Sunday, March 31, 2013

Asking For Help

If you are a family caregiver, you know that much of your energy is focused on meeting the needs of the person you are caring for, and that focusing on your own needs may seem selfish. But preserving your health, getting a break, having time for yourself, none of these are selfish desires. They are part of what we all need to do, caregivers and non-caregivers alike. It's important that caregivers don't try to do everything themselves. Asking for help may be difficult or even seem embarrassing, but you may discover that friends and family are not only willing, but even eager to help. And remember, asking for help means less stress for you, which almost always means you'll be a better family caregiver.

Here are a few suggestions:

  • Sit down with family members or friends in person or find a quiet time to talk to them on the phone.
  • Discuss specific areas in which you think they could help.
  • Clearly explain what they could do to help.
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Nearly 60% of working caregivers have had to make some sort of adjustment to their work schedule--coming in late or leaving early; dropping back to part-time; passing up promotions. Seventeen percent even take unpaid leaves of absence. Nine percent either take early retirement or leave the workforce entirely.

Some employers have programs to help caregiving employees. Even some small or mid-sized employers offer flex-time or compressed work weeks. Or they may offer brown-bag "lunch and learn" seminars on topics like Alzheimer's or how to deal with caregiving over the holidays. Larger employers may offer enhanced resource and referral programs or even geriatric care manager services to help employees with complex home situations.

At a minimum, the person responsible for Human Resources at your Employer should be able to describe what existing employee benefits may help you to balance your job and your caregiving responsibilities.
 
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The Behavior Detective

As a caregiver for a loved one with Alzheimer's disease, it can be extremely worrying to experience the behavior problems associated with mid-stage Alzheimer’s disease, such as wandering, aggressiveness, hallucinations, or sleeping and eating difficulties. Many behavior problems are made worse by a poor environment and an inability to deal with stress. By learning how to make changes in the caring atmosphere, you can increase the quality of life for both your loved one and yourself.
 
Problem behavior is often a way a person  with Alzheimer’s tries to communicate with you. The progression of the disease means that they may no longer be able to communicate verbally, but they are still emotionally conscious and will remain so, often until the very end of life.
In many cases your loved one’s behavior is a reaction to an uncomfortable or stressful environment. If you can establish why he or she is stressed or what is triggering their discomfort, you should be able to resolve the problem behavior with greater ease. Remember that your loved one is not being deliberately difficult. Their sense of reality may be different to yours, but it’s still very real to them.
Here are a few suggestions to help you identify the causes of problem behavior:
  • Try to put yourself in your loved one's situation. Look at their body language and imagine how they might be feeling and what they might be trying to express.
  • Ask yourself what happened just before the problem behavior started? Did something trigger the behavior?
  • Are your loved one’s needs being met?
  • Does changing the environment or the atmosphere help to comfort him or her?
  • How did you react to the problem behavior? Did your reaction help to soothe your loved one or did it make the behavior worse?
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Saturday, March 30, 2013

Reading Alzheimer's

Sadness, joy, appreciation, fear — emotions of many colors still register with your loved one. The difference: It’s difficult now to express them. Just knowing that your loved one still experiences emotions despite Alzheimer's can help make your time together more meaningful and help you improve his or her quality of life.

Watch closely, and you’ll learn the patterns that are unique to your loved one. For example:
  • Are your loved one’s eyes open wide or shut? Are they tracking you or looking away? Tearing up?
  • Are the teeth clenched, or is the mouth relaxed?
  • What’s the nature of the sounds that are made during certain experiences? A distressed moan may come to sound different from a pleased one.
Many caregivers say they can see whole messages — “Thank you,” “I love you” — written on the face, even if no longer uttered aloud.

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The Denture Detective

My poor Mother... she has been looking for her teeth for 6 months. She is convinced a man switched his with hers and they need to switch back. Her teeth, of course, are in her denture cup at the moment. They are hers. Maybe her gums are shrinking and they don't fit as well. She just worries herself to death over them. I have been trying to get her in bed for 20 minutes now, but she keeps getting up to see where she put her teeth. They are hers at night when she takes them out and they are someone else's when she tries to eat.

She'll get up and put them in a drawer and 5 minutes later she is looking all over for them, in a panic. I have to stay one step ahead of her. Then she'll get back up and get them and tell me a story about someone who was here a while back and let their small children run amok in the bathroom and they took her teeth and were out playing with them in the yard! So I always say, "those darn kids. They won't be here tonight." 

It's amazing that she will remember to tell me that story about every other night but she can't remember all of her kids.

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Friday, March 29, 2013

Road Trip

Imagine helping a friend on a journey to a remote monastery perched on top of a mountain. As you begin your trip, the path is fairly clearly marked and the goal easily seen in the distance. But as you approach, the monastery is often obscured by the tops of trees in the forests through which you pass. And you say " if only we could get out of this woods, we would be able to see the monastery again and see where we're going." And as you continue the climb, the path fades and much is accomplished by guesswork. You call on your friend for help. After all, this is his trip and he should know what he's doing. But he becomes older and weaker and relies more on you moment by moment.

Things get worse. You lose the path and you are tired and hungry. But, he can not proceed alone and you can't leave him on the mountain while you return to the warmth and safety of home. So, you find a new reserve of strength, enough for both of you, and you continue up the mountain, for now it is your journey, as well. You look at yourself anew and find that you have gown older, become more mature like your friend, and you accept this as part of the mutual trip. And in accepting your role as guide you find that you are guided, that your friend, whose legs have crumpled beneath him by now, offers you wellsprings of courage and hope. You drink deeply, for you realize that if either of you are to make it to the top, it will need both of you guiding and supporting the other in ways constantly changing and unimaginable.

One day when you least expect it, the heavy cedar gates of the monastery are suddenly dead ahead. The trip had become the whole purpose, it seemed, and the monastery forgotten. But there it stands: Your friend's objective has been reached The door opens to admit your friend and, as if you had performed the ritual many times before, you hand your friend over the threshold. The door closes, and you stand there numb, alone, bewildered.

Out of habit you continue walking. It doesn't seem to matter in what direction, for each of the possible paths lead back down from the mountain.

The trip down seems easier than the trip up was. The mountain holds few surprises, now, and there is ample time to sit and ponder before reaching the valley below. And somehow in reviewing the trip with your friend, its moments of desperation and fear are overshadowed by the times of giving and accepting, of sharing and journeying together. Memory of the monastery fades and in its place stand crystal images of points along the upward trek. There was the time you picked him up and carried him across the rocks when his strength failed. And there was the time when you slipped and lost your grasp, but he held you up and supported you with the power of his mind. There was something special in those moments, something, which if you could string all of those images together in just the right order, that then, maybe then, you would understand.

As it is, you return to the valley a different person, quieter and stronger, knowing only that you have been a part of something .... holy. This friend shared with you his most personal possession, his death. And though you can't quite comprehend its true value, you find yourself hoping that you will have the ability to fully experience and share your final journey with another wayfarer to whom you can pass on crystal images.

Deep gratitude and celebration are the order of the day for those of us who are called to assist in this challenge. The suffering, remember, is found only in our refusal to let go, only when we refuse to go through the pain and move to the other side. We get through by going through. The rewards are wonderful: the joy and blessings that come from extending the self beyond its own comfort zone; the knowledge we gain of life and death; the love that is lost and found again on a higher plane; and the areas of awareness that are opened. Grief is a healing process to be welcomed and not feared, for when it is allowed to go its own course unobstructed, it will fill with wonder the void that the loss created.


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Simon Says...!

If you are having trouble motivating your loved one with Alzheimer's disease to complete routine tasks like bathing or brushing his or her teeth, try making a game of it by playing Simon Says. As the disease progresses, your loved one will probably need step-by-step instructions, so why not make it fun. Here's some example for playing Simon Says to accomplish daily care activities:

Brushing Teeth:

Simon says pick up your tooth brush.
Simon says put some toothpaste on your tooth brush.
Simon says brush your upper teeth.
Simon says brush your bottom teeth.
Simon says brush your upper left teeth.
Simon says brush your lower right teeth.
Ans so on....

Bathing:

Simon says it's time to take your bath (or shower).
Simon says go into the Bathroom.
Simon says take your clothes off.
Simon says step into the Bath Tub (or shower).
Simon says pick up the sopap.
Simon says rub the soap over your left arm.
Simon says rub the soap on your left leg.
Simon says rub the soap on your cheast.
Simon says rub the soap over your right arm.
Simon says rub the soap on your right leg.
Simon says rinse the soap off your body.
And so on...

Washing Hair:

Simon says wet your hair under the shower (or sink, depending on how you normally prefer to do this task).
Simon says put some shampoo in your left (or right) hand.
Simon says rub the shampoo in your hair.
Simon says rinse your hair under the water.
Simon says pick up the towel and rub the water out of your hair.
And so on...

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