How to Deal with Dementia Behavior



When your parent or loved one is diagnosed with Dementia, it poses challenges for you as the caregiver especially as the disease progresses. Some dementia sufferers show very minor signs of bizarre behavior but others may exhibit behaviors that can be embarrassing, frustrating and exhausting.

My mom would take off her shirt and expose herself when she was staying at the group homes as well as the assisted living facility and nursing home. Since then, she has not exhibited that behavior as often and she’ll only do it once in a blue moon. But it’s ok because she’s in her own home now and no one else can see her but us. Nevertheless, there are ways to deal with common behavior problems in dementia sufferers.

Communication

  • Get rid of distractions such as the TV or Radio in order to maintain eye contact with the confused person. When there’s not so much going on in the room, the person may be able to focus a little better.
  • Use short and simple sentences and give only one direction at a time. This one could be a little difficult, because you have to change the way you speak and sometimes you forget that the confused person may not understand what you are saying.
  • Try to make an effort to be very expressive in communicating. For example, use alot of hand gestures or pictures when trying to communicate to the person. My mom understands us without having to do all this, but whatever you think will help or you see helps, you should definitely give it a shot.
  • Sometimes, and we are all guilty of this from time to time, we tend to talk down to seniors as if they are children. I don’t know how that came to be, perhaps because of negative cultural stereotypes, but it’s a No-No. Seniors deserve dignity and upmost respect even when they are no longer able to comprehend what’s happening to them. Therefore, when talking to your loved one, speak to them normally but just repeat yourself if they do not understand.
  • Try not to bring up subject matter that your loved one can no longer remember. Usually, these are things that are in the short-term. My mom remembers a lot of things that happened 20-30 years ago. It’s funny how that works, but we always talk to her about my brother-in-law (who passed away in 1994) and things we did, trips we made, etc. She remembers all of it!

Wandering
This is a scary one. Sometimes it can have tragic consequences. Fortunately for us, it was the first and last time it would ever happen again. (She is monitored closely and unfortunately she no longer walks.) My mom wandered off last year and was gone for a few hours before my father even noticed. Both my sister and I received a call from the police when one of their neighbors discovered her by their car. Luckily, my mom only made it to the parking lot directly in front of their apartment. (This is a huge complex.) My father only discovered her missing when the police knocked at their door. He thought that she was in her room the whole time. With his disability, he wouldn’t have been able to search for her without assistance. My mom was a little dehydrated and confused, but otherwise healthy.

  • My mom and dad’s old apartment did not have special locks, just the normal ones you see. My mom wandered off, despite our hand-written signs telling her not to leave. So you may want to consider either changing the locks or if you can’t do that, install one of those door bell alarms that signal that the door is opening or closing.
  • You can try a sign, though I would suggest buying one that looks like a stop sign or “do not enter” to see if that works. As I stated above, our handwritten signs didn’t work.
  • Try child-proofing doors. You can find doorknob covers at Walmart or other store that sells child-proof supplies.
  • Put away items that would remind your loved one of leaving, such as: their coat, keys, glasses, etc.
  • Have your loved one wear some kind of identification. We bought our mom one of those gold necklaces that had our phone numbers on it. This is how the police were able to locate us. She also carried an identification card that I made with her medical information (doctor, medicines, her condition), our phone numbers and her age.
  • Alert the neighbors that your loved one is a wanderer and give them your contact information.
  • It may or may not help, but if you allow your loved one to have regular exercise, it may decrease the need to want to get up and wander.

Incontinence
I think this is one of the worst aspects of it all besides agitation/anger. This is the most stressful thing, in my opinion, more than the bizarre behavior. Unfortunately for my mom, she suffers from both fecal and urinary incontinence. She started having accidents about a little over 2 years ago.. We cautioned her not to eat too much fatty and lactose laced foods. While that was a partial reason for the incontinence, the dementia also plays a major role.

  • Establish a routine. I would try to bring them or encourage them (if they are able) to use the bathroom every 2 hours. You may want to set an alarm as a reminder.
  • Try to avoid drinks that would cause them to go the bathroom a lot, such as: coffee, soda, beer, etc. Avoid foods that would cause them to get an upset stomach. Limit intake of fluids before bed.
  • Purchase a commode and place it next to their bed so they don’t have to walk very far to use the bathroom
  • Use adult diapers or pads, whichever is appropriate. Our mom has to use full diapers, pull-ups and straps.
  • Use adaptive clothing, if your parent likes to fidget with things. (Our mom would remove her diaper all the time, and accidents occurred, we bought her an outfit that zips down the back instead of the front, so she couldn’t take her clothes off.)


Angry/Agitated Behavior
For us, this is the worst part of it, besides the memory loss. Here is your loved one, they were in control all of their lives, all of a sudden, they are not. They can’t control themselves emotionally, mentally, physically. It’s heart-wrenching to see them go through this. It is because of this reason that we had to move our mom back home. The nursing home couldn’t handle her outbursts, the dementia-ward at the assisted living center could not control her endless pacing, yelling, crying, etc.

  • Take your loved one to the doctor to rule out any medical causes. Sometimes it could be something simple such as a bladder infection and because your loved one is confused, they may not realize it. Unfortunately, we tried everything as listed on this guide and nothing worked. My mom is now on anti-psychotic drugs to calm her mind, but on the flip side, she’s very groggy. This was the last resort and it was something that was started at her stay in the nursing home shortly before moving her back home. Drugs are the last resort and if you can use other methods, you should.
  • Reduce outside noise, and other distractions in the room. Familiar objects and/or photograph
    s may help them feel more comfortable and may facilitate some pleasant memories.
  • Soothing music, gentle touch, reading or a peaceful walk may help with the agitation. Do not try to restrain your loved one if they are behaving irrationally, it only makes things worse. Instead, try the methods mentioned to try and calm them down.
  • Typically, agitation dementia sufferers will start to become more agitated in the twilight hours before and after the sun sets. This is called “Sundowning”. The reason is not known, but it is believed that increased shadows might cause some confusion.
  • Keep requests short and simple. Instead of asking, “What would you like for dinner?”, say, “Here is what we are having for dinner.”
  • Let your loved one know that you understand why they are frustrated.

Repetitive Speech/Actions

  • If your loved one asks the same question over and over, try not to remind them that they already asked the question. Instead ,either ignore it (which works sometimes) , or try to distract them after you reassure them that you acknowledged what they asked.
  • Make sure the loved one is not in pain or suffering from any medication side effects.
  • Your loved one may fidget at times. This is something that my mom does from time to time. She’ll try to “sew” or she’ll pull on her buttons or something to keep her hands busy. This is all part of the effects of dementia. I would just give them something safe that they can hold, like a ball of yarn or just allow them to be.

Traveling

  • Do not try to negotiate with your loved one about traveling. Instead of asking things like, “Are you ready to leave?”, say something along the lines of “Here is your coat and purse.”
  • Just like you would your own children, reassure them that everything will be OK. New and difference surroundings can make them anxious.
  • If you take a vacation or go on a weekend trip and take your loved one, make sure you take someone else to help you out.
  • If you have to wait somewhere, bring things to occupy your loved one such as: cards, snacks,etc.

Miscellaneous

  • Bathing: If bathing is a problem, you can skip a day unless they have soiled themselves heavily. There are products including sprays and wipes that you can purchase at your local drug store to help clean and deodorize your loved one. Adjust the temperature accordingly.

*credit- SCRC
Back to Top

Share

Eldercare: Hiring In-home caregiving

This is one of the hardest aspects of finding care for your parents. If caregiving on your own is impossible or just too overwhelming (In our case, caring for 2 people with different needs and conditions, was just too much for us to handle among everything else) then it’s time to hire in-home help IF you don’t send your parents to an assisted-living facility or other residential or nursing care home.

The type of help you will need will depend on what you think will be beneficial to you and your parents. It’s probably very similar to hiring a nanny for your children. You don’t want to pick just anyone off the street. You want to be able to choose someone that you can entrust your parents’ care. Seeing and hearing about horror stories on the news can make you paranoid about trusting people.However, there are good people out there and it’s just a matter of how to go about getting them!

What are the Options?
Probably the easiest but most expensive way is to hire a helper from a home health agency. You can find them in eldercare directories and also the Yellow Pages or other local phone directory. However, keep in mind that agencies will charge anywhere from $13.00-25.00 or more per hr and extra for special needs and/or 24 hour care which can run about $265/day more or less. If your parent needs 24 hour care, even worse, both parents need 24 hour care, the costs can skyrocket to upwards around $5000-6000 +/ month not including your daily living expenses and other costs such as mortgage or rent. This is the reason why many people end up sending their parents to outside facilities or carrying the burden on their own.

If however, you can afford this, more power to you!

Most others however, like us, will look to hiring privately.If you decide to hire in-home help for your loved one(s), you’ll probably want to figure out what exactly you want the caregiver to do. Typical duties for an in-home caregiver are usually custodial in nature, that is, assistance with daily living. Your parent may need help with bathing, dressing and feeding. The caregiver may also do some kind of light housekeeping and home maintenance tasks to assist your loved one. You may want to draw up some kind of formal contract explaining what will be covered: any benefits, hours of duty, employer-employee relationship, etc.

You also may want to decide how long you’ll want in-home help. Will this only be temporary? Long term? A few hours a week? or 24 hour care? Depending on your budget and needs, you may only be able to afford someone temporarily or as a back up to you if you are taking full responsibility for your loved one’s care.

How to Find Help
One of the best ways to find help obviously is through networking with people you already know. Sometimes you may get a personal recommendation from a relative or friend, your church or synagogue, senior centers, health facilities, etc. (We found our caregiver through a board-and-care we had our parents at last year. She was a former employee there and she has been a God-send to us).

You can also look at search agencies who will help locate a caregiver for you based on your criteria. Unlike a home health agency, search agencies act more like employment agencies. They find and locate a caregiver for you based on your criteria. You then interview the prospective applicants and you and the chosen employee will negotiate salary. The search agency only gets the referral fee if the caregiver is placed in your home.

If you can’t find help with any of the suggestions listed above, your last resort is to place a classified ad. You can post on your local newspaper or post help-wanted cards at grocery stores, senior centers, or you can even post an ad on free online classifieds like Craigslist or join a membership website such as Respite Match Respite Match is a comprehensive classified ad service geared towards both the client and also healthcare professionals looking for work. It provides tools such as background checks, as well as offering a free profile search for visitors to the site.

You don’t have to personally interview every single person who applies for the job. You can choose to have someone else interview them, or interview them over the phone, whatever your preference may be. As with any job, you should always give them an honest description of what the job is going to entail. The level of experience will vary, and it is up to you to decide how much experience you want the caregiver to have. Most importantly, in my opinion, is the caregiver’s character. It doesn’t matter how much experience they have, if they are not compassionate, patient, trustworthy and dependable. Finally, it’s always wise as with any other professional you hire, to call the applicant’s references.

I would suggest checking theIRSwebsite to see the latest rules for employee classification.

Hiring outside help is tough. You may not be happy with the first 1, 2 or even 3 you may hire. But once you find what you are looking for, you may develop a great relationship with that person, both as a working relationship and a personal one. Good Luck!
Back to Top


Reblog this post [with Zemanta]
Share

Nursing Home – Things to Look For


You can use this list for basically any type of housing that you choose outside of the home. However, this will apply mainly to that of a nursing home.

  • Does the Administrator or Manager appear to know the residents or are they oblivious?
  • How are residents treated? Is the staff condescending or do they treat them with dignity and respect? (I hate it when people say, “honey” to me, so I’m sure an elderly person’s family members may not appreciate it)
  • Do they respect the privacy of residents? i.e. not barging into room or leaving the door or curtains open for everyone to see.
  • When assistance is needed, and the alarm cord is pulled, does the staff respond within a reasonable amount of time?
  • Resident Rooms

  • Which area of the home will the new resident be assigned a room?
  • How the rooms look? Is there enough space? Does it look safe? Are the colors vibrant or do they look blank like a hospital room?
  • Do residents have to share rooms?
  • Is there a call button near the bed in case of emergency or if they need assistance?
  • Can residents decorate their own rooms and have their own furniture?
  • Resident Lounging Areas
    Is there a place where residents can relax and watch TV? like a living room?

  • Are the lounges clean and comfortable?>
  • Activity Areas

    • What kind of equipment is laying around? Are there billiards tables? Are there card tables?

    Activity Programs

  • Are there activity calendars posted? There normally are in these types of facilities, but just in case, ask the front desk or the activities director for a description of scheduled events.
  • Are the activities varied?
  • Do residents have a role in planning the activities?
  • Are there any activities for those who cannot leave their bed?
  • Religious considerations?
  • Safety

    • Is everything well lit, including stairwells and halls?
    • Are their handrails alongside the walls?
    • Are there fire extinguishers available?
    • Are the floors clean and non-slippery?
    • Is there an obvious odor? If you smell urine and body odors, either there is inadequate nursing care or poor housekeeping. Heavy air fresheners used to cover up the smells may be a substitute to proper care and maintenance.

    Occupational and Physical Therapy Rooms

    • Is there a variety of equipment available?
    • Are the rooms being used?
    • How many people staff that department?

    Kitchen and Dining Areas

    • Is there adequate ventilation?
    • Are the refrigeration units big enough?
    • Are sanitary practices good?
    • Is the dining area pleasant, clean and comfortable?
    • Are residents encouraged to eat there and is it large enough to hold most of the residents?
    • Is there room for wheelchairs?
    • Does everything seem to be in order during mealtime or is everything chaotic?

    Food

    • It’s good to visit during lunch, but any mealtime is good. How do the residents react when food is presented to them?
    • Are they getting what is listed on the menu?
    • What kinds of dishes and utensils are used?
    • Does the food look good and appetizing, does it smell good?
    • Do the residents seem to like the food?
    • What happens if a resident is sick and are unable to eat in the dining hall, is food brought to them in their rooms?
    • How often are meals prepared? Are there alternatives?
    • Who plans the meals? If the facility doesn’t have a full or part-time dietician, there should be consultations with the residents. Some considerations should be made for ethnic foods unless the resident is prescribed a special diet by their doctor. **California Law requires that no more than 14 hours elapse between the evening meal and breakfast and that bedtime snacks are offered to all residents.

    Baths and Showers

    • Where are the bathrooms at? Are they conveniently located throughout the facility?What about the resident’s room?
    • How many patients share a bathroom? Is there a private bath available?
    • Is there a call button or rope located near the toilet?
    • Check on the showering schedule

    Other Services

    • Is there a social worker on staff? /li>
    • What kind of transportation is available for trips to the doctor, store, community functions, etc.?
    • Are there dental services available? or other medical services?
    • Are there laundry services?
    • Are there personal care services such as: barber, nails, hair dressing? When? and How much?
    • Are there religious services available?

    All of these questions serve as a guide. It all boils down to how you feel about the place. No question is a dumb one, and you should ask as many you feel like. If the staff and facility are honest and genuine, they should have no problems repeating themselves or listening to your concerns. It doesn’t matter how reputable the establishment is, only how you feel inside. Only you know your parents best and know what’s good for them.
    Back to Top

    Share