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

Tips for Meaningful Days

Meaningful activities are those events or tasks that are failure free opportunities for success.  Here are some strategies for creating meaningful days for your loved one who has Alzheimer’s or another related dementia.

• *Look for activities that will be failure free.   A 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.
• *Reduce distractions so the person can focus on the task, eliminating things such as background noise from the television.
• *Keep exercise and physical activity part of everyday, as it helps keep sleep and nighttime habits normal.
• *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 with.  The tasks are meaningful, familiar activities and assist to remain skills as long as possible.
• *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 now as well.

For more information contact 317-218-5111.

Tips for managing vascular dementia

Although there is no proof that normal function can be restored once damage has been done to brain tissue, there are ways to prevent further damage.   Coping with memory loss can be challenging, but here are some practical ways to manage with those deficits:

*Keep a journal to record names of people you meet and thoughts about your daily activities.

*Use a calendar to track appointments and other important dates.

*Keep people in your life informed of changes in your health and memory.  Employers, family, and friends will now what to expect and be able to provide assistance.

*Exercise your mind by reading, working puzzles, learning new things, and talking about current events.

*Socialize with family and friends.  Socialization is one of the most important things that you can do for your memory.

*Take time to complete each task.  You may need to break each task into simple one step instructions.

*Accept help.

*Don’t smoke.

*Eat a healthy diet.

*Exercise daily.

*Set reasonable expectations.  If you set your expectations too high and don’t give yourself credit, then you may    become angry and that will cause a barrier to remembering.

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.

Daily Routine

Consider how you organize your own day when planning the day for the person with dementia. There are times when you want variety and other times when you welcome routine. The challenge for caregivers is to find activities that provide meaning and purpose, as well as pleasure.

Begin by thinking about last week:

Which activities worked best and which didn’t? Why?
Were there times when there was too much going on or too little to do?

Use what you’ve learned to set up a daily plan. A planned day allows you to spend less time and energy trying to figure out what to do from moment to moment. Allow yourself and the person with dementia some flexibility for spontaneous activities.

Oftentimes, structured and meaningful activities reduce agitation and improve mood. The type of activity and how well it’s completed are not as important as the joy and sense of accomplishment the person gets from doing it. So, remember, it’s not about the end product, it’s about having fun, doing something your parent remembers doing, and giving him/her the feeling of being needed again.

The success of an activity can vary from day to day. In general, if the person seems bored, distracted or irritable, it may be time to introduce another activity or to take time out for a rest.

An example of a daily routine:

Morning

·         Wash, brush teeth, get dressed

·         Prepare and eat breakfast

·         Have coffee and make conversation

·         Discuss the newspaper, try a hobby, reminisce about old photos

·         Take a break, have some quiet time

·         Do some chores together

·         Take a walk, play an active game

Afternoon

·         Prepare and eat lunch, read mail, wash dishes

·         Listen to music, watch TV, do some puzzles together

·         Take a short break or nap

·         Do some gardening, take a walk, sand some wood, play a few holes of golf, or visit a friend

Evening

·         Prepare and eat dinner, clean up kitchen. Be social during this time

·         Reminisce over coffee and dessert

·         Play cards, watch an old movie, visit with family

·         Take a bath, get ready for bed, read a book, or watch an old TV show (I Love Lucy, Bob Newhart, etc.)

For more information call (317) 218-5111 or www.behomelivelife.com

“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