Alzheimer’s and Dementia symptoms, once a private family and healthcare issue have become a main stream subject of eldercare and the effects on residents and family members a subject of movies, books and talk shows. Even with all of the information available to families and caregivers, many questions remain about how to relate to the sufferer and care for them on a day-to-day basis.
As someone who has devoted their life to elder care and supporting eldercare staff at Green Hill Inc. in West Orange, I thought penning a periodic article focusing on the challenges and the variety of techniques, employed to take care of Alzheimer’s and Dementia patients may provide added help for caregivers.
Alzheimer’s Disease is one type of dementia. It is the most common form we identify, found in 60%-80% of persons with dementia, and the term has been used as a generalization of memory failing diseases. A majority of people with Alzheimer’s are over 65, but earlier onset of symptoms does happen. Alzheimer’s is a progressive disease and requires a care plan that progresses as the disease does.
Understanding dementia and/or Alzheimer’s is important when caring for someone who has the disease. Alzheimer’s, or dementia, is currently divided into three stages. Stage One, the onset of the disease to mild symptoms of forgetfulness. Stage Two, moderate, is when symptoms become more pronounced and a person will require assistance. Stage Three is severe symptoms, with a complete loss of self. The progression of these stages can take up to a span of 10 to 15 years – is a very long process for caregivers to participate in.
Certified nursing aides and home care aides, while well intentioned and well trained in many areas, are not trained in caring for people in the multiple stages of Alzheimer’s Disease. At Green Hill, all caregivers are given additional training to effectuate appropriate and supportive care for dementia patients.
In the beginning stage, you may not even know for sure that your loved one has Alzheimer’s or dementia. You may just think that what you are experiencing is normal age related forgetfulness that we all experience at one time or another. Eventually, you will realize that there is no denying Alzheimer’s, or some form of dementia, is present as the elder begins to lose a sense of self in negotiating personal activities like grooming and dressing or they may exhibit inappropriate social behaviors. During this time, they may still present many other self-sufficient abilities.
A few of the ways we maintain a resident’s peace of mind and cooperation with daily activities during the first and second stage of the disease is by redirection and/or distraction. If an elder begins to dress incorrectly the important thing to remember is to not let them know there is anything wrong. Criticism will cause them to get agitated. They understand that what they chose is correct and they will deny they erred. Redirecting the issue, for example in the case of removing an item of clothing may be, “I love that blouse. You look beautiful in it. Can I see who makes it?” Then, they may agree to remove the blouse and you can put it away. You can distract the elder by changing the subject for example by asking them if they would like to go to the kitchen with you and have a cup of tea. Another way to avoid conflict is to limit their choices. In the case of clothing, reduce options and coordinate their outfits in the closet for them.
Learn to let the little things go. Not every misplaced item or forgotten instruction is important to address. If it’s important you can take the blame for not telling them something they have forgotten, instead of saying, “don’t you remember?” For example if the doctor tells them they need to do something, take a medication or other palliative action, and its clear that they have forgotten, they will not acknowledge or believe that they forgot. When your loved one wants to know why they need to do this new thing say, “I forgot the doctor said this so we need to start doing this now.”
When an elder is forgetful of where they are or has traveled back in time to an event when they were younger, respond to them by repeating what they say instead of trying to answer their questions directly. For example, if they realize they need or want to get home and they say “can you take me home?” the home where they live is not the home they may be remembering from childhood. Do not reply, “yes I will,” or “no I can’t,” because either answer will cause conflict. Respond by repeating, “you want to get home”, then you can redirect when they give you more information such as “yes I have to get home for dinner.” You might respond, “you have to get home for dinner, are you cooking?” You can also redirect or change the subject to something that might interest them, or engage them in a new activity.
Be creative in solving these daily dementia challenges by learning to let the little things go. Never say “don’t you remember?” Try redirecting if the elder gets unfocused in the present moment and reduce choices that may lead to uncomfortable moments. These techniques will ease their minds and make your life as the caregiver a lot easier.
If you have a topic or need ideas about how to provide positive care for an elder with Alzheimer’s Disease and Dementia, send me an email PR@green-hill.com and I can cover it in a future article.