Tips for Alzheimer’s/Dementia Challenges
As Alzheimer’s Awareness Month comes to a close, I thought it would be helpful to provide some tried and true tips I’ve learned over the years.
Repetitive questions/comments:
As brain disease worsens, short term memory increasingly suffers to the point that many people will ask the same questions, or say the same thing repeatedly. The most important thing is to try not to get frustrated! I realize this is easier said than done! One thing you can do is to make it a personal challenge to respond in different ways each time. This can help stimulate the person as well.
For example: “what time is it?”
Possible answers:
2:00
Its a bit after lunch
Its almost time for snack
Its the middle of the afternoon
Its time for our music program
What’s your favorite time of day ________?
ETC!
Bathing:
Water can become very frightening as a person becomes increasingly confused due to heightened tactile senses, thinner skin, and/or psychological reasons. I’ve had some people act as if the addition of water to their skin makes them feel like they’re melting! What I’ve found is to first provide very secure seating. I like to use a heavy plastic patio chair with a towel folded for padding on the seat, rather than your typical bench type without a back or arms. You must have a hose attached to the shower head, preferably with different settings. The setting should be as soft and gentle as possible. Soothing music, and/or aromatherapy (using a scent you know to be comforting) is also helpful. Remain calm and speak in soothing tones at all times. Start at the toes and slowly move up the body with the water. Washing hair can be the most challenging part of this. Part of the idea of using an actual chair is to have the head fully supported. You can place your hand behind the persons head so its not directly on the plastic. If you’re working alone, put a towel or something soft so you’ll have use of both of your other hands for the hose, and for the actual washing. Sometimes people relax enough to allow you to massage the scalp, making it a very pleasant experience. I’m a big believer in bathing daily, for a variety of reasons, but also because it becomes a routine, and soon enough, not something to be feared.
Picky Eaters:
First, we need to be sure those in our care are are moving enough to be hungry! Second, we want to make sure medications aren’t causing issues. Next, your best friend is color and texture! Make it interesting! Use colorful tableware, and a variety of foods. Try unique garnishes (there are great books for ideas!), shapes, and bright (rather than overcooked) foods. Take into account the persons preferences (which can change as a person ages) but don’t be afraid to try new things. I’m not a fan of protein drinks. We can do better by being innovative, creative, and patient!
Behaviors:
When someone is acting out, there is usually a need that is not being met, be it fear, frustration, confusion, discomfort, etc. Its our job to figure out what might be going on, even when the person may not be able to clearly communicate it. If that’s not possible, we can try redirecting the person. We can do an activity they enjoy, sing a favorite song, ask them about their children or pets, expend energy by walking, etc., anything that might take their mind off of whats bothering them in the moment, while paying attention to any patterns or possible triggers for the behaviors. Its important to have good eye contact, and be a calm, reassuring presence.
I have an example I’d like to share. On the day my second resident, Zelda (of blessed memory), moved into my first facility, I thought it’d be nice to take a walk around the neighborhood. She was understandably agitated once her family left for the first time, and I thought it would help her relax. When we returned, she refused to go inside. I tried everything to convince her that we should go in. No way!! So, I decided to pull up a couple of patio chairs and sit on the driveway with her, while figuring out what to do. We ended up being out there for hours, so long it was time for afternoon snack. After which I had an idea! I asked Zelda if she’d help me clean up, bring the dishes in and wash them. She got right up and marched into the house! I learned that Zelda wanted to be helpful, and in this strange new setting, it was comforting to do something familiar, something second nature to this devoted mom and wife.
Sleeplessness:
This is a tough one! Its exhausting for caregivers, and one of the biggest reasons people consider placement. I can say in my experience, you’re going to make yourself miserable trying to change a persons sleep habits to “normal”. Brain disease affects the sleep-wake cycle and while there are things you can try to improve sleep, most Alzheimer’s patients go through a period of difficulty. Again, exercise is important in that you can make sure the person doesn’t have excess energy at night. Also, that they not be served caffeine, sugar, or processed foods as this can contribute to sleep issues. Be aware that oftentimes the person is fearful, of the dark, of being alone, of noises they’re not used to and address those things if they seem problematic.
While it can be frustrating to address any one of these issues, or a combination of them, its important to remember ‘this too shall pass’. Try to focus on the good moments, relish the funny ones, and remember to give yourself a break. You both deserve that, and more!
