CarePlus

Category: Care

  • Holidays and Dementia — How to Make it Work?

    Dementia is a difficult disease to handle at the best of times–but mix in the constant sensory stimulation of the holidays with an influx of family members, and you could have a recipe for disaster! Dementia patients are often easily distressed, and depending on the variation they suffer from, they could even become aggressive or violent. Luckily, a little advance planning and some honest, open discussion among family members can keep your holiday memories from becoming cringe-worthy.

    Remember to tailor your response to your loved one’s dementia based on their specific symptoms and how advanced the disease is; not all of the tips below will apply to everyone!

    Dealing with Dementia

    A senior citizen with Alzheimer’s disease or dementia has very different needs than many other family members; try to keep them comfortable. Remember to keep a favorite sweater or a warm blanket handy in case they get cold; as we all know, the elderly often feel the winter nip in the air more keenly than those who are younger!

    Many times, a loved one with early or moderate-stage dementia may feel the need to help with holiday preparations; after all, they’ve been doing it their entire lives! Rejecting their offers of help, even out of the best of intentions, can foster wounded feelings. Instead, ask them to help with simple, repetitive tasks, like stringing popcorn and berries for garlands, or signing cards from the whole family. Not only will it cut down on your own load, but repetitive tasks can be soothing for those suffering from dementia.

    Remember that disruptions of routine can be upsetting to dementia patients; try your best to keep their regular schedule! If you have morning or evening routines with your loved ones, don’t let the holidays preempt them; starting and ending the day on the right note can lead to a reduction of stress for everyone involved.

    If traveling is difficult with your elderly loved one, don’t be afraid to ask family and friends to come to you. The holidays are a time to be with the people you care about–and right now, one of those people has some very special requirements. There’s nothing wrong with adjusting family traditions to better facilitate your parents’ or grandparents’ enjoyment of them! Start some new traditions!

    On the other hand, there’s a common saying among memory loss experts that goes, “last in, first out; first in, last out.” What this means is that long-standing memories–memories from decades ago–can be the memories that remain longest. Try to keep long-standing traditions; it can help your loved one remain oriented to their present time and season, and help them to better enjoy the holidays without becoming totally confused.

    Preparing Family for the Differences

    Before they arrive for the holidays, have a detailed, honest, and open discussion with your family members about your elderly loved one’s condition. If siblings, cousins, or nieces and nephews haven’t seen Grandma and Grandpa in a while, it’s best to prepare them, and let them know about any memory loss. Be sure to emphasize that memory loss is not a personal insult. Many times, people can become hurt when their grandparents or parents don’t recognize them, or mistake them for another family member or friend; remind them that this doesn’t mean they aren’t loved, just that your loved one is sick.

    Let them know how to gently remind your loved one who they’re with and where they are, without getting upset; although dementia patients can be intellectually confused, they can pick up on emotional cues from those around them. If the people in their vicinity are upset or emotional, chances are your loved one will be too.

    Explaining dementia or Alzheimer’s disease to children can be difficult and heartbreaking, but it can be for the best. Try to explain to any children present why they need to watch their behavior, even though they’re around family, and be sure to emphasize the first point–that if Grandpa and Grandma don’t recognize them, it’s just because they’ve changed so much!

    Celebrating the holidays with a family member suffering from dementia or Alzheimer’s disease can be difficult, but keeping your eyes open and your expectations realistic can help to curtail any hurt feelings or family disasters. Remember–your loved one hasn’t morphed into a disease. The parent, spouse, grandparent, or sibling you love is still there; they just need a little extra TLC!

    From all of us here at CarePlus, we wish you and your family members the best of holidays, and a happy, hopeful start to the new year.

  • Man’s New Best Friend

    The efficacy of animal-assisted therapy isn’t some sort of state secret; the news regularly fills in holes with fluff pieces about how Fido can keep you young or how research shows Mittens may help lower your blood pressure. But like every other kind of therapy, pet therapy isn’t ‘one size fits all.’ There are definite benefits—but if the benefits are outweighed by the drawbacks, the addition of a pet to your family can increase stress.

    First, let’s take a look at the benefits. One of the obvious upsides to having a pet is simply that they’re there—pets provide companionship, which can be more than just a comfort to seniors who may be isolated and lonely. Not only do pets fill up the time, but as human friends pass away and adult children and grandchildren get busy and increasingly self-sufficient, pets provide a sense of purpose—they may not be the best conversationalists, but being responsible for any other life can renew a senior’s sense of meaning.

    Of course, one of the significant drawbacks to having a pet is upkeep—dogs need to be walked and groomed, and even cats, which tend to be lower maintenance, require attention; additionally, they can get underfoot and be moving, breathing tripping hazards, and can knock over other objects and create messes. Even smaller rodents can trigger allergies. So what’s to be done?

    Amazingly, it’s been shown in several studies that fish can have a notably beneficial effect on Alzheimer’s disease patients. Not only does easy access and exposure to an aquarium soothe aggression and depression in dementia patients, but it also has shown a marked improvement in appetite and food consumption at mealtimes, even leading to an overall, quantifiable increase in weight!

    According to a study done by a nursing professor at Purdue University, participants in an Alzheimer’s study increased their food intake by an average of 17.2%. The same study “showed a decrease in the number of instances and the duration of behaviors such as wandering, pacing, yelling and physical aggression.”

    Aquariums also provide a colorful and constantly moving source of entertainment and stimulation; because of its active nature, it is well-suited to the naturally short attention span of an Alzheimer’s patient. Even better—Alzheimer’s patients will get a boost of confidence from helping to feed the fish and seeing them respond to the arrival of food, and the huge number of aquarium accessories—from the ubiquitous deep-sea divers and castles to laughing Buddhas and popular cartoon characters like Spongebob Squarepants—means there’s no end to the possibilities when it comes to setting up a creative and colorful background for your fish.

    The downside to fish, of course, is that they’re nowhere near as cute and cuddly as, say, a cat or a dog, but as the Purdue professor who headed up the aquarium study says, “[Alzheimer’s patients] might step on the cat’s tail or pull the dog’s hair,” whereas fish are “basically indestructible.”

    While tanks require upkeep and regular maintenance, there’s no risk of “accidents” on the floor, and the last we heard there was no record of a fish chewing on expensive shoes. There’s no grooming, shedding, or walks on rainy days required. With such considerable benefits and fewer downsides, when it comes to your seniors, man may have a new best friend!

  • Quick Stress Relief Tips for Family and Caregivers

    Dealing with a loved one who’s ill or incapacitated is stressful; we all know this. Unfortunately, though, the psychological needs of caregivers, family members and friends often get lost in the shuffle of arranging for care, scheduling doctor’s visits, and dealing with health crises.

    Some caregivers, especially family and friends, feel selfish thinking about their own mental wellbeing while their wife, brother, son or mother is in such dire shape, but the fact of the matter is—whether you’re a primary caregiver part of the time or simply assist while a full-time nursing aide cares for your loved one, if you’re not in good psychological shape, your ability to help is critically diminished.

    Now, this isn’t to say that you should rearrange doctor’s appointments so that you can take a spa day, but an ongoing effort to attend to your mental health—think of it as maintenance work, like you’d do for your car or a garden—can not only benefit you, but also the loved one you’re caring for.

    The question is—how do you do it?

    Relax in Minutes

    Sometimes, as a caregiver, you may feel like you don’t have the time to spare to help yourself relax; we understand. Caregiving is a full-time job, whether or not you have a nursing aide helping you. Here are a few techniques you can use when you’re stressed but only have a couple of minutes to yourself.

    1. Deep breathing. This isn’t quite as simple as it sounds. Often we breathe from our chest, rather than our abdomen, which means we’re actually getting less oxygen than we should. To ensure that you’re breathing from your abdomen, lay a hand on your chest and another on your stomach. When you breathe deeply, your stomach should expand—moving the hand there drastically—while the hand on your chest only moves a little bit.
    2. Visualization. There’s more to visualization than simply remembering a pretty vista you saw once. In order to get the full benefit of visualization’s stress relief, focus on each sense in turn. For example, if your chosen visualization is a tropical beach, you should not only try to see the palm trees in the sun, you should feel the sand beneath your toes, smell the salt water on the sea breeze, hear the crashing waves and the sounds of sea birds, and taste that piña colada!
    3. Stretching. Yoga is a great relaxation technique, but if you’re short on time it might not be the best option. So instead of doing a full series of poses, you can, instead, focus on just a few simple stretches. A good move for stretching your spine is the cat-cow, in which you get down on your hands and knees, and then slowly and rhythmically arch your back (like a startled cat) and then inverse it, letting your stomach arch toward the floor (like a cow’s belly). Any kind of stretching can refresh you and help reinvigorate you, though, and the best part is it requires no equipment—only a few minutes and a little bit of space!
    4. Treat yourself. While self-medicating for stress is never a good thing, treating yourself to something you like every once in a while can have a positive effect on your overall mental health. Love chocolate? Keep a stash of Hershey’s kisses somewhere and, when you’ve had a rough day, allow yourself a few. There are other ways to treat yourself, too—YouTube your favorite scene from your favorite movie, listen to an embarrassingly bad band you happen to love, or take a bubble bath instead of a shower! A little treat can do wonders.
    5. Scalp massage. Massage of any kind feels great, but scalp massage is easy and has multiple benefits—it boosts blood flow, relieves stress, and can reduce headaches and migraines (which is especially useful if you’re prone to tension headaches, often brought on by stress). Place your thumbs in the hollow behind each ear and spread your fingertips over your head, as far as is comfortable; massage in circles for a minute or two for instant relief.

  • Elder Anger – Where Does the Rage Come From?

    In the last newsletter we discussed depression in the elderly, but we haven’t yet touched on another of the most common emotions seen in the aging population—anger. Of course, anger can be a symptom of depression, or rather a masking emotion, put on in order to hide feelings that make an already vulnerable elder feel even more helpless, but often it’s simply a manifestation of the aging process itself.

    No matter its cause, though, anger can be incredibly damaging to the caretaking process, taking its toll not only on the elder, but also on his or her caregiver and loved ones, and the relationship between them. It’s not always easy to be tender and understanding with someone prone to fits of rage over what seems like nothing.

    The key to dealing with elder anger is in understanding where it comes from, and why it exists. Why are our elderly loved ones angry? Where does the stereotype of the crotchety, grumbling senior citizen come from?

    A Walk in Another’s Shoes

    Let’s say you’re older; you’re 85. You may have been one of those enterprising Americans who works even after retirement age, but force of will can’t keep someone in the workforce forever; you finally retired 12 years ago, at 73. You volunteered for a few years until you no longer had the strength to, and now you’re finding that your self-definition has drastically altered—even disappeared. Before, you were a lawyer, or a teacher, or a florist. Then you were a volunteer. Now what are you?

    To compound that, your health is steadily failing. You may insist your hearing isn’t going, but you have to ask people to repeat things more often than in the past. You may have a hip replacement, or a pacemaker; perhaps you’re lucky and have escaped Alzheimer’s disease or congestive heart failure or chronic obstructive pulmonary disease, or any of the other more serious conditions that have robbed you of some old friends. Even in that case, you find that you tire much more easily, you’re often cold though you know you shouldn’t be, and even simple daily tasks you used to do without a second thought can leave joints aching. You find you have to get up multiple times during the night to relieve yourself, and you’re not as steady on your feet when you do so, prompting worries about falling (and potentially injuring your other hip). Additionally, things are starting to slip your mind more often. Is that an indicator of oncoming dementia?

    Your doctor has prescribed pills to regulate your cholesterol, to alleviate your arthritis, to ward off countless diseases. You eat right and take vitamins to try to keep your body in top shape but it seems to keep failing. You finally gave in to your kids’ requests after a close call while driving at night, and gave up your license and your car.

    Of course, that accession to safety has left you even more isolated than you were before. You have to wait for one of the kids or maybe a neighbor to take you to the grocery store, or have your groceries and prescriptions delivered. Perhaps, again, you’re lucky; like you, your spouse is in good health. But your parents and aunts and uncles are long gone, your siblings and cousins are falling victim to the conditions you avoided, and even your children are starting to suffer more in their middle age. You recognize more names in the obituaries than in the wedding announcements.

    A Natural Reaction

    As we discussed in the article about elderly depression in the last newsletter, such negative feelings aren’t unusual—and as we can see from the above example, they’re also not unreasonable. While it’s possible to live a full and happy life even after retirement and aging kick in, there are plenty of reasons for our elderly loved ones to feel blue.

    To most people, depression simply means ‘sadness,’ but in reality, depression stems from a feeling of helplessness, of being stuck. When we feel like we’re in a rut or unable to change the things that are upsetting us, some people become what sad or apathetic—what most people mean when they say ‘depressed.’ Some people, however, react with an increased irritability or develop an unusually short temper.

    How can you deal with this anger? Remember that your elderly loved one is going through major life changes, and many of them are unpleasant; try to react calmly, and never strike or yell at a senior (or anyone, really) when they show irritation or anger. Helping your senior find something they can invest their time and energy in can help assuage their irritability; help them see rediscover their self-definition, or create a new one!

    Of course, when anger comes concomitant with another health issue, such as dementia—for instance, “sundowning” is aggression and confusion that often occurs in the late afternoon and evening among Alzheimer’s patients—simply offering them alternatives and understanding isn’t always enough. Remember to consult a doctor whenever you have concerns about your elderly loved one’s wellbeing.

  • The Best Service in the Worst Times

    Last week, a large snowstorm crippled our community, turning local commutes into hours-long ordeals and depriving thousands of electricity. Among those without heat or electricity were some of our clients, including Mr. and Mrs. W., 96 and 90 respectively, who live in the Bethesda area and both receive round-the-clock home health care from our Certified Nursing Assistants (CNAs) as well as additional oversight from Registered Nurse and Geriatric Care Manager, Cathy Lonas, of Advocate 360 since they have no family in town.

    Upon losing power, CarePlus’ CNAs did their best to keep Mr. and Mrs. W. warm and safe, but when the electricity hadn’t returned the following morning, they called Tom Najjar, owner of CarePlus Home Health, Inc, for advice about what to do. As both husband and wife have medical problems, taking them to a warming station was not the best option. Compounding this was the fact that the city of Bethesda was buried under snow, making transportation even more difficult than usual.

    Tom, working with Cathy Lonas, contacted Mr. and Mrs. W.’s son, who lives in Colorado, and obtained his permission to get his parents a hotel room in the area. Unfortunately, many area hotels had also lost power, and many of those that hadn’t were full. Finally Tom and Cathy found a hotel in Germantown that had one room available; the only problem that remained was how to get the W.’s to the hotel.

    Despite treacherous road conditions, Tom himself drove to Bethesda to pick up Mr. and Mrs. W. and their caregivers, and transported them to the hotel in Germantown, where he stayed to make sure that they were getting settled well; he then went to pick up dinner for them and brought it back to the hotel. By the time he left, the W.’s were in good spirits and much warmer.

    After their scheduled two-day stay at the hotel, Tom discovered that the power was still out at the W.’s house, so he arranged for them to stay for an extra day. On the third day, Tom returned to pick them up and take them back to their home in Bethesda, where the electricity was back—but the heat was not! After 45 minutes of troubleshooting, Tom discovered that the problem was with the thermostat; a quick change of batteries and the house started warming up right away.

    When you sign on with CarePlus, you’re not just getting a personal care agency; CarePlus provides you with a staff who cares enough to go out of their way, and is willing to go the extra mile for you and your loved ones without hesitation.

  • Options For Taking Care of Elderly Parents

    Watching our parents get older is one of the hardest things that we have to go through. It can be difficult watching them get to stages where Options For Taking Care of Elderly Parents imagethey cannot take care of themselves anymore and need basic care. For many of us we are accustomed to having our parents available to help us and take care of our needs. This can be a real change for everyone involved and it can be difficult for our parents to realize they can’t take care of themselves.

    Many of the things that they need can become very time consuming and difficult to keep up with since for many they have their own children and grandchildren at this point. For many they start looking into options for help for their parents, especially if they live far away from us. There is the option of a rest home, but that can be the most difficult thing to do to a parent. They like to stay independent as long as they can.

    Another option is home care. There are several different companies that offer different services at different times of the day, but the best scenario is to have a home health care service that is available 24/7. Then you or your parent can contact them for anything at anytime. It is also nice to have them offer services such as laundry, grocery shopping, general housekeeping, friendship and even basic hygiene care. This provides a way for your parent to develop a companionship and something to look forward to.

    There are several things to consider and it is important to do what is best for all involved.