Posts Tagged ‘meaningful days’

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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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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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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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To Help or Not to Help: Personal Care

Sunday, 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

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“How do I begin reminiscing with my residents on my Alzheimer’s Center?”

Tuesday, June 2nd, 2009

“How do I begin reminiscing with my residents on my Alzheimer’s Center?”

As Alzheimer’s progresses conversations can become more difficult.  As a person with Alzheimer’s begins to notice gaps in his memory, or has trouble understanding questions, he will withdraw from social situations that may become uncomfortable.   As the disease progresses, care givers must learn to rely on non-verbal body language in order to anticipate the needs and wants of their residents with dementia.

 

Try these tips to encourage conversations:

 

  • Pick a topic of interest that you know your resident enjoyed during his 20’s-50’s – for example, fishing.

 

  • Choose materials such as old photos of fish, free fishing guides available at most bait shops and a tackle box. These items can be used for cueing.

 

  • Talk about the items:
    • “Joe, look at this picture of you  at Pike Lake.  Do you remember what kind of fish you caught that day?” 
    • If Joe isn’t able to recall the answer right away, try saying:  “It looks like a Northern Pike to me.  It has sharp teeth, and I remember trying to catch one of those myself.  It wasn’t easy.”
    • Ask:  “What fish was the most fun to catch?  Did you like Largemouth Bass or Bluegill for eating?  What is the best bait to use to catch Catfish?”

 

  • If answering questions is difficult when you first begin the conversation, try going through all of the photos and narrating what happened in each one.

 

  • Once you’ve gone through the photos, try asking the questions again.  If you know the answers to the questions, use a picture to cue your dad to the correct answer.  For example:  “Joe, which fish do you think has the best flavor?” (Show a picture of a Bluegill or which ever fish you know he prefers.)

 

  • You may use the tackle box in an additional way to guide the conversation.  By touching each of the items in the box, your resident will be using his sense of smell, touch, and vision to cue his memory. 

 

Remember, the key to unlocking conversation is using tools to cue his memory.  The more you remember about your residents and their past roles and hobbies, the more cueing you can offer.

 

For more information call 317-218-5113    or www.alzcaregroup.com

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Call to Action

Monday, April 13th, 2009

CALL TO ACTION

 

I received this information today in the Alzheimer’s Association’s ENewsletter.  Please join all caregivers to make a difference in the lives of those who are battling this difficult disease.

 

 

Advocate Impact: Forum 2009 

Last month, over 600 advocates from around the country marched on Capitol Hill to demand that our lawmakers make Alzheimer’s a national priority.

During meetings with advocates, members of Congress made the following commitments:

*       188 indicated support to end the two-year waiting period for Medicare;

*       181 indicated support for a $250 million increase in Alzheimer research funding; and

*       83 indicated support the creation of an Alzheimer’s Solutions Project Office.

*       65 members indicated support for all 3 issues!

You can catch a glimpse of the action at: http://www.alz.org/forum

We have great momentum and now is the time to “seal the deal”. Read on…

What Can I Do Now?

Ask your members to co-sponsor the End the Medicare Two-year Wait Bill!
People under age 65 with dementia who lose their jobs are likely to lose job-related health insurance. Many become uninsured and uninsurable. Just when they need coverage the most, federal law requires them to wait two years to become eligible for Medicare. Because of this wait, families face soaring out-of-pocket costs for health care or completely forego care. http://alz.kintera.org/endthewait 

Email your members of Congress now. Ask them to co-sponsor the Ending the Medicare Disability Waiting Period Act of 2009 (S.700 / H.R.1708).

Go to:

For more information on how you can impact the lives of those with Alzheimer’s contact www.alzcaregroup.com or 317-218-5113

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Sensory Kit: Spiritual

Wednesday, April 1st, 2009

Approach and Communication

 

            As Alzheimer’s disease progresses it can impact the way a person may communicate.  Communication is vital in the care giving process.  It is the way we express our ideas, feelings, and wants.  In order to maintain a quality life, this basic need must be met.   

 

            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 progress, 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 coherent statements where the phrases sound more like “word salad.”  Word salad is an incomprehensible mixture of incoherent words or phrases.    Caregivers must 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 Alzheimer’s 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.

 

Tips to enhance communication:

 

·         Identify yourself by name 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.

·         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.

 

 

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

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Approach and Communication

Tuesday, March 31st, 2009

Approach and Communication

 

            As Alzheimer’s disease progresses it can impact the way a person may communicate.  Communication is vital in the care giving process.  It is the way we express our ideas, feelings, and wants.  In order to maintain a quality life, this basic need must be met.   

 

            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 progress, 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 coherent statements where the phrases sound more like “word salad.”  Word salad is an incomprehensible mixture of incoherent words or phrases.    Caregivers must 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 Alzheimer’s 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.

 

Tips to enhance communication:

 

·         Identify yourself by name 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.

·         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.

 

 

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

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