Care For The Caregiver

Care for the CaregiverWhat You Should Know when Your Loved One has Alzheimer’s

Overview of Dementia• Alzheimer’s Disease is a brain disorder named for German physician Alois Alzheimer, who first described it in 1906. • He presented the case of “Auguste”, a 51 year old woman.

Overview of Dementia

Overview of Dementia • a broad term for any brain disorder that causes confusion, memory loss, personality changes, and mental decline

Overview of Dementia• Is a progressive and fatal brain disease• Causes plaques and tangles in the brain that destroys brain cells• Is the most common form of dementia• Has no cure

Test Your Alzheimer’s IQ1. Dementia is another name for early stage Alzheimer’s. T/F2. If you suspect you have dementia, there is no point in going to a doctor to get diagnosed because there is no treatment. T/F3. Alzheimer’s disease is a psychiatric disorder. T/F4. Alzheimer’s disease is fatal. T/F5. Alzheimer’s disease is more common in older adults (over age 65) than in other age groups. T/F6. Alzheimer’s disease is the most common of the irreversible dementias. T/F

Timeline

Treatment• Current medications slow disease progression, but are not a cure.• Medications include Aricept, Exelon, Reminyl, and Namenda.• Psychotropic medications are used to treat challenging behaviors and moods.• “Hugs instead of Drugs”

Communication• Approach the person from the front.• Always get the person’s attention before speaking.• Avoid startling the person by moving slowly and gently.• Establish and maintain eye contact at face-to-face level.• Identify yourself by name.• Smile.

Communication• Speak in a gentle, soft voice.• Give brief, one-step directions.• Praise successes and emphasize the positive.• Use as few words as possible and be direct.• Be patient and reassuring.• Allow plenty of time for response.• Use non-verbal nods, smiles, pats, and gestures.• Use familiar words and cues.

Communication• Minimize noise and distractions.• Remain calm and reassuring if the person becomes agitated.• Maintain a comfortable distance.• Be repetitive and consistent.• Validate the person’s feelings and respond to them.• Talk to the person as an adult, not a child.• Keep your own stress to a minimum.

Behaviors Whose problem is it,anyway?

BehaviorsHave you ever been lost? Late foran appointment? Made the wrongturn?Scared ANXIOUS Nervous Unsure FrUsTrAtEdUptight ANGRY Impatient MAD

Behaviors• Look for triggers: Time – Pain – Bathroom – Tired – Environment.• Remain calm.• Go for a walk.• Do not argue.• Allow the person to feel that he/she is in control.• Sing a song together.• Use their life story.

BehaviorsKindness is a language that all canunderstand.

Since the person with Alzheimer’s has lost the last 20 to 60 years, they areliving at a younger age in their minds. No matter how hard we try, we cannotbring back their short term memory. This means we should not bring them toour reality, but that we need to live their reality. When they are looking fortheir mom, we need to tell them their mom is getting groceries. By givinganswers that make sense to them, they are able to relax and not worry aboutwhere their mom is. We don’t like doing this because we feel like we are lyingto them. I reassure you it is not lying, but it is “living their truth”. Maybe itwill help if you visualize yourself in their position. Let’s say you haveAlzheimer’s but do not remember that you do. You are actually 85 but youthink you are 24. You wake up in a strange place and remember that youhave children but you cannot find them. So you ask a stranger for help andthey tell you that your kids are grown and you live here now and everything isfine. Your reaction might be, “Everything is not fine. I need to go home andfind my kids!” Does this vision help you understand? More importantly I hopeit takes away some of the guilt you might have about “lying”. There is noreasoning with someone with Alzheimer’s and you will not be able to makethem live your reality. So instead, live their reality, and find treasures on yourjourney in their reality.

“I want to go home.”• Families feel guilt when they hear “I want to go home”.• Families might stop visiting because it’s too uncomfortable.• Understand that the home they are often looking for no longer exists because it’s a home from long ago.

“I want to go home.”• Responses:• Distraction – Tell me about your home.• Support – Your son will pick you up _____.• Magic words – I know things seem confusing right now, but I am here for you and I care about you.• The doctor wants to make sure you are feeling 100% better so he thought you should stay one more day.

“Where are my children?”• Response: Your kids are still in school.• Your daughter is working today.• Your kids are safe. Your sister is keeping them at her house today.• Poor Response: Your kids are grown up now and they don’t live around here.• Don’t you even know that I am your son? How could you forget me?

“I have to go to work.”• Response: It’s a holiday.• It’s Saturday. It’s Sunday. It’s the weekend.• We are supposed to get bad weather today so your boss has instructed us to take the day off.• Poor Response: You are retired and you don’t work anymore.

“Where is my husband?”• Another very difficult situation is when the person asks where their spouse is and their spouse has already passed away. Again, we need to live their reality. This person wouldn’t be asking where their spouse is, if he/she didn’t think their spouse was alive, right? Imagine if someone told you today that your spouse was dead. What grief and pain you would go through. Now imagine that you asked that question every day, and every day you had to relive the news of the death of your spouse. I cannot stress enough that you should not tell the person that their spouse passed away. Instead think of what their spouse might be doing if they were alive. “Jo is at work.” “Alice is getting groceries.”

President Eisenhower

Expectations The course of dementia can take manyalternate routes and can affect individuals in very different ways, so expect the unexpected!

ExpectationsWandering and not recognizing familiar itemsare common symptoms of dementia.Label your loved one’s clothes,glasses, and other belongings with permanentmarking.

Expectations• Misplacing objects is another very common symptom of dementia.• Please remove valuables such as expensive or sentimental jewelry from our home. Try replacing valuable jewelry with costume jewelry.

Expectations• We want to make sure your loved one is safe.• Please notify your loved one’s caregivers when you are leaving with your loved one. Sign out in the book at the front lobby. When keying in the alarm code, be sure a resident does not follow you out.

Expectations• There is no such thing as a magic wand.• Your loved one may not want to take a shower here any more than they did at home, but with the right approach, we hope to partner with you and your loved one in providing them with the best care.

Expectations• Remember in activities and socialization, quantity is not always quality.• It is our goal to enjoy life-enriching activities with each and every one of our residents every day. A simple hug, hand massage, or hearing a memorable story from your loved one can often times be more meaningful than a large group activity such as a movie or bingo.

Adjusting to a New Home• Expect agitation for at least 2 -3 weeks.• Expect the person to be angry but do not beat yourself up about it.• Know that you did the right thing and that your loved one just needs to grieve.

Adjusting to a New Home• Plan a BRIEF visit, 10 – 15 minutes.• A 3-hour visit is going to cause agitation.• If a loved one demands to go home, do not try to explain.• A person with dementia will often start talking about going home when they start to get tired, usually after about 30 minutes into the visit. Take it as an indication that it is time to go.• Don’t focus on goodbye.

Adjusting to a New Home• Take something to do.• Once you are done, it is time to go.• Have the staff divert your loved one to an activity such as a meal.

Adjusting to a New Home• Call before you come so you know what kind of day your loved one is having...

Adjusting to a New Home Talk. Smile. Compliment.

Care for the Caregiver• Who are today’s caregivers? • Spouses • Daughters • Daughters-in-law • Sons • Siblings • Grandchildren • Friends

Care for the Caregiver“Caregivers are at increased risk for depression and illness, especially if they do not receive adequate support from family, friends, and the community.” ~ National Institute on Aging

Care for the CaregiverPace yourself…It’s not a sprint, it’s a marathon.

Care for the CaregiverPut on your own oxygen mask first.

Care for the Caregiver What can you do?• Accept Help.• Let it go. “You cannot control the wind, but you can learn to adjust the sails.”• Don’t give in to guilt.• Educate yourself.• Maintain a sense of humor.

Care for the Caregiver• Be your own best friend.• Take time to relax.• Join a group.• Find support.• See your doctor.

ReferencesAlzheimer’s AssociationBest Friend’s Approach to Dementia Carehttp://bit.ly/hMS4IXhttp://bit.ly/bwYVDt

Contact Uswww.sycamorevillage.netwww.facebook.com/sycamorevillagewww.youtube.com/sycamorevillagewww.flickr.com/sycamorevillagewww.twitter.com/sycamorevillagePhone: 618-222-2571Email: nmcfarland@sycamorevillage.net

Care For The Caregiver

by Amberwood Care Centre on Nov 15, 2011

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