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?

Too Old??

You are never too old to try something new…

A concept proven today as I watched a group of elderly men and women experience their first “Mexican Meal”. We planned for days, talked about the different foods served in Mexico, and all of my senior friends said that they were unsure of how it would turn out, but were willing to give it a shot. They filed in, with Pandora pumping mariachi music, and spirits high, the lunch preparation began. We had a blast stuffing tortillas and faces alike. Everyone loved their lunch and 75% of the people had never tried this type of cuisine. The comments ranged from “better than I thought it would be” to “a real treat”. My personal favorite was when I asked one person who happened to be hard of hearing if she was ready for a Mexican dance, and was met with the exclamation of “I don’t want any man, Mexican or not”. Hahaha. The laughs kept coming, our bellies were full, and we all thought the fiesta was a success!

New experiences keep us fresh. We all get stuck in the same old patterns, but let’s take a lesson from these kids and remember that you never know until you try.

Way to Go Grey's

I love seeing the movement go mainstream!

McDreamy & Meredith are making waves in the right direction :)



http://abc.go.com/shows/greys-anatomy/video-detail/featured/leading-the-fight-against-alzheimers/pl_PL5520968/vd_VD5593036

Perils of Presenting

I did a guest lecture last night at Marshall University. My talk centered on dementia and the SLP’s role. A day later, it is interesting to reflect on that brief time I spent with the class. A little nervousness came over me, far different from my typical experience presenting. I am rarely nervous for an 8 hour day and room full of therapists, but this hour lecture to a few graduate students caused me to loose the timing and fluency that I have worked hard to perfect.

So after sleeping on it I realized what my deal was. I had a room full of people who were seemingly eager to hear what I had to say. Not your standard CE course with texting, passing notes to one another, (both distractors I have learned to tune out completely), but now I had the full attention of 25ish speech-language pathologists in the making. A very different audience that my norm. They were all fully aware, took notes diligently, and the amount of motivation in that room was overwhelming. That is a different sort of pressure than I am used to. The ladies’ passion and desire to take in all of the information they possibly could was refreshing, but also a bit nerve-racking.

I did however enjoy my time with that class and their eagerness was what I appreciated most. They had a look in their eyes, apparent excitement to learn, and thoughtful questioning. Their questions were more frank and to the point than I anticipated. I talked about dementia, how we can provide services throughout the stages, as well some of the reasons I love working with this population. As I started to wrap things up, two unanticipated questions came barreling at me. The first student asked if “I felt prepared for the work I do when I started in the field”, and I answered with honesty. Maybe I even laughing a little at the thought of feeling completely equipped at any phase, new grad or seasoned professional. I didn’t and still can’t be prepared for everything I encounter. The next student asked me if “I wanted to leave them with one thing what would that be?” Now this was the question I had not thought about, and I completely veered off topic. I told students not to box themselves in, not to underestimate what they can achieve, or how their skills might provide service. She probably wanted to know the gold standard for dementia treatment, but if you know me I tend to go beyond, and wanted to bestow a grander knowledge for life fulfillment J

It’s remarkable that we ended on such a note. I was completely out of my element for the evening, and feeling less than confident about it. My guidance to these students was to push the boundaries, and believe in their abilities. You know what? I think that is sound advice. I operate that way in my clinical practice, in my life, and my career. Hopefully the students saw it that way as well, and know that there is no cookbook, there is no right way to do it, or wrong way to do it. Life, work, treating patients, we just have to take what we know and apply it to the reality at that moment.

As Memories Slip Away

Just in case you missed NPR's Morning Edition this morning. I thought I'd share a link to the StoryCorps clip aired. This clip was recorded as part of the Memory Loss Initiative.

http://www.npr.org/templates/story/story.php?storyId=129454463

The Patterson's share what they have learned about living with Alzheimer's, and really living in the present moment. They hit on a key point for sure. Like Eleanor Roosevelt said...

Yesterday is history, tomorrow is a mystery, and today is a gift; that's why they call it the present.