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?

May 3, 2012

- Alzheimer's Care, Blog, Elder Law Articles

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?

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.

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.

What kind of activities do you suggest for me and my husband (who has Alzheimer’s) at home?

By Anthony Ferraro on

April 23, 2012

- Alzheimer's Care, Blog, Elder Law Articles

If you step back and take a good look, there are many options for you. Just about anything you do together can be viewed as an “activity.” It often doesn’t take too much to make a person with Alzheimer’s feel useful. You can do something as helpful as go grocery shopping. Have him push the cart, or hand him things to arrange in the cart. He also can help unload them for the cashier and then later load them into the car. Having him hold a bag while you’re unlocking the car or your front door also can build self-esteem. Here is a list of activities you might like to try at home. Mix and modify as you find useful. You will have to consider cognitive ability and functioning levels, of course, so you don’t attempt something that will prove too hard or frustrating. Some of these things can be done with a partner, or alone. As time wears on, he will need a partner more often. With Alzheimer’s patients, it is always important to have a routine or schedule to rely on. Just don’t adhere to it too strictly if you see your husband’s mood or disposition is not suited for what you think you should be doing. • Play music — Music can enhance memory. Play upbeat music you can dance to, if that is a desirable option. It’s good exercise. Calming music will help everyone relax. • Write his life story with his assistance — Help him remember his life as you both organize photos and story lines. Include special events, family, awards, special events, accomplishments and more. Put everything in a durable book that your husband can carry around and look at often. • Video break — There are numerous videos/discs designed specifically for people with Alzheimer’s in mind. For example, Innovative Caregiving Resources (http://www.videorespite.com/) has 10 interactive DVDs/videotapes that will typically keep the attention of a person with Alzheimer’s for their full duration (20 to 53 minutes). Visit the company online, by phone [(801) 272-9446] or by mail: P.O. Box 17332, Salt lake City, UT 84117. • Exercise — Join a gym (to help both of you), go on walks, use an exercise video or audio program, putt on a portable putting green, bat an inflated balloon back and forth, play suitable games such as horseshoes (soft ones are lighter), bean bags or croquet. Your imagination is the only limit here. • Play cards or board games such as checkers • Relaxation — Have a relaxation period each day after lunch. Burn candles or incense (remember which scents get the best reactions), play calming music, gently massage warm lotion onto hands or arms. Consider this type of ritual around bedtime, too. • Read enjoyable things — This could be something funny, inspirational, spiritual or just reflective. One person can read to the other, or you can read 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 mother refuses to take a tub bath — something she always loved. What can I do?

By Anthony Ferraro on

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.

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?

By Anthony Ferraro on

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.

What can we do for my mother, who used to love to read but now doesn’t?

By Anthony Ferraro on

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.

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

By Anthony Ferraro on

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.