Archive for May, 2014


The Memories Project

It has been just over a month since “Chicken Soup for the Soul: Living with Alzheimer’s and Other Dementias” was released. So far, the demand has been overwhelming, the reviews extremely positive, and a second printing has been ordered!

Chicken Soup For the Soul: Living With Alzheimer's and Other Dementias

Since I was fortunate enough to be selected as a contributor, I have a few extra copies available. Starting today at noon ET, through Friday noon ET, you can enter a raffle for a chance to receive a complimentary copy of “Chicken Soup for the Soul: Living with Alzheimer’s and Other Dementias.”

Note: You must click on the Rafflecopter link below to be registered for the contest. Rafflecopter is a popular, safe contest platform. You can login through Facebook or with an email address. Follow the prompts on the form to enter the raffle.

Enter the book giveaway

View original post

sad senior man

As the population ages, the issue of elder abuse becomes more and more prevalent. Elder mistreatment (i.e. abuse and neglect) is defined as intentional actions that cause harm or create a serious risk of harm (whether or not harm is intended) to a vulnerable elder by a caregiver or other person who stands in a trust relationship to the elder. This includes failure by a caregiver to satisfy the elder’s basic needs or to protect the elder from harm.

Unfortunately, we simply do not know for certain how many people are suffering from elder abuse and neglect. It appears that female elders are abused at a higher rate than males and that the older one is, the more likely one is to be abused.

Signs of elder abuse may be missed by professionals working with older Americans because of lack of training on detecting abuse. The elderly may be reluctant to report abuse themselves because of fear of retaliation, lack of physical and/or cognitive ability to report, or because they don’t want to get the abuser (90% of whom are family members) in trouble.

fhe022

WARNING SIGNS OF ELDER ABUSE

• Bruises, pressure marks, broken bones, abrasions, and burns may be an indication of physical abuse, neglect or mistreatment.

• Unexplained withdrawal from normal activities, a sudden change in alertness, and unusual depression may be indicators of emotional abuse.

• Bruises around the breasts or genital area can occur from sexual abuse.

• Sudden changes in financial situations may be the result of exploitation.

• Bedsores, unattended medical needs, poor hygiene and unusual weight loss are indicators of possible neglect.

• Behavior such as belittling, threats and other uses of power and control by spouses are indicators of verbal or emotional abuse.

• Strained or tense relationships, frequent arguments between the caregiver and elderly person are also signs.

• It’s important to remain alert. The suffering is often in silence. If you notice changes in personality, behavior or physical condition, you should start to question what is going on.

PREVENTING ELDER ABUSE

• Learn when and how to report abuse.

• Get help for commonly seen “tricky situations” involving possible abuse of elders and adults with disabilities.

• Learn about the agencies and organizations that respond to reports of abuse.

•Learn what some communities and multidisciplinary teams are doing to prevent abuse from occurring.

• Explore how the many fields and organizations that serve elders and adults with disabilities may play a role in abuse intervention and prevention.

What to learn more about elder abuse? Visit the National Center on Elder Abuse website by clicking here.

physicial therapy rehab

Every year, nearly 1/3 of all older adults will suffer from some type of fall. Older adults with dementia, however, are more than twice as likely to fall than those without cognitive impairment. Their falls may also be more severe, perhaps resulting in serious bone fractures, hospitalization, or life-threatening injuries. Persons with dementia that suffer from a fall at home are more likely to be admitted into some type of institutional care. In addition, the cost of treating and rehabilitating seniors that have fallen has sky-rocketed in recent years (Montero-Odasso, 2012).

walking down a hall

Researcher continue to study the most helpful methods for reducing risk of falls and preventing injury in those with dementia. Below are some tips that may be helpful in managing fall risk:

  • Implement a regular exercise program to maintain muscle and joint strength
  • Work with the person’s physician(s) to ensure that medication are not causing adverse side effects that could contribute to falls (e.g. dizziness, vertigo)
  • Maintain a regular toileting schedule for the person
  • Anticipate the person’s needs
  • Have a knowledge for the person’s likes, dislikes, routine, preferences, etc.
  • Ensure that clothing and shoes fit properly and are in good condition. Avoid slippers with no supportive backing, pants that are too long for the person, etc.
  • Clearly label key places in the home or residence, such as the bathroom or bedroom, even if the person has lived there for some time.
  • Ensure that the environment is clutter-free. Remove throw rugs that could slip beneath the person.
  • Create a visible pathway from the bedroom to the bathroom, particularly at night. Consider using a bedside commode.
  • If falling in bed is a concern, consider using lowering the mattress directly onto the floor. Do not install bed rails as this could increase the person’s agitation and restlessness. Many individuals with dementia may view bed rails as a sign that they are expected to be incontinent, or they perceive the rails as an obstacle to overcome, increasing the height of their fall. The person could become fatally injured if their head were to get caught between the rails.
  • Make sure the bathroom is not conducive for falls.  Remove clutter, use grab bars, and non-skid strip. A shower chair may be helpful.
  • Use color contrast where appropriate – for instance, a person may not see a white toilet in front of a white wall. Consider using a brightly colored toilet seat to draw the person’s attention.
  • Make sure there is ample lighting in well traversed areas.
  • Provide places for the person to stop and rest, if walking on a long hallway or path.
  • Ensure the person wears sensory aids, such as glasses or hearing aids, if needed.

 

References

Montero-Odasso, M. M. (2012). Gait and Cognition: A Complementary Approach to Understanding Brain Function and the Risk of Falling. Journal Of The American Geriatrics Society60(11), 2127-2136.

van Doorn, C. (2003). Dementia as a Risk Factor for Falls and Fall Injuries Among Nursing Home Residents. Journal Of The American Geriatrics Society51(9), 1213-1218.

Moments of Joy

Alzheimer’s and other dementias are devastating diseases. Overtime, the person with the illness gradually loses their ability to perform many complex, and even once familiar, tasks. However, when a person receives their diagnosis, there is still much life to be lived and to enjoy – the person can still offer profound contributions in love, family, and life. So much of who we are is not our ability to remember facts, but it is how we love and feel from day-to-day, moment-to-moment. These moments of joy are still accessible to the person, even very late into the disease. The person with dementia may be living with their disease for years, or even decades. Therefore, it is beneficial for us as caregivers to develop effective strategies for engaging the person and evoking moments of joy and accomplishment. We must be prepared to offer more guidance, support and supervision to the person as their disease progresses, and it is essential that we practice our ability to be sensitive, patient, and positive in our work with the person.

cb0407bwh_0282

Offer support and supervision
You may need to show the person how to perform the activity and provide simple, step-by-step directions.

Concentrate on the process, not the result
Does it matter if the towels are folded properly? Not really. What matters is that you were able to spend time together, and the person feels as if he or she has done something useful.

Be flexible
When the person insists that he or she doesn’t want to do something, it may be because he or she can’t do it or fears doing it. Don’t force it. If the person insists on doing something a different way, let it happen and change it later if necessary.

Be realistic and relaxed
Don’t be concerned about filling every minute of the day with an activity. The person with Alzheimer’s needs a balance of activity and rest, and may need more frequent breaks and varied tasks.

Help get the activity started
Most people with dementia still have the energy and desire to do things but may lack the ability to organize, plan, initiate and successfully complete the task.

Break activities into simple, easy-to-follow steps
Focus on one task at a time. Too many directions at once often overwhelm a person with dementia.

Assist with difficult parts of the task
If you’re cooking and the person can’t measure the ingredients, finish the measuring and say, “Would you please stir this for me?”

Let the individual know he or she is needed
Ask, “Could you please help me?” Be careful, however, not to place too many demands upon the person.

Make the connection
If you ask the person to make a card, he or she may not respond. But if you say that you’re sending a special get-well card to a friend and invite him or her to join you, the person may enjoy working on the task.

Don’t criticize or correct the person
If the person enjoys a harmless activity, even if it seems insignificant or meaningless to you, encourage the person to continue.

Encourage self expression
Include activities that allow the person a chance for expression. These types of activities could include painting, drawing, music or conversation.

Involve the person through conversation
While you’re polishing shoes, washing the car or cooking dinner, talk to the person about what you’re doing. Even if the person cannot respond, he or she is likely to benefit from your communication.

Substitute an activity for a behavior
If a person with dementia rubs his or her hand on a table, put a cloth in his or her hand and encourage the person to wipe the table. Or, if the person is moving his or her feet on the floor, play some music so he or she can tap them to the beat.

Try again later
If something isn’t working, it may just be the wrong time of day or the activity may be too complicated. Try again later or adapt the activity.

Communication Strategies

communication

As the disease progresses, the communication skills of a person with dementia will gradually decline. Eventually, he or she will have more difficulty expressing thoughts and emotions. Ultimately, the person will be unable to understand what is being communicated and lose the ability for verbal expression.

The challenges associated with communication can lead to frustration. It can be helpful for you to understand what changes may occur over time so you can prepare and make adjustments. Anticipating these changes and knowing how to respond can help everyone communicate more effectively.

Tips for successful communication:

  • Allow time for response so the person can think about what he or she wants to say.
  • Engage the person in one-on-one conversation in a quiet space with minimal distractions.
  • Be patient and supportive. Offering comfort and reassurance can encourage the person to explain his or her thoughts.
  • Maintain good eye contact. It shows you care about what he or she is saying.
  • Avoid criticizing or correcting. Instead, listen and try to find the meaning in what is being said. Repeat what was said to clarify the thought.
  • Avoid arguing. If the person says something you don’t agree with, let it be.
  • Don’t overwhelm the person with lengthy requests that require complex thinking. Instead break down tasks with clear, step-by-step instructions.
  • Speak slowly and clearly.
  • Ask one question at a time. Multiple questions at one time can be overwhelming.
  • Ask questions that require a yes or no answer. For example “Would you like some coffee?” rather than “What would you like to drink?”
  • Give visual cues. To help demonstrate the task, point or touch the item you want the individual to use. Or, begin the task for the person.

Violette Peters and her mother Ablyne Winge.