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.

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.

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.

Gulf Shores United Methodist Church, located at 1900 Gulf Shores Parkway, offers DayBreak, a ministry providing support and service for caregivers and their loved ones with Alzheimer’s Disease. DayBreak is held on Monday and Wednesday from 10 a.m. to 2 p.m. Cost is nominal and lunch is provided. For more information, contact Dolly Crewes at 251-968-3634 or Terry Fowinkle at 251-968-2377.  For more information, visit their website at Gulf Shores United Methodist Church.

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 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.

 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.”

Try these tips to prevent wandering out of the house by your loved one.

1. If there is a securely locked high fence around the whole perimeter of the property, let your loved one go outside, in good weather.  Go outside with them.
2. If there is no secure fence or there is other danger to allowing them to go outside at will, try these approaches:
   1. Remove from site triggers that would make the loved one or person with dementia think of going out, such as coats, umbrellas, shoes, purse, etc…
   2. Tell your loved one or person with dementia frequently where they are and why, in a calm tone of voice. Reassure them with words like, “XXX will return in an hour to be with you” or “Your family knows where you are”.
   3. Don’t confront or argue with the person, walk with them and redirect to another part of the house or to an activity. Use humor if possible.
   4. Purchase childproof doorknob covers, or deadbolts to put on the door above the loved one or person with dementia’s eye level, or slide bolts on the top or bottom of the door. These items will never be used when the loved one or person with dementia is alone in the home, only when someone is with them.
   5. If you don’t want to do any of the above, place warning bells above the outside doors, or activate the house alarm system, or get a monitor that goes on the loved one or person with dementia (such as a toddler monitor) or a pressure mat alarm, so at least you know when your loved one or person with dementia has left the house.
   6.  Try putting a full-length mirror on the inside face of the outside door. Sometimes people don’t recognize themselves and think someone is standing there and turn around and go back.
   7. Try putting a black throw rug in front of the outside door. To some people, it looks like a hole in the floor and that they won’t attempt to cross it.
   8. You might try to hide the outside door by putting a curtain in front of it, or maybe by making sure it is the same color as the surrounding walls, that way it may not be seen by the loved one or person with dementia.
   9. Put a big sign on the outside door saying “Stop” or “Do Not Enter” or “Danger- Do not Open”.
   10. Sew ID labels in the loved one or person with dementia’s clothes, or get a special Medic alert bracelet for the loved one or person with dementia, if they have a history of escaping the house. Also they need to have a current picture and a piece of unwashed clothes (for tracking dogs) handy to give to the police, in case the loved one or person with dementia does escape.
   11. If the loved one or person with dementia escapes while you are in the bathroom , grab your cell phone, and run out side, look around the whole block the house is on. Cover the whole block, if not found, call 911 and tell them that a person with dementia has escaped the house and is lost. Try to convince them that this person needs to be found immediately, they need their medicines badly.
   12. If the loved one or person with dementia doesn’t recognize his or her home as where they live, they may want to leave to go “Home”. They may be thinking of a home they lived in previously, such as in their childhood. Instead of telling them that this is their home, talk about the home they are thinking of. Reminiscing about it sometimes lessens their urge to leave.
   13. If they still want to go “home” tell them you will walk with them, and take a walk with them or tell them that you will drive them there, and take them out for a drive. It may help if you stop to get a treat, an ice cream cone, or snack. They probably will have forgotten about the other home by the time you get back, and may even recognize where they live now as home.

By Carole Larkin  MA, CMC, CAEd, DCP, QDCS, EICS is an expert in Alzheimer’s and related Dementias care. She has a Master’s of Applied Gerontology from the University of North Texas, is a Certified Alzheimer’s Educator, is a Dementia Care Practitioner, is a Qualified Dementia Care Specialist, and an Excellence in Care Specialist at the Alzheimer’s Foundation of America, as well as a Certified Trainer/Facilitator of the groundbreaking dementia care training tool, the Virtual Dementia Tour Experience She is a Certified Geriatric Care Manager who specializes in helping families with Alzheimer’s and related dementias issues. She consults with families telephonically nationwide on problems related to the Dementias. Her company, ThirdAge Services LLC, is located in Dallas, TX, and her website is www.thirdageservices.com.

As my mother’s abilities have declined, I’ve become creative in solving the daily challenges of personal hygiene.  Standing in front of the bathroom sink to brush her teeth became very difficult as my mother’s stamina weakened.  The day I had her sit in her recliner to carry out the task was a relief to us both.  I have a small table that I can place all the implements I need close by.  I lay a towel over my mother’s chest to keep her dry.  I begin the process by first using a brush pick to

Tools used to brush teeth

clean out the excess food stuck between her teeth or pocketed in her jaw. I wipe what I dig out on a paper towel.    I then put toothpaste on a soft bristle child size toothbrush.  All the while, I compliment my mom on what a good job she’s doing, that her dentist would be proud, and what we are doing next.  On most days, she will open her mouth willingly and allow me to gently brush. Next, I give her a small cup of water to swish around in her mouth, then hold up a small bowl for her to spit the contents of her mouth into.  Sometimes I have to show what I want her to do – swishing the water in my mouth and spitting it into the bowl.  I inspect our progress, then may need to use the brushpick again or brush again, and rinse.  Once satisfied that we have thoroughly cleaned everything, I give her a capful of mouthwash.  I remind her not to swallow the mouthwash but show the swishing motion with my mouth and have the bowl close by to empty her mouth.  I wipe her mouth off with the towel on her chest, then finish by applying some chapstick to moisten her lips.  She will agree that she feels better now.

If she is not willing to open her mouth at the beginning of the process, I usually move on to her hands, wiping her hands with a damp towel, cleaning her fingernails with the tool attachment to her fingernail clippers, and applying lotion to her arms and hands.  This will distract and relax her and she will usually agree to open her mouth.  Most times, I follow the teeth cleaning with the hand washing.  I also play easy listening music while we do both activities.

What once was a problematic situation such as bad breath, food stuck in her front teeth and agitation in trying to remedy that has turned into a daily intimate ritual that is satisfying to us both.