Dementia: Coping with the Change

This is a beautiful film. Nic Askew and his Soul Biographies blow me away time and time again. "A Life Beyond" is so relevant to the changes we are coping with today. I may even say it showcases humanity at its finest. It is short, 7 minutes, and well worth your time. Click, watch, and listen. Be prepared for a transforming perspective.

I speak to this concept quite often, to families, therapists, nurses, any caregiver. A change of outlook can make everything we do when caring for someone with dementia much different, less burdensome, more joyful, and the shift happens not just for us but also for the person we love who has this horrible disease.

One of my favorite phrases about the work I do is "my patients give me so much more than I could ever give them". So true when the viewpoint is one of an exchange with this person you hold dear and not just the load of care-taking. This is a valuable angle that should be shared.

Thank you to Soul Biographies and Nic Askew for such meaningful films.

Keeping the Memories

Today will be a day filled with a riot of reminiscing. I'm with my family in Virginia, "The Cooks" for our holiday celebration. This will be a few hours together with my mother, stepfather, aunts, uncles, and cousins. All of us together for a day. We really don't have any elderly left in the family, but the memories of the are abundant. This year I am going with the flow, but throughout the next year I am going to send some time capturing a piece of this family's story. It's too important to lose.

Most of the time is spent during our gatherings is for visiting, talking about our lives today, remembering the past, and what amazing memories they are. I love hearing Mom talk about growing up with 10 other siblings. When she gets together with all of the brothers and sisters it's like they speak a different language. They have code talk, and these key phrases are hilarious to them, but indecipherable to others. Sometimes they explain the story behind the phrase and it all makes sense then. This was a huge part of my childhood, and I wonder if the next generation of kids in our family will know any of the "Cookisms" because it doesn't really translate without the entire story told. I am thinking I'll capture these tales.

I know all families have their own allegory, and I see no better way to honor our elders than to acknowledge the importance of that history and record their narrative. Everyone should have the chance for future generations to hear their own "familyisms". It is so important that we collect memories that make us laugh, or smiles, or cry, or even take us back to that special moment. Let's commemorate!

Will you have some special time with your loved ones this season? I am sure remembering will be a part of the time sent with your loved ones. So rise to the challenge. Use these tools, make he memories last beyond this lifetime.

To converse and record with the person with memory loss...

http://storycorps.org/initiatives/mli/

For anyone...

http://nationaldayoflistening.org/participate

Aging or Living

A few hours ago I spoke with a friend on the phone. We had a great conversation about healthy living, our belief systems about our bodies, our abilities at any age, and the power our minds hold over changing the way we live.

Somehow our society cultivates a belief that once we reach a certain age, our capabilities diminish. Mental capacity, physical agility, as we age, everything about our being changes. Working in a medical setting I know that some of this is true, but I also realize that we are largely responsible for the vitality or arrest of ourselves. Who makes these rules anyway? I know there is some science to back up symptoms of aging. On the other hand, I have encountered 70 year olds who are very fit, and 30 year olds who are on the verge of heart failure. Honestly, I live a much healthier life now than I did at 21. There are exceptions to every rule. So, who are the anomalies and what make them go against the norm?

I saw a patient in therapy a couple of years ago who was in her 90s. She could no longer swallow. She was weak, has been ill, had a feeding tube, and stayed in bed most of the day. She was asking for water, food, typical things that would be missed if after nearly a century they were suddenly taken away. I was the swallowing specialist; so, what could it hurt if I tried? Her family had no hope, but this woman told me from day one that she was sure she could eat and drink if someone would just give her a chance. Disheartened by her horrible quality of life I decided to give therapy a shot. We worked together, she began drinking water again, then food came. She refused to accept that 90 was the age for her to give up. She believed that she could do it again, and with a little help she did.

Wouldn't it be nice if we could reframe our view of what aging should be? Should it include losing something as basic as food and water? Wouldn't it be nice if everyone had the philosophy of being able to do anything you set your mind to. We could look at each year of life as an opportunity to outdo our previous selves. I would love to see us serve as inspiration to those aging around us to thrive, and live their most fulfilled life right now. Seriously, we aren't kidding anyone. We are all "aging." Maybe it would be better stated as we are all "living". It is really that simple.

If we believe we are getting older then guess what, old it is. If we hold the perception that our bodies, our brains are breaking down then guess what happens. Just like my patient who knew that path was not the one for her. She believed she could change direction, so her last years were more pleasant and fulfilling. We can do the same. Imagine if every person on this Earth chose to "live" instead of "age" what a different world it could be. Do we simply grow old, or do we live amazing adventures and make the most of each day, month, year, decade? They pass by quickly. You make the choice.

Travel Time

Airplanes, airports, flight schedules, delays, and diversions; they all make for interesting traveling. As I sat in the airport last night I watched an elderly couple make their way through the madness.

We enter the security checkpoint at approximately the same time. I am in no rush, so behind the couple I stay, watching as they fumble around with their bags. I have it down to a science now, so it baffles me when others enter with no clue. The wife removes liquids and proceeds to dig through her purse taking out some makeup items. She can't maneuver her luggage. Pulling the bag is ok, but when it's time to lift, her companion takes over. Good thing he's there with the muscle I think to myself. The husband removes some items, and to his dismay he has to ditch the Sam's Club size Barbasol. Then their bags go through the scanner, they move one duffle type bag forward and back, repeat, call another agent over to look. Coins are the culprit. One gallon size zip-lock storage bag and one quart size, filled to the brim with coins. Off to the corner searching station they go and I lose sight for a moment, but can hear the man exclaiming that he can't possibly comprehend why coins pose a problem. Ok, so now I'm thinking that confusion with the whole security process could happen to anyone, but I am keeping my eyes and ears peeled in case they run into problems. These seniors aren't too savvy in the traveling department.

Delays and cancellations keep arising. I see the couple sitting at another gate. By this time the lady is sitting, her husband is pacing. He walks to the monitors, back to his wife, and to the monitors again. There are no attendants at the counter. Status change announcements blare over the intercom. Out of desperation the man walks my direction. I suppose I appear elderly friendly. He can't understand what is happening or what's going to come of his itinerary. They need to get to a larger airport and with the delays he won't make his connection. So he shows me the tickets, and when I begin to explain he asks that I talk to his wife as well. We venture across the room, and I launch into a discussion of time zones, standby lists, etc. I am fortunate that the wife understands fully. Her husband is relying on her reasoning skills to make this trip happen.

All flights were cancelled last night, so they went home to rest, while I tried not to think about the possibility that they were driving around in the foggy, dark, stormy weather. I imagine he drove & she navigated. The brawn and the brains had to work as a team. This morning I didn't see them, but hopefully with improving weather this man and wife will experience a flawless trip, much like myself.

So this brings me to my point. We take for granted the ease at which we can problem solve, shift gears and come up with an alternative. Airports can be pretty unfriendly, and I have seen some moments of terrible customer service when flying. I wonder how many elderly would report that flying is difficult for them? What might make it a more pleasant event? What services could benefit the aging population in the industry of travel?

Moments of Clarity

If you have participated in my presentations/courses you know that I am most often the last to give up hope. I am the one who says over and over again that we need to look for the moments of lucidity, and take full advantage of the times when our patients and loved ones with dementia are a resemblance of their former self. So today I saw it, again, firsthand. A woman who I’d basically written off, told her family she was not going to regain any of her thinking skills, and told all of the staff that the compensation system we had in place was all we could do, proved me wrong.

I saw her spark come back a couple of weeks ago, and to my dismay that light remains consistent even now. A few months ago, when I first met her, she told me that if I just gave her time she would feel better and recover. I persisted with therapy then, and I failed. She was correct. Now, it seems like she has shed about 10 years. Today we had a wonderful conversation. She laughed, smiled, and discussed her life with a precision and simplicity that made me know this was improvement. She also gave me some insight that was very valuable. Listen to your patients. Sometimes even when they seem off base and confused if we can listen to what they are truly saying, and realize that our goals and our time frame is not always what best suits them.

By leaving my preconceived notions behind and remembering that we all know ourselves better than any medical professional could, I am able to see the value in reading beyond the uncertainty of dementia. We have a responsibility to help our people live their best lives for as long as possible. How can we possibly begin to do that if we don’t use what they know to our advantage? Use their moments of clarity, find some resolution for yourself, and consider what we are here for. Reflect on our purpose of helping the elderly exist in a way that makes keeps life normal.

Seniors and Holiday Woe

The holiday season can be extremely hard for many. I know that I tend to remember holidays of years past, long to be with my family, and miss loved ones who have passed on. I also have a real distaste for the commercial aspect and the mass amount of consumerism that plays into the holiday season in our culture. Not to mention that we lose focus on taking care of our physical self as we spend time running here to there, shopping, visiting, and experiencing the hustle and bustle. While I know that many people are inspired by the sights, the sounds, and the aromas. You have to admit that the amplified energy levels this time of year creates can be difficult, even for the most avid holiday enthusiast. Many factors come into play, sadness, loneliness, financial stress, time crunches, or sensory overload and they all take a toll.

Seniors are very susceptible to depression associated with the holidays. Just think about it from their perspective…

An elderly widow, we’ll call her Sue, lives at home alone and her children and grandchildren are coming to visit. This year Sue has been feeling less motivated to get prepared than ever. Maybe it’s because she is coming very close to that 80 year mark, or maybe it is just because she has recently stopped driving. Sue is worried that she won’t have all of the necessary food, presents, and amenities that her family is used to when they arrive for their traditional 4 day visit, but what could she have done, she has to rely on neighbors for a ride to the store, or she has to use the senior bus, and it is not easy to be prepared and remember all you need on the occasional bus trip. Plus the stores are so crowded and big that she can’t find anything. Her kids are bringing the dinner, they tell her not to worry about anything, but this makes Sue feel inadequate. Do they think she is not capable? What will be next, if she can’t drive and can’t cook dinner when will they decide she is too feeble to be alone? The last thing Sue wants is to have to move into one of those places for old people. They arrive, her kids, grandkids, a pet dog, they bring presents and food. Sue’s entire routine is changed. Sue is so grateful to have her family with her, happy they are willing to travel and share their time, but she is exhausted before they even arrive, and by the end of the visit, she feels like she could fall over from fatigue. Can you see how this might lead to the holiday blues? Can you see how Sue might have conflicted feelings as she is appreciative and thankful to have this time with her family, but she also is so out of her own routine that she begins to sense anxiousness and worry?

So what do we do?

The Mayo Clinic reports the top 3 triggers for holiday stress are relationships, finances, and physical demands. Sue is burdened by all of these. Many seniors are in this position, and even if they have no issues with money, even if their family takes care of every aspect of the physical load, everyone has to cope with the relationships (or lack thereof) which is an undercurrent of the season. So we need to simplify the whole process. Slow down. Focus on contact, interaction, and connection. Make the seniors in your life realize just how much love surrounds them during this holiday season.

Photo Courtesy of Mimi_K http://www.flickr.com/photos/mimk/2117234691/

November 16th: National Memory Screening Day

The Alzheimer’s Foundation of America is holding its annual National Memory Screening Day this upcoming Tuesday.

A screening is not a diagnosis, or in-depth testing, but a systematic way to look at areas of concern and determine if you or your loved one is at risk for dementia. It is also a great way to examine memory right now. Even if you are not having trouble the screen is helpful for future comparisons.

More than 2,000 locations nationally will provide the opportunity on Tuesday, November 16th for memory screening. Click on the link below for more detials.

http://nationalmemoryscreening.org/index.php

Take this opportunity and screen your parents’ memory, your grandparents’, and your memory. This valuable service could help for earlier diagnosis of dementia, and guess what…the medical treatment available right now for Alzheimer’s and other types of dementias is MOST EFFECTIVE in early stages. So why wait?