Tag Archives: depression

My father keeps asking to go home. What do we tell him? ? | Chicago, Illinois Elder Law Attorney Anthony B. Ferraro

When your father or any loved one starts to ask about home, someone could drive them past a previous home, even from childhood. Often, he will not recognize the old house because a house and a home are two different things. That’s why it is best to make him feel safe and secure, regardless of wherever he is.

To most people, “home” is a place where we feel loved and accepted — and safe. So the best way to answer your question is to think about the word “home” and what it signifies. Depending on where he is with memory loss, your father might be conjuring thoughts of a childhood home with his parents and siblings. Or the home where he was first married, the kids were young or any time before, after or in between

He might be living in the same home he’s been in for 20 or 30 years and still ask to go home.

Due to the nature of Alzheimer’s, your dad is likely feeling insecure, fearful, even unlovable. Please pay close attention to this next point: It is not your fault. He is dwindling a bit, day-by-day, and he is frightened. Fear can drive many emotions, not the least of which are insecurity, anxiety, anger and low self-esteem. Your father needs to feel safe. If he doesn’t carry good feelings about himself, he probably doesn’t feel he can be loved by anyone.

Remember that the most important thing to realize is you need to constantly validate his feelings. Instead of telling him he is home, tell him simply that he is in a safe place and that he is loved very much. You can tell him, for example, “Dad, you’ll be staying with me and Anthony for a while. We’re happy you’re here and we love you.”

Reminiscing about his childhood and looking back at his life and life accomplishments also should make him feel good about himself and decrease negative feelings.

Because Alzheimer’s patients typically have short-term memory loss, he will nonetheless continue to ask about “home.” Repeat over and over that he is in a safe place and loved very much. Giving hugs throughout the day will truly say much more than words. A hug produces feelings of love, acceptance and security — three big concepts that continually need addressing.  For more information regarding how to treat a loved one with Alzheimer’s, click here.

How can I keep my mother (who has Alzheimer’s) busy when she expects me to keep her entertained all day?

It’s not uncommon for an individual with Alzheimer’s to get very attached, or “clingy,” with the person most responsible for his or her care. But that doesn’t mean all of that person’s stimulation has to come directly from you.

Try some of these ideas:

  • Play music with a fast pace
  • Let her walk as much as possible
  • Exercise videos with simple instructions are available from numerous companies
  • Have her shred old documents or clip coupons
  • Have her feed a pet
  • Direct her to get mail from the mailbox and open the junk mail
  • Have her set the table while you make lunch.
  • Bake cookies. She can help stir or put the dough on cookie sheets (while you set the oven)
  • Get her some exercise through activities such as batting a balloon or pulling weeds
  • Let her help at whatever level she can. One example: She can hold a grocery bag while you unlock the door to the house
  • Ask a friend to visit and take her for a walk, read to her or play with a ball. Anything that will give you a break for a while
  • Get audio books from the library. People with Alzheimer’s often like to be read to, especially if they’re no longer able to read themselves. You might have to sample different subject matter or genres before finding a good combination. Humor usually speaks to anyone.

There’s also a good publication with suggestions: “Hundreds of Activities for Men and Women with Alzheimer’s Disease and Related Disorders,” by B.J. Fitzray (published by Rayve Productions in 2001). This and other helpful publications are available online at http://www.ahaf.org. Another good site to check is http://www.alz.org, the Alzheimer’s Association website.

My husband, who has Alzheimer’s, doesn’t like me telling him what to do … How can I improve this?

No matter what, you should always try to make him feel like an equal, and like an adult. Include him any way you can in the goings-on of the day. For example, if you need to pay a stack of bills, you can ask him to pick out one that you should pay first. Give him a choice of two. He could also stay involved by stuffing envelopes or putting stamps on envelopes. Then, you can make a trip to the post office part of the routine. The key is you keep him involved, and he’s comfortable with his involvement.

Be sure to talk with him. Nod and don’t argue when he talks. Let him answer questions and don’t worry about whether he’s really right or not.

Use your sense of humor. If things don’t go precisely as planned, laugh together. By the same token choose your battles. If you must remain firm about something, try to figure out if it really matters if chore “X” gets done. If he doesn’t want to get dressed, is it hurting anyone? Again, treat him with respect and dignity, and like an adult. You can do this by acknowledging his feelings of frustration and loss. Above all, he needs to know you care.

Think about how you would want to be treated if the roles were reversed. You wake up one morning and many simple things you could do yesterday you now can’t do. You might not know where you are in your own (long-time) home, or you might not remember how to get dressed, to go to the restroom or how to set the table. Remember to treat this as a person with a disease, not as a “diseased person.”

It is an admittedly difficult situation for both of you. Your loved one needs help because he is no longer independent. This means you lose some independence, too.

Give yourself frequent breaks. This is obviously a very hard situation. When things get really tough — and face it, there will be those times — take a step back, inhale deeply and then move forward with resolve and patience. Take each moment and each day one at a time.

For more information, please click here to download our FREE “Indispensable Alzheimer’s Kit.”

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

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.”

Can I seriously consider being blessed to be a caregiver?

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.”

Sometimes my mother totally refuses to cooperate with me (for dressing, cleaning up, etc.). But if we call in a familiar nurse-aide, Mom’s a peach and there are no problems. What gives?

The difference in relationships matters. Non-relatives sometimes have easier access or more cooperation precisely because they are NOT family members. Many times, loved ones are harder on their relatives than anyone else. Your mother probably feels she can act however she wants around relatives.

Sometimes, loved ones don’t have good relationships to start with and this is just continuation of that dynamic. But usually a person will be on his or her best behavior for someone outside the family. That’s good news for aides, doctors and sometimes even strangers with whom they interact.

Sometimes all the family contact, and familiarity it brings, is too much. You both might just need a break from one another, having spent too much time together already.

This is not something you should take personally. Your mother still loves you. Just remember that she has a form of dementia. Many people don’t realize that almost all inhibition is eliminated with dementia. It’s a bit of a mystery, frankly, how some people can maintain such good manners with someone who is not as familiar with them as you.

It’s important for caregivers (such as yourself) to learn to let things go. You should weigh things such as: If all she wants to eat is chocolate pudding, is it hurting anyone/anything? If she wants it for breakfast, it might not be the most nutritious thing for her, but it’s not going to harm her (unless medically contra-indicated, of course). 

Learn to step back and evaluate the overall implications of odd requests or off-plan behavior. Choose your battles wisely. Often, if a loved one with Alzheimer’s doesn’t want to eat or dress or do some other common task, she or he will cooperate when you ask again later.

For more information, please click here to download our FREE “Indispensable Alzheimer’s Kit.”

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

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

Are animals and Alzheimer’s a good mix?

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’?

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?

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.