Archive for June 2013

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Nursing Home Placement: Damned if You Do – Damned if You Don’t

Saturday, June 29th, 2013

Virtually no one wants to place a loved one in a nursing facility. But what if you have to work full-time and can’t provide the required 24/7 care?  What if you can’t afford an in-home care service that could help you out? Or what can you do if your loved one becomes too combative to manage?

You and your loved one aren’t the only people in the equation. Family members may argue strenuously against any decision you make. They may try to make you feel guilty enough to give up any plans for institutionalization.

Sometimes nursing home placement is the best (or even only) solution for your benefit and the benefit of the person you’re caring for. But many people feel like institutionalizing their loved one is a cop out – virtually a crime.

If you do it you may feel terribly guilty. But if the person really needs to be in a facility for his or her own safety and well-being you may end up feeling even more guilty if you don’t do it. If something happens to your loved one – such as wandering off or sustaining an injury from a fire or other hazard – you’ll never forgive yourself.

Ask yourself two questions: 1) Would being in a facility provide your loved one with better care, more personal attention, more opportunities for socialization and – especially – greater safety? and 2) Is taking care of the person at home wrecking your own physical and mental health? If you answered “yes” to either one of these questions it may be time to start looking for a good facility.

People with Alzheimer’s placed in nursing homes typically adjust in time and often later forget they were even moved in the first place.

If you decide not to do it, just remember that Alzheimer’s is progressive. You may need to revisit the issue later on.

Teepa Snow on Activities for People With Dementia

Saturday, June 22nd, 2013

Planning Activities to Enrich the Lives of People With Dementia

I recently interviewed Teepa Snow, nationally renowned dementia care expert, about how to plan activities to engage people with dementia.

According to Teepa, the single most important thing for family and professional caregivers to keep in mind is to “Provide more than just entertainment. It’s important to balance the day, also including productive activities, leisure time, fitness activities and, finally, rest and relaxation.”

Productive Activities: These could be as simple as making, sorting, or fixing things.

Leisure Time: Examples include things such as participating in sports, games, dancing, singing, and working on hobbies.

Self-care and Wellness: These include activities such as walking and tasks focused on strengthening, coordination, balance, and flexibility.

Restorative Activities: These would be activities such as taking naps, rocking in a chair, or stroking a pet.”

When I asked Teepa what people should avoid when planning activities she told me, “It’s crucial to be sure the activities are not too hard or, at the other extreme, too boring.” She also advises against mixing people at different stages of the disease because their behaviors may bother each other.

In addition she stresses that your expectations need to change as the person progresses through the stages of dementia. Activities that work well with those in the early stages will not necessarily be successful for those in the mid- to later-stages.

Resources for Caregivers

I asked Teepa to name the single best resource for people planning activities for those with dementia. After some thought she said that for family caregivers she would recommend Best Friends Approach to Alzheimer’s Care by Virginia Bell and David Troxel (available on Amazon).This duo has published numerous books on their “Best Friends” approach, and this is a good one to start with.

What a Person With Alzheimer’s Taught Me About Love and Beauty

Saturday, June 15th, 2013

When we think about a person with Alzheimer’s we rarely think they could teach us anything about life, love or beauty. And in many cases they don’t.

I, however, was most fortunate. Ed, my beloved Romanian soul mate of 30 years, saw beauty in the staff at his long-term care facility and those who visited him there. He expressed it freely – not only in words but also by holding and kissing the hands of these people.

In addition, he felt that I was beautiful and he frequently told me how beautiful I was. So often that I actually asked him to stop at one point! He also expressed his love for me and it was far more often than he ever did before he developed Alzheimer’s.

Ed said repeatedly how lucky he was to be at the Alois Alzheimer Center and how joyful he was to have all the people there who took care of him. He thanked every person whenever they did anything for him – no matter how small.

Mary, the housekeeper, went in one day and emptied his waste paper basket. He thanked her then kissed her hand.

“You are so beautiful and I am so lucky to have your help. I really mean it,” he added. “It’s from my heart – not just words from my lips”

A week later, I was singing out when Maria, the receptionist on duty that day, turned from her computer screen and told me, “I bet that Edward was a real lady’s man in his day. Every time he comes up here he tells me I’m the most beautiful woman in the world, and that it’s not just words from his lips – but that he really means it from his heart.”

Then I realized that no matter how advanced his dementia, Ed still had the innate capacity to feel and express beauty.

How wonderful it would be if we all experienced and expressed the beauty we see in people and the love we feel for them.

This is what I learned from my loved on with Alzheimer’s.

Has anyone else had a similar experience with a loved one who has Alzheimer’s?


Caregiving Pearls

Saturday, June 8th, 2013

1.    Don’t Be in Denial: It’s only natural to be in denial when a loved one begins to show signs of dementia, but that only prevents the person from getting a diagnosis, starting treatment, and planning for the future.

 2.    Don’t Ask, “Do You Remember?” Of course they can’t remember. If they could remember they wouldn’t be diagnosed with dementia. Asking if they remember some person or event could make them frustrated.

 3.    Do Interact With the Person at His or Her Level:  You may want to interact with the person the way you always have, but that isn’t going to be possible. Instead, figure out at what age they appear to be behaving, then connect with them at that level.

 4.    To Connect With People Who Have Alzheimer’s, Put Something Meaningful in Their Hand: This is a valuable tip provided by Tom and Karen Brenner in their book, You Say Goodbye and We Say Hello: The Montessori Method for Positive Dementia Care. You may have to experiment some to find out what is meaningful to any specific person.

 5.    To Connect With People With Late-Stage Alzheimer’s Try Introducing Them to Children, Pets, Music or Art:  These four activities will often reach people in the late stages of the illness – even if they hardly talk anymore. 

6.    Don’t Argue, Correct or Disagree: You can’t win an argument with a person who has dementia – so don’t even try. Neither should you contradict them. It will make them dig in their heels even more strongly.

 7.    Don’t Bring up Topics That May Upset the Person: If you know your loved one will get upset if you talk about politics, for example, don’t start the conversation in the first place. It will probably lead to a battle you don’t want to have.

 8.    Do Quickly Change the Subject If the Person Does Get Upset: If the person does get upset one of the best things you can do is redirect their attention to something else, preferable something pleasant.

 9.    Don’t Quit Visiting When the Person Doesn’t Know Who You Are:  Just because your loved one does not recognize you doesn’t mean they have no feelings. People with Alzheimer’s may enjoy being visited even if they don’t know precisely who the visitor is.

 10.  Do Take Care of Yourself:  Being an Alzheimer’s caregiver is hard work. The gold standard book on Alzheimer’s caregiving isn’t entitled The 36-Hour Day for nothing. Take good care of yourself for your benefit and for the good of the person for whom you’re caring. You can’t be an effective, compassionate caregiver if you’re exhausted and burned out all the time.


Tips for Interacting With Nursing Home Staff

Saturday, June 1st, 2013

On occasion, there is friction between nursing home staff and family members. This is unfortunate because staff members typically become deeply attached and devoted to the residents for whom they care.

The following list of things you should never do will help you avoid pitfalls that can occur when interacting with long-term care facility employees.  

1.    If you are dissatisfied with a staff member’s behavior don’t hold it in and let it eat away at you. Communicate the issue promptly and directly to the administrator or director of nursing.

 2.    Don’t skip your loved one’s regularly scheduled care conferences. These are good times to discuss your wishes or concerns about the care your loved one is receiving and get updates on how he or she is doing.

 3.    Don’t order the staff around. If you have requests related to the care of your loved one discuss them with the director of nursing or the administrator.  

 4.    Don’t ignore input and suggestions from the staff. They spend far more time with your loved one than you do.

5.    Don’t expect miracles. Specifically, don’t expect staff members to achieve things you yourself cannot accomplish.

 6.    If you have a large family, don’t ask the facility to communicate information to each one. Instead, designate one person who will receive information from the facility and then share it with the others.

7.    Don’t give tips or bring gifts for the staff if the facility has guidelines forbidding them. Find out the facility’s policy.

 8.    Don’t be a chronic complainer. Everyone needs a compliment from time to time. Find something positive to say when you can and be sincere about it.

 9.    Don’t call the facility at especially busy times such as mealtime, bedtime or the change of shifts.

 10.  Above all, treat the staff members with respect. Never belittle, criticize, or be accusatory when interacting.