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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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How aggressive should we be with treatment for recurring colon cancer if my father also has Alzheimer’s?

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March 1, 2012

- Alzheimer's Care, Blog, Elder Law Articles

A family meeting with the oncologist to learn about the cancer would help all of you get on the same page. This is a very difficult situation. The oncologist can answer your specific questions about the nature of the cancer, treatment options, prognosis, etc. You most likely won’t want to be too invasive or aggressive with the cancer treatment. Confusion will increase with any type of operation or aggressive treatment. Be sure you know the risks involved if surgery is deemed necessary. As part of this scenario, your physician can order hospice care. Hospice services not only help the loved one but also the family as a whole. Hospice specialists will take the Alzheimer’s into consideration, too. Hospice is a wonderful form of care that provides education, support and care. The goal of hospice is to make it possible for your loved one to stay in his or her own home, out of the hospital, and also to make it as comfortable and pain-free as possible. The overall goal is to create the best quality of life possible. One of the best things about hospice is the fact that it helps not only the patient but family members as well. For further information, please access our FREE  “Indispensable Alzheimer’s Resource Kit” by clicking here.
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Should you tell someone with Alzheimer’s that a close friend has died?

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February 29, 2012

- Alzheimer's Care, Blog, Elder Law Articles

This has been the subject of open debate for a while. The short answer is: It really depends on the person. If it’s your loved one involved, you know him or her better than anyone. If you think he or she can handle it, then the answer is you probably should share news of the friend’s death. Important considerations include thinking how the news will affect your loved one and whether there will be any benefit to it. You also have to consider how well your loved handles stressful situations. If the deceased is someone your loved one has seen regularly, then it might be best to share the news. After that, you are still likely to be asked about the person’s whereabouts, due to short-term memory loss. Then, you have to ask yourself if it’s worth it to keep repeating news of the death or if it’s time to exercise the right to use “therapeutic fibs.” These are always used to protect the person with dementia. See how it goes after you tell your loved one about the death and take it from there. If questions persist about the deceased, you can (honestly) say that the person just “isn’t here right now.” Or you can say in an assuring tone that although you’re not sure where the person is, you are sure he or she is OK and in a safe place. Whether or not to talk about a death also depends on how far Alzheimer’s has progressed. With later stage dementia, it probably isn’t beneficial. Regardless of the stage, if your loved one wasn’t particularly close to or frequently around the deceased, it might not be to your benefit to raise the subject. The same thought process comes into play if your loved one inquires about his or her parents. Even if the parents have died long ago, your loved one’s long-term memory might be kicking in, bringing them more prominently to mind. Validation is the best strategy to use when this happens. Say, “I know your parents aren’t here now and you miss them, but they are OK and they know where you are.” Then, you can reminisce. For more information about communicating with a loved one with dementia, please click here to listen to a Jo Huey speak on this very delicate subject.  It is a very informative discussion available free as an mp3.
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Does Alzheimer’s disease ever bring positive personality changes?

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February 27, 2012

- Alzheimer's Care, Blog, Elder Law Articles

Yes, it can — but probably not the way you think, or may be hoping for. What Alzheimer’s can do is essentially erase bad behaviors or attitudes, which fall by the wayside as memory and decision-making abilities fade. When something like alcoholism, bipolar disorder or schizophrenia is present before the onset of Alzheimer’s, it “goes away” as the disease progresses. This has led some people who have loved ones with Alzheimer’s to say dementia or Alzheimer’s has “blessed” the person. If the victim was abusive or harsh beforehand, he or she might become happy, loving and docile afterward. Sometimes the families can joke about having a support group for people who are happy about Alzheimer’s. One man had an alcoholic wife for most of their 50 years together. This included the rearing of six children. As Alzheimer’s symptoms started to take more and more control of her mind, she forgot to drink and became more loving and soft-spoken. It was as if the dementia had brought out the best of her. She showed sides of herself that close friends and relatives had not seen in many years. Her children liked visiting, and she was kind to them. She also showed a good sense of humor. Often, her husband said those years were some of the happiest times of their married lives. In some ways, he was grateful for the dementia that claimed his wife’s mind. He went as far as to suggest that the disease had given him and his wife a second chance to live together happily. She stayed in their home, and he was her primary caregiver until her death. Alzheimer’s is a tragic disease, but sometimes it brings blessings.  For more information, check out our Indispensable Alzheimer’s Resource Guide which is available FREE online by clicking here
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Does medication cause the confusion and unsteadiness found with Alzheimer’s or are they just part of the disease’s progression?

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February 23, 2012

- Alzheimer's Care, Blog, Elder Law Articles

The short answer is both the disease’s progression and medication can be responsible for confusion and/or unsteadiness in Alzheimer’s patients. Since Alzheimer’s is a neurological disorder, it causes confusion; it also can affect a person’s ability to move around, or ambulate. Alzheimer’s effects on the brain can cause a person to have difficulty with perception, which in turn can affect how a person walks. Black strips in carpeting may appear to be an opening in the floor or something else that needs to be stepped over. A shiny floor might give the impression it’s wet. Perceptions like these understandably can cause unsteadiness. Unfortunately, medicines’ side effects also can cause unsteadiness or confusion. That’s why family members and close friends are so important. As firsthand observers of a person’s behavior, they can notice changes easier than others. It is particularly important to watch for side effects right after a new medication or dosage has been introduced. Any sudden change in behavior most likely will be due to medication because Alzheimer’s typically does not progress quickly enough to create such changes. Ask your pharmacist or visit the website of a specific medication (e.g. www.namenda.com) to learn about possible side effects. These websites have a lot of useful information. Keep in mind that there also could be physical difficulties that arise that have nothing to do with the Alzheimer’s or any medication. Difficulty walking or any sudden confusion could be caused by an infection or another source of pain. Careful observation followed by some “detective” work will help discern what’s going on. It’s not uncommon for this to become second nature. You might not even realize you’re taking these steps after a while. Always remember, though, that if you have investigated and tried various options and nothing seems to work, symptoms such as confusion or unsteadiness could just be part of the disease’s natural, unrelenting progress. To help cope with caring for someone with Alzheimer’s, you might want to obtain a copy of this free resource, The Indispensable Alzheimer’s Resource Kit.    
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Having heard a lot about agitation, I’d like any extra advice I can get

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February 22, 2012

- Alzheimer's Care, Blog, Elder Law Articles

“Love cures people. Both the ones who give it and the ones who receive it.” 

— Karl Menninger

The above is a good quote to keep in mind. Dealing with agitation and/or dementia can be a marathon struggle. Choose your battles wisely and know that just because a person’s behavior might be bothersome to you, that does not mean it is an issue for a person with dementia. If you’re stressed about a loved one’s behavior, first ask yourself: Is this person in danger? Is anything detrimental to his or her health? Do I really have to do anything? Or might I be making a mountain out of a molehill? Here’s a good example: Your loved one is getting dressed — with multiple layers of clothing. This is a change from pre-dementia days. Before worrying, getting angry or trying to change anything, ask yourself: “Is it really hurting anyone?” If the answer is “no,” then let it go. Confronting someone with dementia about this and making him or her change clothes, could produce agitation, and possibly an angry outburst. Remember: Your goal in this type of situation is to prevent or divert any stimulus that could bring on agitation. As typical adults, we don’t like being told what to do. A person with dementia is no different in this regard. Being able to “go with the flow” on your part will go a long way; concentrate more on the issues that are truly serious enough to address. If you can do this, you and your loved one’s lives will be much less stressful. We must constantly remember an underlying premise: People with dementia always need to feel loved, useful and needed. We must help create an environment that shows them love. We also must allow them to help as much as they want, and in so doing set them up for success. A big tenet of this is coming to grips with “behavior acceptance.” As caregivers and loved ones, we have to realize unwanted behavior is part of the disease process and that there is a reason for it. When we think this way, we can respond more effectively to situations where agitation is present, as well as others that need attention. What are some strategies for doing this? For example, instead of putting someone on the defensive with something like: “Your clothes are dirty. Would you please change into something clean?” You could phrase it this way: “Let’s go change our clothes so we an go to the store.” This directs action but it is less demanding of the person with dementia. By involving yourself, it comes off as less threatening. Use this line of thought, if it will help: “We cannot control what comes our way, but we can control how we respond.” If our thought preparation is, “How can I best respond to this situation or behavior?” it averts putting the onus on your loved one as “the problem.” The person with dementia is not able to change, so we have to.
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What can I do to my mother’s environment to lessen her agitation?

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February 21, 2012

- Alzheimer's Care, Blog, Elder Law Articles

Human behavior is greatly affected by one’s environment. Therefore, you must pay special notice to what goes on in the surroundings of a person who has dementia. That person is liable to have heightened chances of feeling fear or insecurity so he or she needs to feel safe to minimize them. Because there are so many environmental aspects that can cause worsened confusion or agitation, a continual assessment of the overall environment can help prevent agitation. A few examples of potential trouble areas include:
  • Temperature (too hot or too cold)
  • Noise (too loud or too much
  • Lighting (too bright or too dim)
  • Walkways/hallways (too cluttered)
  • People (whether they’re comfortable around them)
Look for patterns associated with typical sources of agitation, including: bathing, activities or events such as children visiting, and time of day. Address the specific issue as soon as you denote a pattern. It might mean changing visiting or showering times. While these issues might seem relatively insignificant to you or most people, they can be a HUGE issue to your loved one. Therefore, try to set up environments that are laid back and can help ease agitation. What is best? Whatever works for your loved one. Some examples of calming effects are:
  • Playing a favorite kind of video or music
  • Sititng in front of a fireplace
  • White noise, such as a fan or other motor hum
  • Getting fresh outside air
  • Burning fragrant candles or incense
  • Bird watching
  • Anything else that is known to decrease agitation for your loved one
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What are the effects of pain on agitation?

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February 17, 2012

- Alzheimer's Care, Blog, Elder Law Articles

Confusion and/or agitation almost always increase when pain is present. Furthermore, if there’s a sudden increase in confusion or agitation, it should be a tip-off that something wrong is going on physically. Dementia does not typically progress that rapidly. There is a cycle of pain that gives us a picture of how pain can affect the entire body. It goes something like this: Pain, anxiety, fatigue, depression, pain, anxiety, fatigue, depression, pain … and so on. If a person who has dementia is in this cycle and unable to let anyone know, we have to intercede and determine what’s really happening. The sources of pain can be numerous. Most people forget at least a few when listing them. A partial list includes: arthritis (the No. 1 affliction of older Americans), joint and muscle problems, infection, inflammation and headaches. If your loved one has chronic problems or even just a history with any of these conditions, ongoing visits with the physician (who presumably will prescribe some form of treatment) are critical. Ongoing assessments by a doctor or other clinician are very important. By examining overall health frequently, a clinician can learn whether something like a headache, urinary tract infection or other condition is a sign of something bigger. Be sure to keep the physician informed, even when you’re not going to see him or her in person. Watch your loved one’s facial expressions and body language since they are common indicators. Something as simple as a flare-up of arthritis or a foot wore can cause a change in behavior. Also be aware that some medications can cause agitation. Always call a physician if you have any questions or concerns about medication issues or effects. Caregiving involves ever moving targets so constant assessments and questions should be a part of it. Talking with others in your position can help. Discussions with other caregivers, whether they’re in a support group you’ve joined or are on their own, can be a good source of support. Family members and friends who sincerely care and try to understand are other good resources. There is no need to think you have to go through these challenges alone. Reach out for, and accept, help often. There are many good sources out there, including this free booklet: “The Indispensable Alzheimer’s Resource Kit.” Click here to get it sent to you for free.  
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