Caregiver Tips: When the confused elderly just stop moving.

Elderly Stop MovingStopping Contractures Before They Start

 
When the elder with Alzheimer’s disease is in the mid stage of the disease they often stop moving independently. This independent movement may show itself as no longer making gestures. An elder who always talked with their hands and used many gestures no longer does.

The elder who physically could still go through the motions of dressing but no longer initiates those movements. They still could brush their teeth, or put on a shirt but they no longer seem to know how to start or even seem to know what to do.

This stopping of movement is called Apraxia and it happens when there is a disconnection in the brain from the thinking of doing something and the movement to do the task.

Contractures in elderly are painful.
When people stop moving they become stiff in their joints. When those joints become stiff and they stop moving the muscles and ligaments become shortened and soon they no longer can move, and we call that a contracture. Movement becomes painful when a joint is moved because the shortened muscles are being stretched beyond their ability, and contractures are painful.

Contractures are much easier to prevent than to cure. The prevention is simple movement and exercise of every joint. Whether it is an organized exercise class, watching an exercise DVD, or just moving to music while you are getting someone dressed – the moving is what matters.

Remember – a contracture can develop in as little as 4 days of no movement. While it can take 500 days of movement to fix the contracture and get that joint moving again.

Caregiver Tips: Activities to do when the confused elder you care for is a man.

Activities

Know the person – what did the elderly man you care for enjoy before he became confused?

Watching funny DVDs together can be an especially wonderful connection for a father with his son.

My father-in-law suffered from dementia. My husband, Jerry, knew his dad had enjoyed Laurel and Hardy films as well as those of Ma and Pa Kettle–the comedies of the 1930s and 1940s. Jerry found as many of those old movies as he could and brought them to the nursing home. On his visits, Jerry didn’t have to carry on long one-sided conversations.

When Jerry visited, he would tell his dad what was new with him and the family. After that, he put on an old movie and his dad laughed every time Jerry would laugh. We never knew how much he followed the story, or even “saw” the slap-stick comedy. But he could still enjoy that comfortable, normal activity of sitting with his son and laughing.

4 Activites for the confused elderly man:

• Watch a DVD on travel, sports, history – whatever the man likes.
• Have something from his past interests – fishing pole, anything from a collection he had ( my dad had a tie collection that he enjoyed looking at),
• Read sports magazines together or look at new car brochures. Both are excellent opportunities for conversation.
• Most men like to do something physical. do that but keep it simple. Toss a ball or throw bean bags. These kinds of activities are also great to do with children.
Book excerpt from: Please Get To Know Me – Aging with Dignity and Relevance by Virginia Garberding with Cecil Murphey
available at: amazon.com – barnesandnoble.com – christianbook.com or see right sidebar direct from publisher.

Alzheimer’s Disease: “Oh happy happy wedding day” when the delusions of confused elder seem so real.

Alzheimer's Disease Delusions

Alzheimer’s in the Nursing Home

 
I was told by the Director of Acitivites that we had a “situation” in one of the households. When I got there, there they were, sitting together so incredibly happy in their shared delusion. Bertha all dressed up in a beautiful red and pink flowered organza dress. Hair carefully fixed and bright red lipstick on. Next to her equally glowing her best friend Sally in a black two piece with a black sequenced jacket.

Greeting them with a “Wow, do you both look great, what is the occasion.” With irresistible smiles they both informed me that Bertha was getting married today.

Past elder care for the confused.

 
There was a time about 20 years ago when the wisdom of the time said that you needed to re-orient people with Alzheimer’s disease to the present. And many time that present would be very hurtful. Thinking of those days now and the current reality. How hurtful would it be to say “You are 84 years old, have Alzheimer’s disease, live in a nursing home and no one is getting married today.”

 Current Alzheimer’s care says – join them in the moment.

 
But this is a kinder, gentler time and so we try to work with their reality and join them in the moment. The first thing we needed to do was  identify her “intended” and find out where he is in this scenario. The staff member returns with the information that Bob is only expecting a visit from his son today, he has no other plans.  

The consensus is reached that we need to provide some kind of event for these sweet, happy ladies today. So we plan a get together for the residents that afternoon where we will have a few festive decorations, some refreshments, and a little wine we use on Friday afternoons for “Happy Hour.”    Then we will have a short speech by the director of Activities about friendship and everyone will toast the happy friends.

 And so it went. No one was told that they were wrong, old or confused. 

Oh happy, happy friendship day!

Caregiver Tips: Don’t forget the music, elderly or disabled people enjoy music just like everyone else

Music

Person centered music for the confused elderly.

Everyone knows how certain music can bring back pleasant memories, and put you back in the moment. While some people enjoy very specific music many people enjoy a variety of music. The important thing is to learn what the elder you are caring for likes.

Many caregivers find that playing certain music can make the person they care for more cooperative and generally happier.

8 Benefits of music for the confused elder.


• Music is an energizer – put on a little high energy music with a good beat and sees how quicker you can accomplish a task. Caregivers have found that energizing music helps during bathing, dressing and grooming.
• Music can be used as a distraction from pain. Hospice caregivers are well known for using music.
• Music has been known to lower blood pressure and increase relaxation. Knowing the person you are caring for and what music they find relaxing is important.
• Music increases a sense of well being and improves self-esteem.
• Music many times will decrease anxiety – try music before medication.
• Music is a natural motivator and can provide a sense of control.
• Christian music provides comfort, peace as well as opportunity for reminiscing.
• Music provides JOY.

Early Alzheimer’s Disease – Listen to what the elder has to say.

After the diagnosis.


When someone is just diagnosed with “early onset Alzheimer’s disease, people start treating them differently. As Richard Taylor, author of Alzheimer’s From the Inside Out says “I sometimes inadvertently wince when someone tells me – “I just don’t know what to say to you.” How about a simple “Hello” and let’s go from there.”

Richard continues “I turn away from people who speak louder to me than others, as if dementia causes diminishing ability to hear. I sometimes smile, and sometimes frown when someone tells me to do something, rather than asking me if I want to do it. They frequently ask or tell me to do something that prior to my diagnosis they never would have mentioned in the first place. “Put your coat on now.” “Sit here and I’ll be right back.” “Here, let me do that for you, you know you can’t do it by yourself.”

It might not always be physical help a senior needs.


If you are caring for someone with Alzheimer’s disease, take a tip from Richard and remember people don’t always need help but what they do need is support.

Let the person do as much as they can and then lend what ever assistance they may need to complete the task. Telling a person what to do while acting as if they don’t know what they are doing hurts a person’s self esteem. When mistakes are made – over look them instead of drawing attention to them.

Caregiver Tips: Helping the elder with Alzheimer’s Disease “Stay in Today”

People with Alzheimer’s disease aren’t worrying about what happened in the past they want to function better today.

I was just recently introduced to the work of Richard Taylor PHD, who was diagnosed with early onset Alzheimer’s disease at the age of 58 years. Richard wrote in his January news letter, not so much about how to be in the moment, but what that moment should be about. “Spend more time thinking of creative ways to support and enable us to stay in today, to understand what is happening around and to us, to structure activities so we must make our own decisions – today.”

Richard wrote this in response to all of the current programming directed at helping people remember 20, 25, 30 years ago. When the elder with Alzheimer’s disease isn’t really worrying about what happened in the past. They are trying to function better today.

Depending on where the individual is in the progression of Alzheimer’s disease. Whether it is:

Early On-set -The person is forgetting familiar words, people’s names or getting lost in familiar surroundings.

Mid-stage – The person will have trouble doing routine things – identifying money – cooking – forgetting major life events. As this stage progresses the person loses the ability to care for themselves in grooming, dressing, bathing and eventually eating.

Late-stage – The person now has lost their verbal skills and is total care in all activities of daily living.

This is of course a very simplistic breakdown of what is considered “stages.” However, these stages represent many years for most people. We all need to help elders with Alzheimer’s disease understand what is happening around them and to them right now.

People with Alzheimer

Early Alzheimer’s disease.

One of the first things a family member might notice is that their loved one starts bathing less and less. However they will become highly insulted if someone suggests that they need to bathe. They will say they just had a bath, or they will just “wash up at the sink.” Working in a Nursing Community for many years, I have seen many elderly people when they move into a facility, their family will say they haven’t taken a bath or shower for years. Washing up at the sink in their later years is very common. And the elder might refer to that as a “spits bath.” The elderly population, that is in their 80’s or older, grew up and lived in a time of baths not showers. So taking a shower, especially is not “normal” for them.

Doesn’t want to get undressed.

Many times a person with Alzheimer’s disease will not want to undress. Being dressed makes a person feel put together, even when they have been wearing the same clothes for days. Everyone feels vulnerable when they are undressed. So when a person is unsure of so many things, they can at least feel more competent if they are dressed.

Bathroom is too cold, water is too cold.

Many times a person with Alzheimer’s disease has a changed perception of temperature. Their internal body thermostat no longer functions normally causing them to over dress or under dress. So they will say that they don’t want to get wet and chance a cold.
When the reason for bathing is forgotten, and seems like way to much trouble. And you add to that the fear of getting cold or “catching a cold” and the embarrassment of getting undressed. No wonder, bathing is often the most stressful task of caregiving.

Caregiver Tips: Don’t overlook the power of a pet, Therapy Dogs International, also do home visits.

Elderly in nursing homes love to see pets.


I was walking through the facility and a friendly woman was coming towards me with what appeared at first glance to be a baby carriage. In fact it was our Therapy Dog Team visiting residents. The carriage was just the right size for the tiny black and white lap dog inside and at just the right height for an elderly person in a wheelchair to enjoy.

When a family or direct caregiver is too overwhelmed to take on the added responsibility of a pet. The benefits of visiting with an animal on a regular basis can still be enjoyed through organizations like Therapy Dogs International.

Animals create a sense of normalcy for the elderly.


When you arrange home visits or nursing home visits, the visiting dog can give the loved one a sense of normalcy and make life seem more manageable. Animals make life feel more complete while they give unconditional love and acceptance.

A visiting dog team can give the caregiver a little break as they visit and occupy the attention of the loved one. Many time the team becomes part of the family and even is a welcome participant at funerals to comfort families

God surrounded them with animals.
Randy Alcorn stated in his best selling book Heaven “Adam, Noah, and Jesus are the three heads of the three earths. When Adam was created, God surrounded him with animals. When Noah was delivered from the flood, God surrounded him with animals. When Jesus was born, God surrounded him with animals. When Jesus establishes the renewed Earth, with renewed men and women, don’t you think he’ll surround himself with renewed animals?”

Contact Therapy Dogs International, Inc. for home visits and look for Heaven by Randy Alcorn in your local book store for insight on God’s plan for animals.

Caregiver Tips: How the senior who has Alzheimer’s Disease forgets their words.

Word loss can be predicted for the senior with Alzheimer’s disease.


As a person goes through the stages of this disease they will lose the ability to talk. In the very beginning they have word finding problems, and they start substituting words, when they forget a word. In the mid-stage they may have just a few words and in the late stage many times they have only one word left and it is yes, or no.

Confused seniors no longer understand concept words.


As people with Alzheimer’s disease lose the words they say, they also are losing the ability to understand words. So when working with someone in the mid-stage who has few words saying to them “do you want to have lunch” won’t be understood. This is why Alzheimer’s specialist say to use concrete words and when ever possible show the item.

As a very young child grows they first can identify a banana by seeing a real banana. They then progress to being able to identify a picture of a real banana, then a drawing of a banana and finally they understand the word banana and can be asked if they want a banana without showing them the fruit itself.

Persons with Alzheimer’s disease lose their words and the meaning of the words in the same order they gained those words. So for the person who is losing these words, once again showing them an actual banana and saying do you want a banana will work much better than the word alone.

Help the senior understand by showing.


So when you talk to a person with Alzheimer’s disease, turn “do you want to have lunch” from a question into a statement “let’s have a sandwich” while you show the bread and lunch meat.

Anytime you turn a question into a statement and an idea into something concrete to be seen you will have greater success.

Caregiver Tips: The senior’s name is so important, when working with the senior with Alzheimer’s Disease.

Use the name the senior responds to.


Everyone’s name is important to them. Many people have a special significance to their name. They were named after someone in the family, by someone usually their mother. This is the word that people respond to even very late in the disease process.

I remember a woman who had lost all of her words, was total care in all activities of daily living. And as I walked past her in the hall, all I said was “Gracie”, and her head turned towards me. She was at the end of her life and died soon afterwards but till the end she still responded to her name.

Make sure you are using the name that the person still responds to. When caregivers call everyone “Grandma” that person may have long forgotten that they are a grandma. And so much worse, if the caregiver doesn’t really know them and they never were a grandma – how confusing would that be. I have seen elderly women only respond to their maiden name and when living in a nursing home, the home had to use both maiden and married names to identify them.

Everyone deserves the dignity of being called by the right name; take the time to find out that name.