Tag Archives: Dementia

Getting By with a Little Help……

735910_64656392Many people benefit from products known as assistive devices in the medical equipment world.  These are products that help people continue to be independent in their activities of daily living.  They allow people with physical limitations to feed, bathe and dress themselves, do things around the house, as well as move from place to place.  All kinds of activities can be maintained through the accommodations made with assistive devices.

We are all familiar with the most obvious ones like canes, walkers, wheelchairs and scooters.  And many of you may also have seen raised toilet seats and grab bars.  But there are also all kinds of reachers, grabbers, extenders and grippers that can modify activities such as pulling on your socks, reaching your lower legs and feet in the shower, grasping your toothbrush and holding onto your utensils.  These devices not only create a way to complete a task but also, often, a safer way to do them.

Simple things like grab bars, raised toilet seats and shower chairs can make bathroom activities safer and easier to do.  Many items you can find on your own and purchase from a medical supply store.  You’ll even find a basic selection of these types of items in drug stores and the other stores you frequent.

However, if you know that your loved one needs some assistance but are unsure of what would really help the most, you might want to consider asking the physician for an order for a Physical Therapy and/or Occupational Therapy assessment.  The therapist can work with you and your loved one to identify the deficits, maximize their ability and make recommendations about the products that might be helpful as well as work with them on how to use the device!

Also remember that many medical/assistive devices may be covered by Medicare or your insurance (with a script from your physician).  It would be worth asking and investigating the possibilities before making a purchase (look for the Durable Medical Equipment benefit information in your policy).

There are also many little things that you can try based on your own observations!  While my father was still living at home I noticed that he was having a difficult time with the heavy glassware that my mother was using and actually dropped his glass at dinner one evening.  I suggested to my mother that she try using lighter glasses at meals and this really helped!  With the increased number of falls that Dad was having I also encouraged Mom to pull up all the little scatter rugs (tripping hazards along with clutter, electrical cords, poor lighting, and raised doorway thresholds).  Just be observant and try minor adjustments.

For a time, my father was using walking sticks to aid with his balance (something one of his friends suggested to him) and it did seem to work well for him until his dementia advanced and weakness became more prominent.  Then, I came to refer to them as his tripping sticks as he was no longer able to use them in a beneficial way and more often than not they were getting tangled up in his feet rather than aiding him in his balance.  He resisted the change to a walker but when he had to be placed in a facility, the therapist was able to prevail upon him that the walker would be safer and he began to use the walker (though the dementia still affected his safety awareness and judgment when using it).

For optimal mental health and wellbeing, the goal is to stay independent for as long as possible in the safest way!  Seek the help of a physician and/or therapist in helping you to find the devices that might best help you help your loved one remain active!

On the journey with you…….Kathy

For more information about fall prevention check out:  http://www.scdhec.gov/health/chcdp/injury/docs/home%20safety.pdf

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Does She Even Know I’m Here?

Caring for a loved one with dementia is truly a difficult road.  To see someone important in your life slowly slipping away from you can be heart wrenching.  And when your loved one enters into the later stages of dementia, you may wonder if they even know that you are there any longer.

This video can affirm for you that the connection can still exist.  Though you may not be greeted with that connection during each visit or interaction, when it happens it can be very powerful for you.

 

If you are caring for or have a loved one who is suffering from dementia, please watch this video…..all the way to the end.  Though it may initially break your heart, it will ultimately lift you up and validate your ongoing efforts to connect to your loved one.

 

Naomi Feil, founder of Validation Therapy, shares a breakthrough moment of communication with Gladys Wilson, a woman who was diagnosed with Alzheimer’s in 2000 and is virtually non-verbal.

 

On the journey with you,

Kathy

4 Dementia Impersonators

Kathy Eynon, Parent Care Alliance

Dementia Impersonators

Being given a diagnosis of dementia for a loved one can certainly be devastating news.  But, it is especially important, since there is no cure yet for Alzheimer’s and other forms of dementia, to get an accurate diagnosis.

With many types of dementia, there are treatments that can slow the progression of the disease and allow the patient to maximize their cognitive function for as long as possible.  An accurate diagnosis allows the patient to have access to the appropriate treatments promptly.

But be aware that there are many things that can mimic the signs and symptoms of dementia.  Many of these other conditions can be treated and/or eliminated which will relieve those dementia-like symptoms.

Depression – Because someone who is depressed may exhibit some of the same signs as someone with dementia, it is important to consider this possibility.  When people are depressed they often have a difficult time concentrating and may be more inclined to forget things.  As both of these symptoms are hallmarks of dementia, it can be misinterpreted.  The physician who is assessing for dementia should also be assessing for depression.  Treating for depression can sometimes eliminate the signs of dementia!

Medication – Many commonly used medications in the elderly can lead to symptoms of dementia:  Confusion, Memory Loss and Disorientation.  While these can easily be attributed to dementia, it warrants an investigation and medication review if your loved one is on medications for:  Parkinson’s disease, Allergies, Migraines, Irritable Bowel Syndrome, Depression, Colds and/or Diarrhea.  Also pay attention if the patient is taking any medication for sleep disturbance/insomnia.  By eliminating a problematic medication, the family may see the dementia-like cognitive changes resolve.

Nutritional Deficiencies – Nutritional deficiencies account for as many as 5% of dementia type issues.  The deficiencies most commonly associated with symptoms of dementia are deficiencies of the B Vitamins:  Thiamine (B-1), Niacin (B-3), Folate (folic acid), and Vitamin B-12.  Vitamin B-12 deficiencies can be addressed with B-12 injections as, often, the elderly lack the factor in the gut needed to absorb vitamin B-12.  Other deficiencies can be managed with supplementation.

Substance Abuse – This is not something that we automatically associate with our aging parents.  However, substance abuse is being labeled the ‘Invisible Epidemic’ by some due to the startling fact that 17% of older adults are affected by alcohol and prescription drug misuse.  Substance abuse may go undetected in this population due to several facts:  They are often less involved in the social mainstream, they are less likely to get into trouble with the law, and they are retired so that the abuse is not likely to cause a job loss.  But, alcohol impairs mental function more and more as we age so that even a drink or two can impair function in a more noticeable way.

There are many other conditions that present the symptoms of dementia so you can see the importance of a complete medical work-up which evaluates all possible factors.  The physician needs to do a complete and thorough examination which should include not only a physical exam, but also a detailed history and interviews with close family members if possible.

Getting the appropriate treatment for any of these conditions is important in making the life of our aging loved ones as healthy and full as possible.

On the journey with you…….Kathy

Kathy Eynon is an Eldercare Coach and Consultant who works with those struggling to cope with the demands of caring for an aging parent.  She can be reached by email at: Kathy@ParentCareAlliance.com.

Assessing Pain in Someone with Dementia

Eldercare, Elder Care, Parent Care Alliance, Kathy Eynon  It is important to realize that people with dementia experience pain just as much as anyone else does.  It is a common symptom that frequently goes unrecognized and untreated even though treating pain is not a difficult thing to do.  I think all of us would agree that uncontrolled pain can seriously affect a person’s quality of life.

But, when a person with dementia is unable to say they have pain, caregivers need to work extra hard to recognize the signs of pain that might be exhibited.

People with dementia are not immune to the common causes of pain in the elderly:  Stiffness and pain in the joints, pain from pressure if they have been sitting too long in one position, injuries from falls or bumping into things, or just a plain old headache!

And often relief can be as simple as a change in position, gentle massage, a warm compress, an air mattress or special seat cushion, or a dose of Tylenol.

So how do you assess for pain?

You might first, simply ask.  Many people with even moderate to severe dementia can still provide some information about their pain.  Keep the questions simple.  They may not recognize the word ‘pain’.  Ask, ‘Does it hurt?’ or ‘Is it sore?’

But you may also need to be prepared to look for other signs.  If you know the individual well, you may simply notice that, when they are in pain, they shout out or become very withdrawn and quiet.  Other signs that you might observe:

Vocalizations:  whimpering, groaning or crying

Facial Expressions:  looking tense, frowning, grimacing

Body Language:  fidgeting, rocking, guarding a body part

Behavioral Changes:  increased confusion, agitation, refusing to eat

If you observe these types of changes, try some pain relieving measures and assess the response.  When I worked as a nurse on the 3-11 shift, there were a certain number of dementia residents that exhibited increased agitation in the evening which made it difficult for them to sleep.  When other measures didn’t seem to work, Tylenol was often the answer.  Just as I myself am achy at night sometimes, they were too!

Nobody should have to live in pain simply because they cannot tell you that they have pain.  As caregivers, it helps us to help our loved ones if we pay attention to the signs and try to respond.  Good pain management is a quality of life issue that should not be ignored.  We should be careful not to lump the behaviors associated with pain in with those of dementia.

Caring for a loved one with dementia presents great challenges.  Being aware of and helping your loved one to manage their pain may make the job a bit easier for you and certainly makes their life more comfortable!

On the journey with you…….Kathy

Kathy Eynon is an Eldercare Coach and Consultant that works with those struggling to cope with the demands of caring for an aging parent.  She can be reached by email at: Kathy@ParentCareAlliance.com.

Through the Loving Eyes of a Daughter

A very dear friend of mine sends me updates periodically about how things are going with her father who has dementia.  Her stories of events always make me smile because I relate to the dementia scenario so well; as a daughter and as a nurse.  Because in January I am featuring other bloggers/writers on my site while I am on vacation, I asked her permission to share this tale with you.  I hope you enjoy her tail and her sense of humor, caring and love that comes through in her words.

Took dad to lunch at Arby’s today since he was such a good patient for the dermatologist and stayed very still while she excised a basal cell the size of Lower Manhattan. Or so it seemed to me. I got to sit in the room and watch the whole thing and believe me, I’d rather do the insurance paperwork than watch excision, cauterization, and suturing.

I ordered the French Dip since it was the special at 2 for $5; also ordered coffee and curly fries.

I didn’t know that the dip and the coffee look exactly the same to a person with dementia. So my advice to you, should you ever be caught in this same situation, is to watch VERY CAREFULLY so the one with the dementia doesn’t drink the dip! I WAS able to avoid that disaster but had to re-explain the purpose of the dip no less than 54 times during the meal.

Then there is the matter of those ‘curly’ fries. Fries are not meant to be ‘curly’. Not in any previous life were they ever served ‘curly.’ Therefore, they must need to be ‘straightened’. This takes an exorbitant amount of time as each one must be examined and pulled down to its lowest denominator. As the person who HAD to soon get back to work, this was an agonizing task! I mentioned the need to return to work and his response was that he felt sorry for me and that HE was in no rush!

So we smile and we wait. And we wait and we smile.

We eventually arrive back at his Assisted Living building. “YOU live here?” he asks. “NO, YOU live here!” “I live HERE?” he responds. “Yes, you LIVE here and I WORK here.” A concept that is IMPOSSIBLE to reconcile…..how could I possibly work where he LIVES?? I don’t know, but I have answered that question every day for the past 469 days since he moved in. And will continue to answer it calmly, daily, as if it was the first time it was ever asked, because that is how you deal with dementia, calmly and daily.

I wouldn’t have missed this ‘quality time’ for anything. I mean really, how many more days will we have together. He is a trip and I am blessed by his antics and sense of humor! You can’t make this stuff up!!

 

On the journey with you…….Kathy

Kathy Eynon is an Eldercare Coach and Consultant that works with those struggling to cope with the demands of caring for an aging parent.  She can be reached by email at: Kathy@ParentCareAlliance.com.