Tag: NursePartners

Understanding Alzheimer’s and other dementias: Hand Under Hand™ Approach

As dementia progresses, it is vital to appreciate the changes in a person’s ability to be able to connect. One critical element that is often missed when trying to share information is the value of changing our delivery process. Dementia care pioneer Teepa Snow developed the hand-under-hand technique, as a guiding and assisting technique that provides family members and caregivers with an amazing connection. It promotes a physical touch connection that is friendly, comforting, and successful, without being intrusive or overbearing.

 

 

 

The hand-under-hand technique also provides a system of feedback and communication between the a loved one living with dementia, and a caregiver. It uses the much practiced and automatic connection between the eye and hand to form a closed circuit between the person who is struggling to understand words and tasks and the care partner. It provides a comforting and calming human connection using a familiar grasp and proprioceptive (deep pressure) in the palm at the base of the thumb.

This eye-hand connection is one of the very first sensory-motor loops established in infants is used endlessly throughout our lives. By using the palmer surface of the hand, and taking the person through the desire motion or movement, we are communicating with touch and movement, without the need for words.

It’s also important and helpful to position yourself below the eye level of the person with dementia. By lowering yourself to their eye level and by using hand-under-hand, you will be able to accomplish your caregiving goals and form a meaningful connection in the process.

Remember: the purpose is to control the situation, not the person. Dementia care partners are in the process together: always do whatever you can to respect the independence, rights, and dignity of the person with dementia.

The use of hand-under-hand is multi-faceted:

  • It is used when greeting someone to sustain a physical connection, allowing the person to become more comfortable with your presence in their intimate space. It differs from a normal handshake that can be uncomfortable to sustain. By having a hand-under-hand rap, you will be able to tell if the person is enjoying your presence and wants you to allow them more space. If they keep trying to let go you, let go and move back further. They may need a break or may not want you in their intimate space at that moment.
  • It can be used when helping your loved one move around. It provides greater stability and support as well as a feedback loop.
  1. Since the arm is the rudder that guides the ship, by rotating the foreman outward or inward you can direct the walking path.
  2. By tipping the forearm down you can indicate physically the cue to sit down in a seat or on the bed.
  3. By tipping the forearm upward you can help the person stand upright.

When used in combination with a gesture or point, it can help provide directions and reassurance when moving through the environment in the later stages, or when in an unfamiliar setting. Because a family member or caregiver is close to the person, the awareness of balance, coordination, fear, or distress is telegraphed can be responded to in a timely manner.

  • Hand-under-hand is essential during the Amber, Ruby, and Pearl gem stages. It allows you to use their dexterity to operate the tool or utensil while your loved one is still actively participating and moving their body parts toward their body (hand to mouth, hand to chest) as they have done for their entire lives. This automatic loop allows people living with dementia a sense of both control and involvement.

Finally, it provides the care partner or family member a way to get feedback on preferences, understanding, readiness, and willingness to participate. It provides a way to do with, not to do or do for.

Living with chronic obstructive pulmonary disease (COPD)

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Shortness of breath is never normal. The following are signs that might indicate you are at risk for COPD:

  • Shortness of breath while performing routine activities;
  • Fatigue;
  • Chronic cough;
  • Reoccurring respiratory infections;
  • Cyanosis (lips and fingernails turning blue);
  • Producing phlegm, sputum, or mucus;
  • Wheezing

COPD is a progressive disease and is the third leading cause of death in the United States.  This disease prevents people from doing some of the activities of daily living such as walking and cooking.

COPD is caused by less air flowing through the airways and air sacs.  The inelasticity of air flow is caused by the destruction of air sacs, thickened and inflamed airways, and clogs from mucus.  The disease is usually the result of cigarette smoking, but also can be caused by long-term exposure to air pollution, chemical fumes, and dust.

Palliative care approaches for pulmonary rehabilitation include education, exercise training, nutrition advice, and counseling.  Supplemental oxygen may also be needed to help with breathing.  Symptoms are treated as they arise.

Sources

http://www.mayoclinic.org/diseases-conditions/copd/home/ovc-20204882

https://www.nhlbi.nih.gov/health/health-topics/topics/copd

http://www.lung.org/lung-health-and-diseases/lung-disease-lookup/copd/diagnosing-and-treating/how-is-copd-treated.html

http://www.lung.org/lung-health-and-diseases/lung-disease-lookup/copd/symptoms-causes-risk-factors/symptoms.html

Is it time to find care for your loved one?

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Many families struggle to make decisions about the best living situation and care for their loved one. There are many signs that indicate your loved one might benefit from home care services:

  • Confusion and uncertainty when performing once familiar tasks;
  • Unexplained weight loss;
  • Spoiled food in the fridge;
  • Difficulty standing and walking;
  • Forgetfulness and loss of interest in favorite activities;
  • Neglected personal hygiene;
  • Inability to keep up with house maintenance;
  • Missed appointments, unpaid bills, and late payment notices.

Seniors who live alone often experience isolation and poor nutrition, contributing to depression, cognitive decline, and a lower quality of life. It may be time to consider home care if you find your loved one with some of these symptoms.

In-Home Care Offers Independence

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. A plan of care can be tailored to meet the likes and needs of your loved one.  This is the superior option to scheduled activities and regimented care that is often provided in assisted living facilities.  At home, your loved one can set their own schedule and find comfort in the familiarity of their surroundings.

NursePartners works with each family to enable safety, comfortability, and happiness through home care services. As part of this process, we match your loved one’s needs to a select group of compassionate carepartners.

Our carepartners are dedicated to improving our clients’ quality of life. Our approach to Alzheimer’s and dementia care is based on The GEMS™: Brain Change Model created by Teepa Snow.  

The GEMS™: Brain Change Model

NursePartners recognizes 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, each defined by unique characteristics. Understanding each stage of the process allows carepartners to gain a deeper insight into what your loved one is experiencing.

After an in-home assessment, we work to create a plan of care to help your loved one live comfortably and safely. By keeping a record of everything from mood behaviors, health complications, to daily activities, we can begin to understand what factors contribute to positive moods and overall happiness.

In-home care offers independence, and NursePartners delivers with flexible, customized solutions. Ready to learn more? Our care team would love to offer a complimentary in-home care consultation. Contact us today.

Developing Trust with Your Doctor

As family members and caretakers, we play a large role in overseeing the medical needs of our loved ones. Your relationship with medical professionals is based on trust, communication and understanding.  The stronger the patient-physician relationship, the more value it provides. It’s been shown that individuals who establish relationships with their doctors tend to have better health outcomes. Building a plan of care that includes their doctor enables you to help meet the medical needs of your loved one throughout their later years.

Chupein with Shy

Here’s how you can establish a relationship and keep it on track:

 

  • Prepare for your appointment.

Bring all current medications, along with notes and facts about the state of health of your loved one. Write down any recent health problems or concerns that you have beforehand, so you make sure to bring them up.

 

  • Choose a relationship style.

Whether it’s a new doctor that you’re meeting for the first time or one that you’ve had a relationship with for a while, state clearly at the beginning of your visit that you want to be involved as a partner in the decision-making process.

 

  • Provide some background.

Share your point of view. How is a new technique working?  You should let your doctor know either way. If your loved one has a complicated medical history, or if you are meeting with a new doctor, bring a summary of recent tests, treatments and health problems so the doctor understands quickly.

 

  • Make sure you leave with the information you need.

You need to leave the doctor’s appointment with the information to provide care.  Record your visit, or bring someone to take notes. There’s often a lot of information to absorb during a doctor’s appointment, particularly if you’re facing a major, frightening health challenge. You may be distracted by trying to take in a diagnosis, so it can be helpful to take notes of everything discussed.

 

  • Ask how to reach your doctor after hours.

It’s important to ask your doctor how to keep in touch in the event of a medical emergency that happens outside of regular hours. Every doctor will have a different preference, so find out which method works best.  If you know the system for getting in touch before a crisis.

 

Our carepartners are dedicated to improving quality of life. NursePartners works diligently to ensure carepartners fill their time together with 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, comfortability, and happiness through home-care services.

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