Moving an Alzheimer’s family member to a nursing home presents a heartwrenching challenge for many people.  Some have made promises that they would never do this.  Others feel it’s their responsibility to care for their parent, spouse or sibling at home.

However, there comes a time, I realized, when I couldn’t care for my mother, and she couldn’t care for her sister any longer   Mother was developing Alzheimer’s when I had to make other arrangements for the sister with Alzheimer’s who lived with her.

Mother finally needed more care than I could give her when I moved her to the nursing home full time.  I had to realize I wasn’t superwoman and there was a point when both of us would become unable to function.

I had to make the decision for both Mother and Auntie.  I also had to help Mother adjust to Auntie being away from her.  These did turn out to be decisions that resulted in good care for both ladies and were decisions they eventually accepted with grace.

Moving one’s family member to a nursing home isn’t an easy decision.  It becomes emotionally draining and sometimes objectionable to other family members.  

When did you realize you had to make this decision? 

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When Did You Move Your Alzheimer’s Loved One to a Nursing Home?

“Take pictures of my Alzheimer’s family member!  I’d never want to do that,” you say. However, this can be enjoyable, both for you and your Alzheimer’s patient.  I’m pleased I have now, a series of photos of Mother and Auntie during those years.  Many of Mother’s I’ve placed in  a scrapbook, calling it Legacy of Love.

Included are photos of my grandchildren visiting their great grandmother and participating in activities and special events with her at the nursing home.  The photos bring back special memories for them.

Also, at the nursing home, the staff took photos of the residents (with the families permission).  When I coordinated a scrapbooking program with some of the residents, we used these photos.  How much fun they had looking at and recognizing (for the most party) the photos of themselves as we selected them for inclusion in this project.

So, keep your camera handy.  You may find you enjoy having these photos for projects and memories.

(Amazon image)

(c)2008 Mary Emma Allen

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Keep Your Camera Handy for Alzheimer’s Pictures

In my Alzheimer’s Word of the Week post last week, I wrote about nursing homes and mentioned some people didn’t like to mention the word.  Alicia, blogger at Mental Health Notes, wrote a very enlightening comment, which I think gives insight into the varying reactions to this term.

The term “nursing home” always strikes different emotions from different people, doesn’t it? I think it’s due to a variety of reasons (the poor reputations some nursing homes have, the idea that putting your loved ones in a nursing home is neglectful and selfish, the sad fact that some people actually do “dump” their loved ones in nursing homes and fail to visit them, etc.). It’s sad that, because of these things, those of us who’ve solicited the help of experienced, round-the-clock care are frowned upon by some people. When really, nursing homes are the only responsible options many people have.

The media, in their reports, often focus on the neagative aspects of nursing homes and mention those that may not measure up.  Many nursing homes do a great job, as I found with Mother and Auntie.  These ladies were well cared for in their respective nursing homes, a fact that  gave me peace of mind when I could no longer care for them adequately.  Then when I visited Mother and Auntie, I could relax and enjoy them, bringing them joy, too, I hope.

(c)2008 Mary Emma Allen

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The Positive Side of Nursing Homes for Alzheimer’s Patients

Yesterday I explained Sundowning in Word of the Week. I began thinking about Mother’s sundowning experiences. This wasn’t a big problem with her, but some crisis situations did occur in late afternoon.

I found her sundowning activities usually were connected to something she customarily did in late afternoon in her earlier life.  When I delve deeper into other patients’ sundowning, I’ve realized this often is connected with an afternoon event of former days.

*Feeding chickens - When I was growing up on the dairy farm, we also raised chickens and sold eggs.  We fed the chickens mid-morning and again in later afternoon.  After we discovered Mother regularly feeding invisible chickens in her back yard during her Alzheimer’s days, I finally realized the timing was that of her chicken raising days.

*Catching the bus – One day Mother slipped out of the nursing home and went to a nearby fast food restaurant where they also had a tourist information booth.  She tried to buy a bus ticket (of course, this wasn’t a bus stop) for her hometown.  Upon considering this, I realized that she often caught the bus home from her first teaching job on Friday afternoons after school was out.  She spent the weekend with her family, then returned by bus Sunday afternoons.

*Sneaking out of the nursing home -Another time she stuffed some clothing into her suitcase and eased out the back door of the nursing home.  Again this was late afternoon and she was looking for a bus to go home.  (After that, they hid her suitcase!)

Does your sundowning family member have an agenda that ties in with something they did at that particular time of day in earlier years?

(Amazon image)

(c)2008 Mary Emma Allen

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Sundowning in Mother’s Alzheimer’s Life

In recognition of   National Alcohol and Drug Addiction Recovery Month, the Health & Wellness Channel has initiated a project.  Various bloggers are writing posts revolving around the Twelve Steps of Recovery designated by Alcoholics Anonymous.  The bloggers have selected one or more steps to write about in relation to their own blog topic.  Then Liz Lewis at Healthbolt will compile them.

Although I didn’t participate by writing about any of the steps, I considered how this topic might relate to Alzheimer’s patients.  Do they become addicted because they are prescribed medications, depressants, stress relievers to enable them to cope?

When my mother was very agitated, even hostile, at the first nursing home where she stayed, her doctor prescribed a sedative that would calm her down.  I was new in dealing with a situation like hers, so thought her doctor and the home administrator would know best how to deal with it.

Then when that nursing home had financial difficulties and closed, I had to move Mother to another.  There they told me they used such medications only as a last resort and weaned Mother off the sedative.  She didn’t become more alert, nor could she coordinate her movements any better. But she wasn’t any worse without the medication.  Also, she seemed to stay at that plateau for quite awhile.

Could Mother have become addicted?  Would she have become an zombie but I thought it  Alzheimer’s.  I’m not saying she was over medicated.  But there was the possibility of this happening.  Do some patients need some medication?  Yes, but we, as caregivers need to enlighten ourselves and discover the various options.

For additional information, you may want to check out the series of articles at The Tangled Neuron about Beyond Drugs: Other Ways to Treat Alzheimer’s and Dementia.

(c)2008 Mary Emma Allen

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Can Alzheimer’s Patients Become Addicted?

One of the most frustrating aspects of caring for an Alzheimer’s family member or one with some form of dementia is their lack of need for sleep at night and their wandering when you want to sleep.  I found I cat napped and never slept soundly for the months Mother lived with us.

One of my Alzheimer’s Notes readers shares with us and asks for a solution:

I have a friend whose mother also has mild dementia and when she takes her turn at caring for her mother, she is up all night long.

We have had many conversations about what she and her sisters can do because they get no rest at all when they care for their mother. It is very frustrating for them and they have not yet come up with an answer.

Possibilities:

• Share the caregiving and try to alternate nights.  Or alternate day and night duties. This isn’t always possible, but see what you can work out.

• Talk with someone at a nursing home and see what they do. 

• Limit the area they can access at night.  I blocked off the stairs, the kitchen, and the office so there was only Mother’s sleeping area, living room, and bathroom available. 

• We locked the doors, so she couldn’t get outside.

• Put out snacks, magazines, and other items that might interest her in an area where there is a light on.

Do you have any suggestions?

(Amazon image; click image for details)

(c)2008 Mary Emma Allen

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How Do You Sleep When Alzheimer’s Patients Wander?

My husband and I have been on planes all day and just got home from a business trip.  This reminded me of flying with his parents, when we took them from New Hampshire to visit relatives in Utah several years ago.  Dad was beginning to get confused, but Mum was still very alert.  However, both needed assistance in getting around.

Jim and I realized we had to be with them all of the time so they didn’t get confused or lost.

Have you traveled with an elderly family member or friend?  Have you traveled with someone who has Alzheimer’s?

Do you have tips to share?

(c)2008 Mary Emma Allen

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Does Anyone Have Tips for Flying With Alzheimer’s Patients?

I think one of the most discouraging situations for Alzheimer’s patients, and possibly for family, too, is the “You can’t drive anymore scenario.”  This often creates a big hassle.

Even without someone having Alzheimer’s, there often comes a time when their reflexes aren’t so good,  their eyesight may be failing, stiff or arthritic joints keep them from moving swiftly, and their hearing may not be acute.  For someone who is accustomed to driving, loss of independence ,when they are no longer able, can be a shattering experience.

However, at some time, driving must be curtailed…before they injure themselves or someone else. 

*With my mom, an accident while driving, resulting in 14 stitches in her head and total damage to her car, made the decision automatic.  Although Mother wanted to get a new car, I couldn’t let her.  She was no longer safe on the road.  Just the day before this happened we were discussing how to take the keys from her.  This was a new situation, and we were trying to find out where to turn when Mother’s accident occurred.

With my father-in-law, the family began to realize he wasn’t a safe driver.  Discussion with him proved unsuccessful and somehow he found the extra set of keys.  So family members disabled the car and kept delaying “getting it fixed.”  He finally lost interest in driving and seemed content to let others drive him.

My neighbor’s aunt didn’t pass her sight test, and her doctor informed her that new glasses wouldn’t help enough to enable her to drive. She accepted this although she was frustrated and upset.

However, it often is very difficult.  They even may pass a driving test and receive a license renewal, when you know they’re not safe on the road.

Check out several  resources:

The Alzheimer’s Association – Driving with Alzheimer’s

The Hartford – Alzheimer’s, Dementia & Driving

The Mayo Clinic – Alzheimer’s: When to Stop Driving

How to determine driving ability in Alzheimer’s disease.

When to take the keys from Alzheimer’s patients.

(Amazon image: click for details.  Incidentally this is one of my favorite films and reminded me so much of situations with my mom, a very independent lady.)

(c)2008 Mary Emma Allen

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Giving Up Their Independence – When Alzheimer’s Patients Can’t Drive

 Giving up their independence and seeing their ability to do tasks by themselves slowly erode, becomes one of the most frustrating aspects of the disease for many Alzheimer’s patients.  They know something is amiss, but often don’t understand why they’re not allowed to do the ordinary, everyday activities on their own.  Or why they can’t do them.

• Driving – this becomes difficult to explain and for them to comprehend
• Staying home alone
• Going outside on their own
• Cooking
• Living in their own home
• Taking care of their finances

These are just a few areas that cause frustration as the Alzheimer’s patient loses their independence.  The loss of these capabilities can cause discouragement in the rest of the family as the dependence on them becomes more and more evident.  This causes changes in their lives as well.

How have you faced the loss of independence in your loved one?  How have both of you coped?  There’s no pat answer as every situation is different.  But learning how others have managed often can help.

I’ll share in future blogs how Mother, Auntie and my family got through these situations.

(Amazon image)

(c)2008 Mary Emma Allen

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Giving Up Their Independence – Discouraging for Alzheimer’s Patients

Caregivers, after all, are at great risk of back injury and would find this book useful for learning more about how to prevent and manage back pain.

Christine has been kind enough to write a guest post for Alzheimer’s Notes looking at ‘Three Tips for Avoidng Caretaker Injuries’.

The upcoming Olympic Games should inspire everyone to exercise and use proper body mechanics. These athletes compete at a high level and that requires them to take care of their bodies. Taking care of someone else requires you, as a caretaker, to tend to your own body. If you start to experience aches and pains, then tasks become difficult or impossible to complete. Preventing injuries can be as simple as remembering some basic rules of body mechanics: bend your knees, move your feet, and keep the elbows close. This simple strategy not only helps athletes perform at a higher level, but can also help caretakers avoid being sidelined.

• Bend Your Knees: Physically assisting a person out a low position and picking up something below the level of the waist are both scenarios which are best done with bent knees. Bending the knees allows the powerful muscles in the legs to support you; otherwise, the vulnerable back muscles bear the brunt of the work. The optimal position for these tasks is a squat position with the feet shoulder width apart, the knees bent, and the butt out. Weight lifters are the best ones to watch for learning this technique for squatting. Get into the habit of bending your knees and you will be able the assist people for many happy years.
• Move Your Feet: The body is naturally programmed to conserve energy which means that bending, twisting and reaching come naturally while moving the feet requires some thought. The feet transport the body. By placing your body closer to the objective like a glass of water on the other side of the bed, your shoulders and back are less likely to become injured than if you were to reach over that bed. Moving your feet uses more energy, but also gives you a mechanical advantage. Tennis players are always moving their feet because reaching for the ball just does not allow them to strike it with power. Unleash your feet and you will unleash your power.
• Keep Your Elbows Close: The shoulders are in a powerful, protected position when the elbows are close to the body. If the elbows are flapping in the breeze like chicken wings, the shoulder tendons (collectively called the rotator cuff) are at high risk for injury. Swimmers are commonly afflicted with shoulder pain which is why they are trained to keep their elbows close to their body. This technique allows for a more powerful stroke and protects the shoulders. Next time you make someone’s bed or do some laundry, try keeping your elbows by your side because that minimizes the risk of shoulder injuries.

Physical fitness does not win medals; body mechanics are the key to the podium. Understanding how to put your body in a powerful, protected position is the best way to control how you physically perform. Both caretakers and athletes need physical conditioning and proper body mechanics. Knees, feet, and elbows all play a critical role in preventing disabling injuries. Physical capability is a matter of strategically using these parts of the body. By remembering some simple rules and nurturing yourself, you will be able to continue nurturing others.

(Christina Lasich, M.D, is a concerned physician who suffers from spine pain herself. She has practiced in the area of spine rehabilitation for more than 10 years and is an award-winning graduate from the University of California, Davis School of Medicine. Although she focuses on back, neck and other musculoskeletal injuries, she also meets the rehabilitative needs of people with spinal cord injuries, strokes, traumatic brain injuries, muscular dystrophies, ALS, multiple sclerosis, amputations and other painful conditions. Dr. Lasich is the author of High Heels to Hormones: A Woman’s Guide to Spine Care.)

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Guest Post: Three Tips for Avoiding Caretaker Injuries by Christine Lasich, M.D.