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Giving Dignity to Dementia Patients

How to treat dementia patients with dignityOne of the most tragic aspects of dementia is watching a person who you once knew to be capable, independent, and thriving now have difficulty with basic tasks and revert to a childlike state. There’s often great pain as your loved one knows that they’re regressing but is unable to regain the abilities of their younger self. It may seem like this decline is out of anyone’s control, but there are some ways that you can help to lessen its sting. First, pay attention to how you’re speaking to your loved one. There’s a tendency for us to talk down to the elderly and treat them like children. Are you being condescending? It may help to separate the person’s illness, which may result in strange and childlike behavior, from who they are essentially as a person. Mom is still there behind her dementia, and you want to honor her. Also think about your vocabulary. Are you using words that you might use with a child but not when talking to your loved one before the onset of dementia? Try calling adult diapers underwear or the “potty” the bathroom or whatever your loved one has always called it. In conversations, avoid putting your loved one on the spot by asking questions they may not be able to answer. Try to stay away from facts that can be wrong or right, and instead ask how they feel about something. For example, if someone who doesn’t know your mother asks her how many grandchildren she has, redirect the conversation by getting her to talk about how much she loves them instead. Many caregivers strategically use what they call “therapeutic fibbing” to help their loved ones. For example, dad insists he wants get in his old boat and go fishing by himself the way he used to. Don’t tell him he’s not capable of going out on the water on his own and his boat has been sold anyway, as this will likely make him feel upset and depressed. Instead, you can tell him today’s not a good day because there might be a thunderstorm coming, or that the boat’s engine needs to be repaired. Each and every one of us needs respect and to feel important. Try to encourage and reassure your loved one that they have value as much as you can, and speak with other family members about doing the same. Your loved one may no longer be the exact same person they once were, but with a little cooperation and assistance from those around them, you can minimize embarrassing situations and despair.
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Discussing Alzheimer’s with Family Members and Friends

Stigma against Alzheimer's prevents seniors from getting diagnosed.An Alzheimer’s diagnosis can be isolating, both for the person with the illness and for their caregivers. Illness can often create distance between those who were once close, and the nature of Alzheimer’s disease compounds the problem. Others are unsure if the person will remember them or if they’ll behave inappropriately. Still others may remain in the person’s life, but not acknowledge the disease at all, and thus leave a big silence about a major life event. Many people who suspect they have Alzheimer’s avoid an official diagnosis because they fear the effects on their social world and the painful feelings of rejection and loneliness that would come with it. However, it is vital that patients get a diagnosis so that they can receive proper care. If someone close to you is going through this important turning point, here’s how you can help. Listen before judging. A time like this is ripe for family conflict. Should the person get diagnosed and when? If they do have Alzheimer’s, how will the family plan for the future? It may be that the Alzheimer’s patient has disagreements with the rest of the family, or people within the family are fighting among each other. You will have your own opinion on the issues at hand, but make sure you’re hearing out the other side and giving their point of view fair and compassionate consideration. Hold back on stating your viewpoint and ask others for theirs first, to make sure they have a chance to give input. A third-party mediator may be able to help if you worry that conflict will get out of control. Be supportive. One of the best things you can do for your loved one is to help them think through all the choices they have to make at this time. This may require you to keep your own emotions in check at a time when you might be feeling a lot of fear, so it may not be easy. Keep in mind that your loved one will likely be afraid of seeming to be needy or a worry-wart. Encourage them to talk through their concerns rather than keeping them private. Stay calm. At this time it’s very important to be patient, and not all of us count this as one of our strengths. But keeping your cool can go a long way towards maintaining a positive relationship with your loved one that will keep them open to your much-needed help. Remember that pointing out that you were right or expressing negativity may not be the most productive course of action. Put a focus on keeping a good relationship. Using these skills will put you in a position not only to support your loved one, but also help you bridge the gap between them and family and friends. You can play an important role in keeping the peace.
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Accusations and Dementia

Dementia patients often make accusations.One of the most difficult dementia behaviors for caregivers to cope with is false accusations. We’ve all had the experience of losing track of something, thinking someone must have taken it, and then later finding the object and discovering we were mistaken. Dementia patients, with their short-term memory problems and tendency towards paranoia, are all the more prone to these kind of misunderstandings. Because so much of their world no longer makes sense, they have a need to explain things and are unable to accept that the strange occurrence may be due to their own actions or perceptions. Is mom’s favorite sweater missing? Horrifying as it may sound, to her the most likely explanation may be that you stole it! They are also grappling with the insecurity that comes with old age, so the “lie” may be an unconscious attempt to preserve their dignity. Dad can avoid the embarrassment of misplacing his watch if he believes the aide stole it. Mistreatment and abuse of elders certainly does happen. But perhaps more often, the wrong exists only in the senior’s mind. What’s tragic is that these accusations are often leveled at loved ones and caregivers who are trying hard to make sure the senior is safe and comfortable. How can you cope with this difficult situation? Here are some suggestions. Bring in someone to help you. Find a third person to help you explain yourself. It may be a friend of your loved one’s, a staff member at the assisted living facility, or another family member. Seeing that someone else will back you up may help your loved one realize that they’re placing blame where it doesn’t belong. Seek advice from a senior care counselor. An expert in senior care can teach you good ways to respond to your loved one. You may want to start with the Alzheimer’s Association’s 24/7 Helpline at (800) 272-3900. Keep good financial records. Accusations often have to do with money. Being able to show documentation that proves what’s going on with a senior’s finances can help straighten things out. Bring a family mediator on board. Sometimes within families there can be confusion about what to believe. A mediator can help everyone sort through the issue as calmly as possible. Consult an elder care lawyer. This is only for extreme situations, but especially with accusations of abuse or major financial wrongdoing you may need to take serious measures to protect yourself. Before you take any major action to address the problem, remember that your loved one may forget about it the next day and display no ill will towards you. In the strange world of dementia, sometimes what seems like a serious problem will simply evaporate. And always remember that such behaviors are caused by the disease, and often mean nothing about how caring or devoted you’ve been.
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How Roles Change as Parents Become Older

Our LA home for the aging staff take every precaution.As parents age, adult children gradually find familiar roles shifting. More and more, their elders turn to them for help, rather than the other way around. The individual circumstances will vary. A fall and broken hip can incapacitate a parent, requiring temporary assistance at the least. Degenerative diseases can reduce mobility or vision, making it harder for a senior to drive or even venture far from home on foot. For even basic needs such as groceries or meeting with friends, they’re dependent on others. Alzheimer’s Disease or dementia can also create a need for consistent monitoring and care. When these changes take place, there’s a greater chance of family conflict. Older parents resist  the idea of slowly losing their independence and having to rely on others for help. They often will still try to assert a sense of parental authority when in fact it doesn’t exist at all anymore. Their children themselves are already middle-aged or older, well-experienced in life. Acting out of concern, they may try to take control of the situation, sometimes creating hurt feelings as they make difficult decisions for the best care of an older parent. Much of the problem in conflict usually occurs with faulty communication or a lack of it altogether. Parents can feel downright offended being relegated to a dependent status where they are guided or restricted in decision-making. That emotion can make it hard for an older parent to see reason. At the same time, the older child is balancing a new demand for parent care with everything else in life including raising his or her own kids, holding down a full-time job, paying the bills, and perhaps mid-life relationship issues. Their spouse’s parents may need help too, bringing another set of problems to the mix. Under these circumstances, an adult child’s need or choice to bring up the subject of assisted living can come across to the parent as a rash decision. There is no question that most older parents would love to retain and keep their independence for as long as possible. However, as mobility and mental faculties begin to falter, the need for monitored care begins to increase. Assisted living can serve a real benefit for everyone involved, especially when adult children live a significant distance from their parents. Regular and constant communication between an older parent and caring adult child towards each other is the key. Granted, someone usually has to make a final decision, but as long as they’re able to participate the parent should play a prominent role in the planning for their care. If adult children maintain communication and actively seek the parent’s input, they will generally feel more at ease with the transition to assisted living. But acceptance takes time. Adult children have to be patient and work with their parents as they grapple with the changes that take place during the aging process.
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Dealing with Cranky Elderly Parents

Our Los Angeles assisted living staff are friendly towards all moods.

Photo used under Creative Commons from becstarr.

Has dealing with your elderly parent become an encounter with Oscar the Grouch? If so, you certainly are not alone. However, as their child, it can help to view these encounters from an entirely different perspective. For a person who has always been independent, athletic, and able to recall many details, losing these faculties brings many underlying fears to the surface. Feelings of both helplessness and hopelessness can overtake their thought processes. It is important to remember that anger is often an outward expression of inner fears, and that while the complaints may seem to be hurled in your direction, it often has little if anything to do with you. Be patient, be kind, and reassure your loved one that he or she can talk to you. Understand though that no matter your age, parents generally do not want to place excess burden on their children. If your mother or father is uncomfortable expressing their innermost feelings with you, perhaps arranging sessions with a professional counselor will help your parent to truly process those raging emotions. It’s important for adult children to really assess the situation thoroughly–and honestly. For instance, some individuals always see the glass half empty, regardless of the circumstance. If your aging parent was always negative, illness will not bring out the best in them. Complaining personalities generally remain negative, complaining personalities… and sometimes you, as the caregiver, must be honest with yourself about this. Also, most people are more irritable when they do not feel well. But, there are some elderly individuals who feel that by virtue of their years on this earth, they have somehow earned the right to “not hold back”… and some will use it with a vengeance! In this case, there may be a glimmer of hope for change in circumstance. When your loved one begins taking a new medication, it often can wreak havoc on the body. This is further exaggerated by negative interactions between multiple drugs used to treat symptoms. If you notice a recent change in behavior or attitude that seems to coincide with a new prescription, a pharmacist or your loved one’s doctor can often help you get to the root of the issue. Personality changes can come on quickly and strongly in these scenarios. Bladder infections can also cause severe shifts in mood and personality. Cognitive decline (such as that found in Alzheimer’s disease, dementia and Pick’s Disease) can trigger severe levels of frustration. That is due, in part, to the inability to perform certain tasks that have been routine for years. These disorders cause a person to lose the ability to recognize objects or to remember things and people that are very familiar. It’s a tough time for both the individual as well as their family members; the frustration can spark the types of personality changes that surprise even those closest to the individual. Addressing personality changes brought on by medical challenges is easiest to deal with; simply get your loved one to a physician for treatment. These types of personality changes can disappear very quickly with medical attention or a change in prescription. However, if your parent was always the “Debbie Downer” type, or if he or she had tendencies toward verbal abuse (or worse) in the past, you have to establish reasonable boundaries so that you, as the adult child and caregiver, do not walk away hurt, frustrated, and disrespected constantly. If that still doesn’t work, you may also have to distance yourself from your parent, assisting on a limited basis. If you cannot find a workable solution on your own, you may need to speak with your local Social Services office to find a reasonable solution for everyone involved.  
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Signs of Caregiver Burnout

Our Los Angeles Dementia care staff helps ease your stress.Caring for an ailing loved one is demanding, time-consuming, and quite stressful. Often, caregivers spend a great deal of time making sure their loved one’s needs are met and their affairs are on track. What often goes quickly out the window? The caregiver’s own needs. The following are ways to detect if you, as a caregiver, have neglected yourself to the point of burnout. Isolation. As human beings, we thrive upon healthy relationships. When you find yourself regularly failing to engage in healthy social interaction–even with your own friends and family–this may be a huge signal that caregiving has begun draining you. Avoiding calls from people you enjoy, making excuses for not going out, etc… can indicate you may be well on your way to isolating yourself from others, which is never good. Feeling Overwhelmed. Caregiving can be an emotional rollercoaster for sure. There is the physical toll of spending so much time attending to the needs of your loved one. Further, there’s an emotional toll that comes with facing the shift in relational roles, seeing both physical and emotional decline in your loved one, and having to face day-to-day tasks which reinforce that life as you have known it has changed. It is natural to grieve, especially at the beginning of your caregiving experience. Frustration can arise. Anxiety and exhaustion can arise. But over time and left untreated, those feelings can lead straight into depression. If you become angry to the point of wanting to hurt your loved one or even yourself, get help fast. Your doctor should be able to diagnose whether there is a medical condition driving these symptoms. If medical challenges have been eliminated as a probability, you may have reached the point of extreme burnout and may possibly be experiencing depression. It is important to remember that while you serve as a support system for your loved one, you will also need to create a team of others who can step in to help. Being kind to your loved one is important, but it is also important for you to be kind to–and eliminate excess pressure on–yourself. Loss of Interest. One of the biggest warning signs of depression is loss of interest, especially in things that were once a huge source of happiness and enjoyment. When your hobbies, big and small, no longer inspire you… you may need help. Significant Changes in Your Sleeping or Eating Patterns. Can’t sleep at night? Can’t get enough sleep, no matter how long you’ve been in bed? Binge eating or hardly eating at all? Major shifts in your habits generally indicate huge shifts in your stress levels and turmoil in your emotions. Ceasing Your Exercise Routine Despite Enjoying It Before. Exercise is one of the best stress-busters available. It leaves a person invigorated and energized. So, when you used to enjoy exercise and suddenly stop, start again! The endorphins released while you’re exercising will relieve tension and help elevate your mood, plus you will get a better night’s sleep. Failing To Keep Up Your Appearance. Unfortunately, many caregivers fall into the mode of caring for a loved one so much that simple grooming (haircuts, manicures, etc…) become neglected. Some who once were fashion-conscious and took particular efforts to care for their appearance can suddenly become apathetic in this area. Generally, your outward appearance reflects what’s happening inside. This challenge may require some input from others you trust–close confidants, social workers, or healthcare therapists can help you sort things out to decide if you’re experiencing burnout and if additional help is necessary. Frequently Susceptible To Illness. If you catch every cold or flu that comes your way, and especially if you cannot shake the cold once you get it, your immune system is likely compromised. Our bodies are not created to handle excessive stress for long periods of time. If this is you, caregiving could be getting to you. Take these symptoms seriously. You can only be a good caregiver for your loved one if you yourself are healthy and happy.
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Problems with Living Wills

Our LA home for the aging is there to guide your way.Many of us know that living wills are a smart decision, but even with this document in place many find that making medical choices for a loved one is still complicated in practice. This post discusses some of the common problems with living wills and steps that you might be able to take to make sure that your wishes are followed. The living will document was designed to give the patient the right to determine–ahead of time–the type of medical care desired in the event he or she is unable to communicate those wishes. However, the language commonly used within a living will (which is also referred to as a substantive or instructional advanced directive) tends to be rather vague, often lending itself to interpretation. For example, in this age of advanced medical technology and cutting edge treatments, verbiage such as “little to no chance of recovery” is becoming obsolete. Some living wills, indeed, spell out possible scenarios and the patient’s desired outcomes for each scenario. While this is helpful, with medical technology evolving at its current rate, listing every alternative is virtually impossible, which then forces medical professionals and/or family members to then determine what’s best for the patient. Making matters even more difficult is the fact that for many what they want changes following an illness or hospitalization. One research study on medical decision-making revealed that three of every 10 patients change their minds about the type of care they desire, but those changes are not often reflected as quickly on the living will. So then, we’re back to the challenge of interpretation. It’s important to note that even when the patient’s wishes have been clearly written out, family members are still faced with making these decisions at a very emotional time. Arguments often arise between family members in the midst of the crisis about what their loved one really wanted, when their energies would often be better utilized in coming together to support one another as well as the patient. According to a February 2001 study published in the Archives of Internal Medicine, family members presented with various health crisis scenarios were about 70% accurate in predicting their loved one’s desires if faced with the scenarios given (whether the patient had a living will or not). That’s good news because three out of five patients who have living wills in the first place never give them to their doctors or to family members. While that fact is baffling to most, it leads directly into the necessity for medical doctors to exercise their professional opinions regarding care that is in the best interest of the patient. Family members must often draw from their knowledge of their loved one’s lifestyle and wishes, perhaps even going back to conversations that happened before a crisis ever arose. Sometimes, though, the decisions made can go directly against the wishes of the patient. Having a living will does not always negate a medical team’s decision to perform invasive procedures on the terminally ill. And again, family members who are facing difficult decisions are often reluctant to accept a diagnosis of imminent death and will, in some cases, fail to follow the instructions in a living will (hoping for a turnaround). A number of legal and health care professionals who once championed the idea of each patient having a living will are now suggesting that patients designate a health care advocate. Generally this would be a family member or perhaps a close friend who would exercise what the legal community calls “substituted judgment.” In short, the health care advocate is responsible for making the decision you would make if you were able to. To protect that individual, a patient may even record verbally or write out their wishes, to confirm that the decision made–no matter how difficult–was in accordance with the patient’s desire. There’s really no way to guarantee that what actually happens during a serious medical situation is what you would have chosen for yourself. But you can increase the chance of receiving the care you desire by communicating with your loved ones, with your doctor, and in writing the outcome you would want.
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5 Steps for Taking Responsibility for a Parent’s Finances

Board care for elderly can be expensive, help them manage their finances.

Photo used under Creative Commons from Images_of_Money.

As parents become older, there comes a point where you realize that you need to step in and help them with their finances. The red flag may be a bounced check or noticing that some bills are past due, or you could discover much more serious problems like the fact that mom or dad has been taken in by a telemarketing scammer. The steps below are your roadmap to getting your loved one back on track. 1. Know Your Parent’s Finances The first thing every adult child needs to know is the condition of your parent’s finances. This means that you need to know what debts they have (credit cards, loans, mortgages, etc…), as well as what their living expenses are. Familiarize yourself with utilities, credit cards, and any bills they have and make sure you start paying them right away. You also need to know if there are any safe deposit boxes, and if you parents already have a financial advisor. It may be beneficial to take a look at your parent’s tax returns to get an idea of their financial situation. 2. Learn About Your Parent’s Income and Insurance Situation Find out what sources of income your parent has. Find out of if your parent is receiving income from social security, what Medicare options they’ve chosen, and whether they receive Medicaid. Also find out if they have purchased long-term care insurance or other forms of insurance to make sure any premiums are kept up to date and policies are still in order. 3. Establish Who Has Legal Authority Over Your Parent’s Finances When a parent becomes unable to care for their finances, it is especially important for adult children to know who has legal authority to manage the estate. Find out if your parents have already established legal guardianship with a relative, financial advisor, or with an executor. Pre-planning in this area can be especially important as it‘s more difficult to establish power of attorney if your parent develops dementia or Alzheimer’s. If you parents haven’t established a legal guardian before they become incapacitated, you’ll need to seek guardianship through the court system. A judge must agree that your parent is not legally competent to handle their own finances and that you are, which may take time. 4. Contact a Financial Advisor A financial advisor or accountant can help you not only sort out your parent’s current finances, but also help you plan for the future. Depending on how you parent’s have invested, there may be other ways to maximize their assets to help finance their transition to assisted living. A financial advisor can help you navigate the options and ensure the best possible course for your parent’s financial future. 5. Get Everything in Writing In order to safeguard both your parent’s and your own financial future, it’s best to make sure you have written documentation of everything related to their finances. Make sure you have legal authorization to act on their behalf. Any access to funds should be documented and any decisions with a financial advisor should be copied into a written document so there is a paper trail to help protect you and your parent legally. Having written records will also help if conflict or concern arises among siblings or other relatives. Watching a parent age can be a difficult process emotionally for adult children, but it doesn’t have to be difficult financially. By following these steps, adult children can help ease the transition for their parents, ensuring a brighter and more secure financial future.
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Signs of Alzheimer’s Disease

Our LA home for the aging is skilled at helping loved ones aflicted by Alzhiemer'sAlzheimer’s disease develops gradually over the years, usually going unnoticed at first but eventually becoming impossible to ignore. What signs should families be alert to? The key is to look for major changes that interfere with everyday life. Some examples of actions that might be taken by a senior with Alzheimer’s include:
  • Forgetting things that are part of a well-established routine, and were once done without fail.
  • Repeating questions.
  • Arriving somewhere without any idea how they got there.
  • Losing their way on a familiar route they take every day.
  • Forgetting to turn the stove off.
  • Leaving doors open.
  • Forgetting to eat meals.
  • Unusually poor hygiene that the person is not aware of.
  • Placing objects in unusual places.
  • The inability to remember even basic words, or speaking in such a way that’s hard to follow.
  • Sudden mood swings for no particular reason, or becoming uncharacteristically suspicious or trusting.
  • Lack of awareness of strange behavior.
Such behavior is serious and not to be confused with typical signs of aging, such as momentarily forgetting a piece of information or a name. Even otherwise healthy seniors may take longer to remember things than they used to. We all misplace items or forget important things from time to time—this is normal. Alzheimer’s is marked by the extreme frequency of these sort of incidents. It’s important to compare a loved one’s current behavior to how they were in the past. If someone has been on the more careless side throughout their life, a few odd forgetful incidents is less of a concern than if someone who was always highly conscientious shows the same behavior. If you suspect a loved one has Alzheimer’s, have them evaluated by a competent specialist. The problem may turn out to be simple forgetfulness or even a lack of sleep, but get the input of an expert.  The earlier the diagnosis, the better position you’ll be in to take steps to prevent a situation where your loved one or someone else gets hurt. You’ll also have the opportunity to get finances in order, obtain power of attorney, and plan for the care of your loved one. It’s not easy to accept that a once vibrant and active person may have Alzheimer’s, but it happens to families every day. In fact, half of those over 85 have the disease. The progression of Alzheimer’s can be heartbreaking, but it is more manageable for seniors and their families with counseling and treatment.
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How to Care for a Loved One in Assisted Living From Afar

Our assisted living facility California makes our residents feel at home.Unfortunately, more adult children live far away from their aging parents than ever before. When it becomes clear that mom or dad needs help, the thought of not being there for them can be very stressful. To make matters worse, they may not tell you the truth when you ask about their well-being. They are after all the parent, and they’ve spent your life worrying about you. They simply may not want to worry their child, especially one living far away. If you have siblings who live close to your parent, they will probably by default end up as the primary care givers. Most siblings in this situation will appreciate it if you maintain frequent contact with them and make serious efforts to find ways to contribute. If they are raising their own family or their work leaves time at a premium, discussing the decisions to be made and supporting the decisions they make regarding your parent’s care will give them relief. It is a difficult and unfortunately common situation for the primary caregiver to feel abandoned by their siblings in this case. Ask your sibling what kind of support would be helpful. Often in these circumstances, family members who live at a distance contribute a larger share to any financial efforts, or sometimes come to pitch in for a week or two to give the primary caregiver a break. If you don’t have siblings in the area, ask relatives who do live close by or your parent’s friends or former neighbors to visit them in assisted living. This will probably give mom or dad welcome company, and also give you a chance to hear from a third party how they’re doing. Talking to anyone who your parent knows, trusts, and speaks with regularly will help you sort through what they may actually need. People who can visit often will see potential health issues or other problems that your parent doesn’t want to discuss directly with you. , Get involved with, and stay involved with, your parent’s medical care. If your sibling is the primary caregiver, let them know you want to be a part of this. It’s important to understand the conditions your aging parent has, the medications used to treat them, as well as possible side effects. It goes without saying that you will want to visit your aging parent as often as you can. The guilt often associated with living far away can be alleviated to a degree by maintaining contact. While it is not the same as being there, especially in the case of illness, these steps will give you the basis to be involved in your parent’s care and life.
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