Archive for February 4th, 2009

Posted on February 4, 2009 - by Nurse Virginia

Aging: Please Get To Know Me – Aging with Dignity and Relevance

My Website is www.pleasegettoknowme.com

Posted on February 4, 2009 - by Nurse Virginia

AGING: Promise you won’t put me in a nursing home – fear of becoming old, and frail make seniors ask for “The promise”.

People 85 and older, fastest growing segment of population.

 
Senior citizens fastest growing segment of the population. As people age they often ask of their family “Promise you won’t put me in a nursing home.” Fear of nursing homes is connected to the fear of aging. In this culture people often fear aging, frailty and disability more than death. The picture of aging is often a picture of someone helpless and hopeless.

Many family members give the promise.

 
As a nurse, many times when talking to a family member, they have shared the information with me that “I always promised I would never put her in a nursing home. But I tried to take care of her as long as I could, I just couldn’t give her the care anymore that you can.”

People now living much longer.

 
It used to be rare in a nursing home to see someone over 100 years. When we had a resident over 100 years, staff would all go to see that “old person.” Now it is very common for a nursing home to have much older people. My mother’s home had a monthly birthday party recently and of the 4 people honored – 3 were over 100. My Mom is 85 soon to be 86 and her best friend there is 104 years. Old enough to be her mother.

However for her friend, being 104 means she has out lived almost all of her family. She now has only a Granddaughter left with one child. Anyone she would have asked to make that promise to her is gone. As the population ages, many families who have made such a promise with the best of intentions, because of their own age and health concerns are no longer able to care for a elderly spouse or parent.

3 Promises you should make instead of “The Promise.”
• Promise to do the best you can. The person asked you because they trust you. Tell them that you will always do whatever you can to take care of them. You don’t know what circumstances may happen in the future.
• If someday you may have to find a caregiver or a Nursing facility, promise to find the best one you can.
• Promise to visit regularly – the fear of being abandoned is great. Because people are afraid of being abandoned they use the word put “promise you won’t put me in a nursing home” instead of admit, place, register, words with a more positive sound. As my Mother once told me, some people are just put here like something on a shelve to be forgotten.

If you have an elderly parent see: www.pleasegettoknowme.com

Posted on February 4, 2009 - by Nurse Virginia

Caregiver Tips: How the senior who has Alzheimer’s Disease forgets their words.

Word loss can be predicted for the senior with Alzheimer’s disease.

As a person goes through the stages of this disease they will lose the ability to talk. In the very beginning they have word finding problems, and they start substituting words, when they forget a word. In the mid-stage they may have just a few words and in the late stage many times they have only one word left and it is yes, or no.

Confused seniors no longer understand concept words.

As people with Alzheimer’s disease lose the words they say, they also are losing the ability to understand words. So when working with someone in the mid-stage who has few words saying to them “do you want to have lunch” won’t be understood. This is why Alzheimer’s specialist say to use concrete words and when ever possible show the item.

As a very young child grows they first can identify a banana by seeing a real banana. They then progress to being able to identify a picture of a real banana, then a drawing of a banana and finally they understand the word banana and can be asked if they want a banana without showing them the fruit itself.

Persons with Alzheimer’s disease lose their words and the meaning of the words in the same order they gained those words. So for the person who is losing these words, once again showing them an actual banana and saying do you want a banana will work much better than the word alone.

Help the senior understand by showing.

So when you talk to a person with Alzheimer’s disease, turn “do you want to have lunch” from a question into a statement “let’s have a sandwich” while you show the bread and lunch meat.

Anytime you turn a question into a statement and an idea into something concrete to be seen you will have greater success.

Posted on February 4, 2009 - by Nurse Virginia

Caregiver Tips: The senior’s name is so important, when working with the senior with Alzheimer’s Disease.

Use the name the senior responds to.

Everyone’s name is important to them. Many people have a special significance to their name. They were named after someone in the family, by someone usually their mother. This is the word that people respond to even very late in the disease process.

I remember a woman who had lost all of her words, was total care in all activities of daily living. And as I walked past her in the hall, all I said was “Gracie”, and her head turned towards me. She was at the end of her life and died soon afterwards but till the end she still responded to her name.

Make sure you are using the name that the person still responds to. When caregivers call everyone “Grandma” that person may have long forgotten that they are a grandma. And so much worse, if the caregiver doesn’t really know them and they never were a grandma – how confusing would that be. I have seen elderly women only respond to their maiden name and when living in a nursing home, the home had to use both maiden and married names to identify them.

Everyone deserves the dignity of being called by the right name; take the time to find out that name.

Posted on February 4, 2009 - by Nurse Virginia

Caregiver Tips: 8 Tips for communicating effectively with a senior with Alzheimer’s disease.

8 Steps to better communication with the confused senior:

• Talk slow – people need time to process and understand words. People with Alzheimer’s disease need even more time.
• Make sure you have the person’s attention, make eye contact. This means if the person is in a wheelchair, stoop down or sit down to talk to them at their level – eye level. Standing over someone and talking down to them can be intimidating, or it might make the person think you are speaking to someone else.
• Give one direction at a time. People with Alzheimer’s disease can’t remember several things at a time.
• Use concrete names. Say” please put the plate over here” – don’t say “put it over here” using “it” for plate. Use a person’s name instead of he or she and add the person’s relationship. Instead of “he is parking the car” say “Bob your brother, is parking the car.”
• Remember “please” and “thank yous”. People with Alzheimer’s disease retain courtesy late in the disease process. I have seen people with no language skills left, yet still able to walk. If they bump into you will say “sorry” or “excuse me”, even though they can say nothing else.
• Keep it simple. Don’t use a lot of words when few will do. It might be your way to talk a lot, and the sound of the human voice can be very soothing. But not if the words are expecting something from the person unable to understand and so cause frustration. But informative conversation about the family, the weather, food, anything that doesn’t include questions and require answers, will be positive.
• Don’t argue. In fact if there is a misunderstanding apologize before emotions escalate. If you don’t understand what the person wants or is trying to communicate simply say “I’m sorry, I don’t understand.”
• When things go wrong or mistakes are made, laugh it off. Not in a way where the person might think they are being laughed at – but rather in a way that says, we all make mistakes – this isn’t a big deal.

Let Go – Let God. Keep in mind the big picture see (Let Go Let God) the last chapter of my book Please Get To Know Me – Aging with Dignity and Relevance.