Archive for June, 2014

Top Tips For Managing Dementia Related Anxiety

Alzheimer’s upsets memory, thought processes & speech; also behavioural changes such as agitation, confusion, distress, hallucinations and false beliefs.

We are born unable to do many things and have to learn them. In Alzheimer’s it appears people unlearn these things again, going back to earlier behaviours.

The Film ‘The Curious Case of Benjamin Button’ illustrates the unlearning of social inhibitions, which include what is acceptable to say, or what to do, or even being unable to use the bathroom or feed ones-self. (All of which is perfectly acceptable or even cute, in an infant!)

There may be physical reasons for the anxiety state such as infections (urinary tract infections are common in dementia), drug side effects, pain, hunger, thirst.

Feelings remain, even when facts are forgotten

So a happy occasion can be ‘spoilt’ by a sad farewell.

Plan ahead for:

Happy exit strategies – (for example say ‘I’m just going to the loo’)

Explanations for absent folk – (for eg say ‘‘remember he was often working)

Affirming moments – (such as ‘you always were good at jigsaws’)

Reasons to sit rather than follow around – (tell me ‘we don’t want you to conk out’)

Calling someone by the wrong name means that the person knows you are important to them, even though they do not remember exactly who you are.  Not knowing your name might mean at that particular time that they have no idea who you are, so tell them.

Situations that can precipitate an anxiety attack:

  • Unfamiliar Surroundings
  • A task that is too complicated
  • Difficulty in Communicating
  • Travel
  • Crowds
  • Illness
  • Noise

Strategies for managing anxiety 91 years of life

1.      Introduce yourself.

2.      Don’t ask questions.

3.      Don’t overwhelm them

4.      Simplify or calm their environment.

5.      Reassure, and show them what they should do.

6.      Remove or reduce stress triggers –

  • Noise – turn music down or off
  • Lighting – switch more lights on or off
  • Too many people – take them to a quieter place

7.      Change to a more familiar activity or make a cup of tea.  Perhaps remove them from the situation and take them for a walk or a car ride.

8.      Music can calm and reassure.

9.      Talk about hobbies, passions, or subjects that meant a great deal to them earlier in their life.

10.    Videos or pictures of events or outings.

11.    They might not be able to distinguish dreams from reality. Don’t  laugh or call them a liar.

This post is based on work undertaken by Dr. Jennifer Bute a retired GP who is living with the early onset Alzheimer’s Dementia 

Mother Teresa's Anyway Poem

People are often unreasonable, illogical and self-centred; Forgive them anyway.

If you are kind, people may accuse you of selfish, ulterior motives; Be kind anyway.

If you are successful, you will win some false friends and some true enemies; Succeed anyway.

If you are honest and frank, people may cheat you; Be honest and frank anyway.old-people-beauty-care

What you spend years building, someone could destroy overnight; Build anyway.

If you find serenity and happiness, they may be jealous;
 Be happy anyway.

The good you do today, people will often forget tomorrow; Do good anyway.

Give the world the best you have, and it may never be enough;
 Give the world the best you’ve got anyway.

You see, in the final analysis, it is between you and your God;
 It was never between you and them anyway.

[Reportedly inscribed on the wall of Mother Teresa’s children’s home in Calcutta, and attributed to her. However, an article in the New York Times has since reported (March 8, 2002) that the original version of this poem was written by Kent M. Keith.]

Top Tips For Choosing a Care Home For People Living With Dementia

 I have covered the subject of choosing a care home before but get asked about it so often I thought I would cover it again and aim it specifically for people living with dementia so as to draw on my own experience of choosing a care home for my mother.

Moving into their final home is a life-changing event for your elderly loved one and paying for long-term care is the second greatest investment a person will make in their life after a mortgage. Make sure you get independent, specialist financial advice and spend the necessary time to match their needs, expectations, uniqueness and life style to your ultimate choice. Alternativey get a professional like Relative Matters to help you.

 

Local Authority Funding   

To be eligible, a person needs less than £23,500 in savings/assets including their home and a significant or critical level of needs

If you and the Council agree your loved one needs to go into a care home, they must arrange it if the person can’t do it themselves and no-one is willing or able to act for them. This applies whoever is paying.

Your loved one has a right to a place in a care home ‘that meets their needs’, as specified in their written assessment, even if it is in a different county.

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  • You can get a list of care homes in the area your loved one wants to live by contacting their Local Authority Social Services Department, or the one in the area they want to live
  • Make a list of the homes that 1) are in the desired area 2) are the type of care home you are looking for (dementia or dementia with nursing)
  • Check selected homes are meeting national care standards. You can do this by going to the Care Quality Commission (CQC) website click on ‘care homes’ and enter name of the home.
  • Complete a care home profile with your loved one that sets out what is important to and for them. If they are unable to contribute themselves, ask people who know them well or put yourself in their position and choose for them.
  • Make appointments to view the homes, with your loved one if possible. A glossy brochure is no substitute for a visit! Only show them two at a time or you will confuse them.
  • Make a list of the key questions you want to ask when you visit care homes. Age UK offer a  checklist to help with this and provide other useful information about choosing a care home.
  • Your attention and questions should relate to the care home profile you have developed for and with your loved one. Here are a few questions I asked when researching a home for my mother.
  • Can you give an example of how you retain a person’s sense of identity and self worth?
  • How is dignity and respect embedded in practice?
  • How do you meet the communication needs of people with dementia? (I was looking for things like “maintaining a calm environment, reinforcing the need to approach people in a calm sensitive way, treating people with dignity and respect etc.
  • How do you manage difficult behaviour? I was looking for an answer that goes something like “There is always a reason and we try to find out what it is and seek help from other professionals when necessary” etc.
  • Does the home have Wi-Fi? (Needed for Mum’s iPad)
  • What training is in place for staff about dementia? I was looking for a regular training programme that included relationship-based memory care, which uses a compassionate, innovative, respectful method of dementia care that keeps clients calm and staff members engaged.
  • What is your policy for end of life care? Do residents have to move to hospital or a hospice? Are you linked to a palliative care or end of life team?
  • If your loved one has to fund their own care, ask what would happen if their money runs out after a year or so. Would the home be prepared to accept the council’s standard weekly rate?
  • Remember who you are choosing the home for and look at things from their perspective