Tips for Alzheimer’s Caregivers

Tips for Easing the Life of Someone with Alzheimer’s

By Shelly Beach, Author and Caregiving Expert

 

Most people recognize that Alzheimer’s disease causes memory loss. However, it may be more difficult to understand that Alzheimer’s also deeply influences one’s emotions, mental processing, and physical capabilities. As our loved one progresses through the disease, we and other family members and caregivers must begin to focus on helping our loved one live in the moment, because they lose the capability to reason and live beyond the immediate.

Alzheimer’s experts offer a number of recommendations for how to ease the life of someone living with Alzheimer’s or other forms of dementia. These tips are intended to lower agitation, enhance focus and communication, and give your loved one a greater sense of peace and safety. Alzheimer’s can be a terrifying disease; patients live without an awareness of where they are, why they are in a strange place, and who the people around them are.

  • Keep people with Alzheimer’s active and engaged.   

Cognitive and sensory stimulation is important for them. Check to see if your community offers adult day care for
those with dementia programming. Involve them in simple family chores. Create a small indoor garden for them to
tend or set up a paint studio.

  • Focus on process and not results.   If your parent does something incorrectly, don’t correct them. If your father begins eating with his fingers, let him. People with dementia need to feel that they are accepted and loved without judgment and are part of a group. If Mom folded the laundry wrong, thank her and do it over later when she can’t see you. If Dad cleaned the bathroom poorly, thank him with a smile and sincere tone and finish the job later, when he’s not around.

  • Let your loved one feel useful.

    Depression often occurs in the early stages of Alzheimer’s. Experts estimate that up to 40% of those with Alzheimer’s struggle with depression. Your loved one is aware of their illness and feels as if they are no longer useful. Allow them to contribute—cooking, simple home repair jobs, helping with shopping or laundry, emptying the dishwasher, etc.

  • Never argue. Always agree and meet them where they are.

    Join them in the moment, in their reality, when you talk to them, especially when answering questions. For instance, “I haven’t seen Uncle George (who has been deceased for 7 years), but why don’t we get a snack and sit here and watch TV while we watch for him?” Rather than being a lie, this kind of answer diverts and redirects. It does not engage you and your loved one in an argument or you repeatedly answering that Uncle George is dead.  Adults with Alzheimer’s have lost adult reasoning and live in a hazy world, stripped of the ability to recognize and understand reality. Telling them the “truth” is often cruel and serves no purpose.

  • Give simple instructions.

    Offer no more than three options, and be sure than all of the options are appropriate. If you have a preferred option, list it last because the last option is the most likely to be chosen.

  • Never ask, “Do you remember?”   

    Always tell your loved one who you are and what your name is. If you reminisce with them, allow them to contribute information, but don’t ask them questions they may not have answers to. Asking questions only provides an opportunity for frustration. If you want to know what they’d like to have for lunch for instance, offer two or three options at a time.

  • Avoid things that could be upsetting.

    For many dementia patients, this means loud crowds, like basketball games, parties, or receptions. For my mother it also meant being in crowded waiting rooms. Many dementia patients also deal with Sundowning Syndrome, which means that agitation worsens in the late afternoon. My mom’s behavior quickly degraded after 4:00 in the afternoon, and she often became combative. When I took her to the doctor, we were taken directly to the exam room to wait (simple solution). And I scheduled appointments and activities for her before noon to minimize her frustration.

  • Learn what soothes.

    This might be music (hymns, vintage music, boogie, etc.), looking at pictures (children’s faces are often favorites), rocking or snuggling a life-like doll, old TV shows like I Love Lucy, or gardening. Sensory activities that calm your loved one should be a regular part of their routine. Learn what they enjoy: massage, foot rub, soft fabrics and blankets, a doll or stuffed animal, or something else.

It’s also helpful to learn about any events from your loved one’s past: Were they abused? Attacked by a pet or animal? Confined or incarcerated? Did they suffer prolonged illness? Lose a parent or sibling in childhood? Experience a near drowning? These events could become triggers for fear as their illness progresses.

Our goal as caregivers is to soothe the suffering of Alzheimer’s and dementia. This means doing all we can reasonably do to safeguard our loved ones’ physical, mental, and emotional well-being and to love them as we would want to be loved ourselves.

No More Tug-of-War: How to Get Dementia Sufferers to Cooperate

 

It was difficult to watch my mom progress through the various stages of Alzheimer’s disease. Sometimes she was quiet and sedate, and at others she was combative and uncooperative. It didn’t take me long to discover that certain actions, environments, and responses triggered Mom’s agitation. For instance, keeping my voice calm and my expression smiling, even when I felt tense, helped prevent Mom’s anxiety from escalating.

Dementia patients can seem stubborn, obstinate, or lazy. They may appear mean and ornery or like they don’t want to participate in life. But those actions require choice—choices those with dementia struggle to make.

Behavioral changes occur in those with dementia
because the disease process causes brain damage.

People with dementia can’t process information (seeing, hearing, speaking) quickly or the same way they did when they were younger and healthy. They have a desire to express themselves and be engaged, as all humans do. They retain the desire to be productive and relate meaningfully far longer than they have the ability.

It’s important to keep people with dementia engaged and active. There are many reasons to keep loved ones with dementia participating in activities:

  • It gives caregivers a break
  • It can decrease agitation and fear
  • It can decrease wandering, rummaging, and asking repetitive questions
  • It helps those with dementia feel productive

The brain damage from dementia can make it difficult for people

  • to initiate activity.
  • to understand directions.
  • to make choices.

This is because it can take people with dementia up to 60 seconds to process information. This fact is important to remember when gauging simple speech with a loved one living with dementia.

While we can’t changed out loved one’s diagnosis, we can alter the way we relate to them.

Changing how we approach an elder with
dementia can improve their quality of life.

Consider some of the following steps to help make your loved one’s life easier:

  1. Think of the easiest way to explain directions or a process. Break it down into individual steps.
  2. If someone is being uncooperative, try to think from their perspective about what the problem might be.
  3. When possible, modify activities to be easier.
  4. Don’t ask when you can tell. For instance, don’t say, “Do you remember who I am, Dad?” Instead, say, “Hi, Dad. It’s me, Sharon.”
  5. Be sensitive to your tone and facial expression. It’s more important HOW you say something than what you are saying.
  6. If a word upsets them, don’t use it. My mother hated the shower, so I would say, “Come with me, Mom, I need some help,” which I needed. I needed her cooperation.
  7. If someone is frightened, don’t tell them not to be, which doesn’t help. Acknowledge their fear and tell them you will keep them safe and protect them.
  8. DON’T argue and defer to logic. Acknowledge what concerns them (“I know you miss your mother.”) and try to redirect them Let’s wait for her over here. Can you help me fold towels while we wait?”).
  9. People with dementia often respond to the question “Can you help me?”.
  10. Find or create tasks that your elder can help with: sorting laundry, folding towels, vacuuming, dusting, straightening the pantry, setting the table, etc.When possible, have your loved one do tasks with If you’re cooking, as them to chop the eggs (maybe not with a knife) mix the salad ingredients, or snap the green beans.
  11. Give instructions only one step or two at a time.
  12. Set out any items that are needed for a task.
  13. If you are asking your elder to do something, do it with them to demonstrate.
  14. Get them games, puzzles, cards, books, etc. with enlarged and simplified print and visuals. People with dementia seem to be particularly fascinated with children—books with children’s faces, TV shows featuring children, etc.

Recommended activities:

  • sorting silverware
  • dusting
  • looking through photographs
  • coloring
  • walking
  • petting a dog or cat
  • listening to music yard
  • work sorting coins or nuts and bolts
  • washing windows
  • gardening

What have you found helpful? Share it with us here.

 

 

Tips for Easing the Life of Someone with Alzheimer’s

One Step at a TimeMost people recognize that Alzheimer’s disease causes memory loss. However, it may be more difficult to understand that Alzheimer’s also deeply influences one’s emotions, mental processing, and physical capabilities. As our loved one progresses through the disease, we and other family members and caregivers must begin to focus on helping our loved one live in the moment, because they lose the capability to reason and live beyond the immediate.

Alzheimer’s experts offer a number of recommendations for how to ease the life of someone living with Alzheimer’s or other forms of dementia. These tips are intended to lower agitation, enhance focus and communication, and give your loved one a greater sense of peace and safety. Alzheimer’s can be a terrifying disease; patients live without an awareness of where they are, why they are in a strange place, and who the people around them are.

  1. Keep people with Alzheimer’s active and engaged. Cognitive and sensory stimulation is important for them. Check to see if your community offers adult day care for those with dementia programming. Involve them in simple family chores. Create a small indoor garden for them to tend, or enroll them in a community exercise program for those with dementia.
  2. Focus on process and not results. If your parent does something incorrectly, don’t correct them. If your father begins eating with his fingers, let him. People with dementia need to feel that they are accepted and loved without judgment, and part of a group. If Mom folded the laundry wrong, thank her and do it over later when she can’t see you.
  3. Let your loved one feel useful. Depression often occurs in the early stages of Alzheimer’s. Your loved one is aware of their illness and feels as if they are no longer useful. Allow them to contribute—cooking, simple home repair jobs, helping with shopping or laundry, emptying the dishwasher, etc.
  4. Never argue. Always agree and meet them where they are. Join them in the moment, in their reality, when you respond to their difficult questions. For instance, “I haven’t seen Uncle George (who has been deceased for 7 years), but why don’t we get a snack and sit here for a while and watch for him?” Rather than being a lie, this kind of answer is like responding to a three year-old with an age-appropriate reply. Adults with Alzheimer’s lose adult reasoning and slip away into a hazy world stripped of the ability to see reality. Telling them the “truth” is often cruel and serves no purpose.
  5. Give simple instructions. Offer no more than three options, and be sure than any of the options would be okay. If you have a preferred option, list it last because the last option is the most likely to be chosen.
  6. Never ask, “Do you remember?” Always tell your loved one who you are and what your name is. If you reminisce with them, allow them to contribute information, but don’t ask them questions they may not have answers to. Asking questions only provides an opportunity for frustration. If you want to know what they’d like to have for lunch for instance, offer two or three options at a time.
  7. Avoid things that could be upsetting. For many dementia patients, this means loud crowds, like basketball games, parties, or receptions. For my mother it also meant being in large crowds. Many dementia patients also deal with Sundowning Syndrome, which means that agitation worsens in the late afternoon. My mom’s behavior quickly degraded after 4:00 in the afternoon, and she often showed signs of aggression. The world is a confusing, frightening place for people with dementia, and anger and aggression are natural responses. Imagine not knowing where you are, why you’re there, what you should do, who you’re with, or what’s going to happen to you. Then add physical discomfort.
  8. Learn what soothes. This might be music (hymns, vintage music, boogie, etc.), looking at pictures (children’s faces are often favorites), rocking or snuggling a life-like doll, old TV shows like I Love Lucy, gardening, etc.

It’s also helpful to learn about any events from your loved one’s past: Were they abused? Attacked by a pet or animal? Confined or incarcerated? Suffer prolonged illness? Lose a parent or sibling in childhood? Experience a near drowning? These events could become triggers for fear as their illness progresses.

Our goal as caregivers is to soothe the suffering of Alzheimer’s and dementia. This means doing all we can reasonably do to safeguard our loved ones’ physical, mental, and emotional well-being and to love them as we would want to be loved ourselves.

What tips can you share with us from your caregiving experience?

How to Create Greater Comfort for Your Loved One with Dementia

 Mom and Dad

My Mom and Dad

 

  • Do you really dislike the feeling of water on your face?
  • Do you hate sudden loud noises?
  • Do you, like me, dislike the smell of strong perfume?
  • Does having your feet touched creep you out?

Our senses create our stories.

Life is a sensory experience. We file memories as sights, smells, sounds, sensations, and tastes. Our senses give us the information we need so we know how to react to our environment (how high to step, how far to reach, how to balance, etc.).

As we age, we all develop preferences for certain kinds of sensory information and dislikes for others. We base our habits and preferences based, in part, on this. For instance, you may prefer bright vibrant colors, and your sister may prefer pastels. (Now you know why she painted her house lavender.) But as we age, our sensory efficiency declines, and we become less able to know how to react to our environment. Unfortunately, many caregivers don’t understand the importance of sensory loss in dementia.

Dementia in its many forms shrinks sensory functioning beyond the normal decline of aging.

For instance, you’ll see my mother in the picture above. She was born with severe vision problems and had many corrective eye surgeries over the course of her life. As an adult, her vision was always poor. As she aged, it became worse. With the challenges of Alzheimer’s, life became very confusing for Mom. Although she couldn’t put it into words, we discerned that she had difficulty making sense of her surroundings. Alzheimer’s experts tell us that Alzheimer’s patients often have difficulty interpreting their surroundings and even have hallucinations.

So how can you create a more comfortable life for your loved one with dementia?

Become an expert in reading your loved one’s

verbal and their body language.

What are their likes and dislikes? For instance, I knew my mother feared going from wide spaces into narrow spaces, for instance from the living room down the hallway. Something about wide to narrow or perhaps light to darker appeared frightening to her. She would throw her body backwards and fight moving forward.

  1. Know your loved ones preferences.

Do they prefer a bright environment or dark environment?

Do they find mirrors confusing?

Do certain colors soothe them? Stimulate them?

Do they seek or avoid music, the radio, conversation, and other auditory stimulation, etc.?

Do they enjoy or tolerate touch from those they are close to?

What kind of food do they like and dislike: spicy, sour, salty, sweet, cold, hot, crunchy, chewy, textures? (TIP: Expect these to change over the course of the illness.)

Do they enjoy scents and aromas or avoid them?

Do enjoy feeling textures?

Are they stimulated by books? Music? Children? Dolls or stuffed animals? Gardening? Coloring? Cooking? Singing?

Are they soothed by books? Music? Children? Dolls or stuffed animals? Gardening? Coloring? Cooking? Singing?

What kind of interpersonal contact is most effective with your loved one? (TIP: Tone of voice and eye contact are the two most important elements of communicating with a loved one with dementia. Speak slowly in an even, loving tone, choosing simple words. DON’T ARGUE OR TRY TO REASON. Communicate empathy and try to divert to another activity.

 

2. Create visual contrasts to help increase perception.

If everything in your bathroom is one color, put a contrasting color lid on the toilet seat.

Paint the doors of their bedroom and the bathroom a contrasting color from other doors in the house to help them find their room. (TIP: Those with dementia may increasingly find blues, greens and purples harder to differentiate.)

Paint handrails a contrasting color to walls.

Use plates that contrast with the color of the food.

Avoid dark rugs, which can look like holes in the ground (and also create trip hazards).

Avoid patterned floor coverings and know that striped pavement, square tiles, and changing floor patterns can cause confusion and disorientation, as well as revolving doors, escalators, or fast wheelchair rides.

Above all, love them by investing the time

to truly know them. 

In seemingly insignificant moments we learn to read the intake of breath that unmasks hidden pain. The narrowed  eyes that reveal fear. The knit brow that communicates confusion. As time progresses, your loved one will need you even more to help them see, feel, hear, taste, and touch their world.

Your caregiving will be one of the most loving,

Christlike tasks you will ever accomplish. 

What accommodations have you made for your loved one?

 

Tips When You Suspect Your Loved One Has Dementia

carsharblogpic

Like most people, my family was unprepared for my mother’s Alzheimer’s diagnosis. We saw the signs, but we didn’t want to admit that such an awful thing could happen to our mom.

And so we didn’t talk about the hard things for too long. By the time we were ready to make a plan, we’d already hit crisis stage.

Many of my friends are now in a similar position, and you may be, too. Here are my top recommendations for how to best care for your loved one if you suspect they may have or be heading toward dementia.

1. Get them under the care of a gerontologist. 

A gerontologist is a doctor trained in illnesses in the elderly. My mother had heart problems, a seizure disorder, diabetes, was a stroke risk, and was sensitive to a number of Alzheimer’s-related medications. We needed ONE doctor who understood dementia and could best advise us regarding her medications and long-term care. Gerontologists understand with the various forms of dementia and what medications can best help your loved one, as well as drug interactions and how best care for those with dementia-related needs.

2. Have your loved one assessed by the Area Agency on Aging in the area where they live to find available services.

For a number of years, my mom and dad lived with my husband and me. We found an amazing adult day care program for my mother that offered me respite three mornings a week. A bus came to our home and picked up my mom (and dad) at our doorstep free of charge. The day care program offered programming specific to my mother’s needs, and they also bathed her. This was hugely helpful to me, since Mom was terrified of water, and bath time was a battleground. I’m convinced that this program (one of several that we accessed) extended my mother’s cognitive abilities, as well as the time we were able to care for her (and my dad) in our home.

3. Consult an elder care lawyer.

Our family has never regretted this decision, even though it meant an initial financial “investment,” which was returned over and over again. This decision saved my mother and father tens of thousands of dollars. It preserved funds that are still available for my 93-year-old father’s care. Elder care lawyers can help you and your family make the best possible decisions regarding your loved one’s, your parent, or your parents’ estate. If you live in Michigan or West Michigan, I recommend Tim Alles, who practices in the Grand Rapids area.

4. Begin talking and planning ASAP. 

I recommend Jolene Philo’s Caregiver’s Notebook (published by Discovery House Publishers) to help you begin the discussion and make appropriate preparations. It’s a great tools. Of course, my books are also helpful, especially Ambushed by Grace: Help and Hope on the Caregiving Journey. This book is packed with valuable websites and resources for caregivers who may feel caught off-guard.

5. Don’t be afraid to ask for help.

Bring your loved one’s physician, pastor, or trusted friends into the discussion. Work to put together a long-term plan with flexible options. What works today may not work tomorrow. And above all, turn to God as your ultimate resource. We can never be enough to meet the needs of our loved one. God is with us. He will supply the wisdom and strength that we need every step of the way.

What about YOU? If you’ve been a caregiver for someone with dementia, what would you recommend to others?