| 1994 my mother was diagnosed with Alzheimers | | | | vulnerable, and child like. |
| Disease. | | | | I often look at my mother and see a three yearold |
| At that time she had been demonstrating memory | | | | or a five year old and it makes me feel goodto know |
| deficits for at least two years. My career had always | | | | that no matter what age (stage) she is today |
| been in the field of Geriatrics, the care of the elderly. | | | | I will care for her and love her as she is. |
| I had worked with countless families in caring for | | | | Behavioral Issues: Behavior is not intentional in |
| their elder family members at home, in Assisted | | | | Dementia. |
| Living Facilties and in Nursing Homes. | | | | SOLUTIONS: |
| My least favorite patient type was the | | | | Always look to the basics: hungry, thirsty,cold, |
| Dementiapatient. I know now that why I felt that | | | | toileting needs. Pain-80% of the frail elderly have |
| way wasbecause I had never really walked in the | | | | chronic pain that goes untreated. |
| shoesof the dementia patient. | | | | Keep your phrases short and simple,"do you want |
| In caring for my mother I have come to appreciate | | | | apple juice or orange juice?" Ask questions requiring a |
| her uniqueness. Watching her struggle with her losses | | | | yes/no response. Allow LOTS of time for a response. |
| and struggling myself to come up with ideas to keep | | | | Allow choices as often as possible. Choices must be |
| her moving and feeling good about herself has really | | | | appropriate to their level. |
| helped me to see dementia through new eyes. | | | | We do not ask the three year old if he wants to go |
| It is like caring for a child in reverse order. With a | | | | to bed. We take him to bed. Choices like, "Would you |
| child we wait with anticipation as they grow through | | | | like to wear blue or yellow today?" "Would you like |
| new stages. We watch for them to sit up, then take | | | | tomato soup or chicken noodle soup?" These are an |
| their first steps, potty train, talk, ride their first bike, | | | | example of stage appropriate choice I would give my |
| and on and on. | | | | mother. |
| Well, with aging and dementia, it really is thesame | | | | Avoid statements such as, "Do you want to eat?" |
| process in reverse. Watch carefully for the subtle | | | | "Do you need to go to the bathroom?" "Are you |
| changes (losses) and then make the necessary | | | | ready for your shower?" Those are given tasks not |
| adjustments in the environment and in ourselves. | | | | options. |
| For most elderly, as age advances so does | | | | Do not ask if they want to go to the doctor, |
| thecollecting of chronic conditions. | | | | hairdresser,etc. Just take them. Allow plenty of time |
| Chronic Conditions:to name a few arthritis, heart | | | | for appointments. Dementia patients will never move |
| disease, high blood pressure, diabetes, poor vision, | | | | on your time table. Lots of extra time must |
| reduced hearing,reduced hearing and reduced muscle | | | | beallotted to get ready. |
| strength. | | | | Dementia patients do much better with a fixed |
| Chronic diseases must be managed and it | | | | routine (just like your kids.) Regular meal and snack |
| takeswillingness on the part of the elder and often | | | | times. (do not forget fluids.) Regular shower time at |
| thefamily, to learn about the disease, treatmentand | | | | their best time of the day. Regular bedtime. Avoid |
| limitations. | | | | mentioning an appointment ahead of time. Some |
| Physical Changes : | | | | people will stress on that and ask repeated questions. |
| Aging happens over time, gradually over years. | | | | Use distraction to change a behavior. My mother has |
| Abilities decline and needs increase. | | | | a habit of clapping her hands loudly and repeatedly if |
| The ability to clean house, do the laundry,do yard | | | | she is not busy with somethng. Sometimes just |
| work, grocery shop, participate in hobbies, entertain | | | | asking her a question breaks the pattern. At other |
| in the home, prepare fancy meals, handle | | | | times having her fold clothes, play cards, look through |
| finances,and to drive. | | | | a magazine, or singing a song will also break the |
| Physical changes often progress to personal care | | | | pattern.Activities are a must. Some communities have |
| deficits fear of falling in the shower, they stop | | | | a senior center with activites or adult day care |
| showering,walking distances that they were able to | | | | centers that often do a great job with activities. |
| handle previously, toileting themseves without | | | | Find activities that your parent enjoys,walks, folding |
| accidents, stop going out especially for social events. | | | | laundry, washing dishes, playing cards,etc. Be creative. |
| A variety of reasons will often emerge if asked why | | | | "Remember Times" I learned all sorts of family |
| they stopped doing something. Rarely will the whole | | | | history and fun stuff when my mother was inher |
| truth be told. Denial is very strong due to the fear of | | | | earlier years of dementia. We would do "remember |
| being dependent on others and fear of being remove | | | | time." |
| from their home. As the adult children we are | | | | We would talk about family, how she meet my |
| obligated to watch carefully for these changes in our | | | | father, their first date, hobbies, jobs, vacations, |
| parents. | | | | WWII, the Depression era, etc. Today, my mother is |
| Cognitive Changes: | | | | in her 12th year of Alzheimer's and she does not |
| When it comes to cognitive changes things do not | | | | remember the past. Now she likes us to tell her the |
| get any easier. Approximatly 50% of 85 year old | | | | family stories. |
| have dementia. Their symptoms usually have been | | | | THINGS TO AVOID |
| present a few years before diagnosis. Please read | | | | Do not try to reason with the dementia person. |
| that again, 50% of 85 year olds have dementia. So | | | | They are unable to reason. Do not take their |
| many family members ignore the symptoms (they | | | | behavior personally. They are not doing it to you, |
| also suffer from denial) Your elder usually needs help | | | | they are just doing it. Do not confront or correct. |
| long before he or she is getting the necessary | | | | Leave the room if you have too. |
| support. | | | | Do not argue. You are arguing to a blank wall! |
| Elders with dementia have often lost the abilityto | | | | Do not talk about your parent in front of them. |
| reason, to react logically or correctly interprettheir | | | | Do not ask them or expect them to have recent |
| surroundings. Often unhealthy or irrational decisions | | | | memory. |
| are made frequently related to safety and | | | | Statements like, "I just answered that question"or, |
| medications. | | | | "don't you remember? Remember the "blank wall"! |
| One of the common things I hear is, "She is not my | | | | Remember, between you and your parent, YOU are |
| mother anymore" or "I do not know this person." | | | | the one that has to change, accept, grow, and love |
| You have to get past that to be helpful to your | | | | them through to the end. |
| parent. | | | | When all is said and done you will never regretthis |
| I am sure you had times in your child raising | | | | time spent caring for your elder. Allow this time to be |
| yearswhere you felt the same, the terrible | | | | as fun as possible-find your humor and use it in the |
| two's,teenyears, college years,or even into the adult | | | | daily activities of caregiving. And yes, it is a very |
| years,where you said to youself," I do not know this | | | | difficult job caring for your parent. |
| person anymore." | | | | Arm yourself with support groups and learn all you |
| It is a process of accepting your children at thestage | | | | can about your parent's dementia. Do not become |
| they are at, knowing that you are doing your best. | | | | the " Lone Ranger". Rreach out, ask for help, hire a |
| Well, it is not any different with your parent. Your | | | | babysitter, etc. Just like you did for your kids, you |
| parent will always be your parent. They just act | | | | can do this. |
| differently as they become more frail, more | | | | |