Wednesday, June 25, 2014

Boxing Up One Memory At A Time

"Can you get it open?"

My husband pointed to a tall, old-fashioned steamer trunk bearing a big, official-looking Swiss customs sticker.

"So much dust," I said through my facemask. Everything lay silent under inch-thick decades of undisturbed white.

We were in the walk-in closet of my childhood bedroom. Each of the four upstairs bedrooms had its own attic closet -- my two sisters, my brother, and I always called these "eaves" because they nestled under the eaves of the house -- and each eave was completely packed.

To get in, Mike had to move a table blocking further entry -- not easy, he's 6'5" -- then push aside a heavy chest of drawers riddled with droppings. ("Looks like a squirrel's been here.") It barely budged. I squeezed into the eight inches between the chest and the insulation to join him. It was sweltering.
I pried open the steamer trunk. On its closet side were neatly hung clothes in perfect condition, from my mother's old fur coat to a pair of her pajamas I remembered well. Small drawers were filled with tiny, exquisitely smocked linens.

"Our baby clothes!" I exclaimed.

The trunk had followed us a long way. It went with us when the family moved to Switzerland in 1952. It came back with us when we moved to Cleveland in 1954. Then in 1959, it had been moved to this house near Philadelphia, where my parents have lived ever since.
All without ever having been unpacked.

In fact, it seems nobody had opened it for 60 years, until that blistering summer day in 2011 when I did, while helping my parents get ready to move to a continuing care community three miles away. They were 87 and 89.

They'd put down a deposit on a retirement community.

We're not a family that talks. You definitely weren't allowed to discuss where they might move or plans for when they got older. So it was completely surprising, though also pretty typical, when, without any conversation at all, I got a call on my cell that they'd put down a deposit on a retirement community.

"If we sell the house, we might move," they told us.

That was May. Seizing the opportunity (it had to happen eventually), my siblings and I quickly set ourselves a mid-August deadline to pack everything.

The care community provided a list of resources to help us, including a realtor who warned that the house would have to be emptied before it sold, and resources to make it happen. Moving Solutions, a senior relocation company, helped us organize all the different levels of removal: an eBay specialist who sold some items, an organization that identified clothes and books for charity, an auctioneer, and finally a junk person to clear out what remained. It was expensive, but proceeds kept coming in that paid for the services, so my parents never felt like it was more than they could afford. With all of us living in different states, we could never have done it on our own.

But first we had to decide what to keep. And that was hard.

I'd always dreaded this process.

I knew it would be a terrible loss, giving up this family home after so long. A large, five-bedroom house built at the end of the 19th century, it had once been part of a larger estate in a rural area -- you drive through stone pillars at the entrance. My parents had five acres, including a large wooded lot, gardens, a barn where they once kept pet horses, paddocks, a garage, and a pool that hadn't been usable in years.

"Mom, let's go through these dining room drawers," I suggested. I thought placemats and tablecloths would be an easy place to start.

I tugged open the first drawer -- silverware. The next, more silver. In minutes, I covered the entire dining room table, with its extensions open, with pieces of silver, most of which I'd never seen before.

"Mom! What's all this?"

"It was your grandmother's, or your great-aunt's."

"Have you ever used it?"

She shrugged.

That's when I began to get a real sense of what had been going on for years. My parents had accumulated stuff and never dealt with it. They'd never given anything to charity. They never threw anything away -- not even the mail or the magazines that kept coming in.

Stuff in every drawer, closet, cupboard, nook, and cranny.

None of us had really noticed just how much stuff was accumulating over time. When my grandmother died in 1982, and my great-aunt in 1985, most of their enormous estates were absorbed wholesale into my parents' house, stuffed into every drawer, closet, cupboard, nook, and cranny. We visited, but we didn't think about it -- the house was so big and old, and so cluttered already.

But now that we were faced with packing it up, we were seeing it anew. In the middle of a crazy-hot summer, in an old house without air conditioning. Dust and heat and sweat and stuff, so much stuff.
There was another feeling, too -- amazement. Amid all the hauling and sorting, there were treasures. I teach history at a university. My work is in the 17th century, but we historians can't help but be interested in all history. And here was my history.

My school science projects. Every stitch of clothing, including all my grandmother's dresses. Boxes of my grandfather's National Geographics. Three generations of French and math textbooks.
My father's flight manual from the Naval Air Corps in WWII. A copy of Little Women, inscribed to my grandmother by her father for her tenth birthday in 1902. A wedding dress whose owner we still haven't identified -- but I'm working on it. It went on and on.

"Know anything about this one?" asked my husband, hauling yet another chest down the stairs from my old bedroom on a 90-degree day.

"Not really. It was left to me by my great-aunt a long time ago."

He removed its marble top to make it lighter and a note fluttered out: This chest belonged to my great, great-grandmother and is from Hudson, New York. I now live about an hour from Hudson. The original owner of that chest is buried there. So are many other relatives; I've been to that cemetery.
marble-topped chest
As I packed the chest to go home with me, I couldn't help thinking, "The chest is coming home."

Getting it done.

My parents remained passive and overwhelmed all summer. We took turns coming home to keep the process moving.
My mother wouldn't let anybody touch her papers or her clothes. In fact, she barely showed the slightest interest in packing. She would agree to plans for friends or professionals to help her sort her things, but then she'd keep them waiting for an hour and a half while she dawdled over breakfast. She didn't want to do it. And she never really did; it was handled for her.

My father let us help him go through his den and enjoyed answering our questions. Then the move manager gave us all colored dots to put on the items we wanted. My father did this -- but afterward he was unsettled. He seemed to think he hadn't held on to everything he needed, but he wouldn't tell us more.

My parents couldn't quite get their heads around the fact that these were hard choices that needed to be made. It wasn't just age. They hadn't made these decisions during their whole lives, and they didn't in the end, either.

Now their possessions have found new homes. It was exhausting work, but there were many silver linings. For example, those fabulous baby clothes found in the old steamer trunk? I had them cleaned and sent them to a cousin who'd just had a baby. New memories for a new generation.

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Thursday, June 19, 2014

Living A Normal Life With Alzheimer's

Living with Alzheimer's disease is a challenge for anyone. It's difficult to remember things, make decisions, and find your way around the way you used to. It can be frustrating a good deal of the time, but there are good days and bad days. Here are some helpful tips and things you can do to make things easier for yourself -- to make things feel a bit more normal again.

How Do I Cope With My Memory Problems?

To help cope with memory problems:
  • Always keep a book with you to record important information, phone numbers, names, ideas you have, appointments, your address, and directions to your home.
  • Place sticky notes around the house when you need to remember things.
  • Label cupboards and drawers with words or pictures that describe their contents.
  • Place important phone numbers in large print next to the phone.
  • Ask a friend or family member to call and remind you of important things that you need to do in the day, like meal times, medication times, and appointments.
  • Use a calendar to keep track of time and to remember important dates.
  • Use photos of people you see often labeled with their names.
  • Keep track of phone messages by using an answering machine.

What's the Best Way to Plan the Day?

In planning your day:
  • Find things to do that you enjoy and are able to do safely on your own.
  • It will be easier to accomplish tasks during the times of the day when you feel best.
  • Allow yourself the time to do the things you need to do, and don't feel rushed or let other people rush you.
  • If something gets too difficult, take a break.
  • Ask for help if you need it.

How Do I Avoid Getting Lost?

To keep from getting lost:
  • Ask someone to go with you when you go out.
  • Ask for help if you need it and explain that you have a memory problem.
  • Always take directions for where you're going with you.

What Will Make Communicating Easier?

Communicating with others will be easier if you:
  • Always take your time, and don't feel rushed.
  • If you need to, ask the person you're speaking with to repeat what he/she is saying or to speak slowly if you do not understand.
  • Avoid distracting noises, and find a quiet place to talk.

What About Driving?

Driving can be of particular concern for Alzheimer's patients. Here are some things to consider:
  • Have someone else drive you where you need to go.
  • If you tend to get lost or confused easily, consider alternative modes of transportation.
  • Drive only in areas that are familiar to you.
  • Contact organizations like the Alzheimer's Association to learn what local transportation services are available.
  • The Department of Motor Vehicles will assess your driving skills if you're not sure whether you should drive.
  • At some point, it may no longer be safe for you to drive.

How Do I Take Care of Myself at Home?

To make sure you are well taken care of at home, put some of these measures into place early so they become routine:
  • Local Alzheimer organizations or your doctor will be able to tell you how to get help with things like shopping, housekeeping, meals (including home-delivered meals), and transportation.
  • Ask a neighbor you trust to keep a set of house keys.
  • Ask a friend or family member to help you to organize your closets and drawers to make it easier for you to find things.
  • Ask a family member to check things out around the house, such as electrical appliances, mail, and perishable food items.
  • Keep a list of important and emergency numbers by the phone.
  • Have family, friends, or a community service program call or visit daily to ensure that everything is all right.
  • Ask someone to check your smoke alarm regularly.

How Do I Maintain My Responsibilities?

  • Arrange for direct deposit of checks, such as your retirement pension or Social Security benefits.
  • Inform your bank if you have difficulty keeping track of your accounts and record keeping. They may provide special services for people who have Alzheimer's.
It is important to realize that at some point, it will become too difficult or dangerous for you to live by yourself. But, in the earliest stages of the disease, many people do manage on their own -- with support and help from friends, family, and community programs and with simple adjustments and safety practices in place.




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Tuesday, June 17, 2014

Caring For Seniors With Alzheimer’s Disease: Personal Care Tips



Caring for Seniors with Alzheimer’s Disease


Caring for senior citizens who have been diagnosed with Alzheimer’s disease presents daily challenges, both for the senior and the caregiver. In many ways, caring for an Alzheimer’s patient is similar to child care, depending on the stage of the disease and the personality of the patient. This type of care is even more challenging in a home setting. In home care of Alzheimer’s patients may be preferable in order to keep the senior in a familiar, routine environment, but caregivers may be challenged to meet the very specialized needs that arise in this setting. Particular areas that need to be considered include: providing for personal care, establishing daily activities, addressing safety issues, and seeking caregiver support.

 
Personal Care Tips

The simple daily routines that most people take for granted can be extremely daunting for seniors with Alzheimer’s. Caregivers can follow some simple steps to make these necessary tasks easier for caregiver and patient:
  • Bathing—planning in advance for a bath can simplify the process and make the senior more comfortable in what is sometimes a frightening activity. Caregivers should remain calm and always be gentle and respectful. Schedule baths for the time of day that is most relaxed for the senior, and stick to the routine. Have the bath drawn, the temperature tested, and all needed supplies—soap, shampoo, towels, robe—in place prior to bringing the senior into the bathroom. Make every effort to limit falling risks by installing safety bars, non-slip mats, and using a shower bench if needed. Remember to talk the senior through each step and encourage him or her to perform some steps when possible. Finally, consider substituting a sponge bath for a full bath or shower every day.
  • Dressing—have comfortable, easy-on-and-off clothing laid out in advance. Schedule dressing for the same time each day and stay with the routine. Choose elastic waists over zippers and pullovers over buttons. Provide a few choices and allow the senior to perform as many steps as possible in the process. Be aware of clothing that may bind, pinch, or be painful for him, as he may not be able express his discomfort with the clothing. Lay clothing items out in the order that they should be put on, always remain calm and patient, and provide clear instructions.
  • Bowel and bladder control—as Alzheimer’s progresses, incontinence is likely to become yet another issue to deal with. If so, a doctor should be consulted to rule out other potential medical causes. This can be an embarrassing and upsetting problem, and should be dealt with in a calm, compassionate manner by caregivers. Find ways to anticipate the senior’s urge to go to the bathroom, by picking up on signals like fidgeting or pulling at clothing. It may also be helpful to develop a routine for going to the bathroom (if the senior asks to go, it may be too late), and to stick to it as closely as possible. If accidents occur during the night, it may be a good idea to restrict nighttime fluids, especially drinks containing caffeine. Accidents will occur, both day and night, so caregivers must remember to be understanding and considerate.
 

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Friday, June 13, 2014

Caregiver Humor: Making Sense of Time

 
Martin Avadian
 
Things you and I take for granted are sometimes hard to grasp for a person with dementia. Take this story, “Making sense of time” shared in Finding the JOY in Alzheimer’s.
A month before my father, Martin’s, ninetieth birthday, my husband David and I had the following conversation with him. By this time, he was living with Alzheimer’s disease.

Martin: “What time is it?”

Brenda: “11:40.”

My father appears to be thinking as he looks at me without saying a word.
David takes off his watch to show my father.

Martin tilts his head to focus on David’s watch. David confirms the time: “See, it’s 11:40!”
Martin: “Looks good enough to eat … and then pass through and get rid of.”

David tries to humor my father, and puts the watch in his mouth. Pulling it out, he asks, “Why would I want to eat my watch?”

Martin: “When?”

Such are the JOYS of caring for a loved one with dementia. We had a choice–we could mourn the loss of my father’s abilities or we could celebrate the humor in the smallest things. My father preferred to find the JOY and so did we. It made life as a caregiver much easier.

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