Tag: best dementia care Philadelphia

Most Effective Phrases for those living with Dementia

As we know, often it is not what we say, but how we say it, that impacts our probability of success. It is no different than with caregiving.

Someone living with dementia is grappling with a loss of control. They are older adults who have lived their entire lives, led successful careers, raised families, and are used to being in control. It is not easy to accept the fact that they need help from others to carry on with basic tasks.

Therefore, consider the following phrases and how we might change them:

  • I want you to … –> May I help with that?
  • You need to … –> Can I do that with you?
  • That’s not what I told you … –> Would it be alright if?
  • No, not like that… –> How about we try it this way?
  • You can’t… –> How do you feel about this?
  • Let me do that for you… –> How about we do this together?
  • Why don’t you… –> Do you prefer this or that?
  • Don’t you remember? –> This is your (house/sister/son,etc.).
  • Please do this… –> Would you like to do that now or in a few minutes?

In addition to changing our phrases, we can also use new ones when we encounter difficult situations. If your loved one in angered or frustrated, acknowledge how they feel and explicitly express empathy. They do not like their situation any more than you. This will help them feel understood.

walk outside Most Effective Phrases for those living with Dementia

Some of these ideas came from the Mayo Clinic’s magazine “Living with Dementia”, specifically Chapter 3, p. 42.

Caring for a Senior Loved One: When to Move Closer

Modern technology has enabled people to work and communicate from any part of the world, resulting in many families scattered around several cities and states. However, there are instances when your physical presence and attention are needed. Taking care of a senior loved one presents specific practical challenges that can’t be managed from a distance. Relocating to a new city can be traumatic for your loved one, and there are times when moving closer is the best option. But what are the telltale signs that the time has come?

Today, NursePartners shares some tips to help you recognize and respond to the signs.  

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Signs Your Senior Loved One Needs You

Parents and close relatives who’ve been leading independent lives may not want children, family, or other loved ones to know they require increased care. You may notice their eyesight is deteriorating, and they’re less mobile and active than before. For example, they may have difficulty with day-to-day tasks, such as driving and cooking. A loss of interest in activities and hobbies they previously enjoyed may indicate they suffer from depression and feel isolated.

Before contemplating any action, take a trip to visit them, and talk to friends and any caregivers. By getting a realistic picture of their current situation, you can make informed decisions on the best plan moving forward.

Taking Steps to Move

One of the primary challenges of moving is finding a new home. The best way to overcome these challenges and avoid an emotion-driven purchase is to rent a property in an area close to where your senior loved one lives to assess the situation.

If you plan to purchase a home, for example, top mortgage lenders can help you. The house you can buy depends on your monthly income and total monthly expenses. It means that you have to add up your monthly expenses and divide the total by your gross monthly income. Some online calculators can assist if you aren’t sure how to calculate your debt-to-income ratio. If you’re unfamiliar with the area, it’s a good idea to get a feel for the market and the prices you can expect.

Lastly, develop a plan to help you prepare for the move itself. Don’t think you need to do everything yourself. You can do yourself a big favor by searching online for “movers near me,” then browsing ratings and reviews to get the best deal.

Getting a jump start on this can make all the difference in the world; the sooner you start making a plan, the smoother the process can be. Sure, there will still be a few bumps in the road, but planning ahead is essential when you’re moving — especially if you’re moving yourself and your business.

Arranging Care for Your Senior Loved One 

Your loved one may experience loss of memory, act impulsively, or lose their balance when walking, which may be indicative of the early stages of dementia. Depending on the level of care your loved one needs and the amount of time you can spend taking care of them, consider using professional caregivers’ services. In many cases, seniors require specialized treatment as their condition advances.

Take Preventative Action

Whether or not to move closer to a senior loved one isn’t an easy decision, as it involves several changes for you and the person you’re caring for. By carefully assessing the situation and determining the actual level and need of care, it can help make a move successful in the long run.

NursePartners provides services to assist someone living with this ever-changing condition to help them live fully in their moment. Call 610-323-9800.

This article was submitted by Donna Erickson.

All Home Care Clients are Entitled to a Bill of Rights

 

Our traditional home care clients are entitled to a basic list of rights, which we call the “Bill of Rights”.  We keep these in mind throughout the entire process, from meeting the client, forming the care team, and through supporting them throughout the length of service.

  1. Know his/her rights.
  2. Choose the home car agency that will provider their care.
  3. Receive competent care without regard to race, creed, color, age, gender, sexual orientation, or national origin.
  4. A personal and written care plan and participation in decisions affecting their care.
  5. Receive services with reasonable accommodations of individual needs and preferences.
  6. Be treated with respect, consideration, and kindness.
  7. Be served by dependable and responsible caregivers.
  8. Enjoy confidentiality regarding all medical, financial, and personal information.
  9. Be free of physical, verbal, emotional, and sexual abuse from anyone, including caregivers.
  10. Request caregiver replacements when necessary.
  11. Contact the agency twenty-four hours a day, seven days per week.
  12. Receive services as contracted and given an explanation of all changes.
  13. Voice complaints, have them reviewed, and resolved without an interruption in service.
  14. Receive referrals to other health care providers if the service is denied based upon the ability to pay.
  15. Refuse any treatment or service.
  16. Entitled to privacy, modesty, and security.
  17. Have their property respected.

If the client is living with dementia, they are entitled to the rights above, in additional to a few more which are worth enumerating.

  1. To be informed of their diagnosis.
  2. To have appropriate, ongoing medical care.
  3. To be productive in work and play.
  4. To have expressed feelings taken seriously.
  5. To be free from psychotropic medications if at all possible.
  6. To live in a safe, structured, and predictable environment.
  7. To enjoy meaningful activities to fill each day.
  8. To be out-of-doors on a regular basis.
  9. To have physical contact including hugging, caressing, and handholding.
  10. To be with persons who know one’s life story, including cultural and religious traditions.
  11. To be cared for by individuals well-trained in dementia care

 

Home Care Services for Your Loved One - Nurse Partners

Carole receives the first dose of her COVID-19 vaccination

Our Clinical Specialist, Carole Derr, BSN, receives her first COVID-19 vaccination in an auditorium last week.  She has been working tirelessly since March, enforcing our protocols hands on, including visiting your clients at their personal homes and apartments at facilities.  The first round of vaccinations continues to be administered to those in Tier 1A, including nurses.

Carole vaccination Carole receives the first dose of her COVID-19 vaccination

Tier 1A includes others outside of nurses and other types of frontline workers.  The Pennsylvania Department of Health lists the details on their website, including a map with sites for vaccinations.  This information can be assessed here: COVID-19 Vaccine (pa.gov).

Want to hear more from us?  Like our Facebook page here: NursePartners | Facebook or Linkedin .

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.

2 Personalizing care techniques can reduce behavioral and psychological symptoms of dementia

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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