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 Social Worker, Sheri Wammack at firstname.lastname@example.org.
Care & Share
March 17, 2016
Vision and Dementia
Seeing and understanding our world is a multi-step process – our eyes take in an image, that image is then sent to our brains (along with information from the other senses), and then the brain processes the image using the information gathered and past experience to make sense of what is being seen. When someone has dementia, there is a breakdown in this process.
What can you do as a caregiver or friend of one with dementia?
First and foremost, it is imperative that those with dementia have regular vision screenings so that any issues with vision can be addressed and corrected as soon as possible. An impaired brain needs to receive the best information it can, and regular vision screenings will help ensure this occurs. If the person has glasses, be sure they are the correct prescription and lenses are clean. If glasses are constantly being misplaced, put them on a chain or keep an extra pair at the ready.
Here are additional things you can do to help your loved one:
- Create contrast. Those with dementia have difficulty distinguishing objects of similar color. For example, a pale yellow plate on a white tablecloth may blend in. A brown handrail mounted on a brown wall or a white button on a light colored shirt can’t be seen. A dark mug with black coffee may look like an empty mug. It is best to use contrasting colors to highlight things you want your loved one to see. Put the black coffee in a light colored cup. If the wall is light brown, paint the handrail black. Instead of a light colored shirt with light buttons, choose a blue shirt with white buttons. Serve dinner on a white plate on a red tablecloth.
- Put on your binoculars. An average young person can put his hands straight out to each side and see his fingertips using peripheral vision. As we age, peripheral vision naturally narrows, but with dementia, a person’s field of vision narrows drastically. Dementia care expert Teepa Snow uses the analogy of binoculars to explain this change in vision. Place your hands over your eyes like binoculars. You can’t see much – right? A limited field of vision can easily cause falls and other accidents. Keep this in mind when guiding your loved one through a room or assessing potential fall hazards. Also, when eating, your loved one may not be able to see part of the plate, so you may need to turn the plate so that the other food can be seen.
- Keep in mind difficulties with depth perception. Changes in flooring can be confusing. A dark rug may look like a black hole, so the person will step around it or won’t walk over it for fear of falling into a bottomless pit. Consider moving the dark rug or switching it for a color similar to the flooring. When the flooring switches from carpet to tile, your loved one may think it is a step up/down. When walking with your loved one, verbally reassure him or her that the flooring is the same level. Your loved one may think the chair is close enough to sit, while really he or she is still far from the chair. Help guide your loved one to the seat.
- Fill rooms with bright, direct light. As we age, we require brighter light to see. This is even truer for those with dementia. The brain can play tricks in poor lighting. Imagine sitting in your living room with the blinds open and curtains pulled back in the late afternoon. The sun begins to set and shadows start appearing. Those with dementia may think the coatrack in the corner is a person or the random misplaced shoe is cat on the living room floor. Close the blinds, pull the curtains, and ensure sufficient indoor lighting is available before the sun sets to help avoid extra confusion.
- Eliminate unnecessary visual noise. An environment that is cluttered or filled with multiple, strong patterns can be confusing for the already confused brain. A cleaner and more simplified environment is ideal. Embrace spring cleaning. Enlist of the help of family, friends, or neighbors and declutter as much as possible.
If you have specific questions or concerns, our Social Worker, Sheri Wammack, is available to talk with you and answer questions (901.854.1200 or email@example.com).
December 2, 2015
Caregiving and the Holidays
The holidays can be stressful. No surprise, right? We tend to spend the holiday months in a blur of activities. Parties, family get-togethers, church activities… the list goes on and on. The holidays are also a time for family traditions – donning Christmas aprons to make homemade desserts, decorating the tree with heirloom ornaments, driving hours to share a meal with family. These pastimes can be exciting and meaningful, but when you’re caring for a loved one with memory loss, the holiday frenzy can cause additional stress.
The following are tips to keep in mind for this holiday season. We hope these tips will help make the holidays a bit easier for you and your loved one.
You’re also welcome to join us on Tuesday, December 8 from 4-5 pm at Page Robbins as we discuss “Managing the Holidays” during our monthly Caregiver Support Group. Lowry Whitehorn, Bereavement Counselor at Crossroads Hospice will be our guest speaker. This session is free and open to the public.
- Simplify. It’s okay to start new, smaller traditions. For example, if it feels overwhelming to decorate the whole house, then just decorate the mantel or put up a small tree.
- Don’t aim for perfection. Perfect holidays aren’t attainable. Perfect anything isn’t attainable! It’s easy to think on times past with rose colored glasses, but no holiday is perfect. Your situation has changed. Don’t feel that you need to live up to the expectations of friends and family members. Take stock of where you’re at, set your own limits.
- Make a to-do list, so you’ll know exactly what needs to be done.
- Plan ahead for small outings. Instead of taking your loved one on a day full of errands, break up errands into multiple outings and plan those outings at times when stores are likely to be less busy.
- Know that you don’t have to say “yes” to every invitation you receive. Everything in moderation. Be picky about which events you attend.
- Have important conversations beforehand. As needed, familiarize others with the situation. Let those who don’t see your loved one often know how he or she is doing and what they should expect.
- Make your own wish list. When a friend or family member asks, “How can I help you?” have a wish list ready (a physical/electronic list, not just a mental one). Some items on your list might be a few hours of respite on a Saturday or overnight respite, meals, home repairs, etc.
- Encourage family members to shop non-traditionally. Suggest items for your loved one such as socks, comfy sweaters, a puzzle, or a coffee table book with large pictures, on a topic of interest.
- Book your homecare worker early. This is a busy season. Call your preferred home care agency early with desired dates, so you can be sure to get on their calendars.
- Keep conversations light. Encourage family members and friends to tell stories instead of quizzing your loved one. NOT: “Do you remember when we went to the Grand Canyon for Christmas?” or “Do you remember Cousin Whitney?” Instead: “One of my favorite Christmases was when we went to the Grand Canyon. We sang Christmas carols while we were stuck in traffic for hours. That was a fun trip.” or “Cousin Whitney used to love to visit you, so she could have some of your blueberry pie.”
- Don’t rock the boat. Holiday gatherings are not the best time to have a family argument about the sister who isn’t as involved as you would like her to be. Instead, focus on making the holidays special.
- Designate a quiet room. If visitors are coming over or you are going to a party elsewhere, it is a good idea to have a quiet room for your loved one. Select a room away from the noise and crowd, where your loved one can sit and relax, and friends can go visit one-on-one with your loved one. Make sure the room has a comfortable chair and perhaps books or a TV. Your loved one may also enjoy sitting by the window or listening to music.
- Try to maintain regular sleeping and eating schedules. If you have a mid-afternoon Christmas lunch, your loved one will need to eat something at his or her regular meal time. It doesn’t need to be a full meal, just a small protein and fruit portion to tide over until the big meal. Also, someone should observe and monitor any potential alcohol consumption for that individual as well. One cup of egg nog might turn in to 5 if no one is paying attention! Try your best to maintain normal rest and nighttime sleep schedules.
- Sit back, and enjoy. Embrace each moment, or as we say at Page Robbins, seize the day. Enjoy the time you have with your loved one.
If you’re looking for more information, we hope you’ll join us for the support group. If you aren’t able, our Social Worker, Sheri Wammack, and Executive Director, Herbie Krisle, are available to talk with you and answer questions (901.854.1200 or firstname.lastname@example.org, email@example.com).
May 18, 2015
The greatest gift my mother ever gave me came the week after my daddy died. Daddy had undiagnosed stomach cancer that had been diagnosed as an ulcer and treated accordingly. The blood work showed something else was terribly wrong: the malignancy had metastasized throughout his body. He died 4 days after being hospitalized. We had to make many decisions quickly about life support, feeding tubes and the like. Though we thought we knew what his desires would be, we were required to make the choices.
The week after his death, Mother made an appointment with her attorney and had all the powers of attorney and advance directives completed. She told me I would never have to make those hard choices, ever again. Little did we know that in just a few years, she would experience profound memory loss and would not be able to make those choices known. If she would not have completed those advance directives, I would have had nothing in writing – just words from a past conversation where she told me she did not want to have any ‘heroic’ efforts made if she could not live a normal life.
If your loved one has advance directives completed, I know you are grateful. But if not, what can you, as a family, do? While you can’t complete a living will FOR someone, as a family, you can have a calm discussion about it and come to a joint decision BEFORE a decision is needed. Decisions made in the midst of a crisis are difficult, and often it is impossible to get all parties together when a split second decision is needed. Two big decisions that families often have to make are:
- Would you have a feeding tube inserted if your loved one could no longer swallow?
- Would you have CPR begun on your loved one in the event of heart attack/coronary arrest?
This Thursday, May 21 from 4:00 to 5:00 pm, we will host Wine and Unwind at Page Robbins. This month’s topic is “Advance Directives: What do I need to know?” with guest speakers Emily Stuart, LBSW and Julie Beaty, LBSW from Crossroads Hospice. Please call us at 901-854-1200 to RSVP. All of our support groups and educational sessions are free and open to the public.
If you’re looking for more information about advance directives, we hope you’ll join us for Wine and Unwind. If you aren’t able to join, our Social Worker, Sheri Wammack is available to talk with you, answer questions, and point you to a variety of resources (901.854.1200 or firstname.lastname@example.org).
Written by Herbie Krisle, Executive Director
March 25, 2015
Should you be concerned?
Several members of our staff had a movie night recently and watched Still Alice. We all remarked about what a well done movie it was and how true to life many things were – like how everyone initially overlooked her “slips” and odd choices of words until the lapses were too significant to misunderstand.
Many of you are facing similar issues, maybe not with a middle aged person with young onset Alzheimer’s disease but with an older adult who is experiencing problems.
These are some things to watch for:
- Improper handling of financial matters
- Missing appointments or special days
- Lack of attention to personal appearance and personal hygiene
- Reduced housekeeping, food preparation and often changes in eating habits/patterns
- Change of demeanor
If your loved one is exhibiting these behavior changes, we recommend that you take him or her to see a physician who can give a diagnosis. There are many times when these issues will have nothing to do with Alzheimer’s disease or vascular dementia but may be cause by something reversible, such as a vitamin deficiency. Early review by a doctor who has strengths in this area is important.
On Saturday, April 11 from 9 to 10 am, we will host Starting Point, our quarterly support group for caregivers of those who have been recently diagnosed or those who have yet to be diagnosed but the family knows something isn’t quite right. We hope you will make plans to attend if you have questions and/or need support in this area. If you are interested, please RSVP by calling 901.854.1200. All of our support groups are free and open to the public.
If you have questions about this or other care-related topics, give us a call at 901.854.1200. Our Social Worker will be happy to talk with you and answer your questions.
June 26, 2014
Partnering with Your Doctor
While caring for your loved one, there will be times that you will need to consult with your loved one’s physician for a variety of reasons. Visits to see a physician may be an overwhelming experience for your loved one and may cause anxiety, which can make the appointment not go so well. It is important that your appointments be as productive as possible so that you can get your questions answered and make the most of your time with the doctor. The following are tips that we hope will make future appointments less stressful and much more successful.
Make the appointment at the best time of day for your loved one. Consider when waiting times might be shortest. Ask the person you schedule the appointment with what time of day the waiting room is least likely to be crowded.
Consider parking, office location, and how much time you’ll need to get to the appointment. If the distance from parking to waiting room is quite far, it might be easiest to bring a light-weight wheelchair to transport your loved one, rather than relying on their usual walker or cane. Or you might ask a friend, neighbor, or family member to drive, so you and your loved one can be dropped off at the front door. If the office is located in larger complex or hospital, valet parking might be available (just be sure to bring small bills to pay for the valet parking). Budget extra time, so you don’t have to rush.
There are a few things we recommend you bring with you to the appointment:
- List of current medications – both prescription and over the counter. Be sure to include dosage, name of prescribing doctor, and a very brief explanation for why your loved one takes that medicine. We’ve included an example medication log. Feel free to use this form to record your loved one’s medication, or use it as a guideline to create your own:
- Medical history and list of diagnoses and allergies.
- List of questions, concerns, and changes. If you write these things down as you notice them, you’ll be more likely to remember and bring it up during the appointment.
- Something to write with and something to write on for note taking during the appointment. A lot can be discussed during a doctor’s appointment. It may be difficult to remember everything. Take notes, so you won’t have to worry about trying to remember all that is said.
Set a tone of respect. Include your loved one in the conversation. Your loved one wants and needs to feel respected and included. If you address your loved one with respect, any health professionals you encounter may be more inclined to follow your example.
Along those same lines, don’t talk about your loved as if he or she isn’t there. It can feel like you are tattling and create bad feelings. Instead, prepare a brief yet descriptive list of concerns and give it to the receptionist with a note for it to be given to the doctor before the appointment. The doctor won’t read 3 pages, so prioritize. Keep it to one page. Use bullet points. You can also excuse yourself to the restroom to very briefly talk with a nurse in the hallway.
Note any changes that have occurred and any new symptoms, and be specific. Instead of saying, “He hasn’t been sleeping well;” say, “For the past two weeks, he has been sleeping about 3 hours each night. When he isn’t sleeping, he paces around the house.”
Don’t be afraid to ask questions and to ask for explanations. You are the best advocate for your loved one and yourself.
- If you don’t understand a term, ask for clarification.
- If a doctor orders a test, and you don’t understand why, ask for the doctor to explain the test and why it was ordered. Ask for copies of test results.
- If medication is prescribed, ask about side effects, how long the doctor expects your loved one to be taking that medication, how long the medicine will take to start working, what to do if the medicine doesn’t work.
- And lastly, ask when the next appointment should be.
Follow the doctor’s recommendations. If a doctor asks you to try a new medication or make an appointment with a specialist, etc., really try to follow his or her instructions.
If you have questions or are seeking advice on your specific situation, Sheri Wammack, our Social Worker and Admission Coordinator is available to answer your questions (phone: 901.854.1200 Ext. 14, email: email@example.com). If there are topics about which you would like to see future blog posts, email Katie (firstname.lastname@example.org) with your ideas.