Care and Trust...continued

Often, those with dementia become wanderers. A familiar stroll around the neighborhood can turn into a misadventure as steps become jumbled and surroundings become strange. This is even worse, of course, when it comes to driving. Those with dementia still want to be independent and driving is of supreme importance. After all, when a license is removed, the opportunity for freedom and social interaction diminishes creating isolation, dependence, and depression.  A good conversation includes these concerns and also potential remedies such as a walking partner or driving services. I also recommend that families contact law enforcement about concerns so that officers can learn walking routines of one who may become lost. A GPS device for shoes and/or an identification bracelet with an emergency number engraved on one side and the health concern on the other are vital.

            I recommend that beginning at age 50, people hold a yearly summit about worries, finances, health issues, purchases, and other transactions. By maintaining an open conversation, when problems do arise, much is already out in the open. No, you do not need to divulge deep secrets, precise monetary subjects, or other private material, but honest talk now alleviates some stress of burdensome conversations later. Perhaps spouses, children, and other significant relations may not agree, but at least they are fully aware of wishes and requests. In later family gatherings, if dementia has appeared, realize that your loved one may not be able to assess multi-step processes and questions. A little at a time, a few subjects on the table, will provide the most positive results. “To be continued” is recommended.

            This should probably have come at the beginning, however, I wanted to emphasize the worthiness of building trust and personal reliability. Hopefully your loved has recognized some cognitive decline – forgetting dates, losing valuables, feeling perplexed about decisions – and has already suggested a complete medical examination by a neurologist or gerontologist. Self-analysis is undoubtedly the best way to pursue the most beneficial health diagnoses. But sometimes, denial is far easier and so you, as the caring and devoted family member, may be the one to broach this somewhat uncomfortable conversation. Knowing that an abrupt refusal may greet you, plunge on accepting that your concern is of utmost significance.

Care and Trust

With holidays approaching and family and friends visiting, it is essential to maintain calm and safety for loved ones with Alzheimer’s disease. There is nothing like a ruckus to set off a fuse; being prepared can circumvent that. The more I have thought about appropriate behavior and reactions toward those with dementia, the more I understand that this is the way we should treat everyone – with dignity and respect.

Always approach a loved one from the front so that eye contact is made and safety is assured.  Speak calmly and evenly with no excess inflection or tones that sound accusatory or gruff. A soft, gentle voice is relaxing and is likely to encourage conversation. Although this conversation may be one way, primarily you speaking, you may find that your loved one engages. While this back and forth conversation may be confusing with responses off topic and strange, the sound resonating from this interaction is precious.

If somewhere during the visit your loved one becomes agitated, frustrated, or angry, again remain calm, nodding in agreement even when you are completely baffled with what is transpiring. Kindness goes a long way in helping comfort someone with dementia. Arguments and raised voices only exacerbate the situation transforming a slightly out-of-kilter moment into a disaster which is difficult or impossible to remedy. You will never “win” an argument with someone with Alzheimer’s disease so relent, throw in the towel, and return to being that serene, supportive friend. You may need to remind other family members to avoid confrontation as well. There may be pressing issue about long-term care and future health choices that need to be discussed, but yelling about these solve nothing.

When the family gathering includes the above-mentioned conversations, be sure to include your loved one. Even in the deepest throes of dementia, the individual still possesses minutes, seconds, even milli-seconds of lucidity. No one likes being talked about or being talked over, so deliver this same dignity to someone with cognitive decline. Those with dementia can be amazing as well as wily, explaining or responding to one idea with clarity and to the next with utter bafflement. Grab the lucid moments and hang on to the treasure that they are.

Tips for Getting and Staying Connected

          Here are a few tips for getting and staying connected to enrich your body and your soul plus these can provide a tremendous surge in brain stimulation. First, nurture existing relationships as you cultivate new ones. You have to be a friend to have a friend so schedule time and energy to share with others. Remember, too, that there are many lonely people - become a friend to someone who needs one. You might just offer the magic elixir for good health.

          Schedule time for friends as you schedule private time for yourself. Life is busy - we can get going about 300 MPH and lose track of something very important - our friends. Call, set a time and place, then follow through. And sometimes, after all of those friendly visits, you just need some down time, time to think, reflect, take a walk, write a letter, or curl up with a cozy blanket and a wonderful book.

          As you find more time and energy in your life because of the way you have scheduled time and improved your life with good friends you will find to have time to volunteer. Volunteer to help out to the degree you feel willing and capable. Volunteer where your heart speaks and your soul directs -  at a school, for respite, to assist a friend.

          This next one comes almost automatically if you have followed the guidance of the aforementioned suggestions. Become involved and socialize. Doing something important adds life value and personal spirituality. You can and do make a difference.

          Perhaps one of your new goals (yes, yes, yes) is taking up a bit more physical exercise. Remaining physically active means that the more you do the more capable you become. Perhaps your new friend loves to bike. Maybe your old buddy is into weightlifting. Or maybe you are feeling brave and are ready to launch out into something new and different all on your own. Just do it!

           Empower your brain by taking a class, learning to play an instrument, or immersing yourself in a second language. A little challenge to your mind is a wonderful thing. Although at the outset you may sense some frustration, that's OK. It just means that your brain is filling to capacity with a super new subject or activity. This is good for you and promotes brain growth and mental power.

          No matter what you choose, your brain and your body will love these activities just as you will love yourself more!

Get Your Brain Activated

The following are some tips to keep your brain operating at maximum capacity:

•      Mental flex – keep your hands busy as well as your mind – knit, crochet, paint,   color…
•      Call a friend or family member today and share a happy story with him or her.
•      Tell the world why brain health is important to you and your well-being. 
•      Encourage friends to become involved with keeping a healthy, active brain
•      Enjoy a home-cooked meal - too much eating out is not good for your health
•      Get your body in the game - get rolling in some action
•      Do not be sedentary but rather be up and moving - good for the body and the      soul
•      Complete 3 yoga poses morning and evening plus 3 focused breathing sessions – in through the nose and out through the mouth for 1 minute.

Fully knowing and understanding your family medical history now – to the best of your abilities – will impact not only your health, but the health of most of your family members. You might know your family tree, but now it’s time to learn your family medical history. Schedule time to sit down with your relatives to learn more about the health risks you might face. Write down what you learn and keep a file for your records.

Ouch! That Hurts!!

Ouch! is a video supplied to me by the Alzheimer's Association. In a quick 12 minutes, viewers observe scenarios and listen to conversations that include language that can be hurtful, indiscreet, and just plain wrong. While none of these snippets directly speak to Alzheimer's, they cover a wide range of inappropriate comments that people may make, things like, "You don't have an accent!" (when the speaker appears to be non-white) or "Sally can work overtime - she doesn't have any kids." The film provides optional responses when someone's comment is hurtful.
First, and I often struggle with this, is assume there is only good intent. Sometimes phrases are so common place that the speaker does not even realize the implications. This is your chance to respond with, "Using the word dementia that way makes it sound contagious and frightening. Dementia has so many more aspects."
The second option is ask a question, "Have you ever thought about that saying 'go back to your country' cause mean trauma, fear, and heartache? Many humans who you have grouped together are refugees who have fled brutality and possible execution."
Third choice, interrupt and redirect, "Talking about Joe without him here to intervene is demeaning. Let's wait until the three of us can sit down and talk this out together.:
Make the statement individual, "When you say all employees are bigoted and uneducated, do you include me in that category?"
And finally, when words of explanation escape the brain, there is the option of just replying, "Ouch!" That short word says so much and exemplifies the pain, the humiliation, the trepidation that negative remarks involve.

Vulnerability

Well, a month plus has passed and finally I am returning to this blog. I just completed listening to the audio of Dr. Brene Brown's, The Power of Vulnerability. While I first started it as a sort of "self-help" recommended by my daughter, I have found Brown's to hold so much more. Listening and then re-listening and taking notes, has really opened my eyes to me, my reactions, my ways of thinking and doing, leading to a better understanding of myself and of those around me. The big takeaway (for today, at least) is vulnerability, the vulnerability we feel when deciding to open up a discussion about our own cognitive decline or the decline of someone we love.
We are vulnerable when we toss out a "hot topic" as we quickly thumb through so many possible reactions in our heads: Will the listener be scared? Will the listener have too much advice? Will the listener turn away and run? Will the listener pass judgment and then I will find myself on the fringes of my own problem?
It takes bravery to step forward with honesty and determination. It takes courage to ask someone to pull back on the reins and just listen, not jump in with advice. It takes gumption to speak up about the unknown. It takes a special friend to really hear, ponder, and care.
I have a group called "Let's Talk About It". Although I have been trying to build this group for nearly one year, it is still in the fledgling stages. At times I have several attendees, but primarily it is only me and maybe a casual drop-in. As I have wondered about how to expand this outreach, I realize now how vulnerable people must feel when deciding to open up on a painful topic such as Alzheimer's or other dementia. I must continue to be kind, to exude trust, to let people know of my group, and then to hope I can make a difference and be that special friend that someone needs.

The Longest Day

Today, June 21st, is, of course, the longest day - more sunlight and bright light than any other day of the year in the northern hemisphere. The Alzheimer's Association recognizes that for caregivers and those with Alzheimer's and other dementias, the Longest Day may very well be every day. As these diseases progress, the cognition of the loved one diminishes as the needs expand and grow. What once took just a few minutes, like putting on shoes, for example, can turn into a wrestling match of a half hour. I naturally recommend that you abandon any shoe-putting-on to a very short time. If you are having to force and shove, wedge and push, anxiety will surely increase making the task harder and perhaps even impossible. Resolve that the shoe task is ridiculous and then revert to slippers, simple slip-ons, or bare feet if appropriate. Making life simpler is an excellent way to decrease stress and confusion.
Your community probably has events planned in conjunction with the Alzheimer's Association. These activities fund Alzheimer's research through generous donations from individuals and groups. Contact me to learn more about our Arts and Crafts Extravaganza tomorrow and our Sprint Triathlon July 4th or visit www.adf-winnemucca.com
If a group event is not to your liking, try some random acts of kindness for someone (or someones!) you care about - a walk, lunch out, a shopping spree, an ice cream cone. You can truly light up the life of someone who is isolated, lonely, and in need of personal connection. Caregivers and those receiving care both deserve special recognition and thoughtful gestures.