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Fall Newsletter 2018

Turning Lemons Into Lemonade-Part One

Despite the best intentions to support and care for a family member with dementia, the responsibilities can become overwhelming. So many family members have a “full plate” even before they take on caregiving responsibilities. In addition, because the individual with dementia often does not understand or agree with the change in their functioning, caregivers may feel frustrated.

Once there are warning signs that an individual is showing signs of dementia, others need to step up to the plate to:

  • Run errands
  • Pay bills and oversee finances
  • Assure adequate food
  • Manage medications 
  • Assume household repairs and safety
  • Assist with transportation
  • Schedule and attend professional visits (doctor, dentist, attorney)
  • Maintain social and recreational activities


TIP #1 To Making Lemons Into Lemonade 

If you are the primary caregiver and assume at least 3 of the above responsibilities, it is time to bring in the support of other family members and friends. Ask any seasoned caregiver and they will agree. Reaching out and accepting help is often tough for caregivers. They often say they don’t want to burden others but it’s critical to get beyond this obstacle.

Given that all forms of dementia are progressive in nature, caregivers can expect to assume more and more care responsibilities to assure safety and well-being. For caregivers, it becomes a balancing act between providing needed care and taking care of oneself.  impact on caregiving


 TIP #2 To Making Lemons Into Lemonade  

Look into and select from the array of options to take some of the responsibilities off your plate. Here are some examples of services available: 

  • Doctors and dentist who make house calls
  • Bill payers
  • Local government agencies who offer home repairs
  • Meals on Wheels
  • Home health agencies with trained and experienced aides in dementia care, some of whom drive
  • Adult Day Care
  • Facilities that offer brief respite stays

Some of the above services are covered by insurance, private pay, offer a sliding scale, honor entitlements or have no fee. AlzheimersNJ offers financial assistance to offset some of the expense. AlzheimersNJ Grant

If you need assistance to deal with the daily demands of caregiving, want resources, programs or referrals to professionals geared to your specific circumstance, don’t hesitate to Contact Me

I know how to turn lemons into lemonade


Turning Lemons into Lemonade 
Part Two- Dementia and Hospital Stay

In my previous article, I discussed that due to the progression of dementia, caregivers can expect to reach a tipping point when it becomes unreasonable to mange all the caregiving responsibilities and still continue to take care of their own needs and responsibilities. 

Not only is dealing with the mounting responsibilities tough, but also what about being prepared for the unexpected such as a sudden hospitalization for the individual with dementia? The likelihood of this occurring is not a matter of “if” but “when”. Environments in the emergency room and inpatient units are overly stimulating and confusing for the person with dementia.  It’s wise for the caregiver to be prepared to help relieve some of the stress. 

First and foremost, have a team of family, friends and/or a paid caregiver to be present in the emergency room and for the hospital stay. Keep in mind that you might have to leave the room to talk to a member of the medical team, take a break, or leave the facility. People with dementia will need someone available to keep them reassured and advocate for their needs.

In addition, have the following available:

  • health insurance cards
  • current medications & allergies, 
  • healthcare providers names and contacts
  • key contact persons information
  • snacks and bottled water
  • items to calm or distract such as music, photos
  • required medications
  • a prepared list of the impact of dementia ex: communication skills are limited, frequent requests to be toileted, agitation in the late afternoon.

In preparation of discharge, it is in your best interest to ask, “What is the plan?” Does the medical team suggest transfer back home or to a rehabilitation center or skilled nursing facility? Inform the clinical team about your needs and concerns. The successful discharge plan should take into account both the needs of the person who has been hospitalized and your needs and availability to render the required care. If prior to the hospitalization you were considering at some point to transfer your family member from home to a facility, this might be the time to make the change rather than returning home.  

An unexpected emergency room and hospital stay add to the many challenges and stresses of caregiving.
 Do Contact Me  if you have any questions or need advice.


DEMENTIA & THE HOLIDAYS

FROM STRESS TO SUCCESS

As November approaches, family and friends are making arrangements in preparation for the holiday season. Planning involves thinking about where you will be the gathering, the duration and location of your stay, and what you will be bringing to the holiday meal.  For those who have a family member with dementia, plans must include necessary adaptations to have a successful visit. Gatherings should be engaging, but not too overwhelming, social but not too hard to follow conversations, and enjoyable but not too stimulating. Families that I help often ask what changes they should make to have a successful holiday gathering. Much depends on the particular state of the individual.  Here are some general guidelines and tips to consider:


For those individuals with beginning signs of dementia, prominent challenges include forgetting times/dates, planning and organizing problems, and poor judgment. Although the person might deny the need for supportive assistance, it is needed.

  • Keep in mind that the individual with dementia will not recall new information and will tend to repeat questions (i.e. “Where are we going?”, “How am I getting there?” ”Who is picking me up?”).
  • Provide the individual with information about the gathering two weeks before the event. Record the information on their calendar in an easy to read format. One week and again a few days prior, review the details once again.
  • Be available the day before and the day of the gathering to help in any preparation. For example, discuss and take out appropriate attire, prepare what they are planning to bring, and review the time, date, and location. Items like a pocketbook, house keys, and eyeglasses may get misplaced so allow ample time to address these issues and most of all, be patient.

 

Individuals in the middle stage of dementia tend to be less interested in social activities, are most comfortable in familiar places and need a less stimulating environment to reduce their confusion and frustration. Consequently:

  • Become familiar with the daily routine of the individual;
  • Determine when to inform the individual of the upcoming gathering. (For some, it is best to inform the day before or the morning of the event);
  • Put aside more time than you think to get the individual ready and out the door;
  • Spend time reminiscing about prior holiday gatherings as you offer hands on care;
  • Mention several people who will be at the gathering who are important to the individual;
  • Bring familiar food and utensils as a back-up;
  • Have something that they can contribute to the gathering (i.e. a food item or gift);
  • Find a quiet place at the gathering and ask friends/family to talk on a one on one basis. If meal will be served, a quieter place surrounded with a few people is optimal;
  • Prepare to shorten the stay; and
  • Bring familiar items to have in their room if the stay involves sleeping over, including their alarm clock and look to create a safe environment to avoid a possible fall.

 

Individuals with late stage dementia are increasingly frail and their reactions are greatly influenced by the physical and emotional environment. Being calm and upbeat is always best. Keep in mind that the progression of dementia can prevent the individuals from recognizing their own family and close friends.

With this in mind, consider the following;

  • Hold holiday celebrations in their home;
  • Keep visits short;
  • Limit visitors to one to two at a time;
  • Communicate at eye level;
  • Keep conversation brief with a friendly tone of voice; and
  • Offer gentle hugs and touch as appropriate.

 

Planning will help to assure a more successful holiday for the care recipient but how about the caregiver???

 Planning, preparations and patience can add to stress. Caregivers should have the opportunity to enjoy the holidays. Ask others to help out so you can get a break. If this is not possible Contact Me and I will personalized suggestions and connect you with resources.

 

Please feel free to Contact