Find tips to help with the changes that occur through the stages of Alzheimer’s from the Phoenix senior care experts.
When a loved one is diagnosed with Alzheimer’s disease, families are faced with a number of questions and challenges. How will the disease progress? What changes will I see in my loved one? And how am I going to handle them?
It’s important for family caregivers to equip themselves with as much information as possible about the disease, and this includes creating a plan that is proactive enough to address the current needs, while preparing for those yet to come. While each person experiences the stages of Alzheimer’s uniquely, there are some commonalities to keep an eye out for, particularly as it relates to changes in the person’s personality, mood, and the behaviors that stem from those changes:
Increased agitation, anxiety, and irritability
Loss of interest in once-enjoyed activities
Pacing and wandering
Physical and/or verbal aggressiveness
Difficulty understanding the world around them
Poor hygiene habits
Problems with falling or staying asleep, and differing sleep patterns
Physical challenges such as problems with vision and/or hearing
And many others
These effects may also come and go as the person progresses from one stage to the next, and new challenges then become apparent. And understandably, trying to help someone who’s experiencing such a wide array of emotions and behaviors can quickly become overwhelming for family caregivers.
Try these tips to bring comfort to a loved one with Alzheimer’s, from the Phoenix senior care experts at Nightingale Homecare:
Minimize distractions. Often, confusion and frustration are enhanced for someone with dementia when there’s an overload sensory stimulation, such as the TV or radio playing while others in the room are talking.
As much as possible, stick to a daily, predictable routine.
Avoid open-ended questions, and instead provide choices; for instance, “Would you like chicken or fish for dinner?” is often more effective than, “What would you like for dinner?”
Never correct or argue with the individual.
Use statements that reflect the person’s feelings rather than the behaviors that have manifested from those feelings: “It looks like you’re feeling angry today,” rather than, “Why are you banging your fist on the table?”
While it’s natural for family caregivers to feel upset or frustrated themselves when a loved one’s feelings are elevated and behaviors are difficult to handle, it’s also vitally important to maintain a sense of calm, even in the face of distress. The senior will pick up on your agitation, often leading to escalated behaviors. Take a step back, breathe deeply, and count to ten before responding to the senior’s needs.
At Nightingale Homecare, our specialized Connections dementia care program helps those with Alzheimer’s by utilizing a unique, creative, and compassionate approach through qualified Alzheimer’s Whisperers® who are extensively trained in effectively managing the difficult behaviors that often accompany dementia.
We begin by providing an in-depth evaluation, and then create a customized strategic plan to fully meet the person’s needs while empowering him or her to maintain the highest level of functionality at all times.
Discover the importance of learning life stories when providing dementia care.
When we are working with those diagnosed with Alzheimer’s, it is important to know their stories. What is their history? Where did they live? Who comprised their family? What are some of their most powerful memories? What did they do for a living? And what were their hobbies? If you’re not getting the picture, you might wonder why all of this matters.
It matters because those with Alzheimer’s increasingly live in the past, so that the “old memories” are new again. This applies to so many things in their reality. For instance, a gentleman I remember would become very agitated when it snowed and fret that the animals would freeze if they weren’t protected. At first the family thought that Dad was having a psychotic episode since he had never talked about animals before. Then one day his children discovered a very old picture of their dad when he was a little boy. It was probably taken in the 1920s and showed their dad standing in a field surrounded by cattle. This was right before the Great Depression, when his family lost their farm and the gentlemen lost his dad. He would have been a great-grandfather to the current children, who knew nothing about these losses. Their dad had never talked about what he’d been through, but now he was reliving it. Once the family realized what was happening, they would reassure their father whenever there was bad weather that every animal was locked safely in the barn. He continued to ask about the animals when it snowed, but he was able to relax after hearing they were safe.
Another gentleman had been a wood carver all his life and now lived in North Carolina with his son and daughter-in-law. They were concerned about his failing memory and had him evaluated by a geriatric neurologist, who diagnosed the man with Alzheimer’s at Stage 4-5 on the FAST scale. The family worried that it was no longer safe for Dad to carve wood, but the doctor assured them that wood carving was second nature to their father. They just needed to watch him and they would know when this hobby was no longer safe for him. They did this over the course of several years as his Alzheimer’s continued to grow worse. Finally, they decided assisted living was the safest place for him.
When he was admitted to the facility, the daughter-in-law told the staff how important carving was to Dad and supplied him with bars of Ivory soap and plastic picnic knives every week. The old man would sit in a chair with a trash can between his knees, lean forward, and carve the Ivory soap. Did he carve the beautiful woodland figurines that he had once carved? No, but he continued to carve. His family knew how important this was to their father’s well-being, so they made it happen in a very safe way.
The stories of our patients are like valuable, buried treasures. When caregivers can unlock the past and dig up these stories, it is a transformative experience for the story teller and the listener, too.
The Scottsdale home care team at Nightingale Homecare is always thinking creatively when it comes to enhancing quality of life for those with Alzheimer’s disease. Our Connections Dementia Care Program, staffed by Alzheimer’s Whisperers®, helps those with dementia better manage a full range of challenging behaviors: wandering, repetition, nutritional concerns, sundowning, and much more. Contact us for a free in-home consultation to allow us to offer care solutions for your loved one by calling (602) 504-1555 any time.
About the Author: Verna Benner Carson, P.D., PMHCNS-BC, is president of C&V Senior Care Specialists and Associate Professor of Nursing at Towson University in Baltimore, MD. Dr. Carson can be reached at email@example.com.
Top providers of home health in Scottsdale explain the fascinating connection between music and Alzheimer’s.
Have you ever heard a song playing on the radio and found yourself transported to a time and place from the past? Have you ever had a song stir your deepest emotions – and bring back those memories as if they were happening in the present? Have you been comforted, stimulated, saddened, elated or experienced some other powerful emotion just because of a song? Most of us have had such experiences, and the power of the “remembering” elicited by music can catch us “off guard” when the song evokes emotionally-charged memories.
Music has the same power with individuals diagnosed with Alzheimer’s disease or dementia, and knowing this provides one more tool to help families or caregivers to manage challenging behaviors, to reach someone who appears to be lost in the disease, to calm an agitated individual and encourage cooperation in activities such as bathing that might otherwise be met with resistance. Some research even indicates that music can help restore lost memories and bring those afflicted with the disease back into the present – if only for a short period of time.
These facts about the power of music seem to fly in the face of the progressive loss of memories associated with Alzheimer’s disease – starting with the most recent and steadily erasing long ago memories going back in time. However, it is important to know that the memories of music are “wired” differently in the brain than other memories – it is almost as if the brain is made to contain music. Whereas short-term memories are stored in the hippocampus, music is stored everywhere in the brain, and music with all of its emotional meanings continues to be accessible to people with Alzheimer’s disease, even when they have lost the ability to speak – many can still sing!
What a powerful idea this is! If caregivers fully appreciated the significance of music they would use it all the time and to facilitate many activities of daily living. Caregivers have shared that they engage the person with Alzheimer’s in singing while the individual is bathed and dressed. Nurses sometimes use music while they are performing a painful procedure such as dressing a wound or drawing blood – music can distract, can soothe and can engage the person with Alzheimer’s disease.
Recent research conducted by Brandon Ally, an assistant professor at Boston University, where 32 Alzheimer’s patients participated in a study that examined the power of music, found that these subjects were able to learn more lyrics when the words were set to music than when they were spoken. Ally believes that the results of this study suggest that those with Alzheimer’s could be helped to remember things that are necessary to both their independence and well-being. For instance, creating a short ditty about taking medications or the importance of brushing one’s teeth might be a strategy to help those with Alzheimer’s disease maintain abilities to perform these necessary skills. This was the first study to demonstrate that using music can help people with Alzheimer’s to learn new information.
In the famous YouTube video Man in Nursing Home Reacts To Hearing Music From His Era, we see Henry, a man who was almost totally unresponsive, begin to respond with sound, movement and facial animation when he uses an iPod programmed with “Henry’s music.” After the iPod is removed, Henry is not only quite spirited, but totally involved in the ensuing conversation. He is able to discuss his favorite musician, Cab Calloway, and when asked, “What is your favorite Cab Calloway song?” Henry begins to sing, “I’ll Be Home for Christmas.” Not only is his speech perfectly clear, his face is expressive, he uses his hands in explaining the emotional power of music. The interviewer inquires of Henry, “What does Cab Calloway’s music mean to you?” Henry talks about what music does for him – that the Good Lord changed him through music and made him a “holy man.” The transformation of Henry is nothing short of miraculous and raises questions about why music is not used in every home, in every assisted living facility, and in every skilled nursing home where someone with Alzheimer’s is cared for.
Music should be a routine part of care; not only does it bring joy to the person with this terrible disease, it allows for continuing connections between the caregiver and the person with Alzheimer’s disease. It diminishes the lonely isolation that is part of the disease when the afflicted person appears to be locked in a world that is isolated and isolating to others.
One more story about the power of music: a gentleman named Ben shared this story about his wife who had been diagnosed with Alzheimer’s and was well into the middle stage when he placed her in a facility for care. Ben visited often, and one of the techniques he used to stay connected to his wife and to make the visits pleasant and meaningful for both of them was to draw on his wife’s past history with music. She had sung for many years with the Sweet Adelines and she retained her lovely singing voice despite the ravages of Alzheimer’s disease. Ben loaded music that his wife had sung through her years with the Sweet Adelines. He attached two sets of earphones into an iPod – one for his wife and one for himself, and they would sing together. Music was a powerful connection between them that remained until his wife passed away.
At Nightingale Homecare, providers of the highest quality home health Scottsdale families trust, we are passionate about helping those with Alzheimer’s disease live life to the fullest. Our Connections Dementia Care program incorporates music and a variety of other creative techniques to enhance quality of life. Contact us at (602) 504-1555 for a free in-home consultation to learn more about our specialized dementia care services.
About the Author: Verna Benner Carson P.D., PMHCNS-BC, is president of C&V Senior Care Specialists and Associate Professor of Nursing at Towson University in Baltimore, MD. Dr Carson can be reached at firstname.lastname@example.org
Learn how occupational therapy can enhance the quality of life for those with Alzheimer’s.
Caring for a loved one with Alzheimer’s disease is a constantly evolving process, seemingly changing from day to day or even hour to hour. In the morning, your loved one may be perfectly content to reminisce over family photos and enjoy a walk around the neighborhood; while later in the day, the person may become highly agitated and experience difficulties with sundowning. It can be challenging to know how to most effectively manage the ups and downs of dementia and ensure the senior enjoys the highest possible quality of life.
At Nightingale Homecare, we implement a variety of personalized strategies through our Connections Dementia Care Program, right in the comfort of home, that help those with Alzheimer’s disease live life to the fullest in whatever stage of the disease they happen to be. One of our top recommendations for families is to include an in-home occupational therapist in the care team, something many families haven’t considered. Occupational therapists are trained to adapt the environment of the person with dementia to maximize safety, while focusing activities on the senior’s strengths and interests, leading to a safer and more fulfilling life.
Wandering. Wandering is one of the more dangerous problems in dementia, and can be difficult to overcome. An occupational therapist can develop a variety of customized activities that are engaging and enjoyable for the senior that offer the mental stimulation needed to distract and divert away from the urge to wander. Additionally, other methods can be implemented, such as posting stop signs on doors, recommending the most effective types of door locks, and utilizing a GPS monitor to ensure the senior stays safe.
Dependency. A loss of some degree of independence is inherent to Alzheimer’s disease; yet it’s extremely important to help seniors maintain as much freedom and autonomy as possible. An occupational therapist will observe the senior’s strengths and work with those strengths to create adaptations that allow the person to continue to do as much as possible independently.
Memory loss. Preserving memory helps seniors maintain an emotional connection to both those they love and their own life history. Occupational therapy services can help by providing recommendations for memory-prompting activities, particularly in focusing on long-term memory, which is often better preserved than short-term. Occupational therapists can also create strategies for managing the more difficult aspects of memory loss, such as forgetting who family members are.
We’re pleased to offer professional in-home occupational therapists for help in these areas and many others. Contact us at (602) 504-1555 any time to request an in-home evaluation or to learn more about how our full range of home health care services, including occupational therapy, can help older adults with dementia or any other condition of aging live better lives. Our Scottsdale senior home care experts are always here to help!
Proper oral care is crucial for those with Alzheimer’s disease. Learn tips here.
Maintaining good oral health is essential to everyone’s wellbeing. For a person struggling with Alzheimer’s disease or dementia, daily attention to oral health can prevent problems like painful cavities, infections, digestive problems and eating difficulties. Your loved one may not be able to express the pain of a toothache or gum problems, and without proper attention, this can lead to tooth decay, untreated lesions, possible abscess and serious health complications.
When a person suffers from Alzheimer’s disease or another type of dementia, attention to oral care often gets overlooked. As the disease progresses, those with memory challenges need varying levels of support to keep up with their oral hygiene routine. In the early stages of the disease, your loved one may just need reminders on how to brush and why it is important; however, as the disease progresses, your hands-on attention to this important daily routine is critical in maintaining your loved one’s oral health and overall wellbeing.
Try these tips to help ensure your loved one with Alzheimer’s disease maintains healthy teeth and gums, courtesy of the professionals in in-home care Paradise Valley, AZ seniors need and trust at Nightingale Homecare:
Keep the teeth and mouth clean. Very gently brush the person’s teeth, gums, tongue and roof of the mouth at least twice a day, with the last brushing after the evening meal (see below for instructions).
Try different types of toothbrushes. Experiment until you find the right choice for your loved one. You may find that a children’s toothbrush works best, as the head is smaller and the bristles are softer. You may also want to try a long handled or angled brush, which can be easier to use than a standard toothbrush. Be cautious with using an electric toothbrush on a person with Alzheimer’s disease, as this can create fear and agitation.
Floss regularly. Take the time to floss daily. Flossing can be distressing to a person with Alzheimer’s, so try using a “proxabrush” to clean between teeth. A Waterpic is another option, if the person can tolerate it, which is gentler on the gums and much easier than trying to manipulate string floss. As when using an electric toothbrush, remember to proceed slowly and calmly, letting your loved one know what you are going to do next. Monitor the water temperature, pressure setting and the angle of the nozzle while working. Instead of using only water in the reservoir of the appliance, add a small amount of anti-cavity mouthwash.
Be aware of potential mouth pain. Investigate any signs of mouth discomfort during mealtime. Refusing to eat or strained facial expressions while eating may indicate mouth pain or dentures that don’t fit properly.
Monitor sugar intake. As we know, sugar can cause tooth decay, especially when it’s frequently eaten. If your loved one with dementia is in need of a snack, try to avoid giving too many sugary foods. Tooth-friendly foods and snacks include:
Bread with sugar-free spreads
Crackers and cheese
Pita bread with hummus
Keep your loved one hydrated. Proper hydration helps keep the mouth moist and inhibits bacterial growth. Saliva is meant to serve this purpose, but may older adults suffer from dry mouth caused by a wide range of medications. There are several over-the-counter mouth rinses specifically for dry mouth that aid in keeping the mouth moist. The last step to any meal should be using water to wash everything away.
Timing foods for oral care. Offering fruit at the end of each meal can go a long way in helping break down the sugar and starch from a meal. Crunchy fruits and veggies help remove plaque from the teeth.
Brushing Your Loved One’s Teeth
Everyone should have their mouth cleaned twice a day, so make sure your loved one continues to keep up this routine, and provide assistance when needed. You may find that some days you can just direct the steps, and other days you may have to actually perform the care. Keep these pointers in mind as you accomplish the task of brushing.
Provide short, simple and clear instructions, broken into steps, such as, “Hold your toothbrush. Now put toothpaste on the brush.”
Use a “watch me” technique. Hold a toothbrush and demonstrate to your loved one what to do.
You may need to guide by putting your hand over the person’s hand, gently guiding the brush.
If your loved one seems agitated or uncooperative, postpone brushing until later in the day.
Observe your loved one for signs of discomfort: grimacing, bleeding gums or sensitivity to hot or cold. These are signs your loved one may need to see the dentist.
If you need to brush your loved one’s teeth:
Support the person’s jaw to keep the teeth together to help clean the outer surfaces of the teeth.
Encourage the senior to open wide to help you clean the inside and biting surfaces of the teeth.
Use a pea-sized amount of toothpaste.
Use gentle, circular movements, paying extra attention to the area where the tooth meets the gum.
Encourage your loved one to spit out the toothpaste rather than rinse it out. The fluoride in the toothpaste will continue to protect their teeth.
Clean the teeth from the outer surfaces to the biting surfaces and finally to the inner surfaces.
Replace the toothbrush when it begins to show wear, or every three months.
If you notice your loved one’s gums are bleeding, this means there is some residual plaque in the mouth, which is irritating the gums. Continue to brush the person’s teeth, but if the bleeding continues more than a week, make an appointment with a dentist.
Dealing with Dentures
Many people living with Alzheimer’s disease have dentures, and it’s important to ensure they are cleaned daily and replaced when necessary. Follow these tips to ensure your loved one’s dentures are cared for:
Rinse dentures with plain water after meals and brush them daily to remove food particles.
Clean dentures with a special denture brush and denture paste or non-perfumed liquid soap and water to remove all food and plaque deposits.
Each night, remove the dentures and soak in a denture cleanser or mouthwash.
Ensure your loved one cleans remaining teeth and/or gums before going to bed. Use a soft-bristled brush or moistened gauze if there are no natural teeth.
Most dental insurance plans cover a teeth cleaning (prophylaxis) every six months. Since it can be extremely difficult getting a person living with Alzheimer’s disease to comply with brushing and flossing twice a day, you may want to consider increasing dental visits to every three months. This can help combat plaque and tartar buildup on the teeth. Additional cleanings also help to prevent serious gum conditions like gingivitis and periodontitis, which contribute to decay and tooth loss.
As the disease progresses, those with Alzheimer’s/dementia may become increasingly agitated and noncompliant during cleanings. Finding the right dentist with experience working with the elderly and persons with dementia is critical. Difficult dementia behaviors and diminishing capacity will eventually make regular cleanings too traumatic for your loved one. At that point, assisting your loved one with flossing, brushing and rinsing as often as possible is the best way to maintain oral health.
If providing oral care for someone with Alzheimer’s disease (or meeting any other care needs) is overwhelming, please know that you always have a trusted partner in care with Nightingale Homecare. As the top provider of in-home care Paradise Valley, AZ and the surrounding area has to offer, we can provide a full range of professional Alzheimer’s care services through our specialized Connections Dementia Care program. Call us at (602) 504-1555 to learn more.
A Nightingale representative would be happy to answer your questions or help you arrange for home care that is custom-fit to your needs.