oh, shit! He’s going to call his driver to take him to Kroger’s to buy vodka.

I dialed his driver’s cell as fast as my fingers would move and explained the situation. The driver, Mr. Ellington, promised to tell Ed his cab had broken down and it would take him a few days to get there.

I must admit, however, I was pleased Ed was still alert enough to try this ruse. I checked with Mr. Ellington later that evening and laughed out loud when I found out Ed had indeed called him!

Alzheimer’s and Family Strife

Wednesday, November 23rd, 2011

Having a loved one with Alzheimer’s can create tremendous stress in families. In families where there is generally good will, conflicts can typically be worked through for the common good. However, in families where people didn’t get along well before the diagnosis, it can create nightmares, especially for the primary caregiver.

The situation can become worse if some family members live out of town and only see the loved one for short, infrequent visits. They just don’t have the opportunity to witness the severity and frequency of demented behaviors you deal with every day. 

You may find you’re being criticized unfairly for the care you’re providing even though you’re doing a heroic job and making major sacrifices in your personal life to do so. This can lead to bitterness and create extreme disharmony in the family.

Here are a few things you can try to reduce the friction:   

1)      Be Patient and Understand Where They’re Coming from:  Try to put yourself in the other person’s shoes and understand why they lack knowledge of the situation. If you can stay calm you’ll have a better chance of decreasing stressful interactions.

2)      Educate Others about the Patient’s Condition: Make very detailed lists of the patient’s dementia behaviors and share them with family members. Remember, they’ve never seen many of the things you see on a daily basis. Update these lists and share them frequently.

3)      Have Others Care for the Patient for Awhile:  The best way to let other family members understand the loved one’s condition is to have them take care of the patient for awhile. Afterwards you may find you’re being criticized less and appreciated more.

Go to this Mayo Clinic article (http://www.mayoclinic.com/health/alzheimers/AZ00027) for more information on this topic.

“Silly Saturdays:” Guest Post by Eleanor Cooney

Saturday, November 19th, 2011

 

 

For a little walk on the light side of Alzhiemer’s, I’m posting amusing stories about dementia patients every Saturday. Here’s this week’s story by Eleanor Cooney:

 When Plaids Clash: Haute Couture in the Alzheimer’s Unit

My mother, all her life, was a really snappy dresser. Model-slim, her taste in clothes was simple and elegant. She and I always had a lot of fun, when I was a kid, making scathing remarks about people’s strange clothes and hair. Not in a cruel way–nobody ever heard what we said, it was strictly between us and for our mutual entertainment. My mother’s manners were exquisite (unless she lost her temper in public, which she did on occasion, and always for good reason, like with the cab driver in New York who tried to cheat her; the exchange ended with my mother slamming the cab door in his face and saying: “You JERK!”).

Alzheimer’s has a way of upending everything. A lot of you out there reading this no doubt know how it is in a typical Alzheimer’s unit–the inmates are in and out of each other’s rooms all day every day, carrying things away, bringing things in, like pack rats. Clothes, especially. Things tend to get all mixed and jumbled up, until everyone is wearing each other’s clothes, and of course, everyone is beyond caring what those clothes look like. Plus the staff in these places tend to be women, a lot of them very young, and so a great deal of effort is devoted to nail-polishing and hair-stying. Nail polish was never my mother’s thing, either–short, trimmed, plain sensible nails were her style. Likewise with her hair–curled, styled, poofy hair was just too bourgeois.

After a year or two in the Alzheimer’s unit, behold my elegant mother: nails painted red, hair curled and poofed, wearing costume jewelry and a Snoopy sweat shirt along with orange plaid pants a couple of sizes too short for her. Tragic, or comic? Both, of course, but definitely sharply, wonderfully absurd, the sort of thing over which my mother, once upon a time, would have thrown her head back and laughed heartily.

Eleanor Cooney is the author of Death In Slow Motion (HarperCollins, 2004, (www.deathinslowmotion.com), a memoir of trying (and failing) to care for her Alzheimered mother. It’s not a how-to book; it’s a For-God’s-sake-don’t-do-it-the-way-I-did-it cautionary tale. Cooney is the coauthor of three novels set in T’ang Dynasty China (http://tinyurl.com/3mhhsj3), and she’s been published in Harper’s magazine and Mother Jones. She’s just finished a novel called The Devil You Know, a noir thriller inspired by Michael Lesy’s 1973 classic Wisconsin Death Trip.

 

 

 

Alzheimer’s and Music: How to Engage and Bring Comfort and Joy to Your Loved One – Part II

Wednesday, November 16th, 2011

Last week I wrote about how to engage your loved one with Alzheimer’s by listening to music. Today I’ll talk about how to actually engage them in performing music.

Sing-alongs: This is a favorite activity in nursing homes, and you can arrange family sing-alongs, enjoyable for everyone, for loved ones living at home.

Individual Patient Performances:  Patients can be given drums, tambourines or other simple percussion instruments to “play” while singing or listening to music. This can bring smiles to previously blank faces. You can also have patients who previously played instruments try to play them again. Those with mild dementia may be capable and would enjoy playing a little.

As I mentioned the last time, it’s best to use music that was popular when your loved one was young. Also, be sure to avoid music that is loud or dissonant, and don’t play music that’s sad or could remind your loved one of sad events in his or her life.

Experiment with the above approaches to see if any work. Following these simple guidelines may give you and your family new ways to connect, interact and bring joy and comfort to your loved one.

(Source of this story:  www.AlzheimersReadingRoom.com. By Marie Marley)

Silly Saturdays Guest Post by Carole Larkin: “I’m a Lot Younger than These Old People around Here!”

Saturday, November 12th, 2011

For a little walk on the light side of Alzhiemer’s, I’m posting amusing stories about dementia patients every Saturday. Here’s this week’s story by Carole Larkin:

 

 

Pretty early on my mom’s frontal lobe was impacted and she lost the filter we all have that prevents us from saying what we are thinking. When she was at the assisted living community in Dallas and I’d visit her (2-3 times a week), every time she would introduce me to her friends as if  this was the first time they were meeting me. Some of her friends were not cognitively impaired, so they and I played along.  She would tell them all my name, that I was
born on Christmas day (which was true!) and how old I was. It was always in that order; it never varied.

Early on I had tried to have my mother  just tell people that I was her daughter, and that I was born on Christmas day, but to leave off how old I was. She readily agreed, but when I was introduced she automatically went on to tell them all three things. Realizing that I was stuck  with the telling of my age to all the people she knew, and all the people she didn’t know in the world, I had to say something to get her off the subject of my age.

I came up with, “but Mom, I’m still really young!”

Mom would look at me with surprise and say “No you’re not”.

Then I’d say, “Well I am when I hang around with 80 and 90 year olds!”

Then all of us would laugh. That was our routine.

Then one day, after I finished saying “Well I am when I hang around with 80 and 90 year olds!” Mom said, “Me too. I’m a lot younger than all these old people around here!”

She was 84 at the time. I laughed and laughed at that comment. And eventually she and all her friends were laughing with me. That was a great memory I’ll always carry of my mom.

Carole Larkin  MAG, CMC, CAEd, QDCS, EICS is a geriatric care manager who specializes in helping families with Alzheimer’s and related dementias issues. She also trains caregivers in home care companies, assisted livings, memory care communities, and nursing homes in dementia specific techniques for best care of dementia sufferers. Her company, ThirdAge Services LLC, serves the Dallas/Ft. Worth Metroplex. She can be reached at 214-649-1392 or carole_larkin@tx.rr.com.

 

 

 

Alzheimer’s and Music: How to Engage and Bring Comfort and Joy to Your Loved One – Part I

Thursday, November 10th, 2011

Music can be a significant source of entertainment that also has the power to reach people with dementia on a deep level. Many can sing songs, including the lyrics, long after they’re unable to recognize their loved ones, dress themselves, or remember what happened five minutes earlier. Music also has beneficial effects on patients’ health and social functioning, and has even been found to help dementia patients retrieve some memories thought to have been lost forever.

Today I’ll give some advice for having your loved one listen to music. Next week, in the second installment of this topic, I’ll write about some ways to get your loved one actually involved in music performances. 

Live music:  Patients with mild dementia can be taken to concerts or you can have a musician come to your home. If your loved one played an instrument, bring in a performer who plays that same instrument.  Or you can just sing to your loved one.

Recorded music: Listening to recorded music is somewhat less engaging because unlike live music, it doesn’t provide visual stimulation. It does have the advantage, however, of allowing the person to listen anytime. They can listen through earphones or speakers, with the latter allowing you and your loved one to share the experience.

Background music: Background music can bring comfort to Alzheimer’s patients. It should be played very softly, though, so as to not overstimulate a patient who may be doing something else at the same time.

A couple of final tips: It’s best to use music that was popular when your loved one was young. Also, be sure to avoid music that is loud or dissonant, and don’t play music that’s sad or could remind your loved one of sad events in his or her life.

(Source of this story: www.AlzheimersReadingRoom.com by Marie Marley.)

“SILLY SATURDAYS:” ENOUGH!!

Saturday, November 5th, 2011

Alzheimer’s is a deadly serious topic, but sometimes laughter is the best medicine. So I’ll make a “Silly Saturdays” post weekly with some amusing story about Ed, giving us a chance to smile in the midst of our somber life situation. Please send me your own “silly” stories and I’ll post them, too. Here’s this Saturday’s story:

“Bingo!” a woman hollered in a shrill voice.

I peeked into the activity room and saw Ed smiling, sitting on the far side of the long craft table. He looked like he was having a grand time. I didn’t want to interfere with his fun so I pulled up a chair and sat down beside him. Martha, a tiny, sweet-looking aide, spun the cage, picked up the ball, and called out the combination.

“B-6!”

Ed looked at his card intently then sang out sweetly, “Here ‘tis!” and covered the proper square with a red plastic marker. Quite frankly, I was surprised he was competent enough to play by himself. Martha had seated Lucy and Sylvia on either side of her, so she could lean over and help look for the numbers on their cards. Betty, at least ninety and almost as underweight as Ed, sat undisturbed amidst the players.

The game continued and each time Ed had the number he called out melodically with glee, “Here ‘tis.” I found it amusing and had to suppress a laugh. Martha seemed to find it funny, too, and looked in Ed’s direction, a smile on her face every time he voiced his little refrain.

Sylvia yelled something, in what I would later find out was Portuguese, in a disgruntled tone of voice every time she didn’t have the number. I could tell Ed was getting annoyed with her.

Finally, I guess he decided he’d had enough of her grouchiness because he said so loudly that it was embarrassing, “I just have one word to say!”

“What is it, Ed?” Martha inquired, a concerned look on her face.

He pointed his shaky finger at Sylvia and shouted, “ENOUGH!”

He was right. He did have just one word to say. Again, I had to control myself to keep from laughing, and it looked like Martha was stifling a laugh as well.

November Is National Family Caregivers Month

Wednesday, November 2nd, 2011

November is National Family Caregivers Month – a time to thank, support, educate and empower family caregivers.

During this month we’re reminded, however, that caregivers are struggling to cope with the rigorous demands of caring for family members or friends with chronic illnesses.

More than 65 million people, a full 29% of the U.S. population, care for someone who is chronically ill, disabled, or aged, and they spend an average of 20 hours per week performing their duties. Those responsible for Alzheimer’s patients have an incredibly demanding task.

Alzheimer’s caregiver stress is at an all-time high. More than 60% rate their emotional stress as high or very high, and one-third report symptoms of depression.

Alzheimer’s caregivers also report a negative impact on their employment and finances. Some are forced to change from full-time to part-time jobs or stop working completely. Others fear losing their jobs due to repeated requests for time off to handle unexpected situations requiring their attention.

Fortunately, there are steps you can take to alleviate the stress and other negative consequences of caregiving. Perhaps the single most important thing is to ask for help with your caregiving duties. People want to help – they just don’t know what to do. As I’ve said many times in this blog, be prepared with specific requests for the next time someone asks if they can do anything for you.

For more information on stress management for Alzheimer’s caregivers go to www.Alz.org, www.AARP.org, or www.AlzheimersReadingRoom.com. You can also find advice in the other posts on this blog and by doing a Google search on “Caregiver Stress.”