Try Diverting The Conversation
Keep a photograph album handy. Sometimes looking at pictures from their past and being given the chance to reminisce will ease feelings of anxiety. It might be best to avoid asking questions about the picture or the past, instead trying to make comments: ‘That looks like Uncle Fred. Granny told me about the time he….’
Alternatively, you could try diverting them with food, music, or other activities, such as a walk.
How To Have A Good Visit With Someone With Dementia
Families often ask us about how to better relate to their loved one who has Alzheimers disease or dementia. With some insight into how your Mom or Dad experiences the world and a few modifications on your part, you can improve your communication and have an easier and more enjoyable time with your loved one. These basic tips were developed with help from an Alzheimers expert, Beverly Moore, RN CS, of Alzheimer Coaching Services.
Caregiving In The Middle Stages Of Alzheimers Or Dementia
As your loved ones Alzheimers disease or dementia symptoms progress, theyll require more and more careand youll need more and more support as their caregiver. Your loved one will gradually experience more extensive memory loss, may become lost in familiar settings, no longer be able to drive, and fail to recognize friends and family. Their confusion and rambling speech can make communicating more of a challenge and they may experience disturbing mood and behavior changes along with sleep problems.
Youll need to take on more responsibilities as your loved one loses independence, provide more assistance with the activities of daily living, and find ways of coping with each new challenge. Balancing these tasks with your other responsibilities requires attention, planning, and lots of support.
Ask for help. You cannot do it all alone. Its important to reach out to other family members, friends, or volunteer organizations to help with the daily burden of caregiving. Schedule frequent breaks throughout the day to pursue your hobbies and interests and stay on top of your own health needs. This is not being neglectful or disloyal to your loved one. Caregivers who take regular time away not only provide better care, they also find more satisfaction in their caretaking roles.
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Nursing Homes Turn To Eviction To Drop Difficult Patients
Nursing homes are increasingly evicting their most challenging residents, advocates for the aged and disabled say, testing protections for some of society’s most vulnerable.
Those targeted for eviction are frequently poor and suffering from dementia, according to residents’ allies. They often put up little fight, their families unsure what to do. Removing them makes room for less labor-intensive and more profitable patients, critics of the tactic say, noting it can be shattering.
“It’s not just losing their home. It’s losing their whole community, it’s losing their familiar caregivers, it’s losing their roommate, it’s losing the people they sit with and have meals with,” said Alison Hirschel, an attorney who directs the Michigan Elder Justice Initiative and has fought evictions. “It’s completely devastating.”
Complaints and lawsuits across the U.S. point to a spike in evictions even as observers note available records only give a glimpse of the problem.
An Associated Press analysis of federal data from the Long-Term Care Ombudsman Program finds complaints about discharges and evictions are up about 57 percent since 2000. It was the top-reported grievance in 2014, with 11,331 such issues logged by ombudsmen, who work to resolve problems faced by residents of nursing homes, assisted living facilities and other adult-care settings.
“It’s a risk they’re willing to take,” he said, “because no one penalizes them.”
Norwood Pines did not return calls seeking comment.
Do Keep Eye Contact When Speaking
Communicating with a dementia patient requires a lot of patience, especially during later stages of dementia. It is vital to ensure that you talk in a place that has good lighting, a place that is quiet and without too many distractions. Do not try and stand over the person you are talking to, but rather try to be at their level and keep eye contact at all times. Take care to make sure that body language is relaxed and open. Prepare to spend quality time with the person so that they do not feel rushed or like they are a bother.
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Dont Talk Around Or Over Them
If there is a third person in the room you may be tempted to talk with that person because its easier. This leaves the person with dementia sitting there watching the conversation and not understanding most of it. Then, while you may go home and feel like you did your duty and paid a visit, what happened was you visited the wrong person. Include that person in the conversation or go elsewhere to visit with the third party.
Using Reverse Mortgages For Alzheimers Care
The decision on whether or not to use ones home, through a reverse mortgage, to help pay for care is not an easy one. In many cases, it does not make good economic sense, but in other situations it does.
The two most important factors when considering a reverse mortgage to pay for Alzheimers care are ones marital status and their expected duration of need.
Reverse mortgages come due one year after the homeowner moves from their home. Given that most individuals with Alzheimers will eventually require residential care, it becomes a question of how many years until that point. Should one be at the early stage of the condition and wont require residential care for 5 years, a reverse mortgage might make good sense as a funding resource for occasional assistance around the home. However, if one might need to move within 2 years, a reverse mortgage would be considered an expensive source of funds. The exception to this rule is when the individual with Alzheimers has a healthy spouse who will continue to live in the home when the spouse with Alzheimers moves into a care facility. In this situation, a reverse mortgage could be a sound decision.
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Can My Doctor Prevent Me From Driving
Doctors are not the ones who determine if you are fit to drive. Doctors forward their medical opinion to the Ministry of Transportation. The Ministry of Transportation then determines if the person should continue driving.
Doctors are bound by law, in most provinces, and by professional ethics, to report medical conditions that could be a serious risk to road safety. They also may be held liable if a person in their care who has dementia is involved in a motor vehicle collision and they have not reported the personâs medical condition to provincial licensing authorities.
Things Not To Say To Someone With Dementia
Speaking to an elderly loved one with dementia can be difficult and emotionally draining. Alzheimers and dementia can lead to conversations that dont make sense, are inappropriate or uncomfortable, and may upset a family caregiver. However, over time, its important to adapt to the seniors behavior, and understand that their condition doesnt change who they are.
For senior caregivers, its important to always respond with patience. Here are some things to remember not to say to someone with dementia, and what you can say instead.
1. Youre wrong
For experienced caregivers, this one may seem evident. However, for someone who hasnt dealt with loss of cognitive function before, it can be hard to go along with something a loved one says that clearly isnt true. Theres no benefit to arguing, though, and its best to avoid upsetting a senior with dementia, who is already in a vulnerable emotional state due to confusion.
Instead, change the subject.
Its best to distract, not disagree. If an elderly loved one makes a wrong comment, dont try to fight them on it just change the subject and talk about something else ideally, something pleasant, to change their focus. There are plenty of things not to say to someone with dementia, but if theres one to remember, its anything that sounds like youre wrong.
2. Do you remember?
Instead, say: I remember
3. They passed away.
Instead
4. I told you
Instead, repeat what you said.
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How To Consider What Your Parent With Alzheimers Would Want
When faced with making decisions on behalf of someone with Alzheimers, who has lost the capacity to make the decision, youll want to ask yourself: What would Mom want?
To answer that question, youll need to do the following:
- Review any existing living wills, advance directives, POLST forms, or other documentation thats been completed by your parent.
- Consider your mothers values and preferences regarding medical and life care, based on what you know of her. Use a specially designed conversation guide, if possible.
- You might be able to invite her to express preferences to you, if shes able to do so and if it doesnt cause her too much distress.
Reviewing existing advance directives and other documentation
In an ideal world, every older adult would go through an advance care planning process and specify some preferences in writing, before becoming too disabled by Alzheimers disease.
For more on how older adults should address advance care planning, see 5 Tips to Help You With End-of-Life Planning.
By the way, you said you have a will but it wasnt clear to me if this was a living will, which is a type of advance directive that provides some guidance regarding a persons preferences for care before she dies.
Considering your mothers preferences and values
Even if you already have an advance directive or living will available, I recommend going through a questionnaire that will help you think about your mothers preferences and values.
Tips For Visiting A Person With Alzheimer’s
This article originally appeared on .
Many people simply dont know how to interact with or entertain people who have Alzheimers. The following 25 tips will help you improve the quality of your visits.
1. Make Eye Contact: Always approach them face-to-face and make eye contact. It is vital that they actually see you.
2. Be at Their Level: Move your head to be at the same level as their head. Kneel or sit down the reach their level. Do not stand or hover over them. It may be intimidating or scary.
3. Tell Them What You Are Going to Do Before You Do It: This is particularly important if you are going to touch them so they dont think you are grabbing them.
4. Speak Slowly: Speak at one half your normal speed. Take a breath between each sentence. Give them a chance to catch up to your words.
5. Speak in Short Sentences: Speak in short, direct sentences with only one idea to each sentence. Usually they can only focus on one idea at a time.
6. Only Ask One Question at a Time: Let them answer it before you ask another question. You can ask who, what, where and when, but not why. Why is too complicated. They may fail and get frustrated.
7. Dont say remember: Many times they will not be able to remember, and you are just pointing out their shortcomings. That may be perceived as insulting and can cause anger and/or embarrassment.
8. Turn Negatives Into Positives: For example say, Lets go here instead of Dont go there.
For more information and inspiration visit .
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Do Not Engage In Arguments
One of the worst things a person can do to an individual who has dementia is to start an argument or even force them to do something that makes them upset or angry. When the discussion or argument is too heated, it may be better to walk away to create an environment where everyone can remain calm. Experts agree that one of the ways that can yield results when it comes to dementia behavior problems is to get rid of the word no when dealing with patients. Avoid forcibly restraining a dementia sufferer at all costs.
Distraction: Singing & Reading
For some people, a distraction can be a good way to get the chore done. Its kind of a different communication style that helps in distressing situations. For example, if a patient and/or loved one likes singing, starting him/her singing could allow the caregiver and/or family member to ease into bathing time with a gesture.
Singing actually can help tremendously with memory loss patients and/or loved ones who can no longer talk, or have trouble finding words to form sentences, because they are usually still able to sing a song. Often, they can remember the lyrics of a song from beginning to end.
Many patients and/or loved ones can still read as well. Singing and reading can give the person great joy and hearing a loved ones voice can very comforting for family members.
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Paying For Alzheimers Care Overview
Alzheimers disease, Lewy Body dementia, Frontotemporal dementia , and other related memory disorders and dementia affect over 5.5 million aging Americans. Depending on the stage of these diseases, individuals can require 24-hour supervision or care. This means each year in the U.S., there are billions of hours spent caring for individuals with these conditions. While the vast majority of that care is provided by friends and family members, what happens when those caregivers are not available? Who pays for Alzheimers care? Fortunately, there are many programs that provide financial assistance, respite care, and other forms of aid to help families and caregivers.
The worldwide cost of dementia care is approximately 1 trillion U.S. dollars. If dementia care were a country, it would be the worlds 17th largest economy.
Helpful Resources
Learn About Staff Expertise And Staff
Seniors with cognitive impairment need support and attention throughout the day. Experienced staff who understand dementia symptoms and behaviors, and know how to address them effectively and compassionately, can make a big difference in your loved ones quality of life at a memory care facility.
As you research memory care communities in your area, look for information on staff training and experience in caring for seniors with memory loss. You may want to ask about:
- Facility accreditation and staff certification
- Staff-to-resident ratio
- The type of training staff receive
- Programs and activities for residents
- How specific situations, such as combative behavior, are handled
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Transitioning To Living Without Driving
To help you plan ahead for the time when you must stop driving, consider the following strategies:
- Consider alternative forms of transportation. These can be public transit, taxis, services provided by community organizations, and transportation organized by family members and friends.
- Use these alternative forms of transportation while it is still safe for you to drive. This will help you get used to new routines that you will transition to after you hang up the car keys for good. As well, this may help you accept the difficult decision to stop driving when it eventually comes.
- Look into companies that offer home delivery services. These can be pharmacy or grocery home delivery services.
Dont Assume You Are Not Being Understood
Most of us have heard that people in a coma can sometimes hear our voices so we need to watch what we say. The same is true when someone has dementia. If this person seems out of it, dont just talk about him to others as if he cant hear or understand you. You do not know for certain what is heard or understood. Simply treat the person like you would anyone else. Be kind and dont say hurtful things in his presence.
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Tips For Scheduling Visits With Your Loved One In Memory Care
Visit frequently during the first few weeks The Family Caregiver Alliancearticle, Residential Care Options: Visiting Someone in Dementia Care suggests that during the first two weeks, you should visit often and stay as long as you want.
Likewise, author, speaker, columnist and eldercare consultant, Carol Bradley Bursack states, My opinion is to be with your parent as much as possible while they are making the adjustment to life in the nursing home.
Dr. Rita A. Jablonski-Jaudon, a leading authority on memory care and family caregivers, adds, The answer depends on the physical and mental condition of both parties. Some caregivers are so worn out by the time placement occurs that they can only visit one or two times a week. The location of the facility from the caregiver can also affect visiting schedules. Optimally, daily visits are good because it allows the family to see how the individual is adjusting to the new surroundings, and if the new facility is responsive to the needs of the individual. I pay more attention to the quality of the visits than the quantity of the visits.
Later, you can reduce your visitation frequency while identifying the best times to visit After a few weeks or so, you can begin to reduce the frequency of your visits if you desire. For example, visit every other day instead of every day. Eventually, you can visit every third day.
Learning A New Communication Style
It pains me to think I caused her any grief then about something she couldnt control. As a caregiver, my mantra in dealing with my accomplished, loving parents and stepfather has always been dignity, choice and control. My slip was a reminder of how easy it is to miss the signs of cognitive impairment.
My new goal became learning smart ways to communicate with a loved one who has dementia.
For some caregivers, its just a matter of adjusting your words and actions a little bit, and accepting inevitable memory slips. For others, it may be a matter of overcoming dread, especially for those with a loved one in the late stages of the condition. Its much harder to walk through the door to greet someone who doesnt recognize you or care to interact.
Based on my experiences and those of several experts I contacted, here are nine tips for how to avoid common pitfalls and make it easier for you to have meaningful visits with someone who has dementia:
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