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My father thinks people and events on TV are real and he often wants to interact with them? What should I do?

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March 29, 2012

- Alzheimer's Care, Blog, Elder Law Articles

There have been people with Alzheimer’s who have refused to do something until getting an answer from a TV character; others have thought music shows are actual concerts. This has worried family members, who have wondered whether they should cut off TV watching altogether for their loved one. But you have to think it over: Is this causing any harm? This is not an uncommon behavior for someone with Alzheimer’s. You have to weigh what the TV situations might be doing to your loved one. Does watching TV become distressing, or are the characters and stories seen as friendly? Often, it’s the latter, and you can never have too many friends! If TV scenarios and people become threatening to your father, then you must limit how much TV he watches. If there is a TV in his room, you can remove it. Odds are, it isn’t doing much good for him if stress is involved. If or when he sees other residents watching TV, his attention can be redirected toward other activities. If he’s not living at home, talk with the staff at his care facility and let them know of your concerns. Tell them you would like to have his TV time limited. They can help redirect him toward bingo or other activities instead. If there winds up being no TV in his room, ask staff members to take him to one of the facility’s common areas to watch a favorite show(s) there. If there is a VCR or DVD player, you can bring programming that you have purchased or rented so he can view it.    
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What kind of support is there for a person with Alzheimer’s?

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March 22, 2012

- Alzheimer's Care, Blog, Elder Law Articles

Head to www.alzhope.com. That’s where people with Alzheimer’s can become part of a loving community, can post questions to others caring for their loved ones with Alzheimer’s and more. Another good place is the Alzheimer’s Association’s website (www.alz.org). It has a list of programs offered, including for supporting individuals diagnosed with Alzheimer’s. Link from this nationally focused website to the appropriate local association. That will get the person resources closer to home. Perhaps the most common support is an early-stage support group. These are sponsored by the Alzheimer’s Association and are spreading around the country. These are primarily for the support of individuals who have just learned of their Alzheimer’s diagnosis. An experienced facilitator guides the group in discussions about issues such as the meaning of the diagnosis, family dynamics and emotional issues, and financial and legal concerns. This is a place to express one’s deepest feelings in a safe place — with people who will identify and understand. These groups laugh, cry, eat and problem-solve together. The groups meet once a month on average, typically for about an hour and a half. Someone from the Alzheimer’s Association will be able to judge individuals to determine whether the meetings would be a benefit to them. Meanwhile, family members have simultaneous meetings in their own special area (often in the same building). Professional counselors, members of the clergy and home health agencies also are options for individuals’ support. You also can get in touch with the Alzheimer’s Disease Education & Referral Center (ADEAR) at (800) 438-4380 or www.nia.nih.gov/alzheimer’s, or the National Institute on Aging/Alzheimer’s Disease Information at www.nia.nih.gov or (800) 222-2225.
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Can my father drink alcohol when he has Alzheimer’s? What about medication problems?

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March 22, 2012

- Alzheimer's Care, Blog, Elder Law Articles

Always contact your father’s doctor when you could get into medication or health matters like this. If your father sees more than one doctor, make sure he sees his primary care physician (who likely sees him most regularly and writes prescriptions for him). If this physician thinks it is OK for your father to drink, he will tell how much is permissible. Doctor’s orders must be adhered to very closely. Too much alcohol could trigger an adverse reaction and set off a whole new range of problems. These could include outbursts, violence, lethargy — or any behavior typically associated with alcohol consumption. On occasion, a doctor might suggest wine to help deal with bad behavior for a person with Alzheimer’s. Wine can have a calming effect, which could be helpful for an Alzheimer’s patient who is restless, anxious or agitated. Wine also has been known to help people with Alzheimer’s sleep better. But, to reiterate: Always check with a physician before allowing any alcohol consumption.
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My mom has Alzheimer’s and continually says things like, “I wish I were dead.” What should I do?

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March 21, 2012

- Alzheimer's Care, Blog, Elder Law Articles

There are a few possibilities for this. Your mother could be dealing with depression, or it could be her way of expressing her frustration about the disease. Regardless, she needs to be observed and monitored. A physician can examine her and prescribe an antidepressant if he thinks it’s warranted. So do call a doctor if you think it’s depression-related. Your mother needs assurance about her changing condition. Inquire regularly about how she is feeling and discuss things — not just Alzheimer’s. It is OK to talk until she gets in touch with feelings she might have such as frustration, anger or fear. This is where validation comes into play yet again: It is essential. Say things such as, “I know you’re not feeling yourself lately, but you are so wonderful, Mom. That hasn’t changed.” Or maybe, “Mom, please tell me what you are feeling that makes you want to die.” Odds are she will talk about how inadequate she feels. Constantly reassure her, tell her she is loved and needed. Then go another step and give her opportunities to help so she feels she has something to contribute to the family. All human beings need to feel they are contributing. When Alzheimer’s or dementia hits, however, it’s easy for a person to feel he or she has nothing to offer. That’s where loved ones must see to it that this individual is given an environment where he or she can feel needed and useful. Provide opportunities to help with chores around the house. No matter what the activity is, modify it as needed in order to make the person feel useful. It makes no sense to start a chore set that is too difficult, or start appropriately and then not simplify as needed. For example, if laundry were the focal point, your loved one might be able to start with gathering, loading/unloading and folding the clothes. Also measuring soap, setting the dials, drying and folding could be included. But then, as the disease progresses, tasks might need to be peeled off or scaled back. This still allows your loved one can keep his or her “laundry” duties and identity. For additional information, get our FREE “Indispensible Alzheimer’s Resources Kit” by clicking here.
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Haldol as a medication for Alzheimer’s has me worried. Is it safe for my mother?

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March 15, 2012

- Alzheimer's Care, Elder Law Articles

One of the first psychotropic drugs introduced to the market was Haldol. Its goal was to subdue young and healthy — but violent — psychiatric patients. It is a successful drug when used for the appropriate purpose and at the appropriate levels.  But when used on elderly or Alzheimer’s patients, many questions seem to arise. Can it create confusion? Can something else be given for agitation with better results and fewer side effects? How long does it take for Haldol to leave the system once it is subbed out? And the list goes on.  Medications affect people differently. What works for one individual might not for another. To some degree, prescribers will tell you, it becomes a guessing game. All medications have side effects. Some people will feel them differently, or not at all. There might be, for example, a medication to treat anxiety that … creates anxiety. This type of reaction may be fairly common among older individuals. If taken for a long time, Haldol (Haloperidol) can create many side effects. (Typically, it is prescribed for people who hallucinate and/or act aggressively.) Ask your doctor to try other prescriptions to see if they work reasonably well as an alternative.   Keep in mind that some individuals tolerate Haldol well. Regardless, it builds up in the body, so complete removal from body systems might take a few weeks, depending on how long a person was already taking it.   To allay your concerns, the best strategy is to talk with your mother’s doctor. Tell him what your observations are and ask what the options are. There are numerous medications out there created to treat these same conditions.   As always, if you aren’t satisfied with the response you get from one physician, consult another. Geriatric psychologists and neurologists are usually on top of the latest and most effective medications available. As an aside, older patients are usually started at the lowest doses possible and then inched up as needed.   Another route you can take is to have your mother admitted to a gero-psychiatric unit. These are specialized places for observation of behavior and monitoring or adjusting medications specifically for elderly patients. Doctors get a much more complete picture than usual thanks to 24-hour observation and monitoring over several days.   Dealing with a loved one with Alzheimer’s is a daunting task. There’s no need to tackle it alone, however. An excellent resource is “The Indispensable Alzheimer’s Resource Kit.” It can be downloaded at no cost by clicking here.    
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My spouse has Alzheimer’s and isn’t sleeping at night. What should I do?

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March 14, 2012

- Alzheimer's Care, Blog, Elder Law Articles

Sleeplessness or insomnia can be a common Alzheimer’s issue, though not everyone experiences it. If your loved one does, here are some helpful tips: 
  • Keep your physician informed so he or she can intervene, if needed (this might be a condition you monitor for a while)
  • Ask the doctor about medications that might be interfering with sleep
  • Limit caffeine and alcohol intake
  • Discourage naps during the day
  • Plan relaxing, soothing activities for close to bedtime (play calming music, for example). This could involve having a light snack.
  • Make sure your loved one goes to the bathroom before bedtime
  • Keep to a routine at bedtime, yet, as always, you have to remain flexible
  • Use a favorite pillow or blanket to help relaxation efforts
  • Do bathing or any other activity that could be upsetting earlier in the day: Steer clear of anything that could create tension or be upsetting near bedtime
  • Don’t make bedtime too early
  • Keep the person as active as possible during the day. Walking, working in the yard, dancing or any other activity he or she likes to do can be helpful.
  • Ensure comfortable clothing and temperature are in play at bedtime. If putting on sleepwear agitates your spouse, let it go and let her or him sleep in regular clothes.
  • If your loved one falls asleep on the couch, let her or him stay and sleep there.
  • Use night lights liberally in the bedroom, hallways and bathrooms.
Dealing with a loved one with Alzheimer’s is a daunting task. There’s no need to tackle it alone, however. An excellent resource is “The Indispensable Alzheimer’s Resource Kit.” It can be downloaded at no cost by clicking here.    
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How should I respond if my good friend with Alzheimer’s falls?

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March 13, 2012

- Alzheimer's Care, Blog, Elder Law Articles

As with any “rescue” mission, you must make sure you are secure first. Can you help safely on your own? Are you strong enough? Is the injured person cooperative? The reason for these cautions is if you become injured, then perhaps neither of you would get the help you need. You should background yourself in techniques that you can use to help should a fall occur — whether it’s with a friend or relative, or someone who has Alzheimer’s or simply a frail, elderly individual who might need assistance. For example, gait belts are common tools to assist ambulation. These strong canvas straps are designed specifically for helping in these situations, among others. If your friend or loved one starts to go down when you are nearby, you can simply grab the belt to slow the tumble and lower the person to the floor. This softens the fall, but remember: You have to be careful not to injure yourself as well. Gait belts are commonly available for purchase through durable medical equipment companies, home care agencies and others. Once the person is down, if you can’t get her or him up and nobody else is around to assist you, CALL 911. There should be no embarrassment or concern about this. Most emergency responders are well trained in how to deal with people who have fallen, Alzheimer’s patients, people who wander or are choking, etc. They are more than willing to come into a home to assist you.  They also can do an assessment of any possible injuries, and transport your friend or loved one to the hospital for proper review and treatment. The transportation piece for a disoriented or uncooperative patient can be especially helpful, rather than trying to do it alone. There are many accounts of caregivers calling 911 for help and getting it wonderfully. These families report being treated with full respect, concern and care, so call if you need help!   Wander and falls management companies offer an array of alerting devices that can help a person call for help. These items can be worn like faux watches or necklaces so they blend right in. The wearer pushes a button and someone out of the area is summoned for help. The systems are plentiful and can be researched on the Internet.  Dealing with a loved one with Alzheimer’s is a daunting task. There’s no need to tackle it alone, however. An excellent resource is “The Indispensable Alzheimer’s Resource Kit.” It can be downloaded at no cost by clicking here.
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What can I do to make my house safe for an Alzheimer’s patient?

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March 8, 2012

- Alzheimer's Care, Blog, Elder Law Articles

A person with Alzheimer’s is likely to walk, pace or wander. As a caregiver, you must allow this type of behavior. But you have to create a safe environment for it. People with Alzheimer’s have perception problems. Carpeting or other flooring with black patches can give the appearance of black holes that have to be stepped over. Shiny floors might appear to be wet, also causing altered behavior or motions. Good lighting that reduces glare will ease anxiety. Get the clutter out of the house! It is very important that things such as plants on the floor, footstools, baskets, and any papers or magazines not be left lying around. Remove these and any other things that could be construed as obstacles. There are many vendors that have products that can increase home security appropriately. In fact, there are so many products, a prudent review of their capabilities, costs and pros/cons is in order. Some have bells or alarms, while others can quietly page or notify someone off-site. There are special locks and door aides that also can help keep individuals with dementia safe. Monitoring equipment is plentiful. A common baby monitor works especially well for monitoring at night. If your loved one is prone to falling out of bed, lower the bed (even putting the mattress on the floor) and/or put an extra mattress(es) next to the bed to cushion any tumble. There are also monitors available that can tell you whenever your loved one gets out of bed, or rises from a chair. A good place to find out more about home safety devices is http://www.alzstore.com. Places that sell baby-safety equipment are also good, as are outlets such as Radio Shack. There are plenty of manufacturers and sponsors out there — be sure to compare prices and quality whenever possible. For further information, please access our FREE  “Indispensable Alzheimer’s Resource Kit” by clicking here.  
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Should I watch for symptoms of depression if my loved one has dementia?

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March 7, 2012

- Alzheimer's Care, Blog, Elder Law Articles

You’ll typically notice depression in someone before the person with it does. Some signs to watch for include: desire to sleep a lot, a change in eating habits (weight up or down), loss of interest in previously enjoyed activities, and being in an overall “down” mood.   Attend to comments such as “I don’t want anything,” “I’m no good anymore” and “I wish I were dead” and take them seriously. Any time you detect symptoms of depression it is important to have the person visit a physician. Even if a doctor has already diagnosed dementia, your loved one still needs to be checked for depression. The two go together quite a bit. It might take antidepressants just a few weeks to ease the symptoms. Other things that can make a big difference include better nutrition, better sleep (not too much or too little) and plenty of exercise. For further information, please access our FREE  “Indispensable Alzheimer’s Resource Kit” by clicking here.  
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Does pain — such as from a UTI — worsen the effects of Alzheimer’s?

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March 6, 2012

- Alzheimer's Care, Blog, Elder Law Articles

Pain can worsen confusion, agitation and/or depression in someone with Alzheimer’s. But pain itself does not cause a decline in Alzheimer’s symptoms.  Pain can be a terrible puzzle when dealing with someone with Alzheimer’s. Because many times the person with Alzheimer’s can’t communicate adequately, he or she will resort to wandering, sleeping, grimacing or being agitated — or shutting down altogether. Take a cue and watch closely because if your loved one has a sudden change in behavior (such as confusion, for example), it’s possible he or she is experiencing pain or discomfort. This could be anything from an infection to simply having shoes that are too tight. When caregivers work with cancer patients, their goal is to keep the person as comfortable as possible by eliminating or soothing the pain. It should be the same with individuals with Alzheimer’s, no matter what the stage or age. They should be comfortable and pain-free. A urinary tract infection (UTI) definitely can cause pain. Its symptoms include burning, itching and inflammation. Treatment is neither complicated nor invasive and will increase quality of life. For other chronic pain-producing conditions, such as arthritis, a person with Alzheimer’s should continue treatment according to doctor’s orders. For things like sore throat, backache, headache and foot pain, seek a doctor’s advice as necessary — do not let the condition linger too long or get out of hand. Depression is not uncommon for individuals with pain. If a loved one who has Alzheimer’s is suddenly a lot less enthusiastic about previous interests, it could be a sign he or she is experiencing pain. Be aware, however, that people also can act this way when there is no pain present. For further information, please access our FREE  “Indispensable Alzheimer’s Resource Kit” by clicking here.      
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