When I look back on the techniques our family used as we tried to help my mother throughout her years with Alzheimer's, I realize how much more comfortable she would have been had we known more about the sensory dysfunctions she was experiencing. We found cognitive issues easier to deal with; when we observed her confusion--for example, when preparing a meal--we readily adjusted the activity to accommodate her needs. But when Mom's ophthalmologist told us she had developed "tunnel" vision, we didn't grasp important implications, things such as where we positioned ourselves when walking with Mom would either help or hinder her.
Had we understood the ways in which the deterioration of her senses--hearing, sight, sound, touch, and smell--would impact her ability to engage in basic activities of everyday living, we would have adapted our methods. For example, did you know that each of us has a dominant side in our mouths? Surprised? Think about the side on which you prefer to chew. The same thing applies to which hand, eye, foot you most readily use. Identifying your loved one's dominant side will help you maximize their functioning. (More about this later.)
Because side dominance is so basic, it's a wonder that families and caregivers, especially those providing in-home care, aren't offered information and training in its importance. In the next few issues, we're going to explore this. Our information source will be Teepa Snow, an occupational therapist with thirty years experience working with individuals with dementia.Putting the information we'll discuss into practice will help us expand our skills from those of a "caregiver " to what Teepa refers to as "care partner."
While similar in some regards, the later focuses on the relationship between the person with dementia and the one providing care; it speaks to doing activities "with" our loved ones, rather than "to" that person. It focuses on the process rather than the outcome. For those with dementia, the lack of a quality relationship contributes to becoming increasingly more withdrawn, while a satisfying relationship is a lifeline, an all-important connection with the world.
In the next few issues, we'll share some of the methods Teepa Snow demonstrated during the presentation she gave at the Maine Chapter of the Alzheimer's Association's Educational Conference. Should you have the opportunity to attend any of her presentations, you should plan on going. We're sure you'll leave with an amazing amount of helpful information that will inspire you to become a "care partner." In the meantime, we're going to share a few highlights from our day with Teepa. Let's get started with: Guide Your Loved One With Hand-Over-Hand Walking....
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1. Advocate for your training needs as a caregiver--ask an Occupational Therapist or Physical Therapist to show you how to guide your loved one when walking. They can demonstrate as they are treating your loved one and also give you helpful tips. Don't be shy about asking questions; OTs and PTs enjoy teaching caregivers how best to support their client.
2. Encourage Staff Supervisors at memory care and skilled nursing facilities, Medical Doctors and Nursing Staff, and Home Health Personnel to offer training for family members re: how to perform basic procedures related to walking, feeding, and other activities of daily living.
3.Making mistakes when learning new techniques and procedures is part of the process of learning. Don't give up--practice until you're comfortable with your new found knowledge.
Part 2 of 3: Had We Only Known: Make Showering Pleasurable
Say "NO" to Caregiver Loneliness
HELP SPREAD THE WORD:
Dementia affects the individual, family, and community. Join us in reaching out to those who are dealing with Alzheimer's and other forms of dementia. Encourage your friends, their families, and community members--especially those working in ass't living and nursing facilities--to subscribe to this FREE family-friendly support. Tell them to subscribe at: http://www.catherinegentile.com. Or contact me directly: firstname.lastname@example.org.
Had We Only Known: Basic Facts and Helpful Procedures
Part 1 of a 3-Part Series
Based on a Presentation
by Teepa Snow, OT/R
MARK YOU CALENDARS--UPCOMING EVENT:
TOGETHER WITH ALZHEIMER'S: CARE AND SUPPORT FOR THE CAREGIVER
Join us as we discuss positive ways in which to respond to Alzheimer's.
Catherine Gentile, author, editor, and former caregiver, facilitates.
7:00-8:00, every Wednesday.
Sacred Heart Parish Center,
326 Main St, Yarmouth, Maine
Upcoming Presentation: September 17:
Polly Bradley, Program Director, Southern Maine Agency on Aging
will discuss the Stewart Center, SMAA's newest day program
To Register or FMI: email@example.com
Being a caregiver is a tough job, one we can do, especially when we have the right support.
As Christopher Robin tells Pooh:
"Promise me you'll always remember: You're braver than you believe, and stronger than you seem, and smarter than you think."
So are we.
Increased tunnel vision decreases your loved one's ability to see the whole picture. With that comes an increased need to keep you, the caregiver, within sight. As this occurs you may find:
1. An increase in your loved one's tendency to "shadow" or "follow" you. She may also want to touch you more than usual and possibly engage you in talking.
2. As her anxiety escalates, her brain function shuts down, and her difficult behaviors increase in frequency and intensity.
To avoid a spike in your loved one's anxiety:
1. Remain within her visual field by keeping her on your non-dominant side (refer to procedure for Hand-Over-Hand Walking)
2. To avoid giving the impression that you're trapping or confronting your loved one, turn your body sideways and, without being intrusive, position your hands within her field of vision where she can see them.
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An Editorial Comment:
Keep Our Elders From Falling
McNight's, Daily Report, an online summary of activity within assisted living and nursing facilities, recently reported on a study of nursing facilities that showed a reduction in the use of restraints while the number of falls remained the same. They offered no explanation for this anomaly. Having had extensive experience with family elders who had fallen while in nursing care, I posted this response:
"It seems as though the relationship between the reduction in restraints and the lack of the same in falls needs to be investigated. Methods such as putting bed rails into the upright position for newly admitted patients are discouraged because they are categorized as "restraints." It's a known fact that newly admitted patients, especially the elderly, become disoriented and fall when attempting to use the bathroom at night. Staff are directed to discourage families from requesting "releases", i.e., documents they can sign requesting use of restraining devices that, in these instances, have the potential to keep their loved one from falling. Hence, we must evaluate the impact this zealous and irrational application of restraint policy is having on the number of falls newly admitted patients experience and their subsequent injuries. Surely there is a reasonable way to determine when restraints are unnecessary and when they are a means of keeping patients safe. One wonders what parents would do if someone were to tell them that the use of car seats for their children could be categorized as a restraint."
If you are about to admit your loved one into a facility or have recently done so, I'd suggest reviewing the restraint policy with the facility's supervisor. Should you feel that your loved one is at risk, be sure to insist on signing a release. While facilities are often reluctant to have you do so, signing this document may save your loved one from unnecessary injury. Also, signing this alerts the staff to the seriousness of your concern and heightens the vigilance with which they attend to your loved one. CG