Having a loved one with Dementia or Alzheimer’s can take a lot of patience. There are so many emotions surrounding your parent, loved one, friend having dementia. It is not typically a surprise to your loved ones. You have brought it to their attention or they have been noticing something is off for a while now.
Recognizing there’s a problem:
The first step is to ensure the senior has a safe system in place 24 hours a day, 7 days a week while you get through step 2.
The second step is getting a diagnosis which will provide answers as to what has been going on with your loved one. The wait time to see a Neurologist can be months and months long. While you wait you should have the senior see their primary physician. A primary physician has often taken years to get to know your loved one and has had a long time to establish a relationship with them and one of trust. They will most likely run some blood work and/or urine test to see if there is any simple underlying condition causing the senior to be more confused, forgetful basically not themselves. (*More below on some examples of these underlying conditions below)
Physicians often see a glimpse of their patient. They are very routines visits and your loved one can be exactly who they always are at their visit. A primary physician may prescribe a medication to slow down the progression of a memory impaired resident, it may or may not be all they need or all the doctor can really do until you see a specialist. Also keep in mind a primary physician sees all ages of people and works with a basic approach to medicine. In that glimpse of seeing your loved one I have often noticed they do not like to “side” with the family initially on what’s happening unless something or a scary circumstance brought them there. They are not so happy about taking away someone’s freedoms based on a glimpse of a visit. (Which is why you may notice their resistance to take away a seniors drivers license or agree to an assisted living type environment if the senior is not on board) with no substantial situation to bring them there. Also important to note are the times you are not at the visits with their doctor and your loved one tells their doctor how their son is too busy for them, their daughter has her own family and has little to no time for them. “They are trying to stick me in a home.”Their physician has some sympathy for their patients and often sides with their independence. I personally think they do not want to be the one to take those freedoms away from their patient unless necessary. Not to say all general practitioners are this way but the majority tends to be reserved in their approaches.
Having a Geriatrician which is a doctor that works solely with senior citizens can be a bit more reassuring as they recognize all of their symptoms and take a more aggressive approach until or if a specialist is seen.
Here are some scary and what may seem like drastic scenarios but very common occurrences with someone that has dementia or Alzheimer’s and lives alone.
1. Mom had a kitchen fire forgetting the stove on. She has left the gas on and Fireman responded and neighbors are nervous she’s going to kill them.
2. Dad was found by police 3 states away when he only went to get lotto at our local deli.
3. My uncle is knocking on the neighbors doors in his building at 2am and the doorman said he is dressed and ready to go to work at 3am nightly now.
4. You are starting to notice on your visits that your loved ones mail is piling up which in turn results in their bills not being paid for some time now. Sadly this list can go on and on but in an effort to keep it simple I will just provide a few.
I meet with so many families that say my loved one had some forgetfulness but the last week or two they are unrecognizable and now they have full blown dementia.
This can be a UTI- urinary tract infection and antibiotics can help A senior to return to their normal self. For some this is a traumatic situation and they may not return fully to themselves but will come pretty close. Dehydration and poor hygiene are just a couple of the reasons a UTI can happen to someone. A UTI can be very scary to the senior and their loved ones. They can appear very disoriented, confused, they can hallucinate etc. For a first time caregiver they like most people and sadly some. Doctors do not always recognize that a UTI can have this severe of an effect on someone. I often ask families to go back to the hospital, the doctors office and insist they do a urine test. This is not always the answer but more often than not when someone has such a sudden shift a UTI has a good chance of being in play.
A senior being on a new medication can also present some misguided signs of a memory impaired resident and may need to revisit that with their physician immediately.
A traumatic event such as loosing a spouse, a good friend. Family moving away, depression, a pandemic or in which the senior is isolated in their home can all impact the residents frame of mind.
Isolation leads to depression leads to dementia. Which my profession has been preaching for years and years and now in this time of a pandemic more and more people can recognize how true this actually is.
The third step is to figure out a short term plan until you have things figured out or a long term plan depending on your loved ones needs. Is it a home health coming into the house for a few hours or do you need a senior living community right off the bat, perhaps you consider a respite (a short term stay) in senior living until you get more answers. The answer is really different in each situation. Be Careful!! Whatever situation they are in is going to progress or something is going to happen to force your hand in having care in place.
This cycle of events is common in most every situation. The senior wandered out, the neighbor found her at the store, sent to ER, sent home. Then the senior drove to church but wound up confused in traffic and hit a pole. To the ER, to home? Maybe not home anymore. Repetitive trips to the hospital will have the social worker there and doctor typically move you to rehab in an effort to hold you longer until a next step is in place. Not every senior can go home because the physician does not feel they are safe alone. It is then the reality of a doctor saying you need 24/7 coverage at the home or a senior living community.
Let’s face it a River will run in the exact same direction for centuries unless you place something there and change the current of the water.
For seniors if you do not break the cycle of events that put them in harms way, the cycle will progress and you are gambling with some serious consequences. A Senior living community that offers memory care can not only keep your loved one safe but also keeping them engaged and socializing with other seniors can change their quality of life and their days more purposeful.
The forth step is happening while you wait to see or have already seen the specialist.
There are so many enjoyable things that can be done with someone that has a memory impairment and in all different stages of their memory loss. Keeping it simple is key.
Always Keep it Simple.
Here are some
Do’s and Don’t’s :
Don’t– open the closet and say “what do you want to wear?” Do – Take out two outfits and say “Do you want to wear this or that?”
Don’t– Say “Hey Dad what do you want to eat?” Do – say “Dad do you want Chinese or Italian food?”
Don’t – say “Do you want to watch a movie? Which one? Do – say do you want to watch this one or that one?
( You get my point) simple choices all day enabling the senior to not be overwhelmed but to also feel included in their daily choices.
Spending some time with your loved one doing things they enjoy doing now and maybe some things they enjoyed doing in the past.
Baking, Gardening, Sewing, playing a favorite card game, put together a making a quilt project or whatever it is that sparks a light in your loved one. Quality time and patience make the world of difference. Maybe it looks differently, maybe she is just sewing buttons onto a material, it does not have to be perfect or even make sense it just feels familiar and enjoyable.
Music therapy can be effective at all stages of memory impairment. Even in the later stages if someone loves music, play their favorite songs. You will notice a difference in a music lover almost instantly.
Someone at the early stages of a memory impairment are battling to hold on to their memories. A large planner, some magazines, a glue stick, safety scissors and a pen/pencil is a great way to look back for seniors. They can cut out a photo of a dog and put it on the day you took them to the dog park, they can put a photo of a pie on the day you baked together. You can help them to make a note so they can look back. I had one family gift their dad an easy to use Polaroid camera and they would put that days photo memory in its spot in their planner. Some use it also look ahead, a Christmas tree on the 25th a birthday cake on an upcoming date to remind them what’s coming up. Simple but keeps them Busy and it’s theirs to manage.
Sensory stimulation are usually baskets or a box of items that a senior can have on their lap. Everyday items, buttons, different fabrics, clothing, items familiar to their past. They can be familiar, relaxing or soothing to someone with memory impairment. Especially in the mid to later stages of the disease. They can boost their self esteem, they can help them to communicate and encourage participation.
Was your loved one a mechanic, a cabinet maker etc. Bring in something safe that you may need their help in fixing or just bring in the old car and let dad work on it (safely) . Some screws, tools and some old cabinet(s). The littlest thing can help someone to feel productive and busy.
Aromatherapy & hand massages, are also both great relaxation therapies
I had worked with an elderly woman whose husband had Alzheimer’s and was living in our community. We probed a bit into his past, things he enjoyed, his daily routine. He owned a landscaping business for over 40 years. Each night after dinner they would sit in their yard, they each had their own chair, they listened to Italian music, ate fresh fruit and admired their garden. We set up his favorite chair in our garden, we played some of his favorite songs, some fresh fruit and his wife sat right next to him and enjoyed that time with him. He said not one word, he was not very verbal at this stage but it seemed to me no words were even needed. He smiled, he appeared less anxious, they enjoyed their fruit, the sun, the garden, their music but more importantly it created a moment for the both of them.
One of the most important things to know as a caregiver is to take care of yourself and be your Moms daughter not her aid. So many families have expressed how happy they were to be who they were supposed to be in their loved ones lives once they moved their loved one into a memory care community or they have found the perfect 24/7 supervision setup at home. Over time a caregiver becomes a chef, the housekeeper, the launderer, the nurse, the aid, the appointment transport, does all of the errands, the finances while they still manage their own life and family. You thought your life was chaotic now. A caregivers schedule will blow your mind.
Patience can be a virtue and especially if you are now a caregiver to someone with dementia. Don’t bicker and insist they are wrong. Five minutes after trying to convince Dad of something he does not see you are still a bit aggravated but Dad is not upset he’s moved on. The caregiver is left annoyed with him not understanding what the reality was, he’s not!
Simple ways to connect can mean the world of difference for some seniors, their struggle and their families.
Keep it Simple!
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Senior Care & Living: 101 