Music and Dementia


Christmas music is EVERYWHERE right now: in the car, at the grocery store, in the elevator, on hold on the phone. Have you ever noticed just how many places we hear music? Music is everywhere, and whether it’s in the background or turned up as far as it will go, music affects us and is important.

Research shows that one of the last parts of the brain to be affected by dementia is the part that holds rhythm. Even the brain thinks music is important! Here are some cool things that music can do for those with dementia (and you, too!):

Music evokes memories.

A song from your wedding comes on the radio, and you immediately remember that day. A song that was popular when you were in high school transports you back to your first date with your high school sweetheart. Hearing Amazing Grace takes you back to your church home growing up. Songs can transport us to other times and places.

Music alters mood.

Soothing classical music may help your mom calm down when she is a bit agitated. A happy, upbeat song may be good when you are trying to get some tasks accomplished with your loved one (like bathing or filing fingernails). Quiet, soft music may help your dad settle down at the end of the day to get ready for bed.

Music engages.

Your loved one may be able to sing every word to favorite songs long after they are not able to effectively communicate in conversation. Music can lead to dancing, snapping fingers, clapping and smiling.

Here’s how you can make music work for you and your loved one:

  • Let your loved one choose the music. Your loved one has so little choice now. Allow your loved one to choose what he or she would like to listen to.
  • Figure out what kind of music your loved one prefers. What decade? What genre? Seek out songs and artists he or she might like. You can find just about any song, from any time period, on YouTube.
  • Use music to set the mood and help you accomplish tasks. Your loved one’s personal care routine might be a lot more fun (and less dreaded) with music.
  • Avoid over-stimulation. Choose music without commercials, turn off the TV, shut the door, and don’t turn it up too loud.
  • Encourage movement. Dance, snap, clap. Movement is fun while also working range of motion and fine motor skills and providing physical exercise.
  • Pandora, iHeartRadio, and Spotify are all inexpensive or free ways to get specific types of music.
  • Create a playlist for free on YouTube of your loved one’s favorite songs. Fill an iPod with favorite songs. Or use Apple Music or Spotify (monthly subscription fee) to create different playlists on your smartphone, so you can take music with you wherever you go.
  • Have a carpool karaoke session (a la the Late Late Show with James Corden)… and don’t worry about who might be watching from other cars.
  • DIY a sing-a-long: just turn on close captioning for a musical on TV.
  • Join in! Sing. Dance. Embrace the music and the beautiful connection it can bring between you and your loved one. If you’ve ever wished life (or even just a moment in time) could be a musical, make it so.

If you want to learn more about music and dementia, we recommend the Alive Inside documentary.

Preparing for the Holidays


The holidays are busy. Parties to attend, family to visit and family to entertain, gifts to buy, dishes to make. It can all be too much – especially when you are caring for a loved one with dementia. But it doesn’t have to be this way.

The point of the holidays isn’t all the stuff and the hoopla. The point is to celebrate, to honor, and to cherish. It’s okay if the season isn’t as grand as it once was. Don’t expect it to be. You want to know the best holiday recipe? A heaping cup of simplicity and a half of cup of planning with a pinch of good communication and boundary setting. That makes for some joyful days!

Here’s our recipe for happy holidays. We suggest you start prepping the ingredients now, but in your holiday prep, keep in mind that there’s no perfect holiday. Perfection is unattainable, but really good days are possible. This is how we think you can make them happen:

Declutter the calendar.

Don’t plan to attend every event and party. It is OK to say No to invitations (and not feel guilty about it). Strategically pick and choose which events you would like to attend. For example: Instead of hosting your usual Christmas Eve dinner with the whole family and you cook everything, choose to host a lunch potluck. Lunch may be a better time of day for your loved one, and a potluck takes the pressure off you. AND/OR you can ask another family member to host, so you and your loved one can attend and leave when needed.

Scale down, and turn down the volume.

Your loved one may not be able to handle a full day of the entire family. Limit time at gatherings. You can also find a quiet room for your loved one to be in, and ask family and friends to visit one-on-one in a much more manageable environment.

Stick to the routine.

The holidays can get our schedules out of whack. Keep routines as much as possible because routines make for easier days. Serve meals at regular times, schedule afternoon rest at the regular time, go to sleep at the regular time. Keeping to a schedule will help your loved one remain as rested as possible.

Involve your loved one.

While Mom may not be able to independently make her famous coconut cake, she can help pour pre-measured ingredients and stir everything together. While Grandpa might not be able to chop wood or light the fireplace, he can help carry in a piece of wood. While your wife may not be able to play the piano, she can still sing along, dance, or just enjoy the music.

Make a wish list for you and your loved one.

Your gift wish list should look different than it has in the past. Here are some things we suggest: money to pay for care, soft blankets, 30-piece puzzles, magazine subscription, gift card for stores or for meals to-go, favorite music, personalized book with family pictures and captions about who is in each picture/what is going on in the pictures (recommendation: Shutterfly).

Help your family and friends know how to interact.

Explain to family and friends about your loved one’s current state, so they will know what to expect. Remind them NOT TO QUIZ. Instead of asking, “Do you know who I am?” coach them to prompt: “Grandpa, it’s Jason. I’m so glad to see you.” And instead of asking, “Susan, who is in this picture?” coach them to tell a story: “Susan, (while showing the picture), here is a picture of us in Gatlinburg. That was a fun trip. It snowed the whole time.” Remind family members not to argue, even if what is being said makes no sense. Go with the flow of the conversation.

Simplify decorations.

Too many decorations may be too much for your loved one to take in… and too much for you to put up. It is OK to scale down. Maybe you only decorate the mantle or have a table top tree instead of decking out the whole house. Maybe you just put a wreath on the door instead of lights everywhere. Maybe you just put out a pretty tablecloth instead of the endless china set.

Plan ahead.

Planning ahead allows you to create opportunities for success. Order your groceries online to avoid the craziness of the aisles at the store. Start your gift shopping early to avoid the rush and crowds. Crowds are overwhelming. Plan around them.

Make time for yourself.

Plan for an in-home caregiver, so you can go to a Christmas party or get shopping done. (Schedule this EARLY!) Or ask a family member to come stay with your loved one, so you can get things done.

Enjoy!

Sit with your loved one and listen to Christmas music. Turn down the lights and watch the tree glow. Go for a drive to see lights. Watch an old Christmas movie that you both have always loved. Eat pumpkin pie for breakfast. Take time to enjoy the holidays and your family.

2 Important Bonus Notes:
1. If you are traveling, plan, plan, plan, and see our blog post on travel tips.
2. If your loved one lives in a facility, ask when holiday activities are scheduled, and plan to be there to celebrate with your loved one.

Tips for Mealtime


The following are tips for enjoying meals with your loved one with memory loss. As always, if this blog post sparks a question or if you need advice for your specific situation, give us a call at 901.854.1200. We would be happy to help!

Simplify.

  • Eat at the table, not in front of the TV.
  • Limit table décor. Plastic fruit can be mistaken for real fruit. Centerpieces, chargers, napkin rings, salt and pepper shakers, and placemats all on the same table can be distracting.
  • Limit utensils to reduce confusion.
  • Avoid busy patterns on the table cloth.
  • Be sure food, plate, and table are contrasting colors, so food can be easily seen.
  • If your loved one seems to be eating just a certain portion of his or her food, you may need to rotate the plate throughout the meal.
  • Limit choices. Three veggies and a meat might be too much, instead offer the meat and then one veggie at a time.

Serve food that is ready to eat.

  • Check the temperature. Your loved one may not know if the food is too hot or too cold.
  • If your loved one is not able to cut the food, serve it pre-cut.
  • Be mindful of which utensils are used. A fork may be easier than a spoon, or finger foods might be best.
  • Use plates or shallow bowls with a lip, so there’s something to push against to get food on the fork/spoon.

Serve to your loved one’s preferences.

  • Food preferences may change.
  • If your loved one has eaten spaghetti his or her entire life, but now says, “I don’t eat spaghetti,” serve something different.
  • Serve foods with different colors and textures.
  • If your loved one doesn’t remember that he or she has already eaten, you might offer multiple smaller meals rather than arguing that you have already eaten.

Enjoy your meals together.

  • Don’t rush. It may take your loved one longer to eat than it used to.
  • Your loved one may look to you for cues on how to eat – what to eat first, whether to use hands or a fork, etc.
  • Savor the good stuff! Find foods you and your loved one really like, and enjoy them often.
  • Shared meals are important. They are social. They build and strengthen relationships. Try not to treat them as an item on the checklist. Treat them as an opportunity to enjoy one another. Good food, better company!

The Importance of Laughter


Knock. Knock.
“Who’s there?”
“Humor.”
“Humor who?”
“Humor me for a second, and read this blog post.”

We know… we should stick to the caring and supporting and leave the knock, knock jokes to someone else. If you made it through that joke without cringing or scrunching your face up in confusion, we applaud you. Go treat yourself to a cookie (or several).

Here’s the point: It is so very important for you, as a caregiver, to laugh. Life is hard. Hold on to your sense of humor. Sure, a sense of humor won’t change your situation, but it can change your perspective.

Take these 2 examples:

Your dad stands up in the middle of a restaurant and starts singing and dancing. One of his favorite songs is playing in the background at Huey’s. You can be mortified and quickly ask him to sit down, or you can get up and dance, too. Because WHO CARES?

Your wife says something completely inappropriate to a total stranger. You can blush furiously and angrily shush her. Or you can let it go and laugh later… because come on… it was a pretty funny comment.

*Serious side note: We are not encouraging you to laugh AT your loved one. Laugh WITH him or her. Laugh at the bizarre, awkward, ridiculous situations you get into.

Laughter isn’t just an important part of your emotional health, it’s also essential to good mental, physical, and spiritual health. There are lots studies to back this up, but we won’t bore you with the details.

You need to laugh. You have permission to laugh. You carry a heavy load as a caregiver, so we invite you to put down that load for a few minutes and remember what it’s like to laugh until you cry snort. What it’s like to smile. What it’s like to embrace ridiculous. What it’s like to get carried away into a vortex of funny Internet videos.

So if you’re needing a laugh, here are some things that have made us laugh recently. A little inspiration, if you will. Happy laughing!

This video from Jeanne Robertson because we’ve all had an embarassing clothing malfunction:

This video from Ellen about autocorrect mishaps… because it could happen to you:

This BuzzFeed article with hilarious posts about dogs because dogs are the best (our therapy dog, Daisy, made us say that).

This video from The Late Late Show with James Corden because he’s never not funny:

This video from BuzzFeed of men trying on Spanx (Slightly inappropriate? Maybe, but try not to laugh.):

This epic homemade commercial. We’re not entirely sure what’s going on in it, but it makes us laugh.

This video of quadruplets laughing because what’s not to love about laughing babies:

And finally, these well-mannered insults to have in your back pocket:

The Race of Endurance

I have heard it said that caregiving is not a sprint but a race of endurance. Maybe you’ve just begun the race, but you’re already feeling out of breath. Or perhaps you have been caring for a loved one for several years and are thinking, “I’m too worn out. I just can’t do this anymore.” Caregiving is hard, and even though the road ahead sometimes looks impossible, you’re going to make it! Here are 8 things every caregiver should know for the path ahead.

As always, if this blog sparks any questions or if you would like to talk about your specific situation, give us a call at 901.854.1200 or email our Social Worker, Sheri Wammack, at sheri@pagerobbins.org. We would be happy to answer your questions!

1. You are not alone.

At times, you will feel isolated. Thoughts like, “No one else understands what I am going through…” or “I am the only one who…” are common for caregivers. But you are not alone. According to The Family Caregiver Alliance, in 2015 there were over 34.2 MILLION people providing unpaid care to someone over the age of 50. That is a lot of people who are in your same boat. Seek out a support group (like ours here). Find those friends who understand, so you can share with one another and have someone to run alongside.

2. Lean on others: Accept help. Ask for help.

In our opinion, no one can/should caregive alone. Every caregiver needs assistance and an occasional break. Friends and family are often willing to help, but they do not know how to help you. When friends and family say, “Let me know if you need anything,” take them up on it. Ask for a friend to visit and chat or to sit for an hour to give you a break. Ask someone to bring a meal to your home. Come up with a wish list of things others can help with. Then, when someone asks, “How can I help?” you have an answer ready. Here’s our blog post on creating a caregiver wish list if you’re interested in learning more.

Also, seek the help of professionals. Professionals in the field can help you navigate the waters. They know resources you might not and can be a good source of information for you.

3. Don’t put off making decisions for fear of making the wrong decision.

Many caregivers put off making decisions about care because they worry about making the wrong decision: “Mom needs more care than can be given at home, but I just can’t decide which facility would be best.” Putting off these decisions can cause more work for you because Mom needs more care than you can provide, but you continue to do it and wear yourself out.

As a caregiver, there are so few decisions you cannot take back. For example, you decide to move your parent into Facility A, and a month into it you realize that it isn’t a good fit. Life is not over. Move Mom to Facility B. Or you decide to let the physician start your dad on a medication, but a couple of weeks into it there are some negative side effects. Call the doctor to discuss it, and stop the medication.

When you lay your head on the pillow every night, if you can honestly say you made the best decisions that you could for yourself and your loved one, then, you did the best you could. Tomorrow, you might change your mind and make a different decision. That is OK. You are making decisions based on the information you have, and it is enough. You can change your mind later.

4. You are not perfect.

You were not perfect before becoming a caregiver, so why should you be perfect now?

You will handle situations wrong. You will say the wrong thing at the right time and the right thing at the wrong time. You will react in frustration rather than love. Cut yourself some slack. You will still get mad, upset, and frustrated because you are human and you have emotions. Try to learn from your mistakes. Try to take a breath when emotions overcome you. Try to step back and realize that your loved one is not purposely frustrating you.

5. Find joy in the moment.

Caregivers often stay task-oriented: Mom needs to get a bath. I need to clean up the mess from breakfast. It is time for Dad to take afternoon meds. Spending all of your time focusing on tasks will rob you of your joy. Look for joy in the moment: When liquid dish soap gets put in the dishwasher and the kitchen is filled with bubbles. When Mom remembers your name. When the grandkids have Dad laughing uncontrollably. When life feels normal.

It is so important to hold on to your sense of humor. There will be moments that are just funny, and it is OK to laugh, reminisce, and enjoy. You bear enough struggle and heartache. Choose joy. Make space for joy. Invite it into your home and daily living.

6. This too shall pass.

When you just can’t take it anymore, when your loved one is being so incredibly hurtful, when you are screaming inside… know that this too shall pass. This moment of frustration, irritation, unbelievable sorrow, and anger will pass. These bad feelings may return, and the same situation may arise again, but this too shall pass. To date, you have a 100% success rate at making it through all tough situations.

7. Be realistic. Pick your battles.

You can quickly drive yourself crazy expecting life to be perfect. There will be bumps in the road and days when things just don’t go right. Expect it. Don’t set yourself up for failure. Scheduling 3 appointments in one day may not be the best idea. Mom may insist on wearing her pink polka dot shirt with her red striped pants. Who cares? At least she is dressed.

Try to avoid arguing over small things. There will be plenty of things to argue over later. If the outcome isn’t life threatening, give in, and change the subject.

8. Make yourself a priority.

It seems easy for someone to say this without knowing your personal situation, but know that you MUST make yourself a priority. You MUST take time for yourself, time in which you are not a caregiver but just YOU. Make time to go to your own doctor’s appointments, so you can maintain your health. Make time to invest in your relationships with your spouse, children and friends. Make time to do the things you enjoy.

You may not be able to give the time you used to, but you should set aside some time. Some days, it might be 5 minutes alone on the porch swing, others it might be a few hours, and others it might be a week-long getaway.

Home Safety Tips


As they say, home is where the heart is (and where we spend a lot of time), so it’s important to keep your home happy and safe. When you care for someone with dementia, there are new things to consider when thinking about the safety of your home. The goal of home safety is to prevent the avoidable disasters, to the best of our ability, and to prepare for the inevitable ones. These are our home safety tips for caregivers.

As always, if this blog sparks any questions or if you would like to talk about your specific situation, give us a call at 901.854.1200 or email our Social Worker, Sheri Wammack, at sheri@pagerobbins.org. We would be happy to answer your questions!

General Home Tips

  • Display emergency numbers in a prominent place, such as the refrigerator or taped to the inside of a kitchen cabinet. Also, put those numbers in your cell phone contacts. These numbers could include personal emergency contacts, non-emergency numbers for your local police and fire departments, and poison control (1-800-222-1222).
  • Have an updated copy of your loved one’s medications (dosage and frequency) and allergies in a place where you can find it quickly. OR have that information listed in the notes on your phone.
  • Check your hot water heater settings. The hottest setting needs to bearable to the touch. Your loved one may unintentionally turn the water as hot as it will go and burn his or herself.
  • Test your smoke and carbon monoxide detectors regularly to ensure batteries are working. Once a month is recommended.
  • If you still have a landline, set your answering machine to begin after the shortest ring setting available, so you can better screen calls and ensure your loved one won’t fall victim to telephone scams.
  • Remove all weapons from the house, or have them hidden and locked away. Keep all weapons disarmed.
  • Label important rooms and spaces, such as the bathroom. You may want to use pictures or symbols instead of words if your loved one has trouble reading.
  • Remove locks on interior doors, so your loved one cannot lock his or herself in a room.
  • Get rid of the junk drawer… and the junk in general. Clutter causes confusion. Is it trash or food? Is it scrap paper or an important receipt? No one knows! Keep it simple and clean.

Kitchen

  • Make sure you have at least one fire extinguisher in working order and know how to use it. Here’s a short video from FEMA if you are unsure of the proper procedure.
  • If you have a gas stove, make sure you know where the shut-off valve is located.
  • Unplug the microwave (or any appliance of concern) when not in use. This way you can better monitor use the appliance.
  • Put knives, other sharp utensils, and any precious/breakable items in cabinets with child-proof locks.
  • Keep alcohol hidden or locked away.
  • Use a drain trap in the kitchen sink.

Bathroom

  • Lock up medications (both prescription and over the counter).
  • If your loved one seems confused about the difference between the toilet and the sink, install a brightly colored toilet seat.

Fall Prevention

  • Good lighting is essential in hallways and rooms. Also, consider nighttime lighting. Place nightlights throughout the house, or keep key lights on when it’s dark outside.
  • Try to avoid using extension cords, and if you have to use them, make sure they are tucked away out of foot paths.
  • Make sure your stairway has a hand rail. And if you have slippery stairs, add something like a clear, adhesive stair tread to add more traction. Putting reflective or brightly-colored tape on the end of each stair might also be useful.
  • Use slip resistant wax when finishing floors.
  • Remove throw rugs. While rugs are pretty, they are a fall hazard.
  • Avoid clutter. The more things there are, the more things there are to trip over!

Outdoors

  • If you have a pool, make sure your loved one does not have easy access. A gate will help ensure he or she doesn’t accidentally fall in.
  • Remove the fuel sources for grills when not being used.
  • Keep power tools locked up and out of sight.
  • Keep a spare key outside in a hidden area just in case your loved one locks you out.

Traveling and Dementia


It’s time for travels and vacations. Exciting? Yes! Stressful? Double Yes! Getting ready for a trip can be a lot of work and even more so when you are traveling with a loved one who has memory loss. Here are some ideas to help make traveling a bit easier and safer.

Plan wisely.

Avoid travel during peak times. Friday afternoon on a holiday weekend may not be the best option. Instead, travel on a weekday morning. If possible have 2 caregivers on the trip, so caregiving responsibilities can be shared. Don’t schedule a tight layover. Allow you and your loved one time to visit the restroom and get from place to place.

Inform the airline of your situation.

Get a letter from your loved one’s physician for the TSA, so you can bypass potential additional screening that may cause stress. Inform the airline and medical service department ahead of time of your specific needs. Most airlines ask for a 48 hour advance notice. You may want to ask for a wheelchair to travel through the airport.

Choose a hotel with interior doors.

When choosing a place to stay, get a hotel with doors that open to an interior hallway. If your loved one wanders, he or she would have to pass through the lobby, where hopefully someone can redirect. If your loved one has limited mobility, call ahead and ask for a room that is close to the check-in area to keep you from walking your loved one down a long hallway.

Keep hotel staff informed.

Print out a picture of your loved one and give it to the front desk (or text/email a picture from your phone). Ask that it be posted for employees and that if anyone sees your loved one alone, for them to call you. When you are in the room for the night, lock and latch the door. If there are two beds, sleep in the one closest to the door, so your loved one has to cross your path to exit. You can also bring a portable door alarm or childproof doorknob cover. New environments can be confusing, so you may want to label areas like the bathroom. Ask the front desk or concierge about nearby pharmacy and health service options in case needed.

Plan for the unexpected.

A small issue can throw off all your plans. Allow extra time for the unexpected. Pack things to keep your loved one entertained: magazines, familiar music and headphones, activities. Also, bring essentials: snacks, water, disposable garments, wipes, prescription medications, over the counter medications, change of clothes. If traveling by car, subscribe to a roadside assistance program and have 2 drivers available if needed.

Bring copies of important documents.

You never know what will happen when you are away from home, so having important documents with you is vital. Bring your loved one’s identification, emergency contact information, physician’s names and contact information, list of current medications, list of drug/food allergies, copies of legal papers (living will, advanced directives, power of attorney), insurance information and a written travel itinerary. Be sure not to pack any of these documents in your suitcase, lest that bag be lost or stolen. Keep them on your person or lock them in a safe at the hotel.

Have identification for both of you.

It is very important that those with memory loss have identification on their person in case they get separated from their family. This could be a Safe Return Bracelet through the Alzheimer’s Association, a DIY identification bracelet, or a laminated card in their pocket. Whether bracelet or card, it needs to have their name and “In case of Emergency, please call… (at least 2 names and phone numbers).” You should also carry a card that says: “I am traveling with someone who has memory loss.” This way, in case you are in a wreck and are unresponsive, the responders will know to look for your loved one.

Take a picture at the beginning of each day.

Once your loved one is up and dressed, take a picture of him or her on your cell phone (deleting yesterday’s picture). If your loved one wanders off, you will have a current photo to show the authorities.

Keep routines as much as possible.

If your loved one is used to eating 3 meals a day, try to eat 3 meals at the usual times. If your loved one goes to bed around 9, try to keep that routine. Getting off schedule can cause even more confusion. Keep in mind time zone changes and how that might affect what time you eat and when medications need to be given.

Keep your daily itinerary simple.

If you are sightseeing, try to break up the sightseeing adventures into smaller outings instead of one, long outing. It may be that your loved one can only handle sightseeing in the morning and needs to rest in the afternoon. You may have to alter your pace. Be flexible. Avoid restaurants and tourist attractions at peak times. Instead, visit at less busy times or choose a less busy restaurant.

If you have any specific questions about traveling with your loved one, please give us a call at 901.854.1200. And if you’re looking for additional information, we found the Alzheimer’s Association’s page on Traveling and Dementia and this page from Light Bridge Healthcare Research on Traveling and Dementia to be helpful.

Choosing a Residential Placement


Being a caregiver is incredibly stressful: addressing daily care needs, managing bills, going to medical appointments, making meals, and keeping up the house. In addition to these things, making decisions about your loved one’s care is difficult. Caregivers spend a great deal of time stressing over if they should place a loved one in a residential care facility and wondering which facility is the right one.

If you’re feeling overwhelmed by a care decision, take a breath. We’re here to help. These are our best tips on choosing a residential placement. If you have questions after reading this, be sure to give us a call (901.854.1200) or stop by, we would be happy to answer questions and provide support for you and your specific situation.

Step 1: Decide your breaking point.

The big question: “When is the right time to move my loved one to a residential facility?”
There’s no one answer to this question. In our experience, most caregivers have a breaking point in what they can manage at home. For each caregiver, that breaking point is different.

Some examples of stages your loved one might reach that could be a breaking point:

  • Not sleeping at night and disrupting sleep for the rest of the household
  • Incontinence
  • Hoarding becomes excessive
  • Choking on meals consistently

Choose YOUR breaking point. There is no right or wrong time other than waiting too late. When you wait too late, you suffer and don’t manage your own self-care. As a result your loved one suffers because you can no longer provide adequate care.

Step 2: Determine your loved one’s appropriate level of care.

How do you know what level of care is appropriate – traditional assisted living, memory care, nursing home? We suggest asking your loved one’s physician, consulting with a geriatric care manager, or having a facility admission coordinator assess your loved one to make appropriate recommendations.

Step 3: Do your research.

Ask around. What experience have others had with the facilities you are considering? Also, think about location and cost. If you’re planning to visit your loved one often, it would be wise to choose a facility that is within reasonable driving distance from home and/or work.

This is another step when a geriatric care manager may be of great help to you. He or she can help you narrow down the pool of facilities to consider.

Step 4: Take a tour.

Go out and look. Tour several facilities to see what is out there. It is always best to know about the options in the area, so you can make an informed decision when/if the time is right for you.

Take both scheduled and unscheduled tours. Show up unannounced (maybe at a mealtime or on a weekend) to see how things are when staff are not prepared for you to be there. It is important to have a scheduled tour as well. Scheduled tours ensure that the correct staff person will be available to give you the information you need. Understand that not every staff member will be able to answer your questions, so be sure to ask the right person.

When taking a tour, there are lots of things to consider and observe, but don’t stress too much. You can always take a second or third tour if needed. When you tour, use your five senses:

SOUND

  • Do you hear staff talking with residents, including them in conversations?
  • Is staff speaking kindly to residents and one another?
  • Does staff call residents by name?
  • Is there music playing? Is it appropriate and soothing music?

SIGHT

  • Is the facility nicely decorated?
  • Is there natural light?
  • Does it look clean and orderly or chaotic?
  • Ask for a menu. Does the food look appealing?
  • Are people smiling?
  • What do you see the residents doing? Are they watching Jerry Springer or something more appropriate? Are they staring off into space, or do you see them engaged in an activity?

TASTE

  • If you have a meal at the facility during your tour (which is not necessarily common), does the food taste good?

TOUCH

  • Are the floors sticky?
  • Are the tables still sticky from the previous meal?
  • Are there items around for the residents to use? Games, puzzles, sensory items?
  • Is staff providing physical reassurance and attention to residents, such as a hug or a pat on the arm?

SMELL

  • How does the facility smell? Do you smell lunch cooking, or does it smell like bleach?
  • Is there an odor of old urine? If someone has just had a bowel movement then there will likely be an odor, but it should not be a permanent smell.

The best facility is not necessarily the newest/most expensive facility, and the worst facility is not necessarily the oldest/cheapest. There is no one facility that is the best for everyone. Each person and family is different. Different places for different needs.

Bonus Step: Be an advocate.

Once you have chosen a facility and moved your loved one in, know that you are still your loved one’s caregiver. You are still his or her advocate. It is important that you visit, check on your loved one, and make sure that appropriate care is being provided.

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  • November 30, 2017

    Music and Dementia


    Christmas music is EVERYWHERE right now: in the car, at the grocery store, in the elevator, on hold on the phone. Have you ever noticed just how many places we hear music? Music is everywhere, and whether it’s in the background or turned up as far as it will go, music affects us and is important.

    Research shows that one of the last parts of the brain to be affected by dementia is the part that holds rhythm. Even the brain thinks music is important! Here are some cool things that music can do for those with dementia (and you, too!):

    Music evokes memories.

    A song from your wedding comes on the radio, and you immediately remember that day. A song that was popular when you were in high school transports you back to your first date with your high school sweetheart. Hearing Amazing Grace takes you back to your church home growing up. Songs can transport us to other times and places.

    Music alters mood.

    Soothing classical music may help your mom calm down when she is a bit agitated. A happy, upbeat song may be good when you are trying to get some tasks accomplished with your loved one (like bathing or filing fingernails). Quiet, soft music may help your dad settle down at the end of the day to get ready for bed.

    Music engages.

    Your loved one may be able to sing every word to favorite songs long after they are not able to effectively communicate in conversation. Music can lead to dancing, snapping fingers, clapping and smiling.

    Here’s how you can make music work for you and your loved one:

    • Let your loved one choose the music. Your loved one has so little choice now. Allow your loved one to choose what he or she would like to listen to.
    • Figure out what kind of music your loved one prefers. What decade? What genre? Seek out songs and artists he or she might like. You can find just about any song, from any time period, on YouTube.
    • Use music to set the mood and help you accomplish tasks. Your loved one’s personal care routine might be a lot more fun (and less dreaded) with music.
    • Avoid over-stimulation. Choose music without commercials, turn off the TV, shut the door, and don’t turn it up too loud.
    • Encourage movement. Dance, snap, clap. Movement is fun while also working range of motion and fine motor skills and providing physical exercise.
    • Pandora, iHeartRadio, and Spotify are all inexpensive or free ways to get specific types of music.
    • Create a playlist for free on YouTube of your loved one’s favorite songs. Fill an iPod with favorite songs. Or use Apple Music or Spotify (monthly subscription fee) to create different playlists on your smartphone, so you can take music with you wherever you go.
    • Have a carpool karaoke session (a la the Late Late Show with James Corden)… and don’t worry about who might be watching from other cars.
    • DIY a sing-a-long: just turn on close captioning for a musical on TV.
    • Join in! Sing. Dance. Embrace the music and the beautiful connection it can bring between you and your loved one. If you’ve ever wished life (or even just a moment in time) could be a musical, make it so.

    If you want to learn more about music and dementia, we recommend the Alive Inside documentary.

    October 30, 2017

    Preparing for the Holidays


    The holidays are busy. Parties to attend, family to visit and family to entertain, gifts to buy, dishes to make. It can all be too much – especially when you are caring for a loved one with dementia. But it doesn’t have to be this way.

    The point of the holidays isn’t all the stuff and the hoopla. The point is to celebrate, to honor, and to cherish. It’s okay if the season isn’t as grand as it once was. Don’t expect it to be. You want to know the best holiday recipe? A heaping cup of simplicity and a half of cup of planning with a pinch of good communication and boundary setting. That makes for some joyful days!

    Here’s our recipe for happy holidays. We suggest you start prepping the ingredients now, but in your holiday prep, keep in mind that there’s no perfect holiday. Perfection is unattainable, but really good days are possible. This is how we think you can make them happen:

    Declutter the calendar.

    Don’t plan to attend every event and party. It is OK to say No to invitations (and not feel guilty about it). Strategically pick and choose which events you would like to attend. For example: Instead of hosting your usual Christmas Eve dinner with the whole family and you cook everything, choose to host a lunch potluck. Lunch may be a better time of day for your loved one, and a potluck takes the pressure off you. AND/OR you can ask another family member to host, so you and your loved one can attend and leave when needed.

    Scale down, and turn down the volume.

    Your loved one may not be able to handle a full day of the entire family. Limit time at gatherings. You can also find a quiet room for your loved one to be in, and ask family and friends to visit one-on-one in a much more manageable environment.

    Stick to the routine.

    The holidays can get our schedules out of whack. Keep routines as much as possible because routines make for easier days. Serve meals at regular times, schedule afternoon rest at the regular time, go to sleep at the regular time. Keeping to a schedule will help your loved one remain as rested as possible.

    Involve your loved one.

    While Mom may not be able to independently make her famous coconut cake, she can help pour pre-measured ingredients and stir everything together. While Grandpa might not be able to chop wood or light the fireplace, he can help carry in a piece of wood. While your wife may not be able to play the piano, she can still sing along, dance, or just enjoy the music.

    Make a wish list for you and your loved one.

    Your gift wish list should look different than it has in the past. Here are some things we suggest: money to pay for care, soft blankets, 30-piece puzzles, magazine subscription, gift card for stores or for meals to-go, favorite music, personalized book with family pictures and captions about who is in each picture/what is going on in the pictures (recommendation: Shutterfly).

    Help your family and friends know how to interact.

    Explain to family and friends about your loved one’s current state, so they will know what to expect. Remind them NOT TO QUIZ. Instead of asking, “Do you know who I am?” coach them to prompt: “Grandpa, it’s Jason. I’m so glad to see you.” And instead of asking, “Susan, who is in this picture?” coach them to tell a story: “Susan, (while showing the picture), here is a picture of us in Gatlinburg. That was a fun trip. It snowed the whole time.” Remind family members not to argue, even if what is being said makes no sense. Go with the flow of the conversation.

    Simplify decorations.

    Too many decorations may be too much for your loved one to take in… and too much for you to put up. It is OK to scale down. Maybe you only decorate the mantle or have a table top tree instead of decking out the whole house. Maybe you just put a wreath on the door instead of lights everywhere. Maybe you just put out a pretty tablecloth instead of the endless china set.

    Plan ahead.

    Planning ahead allows you to create opportunities for success. Order your groceries online to avoid the craziness of the aisles at the store. Start your gift shopping early to avoid the rush and crowds. Crowds are overwhelming. Plan around them.

    Make time for yourself.

    Plan for an in-home caregiver, so you can go to a Christmas party or get shopping done. (Schedule this EARLY!) Or ask a family member to come stay with your loved one, so you can get things done.

    Enjoy!

    Sit with your loved one and listen to Christmas music. Turn down the lights and watch the tree glow. Go for a drive to see lights. Watch an old Christmas movie that you both have always loved. Eat pumpkin pie for breakfast. Take time to enjoy the holidays and your family.

    2 Important Bonus Notes:
    1. If you are traveling, plan, plan, plan, and see our blog post on travel tips.
    2. If your loved one lives in a facility, ask when holiday activities are scheduled, and plan to be there to celebrate with your loved one.

    September 29, 2017

    Tips for Mealtime


    The following are tips for enjoying meals with your loved one with memory loss. As always, if this blog post sparks a question or if you need advice for your specific situation, give us a call at 901.854.1200. We would be happy to help!

    Simplify.

    • Eat at the table, not in front of the TV.
    • Limit table décor. Plastic fruit can be mistaken for real fruit. Centerpieces, chargers, napkin rings, salt and pepper shakers, and placemats all on the same table can be distracting.
    • Limit utensils to reduce confusion.
    • Avoid busy patterns on the table cloth.
    • Be sure food, plate, and table are contrasting colors, so food can be easily seen.
    • If your loved one seems to be eating just a certain portion of his or her food, you may need to rotate the plate throughout the meal.
    • Limit choices. Three veggies and a meat might be too much, instead offer the meat and then one veggie at a time.

    Serve food that is ready to eat.

    • Check the temperature. Your loved one may not know if the food is too hot or too cold.
    • If your loved one is not able to cut the food, serve it pre-cut.
    • Be mindful of which utensils are used. A fork may be easier than a spoon, or finger foods might be best.
    • Use plates or shallow bowls with a lip, so there’s something to push against to get food on the fork/spoon.

    Serve to your loved one’s preferences.

    • Food preferences may change.
    • If your loved one has eaten spaghetti his or her entire life, but now says, “I don’t eat spaghetti,” serve something different.
    • Serve foods with different colors and textures.
    • If your loved one doesn’t remember that he or she has already eaten, you might offer multiple smaller meals rather than arguing that you have already eaten.

    Enjoy your meals together.

    • Don’t rush. It may take your loved one longer to eat than it used to.
    • Your loved one may look to you for cues on how to eat – what to eat first, whether to use hands or a fork, etc.
    • Savor the good stuff! Find foods you and your loved one really like, and enjoy them often.
    • Shared meals are important. They are social. They build and strengthen relationships. Try not to treat them as an item on the checklist. Treat them as an opportunity to enjoy one another. Good food, better company!

    August 30, 2017

    The Importance of Laughter


    Knock. Knock.
    “Who’s there?”
    “Humor.”
    “Humor who?”
    “Humor me for a second, and read this blog post.”

    We know… we should stick to the caring and supporting and leave the knock, knock jokes to someone else. If you made it through that joke without cringing or scrunching your face up in confusion, we applaud you. Go treat yourself to a cookie (or several).

    Here’s the point: It is so very important for you, as a caregiver, to laugh. Life is hard. Hold on to your sense of humor. Sure, a sense of humor won’t change your situation, but it can change your perspective.

    Take these 2 examples:

    Your dad stands up in the middle of a restaurant and starts singing and dancing. One of his favorite songs is playing in the background at Huey’s. You can be mortified and quickly ask him to sit down, or you can get up and dance, too. Because WHO CARES?

    Your wife says something completely inappropriate to a total stranger. You can blush furiously and angrily shush her. Or you can let it go and laugh later… because come on… it was a pretty funny comment.

    *Serious side note: We are not encouraging you to laugh AT your loved one. Laugh WITH him or her. Laugh at the bizarre, awkward, ridiculous situations you get into.

    Laughter isn’t just an important part of your emotional health, it’s also essential to good mental, physical, and spiritual health. There are lots studies to back this up, but we won’t bore you with the details.

    You need to laugh. You have permission to laugh. You carry a heavy load as a caregiver, so we invite you to put down that load for a few minutes and remember what it’s like to laugh until you cry snort. What it’s like to smile. What it’s like to embrace ridiculous. What it’s like to get carried away into a vortex of funny Internet videos.

    So if you’re needing a laugh, here are some things that have made us laugh recently. A little inspiration, if you will. Happy laughing!

    This video from Jeanne Robertson because we’ve all had an embarassing clothing malfunction:

    This video from Ellen about autocorrect mishaps… because it could happen to you:

    This BuzzFeed article with hilarious posts about dogs because dogs are the best (our therapy dog, Daisy, made us say that).

    This video from The Late Late Show with James Corden because he’s never not funny:

    This video from BuzzFeed of men trying on Spanx (Slightly inappropriate? Maybe, but try not to laugh.):

    This epic homemade commercial. We’re not entirely sure what’s going on in it, but it makes us laugh.

    This video of quadruplets laughing because what’s not to love about laughing babies:

    And finally, these well-mannered insults to have in your back pocket:

    July 31, 2017

    The Race of Endurance

    I have heard it said that caregiving is not a sprint but a race of endurance. Maybe you’ve just begun the race, but you’re already feeling out of breath. Or perhaps you have been caring for a loved one for several years and are thinking, “I’m too worn out. I just can’t do this anymore.” Caregiving is hard, and even though the road ahead sometimes looks impossible, you’re going to make it! Here are 8 things every caregiver should know for the path ahead.

    As always, if this blog sparks any questions or if you would like to talk about your specific situation, give us a call at 901.854.1200 or email our Social Worker, Sheri Wammack, at sheri@pagerobbins.org. We would be happy to answer your questions!

    1. You are not alone.

    At times, you will feel isolated. Thoughts like, “No one else understands what I am going through…” or “I am the only one who…” are common for caregivers. But you are not alone. According to The Family Caregiver Alliance, in 2015 there were over 34.2 MILLION people providing unpaid care to someone over the age of 50. That is a lot of people who are in your same boat. Seek out a support group (like ours here). Find those friends who understand, so you can share with one another and have someone to run alongside.

    2. Lean on others: Accept help. Ask for help.

    In our opinion, no one can/should caregive alone. Every caregiver needs assistance and an occasional break. Friends and family are often willing to help, but they do not know how to help you. When friends and family say, “Let me know if you need anything,” take them up on it. Ask for a friend to visit and chat or to sit for an hour to give you a break. Ask someone to bring a meal to your home. Come up with a wish list of things others can help with. Then, when someone asks, “How can I help?” you have an answer ready. Here’s our blog post on creating a caregiver wish list if you’re interested in learning more.

    Also, seek the help of professionals. Professionals in the field can help you navigate the waters. They know resources you might not and can be a good source of information for you.

    3. Don’t put off making decisions for fear of making the wrong decision.

    Many caregivers put off making decisions about care because they worry about making the wrong decision: “Mom needs more care than can be given at home, but I just can’t decide which facility would be best.” Putting off these decisions can cause more work for you because Mom needs more care than you can provide, but you continue to do it and wear yourself out.

    As a caregiver, there are so few decisions you cannot take back. For example, you decide to move your parent into Facility A, and a month into it you realize that it isn’t a good fit. Life is not over. Move Mom to Facility B. Or you decide to let the physician start your dad on a medication, but a couple of weeks into it there are some negative side effects. Call the doctor to discuss it, and stop the medication.

    When you lay your head on the pillow every night, if you can honestly say you made the best decisions that you could for yourself and your loved one, then, you did the best you could. Tomorrow, you might change your mind and make a different decision. That is OK. You are making decisions based on the information you have, and it is enough. You can change your mind later.

    4. You are not perfect.

    You were not perfect before becoming a caregiver, so why should you be perfect now?

    You will handle situations wrong. You will say the wrong thing at the right time and the right thing at the wrong time. You will react in frustration rather than love. Cut yourself some slack. You will still get mad, upset, and frustrated because you are human and you have emotions. Try to learn from your mistakes. Try to take a breath when emotions overcome you. Try to step back and realize that your loved one is not purposely frustrating you.

    5. Find joy in the moment.

    Caregivers often stay task-oriented: Mom needs to get a bath. I need to clean up the mess from breakfast. It is time for Dad to take afternoon meds. Spending all of your time focusing on tasks will rob you of your joy. Look for joy in the moment: When liquid dish soap gets put in the dishwasher and the kitchen is filled with bubbles. When Mom remembers your name. When the grandkids have Dad laughing uncontrollably. When life feels normal.

    It is so important to hold on to your sense of humor. There will be moments that are just funny, and it is OK to laugh, reminisce, and enjoy. You bear enough struggle and heartache. Choose joy. Make space for joy. Invite it into your home and daily living.

    6. This too shall pass.

    When you just can’t take it anymore, when your loved one is being so incredibly hurtful, when you are screaming inside… know that this too shall pass. This moment of frustration, irritation, unbelievable sorrow, and anger will pass. These bad feelings may return, and the same situation may arise again, but this too shall pass. To date, you have a 100% success rate at making it through all tough situations.

    7. Be realistic. Pick your battles.

    You can quickly drive yourself crazy expecting life to be perfect. There will be bumps in the road and days when things just don’t go right. Expect it. Don’t set yourself up for failure. Scheduling 3 appointments in one day may not be the best idea. Mom may insist on wearing her pink polka dot shirt with her red striped pants. Who cares? At least she is dressed.

    Try to avoid arguing over small things. There will be plenty of things to argue over later. If the outcome isn’t life threatening, give in, and change the subject.

    8. Make yourself a priority.

    It seems easy for someone to say this without knowing your personal situation, but know that you MUST make yourself a priority. You MUST take time for yourself, time in which you are not a caregiver but just YOU. Make time to go to your own doctor’s appointments, so you can maintain your health. Make time to invest in your relationships with your spouse, children and friends. Make time to do the things you enjoy.

    You may not be able to give the time you used to, but you should set aside some time. Some days, it might be 5 minutes alone on the porch swing, others it might be a few hours, and others it might be a week-long getaway.

    June 29, 2017

    Home Safety Tips


    As they say, home is where the heart is (and where we spend a lot of time), so it’s important to keep your home happy and safe. When you care for someone with dementia, there are new things to consider when thinking about the safety of your home. The goal of home safety is to prevent the avoidable disasters, to the best of our ability, and to prepare for the inevitable ones. These are our home safety tips for caregivers.

    As always, if this blog sparks any questions or if you would like to talk about your specific situation, give us a call at 901.854.1200 or email our Social Worker, Sheri Wammack, at sheri@pagerobbins.org. We would be happy to answer your questions!

    General Home Tips

    • Display emergency numbers in a prominent place, such as the refrigerator or taped to the inside of a kitchen cabinet. Also, put those numbers in your cell phone contacts. These numbers could include personal emergency contacts, non-emergency numbers for your local police and fire departments, and poison control (1-800-222-1222).
    • Have an updated copy of your loved one’s medications (dosage and frequency) and allergies in a place where you can find it quickly. OR have that information listed in the notes on your phone.
    • Check your hot water heater settings. The hottest setting needs to bearable to the touch. Your loved one may unintentionally turn the water as hot as it will go and burn his or herself.
    • Test your smoke and carbon monoxide detectors regularly to ensure batteries are working. Once a month is recommended.
    • If you still have a landline, set your answering machine to begin after the shortest ring setting available, so you can better screen calls and ensure your loved one won’t fall victim to telephone scams.
    • Remove all weapons from the house, or have them hidden and locked away. Keep all weapons disarmed.
    • Label important rooms and spaces, such as the bathroom. You may want to use pictures or symbols instead of words if your loved one has trouble reading.
    • Remove locks on interior doors, so your loved one cannot lock his or herself in a room.
    • Get rid of the junk drawer… and the junk in general. Clutter causes confusion. Is it trash or food? Is it scrap paper or an important receipt? No one knows! Keep it simple and clean.

    Kitchen

    • Make sure you have at least one fire extinguisher in working order and know how to use it. Here’s a short video from FEMA if you are unsure of the proper procedure.
    • If you have a gas stove, make sure you know where the shut-off valve is located.
    • Unplug the microwave (or any appliance of concern) when not in use. This way you can better monitor use the appliance.
    • Put knives, other sharp utensils, and any precious/breakable items in cabinets with child-proof locks.
    • Keep alcohol hidden or locked away.
    • Use a drain trap in the kitchen sink.

    Bathroom

    • Lock up medications (both prescription and over the counter).
    • If your loved one seems confused about the difference between the toilet and the sink, install a brightly colored toilet seat.

    Fall Prevention

    • Good lighting is essential in hallways and rooms. Also, consider nighttime lighting. Place nightlights throughout the house, or keep key lights on when it’s dark outside.
    • Try to avoid using extension cords, and if you have to use them, make sure they are tucked away out of foot paths.
    • Make sure your stairway has a hand rail. And if you have slippery stairs, add something like a clear, adhesive stair tread to add more traction. Putting reflective or brightly-colored tape on the end of each stair might also be useful.
    • Use slip resistant wax when finishing floors.
    • Remove throw rugs. While rugs are pretty, they are a fall hazard.
    • Avoid clutter. The more things there are, the more things there are to trip over!

    Outdoors

    • If you have a pool, make sure your loved one does not have easy access. A gate will help ensure he or she doesn’t accidentally fall in.
    • Remove the fuel sources for grills when not being used.
    • Keep power tools locked up and out of sight.
    • Keep a spare key outside in a hidden area just in case your loved one locks you out.

    May 26, 2017

    Traveling and Dementia


    It’s time for travels and vacations. Exciting? Yes! Stressful? Double Yes! Getting ready for a trip can be a lot of work and even more so when you are traveling with a loved one who has memory loss. Here are some ideas to help make traveling a bit easier and safer.

    Plan wisely.

    Avoid travel during peak times. Friday afternoon on a holiday weekend may not be the best option. Instead, travel on a weekday morning. If possible have 2 caregivers on the trip, so caregiving responsibilities can be shared. Don’t schedule a tight layover. Allow you and your loved one time to visit the restroom and get from place to place.

    Inform the airline of your situation.

    Get a letter from your loved one’s physician for the TSA, so you can bypass potential additional screening that may cause stress. Inform the airline and medical service department ahead of time of your specific needs. Most airlines ask for a 48 hour advance notice. You may want to ask for a wheelchair to travel through the airport.

    Choose a hotel with interior doors.

    When choosing a place to stay, get a hotel with doors that open to an interior hallway. If your loved one wanders, he or she would have to pass through the lobby, where hopefully someone can redirect. If your loved one has limited mobility, call ahead and ask for a room that is close to the check-in area to keep you from walking your loved one down a long hallway.

    Keep hotel staff informed.

    Print out a picture of your loved one and give it to the front desk (or text/email a picture from your phone). Ask that it be posted for employees and that if anyone sees your loved one alone, for them to call you. When you are in the room for the night, lock and latch the door. If there are two beds, sleep in the one closest to the door, so your loved one has to cross your path to exit. You can also bring a portable door alarm or childproof doorknob cover. New environments can be confusing, so you may want to label areas like the bathroom. Ask the front desk or concierge about nearby pharmacy and health service options in case needed.

    Plan for the unexpected.

    A small issue can throw off all your plans. Allow extra time for the unexpected. Pack things to keep your loved one entertained: magazines, familiar music and headphones, activities. Also, bring essentials: snacks, water, disposable garments, wipes, prescription medications, over the counter medications, change of clothes. If traveling by car, subscribe to a roadside assistance program and have 2 drivers available if needed.

    Bring copies of important documents.

    You never know what will happen when you are away from home, so having important documents with you is vital. Bring your loved one’s identification, emergency contact information, physician’s names and contact information, list of current medications, list of drug/food allergies, copies of legal papers (living will, advanced directives, power of attorney), insurance information and a written travel itinerary. Be sure not to pack any of these documents in your suitcase, lest that bag be lost or stolen. Keep them on your person or lock them in a safe at the hotel.

    Have identification for both of you.

    It is very important that those with memory loss have identification on their person in case they get separated from their family. This could be a Safe Return Bracelet through the Alzheimer’s Association, a DIY identification bracelet, or a laminated card in their pocket. Whether bracelet or card, it needs to have their name and “In case of Emergency, please call… (at least 2 names and phone numbers).” You should also carry a card that says: “I am traveling with someone who has memory loss.” This way, in case you are in a wreck and are unresponsive, the responders will know to look for your loved one.

    Take a picture at the beginning of each day.

    Once your loved one is up and dressed, take a picture of him or her on your cell phone (deleting yesterday’s picture). If your loved one wanders off, you will have a current photo to show the authorities.

    Keep routines as much as possible.

    If your loved one is used to eating 3 meals a day, try to eat 3 meals at the usual times. If your loved one goes to bed around 9, try to keep that routine. Getting off schedule can cause even more confusion. Keep in mind time zone changes and how that might affect what time you eat and when medications need to be given.

    Keep your daily itinerary simple.

    If you are sightseeing, try to break up the sightseeing adventures into smaller outings instead of one, long outing. It may be that your loved one can only handle sightseeing in the morning and needs to rest in the afternoon. You may have to alter your pace. Be flexible. Avoid restaurants and tourist attractions at peak times. Instead, visit at less busy times or choose a less busy restaurant.

    If you have any specific questions about traveling with your loved one, please give us a call at 901.854.1200. And if you’re looking for additional information, we found the Alzheimer’s Association’s page on Traveling and Dementia and this page from Light Bridge Healthcare Research on Traveling and Dementia to be helpful.

    March 2, 2017

    Choosing a Residential Placement


    Being a caregiver is incredibly stressful: addressing daily care needs, managing bills, going to medical appointments, making meals, and keeping up the house. In addition to these things, making decisions about your loved one’s care is difficult. Caregivers spend a great deal of time stressing over if they should place a loved one in a residential care facility and wondering which facility is the right one.

    If you’re feeling overwhelmed by a care decision, take a breath. We’re here to help. These are our best tips on choosing a residential placement. If you have questions after reading this, be sure to give us a call (901.854.1200) or stop by, we would be happy to answer questions and provide support for you and your specific situation.

    Step 1: Decide your breaking point.

    The big question: “When is the right time to move my loved one to a residential facility?”
    There’s no one answer to this question. In our experience, most caregivers have a breaking point in what they can manage at home. For each caregiver, that breaking point is different.

    Some examples of stages your loved one might reach that could be a breaking point:

    • Not sleeping at night and disrupting sleep for the rest of the household
    • Incontinence
    • Hoarding becomes excessive
    • Choking on meals consistently

    Choose YOUR breaking point. There is no right or wrong time other than waiting too late. When you wait too late, you suffer and don’t manage your own self-care. As a result your loved one suffers because you can no longer provide adequate care.

    Step 2: Determine your loved one’s appropriate level of care.

    How do you know what level of care is appropriate – traditional assisted living, memory care, nursing home? We suggest asking your loved one’s physician, consulting with a geriatric care manager, or having a facility admission coordinator assess your loved one to make appropriate recommendations.

    Step 3: Do your research.

    Ask around. What experience have others had with the facilities you are considering? Also, think about location and cost. If you’re planning to visit your loved one often, it would be wise to choose a facility that is within reasonable driving distance from home and/or work.

    This is another step when a geriatric care manager may be of great help to you. He or she can help you narrow down the pool of facilities to consider.

    Step 4: Take a tour.

    Go out and look. Tour several facilities to see what is out there. It is always best to know about the options in the area, so you can make an informed decision when/if the time is right for you.

    Take both scheduled and unscheduled tours. Show up unannounced (maybe at a mealtime or on a weekend) to see how things are when staff are not prepared for you to be there. It is important to have a scheduled tour as well. Scheduled tours ensure that the correct staff person will be available to give you the information you need. Understand that not every staff member will be able to answer your questions, so be sure to ask the right person.

    When taking a tour, there are lots of things to consider and observe, but don’t stress too much. You can always take a second or third tour if needed. When you tour, use your five senses:

    SOUND

    • Do you hear staff talking with residents, including them in conversations?
    • Is staff speaking kindly to residents and one another?
    • Does staff call residents by name?
    • Is there music playing? Is it appropriate and soothing music?

    SIGHT

    • Is the facility nicely decorated?
    • Is there natural light?
    • Does it look clean and orderly or chaotic?
    • Ask for a menu. Does the food look appealing?
    • Are people smiling?
    • What do you see the residents doing? Are they watching Jerry Springer or something more appropriate? Are they staring off into space, or do you see them engaged in an activity?

    TASTE

    • If you have a meal at the facility during your tour (which is not necessarily common), does the food taste good?

    TOUCH

    • Are the floors sticky?
    • Are the tables still sticky from the previous meal?
    • Are there items around for the residents to use? Games, puzzles, sensory items?
    • Is staff providing physical reassurance and attention to residents, such as a hug or a pat on the arm?

    SMELL

    • How does the facility smell? Do you smell lunch cooking, or does it smell like bleach?
    • Is there an odor of old urine? If someone has just had a bowel movement then there will likely be an odor, but it should not be a permanent smell.

    The best facility is not necessarily the newest/most expensive facility, and the worst facility is not necessarily the oldest/cheapest. There is no one facility that is the best for everyone. Each person and family is different. Different places for different needs.

    Bonus Step: Be an advocate.

    Once you have chosen a facility and moved your loved one in, know that you are still your loved one’s caregiver. You are still his or her advocate. It is important that you visit, check on your loved one, and make sure that appropriate care is being provided.