Saying "I'm Sorry"

When a loved one with Alzheimer's Disease is upset, many times telling them, "I'm sorry" goes a long way to calming heir fear, anger, or agitation. "I'm sorry," doesn't have to mean you are taking ownership of the problem, that you are promising to fix the problem, or that you consider it your fault that they're upset. "I'm sorry," means just that - sorry. Emotional truth is essential. No one likes to have their fears or worries dismissed. People with Alzheimer's sometimes have trouble finding words to express meanings in their head, but their feelings are intact. And when feelings are acknowledged (sometimes with "I'm sorry,") the bad feelings are diminished and the good feelings are enhanced.

Grief

Grief isn't just a feeling of sadness. It can also include depression, guilt, and anger. If you try to bottle up your feelings by ignoring them, they'll create behavior that can baffle even you. These same feelings are present in your family and even the Alzheimer's patient. Learn to vent your feelings without damage. Talk about them honestly and accept them for what they are - feelings - and know that feelings arise without our consent. How we DEAL with those feelings is the only choice we have. (excerpted from CareNotes, Ten Helps for an Alzheimer's family)

Musically Medical for Mom

I don’t know the particular chemical, emotional, and physiological reason for music being a real important part of the life of every human, and especially for one of us affected by dementia or Alzheimer’s disease. Music has always been important in my family. When I tell my grandsons about my early years, they can not believe the fact that we did not have television; and any music or electronic entertainment was only found in the car or from a big box in our living room with a radio and a record player. One of the things that I am proud of in our family is the fact that my dad would get us all together after supper to get around the piano and sing. My mother played the piano and my dad, my two brothers, and I became a quartet. It was the same thing at church where my dad was the choir director and my family was 80% of the choir. I am telling you this to tell you how important music was to my mother.

Before we were forced to move my mother to an Alzheimer’s/Dementia facility, she had diminished from an independent woman that my mother always presented in the past to one that slept 20 hours out of every day. After entering the facility, she was introduced to an everyday senior sing along, music being played in her room 24 hours a day, and church services with many hymns and other music. At first, getting her to go to the senior sing along and church services was a challenge. The workers at the center were insistent, and the music started to work on her. When I came to see her and went with her to go to the sing along or to church, I was amazed the effect of music on her spirit. She would sit there and even if she would not be able to hold her eyes open, she would not only know the melody and hum along with the music, she would know and sing out loud the words to all the songs and every verse to every song. Before she died her whole spirit had changed dramatically. When she got to the facility, I repeat she slept 20 hours a day and the other 4 hours were spent asking me to kill her or yelling at me about what a terrible son I was to take her to such a place from her home. Before she died she attended almost all the community events, and never missed a sing along or church, joked with the folks that helped her get around and would sing, sing, sing. Now if you were a physician, then you would say that the Alzheimer/Dementia Center wrote or at least studied extensively the book on music therapy and dementia, but the only thing I know is that music was the key that revived my mom from next to death for two years of relatively good quality of life and a chance to be with her children and grandchildren. My mother died almost exactly two months before her 94^th birthday. What a wonderful life she had.

Choices

It's easy to forget to appreciate the many choices we have during any given day--what to wear, eat, drink, or where to go. Many people with Alzheimer's disease either can't make choices or find the task of choosing one item over another very overwhelming, especially if they sometimes suffer from aphasia and their choices cannot be communicated. It's very important to give choices, it can give a person a sense of empowerment and sometimes a feeling of self-worth. In making choices available for the memory impaired, either a yes or no choice can be appropriate or one of two choices for a flavor of ice cream, clothing, etc. Any more than that can be confusing and sometimes even stressful. Keep in mind that most every time you give an Alzheimer's patient a choice he or she will select the second choice that you named because that is the idea most fresh in their mind.

Looking for Mother

When a parent is looking for their mother or father, it can be very upsetting to the adult child, especially if the death or separation is still fairly new. Many times a child gives their gut reaction and almost forgets for a moment that the parent has Alzheimer's Disease, and says "Don't you remember? He died a long time ago." Although we mean well, it sets us up for a whole day of anxiety for ourselves and our loved one as well. The questions, the denials, and anxiety that follows can send us (and the parent) into a tailspin for the entire day. It is much easier and kinder to answer, "no, I haven't see your mother/father today." Then redirecting your loved one to an activity or another subject will stop the series of questions, at least for a moment, and sometimes that's all we need and they want is a "moment."

Field of Vision/Falls

I think it's hard to realize and then accept that a fall is inevitable with an alzheimer's patient. The field of vision of someone suffering from Alzheimer's disease is about a 3 foot square area. This means that they don't see their feet, they have very little peripheral vision, and if their gait is off in any way because of pain or balance the problem is compounded. Also, textures changes in flooring (i.e. going from a carpet to a tile floor) can be very disturbing, as are "welcome" mats. Many people who have the disease think that the mat is a "black hole" and many times they won't step on the mat, in fact they sometimes try to step over the mat.

Give them what they want not what they need.

In observing a lot of alzheimer's patients, you must remember they are living in the moment and you should honor this. I here a lot of caregivers worried about their loved one lossing weight, also they can not get them to eat. You must remember that the taste buds of an alzheimer's patient are one of the first thing attacked by the disease, and all taste except sweets for some reason are reduced. Also, you must remember that nutrition sometimes should not be the caregivers primary concern. To gain weight try sweets (like their favorite ice cream shake or malt) in the morning and the afternoon, they will always like this. If they do not get their nutrician then give them vitiamins, but go to in the moment, give them sweets and they will gain the needed weight and energy to fight off disease and get them active. This is an example of the reverse thinking required by all caregivers. Remember your loved one is living in the moment and does not remember anything short term, so give them what they want and examine if that just could be what they need.

Validation Therapy

Validation Therapy validates "feelings" not facts. It works especially well with an Alzheimer's resident. Years ago when the concept first was introduced I took the course and was volunteering at a Nursing Home. There was a resident who was especially combative and was always yelling the same sentence - "Get the dress!"
The staff insisted that there wasn't a dress in her room. After a few instances of hearing her yelling, I stopped at her door and she yelled at me, "Get the dress!!" I walked to the closet and asked her what it looked like. She answered, "it's blue." I asked, "plain blue?" and she said, "no, blue with flowers."
I asked her where she last wore the dress and she said, "I never wore it. My father wouldn't let me. I bought it to wear to a dance and he wouldn't let me go to the dance."
That created quite an impact with me. A dress for a dance - 70 years ago. I empathized with her and we started a discussion about disappointments in life. She never yelled, "GET THE DRESS" again...