Sollutions

September 25th, 2009

A recent research study from Great Britain suggests that the use of antipsychotic drugs to manage difficult behaviors associated with Alzheimer’s disease and other related dementias may double the patient’s risk for death.

                In 2005 the FDA issued a “black box” warning of all atypical antipsychotics used in those patients with dementia.  The FDA initiated the warning after studies in the United States discovered a higher risk of sudden death in patients with an Alzheimer’s diagnosis after 180 days use of these medications.  In 2008, this warning was extended to include first generation antipsychotics as well.

                Most eldercare experts who specialize in the care of those with dementia agree that the use of antipsychotic medications is not necessary to manage difficult behavioral challenges in those with dementia.  Many times these medications have a variety of side effects that cause additional concerns for caregivers.  These medications may cause the person with dementia to become dozy, lethargic, and apathetic.  When a person with dementia sleeps all day as a result of medication, caregivers may see him/her have difficulty sleeping at night.  Caregivers often also find that the person with dementia may develop an unsteady gait and an increase in saliva which can cause difficulty in swallowing.

                The key to managing difficult behaviors is in how the caregiver perceives the person with dementia.  The caregiver must be able to separate the person from the disease and remember that all care performed is for a “person” and not a “disease.”  All behaviors are a form of communication.  Often when a person with dementia is becoming frustrated the first step to resolving this frustration is to find out what unmet need he/she may have.  Ultimately all people yearn to be safe and to have their core psychological needs met.

                Caregivers must provide a means to ensure that the person with dementia has a personally meaningful day and night.  This means that throughout the course of the day he/she is engaged in activities or projects that are familiar, meaningful, and purposeful.  For example, Helen’s caregiver knows that Helen is a mother of three children. Helen is pacing her home waiting for her “kids” to get home from school.  Knowing that the children are now grown and will not be “walking through the door at 3:15pm” her caregiver has discovered that Helen’s afternoon routine was to make a snack for the children before they came home from school.  Her caregiver sets up a snack for Helen to make and begins to validate her feelings of motherhood and her desire to keep her children safe.  The caregiver also begins to reminisce during this time about her children and her routine as a mother.  Through this process her “unmet” need is resolved and she now is feeling safe and content.

                This is not a simple process that occurs quickly. To effectively communicate and reminisce with a person with dementia, a caregiver must have a good understanding of the life story of the person. 

                A stressed out caregiver may feel that antipsychotic medication is the best and only option; however, after weighing the side effects of this type of medication and researching other alternatives, they may find there are better, more effective, ways to help manage the stress of challenging behaviors.  As these studies have shown, the risk of sudden death is high, and the improvement in the quality of life is not a guaranty.

                For more information the alternative to antipsychotic medication to resolve challenging behaviors, please contact Alzheimer’s Care Group at 317-218-5111 or www.alzcaregroup.com or www.behomelivelife.com.

Tags: , , , , , , , , , , , ,
Posted in Uncategorized | No Comments »

Fall Harvesting

September 16th, 2009

Fall Harvesting

 

            Harvesting vegetables and putting them up for the winter is an old tradition.  It was the life blood for families during the winter until the supermarket became popular in the late 1970’s.  Many people today continue to “put up” vegetables to save money and to gain the benefits of fresh vegetables. Here are a few ideas that will work well to stimulate reminiscing and be a purposeful activity.

 

Shucking Corn:

Have the residents shuck corn cobs.  Once the corn is shucked, cook the corn in water until the water boils and let it simmer for about five minutes.  Have each resident butter a piece of bread, then they can use the bread to butter the corn by sliding the buttered side of the bread along the corn.  Be prepared to cut the corn off the cob if someone is having difficulty due to dentures.

 

Breaking Beans:

Bring in a bushel of beans to be snapped.  Place the beans on the table and have residents sit around the table and snap the beans.  Once the beans are snapped, they can be cooked with some bacon for about an hour.  This is a great activity to do in the morning.  The beans can be cooking around lunch time.  The smell of the beans and bacon cooking will have everyone ready to eat by the time lunch arrives.

 

Pickling:

Cucumbers can be pickled using safe cold brine.  Have a group of residents chop the cucumbers into the desired size.  Then have the group measure out the following ingredients:

                Two cups vinegar                                             One cup water

                One half cup sugar                                          One cup salt

                Three tablespoons dill

Mix all ingredients together, and then add cucumber pieces (three cups).  Place cucumber and pickling ingredients in a bowl with a tight fitting lid.  Let sit for three-five days.  Then enjoy!

 

While the residents are participating in these cooking groups ask questions to get everyone talking about past cooking experiences.

               

                “Did you grow a garden in the summer?”            

                “What kind of vegetables did you grow?”

                “How did you put the vegetables up for the winter?”

                “Did you sell your vegetables at the farmer’s market?”

                “Did you ever have a glass jar bust while you were canning?”

                “Did you make homemade jams or jellies?”  

 

Trivia:

A pickle crunch should be heard from 10 paces away.

26 billion pickles are packed each year in the U.S.

Half of all cucumbers are made into pickles each year.

The average ear of corn has 800 kernels, arranged in 16 rows.
There is one piece of silk for each kernel.
A bushel of corn contains about 27,000 kernels.

 

For more information  contact 317-218-5111 or www.behomelivelife.com

Tags: , , , , , , , , ,
Posted in Uncategorized | No Comments »

Sleep

September 3rd, 2009

Sleep

 

            One of the most common issues that care givers face when providing care for someone with dementia is a lack of sleep.  Between the stress of the day to day care and the struggles with getting a full night sleep, care givers find that exhaustion is their daily companion.           

            There are many factors that can cause a person with dementia not to get a full nights rest.

  • The internal clock is disrupted causing confusion between days and nights.
  • Elderly adults may not need as much sleep
  • The dementia makes it difficult for the person with dementia to recognize the difference between dreams and reality.
  • Diet changes or poor eating habits

 

            A common “quick” fix for sleep is often the use of prescription sleep aids or over the counter medications as in common pain medications with PM effect.  Consulting the physician is very important when beginning this type of intervention.  These medications can in fact cause an increase in confusion as well as make the person with dementia unsteady and at risk for falls that might cause a break of a bone.  Another important point to remember is that the effectiveness of a sleep aid is 14 days.  After that, the medication is often not able to work effectively leading to a need for an increase in the dose.

 

Tips that Succeed:

  • Change the diet:  eliminate coffee or other foods/beverages that contain caffeine.
  • Don’t drink after 6:00 pm.  Trips to the bathroom at night may lead to difficulty falling back to sleep. 
  • Stay busy with meaningful activities during the day.  The common misunderstanding is that when an elderly person is sleeping in his chair it’s because he really needs his rest.  Often the days of sleep are caused by boredom and a lack of anything meaningful to keep him occupied.
  • Keep a structured routine.  As much as possible ensure that the person with dementia is rising and going to bed at the same time everyday.
  • Ensure that the lighting is good all day.  Shadows and poor lighting give the feeling of nighttime.
  •  Assess for all pain and treat it promptly.
  • Avoid rigorous activity five hours before bed.

 For more information contact 317-218-5111 or www.behomelivelife.com

Tags: , , , , , , , , , , , ,
Posted in Uncategorized | 1 Comment »

Dog Day of Summer

August 29th, 2009

Those dog days of summer are quickly approaching.  As the temperature rises, many residents in nursing homes can easily become dehydrated.  Here are some quick tips to make hydration a fun time for all care partners!

 

·         Ice Pops make a cool treat to enjoy especially during those times everyone is outside on the courtyard enjoying the sun.

·         Watermelon can be a tasty treat as well a fantastic way to add hydration to the afternoon.  Seed spitting contest are an added plus!

·         Smoothies:  these treats are easy to make.  Just take a blender of ice and a fruit of choice and blend away.  Fruit juice can be substituted for the fruit as well.

 

For more information contact 317-218-5111 or www.behomelivelife.com.

 

 

Tags: , , , , , , , , ,
Posted in Uncategorized | No Comments »

Resident to Resident Altercations

August 22nd, 2009

Resident to Resident Altercations

            Resident to resident altercations can be a serious and difficult issue to face as a caregiver in a nursing home.  Aggressive behaviors can be verbal (yelling, cursing, name calling) or physical (hitting, pushing).  These events can occur without any provocation or because of a misinterpretation of facts or situations.  Caregivers must be able to respond appropriately when one resident begins arguing or fighting with another resident.

              No group of people living together will get along all of the time.   Even the closest families will argue or become annoyed with one another.  Residents living on an Alzheimer’s Care Center are confused due to the cognition loss that they are experiencing from the disease process.  A roommate for example is a stranger, in most cases, that she has never met before.  She is now sharing this space with someone who she is expected to trust automatically.  If she is already experiencing paranoia then becoming accustomed to sharing her space may even be more of a challenge.  When this is tied together with the fact that all of the residents are living with the same cognition loss and confusion about living in an unfamiliar place, the situation may be fertile for aggression.

            Caregivers must approach the situation in a calm manor.  Typically residents with dementia suffer from lability.  They will mirror the emotions of those around them.  If caregivers rush into a situation yelling, pushing, or threatening, the resident will become even more aggressive.  Caregivers must try to identify the immediate cause of the agitation.  What happened right before the incident occurred?  What is occurring in the environment?  Is it too loud?  Caregivers should focus on feelings and not facts.  Validate what the person is feeling and help put those feelings into words.  “I understand you do not want Sally in your room.  Tell me about this photo of your mother.  Did you help her with the garden she is standing next to in this photo?”  Once a caregiver has been able to put those feelings into words, then use redirection to help refocus the energy onto a new task. 

            The best way to eliminate resident to resident altercations is prevent them before they occur.  Programming is the key to success with this goal.  Caregivers should integrate as much of a resident’s past interests into her current daily schedule.  This will not only help the resident to feel as though she has a purpose, it will also prevent boredom.  The need for a purpose does not diminish as a person’s dementia progresses.  In fact, staying focused with purpose is as important in the late stages of the disease process as in the early stage.

            Caregivers need to remember the following important tips in dealing with resident to resident altercations:

·         Never raise your voice to the residents fighting

·         Focus on the feelings not on the facts

·         Limit distractions during the incident

·         Validate feelings and help put those feelings into words

·         Shift focus onto another activity

·         Prevent behaviors by developing a person centered daily purpose programming calendar.            

For more information call 317-218-5111 or www.behomelivelife.com.

Tags: , , , , , , , , , , , ,
Posted in Uncategorized | 1 Comment »

Finding a Good Geriatric Care Manager

August 18th, 2009

You’ve heard us talk about the importance of care management for your parent with Alzheimer’s or a related dementia.  Today’s blog and article support this.  The following is from Business Week Magazine:

Finding a Good Geriatric Care Manager
Such professionals can be a tremendous help if you’re trying to take care of ailing parents but live far away
By Lauren Young

On a Tuesday night in late July, Jon Meyers, 42, got the call every child with an elderly parent dreads. His 84-year-old mother, Ruth, who suffers from dementia, had fallen in her kitchen and was heading to a New Jersey hospital by ambulance. But instead of agonizing over not being able to get there quickly—it’s four hours from his home in Washington, D.C., to Point Pleasant, N.J.—Meyers took comfort in the fact that Stephen Mielach, a geriatric care manager, was following the ambulance, ready to take control.

Before 2007, Meyers had never heard of geriatric care managers (also called geriatric case managers). But then his mother developed problems that required hospitalization, and Meyers couldn’t keep taking days off from his job as an art director at the Cato Institute, a Washington think tank. On the recommendation of his mother’s physician, Meyers, an only child, hired Mielach. He accompanies Meyer’s mother on doctor visits, looks after her dog on occasion, and even helped with the paperwork for a reverse mortgage so that she could stay in her home.

The role of a geriatric care manager goes well beyond that of a home health aide. The primary job of home health aides is to administer medication and provide companionship. By contrast, care managers oversee many things busy or far-flung family members might not be able to stay on top of: vetting nursing homes and assisted living facilities, overseeing home health aides, providing guidance about applying for federal, state, and other benefits. They may also tend to more day-to-day tasks, like making sure that rugs in a parent’s home don’t slip and that refrigerators are stocked.

An estimated 7 million people care for adult relatives from a distance, according to the National Alliance for Caregiving. On top of the logistical benefits of hiring a care manager, preliminary research indicates that elderly patients who have a geriatric care manager get more thorough care than patients who do not. Evercare by UnitedHealthcare (UNH), which hooks up patients with care managers, conducted the research in conjunction with Santa Monica (Calif.) think tank Rand Corp.

GOOD CHEMISTRY
What kind of expertise do geriatric case managers bring to the table? They often have some background in nursing or social work. Linda Fodrini-Johnson, president-elect of the National Association of Professional Geriatric Care Managers, estimates that 35% of the group’s 2,000 members have nursing degrees and 50% have social work or counseling backgrounds. The other 15% have experience in fields such as physical therapy or occupational therapy, or have advanced degrees in gerontology and related fields.

When choosing a care manager, find one with experience dealing with issues similar to those of your relative. If a parent has a complicated medical history, consider hiring someone with a nursing background to coordinate care among doctors, who often don’t talk with each other, says Julie Davis, managing editor of Parentgiving.com, a caregiving Web site. And make sure there is good chemistry with your family.

The network of caregivers in most communities is fairly small, and many people say the best referrals come from their parent’s doctor, local hospital, or nursing home. Jan Rosenbaum, 53, a molecular pharmacologist working in the life sciences group at CincyTech in Cincinnati, which invests in technology startups, got a recommendation from a psychologist working at her dad’s independent living facility in Orange County, Calif. “We were concerned—and rightly so—that the facility would not be paying careful attention to the details of his case and that as his memory worsened, he might not be properly understanding or communicating everything the doctors were saying,” she says.

Rosenbaum’s advice is to include the elderly parent in the selection process—after all, he or she is the one who will have the most direct contact with the professional caregiver. “The relationship will only work once a high level of trust is established between the two of them,” says Rosenbaum.

It’s also a good idea to ask potential care managers if they receive financial incentives from nursing homes or other providers for directing clients there. “Make sure you are dealing with a care manager who is most concerned with recommending the appropriate care for your parent vs. someone who might have a special financial relationship with a facility,” says Paul Hogan, co-author of Stages of Senior Care (McGraw-Hill), to be published this November.

Caregivers kick off the process with an assessment. This includes a review of the medical history, and, if your parent is living at home, an evaluation of the setup, looking at stairs, lighting, and other issues. Care managers may even take a peek at the checkbook to find out if bills are being paid on time (some people give care managers power of attorney and the right to make medical decisions, but that’s unusual).

Hiring one of these professionals isn’t cheap. Initial assessments, which last a few hours, range from $200 to $850, depending where you live. Hourly rates can range from $80 to $200. While most payments are out-of-pocket, check your parent’s long-term care insurance policy to see if it covers the expense, and check your employer’s elder-care benefits.

In the end, finding someone to help you take care of an elderly relative can benefit your health as well as theirs. Suzanne and Peter Cooper of Upper Saddle River, N.J., are raising their five-year-old son while living with her 84-year-old mother, Irma, who has Alzheimer’s disease. Suzanne, 49, says her own mental and physical state has improved dramatically since she hired Nancy Bortinger, the director of geriatric services at Vantage Health System in Dumont, N.J.

Bortinger plowed through a list of 20 local day-care facilities to get Suzanne’s mother out of the house for stimulation and socialization. Now Bortinger is helping Suzanne place Irma in a respite care center for a week while the family takes a much needed vacation. Suzanne equates the role of a geriatric care manager with a global positioning system for your car. “Even if you have maps in the glove compartment, the GPS gets you right to the place you need to get to,” she says.

Young is a business editor at Business Week

 

For help finding a Geriatric Care Manager for your family:

www.BeHomeLiveLife.com; (317) 218-5111; Ellen@BeHomeLiveLife.com

 

Tags: , , , , , ,
Posted in Uncategorized | No Comments »

Meaningful Engagement

August 8th, 2009

Meaningful Days

 

A meaningful day is a day filled with activities that create a sense of belonging and well-being, and the person with Alzheimer’s disease can participate in easily.  Here are some strategies to create a meaningful day for your residents.

 

  • Enjoy reminiscing with your resident.  Short-term memory may be damaged, but long-term memory often remains.  When reminiscing it is helpful to talk about subjects such as winter snowstorms or making holiday dinners rather than a specific memory or event from the past.
  • Recognize the special abilities that often remain and enjoy them together.
  • All people, with or without Alzheimer’s disease enjoy the same things:  a good meal, animals, babies, or favorite music.
  • People with Alzheimer’s disease enjoy other forms of affection.  Sit close and look at pictures.
  • Look for activities that will be interesting to the person.  In seeking activities the individual would enjoy, it helps to think about past work experiences and past and present interest.
  • Look for activities that will be failure free.   A craft project with a pre-set outcome or appearance may be too difficult, whereas arranging silk flowers in a vase is a failure free task.
  • Reduce distractions so the person can focus on the task, eliminating things such as background noise from the television.
  • Keep exercise and physical activity part of everyday, as it helps keep sleep and nighttime habits normal.
  • Familiar activities such as setting the table and folding laundry should be part of the daily routine that the person with Alzheimer’s disease helps with.  The tasks are meaningful, familiar activities and assist to remain skills as long as possible.
  • If music, exercise, or spiritual activities were part of your resident’s routine each week, those type of activities should occur frequently during the week now as well.

 

For more information contact 317-218-5111 or www.behomelivelife.com

Tags: , , , , , , , ,
Posted in Uncategorized | No Comments »

To Help or Not to Help: Personal Care

August 2nd, 2009

To Help or Not to Help:   Personal Care

 

Self care activities (such as dressing and grooming) are not just tasks that have to be done in order to remain physically alive.  They are opportunities caregivers have to help individuals with Alzheimer’s disease maintain their physical, mental, communication, and social skills, as well as their dignity and self-respect.  Using effective approaches to these activities can help enhance an individual’s overall well-being for as long as possible.

 

Encourage the person to do as much as possible for him/herself.  If the resident can comb his/her hair, allow him to do so while you make the bed or complete another quick task.  You may need to finish (such as combing the back of the head) but it strengthens self care independence while maintaining individual identity and self-esteem.

 

Guidelines for Helping with Daily Self-care Tasks

  • Simplify and clarify the task.  Clothing garments with simple fasteners or a permed hairstyle any go far in enabling the person to complete a task independently.  Clarify the task with environmental cues such as a comb and brush set out by the makeup mirror.
  • Reduce distractions such as background noise to confusing cues (such as clutter or similarly colored toilet and dressing stool covers.)
  • Keep a regular routine.  A regular routine makes life more predictable and easier to cope with.  This reduces confusion and improves the individual’s cooperation and ability to perform self-care.
  • Be flexible and patient.  It is important to remain flexible and patient because the first attempt at getting a task done often will not work.  Also, remember to not take refusals personally, the person with Alzheimer’s disease cannot help his/her behavior.
  • Use good communication techniques.

 

Techniques for Helping

  • Break the task into steps that are small enough to match the person’s abilities.  For example, a person may need to have tasks broken into smaller steps such as:  put toothpaste on the toothbrush, brush your teeth, rinse your mouth, and dry off your mouth.
  • Demonstrate the step.  For example, when you say “wipe your mouth” you can wipe your own mouth.
  • Help begin the action.  Even when you demonstrate a step, the person may still not be sure what to do.  You can help by beginning the action until he/she remembers what to do.
  • Give the person time to finish the step.  Rushing a person with Alzheimer’s disease usually will increase confusion, embarrassment, and resistance.

 

For more information contact 317-218-5111 or www.behomelivelife.com

Tags: , , , , , , , , , , ,
Posted in Uncategorized | 1 Comment »

Summer Safety

July 24th, 2009

Summer Safety Tips

 

            Summer provides wonderful opportunities for caregivers to create meaningful moments with residents diagnosed with dementia.  Enjoying gardens, cookouts, or holiday celebrations are fantastic ways to reminisce.

            There are a few safety tips to remember.

 

  1. Be sure to use sun block.  As a person ages, their skin becomes thinner and will burn more easily.  Also many medications can cause a person to burn more easily the longer they are in the sun. 
  2. Provide plenty of beverages.  Dehydration can be a serious issue for aging seniors.  Someone with dementia may not realize they are thirsty or overheating. 
  3. Sit under a shaded area.  This will also help prevent sunburn or over exposure to the sun. 
  4. Avoid areas where the side walk is uneven or has broken concrete.  A person with an unsteady gait may be more likely to fall if the pavement is not smooth. 
  5. Utilize courtyards or fenced in yards to avoid wandering.  Wandering can become a serious problem in the heat of summer.

Remember, spending time outdoors is an important part of an aging person’s daily routine.  Practicing good safety tips will ensure that everyone has a great time without stress. 

 

For more information call 317-218-5111 or www.alzcaregroup.com.

Tags: , , , , , , ,
Posted in Uncategorized | No Comments »

The Alzheimer’s Action Plan

July 17th, 2009

P. Murali Doraiswamy, head of biological psychiatry at Duke University, wrote The Alzheimer’s Action Plan to illustrate the irrefutable links between healthy living and a healthy brain.  Doraiswamy admits there is no perfectly effective method of Alzheimer’s prevention, but his book illustrates a pragmatic approach, encouraging readers to create a personal “brain health action plan” based on recognizing and managing personal risks. 

Caregivers who have dealt with loved ones with the disease will insist that Alzheimer’s is not a normal part of aging.  Studies agree, showing that distinct physical abnormalities, (such as tangles or plaques), appear in the brain.  Doraiswamy points out that while a cure still hasn’t been discovered, the disease is treatable.  There are currently 4 FDA-approved medications available and myriad more in clinical trials awaiting approval.

Amyloid PET scans, currently in the late stages of testing, are believed to be able to show plaque buildup in people even before they develop symptoms.  Genetic therapies are being developed to aid the brain’s ability to repair itself by delivering nerve growth factor through viral vectors, as some genetic mutations can be made possible by introducing a virus with the desired genetic material in vivo or in vitro.

With new developments in technology advancing early diagnosis and allowing people to see their personal risks, Doraiswamy believes people will have even more initiative to apply the proposals given in his book. 

Tags: , , , , , , , , , , , ,
Posted in Uncategorized | No Comments »

« Older Entries