Live Free Home Health Care, LLC. - Bristol, New Hampshire

All posts within: Alzheimer's Disease

Tuesday, May 11, 2010

The connection between Alzheimer’s and night restlessness

Sundown syndrome—also called sundowning or sunsetting—is a behavior common in people with Alzheimer’s disease. It describes the episodes of confusion, anxiety, agitation, or disorientation that often occur at dusk and into the evening hours. The episodes may last a few hours or throughout the night, which is very draining not only on the caregiver, but on the person with Alzheimer’s disease as well.

While the exact reason why people with Alzheimer’s are more susceptible to sundowning is not known, there are ways to help ward off an episode:

· Schedule the day so that the more difficult tasks are done early in the day.

· Restrict sweets and drinks with caffeine to the morning hours and try serving a late afternoon snack or an early dinner.

· Keep the house or room well lit. Close the drapes before the sun goes down, so the person doesn’t watch it become dark outside. Even keep the room partially lit when going to bed, to reduce agitation that occurs when surroundings are dark or unfamiliar.

· Plan more active days. A person who rests most of the day is likely to be awake at night.

· Seek medical advice. Physical ailments, such as bladder or incontinence problems, could be making it difficult to sleep. The doctor may also be able to prescribe medication to help the person relax at night.

· Change sleeping arrangements. Allow the person to sleep in a different bedroom, in a favorite chair or wherever it’s most comfortable.

For more information on sundown syndrome, click here. Nighttime doesn’t need to be a time to dread. An experienced care partner you trust will allow you to rest easy, knowing your loved one is safe and secure.

Tags:   Alzheimer's Disease, better quality of life, home health care, memory loss

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Wednesday, December 23, 2009

Exercise for the Frail Elderly

There are so many benefits to even moderate exercise that it should not be overlooked, even for the frail elderly. There is an endless variety of heart-pumping, strength-building and balance-improving activities that may work for the frail elderly. What works best for an individual will depend upon a number of factors, including functional skills, available resources, and perhaps most importantly, what forms of exercise are the most enjoyable for the individual and can be sustained.

Keep in mind that it is important to talk to one’s doctor before beginning a new exercise program. There may be other factors--such as osteoporosis, a heart condition, or a balance problem (possibly due to medication)--that could limit or restrict activity.

A doctor may make recommendations about:

• The types of exercise best suited to a person and those to avoid
• The intensity of the workout
• The duration of the workout and any physical limitations

The initial frequency of an exercise routine can be as short as 6 minutes, repeated throughout the day. (Documented benefits in frail elders have resulted from as little as 30 cumulative minutes of exercise a week.) Try to keep specific times each day reserved for exercise, as this routine will help foster a longer-term commitment to the exercises.

Aerobic Exercises

Exercise should not be painful. If whole body movement is not initially possible, start with exercises from a seated position. Check out Collage Video or Arm Chair Fitness online for seated exercise video tapes.

If whole body movement is possible, consider low impact exercises such as:

• Walking
• Swimming or water aerobics
• Bowling
• Dancing
• Yoga
• Tai Chi

Resistance Exercises

Resistance training is meant to increase muscle strength and can be as simple as using elastic bands of various tensile strengths. Exercise bands are inexpensive and versatile (there are many possible exercises to use them for) and a great way to get started with resistance exercise. Exercise bands can be purchased at several area stores, as well as online at Perform Better and Power-Systems. According to the classic April 2002 issue of the Journal of Gerontology: Biological Sciences, resistance training exercise just one day a week can give older adults the strength to maintain their independence and to avoid injuries.

Flexibility Exercises

Stretching to increase flexibility and freedom of movement will help frail seniors do more of the activities they enjoy. Yoga is an excellent way to incorporate stretching, and is sometimes offered at senior centers or local recreation centers. Simple stretches before and after exercise will also help to prevent injuries. It is important to stretch slowly into the desired position, as far as possible without pain, and hold the stretch for 10 to 30 seconds.

Exercise for Those with Alzheimer’s Disease

The type and intensity of exercise appropriate for someone with Alzheimer’s disease depends on the person’s degree of impairment. People in the early stages of the disease may enjoy exercises such as walking, bowling, dancing, golf, and swimming, although supervision may be necessary. Greater supervision may be required as the disease progresses, and activities that could lead to injury should be avoided.

Repetitive exercises—including walking, indoor bicycling, and activities such as folding laundry—may decrease anxiety in people with Alzheimer’s disease because they don’t have to make decisions about the activity or remember what to do next.

Baby toys can be a good option for keeping seniors active while encouraging hand-eye coordination. These toys are generally colorful, easy to grasp, and mind-stimulating.

Soft clay-like products or hand-held exercise balls can be squeezed to help strengthen the hands.

Ways to Encourage and Reinforce Exercise for Frail Elderly Patients

Make it fun: Think of favorite hobbies and how those can be utilized as exercise, or add music to the exercise environment.

Make it social: Promote exercise in groups whenever possible or create virtual groups using videotapes.

Make it sustainable: Choose affordable exercise options and set aside brief, dedicated time periods for exercise daily.

Make it a priority: Think of exercise as a prescribed health intervention and enlist reinforcement from family or caregivers.

At Live Free Home Health Care, we work gently with clients to incorporate appropriate daily exercises and some simple lifestyle changes. In addition to providing care, we can help improve a client’s mobility and thus increase independence.

Tips courtesy of US News Health, Medscape and the National Institute of Health

Tags:   Alzheimer's Disease, benefits of exercise, exercise for the elderly

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Friday, November 13, 2009

Alzheimer’s: The Rising Epidemic

Activities and Communication Tips for a Better Quality of Life

(Central New Hampshire – November 4, 2009) – Alzheimer’s Disease has been a hot topic in recent headlines, and for good reason. The progressive, degenerative neurological disease for which there is presently no cure affects an estimated 35 million people worldwide – a 10 percent increase over 2005. According to the 2009 World Alzheimer Report, the number of people with Alzheimer’s is projected to double every 20 years, to 65.7 million in 2030 and 115.4 million in 2050. Worldwide, the estimated annual economic cost of dementia is $315 billion. Every 70 seconds, someone in the US develops Alzheimer’s, according to the Alzheimer’s Association. As the more than 77 million American baby boomers begin reaching the age of greater risk, this disease and its effects simply cannot be ignored.

Because many in our local community are affected in some way by Alzheimer’s or dementia, Live Free Home Health Care is helping raise awareness of the enormous impact of this increasing epidemic. The disease can take a physical, emotional and mental toll on patients, families and caregivers. As communication skills fade for a person with Alzheimer’s, caregivers often find it frustrating to support the person’s sense of self while trying to minimize skills that may be compromised due to the disease.

“With Alzheimer’s, a daily routine is essential,” said Jennifer Harvey RN, BSN, Owner, Clinical Director of Live Free Home Health Care. “Activities that are done regularly, even at the same time every day if possible, may help establish routine and increase the person's sense of stability. Following structured activity ideas that involve and interest the person w/ Alzheimer’s will help minimize the disturbing behaviors associated with the disease,” such as agitation, anger, frustration, depression, wandering or rummaging.

Harvey offers the following structured activity ideas for helping Alzheimer’s patients experience a better quality of life:

• Motor: Take a walk, do chair exercises, stretch, or even do a dance using just the hands – the important thing is to encourage some sort of movement.
• Sensory: Listening to music on tapes or CDs (not the radio, as commercials can be confusing) while looking at old photographs, watching TV or movies, looking at picture books, sniffing perfume, soap and spices, or working on basic art projects are beneficial to the patient. Be careful to avoid sensory overload by eliminating competing noises.
• Interactive: Invite friends or relatives over for tea or coffee, reminisce, asking basic questions while looking at old photos, play simple card or board games, or try pet therapy (be sure to match the animal’s activity and energy level with that of the individual).
• Cognitive: Practice computerized memory exercises, do simple crossword puzzles or word finds, play games such as “Simon Says” or “I Spy”.

Because Alzheimer’s gradually diminishes a person’s ability to communicate, it is important to help people with dementia express their thoughts and emotions, as well as help them understand others. Here are some tips to help in communication and understanding:

• Create a ‘kind voice,’ talking slower, lower and clearly, smiling in the process.
• To orient the person and obtain his or her attention, call the person by name, identify yourself, and be sure to approach from the front so there are no surprises.
• Ask one question at a time, using short simple words and sentences.
• Avoid using logic and reason, as well as quizzing.
• Avoid criticizing, correcting or arguing, and do not take any negative communication personally.
• Let the person know you are listening and trying to understand what is being said by maintaining eye contact, being careful not to interrupt.
• Patiently wait for a response as extra time may be required to process your request; repeat information and questions. If there is no response, wait a moment before asking again.
• Focus on the feelings, not the facts, as sometimes the emotions being expressed are more important than what is being said.
• Let the person think about and describe whatever he or she wants.

If you fear someone you love may be showing signs of dementia or early stages of Alzheimer’s disease, Live Free Home Health Care recommends a memory screening. Though a memory screening is not used to diagnose any particular illness and does not replace consultation with a qualified physician or other healthcare professional, it is a good first step towards diagnosis and treatment. For more information about memory screenings in the local community or dementia and depression in older adults, please contact Live Free Home Health Care.

About Live Free Home Health Care, LLC:

Serving central and northern New Hampshire, Live Free Home Health Care, LLC is dedicated to providing top quality care in the comfort of home as an alternative to assisted living facilities or nursing homes. Family owned and operated, Live Free Home Health Care offers a wide range of services, from companion care and assistance with activities of daily living to skilled nursing, and all care is supervised and updated by a registered nurse. Live Free Home Health Care also offers medical alert systems to provide extra peace of mind should an emergency care need arise. Whether the need is for short or long term care, Live Free Home Health Care’s compassionate staff promises to treat each client respectfully and like a cherished family member. For further information, contact (603) 217-0149 or visit www.LiveFreeHomeHealthCare.com.

Tags:   Alzheimer's Disease, better quality of life, caregiver, communication, dementia, depression, Jennifer Harvey

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Thursday, October 22, 2009

Communicating Effectively With Someone With Alzheimer’s

Caring for an individual with Alzheimer’s disease isn’t always a walk in the park; in fact, it can be downright stressful. Between memory loss, repetitive questions, false thinking or aggressive behaviors, each day often brings new challenges.

A person’s understanding of the disease as well as their attitude about the illness can have a large impact on the way day-to-day caregiving responsibilities are managed. Just because this illness has taken over someone close to you, it doesn’t have to conquer you as well.

So what do you do when your loved one blames you for something you didn’t do or becomes paranoid that you are plotting against him or her? How about when someone sees objects that aren’t there or says things that simply don’t make any sense?

If your first instinct is to try to orient the person back to reality, you are not alone. Many caregivers spend endless hours trying to prove who they are, where they are and what they are doing, but to no avail. They mistakenly believe that just by showing family photos or having other family members confirm information that the person with Alzheimer’s disease will catch on and it will become clear for them. Even though the caregiver’s heart is in the right place, these efforts most often do not succeed. Their loved ones may continue to press the issue, and even become angry or hostile at the “evidence” presented to them.

Fortunately, there are ways to manage daily challenges in order to minimize a caregiver’s stressful feelings and improve the odds that an individual with dementia will respond positively.

One of the best approaches to use with people with dementia is Validation - a technique that confirms their right to feel a certain way and express their emotions regardless of the situation. The validation theory, developed by Naomi Feil, suggests that an individual could be revisiting past events or trying to solve unfinished business. This helps explain why some people feel the need to go to work years after they retire or pay off a debt from decades ago. By validating their experience, you are meeting them where they are and sending a message that you still accept them no matter what.

Another powerful approach to utilize is redirection-a behavioral intervention that shifts the individual’s focus, by distracting the person or moving away from an undesired topic or behavior to something more pleasant. Here are some examples:

When your mother says, “I want to go home!” Instead of saying “This is your home! Don’t’ you remember? You’ve only lived here for 30 years!” Try Saying “Of course you want to go home! Your house was the prettiest on the block. Why don’t you tell me about those tulips you planted in your front yard?” Why? Memory impairments and disorientation can cause people to forget where they are. When they want to go “home,” it really signals a desire for a sense of safety and familiarity. Bring mom “home” by reuniting her with her favorite memories of what home represents.

When your wife says, “Get away from me, you’re not my husband!” Instead of saying “But I am your husband! Look at our matching wedding rings. You know, you really upset me when you don’t remember who I am.” Try saying “You must love your husband very much. I can tell by the way you talk about him. Why don’t you tell me about your wedding day?” Why? Memory loss can cause individuals to forget even their closest loved ones. When your wife becomes agitated, respect her space, validate the love she feels for her spouse, and allow her to talk about “him” while you are sitting right beside her. Even though she may have forgotten you today, hearing her talk about you will demonstrate that you are still very close to her heart.

When during meals, your father refuses to eat and says, “You’re trying to poison me.” Instead of saying “That’s ridiculous! Why would I ever do such a thing? Eat your meal and stop making up crazy stories!” Try saying “Dad I understand you are feeling afraid, but I want you to know that I would never let anything bad happen to you. You are safe with me. By the way, this meatloaf is delicious. I am having a big plate of it myself. Let’s have some together and you can tell me all about the fishing trip.” Why? It is difficult, if not impossible to rationalize with people with dementia. Instead of trying to orient Dad back to reality, instill a sense of safety, and demonstrate it by eating the same meal as him or taking a bite from his plate. Once you’ve established trust, you can quickly refocus him by shifting the conversation to something more pleasant, such as a fun day he had by the docks.

When your sister says, “You stole my money! Give it back!” Instead of saying “I’m sick of you accusing me every time you hide your money. You stuffed it in your drawer five minutes ago. I saw you do it, so stop blaming me.” Try saying “Oh no, your money is missing? I can see why you’re upset. Well, don’t you worry because I am going to help you look for it.” Why? It is common for people with dementia to hide items and forget where they are moments later. Since it can be embarrassing to admit this, individuals sometimes accuse others to take the focus off themselves. Rather than trying to deflect blame, simply let your sister know that you understand how she feels and that you understand how she feels and that you want to help her resolve the situation. Then walk her over the drawer and ask her to open it. When your sister finds her money, allow her to take pride in finding it all by herself.

When your grandmother says, “I have to leave now. I need to pick up Jimmy from school.” Instead of saying “Grandma, Jimmy is a grown man. He’s 60 years old. You’re not going anywhere.” Try saying “Oh Grandma, you have always been such a loving mother to Jimmy. Why don’t you come with me to get a drink of water and tell me all about what you love to do with Jimmy after school?” Why? People with Alzheimer’s disease often live in the past by re-creating experiences that happened long ago. Despite the fact that Grandma hasn’t picked Jimmy up from school in decades, her maternal instinct is still very strong, and she feels an urgency to follow the same routine she did while he was growing up. Take this as an opportunity to reunite your grandmother with those happy memories: while you are distracting her from going to the front door, she will tell you all about those wonderful times she had with Jimmy and will forget about wanting to leave.

When your uncle believes he’s still at work. He treats you like an employee and tells you he needs the paperwork finished by the end of the hour. Instead of saying “Are you still starting with that nonsense again? You retired in 1985. How many times do I have to keep reminding you?” Try saying “You really run a tight ship around here! I guess that’s what makes you such a good boss. I’ll make sure to get the paperwork to you, but I could use a little help. Can you assist me with one of the documents?” Why? It’s not uncommon for people with Alzheimer’s disease to strongly affiliate with important roles they have taken on in the past. The fact that your uncle thinks he’s at work suggests that a job is still very meaningful to him. Use this moment to create an activity that can contribute to a sense of purpose. Bring him a phone bill or other document and allow him to “help” you interpret it. Support his efforts and remind him what a great boss he has always been.

Tags:   Alzheimer's Disease, caregiver, communication, dementia

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Tuesday, October 20, 2009

Get Ready for Grooming

Most people take great pride in maintaining their appearance. For individuals with Alzheimer's disease or related dementias, grooming tasks that were once simple such as combining hair, shaving and brushing teeth can become extremely complex ordeals. They may look at a comb or razor and have no idea what to do with it; they may have lost their ability to sequence tasks; or they may be experiencing emotions like fear, resistance or anxiety that can sabotage their personal care efforts. These tips can help ease the process:

• Ensure a proper setting. An environment conducive to the activity at hand can help boost a person's concentration and cooperation. Make sure the area is a comfortable temperature, is free of distractions, and has plenty of light. Also remember that privacy counts.
• Adjust grooming tools. Making the switch to safer, more effective supplies can help prevent injuries and simplify the process. Options include using an electric shaver as opposed to a traditional razor. You can also purchase items like foam grips for toothbrushes and hair washing trays or try different products like dry shampoo.
• Develop a routine. Try to perform tasks in the same order and at the same time each day. Also, doing familiar activities can be comforting to someone with Alzheimer's disease. Also consider continuing past habits. If someone is accustomed to going to the barber or beauty shop every week, keep it up if possible.
• Keep it simple. The ability to multi-task is difficult for someone with Alzheimer's disease. So it is likely to be easier to accomplish a task by telling a person what to do one step at a time, using a quiet, calm tone and smiling.
• Demonstrate techniques. Visual cues can move the process along, especially when communication skills diminish. Illustrate what to do with a comb by combing your own hair, or with a toothbrush by brushing your own teeth. Then encourage the person to copy your behavior.
• Build on a person's strengths. Encourage the person to handle self-care that is still withing abilities and do not show discouragement or lose patience if the task cannot be performed. Teamwork may be helpful. Perhaps you need to apply the toothpaste, but then the person with dementia can carry out the brushing.
• Eliminate surprises. Explain what you are doing if you have to complete a task for the person with dementia. Say "I'm going to cut your nails."
• Select favorite items. Let the person select and apply preferred products, such as cologne, make-up or toothpaste. Giving an individual with dementia input adds an element of independence.
• Be creative. A technique that worked one day may backfire the next. This is due to the progressive nature of the disease. You have to be creative in your approach. For example, one study found it effective to use wet wash clothes or to pour water from a pitcher rather than use a spray to rinse a person's hair.
• Be patient. Understand that the activity may take a while so be sure to allow enough time. Rushing the process can stress both you and the person you are caring for.
• Set realistic standards. Recognize that perfection is not always possible. If shaving becomes to difficult, for example, it's okay to grow a beard. If necessary, skip the non-essential tasks in favor of concentrating on crucial grooming like oral hygiene.
• Prepare in advance. Have everything ready for grooming before hand. The right supplies can limit confusion, simplify grooming and reduce stress.

For more information on caring for a person with Alzheimer's disease or dementia visit our website at http://www.livefreehomehealthcare.com.

Tags:   Alzheimer's Disease, communication, dementia, grooming

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