Not surprising, the most popular was a post I wrote about how to help an aging parent who refuses help.  As family members and caregivers, I imagine we’ve all faced this situation, and may likely face it again in the future.

I encourage you to take a few minutes now to read these short blog posts, reflect and gain insight on some of the key issues that you may face now or in the coming year.

1.  How to Help an Aging Parent Who Refuses Help

One question I hear over and over goes something like this, “We see our parents struggling with their living situation, and we have tried every way possible to talk with them about it, but they refuse to accept help in their home.  What can we do?” In this post, I explore the situation from our parents’ perspective, and then provide some suggestions.  Click here.  

2.  Transitioning An Aging Parent to Assisted Living – When & How

Although our aging parents may wish to age-in-place in their homes, the day may come when we need to think about a move to Assisted Living.  In this post, I provide key criteria that would indicate consideration of a move to Assisted Living.  As always, I encourage us (adult children and families) to be thinking ahead and to become knowledgable about local options in our community now.  Don’t wait for a crisis to occur when you have to abruptly choose an Assisted Living facility for your parent.     Click here.

3.  Safety and Innovation – Bathroom Design for the Elderly

If you’re a caregiver to an older adult, you know that bathing is a difficult challenge.  In this post, you’ll read about innovative bathroom equipment for older adults.  You don’t have to have a huge budget or grand remodeling scheme to consider some of these items.  Open your mind to some of the new possibilities (in showers, tubs, toilets) supporting safety, independence and quality of life for your aging parents.  Click here.

4.  Validation Technique – Communicating with Those with Dementia

The Validation technique, created by by Naomi Feil 30 years ago, is a tested method of communication with disoriented elderly that helps reduce stress, and enhance dignity and happiness.   In this post, I share the principles behind the Validation Technique and key benefits.  Both families and professionals can utitlize this powerful technique and ensure that older adults in their care never reach a vegetative state.  Click here.

5.  How to Deal with a Difficult Sibling in Decision-making for an Aging Parent

Why is it so hard for a family to listen to Mom or Dad, consider the options and then, in a unified way, make the right decision in Mom or Dad’s best interest?  In this post, I share key reasons I believe to be true and then a few possible strategies.   Click here.

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NOTE:

If you’re new here, you may want to request my Free eCourse, “Five Essential Strategies to Help Your Aging Parent Face Change”.  Click here.

If you’d like to continue this conversation, please join us on Facebook at our ‘Transition Aging Parents’ page. Click here.

CLEARWATER, Fla., Sept. 7, 2011 — /PRNewswire/ — 1 in every 5 adults in America is in a caregiving role taking care of a family member or friend. That represents 60 million Americans, many of whom are in crisis stages of stress, burn-out and depression. But in areas with more dense senior populations, as many as 1 in 3 are giving care to another person. It is estimated that 1 million caregivers who live in greater Tampa Bay are in need of support critical to their physical and mental well-being.

For this reason, numerous municipalities in the region have declared September 23, 2011 as Caregiver Day. They have issued proclamations to rally area caregivers to attend the first annual New Age of Caregiving Symposium on September 23, 2011 at Ruth Eckerd Hall in Clearwater, Florida and to make everyone in the area aware of the impact the plight of caregivers has on the overall community, businesses and government.

The event is being has been created by The Caregiver Hour Radio Show which airs on Tampa radio station WHNZ 1250 AM every Monday from 11 AM to 12 Noon. The symposium’s keynote speaker is Gail Sheehy, acclaimed author of 16 best-selling books including her latest offering, Passages in Caregiving: Turning Chaos Into Confidence.

Kim Linder, host of The Caregiver Hour Radio Show, is also the symposium’s organizer. Linder is a certified senior advisor who believes in the importance of helping caregivers through holistic methods. The symposium will provide integrative resources vital to caregivers’ physical, mental, emotional and spiritual needs. It will also contribute a portion of the proceeds to the Area Agency on Aging, Pasco-Pinellas, Inc. Tickets are available at www.newageofcaregiving.com.

For more information, contact Kim Linder, The Caregiver Hour Radio Show, at 727-798-2663 or email kim@thecaregiverhour.com.

SOURCE New Age of Caregiving Symposium

• Try appealing to their need to feel safe. Try responses like, “I’m here with you, and I love you very much.  I’ll make sure you’re safe here, and we’ll go home together later.”
• Try responding to their emotional tone. Try responses like, “You don’t feel comfortable here? Or “Tell me about your home.”
• Try validating their lack of recognition. “I know this isn’t your home, but no one is at your home right now and you might get lonely. Your things are all here, and I really like having you here with me.  Please stay and keep me company for a while.”
• Try an affirmative response for your first word. Rather than, “No, we can’t go home right now,” try “Sure we can go home!  But it’s dark right now and we’ll have to wait until morning.”  Many caregivers have found that simply beginning sentences with positive responses like “Yes.” and  “Sure”  rather than “No” and “We can’t.” has really changed the tone of difficult situations.
• Try practical responses like, “Sure we can go home.   But we have to go there later because they’re repainting some rooms and it smells really bad right now. So you and I are here together, and we’re going to have a great time!”
• Try a humorous response like, “Are you tired of me already?  I love you so much and I never get tired of being with you!”
• If they’re asking for deceased family members, like mom or dad, as well as going home, try responses like, “Your mother isn’t home right now, but she just called and made me promise to stay here with you and make sure you’re safe until she gets back.”
• If they insist on leaving, try walking with them, or taking a drive with them. Then enter the house a few minutes later, and say, “we’re home now.”
• Try any response that “fixes” what is giving them anxiety (i.e., the reason they’re seeking home).  For example, if they’re asking to go home because they’re missing their children, tell them their kids are staying overnight at a friend’s house. Then, distract them by suggesting they prepare a snack in the kitchen for the kids when they come back home.

You’ll be able to read more helpful information about Sundowning in this Sunday’s ezine.   “Part 2: Other Helpful Approaches to Help Manage Sundowning Behaviors” will be published on 08/14/11.

To sign up for my ezine, click here.

References:

The 36 Hour Day, Nancy L. Mace and Peter V. Rabins

Therapeutic Caregiving: A Practical Guide for Caregivers of Persons with Alzheimer’s and Other Dementia Causing Diseases, Barbara J. Bridges

Alzheimer’s Disease, Pieces of the Puzzle, developed by the Arizona Long Term Care Gerontology Center at the Arizona Health Sciences Center, The University of Arizona

“Sadness, Agitation, Fear: Could This Be Sundowner’s Syndrome?”, by Aprill Jones,

“Study Helps Explain ‘Sundowning,’ An Anxiety Syndrome in Elderly Dementia Patients,” by Jeff Grabmeier, Ohio State University, 6/27/2011

What does “doing things” mean to you?  Reading a book, knitting a scarf, playing a round of golf?  What about for persons with dementia, who experience memory loss, loss of planning and organization skills, and decreased initiation to do things?  For them, “not doing” activities may result in pacing, sleeping, boredom, or restlessness.

Studies show that nursing home residents with dementia spend 70-80% of their time with nothing to do.  Factors might include limited staff to the number of residents, residents with decreased motivation to do things, due to their condition, and limited tools/items to use for dementia activities.

Most persons with dementia, due to Alzheimer’s or other conditions, actually live in their own homes. At any one time about 70% of the over five million people with dementia are living at home, according to the Alzheimer’s Association.   In 2009, home caregivers provided 12.5 billion hours of unpaid care, a contribution to the nation valued at almost $144 billion.

According to a survey administered by the National Alliance for Caregiving, caregivers are looking for ideas for easy activities they can do with their loved one in spite of the cognitive impairment.  Keeping persons with dementia active not only offers caregiver support, but also important cognitive stimulation and engagement for the user.  He or she will, however, need the caregiver to help set-up and, possibly, facilitate throughout the activity.  Often, caregivers are unsure how to go about helping with this process.

So here are 3 key tips on how caregivers can help keep persons with dementia active.  Remember the “3 R’s” of education – Reading, ‘Riting, and ‘Rithmetic?  Let’s replace those with these 3 R’s – Routine, Reduce, and Reassurance.

Routine

Persons with dementia do best with routine.  To help bring some order to a confusing world of forgetfulness and disorientation, the person needs the same activities done in a typical order and timeline each day. What works best for you may not be what works best for him and her.  Usually, going with their flow will make the day easier for both of you.

Think of incorporating different types of activities into the typical day.  For instance, self-cares, such as dressing or bathing.  Even if the person needs help, let them do a few steps that they can, like wash their face after you get them started with the motion. Also something social, such as eating breakfast together, something physical, such as taking a walk, and something sensory, such as smelling the garden flowers or listening to music.  Also, try to incorporate activities based on the person’s past interests.

Reduce

Persons with dementia have short-circuits in the way their brain works.  They need things to be reduced, so that they can work their way around the short-circuits: reduction in the number of steps of the task; reduction in the directions given for the task; and reduction in the level of abstractness of the task. The level of reductions that need to be made will vary, depending the extent of the deficits or short-circuits the person has.

Examples of how to reduce, include using multiple choice instead of open-ended questions, playing a game with only matching involved, and using short, simple sentences to direct the next step.

Reassurance

The person with dementia may at time be reluctant to participate when you ask them.  This may be due to fear of failure, as mentioned above.  A more reassuring way to ask him to do something is to ask for their help.  This often is more successful.

Again, offer reassurance throughout the activity and after – “You are doing great! Thanks for your help!” This  gives the person pride in that moment, a feeling that can last long after the activity.

According to research, the benefits for the person staying active include minimizing the rate of their cognitive decline, improved sense of self worth, and improved sleep.  The benefits for caregiving have been shown to be increased satisfaction with caregivers and a reduced amount of challenging behaviors to contend with.  Keeping the person with memory loss active is a win-win for both partners of the team.

To learn more about products to keep persons with dementia active, see www.mind-start.com.

References

Caregiving in the U.S. Published April 2004 by National Alliance for Caregiving and AARP

Shon Ingram

(Many thanks to our guest blogger, Shon Ingram.  Shon is owner and lead consultant with Eldercare Life Solutions. Shon holds an bachelors in Health Services Administration from Auburn University and a MPA in Healthcare from Columbus State University. He founded Eldercare Life Solutions after working as a nursing home administrator for several years.  To reach Shon’s website, click here.)

The Brown family reunion has always been an event everyone looks forward to. Family visits, games, stories and everyone’s favorite foods are always on the agenda. On the top of the menu is Grandmas Lemon Coconut Cake. Grandma always makes the traditional cake from her old family recipe. This year, however, the cake tasted a little on the salty side, perhaps a half cup full of salty.

Having memory loss or cognitive impairment does not mean that you have Alzheimer’s Disease (AD). Through a standard medical evaluation and diagnostic protocol, physicians often find that depression, a metabolic disorder, or other medications are impairing a patient’s memory. By following these guidelines and ruling out other causes of memory loss, physicians can diagnose AD with better than 90% accuracy at an early stage of the progression.

Diagnosing Alzheimer’s Disease early and accurately is crucial because for every month that treatment is delayed, there is irreversible loss of function. Current treatment of mildly-to-moderately demented AD persons with FDA-approved medication will delay AD progression by three or more years; the earlier treatment is started the more effectively the progression of AD is blocked, and the longer it is delayed. Below are suggested steps to get the right diagnosis:

1.  Find the Right Physician

For evaluating and treating ADRD, there is no substitute for experience and proper training. Neurologists, psychiatrists, or geriatricians are the specialists most likely to have been trained to evaluate ADRD using the NINDS-ADRDS criteria, and effectively treat the cause. Some internists or primary care physicians have also been properly trained. If you don’t know where to start, ask your primary care doctor or look up the local chapter of the Alzheimer’s Association by searching on www.alz.org.

2.  Get Tested Professionally

Objective tests of mental abilities are used to confirm cognitive impairment as well as to help diagnose its cause. Of the cognitive functions impaired in Alzheimer’s Disease, short-term memory loss is one of the first. Therefore tests of short term memory loss can identify Alzheimer’s Disease at its earliest stages. Your physician or a neuropsychologist may be able to conduct such professional testing.

3.  Collect Patient and Family History

• All medications, including over the counter medications, along with when they were started
• Past medical conditions
• List of all current medical conditions
• Life style history including head injuries, alcohol, smoking, exercise, diet, hobbies or pastimes
• Psychosocial history such as marital state, living conditions
• Family history of memory/cognitive impairment, senility/dementia, AD, ADRD and risk factors for ADRD

The medical and family history is key to a proper diagnosis of ADRD. A proper history includes:

4.  Identify Treatable Medical Conditions

Treatable medical conditions that can cause cognitive impairment or dementia include diseases of virtually every organ and tissue of the body, especially the heart, lung, thyroid, kidney, liver, blood vessels and immune system. Psychiatric or neurologic conditions, such as depression, manic-depression, anxiety and stress can also affect memory and other cognitive abilities. These conditions are identified through history and physical examination, plus diagnostic tests of blood, urine, X-rays, and brain imaging.

5.  Brain Imaging Studies

Brain imaging has two primary functions. First, it helps establish how much damage to the brain has occurred. Second, it helps diagnose the underlying cause of the damage. The choice of which brain image to do (CT, MRI, SPECT, PET or fMRI) depends upon the duration and severity of the condition. When MRI or CT scans show no brain tissue loss, imaging of the brain’s activity should be done with SPECT, PET or fMRI to detect abnormalities and help make an early diagnosis.

6.  Final Diagnosis

Based on the history, examination, laboratory and brain imaging results, a properly trained physician can diagnose the cause of your condition with 90% accuracy or higher using NINDS-ADRDS criteria. Typically it takes a few weeks to complete a diagnostic evaluation of ADRD.

If you missed my last week’s radio show, you missed Gary Owens and his wonderful sharing as a caregiving spouse.  Gary is many things: a problem solver, entrepeneur, cabinet builder, inventor of TenderCare beds.  But,  as he says, his most important role in life is being caregiver to his wife Gina.

14 years ago when Gina became disabled, their world changed forever…shrinking to one room with an institutional hospital bed.  That bed became a constant reminder of her illness.  She didn’t want family to visit because she didn’t want them to see her like that.  Gary knew he had to somehow change that ugly hospital bed into a beautiful piece of furniture.    He settled on a simple but innovative design of slipping hardwood headboard and footboard right over both ends of the hospital bed.

As Gary shared, it is truly all about dignity in living.  He said that transforming Gina’s bed was the “best medicine” ever.  Her room looked like “home” again.  Her spirits were lifted, and she once again found herself looking forward to visits, and finding her “new” normal.  Gary learned another important lesson along the way.  Filling a family member’s room with the many products on the market was both overwhelming and unnecessary.  He adopted the goal of keeping Gina’s room simple, and functional but stylish.  And that is what drives Gary’s innovations forward.  He has seen first-hand how his products have changed the quality of life for entire families!

Gary’s company, Tender Care Beds, produces the slip-on headboards/footboards in hardwood in 5 standard colors, in various styles and even accepts orders for custom items (such as a cover for a ventilator.)  Other standard products include a foot chest, wall shelf and soon-to-be announced new innovative products!

Gary noted that there is indeed a cultural change underway to make the environment for elderly and disabled as homelike as possible.  ”In June 2009 the CMS (Center for  Services) updated its guidelines for long-term care facilities in several ways.  Out of the many changes made, the new ‘homelike environment guideline’ was one of the most revolutionary.”  So, whether your loved one is living at home or is in a skilled nursing facility, they can absolutely benefit from Gary’s wonderful line of products.

Gary’s goal is simple but so very powerful for loved one and their families, “To improve the quality of life for those whose world has shrunk to a single room.”

I encourage your to check out Gary’s website and product offerings.   And, check out the TenderCare bed community of users on Facebook.  You’ll find some amazing stories of lives transformed by the TenderCare bed.

http://tendercarebeds.com/ http://tendercareathome.com/

For the Facebook Fan page (TenderCare beds), click here.

(If you’re new here, you may want to subscribe to my blog posts or request my Free E-Course. Thanks for visiting!)

While discovering that our aging parent has Alzheimer’s may seem like a devastating loss, one woman shows us the way to view it as a life-changing opportunity.

That woman is Lori La Bey.  She is no stranger to Alzheimer’s.  Her mother suffered early onset Alzheimer’s, and after 30 years, is in the end stage of the disease.  However, all you have to do is spend a few minutes talking with Lori, and you will know that Lori considers herself blessed to have gained a deeper understanding and richer relationship with her dear mother…because of this disease.

I interviewed Lori on my BlogTalkRadio show today.  If you can spare the 30 minutes, please listen to our interview.  Click here.

Here are the highlights:

• As Lori sought out resources to help her understand the disease of Alzheimer’s, she found resources that offered statistics and talked about the disease from a medical perspective.  What Lori found lacking was a holistic approach that would help families understand how to relate to and communicate with their loved ones as the disease progressed.  Lori wanted to look beyond the illness.

• Lori began to understand that it is the ‘simple pleasures … the special moments’ that would mean so much to her mom and her.  In fact, Lori likes to say “grasp the moment, and embrace the moment.”

• Lori advises us “not” to lose our original relationship of daughter and parent.  She is a perfect model for what she shares with others.  Her efforts are always directed to help her mother feel great joy, whether through music, singing, a gentle massage, or saying “I love you” every time she walks in the room and leaves.

• On Lori’s website, she offers a special (no cost) tool, called “The Memory Card”.  She advises completing this small card and then reading it every time before you walk in your parent’s room.  It is simple but powerful, and it will frame your perspective so that you remember what is truly important in your relationship, and let any other annoyances go.

• There is another tool, called “The Memory Journal” for visitors and the family. Lori shared that often visitors do not know what to say or do, and may actually stay away because of this.  “The Memory Journal” offers a special way for visitors to write down what is most important to them about the person, what they want to remember about the person, and optionally include a photo.  This is a wonderful gift for the familly to reflect upon and share with their loved one.

Lori’s loving and fun-loving spirit came shining through in the interview.  She said if we ask an ill person what they most want, their answer will often be that they just want to be “normal” again.  She encourages us to laugh with our loved one and to always let the love flow.

I encourage you to check out what Lori offers on her sites.  Know that she is also a much sought after speaker, consultant and trainer around the country.

• To read Lori’s poignant and often funny stories of her journey with her mother through Alzheimer’s, please visit her ‘Alzheimer’s Speaks’ blog
• To reach her incredible resources, the Memory Chip and the Memory Journal, please visit her ‘Alzheimer’s Speaks’ website

Thank you, Lori, for giving families help and hope!!!!

Join me and Lori La Bey, Speaker, Trainer, Consultant, Author, and now an ‘Advocate on Steroids’ for Alzheimer’s disease.

Lori will share her own personal story, the insights she gained and two wonderful tools that help adult children examine their inner journey and strengthen/enrich the relationship with their parent with Alzheimer’s.

Lori is also writing a book on Alzheimer’s disease, “Alzheimer’s Speaks -Guiding Caregivers to be Their Very Best! Giving Voice and Enriching Lives – As the Cookie Crumbles.” Lori’s Resource website & Blog: http://www.AlzheimersSpeaks.com Lori’s Business site: http://www.SeniorLifestyleTrends.com

Don’t miss out on a chance to listen live and call in with your questions.

Listen online at:  http://www.blogtalkradio.com/dalec/2010/06/08/memory-chip-memory-journal–tools-for-the-alzheimers-caregiver

Call in at:  (347) 857-1461

Thanks to Alzheimer’s Reading Room for sharing the following poem by Max Wallack whose great-grandmother suffered with Alzheimer’s.  Max went on to found the non-profit, Puzzles to Remember, providing puzzles to care facilities with dementia and Alzheimer’s patients.  (Links are at the end of this post)

Turning true-blue loyal friends into treacherous strangers…..

It gallops in silently on powerful hoofs
Snatching sweet, precious, forgotten memories
Turning true-blue loyal friends into treacherous strangers
Clogging synapses with emptiness
Crumbling trust into excruciating paranoia

With bleak darkness comes the anxious wakefulness of broad daylight
And bitter terror encompasses every living fiber
“If I sleep, where will I be when I wake up?”
The compulsion to run, the paralysis of fear

Mature, child-like dependence
Retracing youthful development, but in rapid reverse
Cureless medicines, meaningless conversations
Leading up to the inevitable

Max Wallack is a student at Boston University Academy. His great grandmother, Gertrude Finkelstein, suffered from Alzheimer’s disease. Max is the founder of PUZZLES TO REMEMBER , a 501(c.)3 charitable organization. PUZZLES TO REMEMBER is a project that provides puzzles to nursing homes and other institutions that care for Alzheimer’s and dementia patients.

Thanks to Alzheimer’s Reading Room for allowing us to share the poem.