Archive for November, 2009

Posted on November 30, 2009 - by Nurse Virginia

Elderly Christians with Alzheimer’s disease need their Church Community more than ever

Carl, an elderly member of the congregation for 92 years, is no longer attending because of behaviors related to his dementia. Just when he and his family need the support of their church family the most, someone thinks Carl shouldn’t be there.

 

Older Americans fastest growing segment of population

There are currently 5.3 million Americans diagnosed with Alzheimer’s disease according to the National Alzheimer’s Association. And every 70 seconds someone new is diagnosed with this disease. While Americans are living longer, persons 85 and older are becoming the fastest growing segment of the population.  The number of persons with Alzheimer’s disease is also growing. When a person reaches the age of 85 they have a 47% chance of having Alzheimer’s disease.

 

Elderly with Alzheimer’s disease have abilities for church

The truth is that Carl, like many other seniors with Alzheimer’s disease, actually continues to have the very abilities he needs to be an active part of the congregation’s worship.

 

The universal ability to recognize facial expressions and body language continues in a person with Alzheimer’s disease. In any country you visit, a smile is greeted with a smile, a frown is recognized as a frown and the person with Alzheimer’s disease is able to read positive or negative facial expressions as well. But because the elder with Alzheimer’s disease is so aware of their confusion and of making mistakes, the need for a smiling welcome is more important than ever.

 

The response to touch is universal. When someone is touched, a chemical is released in the brain that is referred to as the “care and connection” transmitter.  This transmitter makes us feel comfortable and open to each other. Indeed, that old friend at Church with the warm handshake is just the medicine Carl needs now.

 

Music, (and we all know how much Christians love to sing), is the most recognized of universal languages.  Music triggers reminiscing and creates a sense of comfort and feelings of well-being for the elder with Alzheimer’s disease.  Music, unlike language skills is located in several parts of the brain. Elderly who have lost their words will often continue to be able to sing. I remember a woman who, in her last days, when she was no longer able to recognized her family or herself in a mirror and was in need of total care, continued to sing “Jesus Loves Me” every day.  Singing together with the congregation produces feelings of being connected to others and the ability to enjoy music continues throughout life regardless of dementing illness.

 

Help elderly with Alzheimer’s disease with environmental cues

What Carl needs now is cues to help him understand what is going on. Coming into Church after the music has started will help provide the environmental cue he needs to recognize that he is in a familiar place of worship.  This worshipful atmosphere with the organ playing should help with unwanted behaviors. Having Carl wear a name tag that says “Hi, my name is Carl” can help cue other people to smile and greet Carl by name, creating a warm and comfortable environment for him. 

 

Beverly wanted to continue worshipping with her husband John, who had Alzheimer’s disease. Every time the congregation would stand John would exit the pew. Beverly wanted to give him a cue as to when it was time to go. She told him to watch her purse and when she picked up the purse they would go. Well of course John kept a keen eye on that purse, and when Beverly picked up her purse, John was the first one down that isle. But that cue helped him continue to be part of the congregation worship service for some time.

 

They are calling the aging of America “The Silver Tsunami”, but coupled with that will be another wave – the “Dementia Tsunami.” As congregations, the time is now to educate the flock while encouraging your families with confused elders to continue to come to church and give the congregation the opportunity to be part of keeping the faith.

 

Virginia Garberding, R.N.  

Director of Education, The Wealshire

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

Posted on November 23, 2009 - by Nurse Virginia

BEST GIFTS FOR ELDERLY IN NURSING HOMES

Giving your time and doing something together always the best gift.

This is the time of year to create new traditions around shared moments. Maybe the elder can no longer bake 15 kinds of cookies for their family. But they may still enjoy having the baked cookies brought in and decorating them right there in the Nursing Home, with grandchildren or great grandchildren. Decorating a small tree for Grandma’s room can provide an activity for the entire family.  Doing something, takes away the pressure of having to come up with conversation, which can be upsetting for someone with memory loss?

11 – Great gifts for the elderly:

• Put together a scrapbook with pictures of family, friends, places visited, favorite food, poetry.  (see: pleasegettoknowme.com for a free life story book to download)
• New bedspread
• Decorative pillow
• Stuffed Teddy Bear
• Night-light
• Warm novelty socks for in bed
• Leg warmers
• Costume jewelry
• Cardigan sweater – a size larger to make it easier to get on
• “Relaxation “ body lotion – look for a scent that relieves stress
• Familiar holiday cookies – decorated cookies that remind the elder of the holidays

SEE ALSO:

Holiday Season, Best Time for Elderly with Alzheimer’s Disease to use their abilities

Caregiver Tips For Celebrating the Holidays with Elderly with Alzheimer’s Disease in a Nursing Home

Virginia Garberding, R.N.

Director of Education, The Wealshire

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

Posted on November 18, 2009 - by Nurse Virginia

KICKING, BITING, SWEARING, SPITTING, PUSHING, YELLING, HITTING, WHEN THE ELDER WITH ALZHEIMER’S DISEASE HAS NEGATIVE BEHAVIORS

(Part I)

Max is still strong and active and he has Alzheimer’s disease. He becomes fearful during daily care and hits the caregiver while yelling verbal abuses. Using chewing gum as a distraction technique occupied Max’s attention so that he did not strike out. He also appeared unable to chew gum and swear at the same time, which allowed him to join others and be socially appropriate. Gum chewing wouldn’t be recommended for all physically aggressive elders, but it worked for Max.

Possible triggers for negative behaviors:

• Being surprised. Always approach a person with Alzheimer’s disease from the front – especially if the caregiver is a man – a man coming from behind you or from the side can frighten a confused elder. And always say the person’s name so that they know someone is there.
• Feeling that your privacy has been invaded. This can often happen during personal care. The approach of the caregiver is so important, to create a connection with the elder before you attempt any personal care.
• The approach of the caregiver. If the caregiver is perceived as being angry, critical or hurried, it can scare the confused elder and cause negative behaviors.
• A physical stress such as being over tired or an illness can trigger negative behaviors in a confused elder. Everyone is a little cranky when they are sick or tired and the elder may not be able to communicate that they just want to be left alone, so they strike out.
• If the elder has recently changed medication, consult the pharmacist and see if the new behavior could be a side effect of medication.

Primary cause of physical aggression is fear

When the confused elder is striking out, it is usually fear speaking out through behavior. Fear can turn to anger especially if this has been the elder’s coping response in the past. Many times combativeness and physical aggression are the behaviors that precipitate Nursing Home placement.

Virginia Garberding, R.N.

Director of Education, The Wealshire

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

Posted on November 16, 2009 - by Nurse Virginia

Holiday Season Best Time for Elderly with Alzheimer’s Disease to Us Their Abilities

Holidays, perfect time for elderly with Alzheimer’s disease to use remaining abilities

While the elder may have forgotten what he ate for lunch today. The emotional memory of what he has eaten for Thanksgiving every year can put him in the holiday spirit with just a little cueing from the environment.

Ability to appreciate holiday smells

Using the sense of smell to cue a person with Alzheimer’s disease that it is the holidays is always helpful. Even if you aren’t baking – you can use an old realtor’s trick and put a little cinnamon in water on the stove and just simmer it, till the house smells like apple pie. Or maybe a little pumpkin spice to smell like pumpkin pie in the oven.

Giving the elder with Alzheimer’s disease environmental cues will help them know what is going on. Maybe this is the year for a fresh cut Christmas tree – no room freshener smells like the real thing. The pine smell that is released when the family is trimming the tree can tie right in to those long held emotional memories.

My parents always had eggnog or hot chocolate and cinnamon donuts when we trimmed the tree. I continued that tradition with my daughters, so those things with the smell of pine mean Christmas to me.

Ability to appreciate holiday tastes

As with the sense of taste, spices can be the answer to bringing back the emotional memory of the holidays. When you are making cookies, make a batch with some mint flavoring to wake up the taste buds as well as make the house smell great.  This is the time to search out recopies that make good use of those holiday tastes.

Ability to respond to touch

This is the time of year when everyone is greeting each other with a hug. Elders with Alzheimer’s disease continue to have the ability to respond to touch. There is a chemical in the brain referred to as the “care and connection” transmitter. This chemical is turned on when you are touched. So shake the hand of a man with Alzheimer’s disease, hug that woman and wish them a Merry Christmas. The holidays are just the time to care and connect.

Ability to access emotional memory through music and decorations

Music is of course a universal language which is understood whether a person has Alzheimer’s disease or not. Music triggers emotional memory and provides opportunity for reminiscing, provides enjoyment, a sense of comfort and well being, feelings of being connected to others. The ability to enjoy music continues throughout life regardless of a dementing illness. Music plus decorations add to the auditory and visual cues that the elder with Alzheimer’s disease needs during the holiday season.

Virginia Garberding, R.N.

Director of Education, The Wealshire

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

With New York Times best selling author Cecil Murphey

www.pleasegettoknowme.com

Posted on November 12, 2009 - by Nurse Virginia

Keeping the wandering elder with Alzheimer’s disease in the house

Baby its cold outside!

It is November; the leaves have changed and are pretty much down. Cold weather is right around the corner, and the elder with Alzheimer’s disease who wanders is at greater risk. The elder’s inability to dress appropriately for the season or weather and lack of safety awareness put even greater stress on the caregiver.

Many things may trigger the elder with Alzheimer’s disease to walk out the door.

When you store outdoor things right next to the door, it can trigger or cue an elder to go outside. Store all purses, gloves, coats, shoes, hats and scarves out of sight and away from the area of the exit door. For a person living in the moment, just seeing a coat can trigger opening a door and walking out.

When a confused elder is continuing to go to the door avoid saying “Don’t go outside” This will tend to make the person think about doing exactly what you told him not to. Bettor to say “Stay inside” and avoid conversation with negative words like “Don’t.” A positive word will always work more effectively than a negative. A negative can prompt a response such as “Don’t tell me what to do.”

A confused elder may be trying to get away from something, a loud environment, too much activity, arguing.  Always look first to the environment when a confused elder is trying to walk away. An overwhelming controlling caregiver can create a negative environment that the elder wants to walk away from.

Being able to see right through a window in the door can prompt a confused elder to open that door and walk right out. Trying to block out the view with a large picture or putting pictures on a exit door and all around an exit door can prompt the elder to naturally walk right past all the pictures and turn around.

Virginia Garberding, R.N.

Director of Education, The Wealshire

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

www.pleasegettoknowme.com

Posted on November 10, 2009 - by Nurse Virginia

NOVEMBER IS NATIONAL CAREGIVERS MONTH

SEVEN GUILT BUSTERS FOR CAREGIVERS (Part III)

• If the elder you are caring for has a progressive condition such as Alzheimer’s disease, acknowledge that the disease will worsen despite your best efforts.
• Set realistic goals; take pride in focusing attention on offering care and comfort instead of focusing on “the cure.”
• Get some physical exercise; it is a proven way to reduce stress. Also it will take away the stress of worrying “How long will I be able to do this?” I met a husband who had a caregiver come into the home three days a week just so that he could go to the health club and work out. His fitness goal was to be able to continue to care for his wife.
• Find someone in your life who is a good listener. Not someone who will have a pocket full of advice, but someone wise enough to know the value of listening.
• Laughter is the best medicine and if the elder you care for has Alzheimer’s disease they can prove to be the best of companions. Where other people will stop and weigh what they say, the person with Alzheimer’s disease will usually share their first observation without reserve. Joining the person you care for “in the moment”, not worrying about the past or the future and enjoying the present can be very relaxing and allow you to see the humor in many situations.
• Accept that you might not get everything done to your standards – your standards might have to be adjusted.
• Be good to yourself and give yourself time out.

Remember what your elder needs most is a healthy caregiver. So enjoy National Caregivers month, and tell people about it to raise awareness of what you and so many others do. Remember, at sometime everyone will either be a caregiver or need a caregiver.

Adapted from: Alzheimer’s Disease – Activity Focused Care by Carly Hellen

Virginia Garberding, R.N.

Director of Education, The Wealshire

www.pleasegettoknowme.com

Posted on November 5, 2009 - by Nurse Virginia

Caregiver Guilt – your elderly parent can still make you feel guilty (Part II)

“Are you leaving  already?”  My Mother ended every visit with those words, no matter how long I was there visiting, the last words I heard were always “Are you leaving already?”

Then I had an idea – if Mom had something she was going to, looked forward to, wanted to do, it would be easier for her to say “goodbye.” I had been taking Mom to eat in the main dining room, thinking she would enjoy ordering from a menu and seeing different people for a change. But then I realized that Mom no longer could really see her surroundings, and no longer really knew anyone in that area of the nursing community. Now, she really enjoyed eating in the Health Care center where she lived and missed the friends she ate with when she wasn’t there.

Instead of going to the dining room, what she really enjoyed was having me come, spend time visiting and reading to her from her favorite book Heaven by Randy Alcorn. So I started coming earlier, and spending more time before the noon meal – then when it is time to eat lunch she is eager to go to the dining room, see her friends she always sits with and have her lunch. This makes saying goodbye so much easier, and I leave with a smile on my face, because there is a smile on her face.

Guilt –Nursing Home Placement

Many times families are uncertain about their roles as caregivers after admission to a Nursing Home. When decisions and direct care tasks are transferred to the responsibility of the facility the family caregiver can easily feel guilty.  Many times how they feel is determined by the amount of support they feel from the Nursing Home staff.  If the family is included in decision making and considered part of the team, instead of made to feel they are in the way, the family member can continue to feel useful and needed.

Feeling like you are an important member of the care team, replaces feelings of guilt

• Get to know people – join a family council or family support group. I know several people who years after the loss of their loved one, continue to get together with members of the family support group. They still value those people who supported them when they needed it the most.
• Attend any educational opportunities offered at the Nursing Facility.
• Ask the Administrator if the facility has a “wish list” of things they need. Then spearhead an effort to help the facility get those “would be nice to have” items.

November is National Caregiver Month – do something nice for yourself!

Virginia Garberding, R.N.

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

With New York Times Best Selling Author Cecil Murphey

www.pleasegettoknowme.com

Posted on November 2, 2009 - by Nurse Virginia

When caring for confused elderly parent or spouse, guilt is just the gift that keeps on giving

Caregivers often experience great frustration, anger, depression and guilt in response to the stress of caring for those with a chronic illness.

Although countless situations can induce guilt, a few examples can illustrate common dilemmas:

• The daughter of a person with Alzheimer’s disease works a full-time job in addition to caring for her spouse and three children. She spends every Saturday helping her parents. On leaving for her home, she is distraught as both parents plead for her to spend more time with them.
• The son of a person with dementia begins to argue with his mother who is acting irrationally and ends up slapping her. He quickly realizes that his mother has a brain disorder and cannot control her behavior.
• The husband arranges for his wife with Alzheimer’s disease to attend adult day care a few times per week. In her absence, he is unable to relax or participate in enjoyable activities.
• The wife of a person with dementia had promised her husband and herself that she would never place him in a nursing home. After several exhausting years of home care, she places him in a facility.

In some cases guilt may serve a useful function; but persistent guilt can become a crippling problem for caregivers. Such guilt usually stems from unrealistic expectations put on oneself. Despite unbearable conditions, some caregivers expect that they can handle any problem that comes their way. Instead of freely choosing such challenges, they become caught in a trap of thinking they “should” or “ought to” be able to meet all the needs all the time When guilt becomes a dominant motive in the caregiver role, help is clearly indicated.

From: Alzheimer’s Disease – Activity Focused Care by Carly Hellen

Published by Butterworth-Heinemann

For ways to stop the cycle of guilt – see tomorrow’s “Guilt-Busters”

Virginia Garberding, R.N.

Director of Education The Wealshire

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

with New York Times best selling author Cecil Murphey