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How likely is it that my loved one with more lucid days and less lucid days with Alzheimer’s?

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May 11, 2012

- Alzheimer's Care, Blog, Elder Law Articles

It is very likely he or she will be just like anyone else: The person will have good days and bad days, clearer days and foggier days. Sometimes it will seem like nothing is wrong; others, there will be no doubt Alzheimer’s is at work. On a good day, the person might remember things like he or she once did. Patients might appear upbeat and say they are feeling good. You should savor these times. Such lucidity is a blessing you should embrace. You might begin to question whether the Alzheimer’s diagnosis is accurate. This would be false hope. Realize these times should be savored, for they will pass. Caregivers tend to go through a grieving process and that can lead to fantasizing. It might seem like everything is just a bad dream, or that things will go back to the way they were one day. Denial might set in. We look forward to our loved ones “snapping out of it” any day. If and when lucid days come around, they can validate such fantasies. But then reality will hit us squarely between the eyes. While you must let yourself grieve, you also must remember to enjoy each moment of the good times. It might be a few good days, or even just a few moments. Enjoy them regardless! “Quality” is more important than “quantity.” This is what you have to remind yourself. If your quality time is limited, at least you have those moments to draw from. Look at them as a blessing — and look back to them to help you get through bad times. For more information, please click here to download our FREE “Indispensable Alzheimer’s Kit.”
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Can I seriously consider being blessed to be a caregiver?

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May 10, 2012

- Alzheimer's Care, Elder Law Articles

As devastating as Alzheimer’s is, you can look at it as a burden or a blessing. We cannot control so much of our life — like what people think of us or how they run their lives. Or whether we get a disease. But what we CAN control is our own reactions. While it might be very difficult, as a caregiver you must arrive at a place of acceptance. But you do not get there without grieving first. Grieving is undeniably a personal journey. Some people progress at a fast pace while others take longer periods at various stages. Some stages they might never experience. Grieving can consist of many emotions: Shock — You can’t think, speak or react after hearing the diagnosis Emotional outpouring — Yell, cry, even throw things at this stage Depression — Loneliness and a feeling of isolation set in Physical signs of distress — You might feel ill or extremely tired Anxiety — Worries about what’s going to happen in the future grip you Anger, hostility — You’re mad at the afflicted person, your family, doctors, even God. You then can feel guilty, especially for the anger you have directed at God Guilt — Your thoughts and feelings make you feel guilty, or you feel that you’re not doing enough as a caregiver Not keeping up with normal activities — You worry about how others will react or treat your loved one Healing of memories — You come to the slow realization that healing memories are often painful memories. This is the time to come to grips with what is happening and realize that life has to change if it’s going to continue. Feed off the good memories to keep you going. Acceptance — You start to accept you are in a new chapter of life. If you can accept that, you can get on with your life, and with much less stress. Realize that you will continue to grieve due to the ongoing changes with Alzheimer’s disease. Even when you might get to the “acceptance” stage, you won’t be at the end of the line — you might cycle through the stages again, or through just a few. This is normal. It will not mean you’re regressing or going backwards. Afford yourself a break. Let yourself feel. The blessings start to become apparent once you hit the “acceptance” stage. It’s said Alzheimer’s disease can be a person’s second chance in life. Inhibitions disappear. Patients become blatantly truthful, and often funny in the process. You did not ask for your loved one to have dementia, and you didn’t ask to care for her or him. This situation has been “given” to you. That means it is a gift to you. And you discover that your loved one also is a gift to you. For more information, please click here to download our FREE “Indispensable Alzheimer’s Kit.”
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How do we not upset Mom’s routines if we hire an in-home helper?

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April 19, 2012

- Alzheimer's Care, Blog, Elder Law Articles

Narrow your candidates down to two or three and then invite them into your mother’s house to observe them interacting with her. This should be very enlightening and help you trim the choices further. Look for someone who is kind and attentive. Other things can be taught, such as where things are and where they belong, how routines are run and tips on how your mother likes baths, food, dressing, etc. But if a good spirit and healthy interaction aren’t there between two people, that’s hard to overcome. It’s very hard to force after the fact. Involve your mother as much as possible in the selection process. Even if she has late-stage Alzheimer’s, she can tell you in her own way what she thinks about the candidates. It might be through a gesture such as a wrinkled up nose or a thumbs-up or -down. Or she might resist giving an opinion at all. This is not insurmountable. If she does not consciously want to help you through the selection process, observe her body language around the candidates. How does she respond to each? Once you have hired a helper, bring her or him in one day before the official start of work. Give this person plenty of time together with your mother so they can bond and get to know each other better. By all means, let your mother know what is happening, and that this person is going to be with her for long periods. Be firm but sympathetic. Tell the hired caregiver about your mother’s likes and dislikes with regard to food, activities and other situations. The better the caregiver and your mother know one another, the better the care will be. Some people like to start a new caregiver with just a few hours of work the first day. This helps let your mother know her world has not been suddenly 100% turned upside down. You should keep a good, professional relationship with the caregiver. Encourage this person to call you with information — good or bad — about your mother. Constantly check with your mother on how things are going. Let her express her feelings. If she is unable or unwilling to tell you anything, you still can learn a lot simply by observing her body language. This is vital for determining whether you should keep a current caregiver or move on to another one. 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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How do I deal with my sometimes-explosive outbursts at my mother?

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April 18, 2012

- Blog, Elder Law Articles

Anger is a common emotion when caring for a loved one, especially if she or he has Alzheimer’s. When you see someone you knew as being independent and who was likely somebody you looked up to now having difficulty with simple things, it can be very difficult. Your loved one might not be able to understand much of what is being said to her. She also likely has forgotten many treasured (and helpful) memories. Why wouldn’t you be angry? You are losing a little part of this person, day by day. You are grieving, which naturally can lead to anger. If your yelling occurs only occasionally, you’re may have to own up to the fact that you’re simply going to lose your temper every now and then and yell. If and when it happens, practice letting go of any guilt you feel. Give yourself a break: You are human. Yelling isn’t good, but it happens. This also might be a sign that you need a break from delivering so much direct care for your mother. Taking her to an adult day care center will give her something to do — and give you a break for a while. Or you can hire someone to come into the home so you can go do something on your own. Take advantage of other family members, friends, neighbors and volunteers who might offer to give you a break. You can also find relief by joining a support group or finding a suitable counselor. Knowing that you are not alone in these types of situations usually decreases the pressure you feel. You can also collect some tools to help you cope. If you find the yelling becoming more frequent, you might end up having to find other arrangements for your mother’s care. Quality time with her is more important than quantity time. If your time together is only stressful and becomes consumed by more and more yelling, it is time to make a change. This could mean a group home, nursing home or assisted living situation. Then when the two of you visit together, you might truly enjoy it more. It could be a healthy move for both of you. You shouldn’t feel guilty about having her live in a facility, if you go that route. You can still be very involved in her life, and help manage her care (in coordination with the facility). This can lead to more enjoyable time together. This might entail taking her out to a nearby park, a nice restaurant or even your home. You can have fun together. 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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My mom has Alzheimer’s and will soon live with me, but I need to hire a caregiver. How can I make sure I get a person with the right skills?

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April 10, 2012

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

This will depend heavily on how much care your mother requires. A private agency or home health provider can help determine what skill levels are needed and find you a suitable worker. You might need somebody just for housekeeping-type chores, such as cooking and cleaning. If your mother has not moved past the beginning stages of Alzheimer’s and remains fairly independent, you might want to hire a sitter so she isn’t left alone. If this is the case, make sure you specify you want a sitter with experience with dementia patients. If your mother requires more help with things such as bathing, toileting or dressing, you will need a certified nurse aid, or the equivalent. A nurse would become involved only when your mother would require skilled services. These become needs typically after a hospital stay. A home care agency can provide the aid and advice you require. An agency will do the background checks, actual hiring, training and payment of the worker — and dismissal if/when it’s needed. Many people think it’s worth it to pay for this bit of extra support. If you hire an assistant on your own, you can count on spending a lot more time on the particulars, though the monetary cost will likely be lower. Again, depending upon your mother’s abilities, adult daycare is another option. Your mother could attend all day and get any or all of the services mentioned above taken care of. She would receive supervision, meals, activities, socialization and assistance as needed. For you, as a family caregiver/hostess, it will give a needed break. Your mother probably also will like the change of scenery and socialization, among other things. And she should get good care. This is a scenario many people face. Remember to go with your gut feeling when you are dealing with anyone caring for a loved one. If you are not entirely — as in 100% fully — comfortable with a person charged with taking care of a loved one, you should reconsider and make changes as necessary.  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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My mother refuses to take a tub bath — something she always loved. What can I do?

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April 9, 2012

- Alzheimer's Care, Blog, Elder Law Articles

Hygiene is often a concern as Alzheimer’s progresses. Reluctance to get into a bathtub often has to do with safety concerns for the individual involved so realize what you’re up against. A fear of falling might make her fearful about climbing into the bath. She also might be worried about the water being too cold or too hot, so make sure the temperature is suitable and THEN try to get her into the bath. Difficulty dealing with spatial relationships also can be a challenge with Alzheimer’s patients. When walking, they might not realize a black line or patch on a carpet is not a hole they can fall into. While bathing, they might not be able to discern where the water line is. Adding a few drops of food coloring to the water or using bubble bath can help ease concerns or help your mother discern where the water begins. Another possible idea is to put a brightly colored bath mat on the bottom of the tub. Your mother needs contrast to help determine where the tub begins and ends and where the water begins. Frequently one of these tips or some other modification you discover will lead your mother to start enjoying baths again.  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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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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What can we do for my mother, who used to love to read but now doesn’t?

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March 30, 2012

- Alzheimer's Care, Blog, Elder Law Articles

Try giving her short stories or magazines if the issue has become that books are now too long. You also can involve shorter bits of reading activities, such as asking her to read parts of recipes while you’re cooking. She’ll feel good about helping, too. Of course, there are audio books, which you can check out from your local library. You can choose from all kinds of books and other printed material. In some places, you can actually check out a tape player or other equipment to take home for as long as it might help your mother. Some of the tape players are extremely user friendly; many are intended for use by people who are blind or have other disabilities. Sometimes, headsets are available. This helps allow listening in many places — and without disturbing others. Just pay close attention to the volume. If it becomes too loud, this can cause overstimulation, which might then produce agitation, anxiety or wandering. You can check out all kinds of books — inspirational, funny, upbeat, etc. Many libraries also have reading programs. Perhaps a friend or family member can take her to one of these, making a “trip” of it, if she’s up to it. Seniors centers also offer many adult activities. Adult day care centers are another option in many areas. This can be for most of the day or for just a fixed amount of time. If your mother can still read but doesn’t comprehend, she could read to other individuals, thereby feeling helpful and building some self-esteem. Many times, seniors centers have story times, when she could either read, or be read to. You also can seek out volunteers — such as girls or boys, neighbors, church members, relatives or members of a service organization — who can read to her at her home. These are great service projects for students, who nowadays often need service hours in order to graduate. There are many people who might be willing to help: They just need to be asked. Also, reading together could be some of the best quality time you spend with a loved one. But if you’re not able to do this, don’t feel guilty. Find someone else to do it in your place. There is no doubt, however, that if you’re looking for something to do with your mother, reading to her could be a big help for both of you. Even if she does not totally understand what’s being read, she will be experiencing an activity that she has always loved, and that will feel good to her.    
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