a blog about Kilt and her kids plus Trouble our JRT mascot.

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Sequim, Washington, United States

Thursday, April 21, 2011

Caring for dementia

Pop (94 yrs. young) has put on a few pounds since this photo was taken.  He always has an ENSURE with his lunch.  And, he has an occasional Bourbon with his son in the late afternoon.  :0)  He is a "sun" worshiper.  Those old bones need heat.  And, yeah...he spends a lot of time at the dermatologist carving this and that off of him.  That's the price you pay for being a Sun God.

Many people don't "understand" dementia. 
When the memory fails, dementia folks are on "auto pilot." 

They don't do well in "unfamiliar" environments.  I see this all of the time in the hospital.  We used to "restrain" dementia patients so they wouldn't get hurt in the hospital. Restrain, like tie them down.  You can imagine how that affects someone who can't remember even "why" they are in the hospital.  Now we just spend the extra money for a sitter at bedside or plead with the family to come sit with their loved one who has Alzheimers/dementia.  Taking these people out of their environment equals STRESS with a capitol S and CONFUSION.  They are NO longer on auto pilot. 
Just the other day, a 90 something year old lady came into the hospital with lacerations and a broken hip.  She fell, but she didn't fall at home.  Her children needed a break, so they took Mom to another sibling's home for a few days.  Yes, she had been to this house before, but she no longer was flying on "auto-pilot."  Her bed was higher than her usual bed, it wasn't the same amount of steps to get from one room to the other, etc.  She got up in the middle of the night and fell.  Her children said, "She never gets up in the middle of night without calling for assist."  Well, never say never.  They took her out of her environment and bing, badda bing...tragedy.
I'm very fortunate in that my brother and his wife retired when Dad became unable to care for himself anymore.  They moved into his home in Florida.  Pop will be 94 yrs. old this July.  I will be there for his birthday. :0)  Caring for dementia folks is not easy.  Dad doesn't remember to eat, so his meals are made for him and put in front of him.  He rarely used the stairs anymore, but he does go from back porch to front porch on "auto-pilot."  He goes from his rocking chair in his bedroom, to his bed, to his bathroom on "auto-pilot."  Linda, my sister-in-law is a saint.  Dad likes to close the blinds on the window that sits at the far side of the bathtub and then open the blinds in the morning.  Ahhh!  This means he has to step into the tub to do this.  Linda make sure she closes and opens those blinds before he can even think about it.  Anything to avoid a fall!
They keep a dry erase board on the refrigerator with dates like when did Dad shower last, his next medical appt., etc.  Dad just doesn't decide to shower.  He has to be reminded like a toddler and have things set up for him to shower.  Sometimes we have to say, "Pop put a towel on" we are coming in to be able to make sure he uses deodorant and so forth.  This is a daily, ongoing schedule with dementia folks.  It is tiring on the care givers.  Understatement here.  Please, if you have family members that are caring for a parent with dementia, go and offer them a break, a get-a-away.  We are very LUCKY in that Dad is a loving man.  Not all people with dementia are "loving."  I think a person is who he is (was)...Pop was ALWAYS loving, caring, and a gentleman.  But, if we STRESSED him, I'm sure he wouldn't be so lovely. 
Now, Jim and Linda have an agency girl come in for a few hours every week so they can get away by themselves.  This is SO necessary!  But, it was also necessary to tell the agency that it had to be the SAME girl every time.  If you get anything out of this BLOG please understand that dementia folks need  a ROUTINE.  It is comforting to them to do the same thing everyday.  Take them out of their comfort zone, and even more confusion enters if that is possible.  Stress manifests in many ways;  picking, tapping, scratching, pacing, etc.  We try to avoid stress.  Pop can't even remember the agency girls name, but he is comforted by her sight, because he recognizes her face.
Jim and Linda just took their first trip out of state to their eldest daughter's wedding in Texas last week.  The same agency girl stayed with Dad 24/7.  He did just fine.  I'm not sure if he even knew Jim and Linda were gone.  But, they kept him in his own environment with a familiar face.  That is the IMPORTANT piece of this blog. :0)


Karen said...

That's very informative, thank you!

gvmama said...

Thanks Karen. I once had a gentleman tell me at a sheepdog trial that he reads my blog not so much for the dogs, but for the writings about caring for the elderly with dementia. So from time to time I like to blog on nursing stuff. You never know who might be lurking. :0)

Kym Sorensen said...

Very powerful piece. I think of all the people who are not fortunate enough to have a loving family like your father. He is truly blessed and your words remind us all of the importance of family and community.

gvmama said...

Thanks Kym. My girlfriend who is the best NP ever suggests Nancy Reagan's book The Long Goodbye.