Tips for Personal Care

Guidelines for Helping with Daily Self-care Tasks

• *Simplify and clarify the task.  Clothing garments with simple fasteners or a permed hairstyle any go far in enabling the person to complete a task independently.  Clarify the task with environmental cues such as a comb and brush set out by the makeup mirror.
• *Reduce distractions such as background noise to confusing cues (such as clutter or similarly colored toilet and dressing stool covers.)
• *Keep a regular routine.  A regular routine makes life more predictable and easier to cope with.  This reduces confusion and improves the individual’s cooperation and ability to perform self-care.
• *Be flexible and patient.  It is important to remain flexible and patient because the first attempt at getting a task done often will not work.  Also, remember to not take refusals personally, the person with Alzheimer’s disease cannot help his/her behavior.
• *Use good communication techniques.

Techniques for Helping

• *Break the task into steps that are small enough to match the person’s abilities.  For example, a person may need to have tasks broken into smaller steps such as:  put toothpaste on the toothbrush, brush your teeth, rinse your mouth, and dry off your mouth.
• *Demonstrate the step.  For example, when you say “wipe your mouth” you can wipe your own mouth.
• *Help begin the action.  Even when you demonstrate a step, the person may still not be sure what to do.  You can help by beginning the action until he/she remembers what to do.
• *Give the person time to finish the step.  Rushing a person with Alzheimer’s dieses usually will increase confusion, embarrassment, and resistance.

 For more information contact 317-218-5111 or www.behomelivelife.com

Elder Abuse

Providing care for someone with Alzheimer’s or another related dementia can be one of the most stressful events in a person’s life.  Often, caregivers are the children of elderly parents requiring 24 hour care.  These adult children are not medical professionals nor do they have prior experience providing medical care.  The typical caregiver often has a job during the day and is “sandwiched” between raising a family and caring for their parents.

            According to the National Center on Elder Abuse, “between 1 and 2 million people have been injured, exploited or mistreated by someone on whom they depended for care or protection.”  It is also estimated that only 1 in 14 cases of abuse are reported for investigation.  Nearly everyone would assume that caregivers described in the previous statistics are paid caregivers.  This is not always the case.  It is estimated that nearly 50% of all abuse reported is perpetrated by an unpaid caregiver, typically a family member.

            There are a variety of reasons caregivers become abusive to the aging senior for whom they are caring, especially if the individual has a diagnosis of dementia.  Often people with dementia experience personality changes.  A common statement professionals hear when interviewing a family caregiver is, “My dad was never like this before.”  The person with dementia may refuse to bathe, eat, sleep, or even participate in activities he once enjoyed. Another common complaint is, “My mom asks me the same questions over and over.”  Those repetitive statements and questions can be overwhelming to caregivers already burdened with tremendous responsibilities. 

Many times caregivers will say, “I don’t know who I am anymore.  All I do, day in and day out, is take care of someone else.”  Caregivers forget to take time out to care for themselves.  Often they don’t know where to turn for help, or refuse to ask for help from anyone.

How does a caregiver avoid becoming abusive?  First, the caregiver must have a good support system.  Attending routine supports groups can provide opportunities to vent, ask questions, and receive advice.  It’s important to realize that no one has to go through this alone.

Next, the caregiver cannot be afraid to ask for help.  Relying on other family members, friends, members of their church, and community outreach programs may provide support to give the caregiver respite.  Taking a break to care for one’s self is vital to being fresh and alert in order to provide for needs of their aging senior.

Caregivers should take every opportunity to learn as much as possible about the needs of their aging senior.  For example, if a daughter is taking care of her father with Alzheimer’s, she should attend sessions and seminars which provide education, information and insight for the “just right” care he needs.

Caregivers also need to take credit for the care they are providing.  Being “sandwiched” is not an easy task, but can be accomplished, and good quality of life can be maintained.

For more information contact Sollievo at 317-218-5111 or www.behomelivelife.com. 

Vascular Dementia

“While I’m visiting my dad, I really struggle to hold a conversation with him. Do you have any advice?”

“While I’m visiting my dad, I really struggle to hold a conversation with him.  Do you have any advice?”

As Alzheimer’s progresses conversations can become more difficult.  As a person with Alzheimer’s begins to notice gaps in his memory, or has trouble understanding questions, he will withdraw from social situations that may become uncomfortable.   As the disease progresses, care givers must learn to rely on non-verbal body language in order to anticipate the needs and wants of their loved ones with dementia.

Try these tips to encourage conversations:

• Pick a topic of interest that you know your dad enjoyed during his 20’s-50’s – for example, fishing.

• Choose materials such as old photos of fish, free fishing guides available at most bait shops and a tackle box. These items can be used for cueing.

• Talk about the items:
  • “Dad, look at this picture of you and me at Pike Lake.  Do you remember what kind of fish you caught that day?” 
  • If your dad isn’t able to recall the answer right away, try saying:  “It looks like a Northern Pike to me.  It has sharp teeth, and I remember how it took both of us to pull the fish up to shore.”
  • Ask:  “What fish was the most fun to catch?  Did you like Largemouth Bass or Bluegill for eating?  What is the best bait to use to catch Catfish?”

• If answering questions is difficult when you first begin the conversation, try going through all of the photos and narrating what happened in each one.

• Once you’ve gone through the photos, try asking the questions again.  If you know the answers to the questions, use a picture to cue your dad to the correct answer.  For example:  “Dad which fish do you think has the best flavor?” (Show a picture of a Bluegill or which ever fish you know he prefers.)

• You may use the tool box in an additional way to guide the conversation.  By touching each of the items in the box, your dad will be using his sense of smell, touch, and vision to cue his memory. 

Remember, the key to unlocking conversation is using tools to cue his memory.  The more you remember about your dad and his past roles and hobbies, the more cueing you can offer him.

Call to Action

CALL TO ACTION

I received this information today in the Alzheimer’s Association’s ENewsletter.  Please join all caregivers to make a difference in the lives of those who are battling this difficult disease.

Advocate Impact: Forum 2009 

Last month, over 600 advocates from around the country marched on Capitol Hill to demand that our lawmakers make Alzheimer’s a national priority.

During meetings with advocates, members of Congress made the following commitments:

       188 indicated support to end the two-year waiting period for Medicare;

       181 indicated support for a $250 million increase in Alzheimer research funding; and

       83 indicated support the creation of an Alzheimer’s Solutions Project Office.

       65 members indicated support for all 3 issues!

You can catch a glimpse of the action at: http://www.alz.org/forum

We have great momentum and now is the time to “seal the deal”. Read on…

What Can I Do Now?

Ask your members to co-sponsor the End the Medicare Two-year Wait Bill!
People under age 65 with dementia who lose their jobs are likely to lose job-related health insurance. Many become uninsured and uninsurable. Just when they need coverage the most, federal law requires them to wait two years to become eligible for Medicare. Because of this wait, families face soaring out-of-pocket costs for health care or completely forego care. 

Email your members of Congress now. Ask them to co-sponsor the Ending the Medicare Disability Waiting Period Act of 2009 (S.700 / H.R.1708).

Go to: http://alz.kintera.org/endthewait 

For more information on how you can make a difference in the lives of those with Alzheimer’s contact us at 317-218-5113 or www.behomelivelife.com.

What Makes a Day Meaningful?

A meaningful day is a day filled with activities that create a sense of belonging and well-being, are easy to do, and fulfill a purpose. No one likes to be given useless tasks. Remember that your family member held important roles in his/her day, both personal or professional. Try to incorporate some of his/her past roles in everyday situations. Here are some strategies to create a meaningful day for you and your family member.

1. Enjoy reminiscing with your family member. Short-term memory may be damaged, but long-term memory often remains. When reminiscing it is helpful to talk about subjects (such as winter snowstorms or making holiday dinners) rather than a specific memory or event or name from the past.
2. Recognize the special abilities that remain and enjoy them together.
3. Most people, with or without Alzheimer’s disease, generally enjoy a good meal, animals, babies, or favorite music.
4. People with Alzheimer’s disease still enjoy (and need) hugs and other forms of affection. Sit close and look at pictures together. Enjoy a hand massage.
5. Look for activities that will be interesting to the person. In seeking activities the individual would enjoy, it helps to think about past work experiences and past and present interests.
6. Do activities that are failure-free. A SIMPLE craft project with a pre-set outcome or appearance may be too difficult, whereas arranging silk flowers in a vase is a failure-free task. Sanding wood blocks is usually failure-free. Setting the table is as well.
7. Reduce distractions so the person can focus on the task, eliminating things such as background noise from the television.
8. Keep exercise and physical activity part of everyday as it helps keep sleep and nighttime habits normal.
9. Familiar activities such as setting the table and folding laundry should be part of the daily routine that the person with Alzheimer’s disease helps do. The tasks are meaningful, familiar activities which help him/her retain skills as long as possible.
10. If music, exercise, or spiritual activities were part of your family member’s routine each week, those type of activities should occur frequently during the week as well.

“How do I know when it’s time to look for a nursing home for my mom?”

“How will I know when it’s time to find a nursing home for my mom?”

At the mid-stage of Alzheimer’s disease and related dementias a caregiver often has to manage the challenges of:

·         Difficult behaviors such as agitation and restlessness, or the extreme reaction to an event or situation which the person with dementia doesn’t understand

·         Wandering, and the challenges of keeping someone safe in the home, particularly during the nighttime hours

Care can be a 24 hour a day / 7 day a week task as the person with mid-stage dementia often has day and nighttime routines mixed up. This can create difficulty managing the person safely in the home during the hours a caregiver is sleeping, or may be in another part of the home.

The late stage of Alzheimer’s disease usually requires intensive, around-the-clock assistance. A person in late-stage Alzheimer’s usually:

·         Has difficulty eating and swallowing

·         Needs assistance walking and eventually becomes bedridden or chair-bound

·         Needs full-time help with personal care, including toileting

·         Is vulnerable to infections and pneumonia

·         Loses the ability to communicate with words

At this stage, care requires a fair amount of physical capacity and endurance, as well as additional caregiver support which may strain or exhaust financial resources.

If you are not sure if it’s time to select a nursing home, ask yourself a few questions:

Safety:
Is the person with dementia safe?
Has he/she left the house alone and/or gotten lost?

Health:
Is the health of the person with dementia at risk?
Is my health as a caregiver at risk?
Is he/she incontinent of bowel and/or bladder?

Care needs:
Does the person with dementia need more care than I am able to give right now?
Is it becoming too difficult for me to care for the person with dementia?
Have I exhausted financial resources needed for paid caregiver support in the home?

For more information call 317-215-5111 or www.behomelivelife.com

My dad sleeps all the time. He won’t get involved in any of the activities at the nursing home.

Begin by assessing the current activity calendar with the Activity Director at the nursing home.  Discussing your dad’s interests prior to the onset of dementia with the Activity Director will determine the best schedule of personally meaningful activities for your dad. You may need to adapt an activity to your dad’s level of ability today, but that doesn’t mean he still couldn’t enjoy some of his favorite hobbies. 

Take, for example, fishing.  I use a fishing kit with my grandfather when I visit him in the nursing home.  We straighten the tackle box, practice tying knots, casting the line, and looking at photos of his past fishing trips.  He never actually goes fishing, but he is able to reminisce about the hobby and spend time mentoring me on the best way to catch a bluegill!

For more tips:  check out our website at www.behomelivelife.com or call 317-218-5111

My dad keeps asking the same questions over and over again.

“My dad keeps asking the same questions over and over again.”

Short term memory loss is typical with someone who has Alzheimer’s.  Caregivers may feel themselves becoming very frustrated with repetitive questions and may not know how to help the person with Alzheimer’s.

Tip:

Caregivers should answer the question.  Provide multiple cues to help the person with Alzheimer’s try to remember the answer. 

For example, when asked “When are we going to eat?” try these responses:

Answer #1:  “We will eat at noon.”  Point to a clock and ask if the person if they remember what noon looks like on the clock.  Then say:  “When you smell the bacon cooking you will know that the BLT’s are ready to eat.”

Answer #2:  “Are you hungry now?  We could have a snack.”

Or

Answer #3: “Would you like to help me prepare lunch?”

If this tip isn’t working, try to figure out what need is un-met.  Is the person with Alzheimer’s feeling unsure of himself or the situation?  Is he feeling scared?  Does he need to eat now because he is hungry?  Is he looking for something to do?

Fulfilling an un-met need or using redirection may be an effective tool in reducing repetitive questions and redirecting his thoughts to something different.

For more tips:  check out our website at www.behomelivelife.com or call 317-218-5111

How Do I Get My Mom to Take a Shower?

“How can I get my mom to take a shower?”

Providing personal care is a very demanding job.  Our goal as caregivers should always be do the task “with” the person who has dementia, never to do the task “for” someone with dementia.  Most tasks can be completed successfully; however, many times these tasks will need to be adapted to the person’s abilities. 

Base the bathing task on the routine your mom used prior to the onset of dementia.  Did she take a bath or a shower?  When did she bathe and how often?  Did she wash her hair during her shower?   Once you identify her past routine, you can structure the current routine around her personal preferences.

Remember these tips:

Ensure that the bathroom is comfortable for showering.  Is the temperature comfortable and is the lighting appropriate?

Make sure all necessary items for the shower are waiting in the bathroom.  You don’t want to leave in the middle of the shower to find a towel or soap.

Make the experience a relaxing pleasure, not a demanding chore.

Allow your mom the opportunity to complete as much of her shower herself, as possible.  You may need to stay close by for safety, but remember that dignity is important.

If an argument begins, stop the shower.  Try again later or you may even consider a sink bath. 

Remember, keeping your mom relaxed and feeling safe the important part.  There are many ways to keep a person clean without immersing her completely in the water.

For more tips:  check out our website at www.behomelivelife.com or call 317-218-5111