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

All posts within: dementia

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 29, 2009

Holiday Blues - Depression in the Elderly

The holiday season is quickly coming upon us. If you are a caregiver for an elderly loved one, you may notice a change in your loved one's mood as the holidays approach. Perhaps you are one of many, who visit elderly parents and family during the holidays who live a distance away. When you visit you may notice that loved ones are not as physically active, or they show symptoms of fatigue or sadness and have no interest in the holiday or in their surroundings.

According to the National Institutes of Health; of the 35 million Americans age 65 or older, about 2 million suffer from full-blown depression. Another 5 million suffer from less severe forms of the illness. This represents about 20% of the senior population -- a significant proportion.

Depression in the elderly is difficult to diagnose and is frequently untreated. The symptoms may be confused with a medical illness, dementia, or malnutrition due to a poor diet. Many older people will not accept the idea that they have depression and refuse to seek treatment.

What causes depression in the elderly?

It is not the actual holiday that causes depression, but the fact that holidays tend to bring memories of earlier, perhaps happier times. Additional contributing factors that bring on depression may be the loss of a spouse or close friend, or a move from a home to assisted living, or a change with an older person's routine.

Depression may also be a sign of a medical problem. Chronic pain or complications of an illness or memory loss can also cause depression. In addition, diet can also be a factor when proper nutrition and vitamins are lacking.

As an example, Selma’s husband passed away, a few months before Christmas. Her family lived close by and would call or drop in often to check on her. Selma seemed a little preoccupied and tired, but this was to be expected as she had been the caregiver for her husband for many years. It wasn’t until the family noticed that her holiday decorations were not out and her yearly routine of Christmas card writing was not happening that they began questioning her mental and physical well being.

A trip to her physician confirmed depression, caused by not only the loss of her spouse, but a vitamin B12 deficiency. There were both mental and physical reasons for her depression.

Symptoms to look for in depression might include:

• Depressed or irritable mood
• Feelings of worthlessness or sadness
• Expressions of helplessness
• Anxiety
• Loss of interest in daily activities
• Loss of appetite
• Weight loss
• Lack of attending to personal care and hygiene
• Fatigue
• Difficulty concentrating
• Irresponsible behavior
• Obsessive thoughts about death
• Talk about suicide

How do you know if it is depression or dementia?

Depression and dementia share similar symptoms. A recent article on Helpguide.org gives some specific differences:

In depression there is a rapid mental decline, but memory of time, date and awareness of the environment remains. Motor skills are slow, but normal in depression. Concern with concentrating and worry about impaired memory may occur.

On the other hand, dementia symptoms reveal a slow mental decline with confusion and loss of recognizing familiar locations. Writing, speaking and motor skills are impaired and memory loss is not acknowledged as a being problem by the person suffering dementia.

Whether it is depression or dementia, prompt treatment is recommended. A physical exam will help determine if there is a medical cause for depression. A geriatric medical practitioner is skilled in diagnosing depression and illnesses in the elderly. If you are a care taker of an elderly person it may be beneficial for you to seek out a geriatric health care specialist. For more information on senior health services go to http://www.longtermcarelink.net/about_senior_health_services.htm or visit our website at www.livefreehomehealthcare.com.

Treating depression in older people.

Once the cause of depression is identified, a treatment program can be implemented. Treatment may be as simple as relieving loneliness through visitations, outings and involvement in family activities. In more severe cases antidepressant drugs have been known to improve the quality of life in depressed elderly people. Cognitive therapy sessions with a counselor may also be effective.

As a care giver or family member of a depressed older person, make it your responsibility to get involved. The elder person generally denies any problems or may fear being mentally ill. You can make the difference in and remove the Holiday Blues from seniors suffering from depression.

The Geriatric Mental Health Foundation offers a “Depression Tool Kit.” To read more about the tool kit and depression in the elderly go to http://www.gmhfonline.org/gmhf/consumer/depression_toolkit.html

Tags:   caregiver, dementia, depression, holiday blues

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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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Monday, September 21, 2009

Preventing Dementia

While you can’t control all factors that contribute to Alzheimer’s and other forms of dementia, such as genetics and age, there are many contributing factors that you can control.

An increase in physical activity is shown to decrease the probability of developing many types of dementia. Exercise promotes an increase of blood flow to vital organs including the heart and brain. At least 30 minutes of physical activity such as aerobics and brisk walking can help lower blood pressure. High blood pressure causes damage to blood vessels in the brain. Following the DASH diet (Dietary Approaches to Stop Hypertension) can also aid in lowering high blood pressure. Another advantage of exercise is weight control, which is a crucial instrument in preventing dementia. Being overweight can affect the way the body creates and destroys insulin that may cause brain inflammation.

Alcohol intake is a contributing factor in developing certain forms of dementia, specifically alcohol related dementia, which is one of the top five most common dementias diagnosed in elderly people. Excessive alcohol consumption also worsens psychiatric and intellectual symptoms of dementia. According to many professionals a person that regularly drinks more than one ounce a day should report that to their primary care provider. People with dementia should not drink at all.

It is also very important to continually challenge your mind. Sudoku and other puzzles books are great tools for keeping ones’ mind active. Learning new languages or taking art classes can helpful as well.

Keep in mind that preventative measures are continually emerging so be sure to discuss any lifestyle changes with your doctor.

Tags:   Alzheimer's Disease, dementia

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