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Monday, May 14, 2012

Medical Emergencies

When the unexpected happens, are you prepared?  Do you carry around a list of medications, surgeries, allergies, symptoms and illnesses that your loved one has experienced.  You will need to keep this on your phone or in your wallet at all times.  When you least expect it, something will come up, and you'll end up in the emergency room not able to provide valuable information to the medical staff when they ask for it. Even if your loved one is in a nursing home or assisted living, you need to keep the updated information on you.  Your loved one may not be able to give their address and name, let alone the handful of medication they probably take on a daily basis.  If possible, grab the bag of medications before you go to the hospital.  They like to be able to verify the meds.  If you send your loved one out of town with friends or relatives, they need a complete list of surgeries, medications and medical events.  Send a written form with all the names of the meds along with the doses and number of times a day they take them.   Also add to this list any drug or food allergies and what happens to them if they take those medications.  You should not only do this for your loved one, but for yourself.  Make sure someone close to you keeps an updated list of your meds in case you become incapacitated. Someone will need to communicate this information for you.  If your loved one is in the hospital, do not leave them alone.  Have someone with them at all times to check any medication they are being given.  Mistakes can and do happen.


Have a plan of who is going to care of your loved one in case you have an emergency.  Tomorrow is too late to have all this information together.  You need it; take care of it today!

Saturday, May 5, 2012

I Am Still Here

Your loved one may not be able to communicate with you the way that they want, but they still want you to communicate with them.  They crave attention and normalcy. Talk to them frequently.  It gets lonely inside their own mind.

Often times, people who are different are treated differently - not that that isn't necessary due to their circumstances - but, they want to be treated like they are normal, as much as is possible.  Don't avoid them because you think they don't know what is going on.  Often, they do know. Clarity and levels of reasoning fluctuate day to day, and, sometimes, someone who is fairly clear in the morning will struggle later in the day. They are wishing you would ask for their help, so they can feel needed.  So, even if you don't need it, and even if they can't do the task properly, let them help.  One of the first things people go through with this disease is, as soon as everyone figures out they have Alzheimer's/dementia, they get treated like they can't do anything.  They can do things; it may be different than they used to do it.  You need to find something they can successfully complete.

When I was an administrator of an assisted living facility, I had a very kind gentleman who really thought I needed help with my job.  He had full blown Alzheimer's.  I couldn't figure out anything for him to do; but, I knew I needed to, because he came to my office every day wanting to help.  One day he saw that my closet was full of boxes and supplies.  He asked me when he should move them.  Well, there was the answer right in front of my face.  I got him a cart on which to load the boxes.  He loaded all 20 of them on the cart.  I had him walk down 3 halls that led him right back to my office.  He unloaded those boxes back into the same closet and I thanked him for all his hard work.  He went back to his apartment and was happy and satisfied for the rest of the day.  This went on for about 6 months, until he couldn't do it any longer and forgot about his job.  This may sound insignificant, or even mean.  It wasn't.  I asked him to do this task because I knew it would give him a sense of purpose each day.  He got out of his apartment, got a little physical activity and socialized with the staff and other residents.  But, most importantly, he knew he was needed and appreciated.

Find a way to communicate that does not seem condescending.  Find something that your loved one can do that makes them feel good and important.  We never lose our sense of being needed and loved, let alone the need for communication.  Read the newspaper together; do their devotional with them (or for them); strive to develop and maintain a routine.  If the laundry gets folded the wrong way, what does that really matter?  Maybe they can stir something while you are making dinner.  Have them do these things every day.  Keep them involved in any way you can.  Make them feel like you really needed their help and thank them.  This will help you keep a deep and trusting bond with them and help them to trust you when they reach the point where it becomes  difficult to communicate.  And, even then, they are still there in their own minds.  If you have close and intimate contact with them, you will see it in their eyes and feel it in their hugs.  They are still there, somewhere.

Saturday, April 28, 2012

Acceptance

Acceptance is the best thing that you can do for yourself and your loved one.  Once you've been given a diagnosis, get a second opinion.  If they are the same, as hard as it may be, you will need to accept it as best you can.  I believe you will be happier and less likely to feel regret later if you don't fight the diagnosis until the bitter end of the battle.  


In reality, if you think about it, does it really matter what the diagnosis is? Blind people still want to see, deaf people still want to hear.  Someone in the early stages of Alzheimer's still wants to function.   Someday, hopefully, there will be better ways to treat, and, perhaps, even cure the disease.  But, for now, we have no magic wand. Try to accept where you are in the process and know that there will be good and bad days ahead of you.  Don't waist the precious little time that you have left.


The sooner you accept what is coming, the sooner you can learn coping mechanisms to make each day better and prepare for the future.  Start figuring out how to make your loved one as independent as they can be, safely.  The small stuff really matters. Let your loved one straighten the newspapers, load the dishwasher, or just do any daily task that they can, within reason.  It doesn't matter if it isn't perfect.  If it still bugs you, later, you can do it again, yourself.  Hopefully, you will see the benefit of learning to live with less than perfect results and just enjoy being with your loved one.  At the end of the day, perfection is not something you cross off of your to do list.  Your to do list should be filled with commitment, laughter, bonding, teaching and accepting.


At the top of your to do list should be relief for yourself, the caregiver.  If you are spending a great deal of time with someone that is in the mid to late stages of Alzheimer's, you need a break.  Either work, time with friends, volunteering or a long walk.  Make sure your loved one is safe and then clear your mind, body and spirit. This will give you the stamina to make the journey down the long road ahead of you.   Share your thoughts with your friends.  They likely have an idea of what's going on; don't try to hide what you are going through.  There is nothing to be ashamed of; this is a disease not a choice.


Make sure that everyday has some kind of success for both your sakes.  Don't spend so much time planning to make sure your loved one is safe and has their needs met that you forget to smell the roses.  Take time to pray, laugh and enjoy. This will help you get one step closer to acceptance. Grace is a gift from God; acceptance is your gift to your loved one.

Saturday, April 21, 2012

Clutter

Just like a person who has Attention Deficit Disorder (ADD), someone with dementia or Alzheimer's needs an environment that is as clutter-free as possible.  When they want to make a decision, there is a finite amount of time until they lose their train of thought.  If there is very little clutter, they have a better chance of executing their thought.  This pertains to closets, kitchens and bathrooms as well as life in general.  

Most ladies have way more makeup and hair products than they actually use.  So, put away or throw away anything that they don't need for their daily routine.

In the kitchen, do everything you can to keep the counter tops clear of clutter.  This can really help when they go to get a snack or make a sandwich.  If there is clutter everywhere, they will have a very difficult time deciding what to do next.  The same goes with the refrigerator.  Make sure that everything that they would want is in front of them and in plain sight.

Having a couple of outfits already put together in the closet can be very helpful.  Putting an outfit together and hanging it on the closet door for the next day can even sidestep the whole process of trying to figure out what to wear for the day. Put matching jewelry in a baggie and  attach it to the hanger with their outfit. This will likely make women think that they got everything ready the night before.  It is also helpful to men to take the belt out of their dirty trousers and put it in clean trousers along with their wallet and change.

When your loved one goes to bed, assuming they have taken their clothes off, grab the dirty clothes, get them out of sight and put the clean ones where they will easily find them. If they do sleep in their clothes, usually the only way to get them to change is when they shower.  Put their clean outfit in the bathroom or on the bed where they can see them and know they have already planned what to wear for the day.


On a daily basis, go throughout the house and straighten up anything that has been moved out of place or become untidy. This will, of course, mean extra effort on your part. But, in the long run, as you'll no doubt discover, it will be well worth it.

The more cluttered your loved one's surroundings are, the more cluttered their mind will be while trying to make any decision.  So, keep things tidy to help keep their daily lives as smooth and easy sailing as possible.

Sunday, April 15, 2012

Self - Just Say Yes!

Are you taking care of yourself? Are you getting enough sleep, able to do the things you need to do to keep yourself sane? If you are not able to get enough time to release the stress of the day, you are doing both you and your loved one a disservice. If you can't start fresh at some time during the day, you are hurting yourself.
                                                                                                               
You are going to need a solid support system in the future. So, start setting it up now.  Having people that you can call at a moment's notice is invaluable. You need to start bringing people into your circle that you can trust because your loved one may have a hard time with strangers. Your neighbors may seem as strangers to your loved one so get them familiar again as soon as you can. If your loved one will let them do an activity with them, encourage that as much as possible. The activity could be simple, such as playing cards, a musical instrument, listening to music or taking a walk around the yard or block while you are gone. It will be good for all of you. Ever think that maybe your loved one needs a break from you? It is possible. If you are completely stressed they know it. You can't hide it, so address the stress for both your sakes.


Your friends and neighbors want to help.  They can see what you are going through. If they ask you if they can bring dinner, visit or sit with your loved one for an hour, let them.  Have someone provide a meal once in a while. Admit it, that would be nice. It is imperative that you get a break! No one can do a good job of caregiving 24 hours a day 7 days a week with no break. Stop trying to attain the status of superhero. We already know that you are a superhero. If you weren't, you wouldn't be doing such a good job. This job takes stamina, courage, empathy and an extreme amount of patience.  Asking for help may be the most important and hardest part of this journey.

Sunday, April 8, 2012

Calm

As often as I mention what you should do to remedy a situation, another important thing you can provide is peace and quiet. Loud noises, fast reactions, chaos and busy lifestyle are difficult for anyone with dementia or Alzheimer's. 


The most enjoyable times for someone with Alzheimer's are the quiet intimate moments that are shared with loved ones. Sitting on the swing, couch or at the kitchen table enjoying music, coffee and a loving smile.  Maybe a walk around the neighborhood pointing out the beautiful flowers and landscapes, and enjoying the beautiful sunset together in the evening. 


Don't ask them too many questions during this time, just make statements and short descriptive sentences.  Not having to come up with an answer is a relief at the end of the day.

Saturday, April 7, 2012

Emergencies

If your loved one is at home alone, are they competent enough to realize that there is an emergency, and if so, do they know who and how to call for help?


Ask your loved one what they would do in case of fire, power outage, or sudden illness.  Do they know who to call? If they do, ask them to show you what number they would dial. Don't assume that they know how to dial 911. Many times that does not translate from their mind to the right numbers on the phone. Maybe they could dial 911 if that number were posted on the phone with the word "Emergency" taped to the phone, wall or bulletin board. In an emergency, would they be able to keep a clear enough head to know to look at the note to call for help?


If there is a fire, are they going to try to put the fire out; are they going to run out of the house; or, are they going to stand there until it is a dire situation? Do you need to take the knobs off the stove and unplug the microwave to diminish the chance of fire?  Most of us can't predict how we would react in these situations, let alone know how someone with dementia or Alzheimer's would respond.


You need to think ahead and plan. Try to prepare your house and loved one for any situation. And realize that there will come a time when it is no longer safe to leave your loved one alone. Having a backup plan could make any emergency or unexpected event less stressful.