Archive for October 2013

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Puzzles to Remember

Thursday, October 31st, 2013

PUZZLES TO REMEMBER is a 501(c)3 organization that provides puzzles to nursing homes, veterans facilities, and other facilities that care for Alzheimer’s and dementia patients. Puzzles To Remember was founded in 2008 by Max Wallack, now a student at Boston University Academy in Massachusetts. Max recognized the calming effect of puzzles and many other benefits on people suffering from Alzheimer’s disease.

Puzzles To Remember has already distributed 8,412 puzzles to over 900 Alzheimer’s caregiving facilities in all 50 states and in Canada and Mexico. Many similar programs are being launched in the United States, Portugal, and Australia. All donations are tax deductible. To make a donation go to:

The 5 Most Controversial Decisions You Will Ever Have to Make

Thursday, October 24th, 2013

1.    Should the Person Stop Driving?

The Alzheimer’s Association lists five primary reasons people with Alzheimer’s should stop driving

–  Forgetting how to locate familiar places

–  Failing to observe traffic signs

–  Making slow or poor decisions in traffic

– Driving at an inappropriate speed

– Becoming angry or confused while driving

I would add two obvious items to this list: Causing an accident or running into another car while parking.

When loved ones exhibit one or more of these it’s time to get them to stop driving. This will be one of the most difficult actions you will ever have to take.

2. Should the Person Be Placed in a Long-Term Care Facility?

Alzheimer’s patients in the later stages require around the clock care and monitoring, which is exhausting to the caregiver. You can’t be there for your loved one and provide high quality of care if you are physically worn out and emotionally spent all the time.

So when you reach the point where you’re physically exhausted and emotionally drained the majority of the time, stop and at least give some serious consideration to placing your loved on in a high-quality long-term care facility.  It might be by far the most loving course of action, and the best course of action, for the health and well-being of your loved one.

3.   Is It Okay to Stop Visiting When the Person Doesn’t Recognize You Anymore?

Some people think that there’s no reason to visit a loved one in a nursing home who no longer recognizes them, but others are firmly convinced that you should visit anyway. First of all people with Alzheimer’s may enjoy being visited even if they don’t quite know who is visiting them. More importantly, it’s possible that the person does recognize you but simply isn’t able to say so.

4. Is It Okay to Divorce Your Spouse in the Later Stages of the Disease?

This is indeed a very personal decision to make and one should be bound by his or her personal ethics.

5.  Is It Time to Engage Hospice Care Services?

Specific signs that indicate hospice care may be needed include the following

–  Two or more episodes of pneumonia or other serious infections during the previous six months

–    Difficulty eating and swallowing, even with feeding help, that results in weight loss (10% weight loss over previous six months)

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

One day I spoke to a physician specialized in end-of-life care. He answered all of my questions about hospice. Then he looked to me the real question for the caregiver is “How can I help this person have the highest quality of life possible in the time that’s remaining?”



You Say Good Bye and We Say Hello: The Montessori Method for Positive Dementia Care by Tom and Karen Brenner (Book Review)

Thursday, October 17th, 2013

He’s a gerontologist; she’s a former Montessori teacher and administrator. It was only a matter of time until they merged their talents and developed the Montessori Method for Positive Dementia Care. They use the Montessori Method in cutting-edge ways to support memory function and improve the quality of life in aging populations.

Together they train family members, professional caregivers and medical staff in the use of interventions for persons who have dementia and Alzheimer’s. The Brenners use the Montessori Method as the foundation for their evidence-based memory support program. This program uses the five senses, muscle memory and spiritual engagement to maintain connections for persons with memory loss.

At their numerous speaking engagements over the past few years they were always asked if they had a book detailing their approach. They didn’t. So they finally realized they needed to write one. And here it is. It was just published in February of this year.

For me, one of the most important features of this book is the positive attitude the authors espouse about people with dementia and their caregivers, as illustrated by this passage from the book:

“People with dementia are not the walking dead, being in a relationship with someone who happens to have this condition is not just one long good bye. We have to find a new way to say hello.”

The authors state that oftentimes, when friends and family hear the words “Alzheimer’s and dementia” they react to the news the same way they deal with death. But the Brenners tell us that we are the ones who have to assure them that the dementia journey is not about death, it is about life.

The Brenners share the stories of people living with dementia they have encountered during their years of experience in this field. Even more importantly, they describe in detail the techniques and tools they have developed to help readers stay connected to the people they love.

Tom and Karen also give numerous illuminating examples of how they have used their tools and techniques to reach specific individuals with dementia, even those others have considered unreachable.

This book is a true inspiration to dementia caregivers everywhere. And at their presentations now when they’re asked if they have a book, they say “Yes.” And a marvelous one it is.

Don’t Sweat the Small Stuff at the Nursing Home

Thursday, October 10th, 2013

Family Members: Don’t Sweat the Small Stuff at the Nursing Home

Sometimes there’s friction between family members and nursing home staff. Before complaining ask yourself if the issue is bothering your loved one or is something potentially harmful.  If not, let it go.

Here are just a few of many examples of “small stuff” and significant matters:

“Small Stuff”

How the Resident Is Dressed: This would include things such as occasionally dressing the resident in someone else’s clothes (unless it becomes habitual) or dressing the person in clothes you don’t think go together well. The important thing is for the clothing to be clean.

How Hair Is Styled: The staff may style ladies’ hair in a new way. But If the resident isn’t complaining go along with it. The thing that matters is that residents’ hair is washed regularly.

Activities You Consider Beneath the Resident’s Dignity: You may object to some activities, especially if your parent or spouse is highly educated and had a serious profession. Look to see if the person is having fun. If so, let it be. Activities can be very therapeutic. 

Teasing the Resident or Showing Physical Affection: If it’s truly making fun of the resident, hurting his or her feelings, that’s grounds for complaining. But if it’s good natured and the resident obviously enjoys it, then don’t object. A related issue is if staff members express physical affection to a person who wasn’t previously openly demonstrative.  Again, it’s OK provided the resident clearly likes it. Touch can be therapeutic.

Significant Issues

Clinical Care: Any notable problems with clinical care should be immediately brought to the attention of the administrator or director of nursing. These might include not following the doctor’s orders, not assisting residents who need help with eating, or leaving wheel-chair bound residents (or any resident for that matter)  in bed all day.

 Safety: Issues such as leaving a medication cart unattended or leaving the call system button away from the resident’s reach. For residents with dementia additional issues apply such as having the unit properly secured or allowing a resident to have sharp, potentially harmful objects.

Personal hygiene: Matters such as not changing incontinent residents in a timely fashion, not keeping bedding clean, putting dirty clothes on the resident, not providing regular showers or not shaving male residents who need help with that on a regular basis.


Why You Should Keep Visiting Loved Ones With Dementia – Even If They Don’t Recognize You

Thursday, October 3rd, 2013

Here are some reasons to keep visiting loved ones with dementia, even if they don’t recognize you:

1)    They May Recognize You but Not Be Able to Express it

It’s always possible that your loved ones do recognize you but are just not be able to show it.

I had a personal experience which I believe demonstrates this. Doris, a lady I volunteer to visit, was so frail that the most I could do with her was hold her hand. She never showed any sign of recognizing me from my previous visits.

Then one day as I was holding her hand she put her other hand on my arm and began caressing it. I had the distinct feeling that she remembered me. I don’t think she would have been so openly affectionate with a total stranger.

2)    They May Remember How Often You Visit Even if They no Longer Recognize You

I was speaking at an Alzheimer’s family support group recently. A man there told me that he visited his wife, who had advanced-stage dementia, nearly every day even though she didn’t recognize him.  But whenever he missed a day, she’d always say, “You didn’t come yesterday.”

 3)    They May Enjoy Being Visited, Even if They Don’t Know Who You Are

Although Ed, my Romanian life partner with dementia, always recognized me, he had many visitors he didn’t remember. I observed some of these visits and it was always perfectly obvious that he enjoyed spending time with them.  When they were there he’d often hold hands with one of them the whole time. And he’d have a long, pleasant talk with them.

4)    You May Feel Gratified That You’ve Given Them Pleasure

Although the main focus of your visits are your loved ones, you might find there’s an unexpected benefit for you, too. You may initially feel hurt or frustrated that they don’t remember you, but if you can get over that hurdle and if it’s clear that they enjoy the visit, you will probably feel gratified that you gave them that pleasure.