Archive for April, 2009

Posted on April 27, 2009 - by Nurse Virginia

Caregiver Tips: Why blog? When we have a “silver tsunami” coming at us and more family members are becoming caregivers

The question for healthcare professionals is –
Why not Blog?

Recently I have heard this phrase several times “we have a real tsunami of dementia coming at us” or “the silver tsunami is coming.” What we know is that we now have 4-5 million people diagnosed with Alzheimer’s disease. Current estimates are that there are about 2 million people living in Nursing Communities. People 85 and older are the fastest growing segment of the population. When you are 85 years old you have a 47% chance of being diagnosed with Alzheimer’s disease.

All of these facts point to the overwhelming awareness that we all need to do something now.

The number of caregivers in the home, whether spouse, children or private duty home health caregiver is staggering. And that is just for the people with Alzheimer’s disease. Many home caregivers are taking care of someone with a disability, someone with another dementing disease or someone terminally ill.

This week I have had the opportunity, at the Illinois Department of Aging 2009 conference, to speak to many case managers. The stories they tell of difficulties they and their home health caregivers are dealing with are truly overwhelming.

Opportunities abound for health care professionals in facilities to learn person-centered care. But for the caregiver in the home, how much help is there for them?

If “blogging” is a way of reaching out a helping hand to that growing multitude of caregivers struggling in the home – many times going it alone, why not do it?

Then the question for the health care community should be, why not blog?

Posted on April 22, 2009 - by Nurse Virginia

Caregiver tips: person-centered elder care in the nursing home or in your home, can be as simple as red hair.

It was red, it was orange, it was some color in-between, it was red hair I wouldn’t forget. And then, I saw it again on a 90 plus year old woman coming down the hall of the nursing home in a wheelchair.  It was Clarisse, and I never would have recognized her, except for that hair.

It was twenty odd years since I had seen her. When I was a young bride my husband was taking banjo lessons from Harry and I would visit with his wife Clarisse. My husband never really took to the banjo, but we became good friends with Harry and Clarisse.

They were in “show business” and their claim to fame was the one time a year when Harry played the BOZO Show. Clarisse told me all about the traveling they had done and the shows they had played. Harry’s career always was very much Clarisse’s, they were a team. Show business never paid very well and they lived in a modest home. Harry made most of his income giving banjo lessons.

Clarisse and Harry never had children and looked on his students as the children they never had. So when Harry went hunting and they hosted their annual “pheasant feast”, we were included. They had students coming over all the time and music filled that little home.

When elder care becomes person centered care.
Clarisse had shared with me that she needed a somewhat memorable appearance, them being in show business and all. So, many years ago she had come up with her own “recipe”, a combination of several colors to create her unusual red hair.

The years went by and my husband’s lessons stopped when our children came along. We lost touch with Harry and Clarisse, but I would catch Harrys’ act every once in awhile when, my children were growing up watching BOZO.

And now so many years later, here she was coming down the hall of the nursing home, with Harry by her side. Clarisse was in the late stage of Alzheimer’s disease and Harry had been her caretaker for years now. In all that time dressing her, bathing her, feeding her, Harry had taken the time to mix her “recipe” and color her hair.

Now it was our turn, we inherited the “recipe.” And while Clarisse spent her last year with Harry by her side playing the banjo. We now bathed her, dressed her, fed her and yes, kept that red hair going. Because, that’s person centered care, you know she was in “show business.”

Posted on April 22, 2009 - by Nurse Virginia

AGING: No Nursing Home for Baby Boomer Nurses

When baby boomers don’t downsize.

 
We always thought when we reached a certain age we would think about down-sizing. But with the value of our family home, for past 35 years, now going in the wrong direction, we have to re-think “the plan.” Realizing that people are living longer, and both of our parents being long-livers. We have the expectations of also living to very old age.

The new and improved “plan!” My retired husband is busy everyday working on the lower level of our raised ranch home, turning the area into an apartment. In light of the current need for apartments by those people who have suffered from foreclosure, we will now have a small apartment to rent.

Long term care insurance – housing for future caregivers.

However better than that, we are creating housing for our own caregivers of the future. If and when we get to that time when it is our turn to be old, the hands that assist us in our fragility will be our tenants. Seems like a long term care policy that will be a future win, win. This, I thought was pretty unique thinking until I shared the concept with other Baby Boomer nurses.

Even though we had never had this conversation, I was surprised to hear that they too were creating similar spaces in their homes. They also had thought they would downsize and the present picture in Real-estate has made them rethink the future. Several are looking into home elevators to make their two story homes meet their needs in the future. Many, who thought they would retire soon, are planning working longer because they are concerned about their children’s employment. But, all of them are working on living spaces for their future caregivers.

So, for now we are putting in new doors, painting, looking for new carpet – who ever that kind caregiver is in my future – I hope they like it!

Posted on April 17, 2009 - by Nurse Virginia

Caregiver Tips: Alzheimer’s Disease

When the problem is that the person still looks “so good”, it’s not like a broken leg where you see what is wrong.

Many times especially in the very early stage of Alzheimer’s disease people look so good you can’t tell. The person often looks so well physically, which can cause outsiders to question the caregiver’s talk about incompetence. Or family or friends might suggest medical system failure in the diagnosis.
Family members may experience difficulty accepting the diagnosis of Alzheimer’s disease or related dementia. They may maintain an inner hope that the elder does not have dementia as physicians cannot be absolutely positive.

For the hands on caregiver (usually a family member) the swings between good days in contrast with difficult times becomes a challenge. I have seen many people with Alzheimer’s disease who when visited by family, seem to rise to the occasion and visit very normally. I remember a lady who had very severe confusion every afternoon and evening. I explained the situation to her daughter when discussing a proposed trip several thousands of miles away. The daughter chose to take her Mom and then called the first evening she was gone – saying “I don’t know what to do with her, I never saw her like this.”
Many times in life looks can be deceiving and dementia is a case in point. This makes it doubly hard for the caregiver when they are put in the position of constantly explaining.

Families always maintain an inner hope that the diagnosis is wrong, signs that the loved one is getting better or hope that a cure will be found in time.

Posted on April 17, 2009 - by Nurse Virginia

AGING: Person-centered care, the latest “Buzz Words” in elderly care.

 

“Person-Centered Care”, what does that mean?
 

See: www.pleasegettoknowme.com  for person-centered care for the family.

Posted on April 15, 2009 - by Nurse Virginia

Caregiver Tips: Today’s technology makes it much easier to take care of confused elders with Alzheimer’s.

 

Keeping confused elders safe.

There are many companies that offer products to help the caregiver. Especially in the area of safety products. My favorite is the Floor Alarm Mat that can be set to alarm even ninety feet from the mat.

 

 

Posted on April 15, 2009 - by Nurse Virginia

Caregiver Tips: When the confused elderly just stop moving.

Stopping Contractures Before They Start

 
When the elder with Alzheimer’s disease is in the mid stage of the disease they often stop moving independently. This independent movement may show itself as no longer making gestures. An elder who always talked with their hands and used many gestures no longer does.

The elder who physically could still go through the motions of dressing but no longer initiates those movements. They still could brush their teeth, or put on a shirt but they no longer seem to know how to start or even seem to know what to do.

This stopping of movement is called Apraxia and it happens when there is a disconnection in the brain from the thinking of doing something and the movement to do the task.

Contractures in elderly are painful.
When people stop moving they become stiff in their joints. When those joints become stiff and they stop moving the muscles and ligaments become shortened and soon they no longer can move, and we call that a contracture. Movement becomes painful when a joint is moved because the shortened muscles are being stretched beyond their ability, and contractures are painful.

Contractures are much easier to prevent than to cure. The prevention is simple movement and exercise of every joint. Whether it is an organized exercise class, watching an exercise DVD, or just moving to music while you are getting someone dressed – the moving is what matters.

Remember – a contracture can develop in as little as 4 days of no movement. While it can take 500 days of movement to fix the contracture and get that joint moving again.

Posted on April 13, 2009 - by Nurse Virginia

Caregiver Tips: All swallowing problems, when you have Alzheimer’s disease, need to be investigated by a Speech Therapist

The person with Alzheimer’s disease, as they go through this disease process will at some point develop swallowing problems. The caregiver and anyone involved with a mealtime needs to be made aware of how those problems will look or sound like.

Things to look for when someone who has Alzheimer’s disease is eating:

• the person complaints of a feeling that something is stuck in their throat.
• the person is breathing differently during or after eating.
• the person coughs during eating or drinking.
• you have already seen the person choke on – medication, food, drink or even just saliva.
• food falls out of the person’s mouth when they eat.
• the person holds food in the side of their mouth – between teeth and cheek.
• the person keeps clearing their throat when the eat or drink.
• the person chews and chews for a very long time- or has trouble chewing.
• after the person eats or drinks their voice quality sounds “wet” or “gurgles” when they speak.
• when the person eats their swallow reflex seems gone or late.
• the person has behaviors where they are eating too fast or too much on a spoon full or fork full at a time.

Needless to say – eating problems are very serious and can lead to serious consequences.

Anyone of these problems needs to be communicated to the doctor for a referral for a Speech Evaluation. Time is always of the essence when it is a swallowing problem, because the next meal is coming.

Posted on April 7, 2009 - by Nurse Virginia

Caregiver Tips: Activities to do when the confused elder you care for is a man.

Know the person – what did the elderly man you care for enjoy before he became confused?

Watching funny DVDs together can be an especially wonderful connection for a father with his son.

My father-in-law suffered from dementia. My husband, Jerry, knew his dad had enjoyed Laurel and Hardy films as well as those of Ma and Pa Kettle–the comedies of the 1930s and 1940s. Jerry found as many of those old movies as he could and brought them to the nursing home. On his visits, Jerry didn’t have to carry on long one-sided conversations.

When Jerry visited, he would tell his dad what was new with him and the family. After that, he put on an old movie and his dad laughed every time Jerry would laugh. We never knew how much he followed the story, or even “saw” the slap-stick comedy. But he could still enjoy that comfortable, normal activity of sitting with his son and laughing.

4 Activites for the confused elderly man:

• Watch a DVD on travel, sports, history – whatever the man likes.
• Have something from his past interests – fishing pole, anything from a collection he had ( my dad had a tie collection that he enjoyed looking at),
• Read sports magazines together or look at new car brochures. Both are excellent opportunities for conversation.
• Most men like to do something physical. do that but keep it simple. Toss a ball or throw bean bags. These kinds of activities are also great to do with children.
Book excerpt from: Please Get To Know Me – Aging with Dignity and Relevance by Virginia Garberding with Cecil Murphey
available at: amazon.com – barnesandnoble.com – christianbook.com or see right sidebar direct from publisher.

Posted on April 7, 2009 - by Nurse Virginia

Caregiver Tips: Things to do when the person you care for is a man

from: Please get to Know Me – Aging with Dignity and Relevance

Watching funny DVDs together can be an especially wonderful connection for a father with his son.

My father-in-law suffered from dementia. My husband, Jerry, knew his dad had enjoyed Laurel and Hardy films as well as those of Ma and Pa Kettle–the comedies of the 1930s and 1940s. Jerry found as many of those old movies as he could and brought them to the nursing home. On his visits, Jerry didn’t have to carry on long one-sided conversations.

When Jerry visited, he would tell his dad what was new with him and the family. After that, he put on an old movie and his dad laughed every time Jerry would laugh. We never knew how much he followed the story, or even “saw” the slap-stick comedy. But he could still enjoy that comfortable, normal activity of sitting with his son and laughing.

• Watch a DVD on travel, sports, history – whatever the man likes.
• Have something from his past interests – fishing pole, anything from a collection he had ( my dad had a tie collection that he enjoyed looking at),
• Read sports magazines together or look at new car brochures. Both are excellent opportunities for conversation.
• Most men like to do something physical. do that but keep it simple. Toss a ball or throw bean bags. These kinds of activities are also great to do with children.