Posts Tagged ‘nursing homes’
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.
Tags: activity ideas, Alzheimer's, Alzheimer's disease, antipsychotic medications, caregivers of alzheimer's disease, Grandpa with Alzheimer's, meaningful days, memory loss, mom with alzheimer's caregiver, nursing home ideas, nursing homes, people with dementia are not children, person centered care
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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.
Tags: activity ideas, Alzheimer's, Alzheimer's disease, Alzheimer's Education, alzheimer's support, meaningful days, nursing home ideas, nursing homes, people with dementia are not children, personally meaningful days
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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
Tags: activity ideas, activity ideas for people with dementia or Alzheiemer's, Add new tag, alzheimer's care group, Alzheimer's Education, alzheimer's residents, alzheimer's support, meaningful days, mom with alzheimer's caregiver, nursing homes, people with dementia are not children, personally meaningful days
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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:
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Set goals to reduce or eliminate overhead paging, bed/chair alarms, and piped in music
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Remove institutional signage
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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.
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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.
Tags: Alzheimer's, Alzheimer's disease, annual survey, cms, facilities, homelike environment, nursing homes, people with dementia are not children, person centered care, personally meaningful days
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Thursday, July 2nd, 2009
A catastrophic reaction is the emotional and behavioral reaction to a situation that is either overwhelming or stressful to the individual with dementia because the situation is beyond the person’s ability to understand or comprehend.
This may happen suddenly without any warning to the caregiver. One minute the person with dementia may be happy without a care in the world and the next minute the person begins to yell and scream.
Some situations that might trigger a catastrophic reaction:
· A small accident such as spilling water
· A loud sudden noise such as lightening
· A change in routine
· Pain
· Too many steps in a task
· Misinterpretation of person, place, or thing
Alzheimer’s disease is a progressive disease that will decrease a persona’s ability to comprehend and use written and spoken words, know the correct day, date, time or place, and to use proper judgment. Rapid mood swings with no apparent reason is a typical symptom of Alzheimer’s. It is important to take into consideration a person’s cognitive level when problem solving behaviors and reactions to stimuli.
Remember when problem solving catastrophic behaviors that the situation must be assessed.
· What is triggering the reaction?
· What happened just before the episode?
· Was the task too overwhelming?
· Is the environment uncomfortable?
· Is the person in pain?
Make sure all instructions during a task are broken down into simple one step sentences. Adhere to a routine whenever possible to avoid unfamiliar situations that may cause anxiety. Never scold or talk down to the person with dementia because this will demean the person and cause the episode to continue. Never push or rush the individual to go faster than he is able.
Finally, remember that tactics today may not work tomorrow; and a catastrophic reaction is not a reflection on care.
For additional information please call 317-218-5111 or check out: www.alzcaregroup.com.
Tags: activity ideas for people with dementia or Alzheiemer's, Alzheimer's, Alzheimer's disease, Alzheimer's Education, behaviors, caregiver stress, challenges, improving memory, nursing homes, people with dementia are not children, person centered care
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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
Tags: activity ideas, Alzheimer's, alzheimer's and brain games, alzheimer's care group, Alzheimer's Caregiver, Alzheimer's center, Alzheimer's disease, Alzheimer's Education, alzheimer's residents, alzheimer's support, Call to Action, care giver stress, caregiver stress, caregivers of alzheimer's disease, cognition, congress, cooking ideas in nursing homes, Dementia, Disease, educated caregivers, Ending the Medicare Disability Waiting Period Act of 2009, Grandpa with Alzheimer's, Katrina DeGraff, meaningful days, mom with alzheimer's caregiver, nursing homes, people with dementia are not children, person centered care, personally meaningful days, relief
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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.
Tags: Alzheimer's, alzheimer's care group, Alzheimer's Caregiver, Alzheimer's center, Alzheimer's Dementia, Alzheimer's disease, Alzheimer's Education, alzheimer's residents, alzheimer's support, care giver stress, caregiver stress, caregivers of alzheimer's disease, cooking ideas in nursing homes, Dementia, educated caregivers, exercising your brain, Grandpa with Alzheimer's, Living at home longer, meaningful days, memory loss, mom with alzheimer's caregiver, nursing homes, people with dementia are not children, personally meaningful days
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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.
Tags: activity ideas, Alzheimer's, alzheimer's and brain games, alzheimer's care group, Alzheimer's Caregiver, Alzheimer's center, Alzheimer's disease, Alzheimer's Education, alzheimer's residents, alzheimer's support, care giver stress, caregivers of alzheimer's disease, cooking ideas in nursing homes, Dementia, educated caregivers, exercising your brain, Grandpa with Alzheimer's, improving memory, Katrina DeGraff, Living at home longer, meaningful days, memory care, mom with alzheimer's caregiver, nursing homes, people with dementia are not children, personally meaningful days
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Monday, March 30th, 2009
This week in the news, the Alzheimer’s Association released its Facts and Figures 2009. According to the Alzheimer’s Association 5.3 Million Americans have Alzheimer’s disease and the direct and indirect cost to the nation is $148 billion dollars annually. Additionally, Newt Gingrich presented The National Alzheimer’s Strategic Plan for improving the care of those with Alzheimer’s disease and other related dementia to Congress.
What are you going to do to make a difference in the lives of those with Alzheimer’s and their caregivers?
So often we become stuck in the mindset that people with dementia have no hope. The media often reports the stories of heart ache and despair, but we never hear the heroic stories of people making a difference for others being afflicted with this devastating disease.
Who are those heroes?
· Families who continue to make life the life of the loved one valuable even when that means adapting past interests to current abilities
· Families who continue to visit their loved one even when it appears she doesn’t remember them any longer
· Family members who regularly rotate care and responsibility to ensure the primary caregiver receives some respite
· Caregivers in long term care who engage their residents in dementia with personally meaningful activities
· Caregivers who provide care despite Congress cutting Medicare/Medicaid benefits
· Owners of nursing homes who put Person Centered Care before the dollar
· Innovators who continue to find new ways to bring quality of life to some who can no longer remember
Are you making a difference? Do you know where to begin?
For more information: Call 317-218-5111 or www.alzcaregroup.com
Tags: activity ideas, Alzheimer's, alzheimer's and brain games, alzheimer's care group, Alzheimer's disease, Alzheimer's Education, alzheimer's residents, alzheimer's support, care giver stress, caregiver stress, caregivers of alzheimer's disease, cognition, cooking ideas in nursing homes, Dementia, Disease, educated caregivers, exercising your brain, Grandpa with Alzheimer's, improving memory, Katrina DeGraff, Living at home longer, meaningful days, memory loss, mom with alzheimer's caregiver, nursing homes, people with dementia are not children, personally meaningful days
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Wednesday, February 25th, 2009
Spring is just around the corner! I’m ready for the end of cold weather, snow, and wind. This is the perfect time to start your gardening projects for your residents. Growing food that you later eat can be a rich and satisfying experience. Gardening is a familiar activity many residents enjoy and take pride in doing. And adding fresh vegetables to a meal promotes good health.
The purpose of this activity is to provide residents with an opportunity to perform a past skill or responsibility and to stimulate reminiscence and socialization.
Materials: egg carton, garden gloves, seeds, dirt, watering can, spray bottle, cookie sheet
Set-up
Find an indoor space with good lighting for seedlings and create an outdoor space for gardening.
Process
Getting Started
- Decide what you will grow. Ask the residents to help you choose what to plant. Take time to reminisce and ask questions like,
- What vegetables did you grow from seeds?
- Where did you get your seeds?
- What vegetables did you grow from plants?
- What type of container did you start your plants in?
Seedlings
- Ask families to donate seeds or buy them at a nursery.
- Start seedlings at the beginning of spring.
- Give each resident an egg carton. Next, tell them to punch a couple of small holes in the bottom for draining.
- Direct the residents to fill each egg holder halfway with dirt. Next, tell them to add one seed to each egg holder. Then, tell them to cover the seeds with dirt.
- Give the first resident the spray bottle filled with water. Next, direct the residents to spray water on top of each egg holder.
- Place the egg cartons on the cookie sheet to catch any water that may drain out. Next, follow the directions on the seed package to (1) decide where to put the cartons so the seeds will grow and (2) find out how often to water them. Then, remind the residents in the coming weeks to water the seeds according to the directions.
- Consider asking questions from Garden Trivia
Copyright 2008 Alzheimer’s Care Group
For more information: www.alzcaregroup.com
Tags: activity ideas, Alzheimer's, alzheimer's and brain games, alzheimer's care group, Alzheimer's Caregiver, Alzheimer's center, Alzheimer's Dementia, Alzheimer's disease, caffeine, care giver stress, caregiver stress, caregivers of alzheimer's disease, cognition, cooking ideas in nursing homes, Dementia, Disease, educated caregivers, Grandpa with Alzheimer's, improving memory, Katrina DeGraff, Katrina's Korner, nursing home ideas, nursing homes, people with dementia are not children, person centered care, personally meaningful days
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