Saturday, October 22, 2011

Tips to Manage Anxiety Prompted by a Parent’s Advancing Dementia

Activities directors and other healthcare professionals here is a great dementia resource for caregivers and healthcare professionals.

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The Dementia Caregiver's Little Book of Hope [Kindle Edition]

Parenting Resources Suite101
  1. Ask for regular updates from nurses and carers about a parent’s declining health. Digest any changes in behavior, speech, or ability, and modify expectations; help them feel good about themselves.
  2. Keep feelings of guilt at bay. Guilt prevents a person from acknowledging the impact of dementia on the sufferer and accepting the new emerging person.
  3. Visit when you can for their sake. Dementia suffers may be able to recall events less with time, but they continue to respond to human contact and warm touch.
  4. Visit when you can for your sake to see the deterioration first hand. Acknowledge and accept that their ability to manage even simple tasks is declining, and that their mind, body, and language skills are gradually deteriorating.
  5. Ask them to talk about their childhood. Listen without judging or correcting facts. Good memories bring moments of happiness for both elderly parent and adult child.
  6. Invite them to engage in the activity of the day, eg. Watch the Australian Tennis Open on the tv together; listen to orchestral music or sing along with the ‘golden oldies’ on disk; share a meal; or punch a balloon to each other.
  7. Live in the moment. Breath. Laugh. Relax. Take the opportunity to slow down to their pace. Encourage them to interact but be aware of when they are tiring.
  8. Share your feelings with a family member, a friend, or a professional. A problem shared is a problem halved.
One of the best tips for managing your anxiety due to an elderly parent’s dementia is to acknowledge that you may be grieving the loss of your parent as you once knew them. Find ways to feel these feelings of stress, anxiety, depression or malaise mindfully to get through them, and to accept the condition no matter how difficult this is.

Read more at Suite101: 8 Tips for Coping with Elderly Parents and Advanced Dementia |

Sunday, October 16, 2011

The Essential Checklist for Good Dementia Care

Activities directors and other healthcare professionals here is a great dementia resource for caregivers and healthcare professionals.

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Huffington Post

Marguerite Manteau-Rao

In my work with persons with dementia, I have found Jane Verity's 5 Universal Emotional Needs to be an essential framework for good care:
People with dementia often express themselves in uncharacteristic ways such as a burst of anger, accusations or repetitive actions. Traditional approaches deal mainly with the symptoms, which results in no profound changes to the underlying cause ... [Instead there needs to be a focus] on everything that happens below the surface for the person with dementia where we find the true reasons behind their behavior -- the five universal emotional needs ... These needs are universal and do not change. What does change is the opportunity to have these needs met -- especially for people with dementia or anyone else living in an institution where the focus is on tasks and routines rather than on the social and emotional wellbeing of the individual.
The five emotional needs that need to be met are:
1. Preserving the person's power to choose:
This is the most important need to pay attention to in my experience. In every single one of our interactions, we need to stop and change our stance from single decider to "partner in care," always involving the person in the decision-making. This continues to apply throughout the course of the dementia, including during the last stages when the person may no longer be able to clearly think, or verbalize, or move.
Then comes the art of how to facilitate the person's decision-making process. One good rule of thumb is to stick to small, in-the-moment decisions, and to limit the number of options being presented. It is also important to use simple, direct communication. Would you like to get up now or stay in bed a bit longer? Do you prefer a shower or a sponge bath? Is the water temperature too cold or just right? Which shirt do you want, the red or the blue one? Do you want the music on or off? This way the person's mind can follow, and this gives the person a greater sense of mastery.
#2. Boosting the person's self-esteem:
This need is foundational for all the others. While we could all use some self-esteem boosters, for the person living with dementia, that need is even more critical. First, the person's internal experience of themselves as someone whose mind can no longer be trusted, sends messages of inadequacy, low self-worth and shame. Second is the accumulation of negative messages from the outer world, either passively or in more active forms. The person who is placed in an environment that no longer matches their abilities, keeps being confronted with the impossible task of managing even the smallest tasks.
Conversely, environments that strip the person from the opportunity to exert their remaining abilities have a similar detrimental effect on self-esteem. Also tragic are messages to the person that he or she "should know better" or is not trying hard enough. There are many ways that we, the ones with still relatively intact memories, contribute to such chipping away in our friends hearts. This video from Jane drives home the message:

3. Maximizing the person's opportunities to be needed and useful:
Stop for a second and list all your favorite roles in life. For me, it is being a psychotherapist, a dementia care coach, a writer, a trusted friend, a mindfulness teacher, a social media consultant; so much of our life is tied up into our roles and the sense of meaning we derive from them.
Next, imagine all that these roles are taken away from you. Now, it is just you -- being and no longer doing. You get to watch others around you still very much involved, bustling, doing, working, being thanked. And you are no longer contributing to this world in the same way, or at least not much. You may be sitting in a wheelchair or lying in bed, and they are walking by or standing over you. How would you feel? I know for myself it would not be very long before I start feeling depressed.
This is why it is so important to pay attention to this other essential emotional need of the person living with dementia. Because the ability to initiate task is compromised, it becomes our responsibility to jump start the process often. And also, to not ignore the person's attempts to still contribute, in whatever small ways that may be. I witnessed a resident in an assisted living community offering one of the aides to carry her dirty dishes to the kitchen. The aide declined. "No, you don't have to. It's my job." While it was well intentioned, the aide ended up depriving the woman of an opportunity to feel useful.
#4. Giving the person a chance to care for others, not just to be cared for:
The need to nurture and care for another being is part of our human makeup, and maybe even more so for women. This is why the care relationship should always be thought of as a mutual interaction, and not a one-way transaction as in caregiving. In care partnering, I get to receive care from you, and I also get to care for you or other people.
Let her act as a mother still, and suggest things to you such as, "You are going to be cold; you should be wearing a sweater." And thank her for her kindness. Let him who can't sleep well at night help you keep an eye on other residents. Receive a smile from the one who can no longer speak soothing words or move to offer a gentle touch. Join the woman who is rocking her "baby" and shower the inanimate doll with all the love you can give with her. Every day, I witness many such acts of random kindness from persons with various forms of dementia. And each time, I am moved by the beauty of the human heart.
#5. Letting the person know how much you love them, and be open to receiving their love:
I used to be shy about letting my mother how much I loved her. No longer. Now, every time I call her, I end with a simple "we love you" and I know those words are made even more potent by my mother's lack of memory. Those words get deposited in her bank of good feelings, and will make up a bit for some of the imperfections of her assisted living situation.
I have also learned to take in my mother's affection, all of it. And I have noticed how much that makes her happy.
These five universal needs are almost as essential as food and water to a person's well-being. Next time you spend time with a person with dementia, try to honor those needs. And when the person becomes agitated or withdrawn, ask yourself if maybe one of those needs did not get met, and how can you correct the situation?

Monday, October 10, 2011

Another way to trigger happy memories in those with dementia

Activities directors and other healthcare professionals here is a great dementia resource for caregivers and healthcare professinals.

Here is information on being the best caregiver you can be

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hand care

What you need:

Hand scrub (you can make your own with a tablespoon each of melted butter and sugar), warm water, washcloth, towel, lotion

What to know:

  • Paying attention to the hands is pampering that can inspire both alertness and pleasure.
  • Men and women alike respond to this activity. Touch is a wonderful way to make your loved one feel loved and secure.
  • Start by placing a warm washcloth over the hands. This feels good and relaxes in a nonthreatening way.
  • Next, apply the scrub to gently exfoliate the hands.
  • Rinse and dry with a towel. Apply lotion (scented, if you think your loved one won't mind or has a favorite).
  • Alternative: If your loved one has interest and the patience for it, you can finish the activity with a basic manicure (filing or cutting and buffing nails) and/or nail polish.

Saturday, October 8, 2011

Alzheimer's Disease: Improv Keeps Patients in the Present

Activities directors and other healthcare professionals here is a great dementia resource for caregivers and healthcare professinals.

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Monday mornings, 80-year-old Roth meets up with the Memory Ensemble -- an improv group for people with early stage Alzheimer's and other forms of dementia. For 90 minutes, the ad-libbing actors transform a tiny room at Chicago's Northwestern University into a spontaneous stage where fleeting memories matter not.
"He has a ball," said Roth's wife, Mary Beth. "It's fun and it keeps his brain active."
For the Roths, the lighthearted improv sessions help lift the heavy burden of Alzheimer's -- an unstoppable disease that plagues 5.4 million people in the United States.
"Until we have a cure and a treatment to prevent Alzheimer's, one of our missions is to help people cope and live with this disease," said Mary O'Hara, a social worker at the Cognitive Neurology and Alzheimer's Disease Center at Northwestern University Feinberg School of Medicine. Improv, she said, is one way to do just that.
"There aren't a lot of programs that are specifically designed for individuals with early stage disease. These people are told by doctors to stay active, keep their brains active and stay socially engaged. But memory loss makes it harder to do those things."
The Memory Ensemble, run jointly by the Cognitive Neurology and Alzheimer's Disease Center and the Tony Award-winning Lookingglass Theater Company, lets patients exercise creativity and wit despite failing memories. It's all about the present, said O'Hara.
"Improv is just all about being in the moment and being spontaneous, and there's no right or wrong answer," she said. "For someone with memory loss, it's a really good fit because they still have imaginations and come up with wonderful ideas."

Alzheimer's Disease: Improv Keeps Patients in the Present

Even if confusion creeps in, the group just goes with it. When playing a student, Roth was told he had to stay in and study for a test.
"He said, 'Intestine? What are you talking about?'" Mary Beth recalled. "Everyone thought he was so funny, and he is."
In its early stages, Alzheimer's disease leaves its victims very much aware of the inevitable memory loss that will penetrate their relationships, their identities.
"It's very devastating when someone finds out they have this," said O'Hara. "When people hear 'Alzheimer's disease,' they picture people in the later stages; not someone who's physically healthy and wanting to do things. This is a chance for patients to share in something new together and know they're not alone."
Roth rarely remembers the events of the class. But his wife debriefs him over lunch.
"It's a joy to do this with him," Mary Beth said. "It's a chance to see my husband in public, showing his vulnerability less. It just feels more like the old Wolfgang."
The Memory Ensemble also allows caregivers to connect with each other.
"It's like a support group for me," Mary Beth said. "It alleviates some of the stress, the isolation. I feel like they're helping me maintain my mental health."
O'Hara is using surverys to measure the impact of improv on patients' quality of life. She hopes her research will generate credibility and funds for similar programs nationwide.
For the Roths, the 90-minute class makes missing memories and an uncertain future irrelevant -- however temporarily.
"It's affirming. It helps him feel good about himself," said Mary Beth. "He comes out very positive and upbeat, chattering to the others and to me. He's just happy."

Tuesday, October 4, 2011

Focus on:Certification with easyceu

Activities directors and other healthcare professionals here is a great dementia resource for caregivers and healthcare professinals,

Here is information on being the best caregiver you can be

Here is a way for nurses administrators, social workers and other health care professionals to get an easyceu or two

Here are more interesting dementia brain boosting activities

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Saturday, October 1, 2011

Creating Mad-lib stories

Activities directors and other healthcare professionals here is a great dementia resource for caregivers and healthcare professinals.Benevolant Society

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Mad-libs are fun to create and can generate much laughter for those with dementia and others living at a long term care facility

Mad-Libs™ can be fun for all ages. By creating short stories with key words removed, MadLibs™ allows your audience to create silly short stories.

A traditional Mad Lib™ uses a short subject story, such as a letter home from camp, facts about dinosaurs, or the moon. From the story, key words are removed in several categories, including nouns, verbs, adjectives, numbers and people’s names. One player or group leader can see the story, and is in charge of getting words from other players that fit the missing categories. No one but the person with the Mad Libs™ story should be allowed to know the subject or any other details of the story. Once all the empty spaces are filled, the completed story is read aloud, and generally the laughing begins.

Here is one

A day at the zoo

Word List
_________________Verb(past tense)
_________________verb(past tense)

Today I went to the zoo. I saw a ____________(adjective)

_____________(noun) jumping up and down in its tree. He
_____________(verb: past tense) __________(adverb) through the
large tunnel that led to its __________(adjective)
__________(noun). I got some peanuts and passed them
through the cage to a gigantic gray __________(noun)
towering above my head. Feeding that animal made me
hungry. I went to get a __________(adjective) scoop of ice
cream. It filled my stomach. Afterwards I had to
__________(verb) __________ (adverb) to catch our bus. When
I got home I __________(verb past tense) my mom for a
__________(adjective) day at the zoo.