Don’t Forget to Remember

By Care For You •

Living with Dementia and Alzheimer’s Disease

: Image by Getty Images via Daylife

Do you remember what you had for dinner last night? What about dinner last week? How about the name of your second-grade teacher?

Do you remember where your bedroom door is? How to turn off the stove burner? The way from the mailbox on the corner back to your house? Where you put your glasses? Somebody stole them! What are they doing in your shoes? Do you remember your daughter’s name?

Everyone’s daily routine includes activities like eating, bathing, dressing, and using the bathroom. For people with Alzheimer’s or any other form of dementia, it can become impossible to do such things alone.

De•men•tia – Loss or impairment of mental powers;
from Latin: de – away from + mens – mind

: Image via Wikipedia

Dementia is literally going away from the mind, as parts of the brain are slowly, gradually destroyed. Two common forms are Alzheimer’s Disease and Vascular Dementia, caused by a series of small strokes. The individual can become unable to perform motor tasks like brushing teeth; interpret sensory signals like hunger or pain; recognize objects, persons, or sounds; or communicate.

These sensory and behavioral conditions can make it very hard for caregivers to care for a loved one. How do you know when someone should eat who isn’t expressing hunger—because he or she cannot find the words or cannot recognize the feeling?

Care for You first began working with Mr. B when he was discharged from a hospital for malnutrition and dehydration. If asked if he was hungry, he never was, because he could no longer sense hunger or thirst.

Why does someone never make it to the bathroom on time? Mr. and Mrs. R both have dementia, both are incontinent. When we began working with them, neither was able to consistently get to the bathroom on time; both just urinated while sitting in their chairs. Not surprisingly, the house smelled of urine and both had skin breakdowns. A person with dementia who doesn’t receive constant care can end up suffering from dehydration or malnutrition or living in unsanitary conditions.

We have experience dealing with the behavioral changes that can accompany dementia. These include:
• Over-stimulation
• Paranoia
• Anger with anything unfamiliar or new
• Wandering
• “Sundowning” (agitation or confusion beginning in late afternoon).

Singly or in combination, behaviors like these can turn any task into a tremendous undertaking. Care for You companions receive initial and on-going training in the care of persons with dementia or Alzheimer’s. They know how to smooth out the many small details of everyday life: by preparing familiar foods on a regular schedule, presenting them one at a time to avoid over-stimulation, manipulating utensils, and helping with regularly scheduled trips to the bathroom.

Our Companions know that people with dementia have trouble understanding the meaning of what is said. However, they are very sensitive to how things are said. An agitated tone can be upsetting. A calm tone can reassure.

Individuals are often confused about reality, often can’t separate the past from the present, may forget who others – or themselves – are. Companions know to avoid arguing about reality with the individual and insist on their version of reality – it may cause more confusion and stress. Instead of saying to Ms W, “Your husband died 20 years ago, he’s not coming home!” Franchette says, “I’m sure he’s working late tonight. Let’s call him later.”

When Ms P asks, again and again, about her doctor’s appointment, instead of saying, “I just told you! Your appointment is at 2 o’clock!” Margaret reassures her and says, “Don’t worry, I’m going, too. I won’t leave without you.”

When Ms P tries to leave the house alone, Margaret uses distraction – Instead of saying, “Where do you think you’re going? You can’t leave by yourself!” she says, “Before you go, could you help me with this for a minute or two?”

When we began working with Mr. M, he had not bathed or changed his clothes for 3 months. The odor was “pretty ripe,” and his assisted living facility was going to evict him. When Mr. M insisted that he had already showered, Doug did not argue with or rush Mr. M – he made them coffee. A few minutes later he made a statement instead of asking a question. Instead of saying, “Are you ready to shower now?” he ran the water and said, “Your shower is ready. Here’s your towel.”

Attention to the mental and emotional needs of individuals is just as important as the physical needs. We call it play, and play is critical. Studies show that daily social interaction can reduce or temper the behavioral changes of individuals affected by dementia. Our experience shows that the more engaged the individual is, the healthier and happier the individual is. We walk, we talk, we paint, we make crafts, we literally sing and dance – it’s calming, focused, short-term…and fun.

It’s often very difficult for the family or caregiver of someone with dementia to realize and understand that their loved one can no longer make logical, reasonable decisions. The individual and the family are used to that person being in control – but dementia isn’t reasonable, and the individual is not able to make complex decisions and maintain the control of before.

Care for You works with families to tailor a routine to their loved one’s needs, whether the individual needs round-the-clock care or only a daily telephone call. Companions can give your loved ones the continuous one-on-one attention and care that will put them (and you) at ease and ensure their well-being. Most of all, we work to preserve your loved one’s dignity, privacy and security.