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Come read Raya’s Paradise blog about assisted living Los Angeles.
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- Create A Distraction-Free Zone: Background noises can distract anyone – even those with no cognitive challenges at all. But for a loved one suffering from Alzheimer’s disease, the television, radio, or other device can easily compete with your conversation. Give your loved one’s conversation your full – and undivided – attention in a peaceful environment.
- One-On-One Conversation: While it may sound silly, having multiple individuals gathered together for conversation can create an overwhelming and highly confusing environment for your loved one. After all, the more individuals who are present, the more apt each party is to contribute to the conversation. It can prove to be extremely agitating to your loved one, whose brain may still be trying to process what has been said as well as who has offered the input. Keep the conversations simple – one person at a time.
- Simple, Lighthearted Conversation: There’s always something to be said for small talk, but especially so when your loved one is experiencing cognitive decline. Most of us are taught to converse with others using open-ended questions to spark conversation. However, for an Alzheimer’s patient, this leaves entirely too many choices. Remember, your loved one may not remember the significance of certain titles, such as “nurse.” Therefore, he or she may ask questions like, “What’s a nurse?” Combat these challenges by simply referring to your loved one by name, and referring to yourself (or another person) by name. It helps the Alzheimer’s patient to orient themselves. If you’re speaking to your loved one about an animal, address the animal either by name (if it’s a pet) or by species (for example, “cat”) instead of saying “it.” Again, it helps your loved one keep track within the conversation.
- Be Patient and Non-Combative: It is easy to understand how difficult it becomes for you, as the loved one of a person suffering from such a debilitating disease, to repeat yourself or explain the who-what-and-where’s of very familiar things. But engaging in arguments will most likely end in one result – agitation for yourself and your loved one. Stay calm and repeat yourself if necessary. If your loved one seems to be having difficulty in making a request, do your best to state the question you feel he or she is attempting to ask. For example, if your loved one is fumbling around for something on a table nearby, you may say, “Are you looking for a tissue? Are you looking for your glasses?”
- Watch Yourself! Everyone understands that non-verbal communication is as important as, if not more than, verbal cues. Cognitive decline, especially as it progresses, will undermine a person’s confidence as simple, routine tasks become increasingly more difficult. Thus, your loved one is likely to be highly sensitive to everything you say and do. The tone of your voice and your body language is important. Expressing your acceptance with friendly eye contact and kind facial expressions is important. After all, the goal is to maintain positive communication with your loved one and to minimize feelings of confusion or distress which may lead to negative, hostile reactions or to your loved one “shutting down” due to feelings of isolation.
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- Moving tables and furniture out of high traffic areas to keep travel areas free of obstructions.
- Securing throw rugs or taking them up if that’s not possible.
- Making sure walkways are properly lit (this will especially help those with vision impairments).
- Adding non-skid mats to bathrooms and bathtubs, along with hand rails.
- Buying a raised toilet seat with hand rails.
- Installing grip rails where they’re needed.
- Insuring that there is room for the use of mobility aids such as a walker.
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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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.
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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Alzheimer’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.