Posts Tagged ‘personally meaningful days’

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

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.

 

 

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.

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

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

The Alzheimer’s Action Plan

Friday, 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. 

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.

Symptoms of Alzheimer’s

Friday, June 26th, 2009

Alzheimer’s disease has been in the news a lot these days.   Recently there has been an increase in the number of commercials advertising medications that can help with the disease process.  Even HBO had some success with its documentary, the “Alzheimer’s Project”.  We’ve seen an increase in people inquiring about the symptoms of the disease process.

 

“When do I become concerned if I am forgetting things?

“How do I know if I have Alzheimer’s?”

 

Here are a few symptoms to look for:

 

  • Loss of procedural memory.  Forgetting how to do routine tasks that have been second nature .

 

  • Misplacing items:  Not recalling where you placed an item or finding it in a very strange place.  For example, putting your keys in the freezer.

 

  • Difficulty finding words:  Having trouble finding the right words or understanding common words that you once understood.

 

  • Difficulty with judgment or drawing conclusions.

 

  • Changes in personality:  You begin to experience mood changes or loss of initiative.

 

 

If you believe you are experiencing memory impairment, it is time to see a doctor.  People over the age of 65 should consider annual memory exams, especially if there is a family history of Alzheimer’s or other related dementias.  In some cases, dementia can be reversed. 

 

For more information, please contact us at 317-218-5111 or www.behomelivelife.com

 

Socialization Important For Memory

Tuesday, June 23rd, 2009

This article discusses recent findings regarding socialization and it’s affects on Alzheimer’s and other related dementias.  Interestingly, more and more research is proving socialization is vital to conserving cognitive function as we age.  It is a reminder in the value of staying connected with others.

 

Study links seniors’ loneliness to higher risk of dementia

 

By Kathleen Fackelmann, USA TODAY

Loneliness may put people at risk of an Alzheimer’s-like dementia, a study reported Monday.

“People who described themselves as lonely were twice as likely to develop dementia,” says researcher Robert Wilson of the Rush University Medical Center in Chicago.

Other studies have found that people who are unmarried and socially isolated are at higher risk for dementia, including Alzheimer’s. But this study is one of the first to show a link between loneliness — or the feelings of disconnection from other people — and a higher risk of developing dementia late in life, says Laurel Coleman, a spokeswoman for the Alzheimer’s Association and a geriatrician in Portland, Maine.

Wilson and his colleagues studied 823 people who were about 80 years old and had no sign of dementia at the start of the study. The team gave the recruits a loneliness quiz and tested them annually for signs of memory loss and confusion, two key signs of dementia and Alzheimer’s.

During the four-year study, 76 people developed an Alzheimer’s-like dementia, Wilson says. The risk of developing dementia increased about 51% for each one-point increase on the loneliness scale. People with the highest scores had 2.1 times the risk of developing dementia, a group of conditions that destroy brain cells and lead to mental confusion. Alzheimer’s is the most common form of dementia.

Autopsies were performed on 90 people who died during the study. The researchers found no link between loneliness and the development of the abnormal brain deposits that are the hallmark of Alzheimer’s.

That finding suggests loneliness might be triggering dementia through a novel mechanism — one that doesn’t lead to a brain riddled with deposits, Wilson says.

One theory is that people who are lonely over long periods of time might have higher levels of damaging stress hormones. The elevated stress hormones might lead to an accelerated aging of the brain — and perhaps to dementia, Wilson says.

Other research suggests lonely people are at risk of other health problems such as cancer and high blood pressure, says John Cacioppo of the University of Chicago. Still, he says, the new finding, which appears in February’s Archives of General Psychiatry, must be verified by additional research.

The findings didn’t change much when the team factored in markers of social isolation, such as infrequent participation in social events. That means that people who have a small number of good friends might be better off than those with a busy social schedule but chronic feelings of loneliness, Wilson says.

But lonely people often benefit from signing up for a new class or activity, Coleman says. Research shows that such activities might protect aging brain cells. And seniors who are out and about are more likely to make new friends, which might lessen feelings of loneliness, she says.

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

“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