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My mother has Alzheimer’s and won’t shower any more. How do I keep her clean?

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April 6, 2012

- Alzheimer's Care, Blog, Elder Law Articles

People with dementia typically are reluctant, if not downright fearful, of bathing. This is not uncommon. Take into consideration how she has always bathed and use that as a template for how to proceed. Trying to adhere to the same schedule, rituals and routine will be helpful. If she always has bathed in the morning, keep with that. If she bathed four times a week or daily, stick to that. This is such a challenging issue, quite often family members will hire a bathing aide. Home care agencies can help you find someone if you don’t have someone on your own. It can be a win-win, as quite often the person with dementia will react better to someone outside the family, especially when it comes to something so potentially uncomfortable or embarrassing like bathing. Here are some suggestions for addressing the challenge of bathing someone with dementia: • Let the shower warm up the bathroom for a while before getting under way. Taking off clothes in a cold room is uncomfortable. • Play soft, soothing music. • Ensure good lighting in the bathroom. Fear increases when a person can’t see well. • Use a shower chair so the person can feel steady and comfortable. These can be obtained at medical supply stores or certain pharmacies. • Use a handheld showerhead or wand. This makes the situation less threatening, and it’s less likely to cause anxiety from water beating down on the person. • Use a type of soap she has always preferred. It will help if she recognizes a favorable fragrance. • See if she can bathe herself at all — then let her do it, giving her as much privacy as possible. • If you have a bathtub and she’s mobile enough, try to let her soak in it. This can be soothing, and it also allows cleaning of areas that might be difficult to get to with a shower. • Sponge baths are a good option between “regular” baths. Hospitals and nursing home regularly conduct bed baths, so there is plenty of precedence for it. The market has responded with various products that can help, such as dry shampoo. For more information, 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 do I do if my dad, who has Alzheimer’s, decides to “call it quits”?

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April 5, 2012

- Alzheimer's Care, Blog, Elder Law Articles, Uncategorized

This is a good question for Alzheimer’s patient caregivers since it’s not an uncommon scenario. At some point, you dad may decide he’s ready for death. This could be verbal, but if he can’t talk, you still might be able to sense it. By this point, no doubt, the disease will have been a tough battle. He could be very tired. As hard as it might be for you or other family members, you have to let go and allow your father his wish, and the peace he is seeking. Death is, after all, a part of life. For him, death is a good thing. For those left behind, it can be difficult. It is never easy, no matter how long the disease has been around or how much you’ve prepared for a final good-bye. By this time, you will already have lost a lot of your father along the way, yet it is tough to come to grips with because it is so final. Let yourself grieve. Talk with others around you — friends, family, professional counselors, clergy, etc. Continue to speak with your father. Reminisce together. Sharing your feelings and thoughts can be a healing process. Of course, contact your father’s physician if you sense he is ready to die. The doctor might order hospice care. It is a wonderful service that will not only help your father but also you and the rest of the family. Hospice workers’ goal is to make your father comfortable, peaceful and pain-free. They also want to support you in your time of grief and lighten your load. They will allow you to rest and recoup energy. Hospice is there to help the entire family in the grieving process.  An excellent resource is “The Indispensable Alzheimer’s Resource Kit.” It can be downloaded at no cost by clicking here.
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I moved my father with Alzheimer’s from out of state to be near me. Any suggestions on how to help him adjust to a new area?

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April 4, 2012

- Alzheimer's Care, Blog, Elder Law Articles

First of all, give it time. Your father might need a week, or months, to adjust. He’ll also need to be able to let out any concerns and other feelings. His concerns need to be answered and his feelings validated. Grief likely will be among the feelings. After losing his job, his wife and now his long-time home, he is losing a part of himself each day, too. You’ll find out — if you haven’t already — that many times it’s a dead-end street when you try to reason with someone with Alzheimer’s. Your father could become more confused and unsettled if you try to explain in detail why you had to move him. When he asks about the situation, you can tell him, “I know how hard this move has been for you, but I love you so much, I wanted to be nearby and have you close to me.” Here are some other things you can do to help him adjust:
  • Make a photo album of things that bring up good memories so he can review it over and over. Include pictures of family members, friends, the house, and favorite vacations and accomplishments. He can look to his heart’s content, several times a day, if he wants. When he’s feeling stressed or said, this should have a calming effect on him.
  • Make sure there are personal items he can recognize in his room.
  • Ensure that he knows his friends and neighborhood. Make introductions as necessary.
  • Let him write a journal, in which he can record his feelings at least once a day. (This could require extra help from you, the caregiver.)
  • Find a local support group near your house that he can attend. Call the Alzheimer’s Association for recommendations.
  • Have him talk with various people (not just you). Whether it’s a professional counselor, a priest, a friend or someone else, it will help immensely.
Remember: Your father will need a lot of time and attention. Give them. Constantly reassure him and affirm his presence. Repeat that he is in a safe place, that you love him and that you will continue to make good, healthy decisions for him, based on his wants and needs. Tell him often how well he is doing. Thank him profusely for whatever he helps with. Include him in as much decision-making as possible and ask him for input at a level he can handle. If you do all of this, things still might be difficult, but you will be doing the best that you both can. And who knows, he might surprise everyone and adjust with little difficult.  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 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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