Saturday, July 21, 2012

A Quite Saturday Morning

I found this question on site I visit quite often This question could have been asked by me with just a change in the wording  from 'father' to 'mother'. The answer gave me some insight, so I hope it might help others deal with someone suffering from dementia too.
The past week has had it's ups and downs. Yesterday was going pretty well until my mom started yelling and scurrying down the hall that a 'lady' had told her to come out into the hall so she could tell her that she was going to be arrested so she could get her house. Somehow the thought of losing her home weighs large inside my mom's mind and she comes out with different scenarios about people trying to take it away from her. We do our best to reassure her that all is well and most times we can calm her. All I can think is that at times it must be hell inside her mind. The 'long goodbye' is indeed a cruel disease. I hate it.
The lines marked in red are what we identify with the most in the article.
Q: It hurts to see my father with Alzheimer's deteriorating before my eyes. How can I accept the decline?
A: Many people who have experienced a loved one's dementia have said that given the choice, they'd rather deal with almost any other ailment, no matter how painful or debilitating. There's little we can do to fix the deterioration of memory, communication skills, and reasoning that dementia steals away. Few experiences are as frustrating as watching a once-vibrant person deteriorate into a confused stranger. It's not fair, it's not right, and it's hard to accept gracefully.
Try to remain calm. Pain and helplessness breed anger, and anger about the situation may spill over onto the person. Answering the same question 20 times in one afternoon or hearing your loved one recite a skewed account of events for the hundredth time can make you want to scream, but losing your cool helps nobody. Remind yourself that your father did not develop dementia to annoy you: He's not doing it on purpose, and he can't help it. And it isn't your fault, either. It just happened.
So change the subject. Suggest that you go out on the patio together and look at the flowers. If all else fails take a break, and do something that will help you regain control. Take a walk or grab a cup of tea. Call a friend. If you can keep your wits about you, remain in control, and take care of yourself, you'll be more "present" (and pleasant) for him, and you'll both benefit.

Robert Bornstein, PhD, is Professor of psychology at Adelphi University, and co-authored "When Someone You Love Needs Nursing Home, Assisted Living or In-Home Care."

Regarding the horrific events in Aurora, CO. All I can say is that our hearts go out to the families of the victims.

Sunday, July 8, 2012

More on Care Giving

I found the following information on the Family Care Giver Alliance site. Some good information here. The sections I've put in red are some of the very things we've been dealing with. I've also found good support and help on other care giving sites. It's great because you learn how to deal with the problems you and your loved ones are facing plus you know you are not alone in this fight.
My mom has been having episodes of severe anxiety the last few weeks and first I try to talk her down but sometimes I have to resort to one half of an Ativan pill. I have an appointment set up for mom next Tuesday and have lots of questions for her doctor. For one thing mom actually didn't know who I was two nights ago and went to Frank to ask her where her daughter was. She also ask me today how to eat a peanut butter sandwich. These are all signs that her symptoms have worsened.
I must state again that taking care of my mom since her dementia has gotten worse is far harder than I thought it would be, but thanks to Krystal who helps out and my husband Frank who is as patient as the day is long with her my task is much less stressful than it would be without them. Thanks to Cyndi and her boyfriend Michael for taking her out dancing and coming in to sit with her now and then and to Pam for her expert medical advice and to Evie for her support and holistic medicinal suggestions to the situation we are all facing together. Also thanks to our son Frankie and his wife Sandy for their unwavering support and always hosting such nice family get togethers to get us out of the house and be able to feel normal for a while. I'm going to try again and get a home health care worker in here again but it's going to be difficult. Wish us luck!
My neck problem is still there but the pain is tolerable so I'm not going to go into that problem for now.
I hope you find the following suggestions helpful. I know I did and hugs and good luck to you in your quest to be a care giver to a parent, spouse, or other loved one.
  1. Being Reasonable, Rational and Logical Will Just Get You into Trouble. When someone is acting in ways that don’t make sense, we tend to carefully explain the situation, calling on his or her sense of appropriateness to get compliance. However, the person with dementia doesn’t have a “boss” in his brain any longer, so he does not respond to our arguments, no matter how logical. Straightforward, simple sentences about what is going to happen are usually the best.
  2. People With Dementia Do Not Need to Be Grounded in Reality. When someone has memory loss, he often forgets important things, e.g., that his mother is deceased. When we remind him of this loss, we remind him about the pain of that loss also. When someone wants to go home, reassuring him that he is at home often leads to an argument. Redirecting and asking someone to tell you about the person he has asked about or about his home is a better way to calm a person with dementia.
  3. You Cannot Be a Perfect Caregiver. Just as there is no such thing as a perfect parent, there is no such thing as a perfect caregiver. You have the right to the full range of human emotions, and sometimes you are going to be impatient or frustrated. Learning to forgive your loved one as well as yourself is essential in the caregiving journey.
  4. Therapeutic Lying Reduces Stress. We tend to be meticulously honest with people. However, when someone has dementia, honesty can lead to distress both for us and the one we are caring for. Does it really matter that your loved one thinks she is the volunteer at the day care center? Is it okay to tell your loved one that the two of you are going out to lunch and then “coincidentally” stop by the doctor’s office on the way home to pick something up as a way to get her to the doctor?
  5. Making Agreements Doesn’t Work. If you ask your loved one to not do something ever again, or to remember to do something, it will soon be forgotten. For people in early stage dementia, leaving notes as reminders can sometimes help, but as the disease progresses, this will not work. Taking action, rearranging the environment, rather than talking and discussing, is usually a more successful approach. For example, getting a teakettle with an automatic “off” switch is better than warning someone of the dangers of leaving the stove on.
  6. Doctors Often Need to Be Educated By You. Telling the doctor what you see at home is important. The doctor can’t tell during an examination that your loved one has been up all night pacing. Sometimes doctors, too, need to deal with therapeutic lying; e.g., telling the patient that an antidepressant is for memory rather than depression.
  7. You Can’t Do It All. It’s OK to Accept Help Before You Get Desperate. When people offer to help, the answer should always be “YES.” Have a list of things people can do to help you, whether it is bringing a meal, picking up a prescription, helping trim the roses or staying with your loved one while you run an errand. This will reinforce offers of help. It is harder to ask for help than to accept it when it is offered, so don’t wait until you “really need it” to get support.
  8. It Is Easy to Both Overestimate and Underestimate What Your Loved One Can Do. It is often easier to do something for our loved ones than to let them do it for themselves. However, if we do it for them, they will lose the ability to be independent in that skill. On the other hand, if we insist individuals do something for themselves and they get frustrated, we just make our loved one’s agitated and probably haven’t increased their abilities to perform tasks. Not only is it a constant juggle to find the balance, but be aware that the balance may shift from day to day.
  9. Tell, Don’t Ask. Asking “What would you like for dinner?” may have been a perfectly normal question at another time. But now we are asking our loved one to come up with an answer when he or she might not have the words for what they want, might not be hungry, and even if they answer, might not want the food when it is served after all. Saying “We are going to eat now” encourages the person to eat and doesn’t put them in the dilemma of having failed to respond.
  10. It Is Perfectly Normal to Question the Diagnosis When Someone Has Moments of Lucidity. One of the hardest things to do is to remember that we are responding to a disease, not the person who once was. Everyone with dementia has times when they make perfect sense and can respond appropriately. We often feel like that person has been faking it or that we have been exaggerating the problem when these moments occur. We are not imagining things—they are just having one of those moments, to be treasured when they occur.