At Coastal Concierge we work with Alzheimer’s patients and if you are new to this situation, we understand that it can be very stressful. The most important thing to remember is this, patience is the key. They say in real estate, the three rules are location, location, location. In caring for those with Alz and Dementia, the three rules are patience, patience and more patience. If you get stressed and agitated it will only make your loved one more disoriented.
Marki Flannery wrote a blog post with a list of things one can do to make things run more smoothly:
….. here are seven tricks of the trade that combine into something we might call patience, probably the most valuable and elusive currency of caregiving.
1. Emphasize familiarity. I’m Sandy, I visit you every day… Take every opportunity to reorient the client or loved one to person, place and time. This breeds familiarity and a sense of safety, paramount to a person with dementia. Even with a family member, a dementia patient benefits from simple reminders every time you walk in the room. Hi Gram, it’s me, Amy. I’m on summer break from college, and I’m spending the morning with you. If you arrive looking different — with a new hairstyle or a business suit when you usually wear jeans — make a note of it. It’s me, Amy, with a new, short haircut.
2. Be observant. In the conversation about Miss Johnson’s tea, the aide introduced the morning ritual by saying, “I notice.” Because familiarity can soften the agitation of dementia, successful caregiving depends on careful observation. Observe favorite foods so you can maintain a successful menu. By the same token, observe whether the person you’re caring for prefers variety in day-to-day meals.
It also helps to observe which times of day correspond to increases in clarity or confusion. Often, dementia patients wake up confused, rise to a level of lucidity mid-morning, and decline again around sunset (also known as sundowning). During the periods of extreme confusion, avoid confrontation and expect more repetition.
3. Practice good communication. Conversations are certain to get repetitive, and when that happens, active listening and touching on different points can be helpful as a conversation loops around again and again. Clarification and rewording the question go a long way, too. You mentioned you want this blue sweater. Do you want to wear it even though it’s 90 degrees outside today?
It helps to remember that you can pause in the course of conversation as well. “Sometimes the other person needs time to think,” says Gale Storm. “So give them that chance. You don’t have to fill all the silences.” That is a common temptation when conversing with someone with dementia.
4. Seek input. Asking for your loved one’s input helps foster engagement and dignity. Give suggestions — Its 84 degrees and humid, so let’s wear short sleeves — but let the elder have a say in which shirt, which light skirt. When you go to the store, ask for input. Should I get the DelMonte corn, or whatever brand is on sale? White bread, wheat bread, or whatever’s on sale? Have your loved one write the list or count out the money, if appropriate.
5. Let go of expectations. Gale points out that just because Miss Johnson has had her tea this way every morning for two weeks does not mean she will want it that way today. Alzheimer’s is a disease that keeps confounding expectations. Levels of memory loss and lucidity can fluctuate greatly from day-to-day; the only constant is change. My own mother suffered from Alzheimer’s, and letting go of expectations — both day-to-day and those that were formed over a lifetime — was one of the most difficult things to accept in caring for her — and caring for myself.
6. Be aware of your tone and facial expressions. No matter the level of your loved one’s dementia, he or she will always respond to tone of voice or facial expression — the very things a well-meaning but stressed caregiver might overlook. Even if you have to fake it till you make it, try to keep an encouraging tone to your voice and a smile on your face (or at least a neutral facial expression). “You can say the exact same thing, but it’s a world of difference whether you’re saying it with a smile or a frown,” Gale reminds us.
7. Know when to walk away. One of the most important things you can do for yourself as a caregiver — especially when caring for a loved one with dementia — is to know when to step away. If a situation has become combative or overwhelming, take a deep breath and step away (making sure the situation is safe to leave, of course). As Gale notes, “Taking three minutes to go into the rest room is a perfectly reasonable thing to do. Try to come back with a changed facial expression.”
Our staff is trained to work with those who suffer from this debilitating disease. We can help take good care of your loved ones so you don’t have to shoulder all of the caretaking yourself. Give us a call and we can set up an appointment to get together .