Posts Tagged ‘Alzheimer’s’

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Use Satellite Radio in Your Dementia Program

Wednesday, July 7th, 2010

Music is a wonderful therapeutic tool. Many of our memories are tied to music that we heard while growing up or during a specific event. Imagine Christmas without the carols, road trips in the car without sing alongs, or prom without those sappy love songs!

Satellite radio offers a wide range of options for people living in a nursing home. Activity programs can be designed and complimented with the many different types of music programs played throughout the day. Choices on satellite radio range from Baroque Period Classical, Rock-n-Roll, Gospel and Latin Funk to Country Gold.

For example, jazz or upbeat 50’s music could be played in the morning during an exercise group. A sensory group that needs soft music could be paired with the opera station or nature sounds. You could even use a polka channel during a German Fest. Caregivers were able to help many residents do the polka. Some of the people said they hadn’t had that much fun in years!

Many activity programs use music from the 1920-40’s. It is always important to remember that residents who are in the mid-stage of Alzheimer’s believe that they are 40 years younger than they actually are. Today, when preparing music that would be familiar, program directors should consider music from the early 1970s. That year in music there were many popular hits which are now considered classics. For example:

Simon and Garfunkel – Bridge Over Troubled Water
Otis Redding – Tell the Truth
The Beatles – Let It Be
Elton John – Your Song
James Taylor – Fire and Rain

People with dementia will light up when they hear a favorite song. It is a great way to start reminiscing about school, young love, work, or vacations. Don’t be afraid to use the music that was popular 40 years ago. Chances are good that this music will be associated with many of their memories, and you can get them talking about those meaningful times.

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Approach and Communication

Tuesday, June 22nd, 2010

As Alzheimer’s disease progresses, it can impact the way a person communicates. And we all know that communication is vital in the caregiving process. Alzheimer’s makes it difficult to express our ideas, feelings, and wants. In order to maintain a quality life, this basic need must be met.

Each person with Alzheimer’s disease is unique, as are each person’s communication abilities and deficits. An individual with Alzheimer’s may have trouble finding the right words, may misunderstand statements that are made, may repeat the same words or statements, or may revert to speaking a native tongue. As the disease progresses, caregivers may also see the person relying more on gestures than words. For example, it may be easier to point to an object such as a cup of water, than to ask for a drink. She may pat the sides of her waist to indicate she needs to go to the bathroom. Some people may have trouble speaking in cohesive statements, often with the phrases sounding more like “word salad”, an incomprehensible mixture of words or phrases. Consequently, caregivers must learn to rely on gestures and other forms of nonverbal communication in order to understand what the person is trying to communicate.

Despite the fact that communication may become more challenging as the disease progresses, sensitive ongoing communication is important. Although the person with Alzheimer’s may not respond to each statement, she still benefits from continued communication.

Here are some tips to enhance communication:

• Approach from the front and never from behind.
• Get eye-level and at a comfortable distance (at least 2 feet from face)
• Identify yourself by name (and/or role) and what you are going to do for/with the person. Even if you have known the person for years, it is still important to identify yourself and the task.
• Call the person by his/her familiar name.
• Use short, simple, one step instructions
• Give the person plenty of time to respond to questions and statements
• Limit available choices to two (2) for the person to decide from ( i.e. the blue dress or the red dress, a brownie or ice cream)
• Don’t ask questions that rely on memory (remember when you ate eggs for breakfast last week?).
• Speak in a strong clear voice; don’t yell unless the person has a hearing impairment.
• Don’t talk down or childlike.
• Turn negatives into positives. Say “Let’s go here” instead of “Don’t go in there.”
• Turn questions into statement. Say “Let’s go eat” instead of “Are you ready for lunch?”
• Be aware of your tone of voice. Convey an easy going attitude.
• Approach from the front and never from behind.
• Use positive, friendly facial expressions, even if you’re doing a difficult task.
• Be aware of your stance – avoid standing with hands on the hip or crossed arms.
• Focus on feelings not on facts.
• Validate feelings and help put those feelings into words.
• Be patient, flexible and understanding.
• If you cannot understand her, tell her, “I’m not sure what you’re trying to say, and we’ll come back to that later.”

Good communication will bolster self worth, validate feelings, stimulate memories, and calm and reassure.

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Sollutions

Friday, 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.

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Fall Harvesting

Wednesday, 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

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Sleep

Thursday, 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

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Dog Day of Summer

Saturday, 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.

 

 

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Resident to Resident Altercations

Saturday, 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.

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Meaningful Engagement

Saturday, 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

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Summer Safety

Friday, 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.

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Homelike Environment

Friday, July 10th, 2009

     The Centers for Medicare & Medicaid Services (CMS) has initiated new changes to the survey process requiring surveyors to ensure that a facility is providing a “homelike environment.” CMS defines “homelike environment” as “one that de-emphasizes the institutional character of the setting, to the extent possible, and allows the resident to use those personal belongings that support a homelike environment.  A personalized, homelike environment recognizes the individuality and autonomy of the resident, provides an opportunity for self-expression, and encourages links with the past and family members.”

 

            As facilities across the country prepare for annual surveys, they must address environmental factors to ensure that the nursing home does not feel institutional.  Here are a few tips that may help:

 

  • Set goals to reduce or eliminate overhead paging, bed/chair alarms, and piped in music
  • Remove institutional signage
  • Encourage families to bring in favorite chair or dresser and other personal decorations that their loved one might have used prior to placement, or in a style they would’ve preferred.
  • Avoid mass purchasing of items that will look identical such as bedspreads, furniture or drapes with an identical print. 

     A homelike environment can be a tremendous opportunity to provide personally meaningful engagement for our residents.  Adapting the environment need not be a costly endeavor.  If you are looking for suggestions or need assistance implementing a homelike environment, please contact us at (317) 218-5111 or www.alzcaregroup.com.

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