Archive for December, 2011
Posted on December 20, 2011 - by Nurse Virginia
GOING TO HOLIDAY CHURCH SERVICES WITH THE ELDER WHO HAS ALZHEIMER’S DISEASE
ELDERLY CHRISTIANS WITH ALZHEIMER’S DISEASE STILL HAVE EXACTLY THE ABILITIES THEY NEED TO PARTICIPATE AT CHURCH
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.
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 the 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, Lincolnshire, Illinois
Author: Please Get To Know Me – Aging with Dignity and Relevance
Posted on December 14, 2011 - by Nurse Virginia
HOME SAFETY CHECK – ALWAYS A GOOD IDEA FOR THE CONFUSED ELDER BEFORE THEY RETURN HOME AFTER A STAY AT THE NURSING HOME
Bertha had been so sure she was ready to “go home.” Why anyone could see she had lost a considerable amount of weight since being in the nursing home. Even her doctor was calling the changes in her nothing short of amazing.
Bertha had come to the nursing home from the hospital following a fall at home. She lived alone, said she had been doing so “for years” and enjoyed it. Bertha had a small dog that was now with friends until Bertha returned home.
When Bertha arrived at the nursing home, she was a familiar face, having been a resident about 3 months earlier. At that time Bertha insisted on going home against medical advice and now because of her recent fall, was back in the nursing home.
So this time the staff didn’t want any discharge to home, to come too early, before Bertha was ready. So a trip home was planned for Bertha and two of her therapists, to hopefully see her in her home environment. Some of the things Bertha said about her home were technically true, however not totally accurate.
Bertha’s home environment:
- Bertha did have an elevator that ran along the stairway to the second floor; however it didn’t work, and hadn’t worked for some time.
- Bertha could now walk with a walker. She did have carpeting; however her carpeting was covered with small throw rugs and had electric wires running everywhere.
- Bertha did have a path from room to room, but it was just a path, the rest of the floor area was covered with ‘stuff.” Bertha wasn’t a true hoarder, but she did have a large amount of clutter to walk around.
- She did have a back door where she could easily let the dog out, but the evidence all over the floor in the spare bedroom told another story.
- Bertha did say that she needed some work done in the bathroom, grab bars and so forth. However what Bertha filed to mention was that her town house did not have a shower, only one small bathtub. She was going to need a large renovation, not just a few grab bars.
Now Bertha had a plan with goals. No, she wouldn’t be going home for some time, but when she does, with the help of the nursing home, she will be successful.
Virginia Garberding R.N.
Director of Education, The Wealshire, Lincolnshire, Illinois
Author: Please Get To Know Me – Aging with Dignity and Relevance
Posted on December 7, 2011 - by Nurse Virginia
URINARY INFECTIONS MAY LEAD TO INCREASED CONFUSION IN THE ELDERLY
(Part II)
In the past when an elderly person experienced changes in behavior or increased confusion, the health care community collectively thought that this was normal; after all you’re getting old. How many times has a doctor said to a family member “What do you expect at his age, he’s getting old.”
Addressing the behavior or the increased confusion was the focus, not the underlying physical change in condition. Identifying that physical or pathological change will require the persistence to search for a cause and the ability to clearly communicate your findings.
Signs of a urinary tract infection:
- Going to the bathroom more frequently
- Complaining of a burning sensation on urination
- Increased temperature
- Bladder or kidney pain
- Blood or pus in the urine
- Concentrated, dark/cloudy urine
- Rambling talk, disorganized thinking
- Unstable emotions
- Increased problems with judgment or thinking
The elderly with dementia are more likely to be hospitalized for a fracture, lower respiratory infection, urinary infection or a head injury than an elder without dementia. Once admitted, the elder with dementia will usually remain in the hospital twice as long an elder without dementia. The elder with dementia will also be more likely to be re-admitted within 90 days after discharge than an elder without dementia.
Virginia Garberding R.N.
Director of Education, The Wealshire, Lincolnshire, Illinois
Author: Please Get To Know Me – Aging with Dignity and Relevance
Posted on December 5, 2011 - by Nurse Virginia
URINARY INFECTION MAY LEAD TO INCREASED CONFUSION IN THE ELDERLY
(PART I)
Marty was holding on to the handle of the car door threatening to “jump.” No matter what his wife Betty said, nothing seemed to be able to quiet Marty down. He had been pacing the small home they had lived in for the past 40 years, till Betty said, “Let’s go for a drive.” Thinking the car ride would be soothing for whatever was bothering Marty these last few days. He seemed to have a problem that he didn’t seem to be able to put into words. And now here he was threatening to jump from the car.
Marty had always been a very calm, dependable sort of man. Even when he started getting confused, he laughed it off never showing frustration or anger. This kind of outrageous behavior was so unlike the normal manner of this 78year old man. Not knowing what to do, Betty drove directly to their doctor’s office and luckily they took Marty right into an examination room. Marty would not have been good at waiting, not today.
Marty was well known to the doctor and his staff and after what seemed only a short time to Betty the doctor started writing notes. Betty could just make out the doctor’s note reading it upside down. It read, Altered Mental Status, increased confusion probable cause urinary tract infection.
Urinary tract infections are the most common infections in the elderly and the most likely to lead to increased confusion. The second most likely infection to result in increased confusion is an upper respiratory infection or pneumonia. However just about any infection in an elderly individual may result in increased confusion. Many times the increase in confusion is the symptom that leads the caregiver or physician to the cause which may be infection.
Virginia Garberding R.N.
Director of Education, The Wealshire, Lincolnshire, Illinois
Author: Please Get To Know Me – Aging with Dignity and Relevance
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