Imagine waking up one morning and not knowing where you are.  What is the first thing you might do?  You would probably get up and begin walking around in an attempt to determine where you are.  In many ways, wandering can be very similar.  When a person with dementia is confused and unable to recall where she is, she may actually be looking for a familiar face or setting.

            Problematic wandering occurs when a person with dementia has no awareness of safety.  Care givers may see her attempt to go into unsafe spaces such as a closet with chemicals or attempt to exit the home.  Someone wandering day in and out may also experience falls related to unsteady gait due to fatigue or possibly weight loss and dehydration.

            Care givers can resolve problematic wandering in simple ways that do not cost much, if any, money.  The most effective way to stop problematic wandering is to develop personally meaningful days.  Care givers who can adapt previous hobbies and roles to the retained abilities of their loved one have the keys to unlocking quality care. 

            Care givers should provide opportunities for participation in “normalized” activities each day.  Your mom can begin the day by starting a crock-pot of soup during the day, folding linens, sweeping the floor, or even walking the dog.  These opportunities build self esteem for her and give her a since of purpose.

            Wandering in and of itself is not always a problem that needs to be fixed.  However, when safety becomes a concern; care givers do not need to look  for complicated answers or costly solutions.  For more information, please feel free to contact Sollievo at (317)218-5111 or www.behomelivelife.com

 This week we honor the care givers who work hard each day to make the lives of our seniors living in long term care meaningful and rewarding.

 Many of these individuals see their work as a career – a part of their mission in life to help others. Consider the story of Mary:

 “Mary cared for my mother with such love and kindness.  When I had to place Mom in the nursing home, it was Mary who sat with me and held my hand; assuring me that everything would work out.  Mary always made sure to provide Mom with opportunities throughout the day to enjoy her past hobbies by adapting them to what she was able to do at that time.  Mary and Mom planted gardens, cooked Mom’s favorite dishes, enjoyed the holidays, painted ceramics, and many other rewarding activities.  Mary’s attention to each of the residents on the Alzheimer’s Center did not go unnoticed!  The families who came to visit often commented on how much the Center felt like home.”

 There are many examples of care givers who go the extra mile for their residents – CNAs, nurses, activity, dietary, maintenance, housekeeping staff, and the administration all working to achieve the perfect balance between meeting the medical needs of their residents and providing opportunities for success throughout the day.  Long term care is a demanding job with endless rewards. 

 Take time out this week to thank a care giver working in long term care.

 Thank you Mary, and to the others just like you, for your dedication to our loved ones.

I received this information today in the Alzheimer’s Association’s ENewsletter.  Please join all caregivers to make a difference in the lives of those who are battling this difficult disease.

Advocate Impact: Forum 2009 

Last month, over 600 advocates from around the country marched on Capitol Hill to demand that our lawmakers make Alzheimer’s a national priority.

During meetings with advocates, members of Congress made the following commitments:

       188 indicated support to end the two-year waiting period for Medicare;

       181 indicated support for a $250 million increase in Alzheimer research funding; and

       83 indicated support the creation of an Alzheimer’s Solutions Project Office.

       65 members indicated support for all 3 issues!

You can catch a glimpse of the action at: http://www.alz.org/forum

We have great momentum and now is the time to “seal the deal”. Read on…

What Can I Do Now?

Ask your members to co-sponsor the End the Medicare Two-year Wait Bill!
People under age 65 with dementia who lose their jobs are likely to lose job-related health insurance. Many become uninsured and uninsurable. Just when they need coverage the most, federal law requires them to wait two years to become eligible for Medicare. Because of this wait, families face soaring out-of-pocket costs for health care or completely forego care. 

Email your members of Congress now. Ask them to co-sponsor the Ending the Medicare Disability Waiting Period Act of 2009 (S.700 / H.R.1708).

Go to: http://alz.kintera.org/endthewait 

For more information on how you can make a difference in the lives of those with Alzheimer’s contact us at 317-218-5113 or www.behomelivelife.com.

1. Enjoy reminiscing with your family member. Short-term memory may be damaged, but long-term memory often remains. When reminiscing it is helpful to talk about subjects (such as winter snowstorms or making holiday dinners) rather than a specific memory or event or name from the past.
2. Recognize the special abilities that remain and enjoy them together.
3. Most people, with or without Alzheimer’s disease, generally enjoy a good meal, animals, babies, or favorite music.
4. People with Alzheimer’s disease still enjoy (and need) hugs and other forms of affection. Sit close and look at pictures together. Enjoy a hand massage.
5. Look for activities that will be interesting to the person. In seeking activities the individual would enjoy, it helps to think about past work experiences and past and present interests.
6. Do activities that are failure-free. A SIMPLE craft project with a pre-set outcome or appearance may be too difficult, whereas arranging silk flowers in a vase is a failure-free task. Sanding wood blocks is usually failure-free. Setting the table is as well.
7. Reduce distractions so the person can focus on the task, eliminating things such as background noise from the television.
8. Keep exercise and physical activity part of everyday as it helps keep sleep and nighttime habits normal.
9. Familiar activities such as setting the table and folding laundry should be part of the daily routine that the person with Alzheimer’s disease helps do. The tasks are meaningful, familiar activities which help him/her retain skills as long as possible.
10. If music, exercise, or spiritual activities were part of your family member’s routine each week, those type of activities should occur frequently during the week as well.

Begin by thinking about last week:

Which activities worked best and which didn’t? Why?
Were there times when there was too much going on or too little to do?

Use what you’ve learned to set up a daily plan. A planned day allows you to spend less time and energy trying to figure out what to do from moment to moment. Allow yourself and the person with dementia some flexibility for spontaneous activities.

Oftentimes, structured and meaningful activities reduce agitation and improve mood. The type of activity and how well it’s completed are not as important as the joy and sense of accomplishment the person gets from doing it. So, remember, it’s not about the end product, it’s about having fun, doing something your parent remembers doing, and giving him/her the feeling of being needed again.

The success of an activity can vary from day to day. In general, if the person seems bored, distracted or irritable, it may be time to introduce another activity or to take time out for a rest.

An example of a daily routine:

Morning

·         Wash, brush teeth, get dressed

·         Prepare and eat breakfast

·         Have coffee and make conversation

·         Discuss the newspaper, try a hobby, reminisce about old photos

·         Take a break, have some quiet time

·         Do some chores together

·         Take a walk, play an active game

Afternoon

·         Prepare and eat lunch, read mail, wash dishes

·         Listen to music, watch TV, do some puzzles together

·         Take a short break or nap

·         Do some gardening, take a walk, sand some wood, play a few holes of golf, or visit a friend

Evening

·         Prepare and eat dinner, clean up kitchen. Be social during this time

·         Reminisce over coffee and dessert

·         Play cards, watch an old movie, visit with family

·         Take a bath, get ready for bed, read a book, or watch an old TV show (I Love Lucy, Bob Newhart, etc.)

For more information call (317) 218-5111 or www.behomelivelife.com

Eating regular nutritious meals can become a challenge for individuals with dementia. They may become overwhelmed, forget to eat or think they have already eaten. If your loved one is having difficulty eating, here are some quick tips and strategies:

·         Be flexible to the person’s food preferences – Remember that the person with dementia has long-standing personal preferences. Try to keep these likes and dislikes in mind when you’re preparing food.

·         Serve meals in quiet surroundings – Away from the television and other distractions.

·         Keep the table setting simple – Ensure dinnerware is free from design and of a neutral color that provides contrast with the tablecloth or placemat.

·         Keep in mind that the person with dementia may not be hungry, or remember when or if he or she ate – Smells before mealtime such as bacon cooking, coffee percolating, or bread baking will help stimulate appetite. If the individual continues to ask about eating breakfast, you might consider serving it again for lunchtime.

·         Provide an appropriate activity – If the person needs to wait while you are completing and serving the meal.

·         Encourage independence – Serve finger foods, or serve the meal in the form of a sandwich. Use spoons with large handles instead of forks. Use cups or mugs with lids to prevent spilling, and fill glasses half full; use bendable straws.

·         Let the person set the pace – Have a cup of coffee and keep conversation going to engage your loved one as much as possible.

·         If you need to give hands-on assistance – Explain what you are doing and provide visual cues by demonstrating. Adjust your assistance level to the person’s independence and participation level.

For more information call 317-218-5111 or www.behomelivelife.com

At the mid-stage of Alzheimer’s disease and related dementias a caregiver often has to manage the challenges of:

·         Difficult behaviors such as agitation and restlessness, or the extreme reaction to an event or situation which the person with dementia doesn’t understand

·         Wandering, and the challenges of keeping someone safe in the home, particularly during the nighttime hours

Care can be a 24 hour a day / 7 day a week task as the person with mid-stage dementia often has day and nighttime routines mixed up. This can create difficulty managing the person safely in the home during the hours a caregiver is sleeping, or may be in another part of the home.

The late stage of Alzheimer’s disease usually requires intensive, around-the-clock assistance. A person in late-stage Alzheimer’s usually:

·         Has difficulty eating and swallowing

·         Needs assistance walking and eventually becomes bedridden or chair-bound

·         Needs full-time help with personal care, including toileting

·         Is vulnerable to infections and pneumonia

·         Loses the ability to communicate with words

At this stage, care requires a fair amount of physical capacity and endurance, as well as additional caregiver support which may strain or exhaust financial resources.

If you are not sure if it’s time to select a nursing home, ask yourself a few questions:

Safety:
Is the person with dementia safe?
Has he/she left the house alone and/or gotten lost?

Health:
Is the health of the person with dementia at risk?
Is my health as a caregiver at risk?
Is he/she incontinent of bowel and/or bladder?

Care needs:
Does the person with dementia need more care than I am able to give right now?
Is it becoming too difficult for me to care for the person with dementia?
Have I exhausted financial resources needed for paid caregiver support in the home?

For more information call 317-215-5111 or www.behomelivelife.com

Short term memory loss is typical with someone who has Alzheimer’s.  Caregivers may feel themselves becoming very frustrated with repetitive questions and may not know how to help the person with Alzheimer’s.

Tip:

Caregivers should answer the question.  Provide multiple cues to help the person with Alzheimer’s try to remember the answer. 

For example, when asked “When are we going to eat?” try these responses:

Answer #1:  “We will eat at noon.”  Point to a clock and ask if the person if they remember what noon looks like on the clock.  Then say:  “When you smell the bacon cooking you will know that the BLT’s are ready to eat.”

Answer #2:  “Are you hungry now?  We could have a snack.”

Or

Answer #3: “Would you like to help me prepare lunch?”

If this tip isn’t working, try to figure out what need is un-met.  Is the person with Alzheimer’s feeling unsure of himself or the situation?  Is he feeling scared?  Does he need to eat now because he is hungry?  Is he looking for something to do?

Fulfilling an un-met need or using redirection may be an effective tool in reducing repetitive questions and redirecting his thoughts to something different.

For more tips:  check out our website at www.behomelivelife.com or call 317-218-5111

Providing personal care is a very demanding job.  Our goal as caregivers should always be do the task “with” the person who has dementia, never to do the task “for” someone with dementia.  Most tasks can be completed successfully; however, many times these tasks will need to be adapted to the person’s abilities. 

Base the bathing task on the routine your mom used prior to the onset of dementia.  Did she take a bath or a shower?  When did she bathe and how often?  Did she wash her hair during her shower?   Once you identify her past routine, you can structure the current routine around her personal preferences.

Remember these tips:

Ensure that the bathroom is comfortable for showering.  Is the temperature comfortable and is the lighting appropriate?

Make sure all necessary items for the shower are waiting in the bathroom.  You don’t want to leave in the middle of the shower to find a towel or soap.

Make the experience a relaxing pleasure, not a demanding chore.

Allow your mom the opportunity to complete as much of her shower herself, as possible.  You may need to stay close by for safety, but remember that dignity is important.

If an argument begins, stop the shower.  Try again later or you may even consider a sink bath. 

Remember, keeping your mom relaxed and feeling safe the important part.  There are many ways to keep a person clean without immersing her completely in the water.

For more tips:  check out our website at www.behomelivelife.com or call 317-218-5111