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Attention Caregivers Without an Emergency Action Plan!

Thu, 19 Nov 2020 19:47:36 GMT

75% of caregivers do not outlive the person that they're caring for. Do you have an emergency action plan in place?

Through the coronavirus crisis we all find ourselves in, the number of caregivers without an emergency action plan that have had to deal with crisis situations has made it clear that many caregivers are unprepared for the day that an unexpected crisis knocks on their door. While our future is uncertain as to how COVID-19 will resurface and affect our healthcare systems and facilities. The Tricounty Caregiver Resource Center will be hosting monthly workshops once the quarantine restrictions have been lifted, however affected immediately we will be offering one on one consultations for this exact purpose: sitting down and putting together a plan A, a plan B, and if all else fails, a plan C. We are educating caregivers on how to navigate the healthcare system with the new rules that apply for COVID-19, and all of the benefits and advantages of being proactive and having some resources in place. Please know the sobering statistic that over 67% of caregivers do not outlive the person that they are caring for, and as a caregiver, it is your responsibility to make sure that your loved one will have some of these resources readily available in the event you are unable to provide such care. Having these difficult conversations can alleviate a significant amount of stress for your loved one knowing that you are being proactive. Most people who are dependent on a caregiver sit awake at night, their last thoughts being "what's going to happen if..." and "what's going to happen when..." Let us help you answer those questions.

Dementia Diagnosis

Mon, 20 Jul 2020 20:31:25 GMT

Five steps to take after a loved one has gotten a dementia diagnosis

A diagnosis of dementia can be devastating, not only to the patient, but also to the family. The idea that someone you love may begin to slip away can be frightening and overwhelming. It’s hard to know where to begin to plan for the challenges that lie ahead. Here are some tips that can help.

Begin to develop a support system of family and friends who will be able to help with the demands of caring for a loved one with dementia. Make a list of people you can call to help when the need arises —this could be as simple as driving them to a doctor appointment to having someone spend the weekend tending to their needs. Find a support group in your area of people who are going through the same thing you are. Developing a strong support system will help ensure you have the time you need to take care of yourself, including eating right, getting enough exercise and sleep, and maintaining your social life.
Get your loved one the medical help they need to continue to lead a purposeful life. Once a diagnosis of dementia has been made, if you haven’t already, you’ll probably want to see a neurologist, who is trained to diagnose and treat dementia. Although there is no known cure, there are several treatments available that may slow the symptoms. You may also want to enlist the services of a clinical neuropsychologist, who can assist with rehabilitation strategies, document cognitive strengths and weaknesses, and track the progression of the disease over time.
Have your loved one make legal decisions while they’re still able. Your loved one should establish durable powers of attorney for both their medical and financial needs. When you make a medical power of attorney, your loved one appoints someone to make medical decisions of their behalf should they become too ill to speak for themselves. This is best combined with a living will or health care declaration that provides specific written instructions on what medical treatments are desired in various situations (e.g., do you want to be artificially fed if you’re in a vegetative state?). A financial power of attorney gives someone the authority to handle financial transactions on your loved one’s behalf.
Become educated about the disease and what changes you can expect as the disease progresses. This will help you plan ahead as much as possible. Share this information with other family members, friends and coworkers, so they understand what is going on and can anticipate your loved one’s needs as well as your needs.
Never lose sight of the person you love. No matter how the disease affects your loved one, it is important to treat them with dignity and respect. You will certainly see changes that may make it seem like you are losing them, but remember that they still have a need for companionship and belonging. Engage them in activities and interactions that bring them — and you — a sense of joy and celebration. Focus on the abilities that remain. This will go a long way in adding to the both your and your loved one’s quality of life and help them maintain a sense of self.

Alzheimer’s Disease Fact Sheet | Alzheumer’s Disease Genetics Fact Sheet

Understanding Dementia

Mon, 20 Jul 2020 20:27:03 GMT

Dementia is a word used to describe a cluster symptoms caused by various diseases or conditions. Dementia itself is not a specific disease but a collection of symptoms, which can include:

Memory loss, particularly short-term memory
Loss of reasoning or the ability to understand why and how
Loss of critical thinking skills or the ability to solve problems
Poor judgment
Difficulties with communication, including reading and writing
Disorientation and getting lost
Emotional and personality changes including anxiety, agitation and restlessness
Social withdrawal

Some of these symptoms can be a typical part of the aging process, but for a person with dementia, they can become so severe that they will impact functioning.

Dementia may be caused by temporary factors that can be reversible, such as:

Dehydration
Infection
Malnutrition (simply not eating enough)
Medication changes
Changes in routine/environment

Dementia may also be caused by factors that are not reversible, such as:

Alzheimer’s disease
Vascular dementia
Parkinson’s disease
Huntington’s disease

If you notice any symptoms of dementia, it is a good idea to see your doctor to discover if the symptoms are the result of a treatable condition or are the result of a more serious issue. If it is discovered the dementia is caused by a non-reversible cause, you should schedule an appointment with a neurologist who can help you treat and manage disease. Dementia caused by Alzheimer’s disease — the most common form of dementia — is non-reversible because it causes physical changes in the brain. Specifically, Alzheimer’s causes plaques and tangles in the brain that interrupt the transmission of information between neurons, blocking messages from getting through to their intended target.

Alzheimer’s is a progressive disease, meaning that symptoms will almost always get worse. As Alzheimer’s progresses, the physical and mental demands on the caregiver can become unsustainable. At some point, you may not be able to leave your loved one alone. Certain behaviors may exceed a caregiver’s ability to cope or feel safe. At that point, it may be time to consider full-time in-home help or a facility that specializes in caring for people with dementia.

Managing Difficult Behavior

Mon, 20 Jul 2020 20:21:11 GMT

Some of the greatest challenges of caring for a loved one with Alzheimer’s or dementia are the personality and behavior changes that often occur as the disease progresses. These can show up as aggression, frustration, undressing in public, or a range of inappropriate conduct.

It is important to know that your loved one is not acting this way on purpose. The behaviors are a result of the disease. You can best meet these challenges by using creativity, flexibility, patience and compassion. It also helps to not take things personally and try to maintain your sense of humor. Additionally, there are some specific things you can do to help both you and your loved one better cope with their disease.

See a doctor

Some behavior may be caused by something other than dementia. That’s why it’s important to consult a physician if there is a sudden change in behavior. The change may be due to medication side effects, pain, or even an untreated infection. If there is an underlying medical problem, treating that may stop or decrease the behaviors.

Ensure basic needs are met

Unusual behavior may also be explained by the person simply trying to communicate their needs. It may just be your loved one’s way of saying, “Stop, I need something.” If you can figure out what they need, you can often help alleviate the behavior. Check to see if they are: Hungry or thirsty Afraid, tired or in pain Needing to use the toilet Over-stimulated or under-stimulated.

Pay attention to your body language

Make sure you maintain eye contact, match their emotions, remain calm, and be mindful of your tone of voice, posture, pace and gestures. Remember that we can change our behavior. Changing our own behavior will often result in a change in our loved one’s behavior.

Develop a routine

People with dementia feel safe when they know what to expect next. Involve them in regular daily tasks that are familiar, such as sweeping, dusting, laundry folding, setting the table — this can help give them a sense of purpose and accomplishment.

Live in “their moment”

Do not try to re-orientate them to the present time, which can lead to increased agitation. Try to accommodate the behavior, not control it. For example, if they insist on sleeping on the floor, place a mattress on the floor to make them more comfortable.

Get support from others

You are not alone. There are many people caring for someone with dementia. Call your local Area Agency on Aging, or the local chapter of the Alzheimer’s Association. They can help you find online or in-person support groups, organizations and services that can help you.

Tips for Successful Bathing

Mon, 20 Jul 2020 20:16:38 GMT

Bathing can be one of the activities of daily living that is most affected by dementia. There are many steps in the process of bathing which can seem very difficult for the person with dementia. Additionally, it is likely the person doesn’t remember the reason for bathing and it seems like an unnecessary intrusion into their day.

Resistance to bathing often escalates when someone tries to help. Getting undressed in front of another person is challenging for most people. So imagine what it’s like for someone who doesn’t understand what’s going on. Fortunately, there are things you can do to make the process easier.

Preparing the Space

First, prepare the bathroom in advance. Make sure it’s warm enough. If your loved one is taking a bath, fill the tub beforehand, using only two to three inches of water. Use familiar soaps and shampoos and have your loved one smell them as they get ready to bathe. Use some nice-smelling bubble bath and place some soft music. Make the bathroom familiar to them with a favorite bathrobe, towels or a picture they always had hanging in their bathroom. These can make a bath seem like a treat instead of a chore and can trigger the memory of needing to bathe. Make sure the room is as safe as possible, with no slippery floors. Use nonskid mats in the tub or shower and make sure any rugs have nonskid backing. Once the bathroom is ready, let your loved one know in a soft, gentle voice. If your loved one does best when given choices, try this approach: “Would you like to take a bath or shower?” “Would you like to bathe now or in 15 minutes?”

Getting Undressed

When getting ready for their bath, let your loved one do as much as possible on their own. This will increase their feelings of independence and comfort and trigger their long-term memories. In the early stages a dementia, a simple reminder to bathe may be all that’s needed. As the disease progresses, however, you may need to verbally cue them through each step. Eventually, you may have to help them undress. When helping the person undress, wrap a towel around them for both privacy and warmth. If the resistance to removing clothing becomes extreme, allow the person to keep their clothes on. Once in the tub or shower, the heaviness may cause them to remove clothing on their own.

Taking the Plunge

Once in the bath, again, let the person do as much as they can on their own. Coach them one step at a time: Put your feet in the tub. Sit down. Take the soap. Wash your arm. Help them by providing tactile clues such as touching the body part they should wash. If they are unable to wash themselves, give them a role, such as holding a washcloth or shampoo bottle. Be gentle, as their skin might be sensitive. Check all areas of the body for redness, sores and rashes. If you notice any of these things, seek immediate health care attention.

Post-Bath Care

After the bath, have them sit down and place a towel or robe over their shoulders while you use another towel to dry them off. Pat dry as opposed to rubbing. Give them a word of encouragement for having successfully completed a task. Saying “Now doesn’t that feel better?” will reinforce the idea that bathing is a pleasant activity.

Finally, try to set a regular schedule for bathing, so it becomes part of your loved one’s routine. If they become used to bathing at a certain time every day, they will become less resistant to it.

Making Meal Time Enjoyable

Mon, 20 Jul 2020 20:13:20 GMT

Mealtime for people with dementia can be stressful, overwhelming or frustrating. They may no longer recognize the food in front of them or can’t see it clearly because of poor depth perception. They may struggle to use a knife and fork as coordination becomes difficult. Food may not taste the same or as flavorful as it once did. Food may be difficult to chew or swallow or they may not want to accept assistance with eating. Appetites may also vary among individuals with dementia. Some will want to eat all the time, while others have trouble eating a healthy amount.

Here are some tips to help make mealtimes more enjoyable and successful:

Set the mood

Meals should be relaxed and unhurried in a well-lit and calm setting, free of distractions. Because of possible depth-perception problems, use contrasting colored plates and linens. It can be difficult to see food such as mashed potatoes on a white plate on a white table cloth. Provide the right equipment for independent eating, such as scooped plates, large-handled silverware, and cups with lids. If utensils are cumbersome or frustrating, provide finger foods. If the person is able, have them help set the table and prepare the meal. If your loved one enjoys music, playing soft, instrumental music can help create a soothing mealtime experience.

Savor the moment

To enhance the dining experience, it’s important to know the person’s likes and dislikes and plan meals accordingly. Have the meal ready to serve prior to sitting your loved one at the table. Provide a small number of food choices and serve small portions frequently throughout the day — large portions can be overwhelming which can prevent them from eating any of it. Cut up foods prior to serving them, so they can focus on the food and not the mechanics of trying to eat. Sit with your loved one during the meal. If you have to assist them with eating and drinking, talk about what you’re offering to help remind them of tastes and flavors. Eat with them. Often, they will do what you’re doing and you can gently remind them throughout the meal if they get distracted.

Drink it in

Dehydration is of particular concern among people with dementia as it can aggravate the symptoms of the disease. Therefore, it’s always important to have plenty of liquids available with the meals. Plain water can be boring, even for those in the best of health, so to make beverages more enjoyable, flavor water with lemon or orange slices. Add additional fluids by serving Jell-O, soup, pudding, popsicles, smoothies or “mocktails.” Keep fluids within easy reach during the meal and use travel cups to prevent spills. Finally, avoid really hot or cold drinks as some people with dementia may lose the ability to judge temperature.

Help A Loved On Get Dressed

Mon, 20 Jul 2020 20:10:55 GMT

Getting dressed and feeling good about how we look is an important part of everyone’s self-esteem, but it is also something we typically do in private. Assisting someone who has dementia with dressing can be a challenge because it is something they are used to doing independently. Here are some general tips that may help you assist your loved one with dressing.

Staying with the Familiar

First, try to keep the same dressing routine they had before dementia. Did they get dressed first thing in the morning or did they wait until they had some place to go? Keeping their routine the same will help them understand what is going on and reduce confusion.

Give them Control with Limits

When dressing your loved one, it’s good to give them choices to help them feel in control, but you should limit those choices so as not to confuse or overwhelm them. Would you like to wear the red shirt or the blue shirt? Would you prefer blue jeans or khakis today? Have the clothes laid out and point to each option as you’re saying it. This will make it easier for your loved one to choose. If your loved one is showing resistance, talk about past experiences that motivated your loved one to get ready for the day, such as going to work, going to church, taking care of the home, etc. Keep the clothing options familiar. If your loved one never wore sweat pants, they may not want to wear them now.

Slow and easy wins the race

During the actual dressing, go one step at a time, and go at their pace. Tell your loved one what you are going to do, and tell them what you are doing throughout the process. Provide for their privacy and modesty by using a bathrobe or towel while dressing.

Go shopping!

Finally, when your loved one needs new clothes, take them shopping with you and let them choose the items they like. This will make the clothes seem more familiar and they will be more likely to wear them. If your loved one typically has a “favorite outfit,” buy duplicates so they will always have their favorite outfit clean and ready to wear.

Dealing With Incontinence

Mon, 20 Jul 2020 20:08:08 GMT

With the progression of dementia, your loved one may be experiencing incontinence. The changes in a person’s brain that occur with dementia can interfere with their ability to:

Recognize the need to go to the toilet.
Be able to wait until it is appropriate to go to the toilet.
Find the toilet.
Recognize the toilet.
Use the toilet properly.

If your loved one is experiencing incontinence, the first thing to do is see a doctor. There may be other reasons for the problem, which may be treatable. If your doctor finds no other explanations for incontinence, the cause is most likely dementia.Be aware of your loved one’s body language. If they are fidgeting, undressing, pacing, or otherwise agitated, it may be because they feel the need to use the toilet. If you see this behavior, ask your loved one if they need to use the bathroom or guide them towards the bathroom without asking. If so, go with them and provide any assistance that’s needed. It may help to:

Use short, simple words to give step-by-step instructions. For example, “Sit down.”
Use words that are familiar to the person, such as “pee” or “tinkle.”
Do not rush the person.
Reassure them.

For the long-term incontinence management, try to develop a regular toileting schedule. This will help reinforce to your loved on why they are there. Here are some other things that may help:

Use a contrasting color for the toilet seat, as many people with Alzheimer’s suffer from depth perception.
Make sure there is a night light or motion light in the bathroom.
If your loved one is the only one using the bathroom, remove the door.
Purchase clothing that can be easily removed.
Use a bedside commode or urinal.
If your loved one still faces challenges, adult diapers and protective bed pads are useful tools.

Tips On Maintaining Intimacy With a Spouse Who Has Dementia

Mon, 20 Jul 2020 20:05:18 GMT

It’s natural for couples to experience changes in their level of intimacy and sexuality over time, but when one partner develops dementia, the changes in physical and emotional intimacy can be complex and devastating.

Individuals with Alzheimer’s disease or dementia may have a decreased sexual drive for a variety of reasons, including depression, medications, physical ailments, memory impairments, or personality changes.

The significant loss of emotional and physical intimacy with a spouse can be painful and isolating. At the same time, caregivers often lose sexual desire because of the exhausting demands of caregiving or a confusing new relationship balance as they take on more of a parental role.

It’s extremely normal for caregivers to feel guilt, frustration, resentment, embarrassment and confusion surrounding the love, intimacy and sexuality changes that emerge with a spouse who has dementia. Your challenge will be to address them in a healthy manner and take proactive steps to improve the quality of life for your and your spouse. Here are some tips that will help you reduce stress and enhance your self-esteem.

Self-care tips

Develop a support system of friends and family who you can comfortably share your feeling and experiences.
Keep a journal to help you express the feelings you may not be ready to discuss openly with others.
Join an Alzheimer’s support group that includes a number of spouses caring for their partner and ask the facilitator to raise the issue cautiously.
Seek out individuals in your support networks who are having similar issues and schedule some one-on-one time at a local coffee shop or restaurant so you can talk.
Consult with a religious advisor or therapist.

Promoting intimacy with your spouse

Even with the onset of dementia, there are still aspects of your relationship that you can nurture and that will foster closeness. Here are some activities that you can do together to promote intimacy between you and your partner:

Sing a song
Listen to music
Look at photo albums
Reminisce about happy life events
Take a walk or a drive
Visit with animals or children
Do some simple gardening projects
Exercise
Dance

Physical intimacy through touch

Touch is a very basic human need, and essential for the well-being of individuals with dementia. A touch can convey compassion, reassurance, safety or care — which are crucial in a loving relationship. Here are some tips to incorporate touch into your daily activities with your spouse or partner.

Rest your hand on his or her knee or shoulder when you sit together.
Whenever you walk with your loved one, retain physical contact by holding his or her hand or arm.
Gently massage some lightly scented lotion on your loved one’s hands and feet. Have a podiatrist take care of nail clipping and necessary medical procedures.
Assist with personal care such as shaving, manicures, hair brushing and even scalp massages.

Additional Resources:

Alzheimer’s Association Publications

Honoring Dad on Father's Day

Mon, 20 Jul 2020 19:59:30 GMT

Holidays can pose a special challenge for caregivers of people with dementia. Loved ones may not remember the reason for the day or why you’re making such a fuss. This may be particularly hard on Father’s Day, when your dad may not even recognize you as their child. While this can be an emotional blow, making the effort still matters.

Even if your father can’t remember your name or exactly how you fit into their lives, your face may still be familiar, making your presence a great source of comfort and pleasure. To a person with dementia, the world is often confusing. Seeing a familiar face, even if they can’t place it into a particular context, provides a sense of normalcy and stability.

Here are some ideas to help make your experience with you dad more enjoyable:

Bring him one of his favorite foods, like some BBQ ribs or foods that evoke a specific memory, like watermelon or corn on the cob. This will not only bring pleasure, it may stir some memories and provide him an opportunity to talk about the good times he still remembers.
Spend time doing something he has always enjoyed. Encouraging your father to continue to pursue lifelong passions and hobbies is a great way to provide a sense of fulfillment while also connecting.
Understand that your dad may not enjoy engaging in conversations that he can no longer follow. So, bring along a DVD of one of his favorite TV programs or movies or a CD of his favorite music. Visual and audio stimuli remain a powerful communications mechanism for the memory-impaired even as speech fades.
Give him a gift that he will be able to enjoy on a daily basis, like a framed picture of the two of you together, whether it’s the mountains, the sea, or a shot taken during a memorable family vacation or sporting event. It will be a source of constant enjoyment.

You can still honor your father on his special day, even if he has dementia. In fact, your simple act of spending time with him may be the greatest gift you’ve ever given.

Keeping Mothers Day Special In The Face of Dementia

Mon, 20 Jul 2020 19:56:23 GMT

With the rise in Alzheimer’s disease and its special impact on women, more families are celebrating Mother’s Day with moms who have dementia. Nearly two-thirds of the Americans with Alzheimer’s are women. It’s not their gender that makes them more susceptible, it’s their greater life expectancy. Because women live longer and dementia tends to be a condition of the aged, they simply have more opportunity to get the disease.

While brunch is a much-beloved Mother’s Day tradition, dementia can make dining difficult. Smell and taste often diminish, making meals less enjoyable and many times leading to loss of interest in food. As dementia progresses, it can also become physically difficult to eat. Remember that the Mother’s Day brunch has its roots in “giving Mom a break from cooking.” If your mother no longer does her own cooking, the idea of taking a “break” from it may no longer makes sense. So celebrate the day doing something your Mother truly enjoys. If she still enjoys eating, here are some tips to make brunch (or dinner) more enjoyable.

Make your mother’s favorite dishes, even if it’s not what you would normally prepare at that time of day, and remind her that she has always loved whatever it is you’re serving.
Bring the meal out one item at a time so it’s easier to focus on it: first the fruit salad, then the French toast, and then the bacon.
If you dine out, choose a restaurant that is familiar to her.
Go at an off-peak time and even consider celebrating on a different day to reduce the noise and distractions.
Create and bring a menu for your mother to look at that offers just two meal choices, rather than overwhelm her with selecting from the restaurant’s menu.

If dining doesn’t seem like the right way to celebrate, here are some other ideas for the day:

Take a photo album of your family and engage her in a conversation about the people pictured there. Long-term recollection is more enduring than short-term for the memory-impaired, which means she may still have memories that you can share together.
Realize that talking isn’t the only way to enjoy your relationship with your mother, especially if she has trouble communicating. Bring a CD of music that you know she likes and listen to it together. Music remains a powerful and pleasurable mechanism for the memory impaired even as speech fades.
Give her a gift that provides visual or tactile comfort. A soft sweater in a bright color will give pleasure on a daily basis. So will a framed picture of you and your mom together. Even if she won’t always remember who it is in the picture, It will be a source of constant enjoyment.

You can still celebrate your mother on her special day, even if she has dementia. In fact, your simple act of spending time with her may be the greatest gift you’ve ever given.