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

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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.
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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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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 father thinks people and events on TV are real and he often wants to interact with them? What should I do?

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March 29, 2012

- Alzheimer's Care, Blog, Elder Law Articles

There have been people with Alzheimer’s who have refused to do something until getting an answer from a TV character; others have thought music shows are actual concerts. This has worried family members, who have wondered whether they should cut off TV watching altogether for their loved one. But you have to think it over: Is this causing any harm? This is not an uncommon behavior for someone with Alzheimer’s. You have to weigh what the TV situations might be doing to your loved one. Does watching TV become distressing, or are the characters and stories seen as friendly? Often, it’s the latter, and you can never have too many friends! If TV scenarios and people become threatening to your father, then you must limit how much TV he watches. If there is a TV in his room, you can remove it. Odds are, it isn’t doing much good for him if stress is involved. If or when he sees other residents watching TV, his attention can be redirected toward other activities. If he’s not living at home, talk with the staff at his care facility and let them know of your concerns. Tell them you would like to have his TV time limited. They can help redirect him toward bingo or other activities instead. If there winds up being no TV in his room, ask staff members to take him to one of the facility’s common areas to watch a favorite show(s) there. If there is a VCR or DVD player, you can bring programming that you have purchased or rented so he can view it.    
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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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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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