My father has Alzheimer’s and is abusive to many of us, including my mother, who lives with him. How can we help her?

May 2, 2012

Even if an abuser has Alzheimer’s disease and can’t control his temper because of it, it is still difficult to put up with. But you can’t take it personally. If his behavior is merely an extension of the way he used to treat people, you at least know what is happening. But if it’s a full personality change, it understandably could come as a shock. It will likely signal a period of mourning, where you will have to come to a point of acceptance that there has been a dramatic change. Give your mother breaks since she is otherwise with him all of the time. It might mean hiring someone to come in and be with him, or using an adult day care center, or having family members rotate in. But you must realize that your mother needs breaks. The odds are he will act differently with non-family members. However, if he still verbally abuses home care workers or staff at the adult day care center, you have a bigger problem. Then, it might be time to get the doctor involved. See if the doctor has any suggestions — he might suspect depression or anxiety is in play and prescribe something for it accordingly. Often, Alzheimer’s patients act out due to an underlying cause such as depression, anxiety or pain. You also can deal with this volatile situation with humor. You can’t control how your father acts out, but you can control your responses. The staff at one adult day care center simply refers to harsh words or verbal abuse as its “terms of endearment.” You also might want to openly acknowledge your father’s feelings to him. This could lessen his frustration level. A person with Alzheimer’s loses so much independence, he may rail against those nearest to him, especially if he’s receiving different sets of advice or orders from different people. Would-be advice givers need to be careful that they offer suggestions and directions in a non-threatening way. If your father resists, don’t press him and go back to the topic later. After an informal cool-down period, you may have better luck. To have success, you should also not talk down to him. He’s an adult and has his own personal history of independence and success. That should not be discounted. Your father will sense if he is being treated differently. Another solution for you caregivers is to join a support group. Very often, there will be others in a group with the same or similar problems. They can either give you successful strategies or simply the comfort and understanding that you need to know you’re not alone in this battle. You and your mother also should journal feelings and frustrations about your dad’s behavior. By dealing with your feelings, you’re better able to help your father. To find a support group near you click here.

If a person has Alzheimer’s disease, how important are routines for them?

By Anthony Ferraro on

May 1, 2012

- Alzheimer's Care, Blog, Elder Law Articles

This is a very good question because routines are very, very important. A steady routine will be familiar and comforting as a person with Alzheimer’s progresses into the disease and loses more memory. If you live with your loved one, make everything a part of a schedule or routine if possible. You should do this for both of your sakes. Rituals, such as at bedtime, are critical. If your loved one always ate something particular before bed, or checked a door(s) or performed some other task, you should continue with it. If your loved one becomes restless before bed time or is having a hard time getting to sleep, allow him or her to get up and do anything in their ritual. This will help the person feel at home. To reiterate rituals and routines are very, very important. A daytime routine might include specific medication or eating times, checking the mail, bathing, going to get a haircut, grocery shopping with you and just about anything else you want to include. Putting drinking water into the routine is great because it can add to a sense of process but also keep a person with Alzheimer’s hydrated, which can sometimes be an elusive task. You both should also be sure to include relaxation time in your regular schedules. Some other good things to include in a daily schedule could be: feeding a pet(s), folding laundry, reading the newspaper, going for a walk or drive, taking out the garbage, getting a snack, drinking coffee, etc. It might be difficult, but while trying to keep a steady routine, you have to avoid becoming too rigid. If the activity you had planned isn’t working out well for your loved one, be flexible and don’t argue. Move on to the next thing and go with the flow. If you have an activity that simply must be done (such as dressing), take a break from it and try again late. For more information, click here to receive our FREE “Indispensable Alzheimer’s Resource Kit, ” which has additional information regarding caregiving issues. In addition, attend an Alzheimer’s Support Group. To find one in your area click here.

Would it be helpful to have my mother hold a doll since she is in Stage 5 of Alzheimer’s and always looking for ‘her children’?

By Anthony Ferraro on

April 27, 2012

- Alzheimer's Care, Blog, Elder Law Articles

There are pros and cons to this, but it is probably worth a try. It has worked for many people who have Alzheimer’s since a basic human need is to nurture. There have been many people with Alzheimer’s who have thought the doll was real. It can be beneficial, as they carry the doll everywhere and make sure it is cared for. However, it also can have negative effects since the person with the doll might take worrying about it to extremes. Take, for example, one woman at an adult daycare center who had been a volunteer in healthcare facilities much of her adult life. She loved to take care of people and things, and she liked to keep busy. The staff gave her a doll. It looked like a great idea at first and appeared to be a solution to her “busyness.” But after just a few hours, she began worrying about feeding the “baby.” She worried so much, she became agitated. Some clever staff members told her they were baby sitting and were able to get it out of her sight that way. With the “baby” out of view, the woman began to calm down. Staff put the doll away for several months and then gave it back. The woman was able to carry it around and not stress out about it at that point. Your mother needs a lot of validation and assurance — on an ongoing basis. Assure her that her children are safe and doing fine. Most likely she is thinking about them as being young and is therefore worried about their wellbeing. Try to redirect her toward other kinds of activities to keep her mind busy, and off her children. One alternative that has worked well is stuffed animals. A person with Alzheimer’s has the need to touch, love and give affection, just the same as anyone else. Stuffed animals can fill that need.

Are animals and Alzheimer’s a good mix?

By Anthony Ferraro on

April 26, 2012

- Alzheimer's Care, Blog, Elder Law Articles

Pets in general, including dogs and cats, can be very therapeutic. Many nursing facilities, in fact, incorporate “pet therapy” into their daily routines as much as they can. However, as with many treatment or alternative therapy options, everything is contingent upon the individuals involved. Some will respond well to animals, some do not. Sometimes, responses are entirely a surprise. Take, for example, the resident of an Alzheimer’s unit who grew up on a farm. She liked animals, but because they were never allowed in the house, an aide had to take her for a walk whenever visiting pets were brought into her facility — her HOME. It upset her to see dogs in her “house.” Many people fear animals, including dogs. Some dogs, however, can be trained to be excellent companions or “playmates.” They are taught to remain calm around elderly individuals and will not to become rambunctious or jumpy. Often, the trained pets are taught to lie nearby so they can be petted throughout the day. It also creates a more leisurely “home-like” feel. If a person with dementia has enjoyed pets most of his or her life, odds are pets going to be well-received and enjoyed even after Alzheimer’s or another debilitating condition arrives. Sometimes caregivers or family members buy a dog specifically to give an individual something to focus on and to provide more companionship. A pet will create an entirely extra world of activities. A person with dementia can feed and/or water a pet, or brush it or take it for a walk. This also can raise self-esteem because the person will acquire a sense of responsibility for a living, breathing and tail-wagging friend. Every individual needs to feel needed and a pet can fill that purpose. If there is a dog already in the house, watch to see if its behavior changes, too. If a dog senses something is different, it will respond and, in this situation, become very protective. The dog is likely to stay close to the person with dementia and act as guard and protector. If the dog belonged to another family member or was not particularly close with the Alzheimer’s patient previously, it doesn’t matter. The animal will remain close with both of you, but it most likely will take a lead in accompanying the person with Alzheimer’s. Many types of pets can be therapeutic. Cats have soft coats and like to curl up in laps. This is an example of the way pets can be wonderful additions to Alzheimer’s patients because they offer “unconditional love.” Fish can be fun to watch and are quite soothing. Birds can serenade, and also be fun to watch — inside or out. Filling outside bird feeders might be a good activity for you and your loved one to complete together. Then, you can sit back and watch the grateful birds fly in for their snacks.

Can art be therapeutic, even if a person was never an artist or very ‘artsy’?

By Anthony Ferraro on

April 25, 2012

- Alzheimer's Care, Blog, Elder Law Articles

Art is an excellent way someone can express himself in a non-verbal manner. It is one of the common therapies used for people with dementia. In essence, it is another way of journaling thoughts and feelings, just in pictures not words. Caregivers should remember to savor the moment when a person with dementia is creating art; it is not the end result that should be celebrated (necessarily) but rather the process. If an individual with Alzheimer’s is having fun while creating some piece of art, realize you have achieved success and art will have served its purposed. It is “the process of getting there” that is the key. Realize ahead of time that your loved one might finish a painting with satisfaction but a short time later fail to recognize it. There is a highly commendable program run by the Alzheimer’s Association called “Memories in the Making.” It involves volunteer artists going to facilities to work with watercolors with small groups of people with Alzheimer’s. The facility purchases supplies for the project through the Alzheimer’s Association. To see someone who hasn’t spoken for months pick up a brush and begin to paint is beyond expression. It is incredibly uplifting. You can simulate this program in a home setting, too. Seek out artists in your community who would be interested in volunteering some time. The artist can either recommend materials to you or bring them himself or herself. It’s not uncommon for someone with Alzheimer’s to resist taking part in an activity like this. Praise their efforts, no matter how big or small, and encourage them throughout. Remember: It is the process, not necessarily the end product, that is the goal. That said, often you will still be amazed at the results.

As the primary caregiver for somebody with Alzheimer’s, should I journal my thoughts?

By Anthony Ferraro on

April 24, 2012

- Alzheimer's Care, Blog, Elder Law Articles

Absolutely. Keeping a journal is a good idea for everyone — especially someone with a stressful and emotional burden such as caregiving. Journaling means putting your thoughts on paper and keeping them between you and the paper. Keep the journal in a secure place if you’re worried about someone else reading it. Just don’t forget where it is so you don’t write in it! Actually take time to schedule journaling into your routine. You don’t have to find time every day, but you should make a point of doing it regularly. Journaling is to the brain and emotions what physical exercise is to the body. You don’t have to write a lot, just enough to get things out and off your chest. Write about your thoughts and feelings. Write of your anger, resentment, fear, guilt and any other strong emotions. You can even make this a practice of “writing to the disease.” Go ahead and tell it how it is upending your and your loved one’s lives. Let it know you hate it. Tell it that it is messing up your retirement years after so many years of hard work and planning. This is a good way of dealing with your feelings. It is healthy to do so. Your journal also can reflect your observations about your loved one. Include notes on patterns that might emerge regarding behavior, eating, sleeping, toileting, etc. This will help when you talk with the doctor. It also can help you reflect on the way you handled certain situations. Journaling is a good way to help you sort out your thoughts — on many levels. If you’re feeling overwhelmed, it can help pull things back into perspective. It is important, however, not to allow journaling to be your only outlet or release. Human interaction is still very important. You must continue talking with friends and other members of your family. A support group might also be a good idea. Everybody needs human contact and socialization to re-energize. In fact, The FREE Indispensable Alzheimer’s Kit includes a Caregiver’s Journal specifically for this purpose. Click here to download it now.

How do we not upset Mom’s routines if we hire an in-home helper?

By Anthony Ferraro on

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.

How do I deal with my sometimes-explosive outbursts at my mother?

By Anthony Ferraro on

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.

My grief is nearly constant about seeing my loved one slowly slip away. How can a person cope with this?

By Anthony Ferraro on

April 11, 2012

- Alzheimer's Care, Blog, Elder Law Articles

First, realize that grief is natural and should be allowed to happen. You are not alone in this, and yet you ARE unique. To that end, if you know someone else in a similar situation, try not to compare yourself to him or her. They might handle the process differently. Some grieve quietly, some quickly, some prolonged. The goal is for all to reach a stage of acceptance. How can you alleviate your pain? Try writing in a journal. Grieving actually is an array of emotions — anger, depression, shock, resentment, fear, loneliness, anxiety — that need to be expressed. If you can journal your thoughts, it can create an “escape” to a “safe” place, which is easier than going to a support group or a counselor, or even talking with a friend. Writing in a journal is an immediate and healthy way of coping. You should still consider attending a support group. It can be very helpful. Go with an open mind — don’t become overwhelmed when you hear others describe their situations. Everybody will have his or her own similar, yet unique, situation. Remember, too, that you’re not only there to get help — you’ll also be helping others. We forget that doing something for others makes us feel good about ourselves, which enhances our personal health in several ways. If there is someone you can confide in, such as a close friend(s), talk with her or him as often as the two of you can. Instead of feeling that we’re a burden to others, we should realize “that’s what friends are for” was coined for a good reason. Our friends want to help us, but usually we have to make a first step somehow. Or at least a welcoming one. Don’t worry about having too many people to confide in, or feeling obligated to confide in more people than you might want. Usually, just a few will become the ones you rely on. You also should consider talking with a member of the clergy whom you know and trust. Many are trained for just these kinds of talks. In many church communities, there are also others with whom you could speak. Depending on your needs, do not think twice if you believe you might benefit from a professional counselor who is trained in grief consultations. Some of them lead grief support groups — something you might want to consider (as opposed to just a general caregiving group). Family members, of course, can fill many of these roles. Some families are always close when it comes to personal matters. But keep in mind that even those families that don’t consider themselves “tight,” often have members who answer the bell and are nonetheless there for one other when the going gets tough. If you have family members who are either unable or unwilling to “be there” for you, however, you definitely should turn to one or more of the sources mentioned above. For more information, an excellent resource is “The Indispensable Alzheimer’s Resource Kit.” It can be downloaded at no cost by clicking here.

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?

By Anthony Ferraro on

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.