Care & Share

Welcome to our Care & Share blog! This blog features care advice for caregivers, family members, and friends of those with dementia. We also have information on caring for caregivers. If there’s a topic you would like to see addressed, please let us know! You can give us a call at 901.854.1200 or email our Program Director, Sheri Wammack at sheri@pagerobbins.org.

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  • 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.

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