Category: Holidays with Seniors

Dementia during the Holidays: Emerald

Brain Change Model

This is the continuation of our series about connecting with a loved one, living with dementia, during the holiday and winter season.

In the previous article about Diamonds, we discussed someone exhibiting the first signs of dementia. About half the time, the person and/or their loved ones, may not know they are living with the disease. During the Emerald stage, the signs become more obvious.

The path is different for everyone

The previous article defined dementia. It is important to remember that although there is a general disease progression, the path will be different for everyone, primarily for two reasons:

  1. There are different types of dementia. A dementia is defined by at least two parts of the brain with larger accumulations of insoluble tau protein tangles and amyloid plaques protein molecules. The brain is subdivided into many parts, specializing in different functions. If some parts are more compromised than others, this will impede upon a person’s daily existence in a unique way.
  2. We are all different. Our personalities and life histories will play their role. Repressed desires or family conflicts may reappear as the person loses the ability to filter their words, put their feelings in context, and control their actions.

 Seeing the glass half full, engage with your Emerald

  • The person living with dementia will still feel capable and independent, and usually has a very limited awareness of any change in their ability to complete most tasks. Allow them to participate as much as possible in their routine daily activities. Remember to do with instead of for them.
  • There will be times when your loved one appears much more lucid. They will remember and then forget. Look for changes in their cognitive reasoning skills and ability to perceive others’ feelings. Anticipate faulty logical trains of thought and help steer them towards better decision making, by including them in the process. If they appear inconsiderate of your feelings, it is not their fault, but cause of the disease. This is especially common in frontotemporal dementia types. Do not take offense.
  • Their ability to understand language is changing. Begin to introduce other visual and touch cues while speaking. Change the way you speak but remember not to be condescending. If you speak to them as a child, they will pick up on this and your relationship will worsen. We recommend speaking slowing and repeating the same words in your sentences to convey singular thoughts.
  • They will repeat themselves. Although this can become exhaustive to the listener, try to avoid stating the obvious, that they already said the same thing before. They will not be able to help it or remember not to say it again. Insisting on logic in these situations will only further tire the caregiver and recipient.
  • Notes, along with other visual and touch cues, will help them complete a daily routine. The more consistent the routine, the better muscle memory will guide them through their day.
  • Do not insist on awareness of the correct time, place, and situation. Meet them wherever they are and make the best of that moment. If they are packing for a childhood vacation, pack the suitcase, and use this as a time to talk about their favorite childhood memories. You can often spin these situations into others that allow you to bond with your loved one.
  • Beware of strong emotional reactions. These are often based on fears, desires, or unmet needs. Your loved one will become increasingly incapable of verbally expressing themselves, so find refuge in other senses, such as smell, taste, and sounds. These can serve as emotional outlets in times of frustration.
  • They will look to you to fill their day with meaning. They are either on the go and cannot unwind, or the opposite, not being able to begin their day without you. The more you emphasize a routine, the better they will feel. Show gentle guidance and assist, remembering to include them in the process.

You will need a team

If you have not started building your team, now is the time. Your loved one is beginning to depend on you for their daily routine. If you are the only one, as their dependence grows to include physical needs, you will also be the natural provider.

Remember, someone living with dementia does not have needs that are met at your convenience. Increasingly they circadian clock will not match yours. They may lose ability to perceive your own frustrations and sleep deprivation. They will begin to not parse words or practice tact in conversation. If you are the only caregiver, under a lot of stress, this quickly leads to a deterioration of your relationship, and subsequently the health of both the caregiver and recipient will suffer.

Assessments at no cost

NursePartners has decades of experience constructing care teams to support older adults. If you reference this article, we will provide your loved one a wellness assessment at no cost. Call us today at 610-323-9800.

Dementia during the Holidays: Diamonds

Brain Change Model

This is the continuation of our series about connecting with a loved one, living with dementia, during the holiday season.

In the previous article about Sapphires, we discussed someone exhibiting signs of dementia, but not actually suffering from the disease. Depression, as well as other possible culprits, are mostly curable. Dementia is different.

What is Dementia?

In this article, we will discuss the first stage of dementia: Diamond.

If you are looking for a three-minute explanation of dementia, here is a great video.

Here are a few important statements to keep in mind:

  1. Dementia is progressive, without a known cure, and leads to death. However, medications and engagement can slow the progression of the disease.
  2. There are over 80 known types of dementia, and sometimes some can exhibit multiple types. The most common type of dementia is Alzheimer’s disease.
  3. Many people are only officially diagnosed further in the disease progression, if at all. (There are many Diamonds that do not know they have the disease, nor do their family members.)
  4. A person living with dementia will loose various skills and abilities as the disease progresses, not just their cognitive capacity.

Diamond

The first stage of dementia is a Diamond because this gem is “clear and sharp”. Diagnosis is tricky because sometimes picking up on changes requires a long visit.

Diamonds can be successful at established habits and routines. They can engage in small talk and appear pleasant. This is because the first skill to be compromised, in Alzheimer’s type dementia, is short-term memory. In other types of dementia, such as frontotemporal, the person loses the ability to control their impulses.

Established habits and social mannerisms continue, because they were usually adopted at a younger age. These memories and skills are preserved are stored differently in the brain.

Interactions become more difficult as they become more substantive. During conversation difficulties can arise if you reference recently learned information. The person living with dementia becomes less flexible at changing habits and behaviors in response to new information. In conversation, the person will begin to appear overly rigid and are prone to snap if they cannot follow the conversation.

Recommendations for engaging with Diamonds

For those living with dementia and are operating as a Diamond, here are some recommendations:

  • Throw out the phrase “Do you remember?” and anything similar. They do not remember and you quizzing them will leave no one feeling better. Instead, try to focus on what they remember, resorting to more distant memories.
  • Involve them in the process as much as possible. They will feel frustrated by being unable to accomplish certain tasks, but your job is to find out the ones they still can do with you or on their own. If they can participate, they will feel competent and valued. Best activities will vary depending on physical abilities and past hobbies, but here are some ideas:
    • Ask them to help you sort or organize, preferably a task that you are not highly prioritizing, but would be nice if complete.
    • Have them paint or color certain objects.
    • Request they tell you a favorite childhood story.
    • Enlist their help watching a pet dog or cat.
    • Try a simpler version of a task they used to enjoy. For example, if they used to complete 1,000-piece puzzles, try a 100-piece puzzle.
  • Do not rationalize or try to occupy the moral high ground. Meet them where they are in their moment. If you seek to stop or prevent a certain activity, offer them an alternative. Substitute, then subtract.

GEM levels can fluctuate based on the person’s energy level, stress, and nutrition. For example, a fatigued or sick Diamond, can operate more like an Emerald for periods of time, before the Emerald stage become their modus operandi. Learn when and how your loved one operates best and use these moments to maximize a connection. Remember, always connect before providing care.

Build your team

It is important to build your care team at this stage before you reach a state of desperation. As the disease progresses, the person will become increasingly dependent on the people who are currently fulfilling the role as caregiver. If this person is you, it will be more difficult to introduce outside help effectively. Your loved one living with dementia may develop abnormal sleep patterns and become less considerate of your needs until theirs are met.

Providing hands on care is more effective after a connection is established. It is recommended that you introduce care early, on a regular weekly schedule, to get the person comfortable with the idea of help before someone needs to actively assist with hygiene and other more private care needs. In this way, you can gradually build your team and establish coverage with a reputable care provider.

Let’s talk

NursePartners is happy to complete a wellness assessment, at no cost, if referencing this article. All assessments are completed by a registered nurse and certified dementia practitioner. Your call is answered by a member of the admin team, at any time around the clock: 610-323-9800.

Dementia during the Holidays: Sapphires

Brain Change Model

NursePartners’ approach to Alzheimer’s and dementia care is based on The GEMS™: Brain Change Model created by Teepa Snow. NursePartners recognizes the Teepa’s Positive Approach™ to Care as an effective method to provide care for loved ones affected by dementia. This approach categorizes dementia stages with six different gemstones, defined by unique characteristics.

This approach to care serves as an effective method for understanding and meeting the needs of individuals affected by Alzheimer’s Disease and other forms of dementia.  To learn about all the GEM levels, explore here.

Other methods of dementia classification might use numbers or levels of severity to describe the progression of dementia. However, we at NursePartners speak in GEMTM levels. It is not enough to simply describe the stage of dementia, we need to emphasize how to connect with your loved one, wherever they are in the disease process.

During the holiday season, you may see changes in an older adult. This article series is meant to help you reconnect with them.

Sapphire

The first GEMTM level is Sapphire, the only level that describes the absence of dementia. This is included because we must remember to always investigate other possible causes for forgetfulness, confusion, poor concentration, personality changes, apathy, and inability to do everyday tasks.

Depression can share many of the same side effects as dementia. Older adults can feel isolated, especially during the winter months. They may struggle to fill their days with meaningful activity and social interaction. The Sapphire level is “a true blue” color for this reason.

Depression severity varies and may require pharmacological and psychotherapeutic intervention, but we can do little things to help our loved one, even if it is in conjunction with these other treatments. Even if we are pursuing other solutions simultaneously, the causes of depression are often complicated and persistent. It helps to make real and consistent changes to our daily life in order to combat the effects of depression.

Three Ways to Combat Depression

  1. Fill their world with meaningful activity
    • If they do not have a schedule, make one. The schedule does not have to be arduous, but there should be a reason to get out of bed each morning, dressed, showered, and out in the world.
    • Choose activities that are aligned with their interests and personality. Just because someone is an introvert, does not mean they cannot visit the craft store or volunteer at the local animal shelter.
    • All activities should make the person feel loved and needed. When someone feels as a contributing member in society, mood generally improves.
    • Involve them in the decision making. If they cannot decide, switch up your approach. Try presenting a few options versus proposing open-ended questions.
    • Ask them to help you. Do you need help wrapping presents, meal prep, or picking up the kids from the bus stop? Request their assistance. This helps them feel needed while helping you get everything done.
    • Don’t forget to schedule time for your visits! As you help build their schedule, do not be surprised if they become “too busy” for your visits.
  2. Exercise
    • Start with moving more around the house and then take it outside, weather permitting.
    • If your loved one benefited from a program designed by a physical therapist, continue those exercises even when the physical therapist sessions end. The adage “move it or lose it” applies here.
  3. Boost their Diet
    • What are they eating? Sometimes vitamin deficiencies are the culprit. Try enriching their diet and involving them in the process. Start slowly, by adding a few new options each week.
    • You can teach them how to use these new ingredients but bringing them a freshly baked meal instead might persuade them quicker. They may be surprised that eating well can also taste good.

Bring in an ally

You can enlist the help of professionals to kickstart a change in lifestyle.  The advantage of working with a certified nursing assistant is that they can be your eyes and ears on the ground.  While you are at work or with your family, they are helping mom or dad out of bed and into the world.

There are additional benefits you might not have expected:

  • Constant and ongoing fall risk mitigation
  • Light housekeeping
  • Meal preparation and socialization
  • Performing and assisting with personal care activities
  • Home exercise program support
  • Detailed family updates
  • Familiarity and rapport
  • Coordinate grocery purchases and deliveries
  • Medication management

Older adults are not children.  They have lived a life rich in experiences.  It is unrealistic to think that one adult can take care of all the needs of another.  Enlist help to optimize the results for both you and your loved one.

Want to talk more or schedule a wellness assessment?

Call us at 610-323-9800.  Expect you call to be answered by a member of our administrative team, never a call center or third party.  Mention this article and receive the wellness assessment completed by a registered nurse, free of charge.

Tips for the Holidays – a collaborative piece from the National Aging in Place Council

NursePartners is proud to be a co-founder of the National Aging in Place Council of Philadelphia.  Monthly we meet with other vetted service providers to determine how we can best support older adults as they age in place.

National Aging in Place Councils from across the country have collaborated to prioritize five tips we can offer families during the holiday season.  The original post below has been supplemented by additional tips from NursePartners.

seniors during the holiday, senior care in Philadelphia,

Tips for the Holidays from NAIPC

      As the holiday season approaches, NAIPC members would like to offer seniors, caregivers and family members some health and safety tips for enjoying the holidays with loved ones.NAIPC members compiled a list of the five most common things that normally concern seniors, caregivers and their families.  We recommend that all stakeholders remain vigilant to minimize the risks and effects of the issues below:

  1. Isolation

  2. Safety

  3. Nutrition/Health

  4. Finances

  5. Transportation

      1. Isolation. Many older adults who have raised families, or been a central figure in their community, are now at a place where those roles are no longer part of everyday life. This leaves them searching for where they fit in the bigger picture and this is especially true during the holidays. It’s important for them to feel their participation is valuable and meaningful. Here are some ways you can mitigate isolationism:

  • Social visits include busy and quiet environments.  If your loved one is living with dementia, consider minimizing excessive noise and chaotic environments.  Try driving around your neighborhood to look at the holiday lights.
  • In they are unable to stand in the kitchen, have them sit and decorate cookies. You are involving them in the process, but also preventing the activity from being exhausting or overwhelming.
  • Reduce lengthy travel for older adults during the holidays.  Try suggesting that younger family members reunite in the home of the older adult.  If not, plan a virtual visit.
  • Older adults have rich stories of past holidays; incorporate these into your traditions and watch how they feel honored and valued.
  • Decorate as an intergenerational affair. From the youngest to the oldest, memories will be built when everyone can participate.

      2. Safety is a big concern, whether it be safety from the elements or safety from the unknown.

      For those aging in place, whether living alone or with the assistance of a caregiver, winter weather can be treacherous. It’s important to ensure that walkways and driveways are cleared of snow and ice before venturing out.  Hire someone to shovel pathways and salt sidewalks. Additionally, it is wise to keep a supply of candles, matches, food, extra blankets and medications at the ready.  If the older adult is living with dementia, consider having someone stay with them during snow storms.  Arrange for a groceries to be delivered before the storm, either online or by a relative or friend.
      Only use flame-resistant decorations and keep power cords away from heavily trafficked areas. Do not leave lights unattended and always assist the older adult while they are decorating.

      3. Nutrition/Health. It is always important to manage a sensible diet, but especially over the holiday season with the rich foods and drinks, that could potentially be detrimental to anyone with a risk of diabetes, heart disease or worse. Encourage those at risk to limit consumption, by taking smaller portions and balancing their diet, or avoid holiday treats altogether.

      4. Finances. We all cope with the financial pressures that our society imposes on us as we approach the holiday season.  We need presents, trees, decorations, festive meals, and constant entertainment.  This can certainly deplete the funds for someone living on a budget.

  • Consider going to another relative’s house rather than cooking a meal yourself.  If this is not an option, consider ordering a meal from somewhere like Boston Market.
  • Minimize holiday decorations by purchasing a table top tree.  This would be more manageable and easier to dispose.  Use holiday decorations that you already own.
  • Shop online for the best holiday deals to save on gifts for family members.  Assist an older adult with this process!
      Beware of charitable fraud.  Checking the IRS website for legitimate charities could be a lifesaver.

      5. Transportation. Whether it be local or long-distance travel, transportation becomes a larger issue around the holidays. Either it’s the inaccessibility of running errands or it’s waiting in long lines, navigating airports and security, claiming baggage and meeting up with relatives.  Don’t subject an older adult to these inconveniences.   Instead, celebrate your holidays by traveling to them.

The holidays are supposed to be full of joy, love and family. So, keep your family safe and happy this year.

      HAPPY HOLIDAYS from all of us at NAIPC!

Dispelling a few myths about home care

Over the next few weeks we will spending time with those we might not get to see often.  It is important to recognize that they will be putting their best face forward during these reunions.  We should have an acute awareness of changes that have occurred since we last saw them.

The AARP, published a report “Chronic Conditions Among Older Americans” where they state: “More than 70 million Americans ages 50 and older suffer from at least one chronic condition.”  This translates to 4 out of every 5 older adults.

Home care can be the perfect solution, but families worry about entrusting someone with the care of their loved one. When it comes to the health of your loved one, there is no room for uncertainty.  In the interest of setting the record straight, we’ve identified four major myths surrounding home health care:

Myth No. 1: Caregivers aren’t trustworthy

Many families believe that an in-home care provider cannot provide the quality of care their loved one needs and deserves. But trained care providers are knowledgeable, experienced, and dedicated to providing peace of mind for you and your family. All NursePartners’ care providers are bonded, screened, insured, and have clean backgrounds.  You can rest assured that your loved one will be safe in our care. Each carepartner participates in a behavioral interview, competency testing, skill matching, and orientation to meet the needs of your loved one.

As a licensed home care agency, we specialize in providing highly individualized, quality care in one’s home or residence. We are a network of caring professionals who work with each family to enable safety, comfort, and happiness through home care services.

Myth 2: I will have no say in choosing a care provider.

Reputable agencies will work diligently to match care providers that fit the needs of your loved one. When you choose NursePartners as your home care provider, we begin by reviewing your loved one’s current level of health and wellness. After a care consultation and assessment, we’ll work to match an experienced carepartner to fit your preferences, including personality, communication, behavior styles, and skill set.

Myth 3: Home care will take away independence from my loved one.

Care at home can actually provide a new level of independence for your loved one. A professional care provider can help maintain a person’s safety and independence at home, from planning and preparing meals, to providing transport, and support around the house.

NursePartners strives for exceptional care, forming interactive, trusting relationships with our clients. By appreciating and understanding what is changing and what is still possible, we generate a plan of care that is positive and productive.

Myth 4: Home care is unaffordable.

Many people assume in-home care is more expensive than assisted living.  However, assisted living communities in our area cost at least $5,500 a month.  Once these communities determine that your loved one needs additional care, the daily rate will increase or they will be moved to another facility such as skilled nursing.

Home care is flexible because you choose the hours of care.  Although we may suggest a certain level of services based on our experiences, it is ultimately up to you to decide what coverage is needed.

Many individuals, if given the choice, would choose to remain in the comfort of their own home for as long as possible. In-home care is an option for providing support, without moving them from their current residence. While there is a lot to navigate, it’s important for you and your family to know that many options exist.  Our team is available to guide you through this process.

If you or a loved one is thinking about home care assistance, our team would love to help.Contact us today.


Sources

“Genworth 2015 Cost of Care Survey.” Genworth (n.d.): n. pag. https://www.genworth.com. Genworth, 20 Mar. 2015. Web.

The prices of assisted living communities was compiled through a screening of over 20 assisted living communities in Delaware, Montgomery, Philadelphia counties in Pennsylvania and Camden and Burlington counties in New Jersey.

Home care services can alleviate loneliness

Loneliness and Isolation are Preventable

As family members and caretakers, we all have a role to play in supporting our loved ones. Loneliness and isolation is a problem for many seniors, but it’s particularly difficult for those struggling with dementia.

Reading together to alleviate loneliness

Loved ones suffering from dementia are more likely to experience loneliness for a number of reasons, including:

  • Loss of confidence after diagnosis
  • Mobility difficulties and other physical impairments
  • Lack of face-to-face interaction
  • Chronic illnesses that affect daily activities
  • Not remembering visits from friends (not perceiving social contact)

The Danger Loneliness Poses

Feelings of loneliness negatively affect both mental and physical health. Studies have found those without adequate social interaction are twice as likely to die prematurely. Isolation impairs immune function, leading to diabetes, heart disease, arthritis, and other serious health conditions.  Perceived loneliness also directly contributes to cognitive decline and puts seniors at risk for dementia. A care professional can reduce the feeling of isolation by offering companionship and access to services not regularly available.

Health Risk

Many times, individuals who lack daily social contact may be at increased risk of death because of health-related injuries. A care professional can provide the necessary support to help your loved one live healthy and happily.

Each NursePartners clinician possesses the knowledge and experience to provide care for your loved one. NursePartners works diligently to ensure carepartners promote health, safety, and comfort. The goal is to provide better support, helping them live fully in their moment.

Transportation Challenges

Adequate transportation can reduce the risk of isolation and loneliness. Having access to transportation allows seniors to feel a sense of community. It can provide the opportunity for your loved one to feel connected to a variety of programs, activities and events that will keep them physically and mentally stimulated.

NursePartners staff are insured privately, and will transport and accompany your loved one to care services, including grocery shopping, medical appointments and shopping trips.

Activities to Enjoy Together

A caregiver can be a viable solution to alleviate your loved one’s loneliness, by offering companionship and home care assistance. Even if you’re loved one isn’t housebound, a caregiver can provide companionship, from as little as a few hours a day to around the clock care.

Keeping loved ones stimulated and providing ability-based care and support cannot be overstated. Care partners can participate in many activities with your loved one, including:

  • Playing and listening to music
  • Preparing and cooking meals
  • Arts and crafts projects
  • Scrapbooking, and looking through photo albums
  • Crosswords, puzzles, cards, board games
  • Gardening, dancing, swimming

Our carepartners are dedicated to improving quality of life. NursePartners works diligently to ensure carepartners fill their time together with meaningful activities and positive interactions. By keeping a record of everything from mood behaviors to daily activities, we can begin to understand which factors contribute to positive moods and overall happiness.  Our carepartners are trained in the Positive Approach to Alzheimer’s and Dementia Care (GEMS™) and work with families to enable safety, comfort, and happiness through home-care services.

If your loved one need home care assistance or relief, our team would love to help.
Contact us today.

caregiving, carepartner, companionship, NursePartners
Nana and Angie in the snow

How to connect with your dad on Father’s Day

Do you need to connect with your father this weekend? You still can when they have dementia.
Alzheimer’s, or another form of dementia, does not need to signal the end of your relationship. You can still find ways to connect with your father.

 

As you celebrate Father’s Day, here are some tips:

Talk less, do more: A prolonged conversation may just confuse your father. He may feel frustrated because he cannot hold his end of the dialogue. Try to engage him in activities instead. Ensure that your father in genuinely interested. If he is having difficulty understanding the activity, demonstrate how to do it or simplify the activity.

Enter his world. Choose the time when he feels best: Someone living with dementia lives in a small world. They find comfort in routine. They usually perform best during certain parts of the day. Plan to spend time with your father during his best moments.

Choose a comfortable environment: After you find the right activity and meet at the appropriate time, ensure that you are also in a comfortable environment. Do not let loud noises, bright lights, or other distractions divert attention away from your time together.

Put your agenda away, just enjoy the moments together: After carefully planning your day, do not be upset if it does not work out as planned! Sometimes your father might act in an unexpected way. Enter his world and try to make the best of that situation. Do not underestimate the importance of a hug, sharing a meal, or a walk around the park.

 

We use Teepa Snow’s positive physical approach™ to connect before providing care to our clients. As dementia progresses, it is important to focus on what an individual can still do, instead of focusing on what they cannot. Enjoy Father’s Day!

connecting, care, dementia, Alzheimer's, carepartner
Do not over think your activities. Your father wants to feel needed. If he does not seem interested in the activities you plan, try asking him to help you around the house.

The Healing Power of Music

music therapy, singing, NursePartners, dementia

Music is one of the ways we communicate

Research is confirming an idea long held by those who work and care for dementia patients: music has the power to shift mood, manage stress, stimulate positive interactions, facilitate cognitive function and coordinate motor movements.  It can provide a way to connect, even after verbal communication has become difficult.

This happens because rhythmic and other responses require little cognitive and mental processing.  They are influenced by the motor center of the brain that responds directly to auditory rhythmic cues.  A person’s ability to engage in music, particularly playing and singing, remains intact late into the disease process because these activities do not mandate cognitive functioning for success.

Many individuals with Alzheimer’s can learn to move better, remember more, and even regain speech through listening and playing music.  By pairing it with everyday activities, your loved one can develop a routine that helps them recall memory, as well as working to improve cognitive ability over time.

Incorporating music into a treatment plan:

  • Use familiar songs to help soothe and take the edge off difficult moments.  Make sure that the songs you select do not bring up bad memories and are not connected to sad events of the past.
  • Identify music that is familiar and enjoyable to your loved one.  If possible, let them choose the music.
  • Compile a playlist of favorite recordings, which can be used for memory recall.  Singing a familiar song together can offer a welcome distraction and help a person “snap out” of a repetitive action or behavior.
  • Encourage your loved one to move along to the music to develop a routine (clapping, dancing, playing).
  • Choose a source of music that isn’t interrupted by commercials, which can cause confusion (iTunes, YouTube channels, playlist building apps).
  • Song sheets or a karaoke player can allow your loved one to follow along and sing to old-time favorites.
  • You can use music to influence your loved one’s mood.  A softer piece of music can help create a calm environment while a more upbeat song can uplift spirits.
  • Playing animated, happy songs in the morning can help with getting your loved one started.

music therapy, dementia, NursePartners