Nursing Care Plan: Using Validation Therapy to Deal with Dementia Patient

February 13, 2014 at 9:17 am

Click on Validation Technique for a helpful article that offers understanding of the dementia patient that can make interacting with them easier and satisfying.

Join the Long Good-bye Support Group

February 8, 2014 at 2:44 pm

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The Long Goodbye Alzheimer’s Support Group meets Tuesday, August 15 at noon in the Bishop’s Meeting Room at Dauphin Way Methodist Church.  The cost of lunch is $5.00.  If you plan to eat, RSVP by calling the church at 251-471-1511 by Friday, August 11, 2017.

When Caregiving and Cell Phone Technology Come Together

August 27, 2013 at 6:45 pm

My family did a cell phone intervention with me two years ago. I had held on to my original cell phone plan for many years and resisted any changes.  So when they transferred my number to a smart phone and a new company, I knew I was beat. I tried to keep an open mind. According to my family, now I would be able to text with them and do all the other things they could do—whatever that was.

 

My family was right. Once I mastered texting and using the phone, I began to explore apps.  First I followed recommended apps from my husband and son but then began to branch out and find what interested me. Since I am a caregiver for my mom who has Alzheimer’s disease, I soon found that my cell phone was my constant companion and record keeper. For example, I store information I need for doctor visits under Notes, as well as document what we discussed at the appointment. I set up Reminders for myself such as pay the private duty sitter and other bills or get medication and supplies. I have a Pill Finder app that helps me identify pills I find on the floor that Momma didn’t take and threw away. I can look up medications and their side effects if she is having some unexplainable symptoms. When we do her laundry, I can set the Timer to alert us to when the washer and dryer cycle is finished.

 

My phone has replaced the camera I once carried around. Just like everyone else with a smart phone, I am constantly taking photos of all the people in my family’s life. Once Momma moved to assisted living, we used photographs to help us remember faces and names of all the people that helped care for her. We set up a poster-sized frame in her room with pictures of all the employees, their job titles, and names. To boost visibility, it hung on the wall just inside her door, which encouraged many impromptu visits and comments. I was surprised to find how willing doctors are to have their photo taken with their patients. These photos would come in handy when we were about to have an appointment with the doctor and I could show Momma who we were going in to see. The pictures serve as our memory, and we can look at them over and over again.

 

The phone is also a resource for activities. We enjoy listening to Pandora’s easy listening music while accomplishing activities like brushing her teeth, painting her nails, or playing cards. I attach speakers to the phone to provide vintage music while leading a group exercise class for the other residents, and I can take requests without any prior preparation. Sometimes I look up words to old songs we can sing together because we’ve forgotten some of the words. Poems and even nursery rhymes are just a touch away with Internet service as part of the phone plan.

 

One app allows me to scan important documents and even send them by email with FasterScan, which expedites duties like filling out paperwork for moving into skilled care. I no longer have to be home to receive phone calls, send emails, or handle bank business. I can manage these responsibilities and still be with my mom. I finally have learned to complete as much information as I have on a phone contact to save time for future communication. I can text messages with Momma’s private sitters and receive an immediate response when needed. For my peace of mind, they have sent me photos of Momma while she is in their care just to let me know what they are doing. When I’m with her, I can send a text and photo to one of my children and share a response on the spot.

 

Even though cell phones are relatively new, Momma has embraced the little rectangular box we carry around that emits music and provides amusement in so many ways. I usually hand it to her to hold when I am pushing her in the wheelchair when we have the music playing. Because of her failing eyesight, the bigger screen of a computer or iPad is a better choice if I want her to see specific pictures clearly. However, for daily use and ease of transporting, my cell phone is all we need.

 

E.A.Roberts Alzheimer’s Center has a genuine treasure in RN Laura Harrington.

August 21, 2013 at 9:00 am

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Mobile Infirmary’s E.A. Roberts Alzheimer’s Center is managed by Laura Harrington.  She is a Board Certified Gerontolgical Nurse.  Aside from her very capable credentials, she is one of the nicest people I know.  She has a knack for making people feel valued and cared for.  I always feel better just being in her presence.  I have seen her show such care and concern for the weary caregiver.  If you have a loved one with Alzheimer’s Disease, you may want to visit the E.A.Roberts Alzheimer’s Center, see the facility and learn about their Adult Day Care program.  Who knows, you may get to meet Laura.  You and your loved one will be glad you did.

You are a purple angel, Laura, for all the years and care you’ve given to helping those with Alzheimer’s Disease and their loved ones.

Summer Reading

July 18, 2013 at 8:21 pm

Since I have become a caregiver, I enjoy reading anything to do with Alzheimer’s Disease especially personal stories from people who have walked the journey alongside their loved one. The theme of my last three books addresses the approach taken when dealing with a person with dementia and how to engage them in meaningful activities to maintain qualify of life and make life manageable for the caregiver.

Virginia Bell and David Troxel are in their fourth printing of “The Best Friends Approach to Alzheimer’s Care”.   The Best Friends Approach is designed to create empathy from the carer point of view in order to understand how best to communicate with their loved one living with dementia.  They  have coined the term “knack” to refer in caregiving as a clever trick or stratagem or the ability and skill to do something easily.  Some individuals are simply born with knack; their personality and sensibility help them to be wonderful caregivers.  The Best Friends model can teach the abilities and skills of knack and along the way offer many clever tricks in the “dos and don’ts of Alzheimer’s care.  This is a worthwhile book and is only one of several written by these authors.

Hot off the press is Tom and Karen Brenner’s new book,” You Say Goodbye and We Say Hello: the Montessori Method for Positive Dementia Care”.   Incorporating songs from the Beatles as each chapter title, this easy read has a  clever appeal to the targeted baby boomers providing care.  Granted that dementia care is  an overwhelming task, they have broken down their personal experiences as a gerontologist and a Montessori teacher to  share their findings labeled “Guideposts” throughout their story.  They weave innovative and doable activities throughout the book and leave both professional and family caregivers with a renewed hope for creating a positive environment to deepen the connection with the people they love and care for.

Finally, having to wait longer than expected to receive this book in the mail, “Contented Dementia” traveled across the pond from England to find its way to me. Author  Oliver James lives in Oxfordshire and is trained as a clinical child psychologist and is a trustee of the Alzheimer’s charity, SPECAL.  An open letter from the inventor of the prescribed method in this book tells the reader if they have dementia and are reading the letter, not to worry about the future, appoint a person they trust as their advocate and have them read the book, then forget all about the diagnosis and get on with enjoying their life.  The rest of the book goes into great detail on how to use the person’s history to help create a life living in the present with memories from the past.  Penelope Garner developed the SPECAL Technique after caring for her own mother followed by years of observation and research with other clients. Get ready to do your homework as you read so that you will develop a customized world where your caree lives contently. For more information, go to Contented Dementia Trust.

All three of these books are similar.   Each stresses the importance of knowing the history, preferences and interests of someone with dementia and not to argue with but learn how to navigate away from unwanted negative behaviors associated with dementia.  Once these methods are perfected, consistency with all carers involved is required for optimum outcome.  All are worth reading.  We have a long way to go to get everyone on the same page with caregiving techniques.  May it begin with us – the ones who care the most.

Playing the Hand We’re Dealt

June 26, 2013 at 2:03 pm

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An activity I’ve discovered that my mom and I can enjoy is the card game of solitaire.  Although the name of the game would suggest a solitary player we’ve teamed up to play separate parts to reach the goal of the game.

Originally, we played solitaire as an afternoon diversion in Momma’s assisted living apartment.  As time has gone by, it has also become a tool for me to gauge her state of being.  Since she has stopped talking, I read her body language to determine how she is feeling, i.e., does she have a urinary tract infection that needs to be treated.  The way she plays cards says it all.

Whether we are seated side by side at a table or we have a table between us, I initiate the game after we have accomplished the daily ritual of cleaning her teeth, hands, and fingernails, which I follow by rubbing lotion onto her arms and hands.  Now I know her hands are clean and how well she cooperated tells me if we can proceed with card playing.

Some days, her answer is no to the suggestion of cards.  However, I may go ahead and deal out the cards in front of her and see if I can engage her interest.  I count out the seven cards out loud, over and over, each set of seven, until the game is set.  We look over the hand that we’ve been dealt and see if any cards can be played.  I play those cards, naming what I’ve done like the red six goes on the black seven, until  we’ve played all we can,  Then I set the remaining deck in front of her on the table and see if she’ll pick them up.  Here’s when I need to wait for her to make a decision.  She may eventually reach for the cards to begin the game. I may offer the deck to her and she may accept them.    If not, I pick them up and count out the first three cards to lay face up.  I go on like this until she decides to join in. When the game calls for a card to be turned over, I tap my finger on the card as a queue for her to do so.   If she has become interested in the game, she will comply.

I have found that the longer we play, the more engaged she becomes.  We may play multiple games, hoping to finally win and when we do, I celebrate with a lot of cheering.  This generally elicits a chuckle or smile from her at our success. Eventually, with repetition, she may even initiate laying out the beginning cards, which is quite an accomplishment compared to where we started.

This time we spend together has become not only a diversion and a communication tool, but also a philosophical attitude. Although the game of life is often played alone, we’ve teamed up to play the hand we’ve been dealt together.

My Prayer for Finding a Caregiver by Alzheimer’s Daughter

June 19, 2013 at 9:42 pm

In a world of advanced directives, I have written a prayer to ask God to secure my longterm care.

Dear God,

If I enter the darkness that enveloped the women in my family before me, I pray for a good caregiver. I want someone to care for me as a friend, and is empathetic to my plight.  I want someone who will get to know my life history and cherish the time we spend together.

If I am lost to who I am, I want my “friend” to tell me a story about a little girl fondly called Buffer by her daddy and who always cared deeply for the needs of her family.  I want to hear about my special dog named Pittman that loved me so much.  I want to know about my two fine sons and my faithful and handsome husband.

And Lord, sometime we can just live in the moment, when we’ll spend a happy day accomplishing the menial chores that we must do.  Grocery shopping would be an exercise in stimulating my body and my senses starting with the pretty pastries in the bakery, then the feel of firm tomatoes in the produce section and take in the lovely sights of all the other garden varieties carefully displayed.  I’d want to grind some coffee beans just for the rich scent that emanates from the machine even though I don’t drink coffee.  I’d get to push my own grocery cart and have time to investigate something of interest that catches my eye.  I could hold on to my cart while bending down to peer into the big glass doors covering the freezer sections.  When it was time to check out, I would help lift the items from the buggy on to the conveyor belt, using my bent fingers in hopes of relief from their constant ache.

My companion would protect me from the questioning eyes of those who didn’t know what a special person I am.  She would lovingly put her arm around me and tell me how much she loved me when I tried to go where I shouldn’t.  She’d draw my attention to something I couldn’t resist and I’d desire to follow her lead.  We’d move on toward the unknown together and I‘d be happy to be with someone who knew what to do.

Lord, you remember the women who cared for my mother.  Some would know just how to enter her world and go along with her as they reached their daily goals of care.  Others just did the minimum of effort and sat quietly, lost in the crossword puzzle or handheld device brought along to help pass the hours of sitting, taking the term private duty sitter literally, as they added up their weekly paycheck.

My dear grandmother never forgot who I was, even when she was confined to her bed under the watchful eyes of three shifts of women, round the clock for several years.  We had spent so much time together in her later years, that the sound of my voice and the touch of my hand on her arm brought my name to her lips. She said it as if it represented all the life and love we had shared together.  Dear God, that’s the kind of care I want to receive.   Someone who will see me how I looked in the photograph taken when I was a young, beautiful woman, full of promise, fresh and unblemished.  Not like the wrinkled, worn, volatile creature that I now may appear to be.

I want someone who wants to be with me and thinks of things we can do together that will cause us to laugh and smile. She will show me, tell me, and sing with me.  She will pray for me, include me and hold my hand. She’ll read aloud short stories and bible verses that may still be hidden in the depths of my heart.  I want to recognize something and sing that song buried beneath the noise and confusion that predominates my consciousness.

She’ll look into my eyes and try to see what I see.  Even if my words are few or gone altogether, I’ll still be here, listening for a friendly voice, one that is full of love and compassion. She’ll give me time to respond to her efforts and I’ll try to find my way to the surface.  She knows that I might be getting lost along the way, and it may take me a while to begin to understand what is happening.  She’ll know that I do best when things are done consistently; she’ll keep her sentences short so I can comprehend and she’ll give me one command at a time.  I’ll want her to stay with me.  She won’t leave because I’m here and I don’t know what to do.  She’ll know whatever she does for me, she does for you.  She’ll know you are with me and trusts you.

Please Lord, hear my prayer.  If I begin to wander away from who I was, please seek me out, and rescue me back into the flock as you have done before.  Send a faithful servant in the form of a caregiver to keep me safe until I am in your arms forever.

AMEN

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“Even to your old age and gray hair, I am he.  I am he who will sustain you.  I have made you and I will carry you.  I will sustain you and I will rescue you.” (Isaiah 46:4 NIV).

E. A. Roberts Alzheimer’s Center – Daycare Services for Individuals with Dementia. They are located at 169 Mobile Infirmary Blvd, Mobile, AL 36607.

May 28, 2013 at 9:13 pm

Caring for someone with Alzheimer’s disease or other dementia may be one of the greatest challenges many face in life.  At the E.A. Roberts Center, their program is designed to help caregivers meet that challenge.  The primary goal of the program is to maximize levels of functioning for those with dementia while offering support and relief to caregivers.  The staff consists of qualified professionals  who offer the following services:

Personal care, daily health monitoring, nutritional counseling, therapeutic activities, social interaction, meals and snacks, family/caregiver education, and support groups.

The center is open 7 a.m. – 6 p.m., Monday through Friday, and offers flexible one – to- five day per week attendance schedule. They  have added a Saturday a month to their schedule.

To be eligible for the program, an individual must have a diagnosis of Alzheimer’s disease or other dementia, and must be ambulatory or able to use a wheelchair.

For more information regarding the program, please call 251-435-6950.

Via Health, Fitness and Enrichment Center offers GrandFriends, a day care for adults with dementia or special needs. They are located at 1717 Dauphin Street, Mobile, AL 36604.

May 27, 2013 at 11:15 am

 

Via has an enduring reputation for providing vital support services to residents in the Mobile Area. GrandFriends, an adult day services program, is one of the most valuable benefits offered.

GrandFriends combines structured, supervised activities with a safe, affordable and comfortable environment for elderly adults with dementia or special physical needs. The program is available 7:00 a.m. – 5:30 p.m., Monday through Friday, excluding holidays. Program members can participate one day a week or up to five days. Program members routinely participate in socialization, recreation and exercise activities that are focused on maintaining independence, dignity and life enjoyment within the scope of their individual abilities. Breakfast, a hot lunch and an afternoon snack are provided daily.

The GrandFriends staff consists of Certified Nursing Assistants, a Certified Therapeutic Recreation Specialist, fitness trainers, and trained companions and volunteers. They are all dedicated to helping families who are confronted with the challenges of Alzheimer’s disease and other age-related issues. The program is dedicated to providing care-givers with much needed respite. Family members and friends are able to continue their daily routines knowing that their loved one is in a caring environment that fosters safety and activity.

All individuals must complete a screening and assessment to ensure eligibility.  Contact Via at 251-478-3311 or go to www.viamobile.org for more information.

“In the sweet by and by, we shall meet on that beautiful shore.”

May 3, 2013 at 8:29 pm

 Today was my last afternoon activity with the residents at the Special Care Assisted Living Facility where my mom lives.  We moved there September of last year.  Over the months, I have enjoyed getting to know the residents as they all gather in one big community room throughout the day.

At first, my purpose in knowing everyone was to help my mom feel a part of the group and become acquainted with her new “neighbors”.  As time went on, however, I began to look forward to my visits not only with my mom, but with my new friends as well.  After I spent some one on one time with my mom in her room or outside, we would move into the common area and visit with anyone who was interested.  One day mom and I sat at one of the round dining tables when soon everyone who could squeeze around the table was present.  We began to roll a small rubber ball back and forth between us.  After we got the hang of that, we added spontaneous singing. As elementary as this may seem, we all enjoyed the challenge of keeping the ball on the table and the familiar songs. This became a regular occurrence. It kept the residents engaged until suppertime and boosted everyone’s spirits.

Sometimes we connected a speaker to my smartphone and played music from their era and took any requests that came up.  It was like sitting around the record player and listening to all our favorite music.  To look around the table at the smiles and broken sentences was pure joy. From my favorite singing partner who could harmonize with and follow anything I sang, to my tall friend who could play the harmonica and my dear little friend who could only see shadows and hear when I spoke loudly into her ear, I will always remember you with great fondness.

Some of those folks have already passed to their eternal destiny.  I was privileged to have been at the bedside of several of my new friends as they began their approach to their new life in heaven.  The families also became very precious to me, along with many of the staff members of the facility.

Now we must move to a higher level of care as my mom’s abilities have declined.  As difficult as it is to leave our friends at this place, I know the next place offers new friends and unknown possibilities.

Good-bye, Brookside.   I’ll always cherish the time spent with you and expect one day, “in the sweet by and by, we shall meet on that beautiful shore.”