Archive for the ‘Alzheimer’s Disease’ Category

Posted on May 15, 2013 - by Nurse Virginia

LISTENING – CAN BE A GREAT GIFT FOR THE ELDER WITH ALZHEIMER’S DISEASE

Everyone wants people to show interest and pay attention when they speak. A person with Alzheimer’s disease is no different; they want the respect that was given to them and their conversation before they developed Alzheimer’s. Yet, persons with Alzheimer’s disease many times will be unaware that their speech has changed and may even be non-sensical.  Showing that person the courtesy of paying attention is a great gift that anyone can give to the confused elder.

Four Ways to Show your Interest:

1.      Show that you are listening by leaning forward toward the elder, possibly nodding slowly to indicate you understand and maybe even agree with what the elder is saying. When the listener nods too fast it indicates impatience, nodding slowly indicates that what the elder is saying is interesting maybe even too interesting to miss.

2.      Showing patience by letting the elder finish, not butting in just to make the conversation stop sooner than the elder intends.

3.      Ignoring the phone ringing, the TV, someone else interrupting – ignoring all distractions while just paying attention to the elder makes the elder feel very important.

4.      Making little positive sounds like “uh huh”, “I see,” can make the person feel like you really understand them and encourages them to continue to share.

 

We all know what the “bored” listener looks like. He might frequently check his watch while you are talking, or yawn to show his boredom with you. Instead of sitting forward in his chair he might slouch or appear to be ready to fall asleep.

The elder with Alzheimer’s disease even in the late stage of the disease will continue to be able to read body language and knows when he has been insulted.

Virginia Garberding RN

Director of Education, The Wealshire, Lincolnshire, Illinois

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

Posted on April 9, 2013 - by Nurse Virginia

PROTECTING YOURSELF FROM ALZHEIMER’S DISEASE MAY BE AS EASY AND PLEASANT AS HAVING MANY FRIENDS AND LIESURE ACTIVITES

I just attended the Illinois Department of Aging Conference, which stressed the positive effects of having friends and activities in your life. The conference focus was on mental health and aging. It seems the more friends you have and the more activities you enjoy the better you will protect yourself from mental health issues and even Alzheimer’s disease.

 

They went so far as to give a magic number for friends. People with nine or more friends or regular social contacts have the best chance of not developing Alzheimer’s disease. I like everyone else in the room mentally started totaling up my numbers. Then it occurred to me how many of those contacts were connected to my work. So many people that I might not think of as being in my inner circle of friends and family, yet more than acquaintances.

 

We always hear stories of how people have declines in their health once they retire. Maybe all these people I see five days a week are doing more than; sharing their families and their lives, sharing a joke, brainstorming our newest programs, catching me up on the latest news, maybe they are helping me stay healthy.

 

I have always heard it said that you can’t have too many friends. Seems like not only is that true but you also can’t seem to have too many interests. No magic number was given for leisure activities just the encouragement to have many.

 

I always thought the time to indulge in leisure activities would be when I retire. Maybe the time to brush up on my piano playing is now.

Virginia Garberding RN

Director of Education, The Wealshire, Lincolnshire, Illinois

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

Posted on April 8, 2013 - by Nurse Virginia

INSOMNIA IN THE ELDER WITH ALZHEIMER’S DISEASE MAY LEAD TO THE NURSING HOME

(PART II)

Most people have experienced the fatigue, confusion and insomnia connected with “jet lag.” When the family caregiver is no longer able (night after night), to a get good night’s sleep, they suffer those same symptoms of jet lag. Eventually they may have to consider nursing home placement for their loved one. The loss of sleep plus the strain of caregiving will prove too much for the caregiver. Knowing a person’s natural biological rhythm can help the caregiver encourage a better sleep-wake cycle.

 

When the weather is good is the time to develop good sleep habits.

 

• Take a thirty minute walk every day – outside where you can benefit from the sun light. Spending time outside in the sun will re-enforce the elder’s  natural reaction to a light/dark cycle.
• Get other opportunities for sun by sitting on a porch or deck, working in a garden.  Plant some flowers or vegetables just for the opportunity to get outside to take care of them.
• Don’t spend the day in front of the TV – the elderly with Alzheimer’s need work to do also – fold clothes even if they are the same clothes you folded already
• Have a regular schedule – eat at regular times – have a evening routine
• Read to the elder in the evening instead of watching TV
• Don’t let the elder nap during the day – if they really need to lay down – no more than thirty minutes. Studies have shown that a short, “power-nap” doesn’t have any negative impact on a person’s natural sleep/wake cycle.
• If the elder is incontinent, use a twelve-hour incontinent product during the night
• Make sure the elder’s room is totally dark, windows with blinds or shades to make sure there is no reflection off the glass
• Have night lights in the elder’s room, so if they need be to attended to – you are using the smallest amount of light so as not to arouse the sleeping elder.
• Elderly people usually suffer from some stiffness whether they have been diagnosed with Arthritis or not. Pain or stiffness will cause the elderly person to wake up, when they become uncomfortable. Most likely that time will be between 4:30 am and 5 am when a person has a normal dip in body temperature. Make sure the elder is warm and pain free, in order to enjoy a full nights sleep.

 

Virginia Garberding, R.N.

Director of Education, The Wealshire, Lincolnshire, Illinois

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

www.pleasegettoknowme.com

Posted on April 4, 2013 - by Nurse Virginia

INSOMNIA IN THE ELDER WITH ALZHEIMER’S DISEASE

(PART I)

A new study from the National Institute on Aging identifies increased risk of falls and the resulting hip fractures with the use of sleep medications in the elderly. Especially in elders with mild cognitive impairment or those diagnosed with early Alzheimer’s disease.

It seems that many of these medications cause a decrease in attention as well as balance in these elders. The confused elder may be somewhat disoriented in the dark, not put lights on and due to a decrease in safety awareness sustain a fall. It is the mildly confused elder who gets up during the night and takes a sleep aid, who is more likely to fall.  The study also made a rare statement, noting the problem with physicians being more likely to start medications than stop them. Once given a sleep aid, it is  not likely it will be stopped.

Persons with more advanced Alzheimer’s were less likely to get out of bed during the night and because of that had no increase in falls or fractures from sleep medications.

It seems reasonable to go back to the times when we used nondrug approaches for sleep disturbances in the confused elderly. Things like looking at the foods the elder is eating, sweet carbohydrates while they will put you to seep, they don’t promise a long sound sleep. As with caffeine, carbohydrates cause the elder to wake up a few hours later and have trouble falling back to sleep.

It could be a much too exciting TV show causing the elder a poor night sleep. When the elder has trouble sleeping you always need to consider pain as a potential problem. Incontinence can cause sleep problems as well.

Many elders first enter a nursing facility due to sleep issues. They have suffered a fracture because they were up during the night and fell. or they are up all night and the direct caregiver cannot get any sleep. I wonder how many of those, not participating in studies, who fall are taking a medication for sleep?

 

Virginia Garberding RN

Director of Education, The Wealshire, Lincolnshire, Illinois

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

Posted on April 1, 2013 - by Nurse Virginia

TOO MANY DRUGS – TOO MANY SIDE EFFECTS TRY A DRUG HOLIDAY

For the elderly, many times we just keep adding more drugs.

Ann was in the late stage of Alzheimer’s disease. She no longer recognized her family or even herself in a mirror. She did not know her caregivers or even where she was. Over the years she had been diagnosed with a heart condition as well as having many negative behaviors. As time went by more and more medications were added to her day. Medications for her heart as well as her dementia.

Medications many times have a way of building and being added to and multiplying. Until the confused elderly are taking so many medications you no longer really know how the person would function without all those pills.

For Ann a defining moment came when her husband became ill and the family decided that it was just too much for him to continue going to the nursing home everyday to visit Ann. So with the blessing of her doctor and because of her end stage Alzheimer’s disease they all agreed to a “drug holiday” for Ann.

“Drug Holiday” or when the doctor gives the elderly a vacation from drugs.

To everyone’s surprise Ann blossomed. She was more wide awake, smiling, greeting everyone who came within ear shot of her. She now was singing all the time, very happy and responsive. She still no longer recognized anyone, but she sure enjoyed seeing you.  Ann continued  on her “holiday” some 3 years later.

Many times the accumulation of multiple medications is just taken for granted in the elderly population. Maybe as we age, we should be taking away medications instead of adding to them.

Virginia Garberding RN

Director of Education, The Wealshire, Lincolnshire, Illinois

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

Posted on March 28, 2013 - by Nurse Virginia

PERSONS WITH ALZHEIMER’S DISEASE NEED TIMES OF ACTIVITY ALTERNATING WITH TIMES OF QUIET- TOO MUCH ACTIVITY RESULTS IN AGITATION

AGITATION: excessive motor or verbal activity that is usually nonpurposeful and associated with internal tension and perceptual or cognitive abnormalities.  Agitated behaviors contribute to functional decline, increased falls and injury, social isolation, and the use of physical and chemical restraints. The behavior is not explained by the events, and in a nondemented person in a similar situation, the behavior would not be expected. Research demonstrates that agitated behaviors are not the inevitable consequence of dementia, but are often the result of external factors that can and should be controlled.

Four categories that explain behaviors in people with Alzheimer’s disease:

1. Neurological deterioration causes agitated behavioral disinhibitition.
2. Agitated behavior is controlled by triggering situations and the feedback given from others once the behavior is initiated.
3. Unmet needs – dementia causes an inability to comprehend or make needs known, so behaviors are mechanisms for communicating physical or psychic distress resulting from an unmet need.
4. Environmental vulnerability – dementia decreases the threshold for stress or stimuli from the environment.

A long period in a state of high arousal exceeds the person’s stress threshold, and a long period of disengagement creates a condition of sensory deprivation.

When this method of balancing times of arousal by altering a person’s daily activity schedule – found that persons with significant dementia only spent a small amount of the day in disengagement, improved other negative behavioral symptoms, and have proven to prevent functional decline. Remember: Persons with dementia have no insight into what triggers an emotion as well as decreased ability to control their environment.

Low-arousal activities: music, napping,

High-level of arousal: (for person in a disengaged state) social visiting, fine-motor skill recreation, music, storytelling, reminiscence

Activities used for high and low arousal: music, massage, multisensory, natural environments, pet therapy.  These interventions prove to be low cost, simple, noninvasive and non-technological.

Virginia Garberding RN

Director of Education, The Wealshire, Lincolnshire, Illinois

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

Posted on March 25, 2013 - by Nurse Virginia

GREAT CAREGIVING – CULTIVATE THE ABILITY TO REALLY SEE AND BE IN THE MOMENT THROUGH ART

PART II

In The Monk Who Sold His Ferrari, by Robin S. Sharma, one of the enlightening rituals he shares is to stare at the center of a rose.

When you start this practice you find it hard to concentrate for more than a few minutes, without becoming distracted. However with daily practice you get better at focusing and develop a more disciplined mind.

This is the same benefit you receive from learning to draw. However if you are going to draw that same rose you will look even closer. You will see where each petal intersects with the next as you see every subtle difference in shadow from each petal. This concentration teaches you to switch to the right side of your brain. When you are on the right side of your brain, you have no sense of time and experience really being in the moment.

After a time you realize that you are now seeing so many things so much clearer than you ever did before and without even trying. It is a major gift you have given yourself. Your vision isn’t better, yet you now seem to see so many more things.

My mother had her stroke eleven years ago now and since that time I have taken the hour and a half drive to see her once a week. Early on I decided that this would soon become a chore if I didn’t learn to enjoy the “journey.”  So I got off the interstate and started taking the lesser traveled country road. I now find that even though this trip does take a chunk of time out of my weekend, I enjoy the trip almost as much as the visit with Mom.

When the seasons change and the first new leaves of spring arrive, I love to see the trees with their new bright green growth, while you can still see every branch and twig of the tree. Learning to draw gave me a gift that I carry with me whether traveling down a country road or just looking out the window while I use my treadmill.

I do recommend The Monk Who Sold His Ferrari, it provides some very positive life advice in an entertaining way. Yet to achieve the really full and rich life he promises a person needs to take bigger steps than he suggests. I don’t know why people assume that monks who live a very isolated, self-centered life in the Himalayas have an answer for others. The answers in life continue to be what Jesus taught almost 2,000 years ago – be of service to others.

And if you have a choice, take that road less traveled with your elder and enjoy the scenery.

A Thank You to all the readers who are recommending this blog on their Twitter and Facebook sites – You are making it grow – God Bless You and Keep You.

Virginia Garberding, R.N.

Director of Education, The Wealshire, Lincolnshire, Illinois

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

www.pleasegettoknowme.com

Posted on March 20, 2013 - by Nurse Virginia

GREAT CAREGIVING- CULTIVATE THE ABILITY TO REALLY SEE AND BE IN THE MOMENT THROUGH ART

Part I

I remember in the late 60’s when the Beatles were all over the news during their trek to Rishikesh, which sits in the foothills of the Himalayas, to learn meditation. It all seemed so foreign and mysterious, now we call a lot of those principles “new age.” The search for enlightenment seems to impact every generation.

My Mother gave me the answer in the form of a book years ago, the book Drawing on the Right Side of the Brain. (still available by Dr. Betty Edwards, but most people like the original edition -1979 -the best – check your library) I was all over it because I will read pretty much anything about the brain. But this was no new theory or break through to study and accept and or reject, this book was anything but.

This book gave the secret to drawing – practice and concentration. But the practice and learning the skill of concentration taught me much more than how to draw.  It seems that most of us stop trying to draw at the age of about six. So if you drew stick people at six, you very may well continue to draw stick people when you are sixty-six.

At the age of six your brain makes a significant shift from right side dominance to left sided dominance. The right side of the brain is where your arts and touchy feely skills are and your left is your word skills and analytical strengths. So at the age of six when your left side becomes more dominant – your internal voice, the most influential voice in your life, tells the child “You’re no good, your drawing stinks,” and you no longer try. So your ability is stuck at that age.

The beautiful thing about the small child working on a drawing, is seeing them clearly working with the right side of their brain. When you call their name – at first they can’t answer because they are right there, in the right side brain activity. They need to switch to the left side to answer because that is where the language skills are.

Reading that book took me to a drawing class at the local community college for only one semester. Drawing takes time, discipline and concentration. The discipline to give up time, to sit quietly, study lines, shadows, and reflections. But most of all learn how to once again go to that right side of your brain – which is such a full, calm and happy place.

Part II

What does that have to do with the Himalayas?

A Major “Thank You” to all the readers who are recommending this blog on their Facebook and Twitter sites – you are making it grow – God Bless You and Keep You.

Virginia Garberding, R.N.

Director of Education, The Wealshire, Lincolnshire, Illinois

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

www.pleasegettoknowme.com

Posted on March 11, 2013 - by Nurse Virginia

BODY MEMORY AND ALZHEIMER’S DISEASE

Body memory is the memory you have learned through “doing.” When you train your body to ride a bike, play an instrument, or find the right keys on a keyboard you are tapping into body memory. Body memory remains long after other forms of memory are lost through Alzheimer’s disease.

 

A case of using body memory: An elderly man with Alzheimer’s disease is walking down the hall in a Nursing facility in full view of the staff. Suddenly he blacks out, loses consciousness and instead of falling and possibly breaking a leg or a hip – he tucks his head down and goes into a perfect roll forward, landing uninjured on his back – everyone saw it.

 

What happened here? This was body memory! You see when this man was young he studied a martial art called Hapkito. In this form of martial art you learn to roll. So even though he had not practiced this roll for many years and didn’t even remember learning this art, his body remembered and still knew how to roll.

 

This is the memory (body memory) that you want to use when working with your elder when brushing teeth, dressing, going to the bathroom. Using all of those familiar and over practiced movements that are still remembered by the body. Using the elder’s body memory. 

 

For a person with memory loss – focusing on the abilities that remain and that the body remembers provides opportunities for success.  These are movements the body learned at a very young age and have been repeated daily over so many years; this is the memory that the Alzheimer’s patients need for continuing those personal tasks of daily living.

 

Tuning into the elder’s body memory can be as simple as putting your hand over the elder’s hand when eating to “get him going.” I call this technique using your “helping hand.” Once you get the elder going, many times he will continue on, now eating independently, because his body remembered.

 

Virginia Garberding RN

Director of Education, The Wealshire, Lincolnshire, Illinois

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

www.pleasegettoknow me.com

Posted on February 19, 2013 - by Nurse Virginia

PROBLEMS IN THE KITCHEN CAN BE THE FIRST SIGN OF ALZHEIMER’S DISEASE

Edith’s daughter-in-law knew Edith was more than a little forgetful. But it wasn’t until Edith gave the family a nasty case of food poisoning, that they realized how confused Edith was. Edith was in the habit of making all the meals for the family. In fact she strongly felt it was her kitchen.

When the family became sick, Joyce thought she should take a closer look at what Edith was doing in the kitchen. She soon observed Edith handling raw meat and then without washing her hands she filled the fruit bowl on the kitchen table.

When the elder becomes confused they may also lose their safety awareness. Sharp knives may need to be replaced by items that are not as prone to injury. The elder may no longer be able to understand how to use a microwave oven safely. They may put a pot on the stove – turn on the burner, walk into another room and totally forget they put that burner on.

Signs that the elder is becoming unsafe in the kitchen – are finding unusual things in the refrigerator, stove or cabinets. Finding signs that there has been something burnt – a pot, pot holders, cutting boards anything with a scorch mark. Or the whole family getting sick, like Edith’s family.

Telling your mother-in-law she doesn’t practice good hygiene in the kitchen is more than a tricky conversation. So Joyce did the only thing she could, she asked her husband Bob to break the bad news to Edith, that she was the one in fact making the family sick by not washing her hands. While that didn’t go to well even coming from Bob, it saved the relationship between Edith and Joyce. Because now Edith and Joyce share the kitchen while Edith “teaches” Joyce how to cook.

Virginia Garberding R.N.

Director of Education, The Wealshire, Lincolnshire, Illinois

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

www.pleasegettoknowme.com