By Pamela Atwood, MA, CDP, CLL, Director of Dementia Care Services, Hebrew Health Care
1. Keep your car doors locked. A confused person climbing into your car on a hot/humid day presents more risk than wandering in a snowstorm.
2. Avoid too much sun. People with dementia may not be able to express pain or discomfort. Limit how much time they spend outside in the heat or sitting in direct sun. Also remember sunscreen, a hat, sunglasses, and light clothing.
3. Ensure adequate hydration. Older adults often limit fluids to avoid multiple trips to the bathroom at night. Push fluids especially in the summer. Provide non-alcoholic beer and other drinks.
4. Keep an eye on pets. Anticipate that people with progressive dementia will have a harder time keeping pets healthy. Remember our furry friends need cool air and water too.
5. Watch out for slippery floors. As kids come in from the pool, wet suits may create a slip-hazard; falls are catastrophic for people with dementia who may not relearn to walk after a fracture.
6. Time for driving retirement? Many people are reluctant to drive in winter weather. With the summer, they may be returning (unsafely) to the road. Knowing how to operate a vehicle does NOT equate safe driving. Call us at 860-920-1810 for information on how to have these difficult conversations.
7. Think of gun safety. As the long winter leaves us, more people are going outside and enjoying their favorite hobbies. Guns and Alzheimer’s are a dangerous combination – 40% of Veterans with mild dementia have loaded guns in their homes according to the VA. Disable guns, remove them or at least secure the ammo.
8. Medication mix-ups. If you utilize professional help, summer vacations often mean replacement staff. Avoid problems with medications, and other care needs, by keeping clear, easily read, and up-to-date lists of medications, allergies, and routines.
9. Getting lost. We all enjoy a nice walk on a cool summer night. Ensure safety by investigating alert programs or GPS devices – call us at 860-920-1810 for our recommendations. If going on outings or to a game, have a buddy so no one walks around alone.
10. Avoid overstimulation. This time of year is when we all love family picnics, parties, BBQs or just going to a park. Too much noise, too many people, too much to think about can increase restlessness and anxiety in people with dementia. Visit www.agingcareacademy.org for caregiver tips and suggestions.
I’m going through my old files today – some simple spring cleaning is good for the soul. I think it reduces stress for me. Stress is a natural (and necessary) part of life, and we all have positive and negative ways of coping with stress. When I’m really stressed though it seems that I can think of many more negative stress relief strategies than positive. In my spring cleaning I’ve found a list of 24 positive stress-busting strategies. Happy day!
There are four basic categories and I thought I’d share them with our readers, especially for those stressed with age-related changes or care-partner stress.
Physical and Lifestyle Strategies – these are positive habits that are physical in nature and they have some of the most profound impacts on stress. From exercise to diet, changing your physical habits significantly busts stress.
Emotional Strategies – ensuring laughter in your day, and nurturing your soul through music you love are just two simple things to uplift the emotions and reduce stress.
Cognitive Strategies – gaining
control of our thinking is a habit to be developed, and these strategies help develop armour against stress. Challenging our comfort levels with “shades of gray” and practicing awareness of “stinking thinking” with distraction strategies helps us prepare for fluctuating stress levels.
Philosophical/Spiritual Strategies – the power of prayer may be obvious, but also just having a more philosophical view of the world in which we live can reduce stress. These strategies probably take the most reflection and practice to make habit, but may also have the most profound impact on keeping stress at bay.
Develop a list of your own positive stress-relief strategies and try to strike a balance with the kinds of relief you utilize. This is important to ensure positive aging – for instance, if your greatest or only stress relief happens through running, how will you cope with stress if you lose the ability to run/walk? A variety of strategies is best.
I am pleased to share more thoughts about health risks for caregivers. In a previous post, I misquoted research done and it was picked up by reader Claude Thau of Kansas (if I’m remembering your home state correctly). The JAMA article I quoted actually indicated that caregivers had 63% higher mortality indicators than noncaregivers. I misquoted the article and I am happy to provide the clarification.
Certainly the point of the original post was that health risks for caregivers can and should be minimized — and that’s why I’m really happy to have Mr. Thau’s attention drive home the point once again.
I bring this message of “CAREGIVERS, SEEK WELLNESS” as a once-again (albeit temporary) caregiver myself. My 58-year old cousin from Dallas was diagnosed with younger-onset Alzheimer’s a few months ago. She has come to CT to have me teach her how to live with it. And so I am. But my heart stops when I “lose” her in the grocery store, even if for a moment. And my brain is distracted when I’m at work, wondering when she will reappear from volunteering with our residents. And I don’t sleep well, considering the financial strain every time she has an urge to buy something or gets up to use the restroom, or even rolls over in bed. And my heart aches with my 9-year old’s frustration when “Auntie P” wakes her up to check on her in the wee-hours of the morning. My dog loves her though as Pat feeds the dog breakfast again…(we had to hide the treats).
So I know first hand how hard it is – but we MUST take time to get to our own MD visits, do some tai chi before they wake up in the am, rest and rejoice with friends through support groups – or journal to get it out of your system. Be well caregivers, in any way you can when you can. We are here to support you and will help you think of ways to minimize your risk factors. Check www.agingcareacademy.org for more ideas.
And now I’m off to schedule my overdue mammogram – thank you Ms. Sarah, secretary on our Dementia Special Care Unit for reminding me that I’m important too!
Pamela Atwood, MA, CDP, Director of Dementia Care Services, Hebrew Health Care
That is the first thing I tell the caregivers of people with memory loss. And it is human nature, our gut instinct. We think, “Maybe they are better today” or sometimes, “Is it a good day or a not so good day?” and we test the memory by quizzing people.
“What did you do at Day Center today?” “What did your aide make you for lunch today?”
Unfortunately, these quizzes have two negative effects: we feel sad when the person with memory loss cannot answer correctly, and the person feels stupid or crazy. Instead of quizzing, make statements about the present moment like, “I’m sure you must have had a full day at the center. Are you tired now or would you like to help make supper?” “It’s been a long time since your lunch. Would you like something to drink?”
Here are some other basic rules for communicating with someone with memory loss:
There is no point in arguing. If the person says something incorrect or something you know to be untrue, let it go. It only makes things worse if you argue.
Point out remaining strengths.
Avoid criticizing or correcting. If people with memory loss become unsure of themselves, they can have more problems with communication. Compliments go a long way (regardless of memory loss!).
Focus on the emotions, not the words.
If someone excitedly says, “There’s my sister!” when she should have said “daughter,” let go of the mistake and support the happy moment: “Isn’t it fantastic to see her!”
Watching someone with memory problems struggle with communication is painful for caregivers and family members. It requires patience and support. For more information on communication tips or to join our support group call us at (860) 920-1810.
Pamela Atwood, MA, CDP, Director of Dementia Care Services, Hebrew Health Care
One of the most challenging aspects of caregiving is assisting with personal care. However, independence increases success and minimizes how stressful these tasks can be. Caregivers that keep the individual’s remaining abilities in mind are most successful.
Some basic tips to encourage independence with toileting, bathing, dressing, grooming and eating include:
Help the person feel in control
You may need to experiment to learn what the individual can do for him or herself. Give the person time to complete the activities that can be done with coaching and cueing only.
Use task breakdown
Give instructions a step at a time breaking tasks into individual actions. “Brush your teeth” sounds simple, but requires a great deal of cognitive and physical activity. Coach the individual through each step. If you separate each action, you may find the person can still accomplish the task with cueing only.
Lay out clothing, prepare bathrooms, and offer one food item at a time. Activities of daily living can quickly become overwhelming to someone with cognitive impairment.
Monitor for safety and health
Install grab bars (do not use towel racks), use non-slip mats, and ensure the water is a comfortable temperature. Monitor for choking while eating. Observe for skin irritations if the person is incontinent.
If you need more ideas, there are many professionals at Hebrew Health Care who can assist you. Ask the day center staff or home care nurses for other ideas on how to maintain independence. There are also great resources available through various caregiver groups. If you would like resources, access Aging Care Academy website at www.agingcareacademy.org or contact us at (860) 920-1810.
Pamela Atwood, MA, CDP, Director of Dementia Care Services
Holidays represent opportunities for togetherness, love, laughter and sharing with family and friends. In reality, they can be stressful times for everyone. They can be completely overwhelming to caregivers, and often represent loss, sadness and disappointment. Keeping these survival tips in mind will help caregivers make the most of this holiday season.
Know your limits, and the limits of your loved one. Adjusting expectations will help caregivers, family and friends. Activities often need to be simplified and minimized to reduce stress levels. If you usually serve 20 people, serve only 5 this year. Or instead of making all the food, have guests bring the holiday dishes that mean the most to them. Caregivers can expect the normal tensions of the season, plus the stress of caregiving responsibilities. Let others know what they can do for you – and then let them do it!
Involve your loved one but recognize signs of stress in them
The care recipient may want to participate in festivities, but not feel comfortable in large crowds. Observe for symptoms of increasing anxiety or cues that s/he is becoming over stimulated. Explain to your host in advance that you may need to leave early and unexpectedly. Avoid a scene by explaining in advance. For people with dementia, most gatherings must be with smaller groups and for shorter periods of time than in the past.
Try to stick to routines
Especially if your care recipient has dementia, sticking to the usual routine is very important. Taking on too many holiday tasks will stress out caregivers and thus care recipients.
Adapt gift giving
Ask for gifts that are useful, such as adaptive, washable clothing, tapes of favorite music or old movies, respite time, subscriptions to newspapers or magazines, or labeled family photo albums. Beware of toxic plants, such as poinsettias, holly and mistletoe.
Take care of yourself
Be sure to get enough rest, eat properly and exercise. Caregiving depletes your physical and emotional energy; caring for yourself can get it back. Limit alcohol consumption (a depressant drug). Be realistic about our own emotional needs but keep a sense of humor – the best coping strategy to survive the holiday season.