Self-Care for Caregivers

Being a caregiver is hard. Being a caregiver for a loved one with dementia is even harder. You hear it all the time: “You need to take care of yourself.” I’m sure caregivers get tired of hearing it because it is much easier said than done. Taking care of yourself takes time and effort that quite frankly, you just don’t seem to have. 

But the truth is you MUST take care of yourself. If you ignore your own mental and physical well-being, it’s quite possible that you won’t be around to care for your loved one. There are lots of scary statistics out there about health problems brought about by caregiver burnout. Unchecked, extreme stress can be detrimental to health, so it’s important to address it.

There are small steps you can take to maintain and improve your well-being. We don’t suggest you try all the following suggestions at once. Pick 2. Pick one that you WANT to do and know you can accomplish. Then, pick another that you know you NEED to do (even if it scares you a little bit!). Ask a friend to help hold you accountable.

  • Set aside time for yourself. This could be a week in the mountains or 10 minutes on the front porch with a cup of coffee. You could have a friend or family member sit with your loved one while you go to a movie or get your nails done. You could arrange respite care for your loved one and go on a trip with friends.
  • Educate yourself. The more you understand the disease process, the better you can respond to your loved one. There are resources to meet every caregiver’s needs.  Here are just a few”

Books

We suggest The 36 Hour Day and A Pocket Guide for the Alzheimer’s Caregiver.  Come by our center at 1961 S. Houston Levee Road in Collierville (Monday to Friday, 6 am to 6 pm) to pick up your own copies for free. We are able to provide these books to public for free thanks to a grant from the Collierville Community Fund.

Online

The Alzheimer’s Association’s website has lots of helpful resources, as does the National Institute on Aging. Search Teepa Snow on YouTube for practical, honest information on personal care, communication, and more.

Educational Sessions

Look for caregiver education sessions in your community. We host a support group called Wine & Unwind that features a monthly care topic and guest speaker.  You can learn more about this and our other support groups on the Caregiver Support section of our website.

Save the date for Baptist’s caregiver conference on Saturday, November 16 with featured speaker Eileen Poiley, Director of Education at USF Health Byrd Alzheimer’s Institute. More information to come. Sign up for our monthly Caregiver Connection emails to stay up-to-date on this conference, as well as our monthly blog posts and support group meetings.
  • Go to your appointments. It is common for caregivers to cancel or forget their own health appointments.  But it’s important to get your annual physical, mammogram, 6-month dental cleaning, etc. Neglecting your own health can lead to more severe concerns down the road.
  • Talk to someone. Talk to a friend, counselor, minister, or fellow caregiver. Join a support group. If you hold it all in, the pressure builds, and at some point, you will explode on the wrong person. It can be hard to talk to family, as they are too close to the situation and may not share your same view. Try to find a non-family member with which to share your frustrations and worries.
  • Give yourself a break and some credit. When you lie down each night, say to yourself: “I have done the best I could with the information I have, and that is enough.” You were not perfect before, so don’t expect yourself to be perfect now. Don’t dwell on the “what if’s” and “if only’s”. Focus on your strengths and the positives. You do a lot physically. You manage a lot emotionally. Give yourself a pat on the back, even if no one else is doing that for you.
  • Ask for help. There will be times when you will not be able to handle caregiving alone. Ask a professional for help. Call a friend. Reach out to a physician. Tell another family member what you need. You are not going to know the answer to every question – ask! Call Page Robbins (901-854-1200), and we will help you navigate.
  • Give yourself a present. Get a manicure. Order a new gadget. Pick up your favorite meal. When you don’t receive gifts very often, it can be a good boost.
  • Allow yourself to laugh. Laughter can heal the soul. Turn on a funny movie or TV show, listen to a funny podcast, read a silly story.
  • Eat well. Exercise. Sleep. Food is your fuel. Eat balanced meals. It’s tempting to live on junk food and snacks because it’s easy. Get plenty of fruits, vegetables, healthy fats, protein, and water. Exercise is good for your body, mind, and sleep. You don’t have to run. Walk, stretch, maybe try some yoga (a class or YouTube videos at home). A good workout will help you sleep. Sleep is important to healthy brain functioning. Don’t stay up too late if you don’t have to. Take naps, and don’t let anyone make you feel guilty about it!

Dental Hygiene Tips

Keeping Up Dental Hygiene

Most of us take our pearly whites for granted. We brush them morning and night. We floss. We get food stuck between our teeth and can get it out. We recognize when something hurts.

People with dementia can’t always do these things, so their caregivers assume the responsibility. It isn’t easy to get an adult who doesn’t want to brush his/her teeth to do it (especially if you’ve just had a similar battle over changing into or out of pajamas). But it is worth the effort.

When oral care diminishes, a domino effect of bad things can happen. First, cavities, broken teeth, and bad breath. Next, teeth pulled. Then, lost appetite and weight loss. An unhealthy mouth can also lead to infections and abscesses.

If you notice your loved one’s oral care isn’t what it used to be, here are some ways you can help:

  • Instruct step-by-step. “John, lets brush your teeth.” “Put toothpaste on the toothbrush.” “Brush your top teeth.” “Spit into the sink.”
  • Model the action. Brush your teeth along with your loved one – just slow down and slightly exaggerate how you normally do it.
  • Assist hand-under-hand. Watch this short video from Teepa Snow. She demonstrates the proper form.
  • Brush your loved one’s teeth for them. Brush at a 45-degree angle. Focus on the teeth, gums, and tongue.

Try both a regular and an electric toothbrush to see which one works better for your loved one. The electric brush may be helpful for some but too much stimulation for others.

Mouthwash can be a good option as well. If your loved one swallows mouthwash, look for one that’s alcohol free.

Regular dental check-ups are important – especially when your loved one’s personal dental hygiene is failing. Call ahead of the appointment to let your hygienist and dentist know about any problems.

If your dentist office isn’t familiar with your situation, let them know ahead of time (without your loved one present) that your loved one has dementia/Parkinson’s/etc. When you prepare the dentist, they can provide a better and more dignified experience for your loved one.

Can my loved one still stay home alone?

In the beginning stages of dementia, it is usually fine for your loved one to be left home alone for periods of time.  As your loved one’s cognition declines, his/her ability to be alone declines.  So it is important to reassess on a regular basis.

Here are some scenarios to help you assess your loved one:

If there were an emergency, could my loved one respond appropriately?

  • If the hot water tank started spraying hot water, would my loved one know what to do?  Could he/she avoid being burned?  Could he/she call someone for help?
  • If there were a fire in the house, would my loved one know how to get out safely?  Would he/she know to call 911?

If someone tried to scam my loved one, is he/she aware enough to be suspicious?

  • If someone rang the doorbell and said they needed $300 for the pipe repair work they’ve been doing (but not actually doing), would my loved one pay?
  • If someone called and asked my loved one to verify his/her social security number, would he/she give out that number?

How confidently can my loved one perform basic, daily activities?

  • Can he/she safely navigate the house without falling?
  • Is my loved one able to prepare basic meals and snacks?
  • Is my loved one independent with toileting?
  • Can my loved one manage his/her medicine?
  • Has my loved one ever had a stove or microwave incident that wasn’t an issue because someone was home?  BUT if he/she had been alone, it could have been a major incident?

How does staying home alone affect my loved one’s psychological wellbeing?

  • Does my loved one become anxious at certain times of the day or when left alone?
  • Does my loved one call me constantly throughout the day, worried about where I am?

If any of the questions/scenarios listed above made you hesitate, even just a little bit, then your loved one should NOT be left home alone.

This is so important, we’ll say it again: If any of the questions/scenarios listed above made you hesitate, even just a little bit, then your loved one should NOT be left home alone. 

When the time comes that your loved can no longer be left alone, you have options:

  • Take your loved one with you on outings.  Individuals with dementia need social stimulation.
  • Ask family or friends to be with your loved one for a couple of hours, so you can run errands.
  • Ask family or friends to take your loved one out for breakfast or lunch to give you time to do what you need.
  • Enroll your loved on in an adult day program.  Adult day programs are all about fun activities with friends in a safe environment.  The National Adult Day Service Association has information on choosing a center that is right for you.
  • Enlist the services of an in-home care agency.  In Shelby County, these services range from $18 to $22 per hour.  You can set up in-home care on a schedule or call the agency as needed.  (Pro tip: If the care provider they assign to you doesn’t appear to be a good fit with your loved one’s situation/personality, don’t be afraid to ask for someone else.)
  • Consider moving your loved one into a residential program.  We have a blog post here with tips on choosing a residential facility.

If you determine that it’s fine for your loved one to stay home alone, here are some simple things you can do to keep your loved one safe:

  • Post a schedule for your loved one
  • Post a schedule of where you will be
  • Keep a list of important phone numbers by the phone
  • Prepare meals ahead of time (ready to eat or microwave)
  • Have family or friends call or stop by to check in
  • Set medications up in easy pill boxes or in an alarmed pill dispenser

As always, if you have questions about your specific situation, we’re happy to help! Give us a call at 901-854-1200, or make an appointment to come see us in person.

Guilt and Caregiving

Let’s talk about guilt.  Many (if not all) caregivers struggle with guilt.  There’s guilt over being embarrassed by your loved one, guilt for wanting to get out of the house and be alone, guilt for taking the car keys away, guilt for moving your loved one into a memory care facility, guilt for not handling a situation well.  It’s there in the big decisions and the day-to-day stuff.  You may even feel guilty about feeling guilty.  What’s a person to do?

You do have a choice.  You can recognize and address guilt.  OR you can let it tear you apart.  You can acknowledge your negative feelings, or you can tuck them away, where they may grow into an even bigger problem.

Let’s bring guilt out into the open and talk about it.  Because one of the things that makes guilt feel so awful is that it’s secret.  Let’s talk about guilt with these 10 tools for battling the guilt monster.  If you’re weighed down by guilt, print this list out, and put it up somewhere you can see it.  Be reminded that you are not alone.  There is a way forward.

  • Admit that you are experiencing guilt.  When we ignore it, it grows and causes us to make poor decisions that make the problem worse.  Your guilt doesn’t have to control your decisions.  Naming the feeling can give you a new mindset and make room for clear-headed decision making.
  • Be kind to yourself.  Bad days will happen.  You will be a mean, grouchy person.  You will say unkind things in anger and frustration.  Allow yourself some grace for the bad moments.
  • Apologize and move on.  Especially when it’s something small.  If you raised your voice at your loved one or didn’t handle a conversation well, apologize and accept responsibility.  Both parties will be better off. 
  • Don’t play the “What if…?” game.  You’re making lots of really hard decisions.  It’s easy to second guess yourself.  It’s easy to play the “What if…?” game.  (What if I would have taken mom to the doctor sooner or checked on her sooner?)  The “What if…?” game is toxic.  It does nothing but cause more guilt.  Recognize that you made the best decision you could with the information you had at that moment, and IT WAS ENOUGH.  That is the best anyone can do.
  • Remember that you cannot prevent the progression of the dementia.  This illness is not your fault. 
  • Remember that your loved one cannot make responsible decisions.  You will have to make decisions for him/her.  Do the best you can with the information you have.
  • Remember that you are not perfect.  You never were perfect, so don’t expect yourself to be perfect now.  Everyone messes up in big and small ways.
  • Take time for YOU.  When you feel guilty about taking time for yourself, remember: “You can’t pour from an empty cup.”  In order to care for your loved one, you need to be healthy.  Take time to care for your own physical, mental, and spiritual health.
  • Ask for help.  Is anyone as bad at this as we are?  Asking for help is hard!  It always helps me to think about it this way: When others ask me for help, I feel great joy in helping them, and I am honored that they trust me enough to ask.  Reminding myself that most people are happy to help gives me the courage to reach out to others.  Don’t be afraid to ask for exactly what you need.
  • Find a confidant.  Call your friend, sister, or cousin and talk things out.  Sometimes just saying what you feel can help.  A good confidant can give you a new perspective.  And if guilt is really pulling you down, seek help from a counselor, therapist, or minister.
  • Last, but not least: If you think you might be depressed, talk to your doctor or a mental health professional.  Don’t delay.  Overwhelming feelings of guilt can lead to depression.  Be aware, and don’t hesitate to tell your physician.

Wandering

Wandering

Unfortunately, the news is full of reports of individuals with dementia who are missing.

They were left sitting on a bench at the grocery store or mall and told to wait, but they aren’t there anymore.

They have driven to a doctor’s appointment and been found hundreds of miles away.

Their caregiver took a shower and finished to find the front door open and the person with dementia nowhere to be found.

They were traveling, and their caregiver went to the restroom for 2 minutes, to exit and find their loved one gone.

Situations like these can have unhappy endings.  Extreme cold or heat makes a scary situation even scarier.  Also, there are those who will take advantage of individuals with memory loss – financially or physically. 

Know this: if your loved one with dementia has ever wandered away, they will do it again.  It’s nearly impossible for a caregiver to stop a loved one with dementia from wandering.  But being aware that it will happen makes a difference.

Be proactive:

  • Alert your neighbors that your loved one is having issues.
  • Get your loved one an identification bracelet or GPS tracker.  Don’t just buy it and put it in a drawer – actually use it!
  • Install door alarms.  You can usually find them for less than $25 at hardware stores.
  • Those with dementia are often looking for a particular person or home.  If your loved one is talking about these things, be extra aware, as he/she may strike out to find that person or childhood home.

If it happens, act quickly:

  • Call the police immediately It is far easier to find someone when the search radius is small.
  • Keep in mind, those with dementia may not follow an obvious path.  Their vision is frequently down cast and their peripheral vision is narrow, so they may not travel a main road.  They may focus on a smaller path and go places you would not expect.

Wandering isn’t something we like to talk about because it’s scary.  But it’s oh so important to be aware.  Being aware and proactive and acting quickly can make all the difference.

From the Nurse’s Desk: Infection

It is important to be on the lookout for signs of infection in people with Alzheimer’s and dementia.  A person whose cognitive functioning is intact would tell us if he/she is in pain or doesn’t feel well.  But dementia makes this process more difficult.  Those with dementia can’t always express how they’re feeling.  The key to detecting infection is noticing symptoms and changes in behavior.

There are several types of infections that can cause mental status changes in your loved one. Some of the most common infections include:

  • Urinary tract infections (UTI)
  • Upper respiratory infections
  • Ear infections
  • Sinus infections
  • Abscessed teeth

How can you tell if your loved has an infection?

A person with dementia who is experiencing an infection may demonstrate the following symptoms:

  • Fever – Look for warm forehead, dry lips/skin, or signs of shivering.
  • Increased Confusion –Although it may sound like a challenge to notice confusion in someone who has dementia, an infection can cause significant changes that may include increased disorientation to person, place, or time. Remember you know your loved one’s baseline, so if something seems off, it may be a sign. Mental status changes are your biggest clue.
  • Pain or Discomfort – Watch for non-verbal signs of pain such as grimacing, guarding against touch, crying, refusing to eat, and restlessness. 
  • Abnormal Urine – Check your loved one’s urine for odor, cloudiness, dark color, or blood.
  • Increased Lethargy – Look for out-of-the-ordinary fatigue, withdrawal, and desire to sleep.
  • Decreased Appetite – Some infections can cause nausea and vomiting, and others might just cause someone to feel a little “off” to the point where they just don’t want to eat.
  • Falling – Infections can affect balance and cause muscle weakness.  Repeated falls may be a sign.
  • Paranoia or Hallucinations – If your loved one does not normally experience hallucinations, seeing or hearing things that aren’t there could be an indicator.  Some people become very suspicious of others.
  • Behavior Changes – People with Alzheimer’s and other kinds of dementia may experience some challenging behaviors, but an infection can cause a significant increase in the frequency and intensity of those behaviors.  Your loved one might be somewhat resistant to getting dressed in the morning, but an infection could trigger an extreme reaction of screaming, swearing, hitting and throwing things.

What do you do if you notice these changes in your loved one?

Inform your doctor right away!

It is important to have a great primary care physician involved in your loved one’s care.  Be sure to explain everything you’re noticing that’s different in your loved one’s daily operations.  Remember you are the eyes, ears, and voice for your loved one, so you must advocate for him/her. 

If medication is prescribed, finish all the antibiotic or treatment.  If you do not see any changes within a few days, call the doctor back and discuss further treatment options.

Television and Dementia

Let’s just admit it: Most of us watch TV more than we should.  It’s an easy way to pass the time.  Especially when it’s cold and rainy outside.  Especially when you’re not as active as you used to be.  And especially when you have dementia.  TV seems like a good time filler. 

Television isn’t a bad thing.  It’s okay to watch good content in moderation.

Please Note: There are many other activities that are better for your loved one’s physical, emotional, and cognitive health than TV.  Walking, playing a game, reading, visiting with friends, etc.  (You can find a previous blog post about activities here and a list of in-home activities here.)

Dementia affects people’s perception.  Your loved one with memory loss may have a very different experience watching TV than you because of this altered perception.  They may think that the things they’re seeing on TV are happening in real life.  Some examples:

Mom watches a news story about a burglary.  Now, she thinks she has been burglarized.

Your wife watches a crime show about a serial killer.  Now, she is convinced that the serial killer is after her.

Dad watches the news every evening.  Now, he thinks the national news anchor is his best friend who comes over every day to talk about the news.

Grandma watches a sitcom.  Now, she believes that all the people from the sitcom are at her house and that she needs to find a place for them to sleep.

Moral of the story: It’s important to monitor what your loved one with dementia is watching!  Oftentimes as dementia progresses, it becomes increasingly difficult to follow a program.  The person may nod off, lose interest, or ask repeated questions to try and keep up with the story line. 

When you do watch TV, here’s what we suggest:

  • Avoid shows that upset your loved one.  If it causes any stress or anxiety, don’t watch it.
  • Block home shopping channels. Your loved one has impaired decision making skills.  Home shopping commercials are designed to be very convincing.  You don’t want to end up with 7 sets of luggage from QVC.
  • Avoid shows with lots of family drama. Have you ever noticed how a show can alter your mood?  Your loved one is even more susceptible to this.  Don’t watch shows that amp up the drama.  Most families don’t need any more drama.
  • Choose programming from your loved one’s generation.  Examples: I Love Lucy, Lawrence Welk, Sanford and Sons, etc.  This might be a great opportunity to reminisce and talk about times past.
  • Watch a game show.  There’s no story line to follow, so they’re easier to watch.
  • Watch through a streaming service (Netflix, Hulu, etc.), so you can curate the content to your loved one’s specific interests.  Does Mom like baking?  Watch the Great British Baking Show.  Does Dad like war documentaries?  They’ve got those!  Does your husband love dogs?  Search for a movie or documentary that features a dog.
  • Watch a musical.  Music is always good for the soul.  Bonus: Put on the closed caption to make it a sing-along. 

From the Nurse’s Desk: Dehydration

In addition to our monthly blog posts, we’re about to start a new monthly feature called “A Tip from the Nurse’s Desk.” This series will share information on preventative care and tips for healthier living from our nurse, Kiesha.

If you want to receive this information, be sure you’re subscribed to our monthly caregiver email, Caregiver Connection. At the first of each month, we’ll send you an email with a list of caregiver support groups, a Care & Share blog post or video, and A Tip from the Nurse’s Desk.

This first tip is so important we decided it needs to be its own blog post.

From the Nurse’s Desk

Dehydration is something that gets talked about a lot in the summer months, but it’s a problem all year round. In the winter, we may not feel as thirsty, so we don’t drink enough. Also, central heat creates a dry environment, meaning we need more fluids to make up for the dryness.

Dehydration is a term used to describe an excessive loss of water that disrupts the body’s normal functions. Dehydration takes place when more fluids are lost than taken in. It has become a common problem among seniors. It is important to watch your loved one for signs of dehydration.

Some causes of dehydration:

  • Medications (example: Diuretics such as Lasix)
  • Decreased thirst
  • Forgetting to drink fluids
  • Decreased kidney function (As we age, our kidney function decreases, and they can’t hold as much fluid.)
  • Illness

Some symptoms of dehydration:

  • Increase in confusion
  • Delirium over and above typical dementia symptoms
  • Dark, strong smelling urine
  • Dry, papery skin
  • Dry, cracked lips
  • Urinary tract infection (which can also cause delirium)
  • Headache
  • Sunken eyes
  • Constipation
  • Lower than normal blood pressure
  • Fast/weak/irregular pulse
  • Loss of consciousness in severe cases

Dehydration is a serious (and unfortunately common) problem and can cause serious health issues. So how can we prevent our loved ones from getting dehydrated?

1. Pay attention to fluid consumption! Pay attention to how much water your loved one is drinking. Keep a log if you need to.

2. Make drinking easier.  Some ideas: Easy-to-open tops, non-spill cups or water bottles, one-way straws.

3. Set reminders with technology. Set up Reminders or alarms on your phone. Use something like an Ulla. Ulla is a water sensor you can strap around your drinking glass or water bottle. It glows to remind you to drink at regular intervals.

4. Get creative. You don’t have to just provide plain tap water, and even if you do, you can make it more interesting by adding slices of citrus or cucumber. Trade water for a low-sugar sports drink. Popscicles are always a fun way to stay hydrated.

5. Offer food with high water content. Broth-heavy soups, apples, oranges, berries, grapes, watermelon, cucumber, and cottage cheese all have high water content.

6. Keep an eye on caffeine intake. Sodas, coffee, and other things containing caffeine are fine in moderation, but caffeine is a diuretic and may contribute to dehydration. Don’t count coffee or soda in your daily fluid intake.

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  • July 30, 2019

    Self-Care for Caregivers

    Being a caregiver is hard. Being a caregiver for a loved one with dementia is even harder. You hear it all the time: “You need to take care of yourself.” I’m sure caregivers get tired of hearing it because it is much easier said than done. Taking care of yourself takes time and effort that quite frankly, you just don’t seem to have. 

    But the truth is you MUST take care of yourself. If you ignore your own mental and physical well-being, it’s quite possible that you won’t be around to care for your loved one. There are lots of scary statistics out there about health problems brought about by caregiver burnout. Unchecked, extreme stress can be detrimental to health, so it’s important to address it.

    There are small steps you can take to maintain and improve your well-being. We don’t suggest you try all the following suggestions at once. Pick 2. Pick one that you WANT to do and know you can accomplish. Then, pick another that you know you NEED to do (even if it scares you a little bit!). Ask a friend to help hold you accountable.

    • Set aside time for yourself. This could be a week in the mountains or 10 minutes on the front porch with a cup of coffee. You could have a friend or family member sit with your loved one while you go to a movie or get your nails done. You could arrange respite care for your loved one and go on a trip with friends.
    • Educate yourself. The more you understand the disease process, the better you can respond to your loved one. There are resources to meet every caregiver’s needs.  Here are just a few”

    Books

    We suggest The 36 Hour Day and A Pocket Guide for the Alzheimer’s Caregiver.  Come by our center at 1961 S. Houston Levee Road in Collierville (Monday to Friday, 6 am to 6 pm) to pick up your own copies for free. We are able to provide these books to public for free thanks to a grant from the Collierville Community Fund.

    Online

    The Alzheimer’s Association’s website has lots of helpful resources, as does the National Institute on Aging. Search Teepa Snow on YouTube for practical, honest information on personal care, communication, and more.

    Educational Sessions

    Look for caregiver education sessions in your community. We host a support group called Wine & Unwind that features a monthly care topic and guest speaker.  You can learn more about this and our other support groups on the Caregiver Support section of our website.

    Save the date for Baptist’s caregiver conference on Saturday, November 16 with featured speaker Eileen Poiley, Director of Education at USF Health Byrd Alzheimer’s Institute. More information to come. Sign up for our monthly Caregiver Connection emails to stay up-to-date on this conference, as well as our monthly blog posts and support group meetings.
    • Go to your appointments. It is common for caregivers to cancel or forget their own health appointments.  But it’s important to get your annual physical, mammogram, 6-month dental cleaning, etc. Neglecting your own health can lead to more severe concerns down the road.
    • Talk to someone. Talk to a friend, counselor, minister, or fellow caregiver. Join a support group. If you hold it all in, the pressure builds, and at some point, you will explode on the wrong person. It can be hard to talk to family, as they are too close to the situation and may not share your same view. Try to find a non-family member with which to share your frustrations and worries.
    • Give yourself a break and some credit. When you lie down each night, say to yourself: “I have done the best I could with the information I have, and that is enough.” You were not perfect before, so don’t expect yourself to be perfect now. Don’t dwell on the “what if’s” and “if only’s”. Focus on your strengths and the positives. You do a lot physically. You manage a lot emotionally. Give yourself a pat on the back, even if no one else is doing that for you.
    • Ask for help. There will be times when you will not be able to handle caregiving alone. Ask a professional for help. Call a friend. Reach out to a physician. Tell another family member what you need. You are not going to know the answer to every question – ask! Call Page Robbins (901-854-1200), and we will help you navigate.
    • Give yourself a present. Get a manicure. Order a new gadget. Pick up your favorite meal. When you don’t receive gifts very often, it can be a good boost.
    • Allow yourself to laugh. Laughter can heal the soul. Turn on a funny movie or TV show, listen to a funny podcast, read a silly story.
    • Eat well. Exercise. Sleep. Food is your fuel. Eat balanced meals. It’s tempting to live on junk food and snacks because it’s easy. Get plenty of fruits, vegetables, healthy fats, protein, and water. Exercise is good for your body, mind, and sleep. You don’t have to run. Walk, stretch, maybe try some yoga (a class or YouTube videos at home). A good workout will help you sleep. Sleep is important to healthy brain functioning. Don’t stay up too late if you don’t have to. Take naps, and don’t let anyone make you feel guilty about it!

    June 28, 2019

    Dental Hygiene Tips

    Keeping Up Dental Hygiene

    Most of us take our pearly whites for granted. We brush them morning and night. We floss. We get food stuck between our teeth and can get it out. We recognize when something hurts.

    People with dementia can’t always do these things, so their caregivers assume the responsibility. It isn’t easy to get an adult who doesn’t want to brush his/her teeth to do it (especially if you’ve just had a similar battle over changing into or out of pajamas). But it is worth the effort.

    When oral care diminishes, a domino effect of bad things can happen. First, cavities, broken teeth, and bad breath. Next, teeth pulled. Then, lost appetite and weight loss. An unhealthy mouth can also lead to infections and abscesses.

    If you notice your loved one’s oral care isn’t what it used to be, here are some ways you can help:

    • Instruct step-by-step. “John, lets brush your teeth.” “Put toothpaste on the toothbrush.” “Brush your top teeth.” “Spit into the sink.”
    • Model the action. Brush your teeth along with your loved one – just slow down and slightly exaggerate how you normally do it.
    • Assist hand-under-hand. Watch this short video from Teepa Snow. She demonstrates the proper form.
    • Brush your loved one’s teeth for them. Brush at a 45-degree angle. Focus on the teeth, gums, and tongue.

    Try both a regular and an electric toothbrush to see which one works better for your loved one. The electric brush may be helpful for some but too much stimulation for others.

    Mouthwash can be a good option as well. If your loved one swallows mouthwash, look for one that’s alcohol free.

    Regular dental check-ups are important – especially when your loved one’s personal dental hygiene is failing. Call ahead of the appointment to let your hygienist and dentist know about any problems.

    If your dentist office isn’t familiar with your situation, let them know ahead of time (without your loved one present) that your loved one has dementia/Parkinson’s/etc. When you prepare the dentist, they can provide a better and more dignified experience for your loved one.

    May 29, 2019

    Can my loved one still stay home alone?

    In the beginning stages of dementia, it is usually fine for your loved one to be left home alone for periods of time.  As your loved one’s cognition declines, his/her ability to be alone declines.  So it is important to reassess on a regular basis.

    Here are some scenarios to help you assess your loved one:

    If there were an emergency, could my loved one respond appropriately?

    • If the hot water tank started spraying hot water, would my loved one know what to do?  Could he/she avoid being burned?  Could he/she call someone for help?
    • If there were a fire in the house, would my loved one know how to get out safely?  Would he/she know to call 911?

    If someone tried to scam my loved one, is he/she aware enough to be suspicious?

    • If someone rang the doorbell and said they needed $300 for the pipe repair work they’ve been doing (but not actually doing), would my loved one pay?
    • If someone called and asked my loved one to verify his/her social security number, would he/she give out that number?

    How confidently can my loved one perform basic, daily activities?

    • Can he/she safely navigate the house without falling?
    • Is my loved one able to prepare basic meals and snacks?
    • Is my loved one independent with toileting?
    • Can my loved one manage his/her medicine?
    • Has my loved one ever had a stove or microwave incident that wasn’t an issue because someone was home?  BUT if he/she had been alone, it could have been a major incident?

    How does staying home alone affect my loved one’s psychological wellbeing?

    • Does my loved one become anxious at certain times of the day or when left alone?
    • Does my loved one call me constantly throughout the day, worried about where I am?

    If any of the questions/scenarios listed above made you hesitate, even just a little bit, then your loved one should NOT be left home alone.

    This is so important, we’ll say it again: If any of the questions/scenarios listed above made you hesitate, even just a little bit, then your loved one should NOT be left home alone. 

    When the time comes that your loved can no longer be left alone, you have options:

    • Take your loved one with you on outings.  Individuals with dementia need social stimulation.
    • Ask family or friends to be with your loved one for a couple of hours, so you can run errands.
    • Ask family or friends to take your loved one out for breakfast or lunch to give you time to do what you need.
    • Enroll your loved on in an adult day program.  Adult day programs are all about fun activities with friends in a safe environment.  The National Adult Day Service Association has information on choosing a center that is right for you.
    • Enlist the services of an in-home care agency.  In Shelby County, these services range from $18 to $22 per hour.  You can set up in-home care on a schedule or call the agency as needed.  (Pro tip: If the care provider they assign to you doesn’t appear to be a good fit with your loved one’s situation/personality, don’t be afraid to ask for someone else.)
    • Consider moving your loved one into a residential program.  We have a blog post here with tips on choosing a residential facility.

    If you determine that it’s fine for your loved one to stay home alone, here are some simple things you can do to keep your loved one safe:

    • Post a schedule for your loved one
    • Post a schedule of where you will be
    • Keep a list of important phone numbers by the phone
    • Prepare meals ahead of time (ready to eat or microwave)
    • Have family or friends call or stop by to check in
    • Set medications up in easy pill boxes or in an alarmed pill dispenser

    As always, if you have questions about your specific situation, we’re happy to help! Give us a call at 901-854-1200, or make an appointment to come see us in person.

    April 29, 2019

    Guilt and Caregiving

    Let’s talk about guilt.  Many (if not all) caregivers struggle with guilt.  There’s guilt over being embarrassed by your loved one, guilt for wanting to get out of the house and be alone, guilt for taking the car keys away, guilt for moving your loved one into a memory care facility, guilt for not handling a situation well.  It’s there in the big decisions and the day-to-day stuff.  You may even feel guilty about feeling guilty.  What’s a person to do?

    You do have a choice.  You can recognize and address guilt.  OR you can let it tear you apart.  You can acknowledge your negative feelings, or you can tuck them away, where they may grow into an even bigger problem.

    Let’s bring guilt out into the open and talk about it.  Because one of the things that makes guilt feel so awful is that it’s secret.  Let’s talk about guilt with these 10 tools for battling the guilt monster.  If you’re weighed down by guilt, print this list out, and put it up somewhere you can see it.  Be reminded that you are not alone.  There is a way forward.

    • Admit that you are experiencing guilt.  When we ignore it, it grows and causes us to make poor decisions that make the problem worse.  Your guilt doesn’t have to control your decisions.  Naming the feeling can give you a new mindset and make room for clear-headed decision making.
    • Be kind to yourself.  Bad days will happen.  You will be a mean, grouchy person.  You will say unkind things in anger and frustration.  Allow yourself some grace for the bad moments.
    • Apologize and move on.  Especially when it’s something small.  If you raised your voice at your loved one or didn’t handle a conversation well, apologize and accept responsibility.  Both parties will be better off. 
    • Don’t play the “What if…?” game.  You’re making lots of really hard decisions.  It’s easy to second guess yourself.  It’s easy to play the “What if…?” game.  (What if I would have taken mom to the doctor sooner or checked on her sooner?)  The “What if…?” game is toxic.  It does nothing but cause more guilt.  Recognize that you made the best decision you could with the information you had at that moment, and IT WAS ENOUGH.  That is the best anyone can do.
    • Remember that you cannot prevent the progression of the dementia.  This illness is not your fault. 
    • Remember that your loved one cannot make responsible decisions.  You will have to make decisions for him/her.  Do the best you can with the information you have.
    • Remember that you are not perfect.  You never were perfect, so don’t expect yourself to be perfect now.  Everyone messes up in big and small ways.
    • Take time for YOU.  When you feel guilty about taking time for yourself, remember: “You can’t pour from an empty cup.”  In order to care for your loved one, you need to be healthy.  Take time to care for your own physical, mental, and spiritual health.
    • Ask for help.  Is anyone as bad at this as we are?  Asking for help is hard!  It always helps me to think about it this way: When others ask me for help, I feel great joy in helping them, and I am honored that they trust me enough to ask.  Reminding myself that most people are happy to help gives me the courage to reach out to others.  Don’t be afraid to ask for exactly what you need.
    • Find a confidant.  Call your friend, sister, or cousin and talk things out.  Sometimes just saying what you feel can help.  A good confidant can give you a new perspective.  And if guilt is really pulling you down, seek help from a counselor, therapist, or minister.
    • Last, but not least: If you think you might be depressed, talk to your doctor or a mental health professional.  Don’t delay.  Overwhelming feelings of guilt can lead to depression.  Be aware, and don’t hesitate to tell your physician.

    March 29, 2019

    Wandering

    Wandering

    Unfortunately, the news is full of reports of individuals with dementia who are missing.

    They were left sitting on a bench at the grocery store or mall and told to wait, but they aren’t there anymore.

    They have driven to a doctor’s appointment and been found hundreds of miles away.

    Their caregiver took a shower and finished to find the front door open and the person with dementia nowhere to be found.

    They were traveling, and their caregiver went to the restroom for 2 minutes, to exit and find their loved one gone.

    Situations like these can have unhappy endings.  Extreme cold or heat makes a scary situation even scarier.  Also, there are those who will take advantage of individuals with memory loss – financially or physically. 

    Know this: if your loved one with dementia has ever wandered away, they will do it again.  It’s nearly impossible for a caregiver to stop a loved one with dementia from wandering.  But being aware that it will happen makes a difference.

    Be proactive:

    • Alert your neighbors that your loved one is having issues.
    • Get your loved one an identification bracelet or GPS tracker.  Don’t just buy it and put it in a drawer – actually use it!
    • Install door alarms.  You can usually find them for less than $25 at hardware stores.
    • Those with dementia are often looking for a particular person or home.  If your loved one is talking about these things, be extra aware, as he/she may strike out to find that person or childhood home.

    If it happens, act quickly:

    • Call the police immediately It is far easier to find someone when the search radius is small.
    • Keep in mind, those with dementia may not follow an obvious path.  Their vision is frequently down cast and their peripheral vision is narrow, so they may not travel a main road.  They may focus on a smaller path and go places you would not expect.

    Wandering isn’t something we like to talk about because it’s scary.  But it’s oh so important to be aware.  Being aware and proactive and acting quickly can make all the difference.

    February 22, 2019

    From the Nurse’s Desk: Infection

    It is important to be on the lookout for signs of infection in people with Alzheimer’s and dementia.  A person whose cognitive functioning is intact would tell us if he/she is in pain or doesn’t feel well.  But dementia makes this process more difficult.  Those with dementia can’t always express how they’re feeling.  The key to detecting infection is noticing symptoms and changes in behavior.

    There are several types of infections that can cause mental status changes in your loved one. Some of the most common infections include:

    • Urinary tract infections (UTI)
    • Upper respiratory infections
    • Ear infections
    • Sinus infections
    • Abscessed teeth

    How can you tell if your loved has an infection?

    A person with dementia who is experiencing an infection may demonstrate the following symptoms:

    • Fever – Look for warm forehead, dry lips/skin, or signs of shivering.
    • Increased Confusion –Although it may sound like a challenge to notice confusion in someone who has dementia, an infection can cause significant changes that may include increased disorientation to person, place, or time. Remember you know your loved one’s baseline, so if something seems off, it may be a sign. Mental status changes are your biggest clue.
    • Pain or Discomfort – Watch for non-verbal signs of pain such as grimacing, guarding against touch, crying, refusing to eat, and restlessness. 
    • Abnormal Urine – Check your loved one’s urine for odor, cloudiness, dark color, or blood.
    • Increased Lethargy – Look for out-of-the-ordinary fatigue, withdrawal, and desire to sleep.
    • Decreased Appetite – Some infections can cause nausea and vomiting, and others might just cause someone to feel a little “off” to the point where they just don’t want to eat.
    • Falling – Infections can affect balance and cause muscle weakness.  Repeated falls may be a sign.
    • Paranoia or Hallucinations – If your loved one does not normally experience hallucinations, seeing or hearing things that aren’t there could be an indicator.  Some people become very suspicious of others.
    • Behavior Changes – People with Alzheimer’s and other kinds of dementia may experience some challenging behaviors, but an infection can cause a significant increase in the frequency and intensity of those behaviors.  Your loved one might be somewhat resistant to getting dressed in the morning, but an infection could trigger an extreme reaction of screaming, swearing, hitting and throwing things.

    What do you do if you notice these changes in your loved one?

    Inform your doctor right away!

    It is important to have a great primary care physician involved in your loved one’s care.  Be sure to explain everything you’re noticing that’s different in your loved one’s daily operations.  Remember you are the eyes, ears, and voice for your loved one, so you must advocate for him/her. 

    If medication is prescribed, finish all the antibiotic or treatment.  If you do not see any changes within a few days, call the doctor back and discuss further treatment options.

    Television and Dementia

    Let’s just admit it: Most of us watch TV more than we should.  It’s an easy way to pass the time.  Especially when it’s cold and rainy outside.  Especially when you’re not as active as you used to be.  And especially when you have dementia.  TV seems like a good time filler. 

    Television isn’t a bad thing.  It’s okay to watch good content in moderation.

    Please Note: There are many other activities that are better for your loved one’s physical, emotional, and cognitive health than TV.  Walking, playing a game, reading, visiting with friends, etc.  (You can find a previous blog post about activities here and a list of in-home activities here.)

    Dementia affects people’s perception.  Your loved one with memory loss may have a very different experience watching TV than you because of this altered perception.  They may think that the things they’re seeing on TV are happening in real life.  Some examples:

    Mom watches a news story about a burglary.  Now, she thinks she has been burglarized.

    Your wife watches a crime show about a serial killer.  Now, she is convinced that the serial killer is after her.

    Dad watches the news every evening.  Now, he thinks the national news anchor is his best friend who comes over every day to talk about the news.

    Grandma watches a sitcom.  Now, she believes that all the people from the sitcom are at her house and that she needs to find a place for them to sleep.

    Moral of the story: It’s important to monitor what your loved one with dementia is watching!  Oftentimes as dementia progresses, it becomes increasingly difficult to follow a program.  The person may nod off, lose interest, or ask repeated questions to try and keep up with the story line. 

    When you do watch TV, here’s what we suggest:

    • Avoid shows that upset your loved one.  If it causes any stress or anxiety, don’t watch it.
    • Block home shopping channels. Your loved one has impaired decision making skills.  Home shopping commercials are designed to be very convincing.  You don’t want to end up with 7 sets of luggage from QVC.
    • Avoid shows with lots of family drama. Have you ever noticed how a show can alter your mood?  Your loved one is even more susceptible to this.  Don’t watch shows that amp up the drama.  Most families don’t need any more drama.
    • Choose programming from your loved one’s generation.  Examples: I Love Lucy, Lawrence Welk, Sanford and Sons, etc.  This might be a great opportunity to reminisce and talk about times past.
    • Watch a game show.  There’s no story line to follow, so they’re easier to watch.
    • Watch through a streaming service (Netflix, Hulu, etc.), so you can curate the content to your loved one’s specific interests.  Does Mom like baking?  Watch the Great British Baking Show.  Does Dad like war documentaries?  They’ve got those!  Does your husband love dogs?  Search for a movie or documentary that features a dog.
    • Watch a musical.  Music is always good for the soul.  Bonus: Put on the closed caption to make it a sing-along. 

    January 30, 2019

    From the Nurse’s Desk: Dehydration

    In addition to our monthly blog posts, we’re about to start a new monthly feature called “A Tip from the Nurse’s Desk.” This series will share information on preventative care and tips for healthier living from our nurse, Kiesha.

    If you want to receive this information, be sure you’re subscribed to our monthly caregiver email, Caregiver Connection. At the first of each month, we’ll send you an email with a list of caregiver support groups, a Care & Share blog post or video, and A Tip from the Nurse’s Desk.

    This first tip is so important we decided it needs to be its own blog post.

    From the Nurse’s Desk

    Dehydration is something that gets talked about a lot in the summer months, but it’s a problem all year round. In the winter, we may not feel as thirsty, so we don’t drink enough. Also, central heat creates a dry environment, meaning we need more fluids to make up for the dryness.

    Dehydration is a term used to describe an excessive loss of water that disrupts the body’s normal functions. Dehydration takes place when more fluids are lost than taken in. It has become a common problem among seniors. It is important to watch your loved one for signs of dehydration.

    Some causes of dehydration:

    • Medications (example: Diuretics such as Lasix)
    • Decreased thirst
    • Forgetting to drink fluids
    • Decreased kidney function (As we age, our kidney function decreases, and they can’t hold as much fluid.)
    • Illness

    Some symptoms of dehydration:

    • Increase in confusion
    • Delirium over and above typical dementia symptoms
    • Dark, strong smelling urine
    • Dry, papery skin
    • Dry, cracked lips
    • Urinary tract infection (which can also cause delirium)
    • Headache
    • Sunken eyes
    • Constipation
    • Lower than normal blood pressure
    • Fast/weak/irregular pulse
    • Loss of consciousness in severe cases

    Dehydration is a serious (and unfortunately common) problem and can cause serious health issues. So how can we prevent our loved ones from getting dehydrated?

    1. Pay attention to fluid consumption! Pay attention to how much water your loved one is drinking. Keep a log if you need to.

    2. Make drinking easier.  Some ideas: Easy-to-open tops, non-spill cups or water bottles, one-way straws.

    3. Set reminders with technology. Set up Reminders or alarms on your phone. Use something like an Ulla. Ulla is a water sensor you can strap around your drinking glass or water bottle. It glows to remind you to drink at regular intervals.

    4. Get creative. You don’t have to just provide plain tap water, and even if you do, you can make it more interesting by adding slices of citrus or cucumber. Trade water for a low-sugar sports drink. Popscicles are always a fun way to stay hydrated.

    5. Offer food with high water content. Broth-heavy soups, apples, oranges, berries, grapes, watermelon, cucumber, and cottage cheese all have high water content.

    6. Keep an eye on caffeine intake. Sodas, coffee, and other things containing caffeine are fine in moderation, but caffeine is a diuretic and may contribute to dehydration. Don’t count coffee or soda in your daily fluid intake.