Tag: best dementia care Philadelphia

Establish a Daily Routine for those living with Alzheimer’s disease or another dementia

Daily Routine

For most of us, routines are a key part of our day-to-day lives. Routines are powerful tools that keep us energized, productive, and most importantly –  grounded during a stressful time.

Overall, routines are a key component of staying healthy. For people with dementia who have trouble receiving and storing new sensory information, routine and repetition are critical to function.

A model routine includes set times for waking up and going to sleep, regular hygiene practices, consistent eating patterns and other key activities. The effect the coronavirus pandemic has had on daily life has unfortunately disrupted much of our normal routine living. Disrupting the routines of those with dementia creates a lot of stress for someone who cannot track information. The pandemic is already stressful enough to most of us, yet for those suffering with dementia this abundance of stress can lead to an increase in confusion and memory issues. The good news is that this is most often temporary and can stabilize once people get back to a routine.

Ways to help

Here are some recommendations for the best ways to help a loved one with dementia during this time:

  • Stick to a routine as much as possible.

    In all the chaos and confusion of the pandemic, creating structure and routine in your loved one’s life can create an environment that is comforting with clear expectations. One way to implement a clear routine is to have a white board, or a calendar on the wall that includes a plan for the day. You can alter these to reflect new activities to be done throughout the day and week.

  • Connect Online.

    Online communication is a valuable tool in times when we may not be able to visit our loved ones face-to-face. From Skype, to Facetime, to Facebook Video calls, there is a great deal of technology that can help you keep in touch with your loved one and fight social isolation.

  • Beware of negative media.

    While online communication can be a good and useful tool for connecting, you must also ensure that your loved ones are not being bombarded by fear and hysteria in the free time they spend online. Exposing your loved one with dementia to too much negative information can have serious effects on their emotional state. While they might not remember the details of newscasts, they hold on to the emotional information. As a result, they may feel increased fear, anxiety and stress, but not understand why.

  • Manage stress

Engage your loved one with activities, hobbies or listening to music.

  • Focus on the Past

Since taking in new information is difficult, focus on reminiscing – talk about past events, trips, other activities that they have done.

Signs to watch

In times of stress, someone with dementia may experience increased confusion or agitation, or may exhibit behavioral changes and act out of character. This is most often only temporary.

However, if you notice some of the following behaviors developing, you should contact your care provider:

  • If your loved one is acting out of character or begins putting themself in danger by wandering off or becoming physically aggressive.
  • If there are new areas of confusion or new types of behaviors that persist over the course of several days.

We understand these are difficult times, and for our loved ones experiencing memory disorders, it can be even more trying. Remember, we are all in this together. .

NursePartners creates permanent care teams to introduce stability and routine into the lives of older adults.  All teams are managed by a registered nurse and certified dementia practitioner.  Care is provided right at home, or wherever home may be.  Want to learn more about how we can help you?  Call us, and ask for Angie, Carole, or Jessica:

610-323-9800

 

Could it be dementia?

Early symptoms of dementia can be subtle and vary between people. While some people pick up on changes in their own thinking or behavior that might be caused by dementia, sometimes these signs are first noticed by those around them.

If you have noticed a change in someone close to you, the steps below can help you assist them in seeking diagnosis and treatment.

Identifying the Early Indicators

Early diagnosis can help people better live with the disease, giving them options to pharmacological and social remedies that have help to slow the progression of dementia.  It also allows your loved one to have control in preparing for their future.

Early signs that a person might have dementia can include:

 

  • Being vague in daily conversation
  • Memory loss that affects daily functioning
  • Loss of enthusiasm or interest in activities that used to be fun
  • Difficulties in thinking or choosing the right words
  • Changes in personality
  • Difficulty following instructions
  • Difficulty following stories
  • Emotional instability

 

If you notice these changes, try to find a time and place to have a conversation with your loved one.  See if they notice these changes too.

 

Seek out a medical professional

Try to set up an appointment with a doctor.  Any doctor can diagnose dementia, including a primary doctor.

If they are reluctant to see a doctor to discuss memory concerns, try to pair this appointment with a routine checkup.

Accompany your loved one to the doctor’s office to make the trip easier.  Offer to take notes and drive.

 

Avoid self-diagnosing

Do not self-diagnose.  There are other conditions that mimic signs of dementia and delirium, the most common being a urinary tract infection or depression.  Others are medicines, stress, nutritional disorders, stroke, alcohol misuse, hormone disorders and brain.  It is important to identify the cause, even if not dementia.

To know one person with dementia is to know one person with dementia

As of now, there are over 80 types of dementia, the most common form being Alzheimer’s disease.  All people carry unique live experiences and family structures.  This includes where we grew up, our occupation, and education.  Throughout the progression, including in the beginning, appeal to the likes and interests of the person living with dementia.  Simplify tasks if they are stuck.

 

It will take a team

The needs of someone living with dementia intensify throughout the course of the disease.  Eventually all regular bodily system cycles may not correspond with those.  Your loved one may want to be up during the night, eat at different intervals, and even wander and forget where they are going.  You will be tested 24/7 all days of year, without vacation.  Your job becomes thankless and their frustration may be taken out on you.

It is important to build your care team slowly as needs change.  Consider at a minimum help every other day.  This will be a good start in ensuring that your loved one’s needs are met and that they continue to engage socially with other people.

 

Let us be part of your care team

We have been caring exclusively for older adults since 2002.

Call us today to learn how NursePartners can help you through this journey: 610-323-9800.

Are you Connecting?

Connecting

Never underestimate how important it is to empathize and communicate effectively with your loved one living with dementia.  All too often they become “different” or “unreachable” as their dementia develops. You might despair that the person you once knew is completely gone.

You may grow tired, frustrated, or even angry with your loved one; and from this position any hope of healthy and effective conversation is lost. The good news is that we are in control of these emotions.  With a little bit of compassion, we can find new ways to say hello and build engagement with our loved ones where it is still possible.

 

How can we learn to understand?

In the early stages, talk to them! Ask simple, genuine questions.  See if they want to talk to you about what they are going through and changes they are noticing.  This is going to require patience, your most important skill going forward.  You might as well begin developing it now!  Remember your body language will need to match what you say.  Want to learn more, read our previous post.

In addition to simple conversation, you may want to consider joining a support group or looking for other resources online.  Some of these resources are authored by those who are experiencing dementia themselves. These will help us understand what a loved one is going through.

One blog that we recommend is My Voyage With Dementia. The blog is a collection of thoughts from a 79-year-old man living with dementia in Canada. The author, Bob Murray, uses his blog to keep his mind active and to fight against decline.  He has created an expansive collection of writings that give us an unfiltered look into what the world is like through his eyes.

Another great read is Dancing with Dementia; a book written by Christine Bryden who was diagnosed with dementia at 46. Dancing with Dementia records Cristine’s experience living with dementia, exploring the effects of memory problems, loss of independence, difficulties in communication, and the exhaustion of coping with simple tasks. Like Bob, Christine’s writing is used as a tool of empowerment and shines a valuable light onto the perspective of a person with dementia.

At the end of the day, the more you are informed about dementia the more you can understand the experiences of your loved one and the better you can care for them. It is important to know the facts, the objective data, the things the doctors will tell you about dementia, but it is also essential to know how to connect emotionally.  How do they really feel?  What does the world look like to them?

 

Work with an expert

NursePartners has been working with older adults since 2002.  We love it so much that it is all we do.  All carepartners are dementia trained by certified dementia practitioners.  Want to know more about how we can help you?  Give us a call today at 610-323-9800.

 

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Denise uses the Positive Physical Approach to Care to guide non-verbal client

Dementia and Loneliness

Social Isolation for those living with dementia

Living with dementia can often be isolating. Over time, the ability of a person with dementia to communicate may become worse and interactions that once seemed to come so easily may become more difficult. This can be frustrating for everyone involved, though it is important to try and understand the loneliness your loved may be experiencing so you can best engage them.

Take note that there are different types of loneliness – for example, someone can feel lonely, even if they have regular contact with friends and family, while others may have limited contact with people and not feel lonely. NursePartners alters our care approach depending on a client’s personality and life history. We engage with introverts differently than extroverts. We also need to consider the person’s skills when creating opportunities for engagement.

These days it can be tough to have regular face-to-face contact, especially if your loved one lives in a facility or if you live far away. FaceTime will only go so far for someone living with dementia. If they are a Pearl, Ruby, or Amber stage of dementia, it might be nearly impossible to connect with them via video chat. This is because the best way to connect with these people if through sight, touch, taste, and smell. However, you may be able to have a virtual breakthrough if you can engage them through song.

Another factor to consider is that those living with dementia are also usually living with diminishing social circles. They may move away from friends and older loved ones die. It also becomes harder for them to initiate new conversations and build new relationships. This is just another reason why it is important to build you care team early!

Social Isolation in the Age of COVID-19

How would you experience social isolation if you were not processing the rationale behind it? As we head into future months of quarantine and social isolation, consider how this is affecting a loved one living with dementia. Consider how your loved one is remaining socially connected in safe way. Do they have close friends or family that visit? Do they see someone at least once a week? How often do you check in and are these calls effective?

If you are answering no to any of these questions, it is understandable. Life gets busy and sometimes we forget how those living with dementia come to depend on us more over time. Nonetheless, you may want to consider seeking help for your loved one if you feel you are unable to provide this care yourself. (Over time it will become impossible for one person to provide all the necessary care for one other person living with dementia.)

The NursePartners Difference

NursePartners has been caring for older adults since 2002. We specialize in Alzheimer’s disease and other forms of dementia, focusing on what the client can still do, not what they cannot. We build stable care teams for our clients, supporting them from three assignments per week to 24 hours a day, every day of the year.

Let us show you how NursePartners can make the difference in the life of you and your loved one. Call us today, 610-323-9800.

610-323-9800

So, you can do it all by yourself?

It is a natural instinct to jump into the caregiving role. What else would you do for someone that you love? If it is a parent, what better way to return the favor for them raising you? If it is a spouse, you vowed to take them in sickness or in health.

Yes, you should pitch in to care for your parent or spouse, but not alone. Unlike raising a child, an older adult has lived a life rich in experiences and has needs very distinct from a child. Also, unlike a child, the care recipient will become more dependent on you over time, which is a different outlook compared to a child who is growing, developing, and becoming ever more independent.

If you are caring for someone living with dementia, it is even more important to prepare yourself mentally for the road ahead. Have you heard of Teepa Snow’s Positive Approach to CareTM? NursePartners practices this methodology while caring for our clients. As clients progress through the stages of dementia, we focus on what they can still do, not on what they cannot. There are still ways to connect, even far along in the disease progression.

It is important to build your care team. This can mean you and many family members, a completely private staff, or a combination of family and private. Never underestimate the value of having certified nursing assistants in the home, overseen by a registered nurse.

Without a care team, both the carepartner (you) and the care recipient are left with a bad situation. The carepartner is unsupported and operates in a high stress environment, often neglecting their own needs. Over time lack of self-care not only hurts the carepartner, but becomes reflective in the care delivered. Care becomes more routine and less focused on creating meaningful interactions. These meaningful interactions are important for someone living with dementia, especially as their way of communicating evolves over time.

Want to add us to your care team? Call us today to learn more about how NursePartners can better support your loved one at home, or wherever home may be: 610-323-9800.

 

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Personalizing care techniques can reduce behavioral and psychological symptoms of dementia

The most effective care begins with forming a connection, which includes meeting clients where they are in the disease process.

The Tailored Activities Program (“TAP”) aims to reduce behavioral and psychological symptoms of dementia (“BPSD”). This is often what we struggle with as family members and caregivers. How do we engage the person with just enough activity to make them feel loved and needed?

Unchecked challenging behaviors can lead to increased healthcare costs, caregiver burden, and care recipient placement into facilities. There the person living with dementia usually faces pharmacological intervention, which may exacerbate these challenging behaviors or worse.

An Australian trial randomized 180 participants living with dementia by placing them into two groups. One group received 8 home care visits using the training from TAP to train the caregiver and engage with the person living with dementia. The control group received three phone calls with the caregiver about basic dementia related materials from a book, and did not involve the care recipient. Follow up continued four and eight months after the home care visits and phone calls.

The trial was done with individuals living at home or with relatives, outside of formal care facilities.

The results of the TAP pilot trial:

The TAP pilot trial showed overall reductions of incidences of challenging behaviors or BPSD. There were also reductions in other specific behavioral categories as defined by the study:

BPSD overall: F(1,41) = 7.58, p = 0.009, Cohen’s d = 0.72,

Shadowing: F(1,4) = 58.9, p = 0.003, Cohen’s d = 3.10, agitation, Wald X2(1) = 6.0, p = 0.014, Cohen’s d = 0.75

Repetitive Questioning: F(1,22) = 5.94, p = 0.023, Cohen’s d = 1.22

Argumentation: Wald X2(1) = 6.6, p = 0.010, Cohen’s d = 0.77 ()

To read more about the study, click here.

In many ways, TAP is like the Positive Physical Approach to Care as pioneered by Teepa Snow. NursePartners has embraced this methodology since the inception of our GEM division in 2015. It builds on the intuitive notion to engage with people living with dementia according to their life experiences and interests. By appealing to their sense of self-worth, we can prevent or mitigate some of the most challenging behaviors.

 

NursePartners trains all carepartners in the GEM methodology as perfected by Teepa Snow.

All carepartners are trained to engage with clients, focusing on what they still can do and letting go of what they cannot. Even at the most advanced stage of dementia, you can find new ways to say hello and make the person feel valued and with purpose.

To learn more about how we can engage your loved one living with Alzheimer’s disease, Frontotemporal dementia, or another form of dementia, call us at 610-323-9800.

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Caring for the Caregiver

Both formal and informal (family) caregivers provide care for older adults.  It is important that carepartners practice self care, in order to continue being effective in their roles regardless of whether they are compensated for caregiving services.

Formal carepartners are better able to establish personal boundaries if they are working set hours at established rates via a reputable company.  Although paid carepartners are connecting and building a relationship with the older adult, there are times that they are able to take care of themselves.

In contrast, family caregivers often find themselves in a caregiving role unexpectedly.  They usually find themselves faced with some of all of these predicaments:

  • The needs of the care recipient are increasing over time.
  • The caregiver had another relationship with the care recipient before the illness.  This often complicates the dynamics of the developing relationship as the care recipient feels embarrassed of their condition and the caregiver becomes stressed.  Communication issues and stress can fuel tension.
  • The caregiver does not necessarily know about the disease progression or have medical training.  They may be in denial of basic facts concerning the care recipient’s condition.
  • The caregiver needs to work at least one other job to support themselves and possibly their families and/or care recipient.
  • The caregiver is giving up opportunities for self development, career advancement, and/or building their own immediate families.  The can cause built up feelings of resentment, inhibiting the quality of care of the older adult.
  • The caregiver needs to navigate internal family dynamics.  Typically children are allocated responsibilities based on geographic proximity or other circumstances.  A child without their own family or job may be the first candidate to move in with mom and dad.  Children usually disagree about the equity of task distribution, leading to feelings that can compromise the level of care provided to the care recipient.
  • The caregiver may be caring for an older adult for the first time.
  • They or members of the care team are in disagreement on the basic facts of the situation, such as the validity of the disease diagnosis.  
  • Informal caregivers are always on call.

Regardless of whether you use formal, informal, or both methods of care, it will take more than one person to care for an older adult, especially someone living with a progressive disease such as Alzheimer’s or another form of dementia.  

One important step is developing relationships with other informal caregivers, through organizations such as ARTZ Philadelphia and the CARES program of the Lutheran Settlement House.

ARTZ Philadelphia organizes a meeting of caregivers on a periodic basis to discuss ongoing challenges.  They also host separate events that are meant to provide bonding opportunities for the caregiver and care recipient.

The CARES program of the Lutheran Settlement House organizes events exclusively for informal caregivers.  The creator of the CARES program, Sarina Issenberg, also provides individual counseling meetings free of charge, outside of the organized events.

It is also important to employ the help of formal caregiving services.  There are numerous advantages for having a home care agency involved.  .  Here at NursePartners, we have been extensive experience caring for older adults exclusively for over 18 years.  Although we care for older adults with a variety of chronic and progressive conditions, we formally incorporated a dementia training module into our business operations in 2015.  All carepartners and management are trained and certified in the Positive Approach to Care methodology.

We welcome the opportunity to tell you more about how we can form a new care team, or supplement one that you have established.  Give us a call at 610-323-9800 to learn more. best home care Philadelphia, dementia care Philadelphia, Alzheimer's disease Philadelphia

 

Lakeya meets with PAC Trainer at our site in Philadelphia

NursePartners’ Senior Recruiter, Lakeya Dula, completes her training to become a PAC certified dementia coach.  After on site training in Baltimore with Teepa Snow, Rebekah Wilson visited us at the NursePartners office in Philadelphia.  Rebekah served as Lakeya’s mentor throughout these past 8 weeks.  Lakeya and Rebekah used the PAC materials and tools from the course to increase Lakeya’s confidence in becoming an effective coach to our carepartners.

The Positive Approach to Care (PAC) methodology was created by Teepa Snow in response to the shortcomings of other dementia progression models.  Other models seemed to focus on the cognitive decline, versus emphasizing what the person could still do.  Each in the last stage (Pearl), a person still exists behind the ugly façade of the disease.  Teepa sought to teach others how to connect before providing care, which is the bedrock of any effective carepartner relationship.

As a dementia coach, Lakeya plays a fundamental role in training each carepartner before they begin working with us.  Lakeya leads a dementia workshop where we act out various difficult situations with our carepartners.  NursePartners’ admin takes on the role of our clients and the carepartners show us how they would respond in a given situation.  Carepartners consent to being video recorded.  This allows them to watch their own interaction later, from the view of the client.  This activity helps them break preconceived conceptions and to adapt their own care approaches to become more effective carepartners.

During this workshop, carepartners learn about the GEM levels, the Positive Physical Approach to Care, and receive a general overview of dementia.  Afterwards, carepartners must complete additional training in order to become eligible to work with any of our clients living with dementia.

Lakeya is the third member of the NursePartners administrative team to complete a certification with Teepa Snow.  Angela Geiger embraced the methodology as the basis to create the GEM division in 2012.  She became certified as the company’s PAC dementia trainer in additional to another national certification as a dementia practitioner.  Peter Abraldes developed the dementia program with Angela in 2016 to make this training a requirement for any carepartner working with a client living with dementia.  At this time, all other admin members were trained as well.  This prepared us to respond to any issue arising from clients, family members of clients, or carepartners.

NursePartners also provides training to family members and other organizations as requested.  We have seem the effectiveness of this approach in the field and always glad to help others provide more effective care to their loved ones or clients.

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Lakeya received her PAC certified dementia coach certificate!

 

Angela scheduled to be keynote speaker for “Remembering Those Who Forget”

We are excited to announce that Angela will serve as the keynote speaker for the Presbyterian Older Adult Ministry (POAM) at the event, “Remembering Those Who Forget”.  Angela will talk about her decades of experience working with those living with dementia.  She will be sure to touch upon practical care approaches that can be implemented immediately, in addition to giving her clinical perspective on the disease.  The event is open to those wanting to learn more about Alzheimer’s disease and other forms of dementia.

We would appreciate registration prior to attending the event.  This event is scheduled for next Thursday, May 2, at 8:30am to 1pm in Plymouth Meeting.  Exact details can be found via this link: https://presbyphl.org/events/presby-older-adult-dementia-workhop/

Early warning signs of Alzheimer’s disease or another form of dementia

NursePartners presents on behalf of the Alzheimer’s Association.  One of the most commonly requested presentations discusses the early warning signs of Alzheimer’s disease or another dementia.  We compare these signs with others that are more typical of age-related changes.

It is very important to remember that each person is unique, with their own baseline. If you are looking to identify a developing form of dementia, consider all factors that make up that individual, including their personality, life experiences, family, and education. Warning signs are problematic when a few more or more exist.  

The signs of normal aging are just examples. These vary depending on each person.  If you have additional questions, you are welcome to call our 24/7 line at 610-323-9800 or the Alzheimer’s Association hotline 1-800-272-3900.

If you would like to see one of our dementia practitioners or coaches speak, join us at an upcoming event or request one by calling 610-323-9800.

 

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