Thursday, December 31, 2015

Until We Meet Again

  



It was a complication. Nothing had been planned in advance.  And why should there be morose reflections on, "What if's," or "What might be?"  Everything was going so well, and had gone well for over 40 years.  And oh, the 40 years were very good years indeed.  Sylvia and Bob meet in high school, and it was love at first sight.  An absolutely wonderful marriage,  Sylvia and Bob's marriage was a marriage made in Hollywood!  No, not the Hollywood of today, but a marriage built on love, typical of Hollywood movie endings from the 1940's where the perfect couple falls in love, and rides away at the end of the movie, off into the sunset!!

  The beginning was just that, perfect. And although there were the typical rocky roads of financial struggles, ups and downs of raising kids, switching jobs, etc.  Sylvia and Bob had a very happy marriage. They married in the 1950's had 3 kids and became grandparents in the late 70's. Everything seemed to fall into place. And their health was superb. On occasion, one of them would have a cold, or the flu once a year maybe,  there were no hurdles other than that concerning health. No hurdles at all, just every day waking up, and enjoying life, loving each other and that was pretty darn good, in fact, Sylvia and Bob were very happy for 40 years!!

  And then, when they both entered the realm of their 80's, things started to go South, and all hell broke lose.  It wasn't gradual, either.  It was all at once like a runaway wagon train pulled by wild horses.  A tornado of awful, terrible loss that no one in the world could have predicted.

  Firstly, Bob started forgetting things. He would go shopping, forget where his car was, and would forget what he went to the store to buy, so he bought 4 of everything. His buying habits started to not only concern Sylvia, but began to annoy her. And Bob started feeling agitated, possibly from the memory loss, but would mask his agitation on political issues, oftentimes screaming at the TV in rage filled explosive rants.  When the grandchildren would come over, it didn't take much for the normally very patient Bob to completely lose his temper. It got so bad that his grandchildren would no longer visit the house without being accompanied by a parent.  The once calm and beloved Bob was becoming a grumpy,  angry, forgetful old man. Finally, he was diagnosed with Alzheimer's Disease which Sylvia was left to manage.

 Shortly after Sylvia became Bob's care partner she  herself received a diagnosis. She found out that she had aggressive breast cancer, and had to juggle chemotherapy treatments with managing her husband's late night wandering, along with protecting herself from his volatile temper.  The cancer soon started to spread and with a heavy heart, Sylvia had to admit her beloved husband Bob into a nursing home.

Sylvia went to visit Bob  frequently in the nursing home, and one day she couldn't find Bob in his room. After searching for Bob down the long corridor, Sylvia saw him sitting with his back to her looking out the window at sunset holding the hand of another woman.  Just as Sylvia was about to approach the two, Bob stood up unaware of Sylvia's presence and gave the other woman a long and  passionate kiss.   This was so shocking to Sylvia that she almost fainted, and ran away before Bob could see her. After months and months of Bob appearing detached from Sylvia, Sylvia stopped visiting him and one night,  all alone in the happy home Sylvia and Bob once created together, Sylvia died in her sleep.

Sylvia and Bob's children were heartbroken by the loss of their mother and dreaded breaking the news  of her death to their father.  (All along, everyone had been mourning the slow demise of their father, and were surprised to see that their mother was the first of the two to go.) When they approached their father to tell him of her death, they surrounded him with a group prayer and slowly got his attention. Bob's oldest son looked into his eyes and said, "Dad, Mom has gone to heaven, and you won't be seeing her anymore. She died in her sleep, but she loved you."  There was a solemn nod of his head to acknowledge what was being said, and then Bob looked up and smiled, "We will see each other again in heaven. We will see each other again in heaven."

Sometimes people with Alzheimer's and dementia's will re-live this news over and over again especially when they are unable to call their loved ones, or to have their loved ones visit them. Some care-partners choose to not bring up the subject until the carer brings it up. When that happens, according to Naomi Feil, MSW., it is best to tell them the truth.  Have a gentle way to say what needs to be said. Some people will ask a question with a question like, "Where is so and so?"  and an example of an answer could be, "Where would you like them to be?" Another question could be, "Where do you think he/she is?"  And many times they know the person has departed, but just want reassurance that everything in the present moment is okay. They may even answer their own question like Lori's mother often does by saying. "He is in heaven and I will see him when I get there."  Or "My mother is waiting for me and will meet me at the bridge."  And Lori will say, "How does that make you feel?"  And Lori's mother will say, "Like he, or she is still with me in my heart."  She then smiles and doesn't bring it up until she wants to bring it up.


Having an item that belonged to the departed person is very helpful, along with an obituary. Again, rather than dwelling on the death, it is best to let the person suffering the loss to lead you.  They will share things when they are ready to share things. And when they want more information like an obituary, they will tell you.  Lori's mother chose not to look at an obituary, and told Lori to put it in her diary. Since Lori's mother is a very private person, she will be able to have her privacy when she reads the obituary alone at her choosing, but Lori will be close by if she needs her.

 Dwelling on death day in and day out can bring up fear, loneliness and even more confusion. Lori's mother has a beautiful book filled with pictures of her loved ones and stories that she herself wrote in her younger years. Reminiscing can be healthy ways to honor a loved one and to bring back very happy memories.

  However, breaking the news is never easy and can be heartbreaking for everyone, especially the caregiver/care partner.  It is important to foster a support system of friends, family or counselors so that you the caregiver can grieve too, if you knew the departed person. (This can be especially hard if this involves the loss of a child, even if the child is a grown adult when they make their transition.) A loved one  being cared for by a family member will pick up on the family caregiver's mood of sadness, etc.  Support groups can be very helpful during this time of loss.

 (For those who have touched our hearts, and have recently passed, "May the Lord hold you in the palm of His hand, until we meet again!"  RIP )


Positive Communication methods for people living with dementia:  We recommend seminars by Teepa Snow,M.S., OTR/L.FAOTA www.teepasnow.com, Naomi Feil, MSW, www.vfvalidation.org, and her books, all of them. And the life changing, ground breaking books, "Contented Dementia," by Dr. Oliver James, "The Mindful Caregiver," by Nancy L. Kriseman, and "Deeper Into The Soul," by Nader Robert Shabahangi, Ph.D, and Bogna Szymkiewicz, Ph.D

Copyright 2015 Caregivers Get Fit! Mama  Nicey

The information in this blog is information. It is not meant to be a replacement for getting medical advice from your own health professional regarding your own individual health challenge or condition. Dr. Denise will not diagnose, treat, or give direct personal consultations/advice to you on this blog for any medical condition, but will give general examples, and scientific research on many different health topics.  How you decide to use the information is between you and your own medical/ health professional.
   



Sunday, December 13, 2015

Caregiving Mom Earns More Than Six Figures Working From Home!




She never knew it was possible, way back when when the economy tanked, and Jennifer (not her real name),  a self employed consultant, received another foreclosure notice (her 12th), on her dream home that she built just a few short years ago.  What was she going to do???  Her business was so slow, she had to close it, and she had a son with special medical needs, along with 6 other children. So, working outside of the home was not even a consideration. However, Jennifer was desperate, and her family was hungry.  Her husband's two jobs did not cover what was needed to pay the mortgage, the household bills, their son's medical bills, and their need to save for retirement.  During her job interviews for 9-5 positions, Jennifer would always get, "We think your resume is impressive, but you may be overqualified for what we are looking for and could offer you."  In other words, what wasn't being said was, "We want to hire someone younger than you!" Soon, Jennifer and her family had to go on medicaid, and they found themselves eating expired 2 for 1 discount grocery specials. When it was time that year to buy school supplies and new shoes for her son, Jennifer found herself one day sobbing in the parking lot of a mall, praying to God to lift her out of poverty and into prosperity so that she could provide for her family and live an abundant life.

   How many times does poverty happen to good people in the U.S.,  who want to help their loved ones, and want to care for them in their homes, rather than sending them to institutions for care????  Statistics from AARP, The Alzheimers Association, and varied independent studies state the following with regards to the economic impact that caregivers in the U.S. face today:  Caregiver services were valued at $450 billion per year in 2009- up from $375 billion in year 2007. And the stats are climbing higher and higher every year. 52 million caregivers provide care to adults (aged 18+) with a disability or illness. 43.5 million of adult family caregivers care for someone 50+ years of age and 14.9 million care for someone who has Alzheimer's disease or other dementia. Parent care continues to be the primary caregiving situation for mid-life caregivers with 70% of the caregivers between the ages of 50 and 64. In 2010, 14.9 million families and other unpaid caregivers of people with Alzheimer's disease and other dementias provided about 17 billion hours of unpaid care. This represents an average of 21.9 hours of caregiving per week, or 1,139 hours of care per caregiver valued annually at $11.93 per hour- an estimated $202.6 billion in 2010. And now in 2015, the numbers have increased and will keep on increasing as more and more people are diagnosed with one of the dementias.  Caring for persons with dementia is reported to impact a person's immune system for up to 3 years after their caregiving experience ends, thus increasing their chances of developing a chronic illness themselves. Reports show there is a correlation between a caregiver's health and income. Of caregivers with less than $30,000 in household income, 34% report fair or poor health as compared with 3% of caregivers with $100,000 or more. The same pattern is also found with a caregiver's level of education.

  Jennifer stopped looking for a 9-5 job, and decided to look into a way to make money working from home.  She researched working from home opportunities and found a direct marketing company that specialized in training stay at home mothers with no experience , to have the tools needed to thrive in network marketing by consuming and promoting weight loss, wellness and healthy aging products from her computer. Today in 2015, Network Marketing is a 167billion dollar industry, and "NO, THIS IS NOT THE SAME THING AS A PYRAMID MARKETING SCHEME!!"  There are hundreds of legitimate companies out there which are international companies.  And statistics have proven that 80% of women in the  U.S. working force who are making $100,000, or more are " stay at home moms,"  who are working in network marketing.

Jennifer saw the potential of the opportunity, took action, worked hard, made over $100,000.00 her first year and is now making a multiple six figure income.  And although, this isn't typical for everyone who is involved in network marketing, or for that matter,  the particular company that Jennifer works for,  it is very possible for some. It just depends on the amount of work, time, etc. Like anything else. And this type of work isn't for everyone, only people who are interested in putting some time in for a residual cash flow. Some people have no interest in this type of business model, and others do this and are not as successful as they attempted to be when they first started out. So there is no, "get rich quick," promise here, but since network marketing is a 167 billion dollar industry, it may be an important income generating opportunity for family caregivers.   

  A majority of  family caregivers today are unpaid caregivers who have left their jobs, and given up their incomes to care for their loved ones. These caregivers could benefit greatly from learning more about the benefits of network marketing. Lori, (see other blog posts), currently works in network marketing.  She is able to work from her computer while her mother who has dementia and needs 24/7 care, takes her naps. This financial opportunity has been an incredible blessing for Lori who is able to work less than 10 hours a week from her computer, while making a residual income which will soon surpass her 9-5 salary as a health care professional. 

  There are many international network marketing companies out there which are profitable, reputable and successful. If interested in finding information on the network marketing company that Lori and Jennifer would recommend, click links and watch these videos: 

http://media3.repstars.com/thumbs/links/full_d3d3Lm15aXNhZ2VuaXguY29tL215L3Nwb3RzL3RodW1ibmFpbD9mbl9zcG90X2lkPTc3NDImZm5fdGh1bWJuYWlsX3Jlc2l6ZT0xJmZuX3dpZHRoPTMzMiZmbl9oZWlnaHQ9NDkwJmZ2X2NiPUFa.jpg
Discover the missing link to amazing health!



 http://media3.repstars.com/thumbs/links/full_d3d3Lm15aXNhZ2VuaXguY29tL215L3Nwb3RzL3RodW1ibmFpbD9mbl9zcG90X2lkPTQ5ODA3NSZmbl90aHVtYm5haWxfcmVzaXplPTEmZm5fd2lkdGg9MzMyJmZuX2hlaWdodD00OTAmZnZfY2I9QVo=.jpg
Discover the missing link to amazing health!





References for stats on Caregiving above:   https://www.caregiver.org/selected-caregiver-statistics


Positive Communication methods for people living with dementia:  We recommend seminars by Teepa Snow,M.S., OTR/L.FAOTA www.teepasnow.com, Naomi Feil, MSW, www.vfvalidation.org, and her books, all of them. And the life changing, ground breaking books, "Contented Dementia," by Dr. Oliver James, "The Mindful Caregiver," by Nancy L. Kriseman, and "Deeper Into The Soul," by Nader Robert Shabahangi, Ph.D, and Bogna Szymkiewicz, Ph.D

Copyright 2015 Caregivers Get Fit! Mama  Nicey

The information in this blog is information. It is not meant to be a replacement for getting medical advice from your own health professional regarding your own individual health challenge or condition. Dr. Denise will not diagnose, treat, or give direct personal consultations/advice to you on this blog for any medical condition, but will give general examples, and scientific research on many different health topics.  How you decide to use the information is between you and your own medical/ health professional.
   
 

Wednesday, November 11, 2015

I Miss Me, Too!





  It was a combination of the changing of seasons and the settling of an estate. Lori's mother in law had passed on, and all of the contents in her house were arriving on a truck outside of Lori's mother's window. This left many questions for Lori's mother, and moments that Lori hadn't anticipated.

  "Did she know?" Lori's mother would pass from room to room inspecting the new, very old furniture additions, and was trying out every chair, couch and bed that the movers had delivered, on every floor. "Did she know what, mother?" Lori was listening to her mother while she was putting folded clothes into her newly acquired chest of drawers. "Did she know that she was going to die?" Lori's mother asked the question while focusing her gaze out the window. "That's a great question Mom, worth pondering. I think she knew.  It's something we all think about, but becomes more of a common question we ask of ourselves when we age or when we are facing a serious illness, don't you agree?" "Oh, yes that is true. Ohhh yes." Lori's mother then stood up, walked into her grand daughters room and laid on her new/old bed. "This is a nice room. I'm going to like this very much and look at my new bed!" Lori's mother then laid down on her side with her head on the pillow and struck a glamour pose. Lori, without wanting to ruin her excitement didn't say a word, and continued down the hall into the other room. "Mom, " said Lori's daughter with a frantic tone. "How are you going to tell grandma that is not her room? She's napping in my bed with a smile on her face. I think she thinks MY room is HER room!" Give her some time, she will shift her attention to other things in a few minutes. Let her enjoy herself, honey. "I just don't want an old lady sleeping in my bed, Mom." "Show some respect, young lady, " said Lori. "An old lady who is now in heaven, (your other grandmother),  slept in that bed  for more than a few years, okay???" (Lori's daughter rolled her eyes, and tried not to show Lori her teen-aged disgust!!)

  "Hey where did grandma go, now?" Lori's daughter couldn't believe how perked up her grandmother had become. They both found Lori's mother in the basement admiring the couch and lamps. "What do you think of my living room?" Lori's mother was so happy to see the furniture in place.  "I think that couch has "nap," written all over it!"  Lori's mother laid on the couch and was hugging the pillows. "This bed is smaller than the other bed," Lori's mother was comparing rooms. Lori noticed that a midst the chaos, her mother was putting things together more fluently than she would normally put things together on a daily basis. It was then that she thought that maybe very old people ( as Naomi Feil, MSW who is 86 herself, calls people over 80 with dementia), can become energized synaptically (directly influencing new thought patterns by new connections formed in their brains), by a break in routine. Too much rapid change appeared to cause confusion for Lori's mother.  But a slight change in routine could be stimulating,  forming new thought patterns, creating physical endurance. Her mother's reaction to the new furniture and observations of the movers, etc., almost made her appear to be without disability.

  And then it happened. While Lori was cleaning boxes in her room, transferring journals, mementos, and special cards she had received from people in the past - she found a card with a puppy on the cover from her mother. It was filled with deep love and overflowing compassion, sent to Lori at very difficult time in her life.Probably the most painful emotional ordeal that Lori had ever gone through. The words were so comforting and inspired. Lori's mother spoke from her heart about how hard it is to watch someone who you love so much, experience so much suffering and pain in their lives. Especially when that someone is your child. Reading the letter brought Lori's mother back to her in an instant. The mother who loved her children more deeply than she loved life, and who was always there for Lori, her sisters, her friends, family and spouse though the thick and thin. ALWAYS there with a phonecall, a card, a hand, a hug, a hospital visit, ALWAYS there, loving and accepting everyone with overflowing empathy, acceptance, forgiveness and compassion. Truly a person who always listened on a deep, deep level to the needs and feelings of the person sitting in front of her.  And Lori couldn't help but think to herself after reading the letter "I miss you, I miss you so much mother! I miss you so much it hurts! It hurts so much I can hardly breathe sometimes!!"

This may sound strange to the reader, knowing that Lori is living with her mother, and seeing her every day. However,  the disease of dementia can can rob intimacy, and create levels of detachment. Lori's mother is no longer able to relate in the same way as she did in the past, regarding the initiation of supportive behaviors for others because she has lost so much of her short term memory. And so, Lori decided to cope with the detachment by using some of the things her mother as her role model taught her, throughout her life.

  Lori's mother's greatest life lessons to share with her loved ones have been two things. After being married to a man with mental illness, she had to learn, 1) forgiveness and, 2) acceptance. Lori's mother always told her that the man, (Lori's father) that Lori knew growing up, was not the same man that she  had fallen in love with and married in the early 50's.  His illness took him from her. But she always told Lori, that there are blessings in everything, even when we can't see them. She would say, "If we have faith and can look up, God will show us miracles in everything, and love itself can heal anything, anyone and any situation." Lori has worked hard to forgive others, and to accept God's will which, (as hard as it can be),  includes watching her mother suffer from dementia.

So,  on days like the day Lori had recently, of  finding an old card from the past and thinking, "I miss you Mom." Lori's mother might also have moments of lucidity, when she realizes she can no longer be there in the same way she was in the past for herself, and for others- and may also think to herself, "I miss me , too." 
 
Positive Communication methods for people living with dementia:  We recommend seminars by Teepa Snow,M.S., OTR/L.FAOTA www.teepasnow.com, Naomi Feil, MSW, www.vfvalidation.org, and her books, all of them. And the life changing, ground breaking books, "Contented Dementia," by Dr. Oliver James, "The Mindful Caregiver," by Nancy L. Kriseman, and "Deeper Into The Soul," by Nader Robert Shabahangi, Ph.D, and Bogna Szymkiewicz, Ph.D

Copyright 2015 Caregivers Get Fit! Mama  Nicey

The information in this blog is information. It is not meant to be a replacement for getting medical advice from your own health professional regarding your own individual health challenge or condition. Dr. Denise will not diagnose, treat, or give direct personal consultations/advice to you on this blog for any medical condition, but will give general examples, and scientific research on many different health topics.  How you decide to use the information is between you and your own medical/ health professional.
   

Friday, November 6, 2015

Invisible People





Lori was sitting in the corner of a pediatric dental office waiting for a consult for her 7 year old daughter. It was a cold winter day and the breeze was blowing into the office through the window cracks causing a shiver up Lori's spine. Lori's daughter had been to 4 dentists, and was not a cooperative patient. When the dentist, a burly man with an edge of impatience in his voice started to explain his findings, he completely ignored Lori's daughter. He didn't even give her any eye contact. From the time of his entry into the office, he sat next to Lori's daughter in a chair and spoke directly to Lori as if her daughter was an invisible, inanimate object. He appeared to have forgotten the common courtesy of connecting to another human being, regardless of her age. Somehow, since Lori's daughter was 7 rather than 27, she had lost her right, in his eyes (whether it was a conscious act on his part, or not) to be acknowledged as a human being and to be heard.

Lori noticed these actions by the dentist because her daughter had a very hurt and surprised look on her face as if to say, "Mother , why is he acting this way?"  So, Lori in a very direct tone said, "Doctor, I would appreciate it if you would speak directly to my daughter, rather than to me,  since she is your patient." The doctor's face turned bright red, and without apologizing, clearing his throat, he very awkwardly addressed her daughter.

Years later, when Lori's mother was diagnosed with dementia, she noticed the same thing with doctors, pharmacists, grocers, people at church, etc!  As soon as people were told of her mother's dementia, they would ignore her mother, almost as if she was invisible. And ignoring her mother was not enough for some people,  who would talk in front of her, about her, as if she no longer had feelings.  It was almost as if people thought that memory loss also meant loss of emotions thus giving some people permission to forget common courtesies extended to others.  "She's gone, and no one is at home," one would say. "She just sits there and stares, looking off into space like a deer in the headlights!" People would make these comments right in front of her!!! And when Lori was a child, she witnessed her own family treating her grandmother in the same way. When her grandmother would be released for an afternoon from the nursing home, no one in her family would talk to her.  She would sit on the family couch alone, becoming an outsider in her own family, from no fault of her own!!!

And then, in Lori's case there would be moments of pure clarity where Lori's mother would say, "I can't remember things," and Lori would offer her assurance of, "You're right, Mom. You can sometimes be pretty forgetful, but I'm here to help you to remember, okay?"  And just by acknowledging the truth when asked about it, would offer Lori's mother a level of comfort and confidence. "We are going to get through this together, Mom. You aren't alone, we've got this and God's got this."  Lori would say these things because according to Naomi Feil, MSW in her book,  "Validation Breakthrough,"  people with dementia do not want to be patronized. When they ask a direct question, they want and deserve to hear the truth.  But what Lori had observed, was that they also don't deserve to be ignored.  There are many ways to connect with people, and through connections, we can create avenues that give people in our lives opportunities to be heard. ALL people, regardless of age, disability, or social standing deserve to be heard, and to be given the common courtesy of respect, dignity and understanding.

And sometimes, if a person is old, young or has a disability - people make assumptions that are totally false and biased.  Lori's mother-in-law, an outspoken Italian woman once had to go to the doctor for a physical. The staff nurse was new, and when she saw an 87 year old woman with labored ambulation walk into the office, she assumed she must be hard of hearing, too. "Mrs. Rigatoni (not her real name), MRS. R-I-G-A-T-O-N-I!!!!!!!" The nurse yelled so loudly, you could practically hear her in another state.  Lori's mother-in-law was so mad at this staff member that she immediately yelled back at her, "I'm old, not deaf!!  Stop yelling at me!!!"


Positive Communication methods for people living with dementia:  We recommend seminars by Teepa Snow,M.S., OTR/L.FAOTA www.teepasnow.com, Naomi Feil, MSW, www.vfvalidation.org, and her books, all of them. And the life changing, ground breaking books, "Contented Dementia," by Dr. Oliver James, "The Mindful Caregiver," by Nancy L. Kriseman, and "Deeper Into The Soul," by Nader Robert Shabahangi, Ph.D, and Bogna Szymkiewicz, Ph.D

Copyright 2015 Caregivers Get Fit! Mama  Nicey

The information in this blog is information. It is not meant to be a replacement for getting medical advice from your own health professional regarding your own individual health challenge or condition. Dr. Denise will not diagnose, treat, or give direct personal consultations/advice to you on this blog for any medical condition, but will give general examples, and scientific research on many different health topics.  How you decide to use the information is between you and your own medical/ health professional.

Thursday, November 5, 2015

Change Anyone?




Change can happen in an instant. It happens in attitudes, the changing seasons,  how we relate to our inner and outer environment, and to ourselves.  And for most of us, we can adapt to change rather quickly. We give ourselves cues of where we are, what we are doing, how we arrived at our destination, who we are traveling with, and what prompted our journey in the first place.

 The processes that relate to change in human beings, are all mediated by areas in the brain. Our cerebral cortex covers 2 cerebral hemispheres which transfer signals for immediate outcomes into bio chemical-electrical impulses eventually leading to active patterns of sensory motor control and behavior. The rate at which these signals are transferred, interpreted and engaged is directly proportional to the health of our neurons, or nerve cells themselves. As we age, the functional capacity of our neurons can diminish, due to many factors. Nutrition, lack of exercise, dehydration, lack of mental stimulation, physical, chemical and emotional traumas affecting nerve centers, etc.

According to cognitive psychologists Fergus Craik, PhD, and Timothy Salthouse, PhD, the neurons (nerve cells) themselves in human beings can shrink or atrophy, and there's a large reduction in the extensiveness of connections among neurons (dendritic loss). This can happen after 40 years of age, and can continue throughout the aging process. These researchers have concluded in their study, "Memory changes In Older Adults, " published by the American Psychological Association Monitor, that the aging brain has lower blood flow and gets less efficient at recruiting different areas into operations.

 All of the above has to due with normal aging. However, it is common knowledge that the elderly population throughout history has been less flexible to change, than the younger population,   which could possibly be caused by the physiological limitations of aging itself (blood vessels, musculoskeletal systems, and neurons) which literally become , "less flexible, " as we age. And also, there can be many life altering changes happening all at once around the same period of time. Changes caused by the death of a spouse, a serious illness, a change in residence, changes in hearing, vision, losing the ability to drive, physical strength and mobility, etc. So much change can not only be overwhelming, but can be heartbreaking to the person experiencing these sudden changes.

However, when a person has dementia, change is interpreted physiologically, neurologically and behaviorally much differently than from a person experiencing a normal aging brain. Short term memory retrieval is greatly diminished. And a slight change for a person with dementia, can have far reaching implications. Pathways of neurons suffer from a lack of connections, and lead to an incredible degree of confusion. The implications of one little change in routine, is illustrated by the example below.

Lori's mother had been napping for most of the morning. She had eaten well, had her medications and supplements, and wanted to go back to sleep. She woke up around 1 PM. Lori was in the living room on the computer. And then the pacing started. Lori's mother was shuffling her feet, pacing from one end of the room to another looking out both of the windows at either end of the room. Her walking was sped up, almost as if she was ready to walk out of the house. Then she started shaking her head. "I don't know where to begin, it's just terrible, just awful news, terrible. Oh Lori, this is bad, really bad!"  Lori looked up at her mother. "What's happening Mom?" "Your grandma died, and I have to plan the funeral. What am I going to tell everyone? And I wasn't even with her, she died alone, she died alone."  Lori observed her mother pacing and pacing, and then intuitively decided to offer her mother a new understanding of her mother's transition. "Mom, sometimes your heart doesn't bring enough oxygen to your brain and when that happens, you can become forgetful. Would you like me to help you remember what happened? Would that be okay with you?" Lori waited for a response. "I don't remember what happened, Lori." Lori's mother almost looked relieved to admit that she didn't remember. "Well Mom, your mother wasn't exactly alone. She made her transition while she was sleeping and I do believe that she knew you were with her helping her the entire time. You were a great daughter to her, the best ever!! " Lori's mother stopped pacing and looked at Lori. "I was?""Yes Mom, you really were!"

Lori's mother was calming down now, like a child after they cry from being overstimulated by too much input. "You gave grandma a beautiful eulogy. You stood up there at the podium where the preacher stands and told everyone how much you loved her, and I believe she was listening from heaven and that she heard every word of it, she really did!!! At least that's what I believe, mother!" Lori was not holding back. Then Lori's mother had a smile on her face and slowly walked back to her room.

 "What are you thinking right now, mother?" Lori's mother looked out the window. "It's a beautiful day, Lori."  Lori's mother went back to her room and started writing in her journal.  But what surprised Lori, was that her mother wasn't writing about her mother, but about her immediate circumstance, even referencing the month and where she was in the present time and place.


  What was the change that caused the pacing, and anxiety illustrated in the example in the above paragraph???  Lori and her husband were expecting some furniture to arrive by a moving truck and moved some things out of Lori's mother's room, and cleaned some linens. Again, a slight alteration in routine can cause an incredible amount of confusion for a person with dementia,  and can bring up memories from the past.

 Knowing that confusion, anxiety, agitation and pacing behaviors by people with dementia are all probable during times of change, proper planning can create comfort and security for both the carer and caregiver. 1) When leaving the house, allow plenty of time for confusion.If it takes 10 minutes to get to an appointment, allow 60 minutes or more to get ready. Never rush a person with dementia.  Give them time to get dressed,to put on their shoes, and to walk out the door. 2) When traveling long distances stop the car several times to allow for visits to the rest room. A person with dementia can get distracted riding in a car and can forget that they have to visit the bathroom. 3) Always carry Depends, bottles of drinking water, a change of clothes that you keep in the trunk, and healthy snacks when traveling even to church or the grocery store. Again ANY change can cause confusion, and blood sugar can be a physiological change people with dementia can experience, too. So, healthy snacks are good. Lori's mother loves trail mix with walnuts, sunflower seeds, etc.  4) Bring toys. YES TOYS. (Mini etch a sketchers, Word Searches, Sudoko.)

Having an awareness as a caregiver/care-partner of how change affects a person with dementia either in the home, or while traveling away from the home, and expecting the change that change can bring, can  avoid difficult, or confused behaviors altogether,  and lead to a happy, peaceful home. 


Positive Communication methods for people living with dementia:  We recommend seminars by Teepa Snow,M.S., OTR/L.FAOTA www.teepasnow.com, Naomi Feil, MSW, www.vfvalidation.org, and her books, all of them. And the life changing, ground breaking books, "Contented Dementia," by Dr. Oliver James, "The Mindful Caregiver," by Nancy L. Kriseman, and "Deeper Into The Soul," by Nader Robert Shabahangi, Ph.D, and Bogna Szymkiewicz, Ph.D

Copyright 2015 Caregivers Get Fit! Mama  Nicey

The information in this blog is information. It is not meant to be a replacement for getting medical advice from your own health professional regarding your own individual health challenge or condition. Dr. Denise will not diagnose, treat, or give direct personal consultations/advice to you on this blog for any medical condition, but will give general examples, and scientific research on many different health topics.  How you decide to use the information is between you and your own medical/ health professional.
   

Monday, October 26, 2015

Sun Downing Behavior Management: "Would You like Some Pizza?"




Lori was exhausted. Her husband was preparing for a major teaching project, and was, "in," and "out," of the house spending more time at the office than at home. He was the domestic partner who always cleaned, cooked, took out the garbage and actually enjoyed doing the laundry. "How do these women do it?" Lori thought as she scrubbed the showers, vacuumed the floor, dusted the end tables, bleached the toilets, changed the bedding and laundered the clothes. With her teen-aged daughter still awake at 11:30PM on a Saturday night and her mother fast asleep, Lori was more ready than ever to go to bed.

"Lights out by 1AM young lady!" "Oh mom, it's Saturday. Can't I stay up even later than 1AM?" Lori's daughter was persistent, but Lori said, "No, 1AM is your latest weekend bedtime!" As Lori and her daughter said their ."Good-nights," Lori checked in on her mother and noticed that her mother was sleeping soundly like a baby. This made Lori very happy.

Lori contributed to her mother's good night's sleep in several ways. She made sure that her mother got some walking exercise in during the day. Her mother would participate in activities around the house, she would fold clothes, chop vegetables, put dishes away, etc. Lori had word searches for her, she would play classical music, play with the dog, interact with friends that came to visit, etc. After dinner and teeth brushing, when it was time to retire for the night, Lori would give her mother (after originally clearing this with Lori's mother's doctor), a Melatonin sleep spray. (See our natural living tab on this blog for more info.) The Sleep Spray, being a combination of natural supplements, along with stimulation during the day appeared to work well to regulate Lori's mother's natural sleep cycle.

Before knowing the importance of putting these sleep assured practices in place, through daily exercise etc., there were episodes of Sun Downing,* (anxiety at night causing endless wandering and bizarre behaviors experienced by people suffering from dementia), that happened on a regular basis which made Lori and her family question if they could handle her mother's bizarre wandering behaviors. After taking online and local seminars on caregiving/carepartnering for people living with dementia, Lori was able to develop her own techniques. Sun Downing can be very hard to handle.  During Sun Downing episodes, Lori's mother appeared to come to life at night when everyone else was sleeping. She would turn on all of the lights in the house, burst through bedroom doors like a rambling drunk, take the car keys and try to drive Lori's car, wander up and down the basement steps, take all of the pictures off the walls, blast the TV, prepare food by leaving the gas stove on, etc  ALL at 3 or 4 AM!!  When this first started happening, Lori was overwhelmed, and had no idea of what to do.  But with proper training, the torment,(on both sides), turned into healing opportunities and the behavioral challenges ended. It is very important to remember that there is ALWAYS a reason for these behaviors, and if we learn the importance of the "why," and let go of our judgments, miracles can happen. Below is an example of a recent occurrence, and how Lori resolved it using proper communication techniques.

 "Mom, Mom!!!!" Lori's daughter was frantically trying to wake her. Lori opened her eyes and her daughter said, "She came into the room while I was watching TV,  wanting to know if I had any siblings, Mom. Do you think she has forgotten who I am??"  "Don't worry," said Lori . "You just go to bed, Grandma is sleep walking and is in a dream state. I'll take care of her." "Thanks, Mom, " said Lori's daughter. "And don't worry, your grandmother will remember you in the morning, okay?" It was after 1AM.

Lori entered her living room to find all the lights on and her mother fully dressed in a blue silk blouse (Lori's blouse), black slacks, her hair primped and sprayed, lipstick on her lips and her teeth in. "Well, hello. It's so great to see you!" Lori's mother's voice and mannerisms took on the tone of a hostess at a cocktail party welcoming a long lost friend. "It's great to see you, too!" Lori matched her mother's tone and character. "Well, are you hungry? Can you stay long?" Lori's mother was energized and ready to serve her. Let's see what we have." Lori followed her mother into her own kitchen. "Would you like some pizza? " ( Lori's mother thought she was in her own kitchen, and Lori was a guest.)  Lori told her mother she just wanted a glass of water. So, Lori and her mother sat on Lori's couch. Lori sipped her glass of water with her head dosing and her legs crossed,  and her mother said nothing. They sat in the silence together at 1:30AM, (Lori fighting the urge to fall asleep, trying desperately to stay awake),  both women looking forward, staring at the wall, not uttering a word. Lori just waited and waited, intuitively knowing that she needed to follow her mother's lead, and that something very important that her mother had been holding in her brain for YEARS possibly, was about to emerge. And boy, was she RIGHT!!!

Lori's mother said, "My mother never approved of my friendship with the Paris family." (Not their real name.) As soon as Lori's mother started leading the conversation, Lori followed her into her own world by asking specific questions about her present statements without ever asking the question, "why." (See Validation by Naomi Feil, MSW) "WAS there a reason for your mother's disapproval?" Then Lori's mother's eyes lit up like a Christmas tree. "OOOOHH YES there was a reason, and you won't believe it!" Now they were connecting. Lori's mother was about to spill the beans on something she had been holding onto for years. "What was the reason that made your mother so upset?"  And then Lori's mother even shocked Lori by telling her about a very close family member that was the result of an affair by another close family member which was hidden from Lori's family for generations!!!    "How did you feel about this when it happened, mother?" "I resented him. "  She then went on to share that this particular person was a neglectful, quiet alcoholic who made her feel unsafe, and even unloved at times. And out of the blue she said, "He had a hearing problem, too!" Was that possibly her way of saying that she didn't feel heard? Interesting.  "I'm tired Lori. I think I better go back to bed, "said Lori's mother. Lori's mother then, on her own went back to bed.

 During the exchange, tons of sharing was happening, and what amazed Lori was her mothers vocal tone, physical gestures and mannerisms, which all reflected her pre-dementia state of being. The more Lori's mother was feeling heard, the more she was being freed, and her body language was expressing this freedom.  It was as if Lori's mother had lost the dementia completely, and had returned to the person she was before she had been given her diagnosis.

This momentary return to the pre-dementia state happened once before between Lori and her mother shortly after Lori had some training on proper ways of handling these bizarre behaviors, and one day Lori's mother ended Lori's questions with a few questions of her own. "Do you have any more questions for us?" It was never: "Do you have any more questions for me ."  It was always," Do you have anymore questions for us."

  When this would happen, Lori, (for lack of a better comparison), would feel as if she was watching  her mother taking on the role of psychic, or highly evolved spiritual leader channeling information from the spirit world, because the questions she would ask Lori were very surprising. Questions such as: "What would you like to do with the rest of your life while you are still here on earth?" And observations like: "I feel God's presence," etc.   

This was and is very confusing to Lori, but what isn't confusing to Lori,  is that midnight wandering and confusion called Sun Downing is not something that needs to be suppressed. It is coming up for a reason. The Sun Downing activities and behaviors are directly related to unresolved or suppressed emotions that need to be expressed in order to be released, and Sun Downing is a very important part of the healing process, leading to the transition state or end of life liberation of the soul. Naomi Feil, MSW once put it this way,(to paraphrase). "They are packing their last suitcase and need to get rid of excess baggage before making their final journey home."

 So, the healing that Lori speaks of is not a healing from dementia, but a healing from the mental suffering that causes the dis-connect, or confused cognition in the first place. Caregivers and care-partners are certainly not psychotherapists, but they can learn a verbiage that can create a momentary release from inner suffering,  creating deep connections between care-partners and carers. The art and skill of using positive communication techniques, offers people experiencing dementia opportunities to not only release their emotional baggage, but to live in a state of contentment while they are still with us here on earth. And by releasing, rather than suppressing these emotions, individuals can become consciously aware of their peaceful presence in the NOW, fearlessly embracing the wings of freedom they will be given by the angels when their time comes, to fly home to God.    

 When Lori's mother woke up she had no recollection of what had happened during the night. She played with the dog, laughed and went about her day.

It is ironic to think that ALL of our modern day scientific research on dementia embraces a theory that was arrived at 100 years ago by performing an autopsy on a section of a cadaver's brain. Wouldn't it make more sense to study behavior rather than brain pathology???  Perhaps there will one day be a way to study both ways, and to fully honor the sacred wisdom of aging.

(Sun Downing * definition by Merriam/Webster Dictionary)

Positive Communication methods for people living with dementia:  We recommend seminars by Teepa Snow,M.S., OTR/L.FAOTA www.teepasnow.com, Naomi Feil, MSW, www.vfvalidation.org, and her books, all of them. And the life changing, ground breaking books, "Contented Dementia," by Dr. Oliver James, "The Mindful Caregiver," by Nancy L. Kriseman, and "Deeper Into The Soul," by Nader Robert Shabahangi, Ph.D, and Bogna Szymkiewicz, Ph.D

Copyright 2015 Caregivers Get Fit! Mama  Nicey

The information in this blog is information. It is not meant to be a replacement for getting medical advice from your own health professional regarding your own individual health challenge or condition. Dr. Denise will not diagnose, treat, or give direct personal consultations/advice to you on this blog for any medical condition, but will give general examples, and scientific research on many different health topics.  How you decide to use the information is between you and your own medical/ health professional.






Saturday, October 17, 2015

She Talks Too Much





It was Saturday, and sensory stimulation was everywhere. Buzzing sheers, electric shavers, snipping scissors, and plastic aprons. The sounds, smells, head rocking, scalp scrubbing gyrations, were a rude awakening for Lori's mother who preferred her, " happy place," on a padded chair on a quiet deck  surrounded by singing birds, beautiful trees and passing clouds. There, without a care,  living in her "now-filled,"  presence of one-sided canine conversations, she was in control, she was loved unconditionally without any expectations, and could just sit in the silence. It was in this peace-filled presence, a partition for her soul, where she felt most alive.   Nonetheless, she approached this aerosol spraying, foil wrapping, chin waxing jungle, with hopes of future elegance, obtained only after putting in her obligatory appointed time in a spinning chair with hydraulic elevations. And hairdressers who had habits of filling in silent spaces with empty conversations, along with giving Lori's mother specific instructions that were difficult for anyone to follow, much less a person challenged by dementia.  "Tilt your head. Lift your chin. Tilt your head again. Could you lift your chin? Alright, almost done, just close your eyes, hold your breath, and turn to the right.  Now, if you wouldn't mind, could you tilt your head again?"  All of this effort, under the hood of a dryer with tightly wound curlers so that she could look, " put together," in her favorite pew, singing her favorite hymns on Sunday mornings at church. But even Lori's mother, as patient as she could be, knew her limitations.

 Lori's mother had other medical challenges, along with dementia and many times needed to rest which caused them to visit many different salons as a "walk in" rather than at an appointed time. The first hair salon Lori took her mother to was right around the corner from Lori's house. Lori's mother enjoyed the hair stylist, but after only a few months, the salon moved, and they needed to find a new place to go.

Every salon was different, but all of them had characters with unique faces.  Faces greeting faces with bleached hair, mousse ridden, hip swinging, gum smacking spontaneity. Very happy people in a happy place!  There was bright lipstick, painted nails, too much rouge, glued- on lashes, and eyebrows drawn above the eyes of one stylist with a  black grease pencil,  looking more like Mickie Mouse, than human!  And the new people cowering,  in the corner were easy to spot,  because they hid their hair behind magazine covers waiting for their names to be called, preparing themselves to be the new kids on the block.

Faces on the phone, faces with their heads all lathered up with soap, towel covered faces, faces with ratted up hair almost as tall as, "The Cat In The Hat!" Faces wearing curlers stacked and rolled in plastic cylinders clipped tightly to their heads.  But amid st the culture of creativity, there was a deep respect and heartfelt compassion, even from the oddest looking appearances. But Lori's mother didn't judge her hair stylists by the way they did her hair, but by the questions they asked.

Lori would point out different hair stylists saying, "Maybe she will take you next?"  And Lori 's mother would always say the same thing, "She looks like she talks too much."  Lori would say, "What makes you think she talks too much?"  Lori's mother would just roll her eyes, and would whisper under her breath for only Lori to hear, "I don't like her shoes."  And if Lori would ask her more questions there would be more insults. Finally after much searching and much hair spray, Lori and her mother found the perfect stylist. And true to form, the stylist is still her stylist today. Not only is she a skilled hair dresser, but she doesn't talk when she works on Lori's mother's hair. She is very comfortable with the silence.  After she works on Lori's mother's hair, her mother says the same thing, "I like her, we need to see her from now on." And Lori would ask, "What do you like about her, Mom?" And her mother would respond, "She doesn't talk so much."

So, the moral of the story is that if you are in a position to work with people, and the person in front of you has dementia. 1) Ask them one thing at a time and then pause for a response. If there is no response, then repeat, but repeat the same ONE question.  And if you have to give them specific directions in a medical or spa setting, be patient and  give one direction at a time. If you feel impatient, have someone who is more patient than you are work with the person. And watch how the person who is mindfully patient, handles the situation.  You will find yourself gaining skills that you never thought you had, but you must be willing to be led.

People with dementia can only take in a few things at a time,  and become not only confused but agitated when they are overstimulated by too many questions. If the person with dementia you, or your staff are working with always appears agitated,  (and doesn't have a medical history of  a pathology causing the agitation), organize a few dementia communication training sessions. It is quite possible that caregivers themselves, may unknowingly be causing the agitation. (I know this is hard to hear, especially when caregiving/care-partner's intentions are pure), but getting some training in positive dementia communication skills may be all that a caregiver needs to improve the agitation levels. And the good news, is that in time you may find that you, or your staff can become wonderful, patient and skilled, positive communicators!  So, again ask only one question at a time.

 2) Small talk with scattered subjects may be too much talk for people with dementia. Use small talk to connect, but make it about the present moment, not long stories about you, because they can't follow your long stories.  For instance: If you are standing outside and a leaf falls, talk about the falling leaf.  I promise you, the entire world of connections will open up for both of you, if you keep everything in the present moment.

 3) Let them lead you by their own conversations.  If they have a favorite memory from 60 years ago, go with them into their world. Ask questions about What? When? How? Where? Many things will open up and you will be FLOORED to see that they will not repeat these stories very much, anymore. All they wanted to do in the first place was to FEEL the emotion of the the memory of long ago, and your ability to connect with them while they are re-living that memory brings them to the innermost center of that emotion and they will then have closure and completion with that memory. (And this is true for unpleasant memories, too that may wake them up at night.) Please note: This isn't psycho- therapy. This is active, mindful and skillful listening, using validation.  Remember,  as Maya Angelou once said: " I've learned that people will forget what you said, people will forget what you did, but people will never forget how you made them feel."  (See Validation Breakthrough by Naomi Feil, MSW to learn more about this.)

Lori picked her mother up today from the salon. She was sitting in the front with the people hiding behind the magazines, but she wasn't hiding.  She was proudly and confidently holding up her ratted, teased, curled and sprayed hair. "How did it go mother? You look beautiful!! Lori's mother was smiling, "I like her a lot, she's my favorite, not like that other one. This one's a keeper," said Lori's mother. "This one, mother?  And not the other stylist? The one with he ugly shoes? " Lori was trying to get an answer out of her. "I don't like her at all. She talks too much, Lori!  She talks too much!"

Positive Communication methods for people living with dementia:  We recommend seminars by Teepa Snow,M.S., OTR/L.FAOTA www.teepasnow.com, Naomi Feil, MSW, www.vfvalidation.org, and her books, all of them. And the life changing, ground breaking books, "Contented Dementia," by Dr. Oliver James, "The Mindful Caregiver," by Nancy L. Kriseman, and "Deeper Into The Soul," by Nader Robert Shabahangi, Ph.D, and Bogna Szymkiewicz, Ph.D

Copyright 2015 Caregivers Get Fit! Mama  Nicey

The information in this blog is information. It is not meant to be a replacement for getting medical advice from your own health professional regarding your own individual health challenge or condition. Dr. Denise will not diagnose, treat, or give direct personal consultations/advice to you on this blog for any medical condition, but will give general examples, and scientific research on many different health topics.  How you decide to use the information is between you and your own medical/ health professional.

Wednesday, October 14, 2015

I Thought It Was Sunday!






Dementia affects everybody, not only the person with the disease, but the people surrounding the person who is suffering. The spouse, the children, the siblings the parents, the coworkers, the community leaders and the long lost friends, to name a few.  And the suffering grows like blooming flowers out of many places, not just the neurofibrillary tangles found in diseased brain tissue. The effects are immense for many reasons, but mainly, the most prevalent reasons are because all of the categories of dementia, especially A.D.,  press our fear buttons. And the big question is: "What am I going to do if this happens to ME?"

So, people living with this fear, which most of us, (either consciously, or unconsciously) have - do what people typically do when they are faced with uncomfortable situations.  They disappear. They busy themselves with social obligations and completely ignore the one person who could benefit the most from the healthy effects of social stimulation. "She won't remember me anyway," and they never call, write or visit the person with dementia. Why? Because they don't know how to communicate with the person. So, the person suffering from the disease, without choice, becomes a social outcast.

Well, get this one nugget today:  When carrying on a conversation with someone struggling with dementia, SPEAK IN THE NOW. (Ie: What are you doing NOW?  What are you thinking, NOW? What are you looking at, NOW?)  NEVER say, "What did you do today?"  NEVER!! Because they can't remember what they did, and they feel terrible about not being able to remember.  They really do. 

Lori's mother has had dementia for 2 years, and still, everyday looks at the mail searching for letters.  And the sad part is that Lori's mother loves people, and loves to interact - but can't use the computer anymore. She has lost the ability to use her email and can barely use her cellphone anymore.  So, people do not make the extra effort, (other than her children who all get together and Skype her a few times a month.) And if people only knew that Skype alone is a great way to communicate - they would be able to have lasting communication with their friend suffering from dementia long before they would ever lose their ability to speak. Sixty percent of communication is non-verbal and visual - so Skype is a great way to stay engaged.

 Lori's mother has vascular dementia and could even live well into her nineties.  But some people think that dementia is a death verdict and already treat the person suffering from dementia as if they are already dead.  They speak over them to their caregivers, and do not acknowledge their fears. Lori's mother insisted on watching the Glen Campbell special on A.D.  And when Lori asked her questions about how she felt watching the special, her reply was, "I'm scared, really scared."  Lori said, "What are you scared about, mom?"  "I'm scared that I may have that." "Lori responded, "Well, you are very forgetful sometimes, but your doctor doesn't think you have what he (G.C.) has, but another type of forgetfulness caused by your heart issues, and that type of forgetfulness has a very long life span. And, anyway - when you forget things, I'm here to help you remember. And when I forget things, you help me to remember, so we are both in this forgetfulness together for the long haul. Is that okay with you, mom?" Then, Lori's mother busted out laughing. "So mom, what do you think about changing the channel and watching a cooking show?"  Her mother said, "No, I want to see this until the end."

Lori woke up, yesterday and her mother jumped, (literally jumped) out of bed. "Mom, what is your hurry?  Did you miss the bus?"  Her mother started laughing.  "Lori, we need to get ready for church!" It was Tuesday yesterday.  "Oh, mom it is Tuesday and there is no church today." Lori's mom looked sad. "I thought it was Sunday."  "That's okay Mom - I do the same thing. Sometimes the days run into each other, and when that happens, week days can feel like a weekends, right?"  That was the end of it. There was no more talk about church.

Then at 9:15AM Weds. ( today), Lori knocked on her mother's door, and out walks Lori's mother decked out to the nines with her hair done, her make-up on, her best dress on, shoes on, carrying her purse.  "Where are you going all dressed up, mom?"  "I want to go to church," said Lori's mother.  Since Lori was driving right past a church during her errands, she said, "Mom we can go to church right after breakfast, okay?"  So 20 mins later, Lori and her mother were in the car driving to church on a Weds., morning one town away.

 Lori brought her mother to a church, not the same church that they attend on Sunday, and Lori's mother smiled and smiled when they walked in. Lori's mother whispered, "We can sit here."   So, the two women, whispering to each-other in an empty church,  sat in the second row pew of a very old church. And then in the silence, Lori's mother closed her eyes. Lori said, "What caused you to want to go to church today and yesterday. Is there a special reason?" Lori's mother, with her eyes closed, said - "God is here, God is here." And with reverence, Lori and her mother prayed. "Who shall we pray for, mother?" "Everyone,  pray for everyone, "said Lori's mom.  So, Lori and her mother prayed for people they know, strangers, and the entire world.  Then Lori and her mother sat in silence for 30 mins., Lori's mother wanted to stay, but Lori told her they would return every Wednesday.  Lori's mother thanked her, saying, "That was nice. That was really nice."
  
Positive Communication methods for people living with dementia:  We recommend seminars by Teepa Snow,M.S., OTR/L.FAOTA www.teepasnow.com, Naomi Feil, MSW, www.vfvalidation.org, and her books, all of them. And the life changing, ground breaking books, "Contented Dementia," by Dr. Oliver James, "The Mindful Caregiver," by Nancy L. Kriseman, and "Deeper Into The Soul," by Nader Robert Shabahangi, Ph.D, and Bogna Szymkiewicz, Ph.D

Copyright 2015 Caregivers Get Fit! Mama  Nicey

The information in this blog is information. It is not meant to be a replacement for getting medical advice from your own health professional regarding your own individual health challenge or condition. Dr. Denise will not diagnose, treat, or give direct personal consultations/advice to you on this blog for any medical condition, but will give general examples, and scientific research on many different health topics.  How you decide to use the information is between you and your own medical/ health professional.

Canine Dementia Caregiving Tips



   Lori was 23 years old, and had been training for a job that would give her opportunities to travel around the country with a Broadway show, and even have an opportunity to work on a movie. But her job was all resting upon one skill, and this skill was so important, that any alteration would not only cost Lori her job, but her future employers would lose and estimated 500K/night. As one of Lori's Broadway company managers once told her. "Shutting down the tour even for one night because of a dog issues could cost the company half a million dollars, so you have quite a responsibility on your hands young lady!!"

 When opening week came around for this Tony winning Broadway musical, and they were putting the show in for the first stop on a 150 city tour, the dog Lori was working with refused to follow it's commands and cues from the actors on the stage. And opening night,  was now less than two days away!!  This was shocking to Lori, because the canine had performed these cues flawlessly for months leading up to the opening! Lori was concerned and even angry.  And all she could think about was, "the dog is being disobedient. " Lori was only looking at the behavior from her own perspective, and not from the dog's perspective. What was the REASON or the CAUSE for the behavior?

Then, - the genius of Lori's mentor, (a world famous dog trainer who now has his own TV show),  gave Lori some important pieces of wisdom. "Two things to remember: 1) There is always a reason for the behavior, and 2) Learn to follow non-verbal cues, be willing to be led and look at the situation through the dog's eyes, not yours." After careful investigation, looking at the challenge through the dog's eyes, it was found that the dog was used to taking less steps to get to her mark, center stage at her training stage on Broadway.  Once the steps were in place at the new theater, along with having tech people and the creative staff off of the stage during the scene, the dog performed beautifully.  Lori learned that the changes greatly affected the dog's ability to perform, thus causing behavioral changes.

  The advice of Lori's mentor helped immensely, and these two pieces of information directly correlate to caring for a person who is living with dementia, with Lori adding one more piece of advice: Number 3 - "Don't take anything personally. It isn't about you, but solely about the person you are caring for so do what you can to get yourself out of the way. Once "I," is replaced with, "we," magic happens and you and your carer can meet someplace in-between where wisdom resides."

Being willing to be led without expectations will give you important cues regarding, "why," the person you are caring for is acting the way they are acting. Lori's mother has a history of being a secretary. Lori has found that if she doesn't straighten her mother's room up everyday putting everything in order in precisely the same place, everyday - her mother will start pacing and wringing her hands.  But when Lori stacks her mothers books in the corner, hangs up newly laundered clothes and makes sure her bed is made immediately after she wakes up with the pillows stacked a certain way, and with the curtains opened and tied, the pacing and hand wringing goes away.

Her mother is content, and talks about being home. She will say she is home and Lori will ask her where home is and she will always, every time say that she is in her childhood town at her grandparent's house where she was loved and adored as a child. With her mother sharing this information, Lori is then given direct feedback from her mother that she is happy and content.

(The above post is in memory of Roxanne, pictured above. Rescued from the ASPCA, Roxanne played "Sandy," in "Annie," did several TV commercials and "Shakespeare In The Park," in Central Park, NYC.) 
Positive Communication methods for people living with dementia:  We recommend seminars by Teepa Snow,M.S., OTR/L.FAOTA www.teepasnow.com, Naomi Feil, MSW, www.vfvalidation.org, and her books, all of them. And the life changing, ground breaking books, "Contented Dementia," by Dr. Oliver James, "The Mindful Caregiver," by Nancy L. Kriseman, and "Deeper Into The Soul," by Nader Robert Shabahangi, Ph.D, and Bogna Szymkiewicz, Ph.D

Copyright 2015 Caregivers Get Fit! Mama  Nicey

The information in this blog is information. It is not meant to be a replacement for getting medical advice from your own health professional regarding your own individual health challenge or condition. Dr. Denise will not diagnose, treat, or give direct personal consultations/advice to you on this blog for any medical condition, but will give general examples, and scientific research on many different health topics.  How you decide to use the information is between you and your own medical/ health professional.


Thursday, August 20, 2015

Anything That Sparkled






 It was a small farm town, not more than an hour Northwest of Chicago. The train would make 4 stops a day, from cornfields, hog farms, and silos to the center of Michigan Avenue. And the sun, just eclipsing upon the tracks looked mysteriously shadowed by an early morning fog.  A junction town where the Illinois Central met the Aurora line bringing people from all over the world to settle down into a junction of cultures creating artists, farmers, bakers, businessmen and families of German immigrants. It is said that in the 1800's, Lincoln himself once stayed in one of the hotels,  along with a one time visit from a royal dignitary from Japan.

On the outskirts of town where the trellis supported the tracks was a high wooden platform overlooking acres of corn. Silhouetted under the sun,  bursting with excitement sacredly inhaling yellows, blues, pink pastels and dancing colors with each and every breath, stood an elderly woman with rosy cheeks shadowed on a leather leash by a three-legged dog. Her speech was fast, very fast almost as if her words had trouble catching up with her thoughts. But her wisdom came to life with a blank sheet of paper, and a paint brush, a crayon, a pencil and a pen. And her canvas was anything and everything. Because her eyes only saw the possibility of things. And so she walked picking up twigs, pine cones, rocks, old tin cans, bottle tops, and anything that sparkled.

Every morning she would walk, leaving her small apartment just at the crack of dawn. With her dog in tow she would talk carrying on conversations of long ago. "Peppy, " she would say to her dog - "When I was a little girl, I would play marbles over there in the school yard. Do you see that church over there? I was confirmed a Lutheran there. And Peppy, this alley was the alley behind Daddy's bakery where he would make fresh bread, and German cinnamon rolls."  Story upon story would be told to the dog, and other than being thought of as a little eccentric, this elder artist was looked upon with respect and understanding by everyone who knew her.

And then changes started happening. Her appearance changed and became less tidy.  Her pleasant personality had moments of paranoia. Her apartment and family house which she frequented often became a hoarder house filled with everything that she collected, including animal feces and urine from neglecting her duties as a pet owner. And then one day, her brother collapsed, and rather than calling someone for medical assistance, she lacked the presence of mind to care for him and he laid on the floor for three days without food or water."He's just taking a nap, nothing is wrong with him," she would say when the ambulance finally arrived.  (Her brother would have died on the floor had it not been for Lori's mother checking on him, and calling 911.) 

After an evaluation,  this amazing and talented woman, Lori's Aunt Carol,  was diagnosed with Alzheimer's Disease and lived out the rest of her life in a nursing home.  Because of the care she received, Lori's Aunt Carol believed she was visiting a resort.  The nursing home had a particular section for Memory Care, and most of the staff had been trained in positive communication techniques. This made Aunt Carol very happy. "We play cards, get our hair done, go to music and art class and have someone who cooks for us every day.  This is a swell place," she would say.

 Lori's Aunt Carol lived a very long life well into her upper 90's. She retained much of her cognitive capacities through excellent care, quietly passing away in a nursing home by the train tracks as the sun came up, in the junction town of her birth.  Aunt Carol's secret to happiness and longevity will always be her legacy of  living in the moment, and seeing beautiful colors, sparkles, lines and artistic promise everywhere!!!

(Dedicated to the loving memory of  Chicago Artist, Carol Zapf Stoner  1912 - 2009)

Positive Communication methods for people living with dementia:  We recommend seminars by Teepa Snow,M.S., OTR/L.FAOTA www.teepasnow.com, Naomi Feil, MSW, www.vfvalidation.org, and her books, all of them. And the life changing, ground breaking books, "Contented Dementia," by Dr. Oliver James, "The Mindful Caregiver," by Nancy L. Kriseman, and "Deeper Into The Soul," by Nader Robert Shabahangi, Ph.D, and Bogna Szymkiewicz, Ph.D

Copyright 2015 Caregivers Get Fit! Mama  Nicey

The information in this blog is information. It is not meant to be a replacement for getting medical advice from your own health professional regarding your own individual health challenge or condition. Dr. Denise will not diagnose, treat, or give direct personal consultations/advice to you on this blog for any medical condition, but will give general examples, and scientific research on many different health topics.  How you decide to use the information is between you and your own medical/ health professional.

Sunday, July 26, 2015

What Was It About Mildred?




 Down the corridor, in the last room on the left sat a 95 year old woman petting a white, furry toy cat. She slept with the cat as if it were alive, brushing it's hair with knotted knuckles and wrinkled palms appearing curiously elegant and perfectly defined.  Hands that had ironed 200 pieces of cloth a day 80 years ago,  from a heavy metal block heated from the platform of a wood burning stove. Hands that had reached up high to hang linens on the line, anchored with wooden clothespins out back, under the morning sun to dry. Hands that birthed babies,  hands that changed diapers, and  hands turning pages, holding toddlers on her lap, " two at a time,"  while reciting nursery rhymes. And there were praying hands, cradling other hands held close to her heart offering words of wisdom, just before someone close had died. And everyone who worked at the nursing home loved to serve Mildred, but no one knew "why."

What was it about Mildred that made her so easy to spend time with? And what was it about Mildred that uplifted an entire staff and made everyone feel so alive?  And why didn't anyone ever come to visit Mildred? Surely, Mildred had family and friends who loved her. Why didn't anyone ever stop by?

There were never any complaints from Mildred, even when she appeared to be sick. There were days when Mildred could barely sit up in bed, and other days when Mildred would surely not make it through another day.  But the spark of love, and twinkle in Mildred's eyes just kept on shining. And her face always lit up with a huge smile, every time anyone would engage Mildred in conversation. She always said, "Thank you." And was always very happy talking to her stuffed cat. "You are not any trouble at all.  You are the perfect cat. You never ask for anything at all, just a scratch under the chin and you,"purr," so pretty.  You are my beautiful kitty, and I love you!."  Mildred would recite the same thing over and over again.  And at the age of 96, with her stuffed cat held close to her heart with her arms folded over her chest, and a smile on her upturned face, ready to fly - Mildred quietly passed away.

  At Mildred's funeral, in the chapel of the nursing home, the entire staff felt her loss. There were many tears, even from the most seasoned professionals. The chapel, seating only 75, was filled to twice it's capacity!!  People all over town filed in, one by one to offer their last, "good-bye."  Young families, total strangers, close family members, many who never once came to see Mildred and her cat when she was still alive, all attended her funeral. People appeared out of the wood work, (as they say). But oddly enough, the question was, "why"? Why would people wait to acknowledge a special person in their life, in death, (rather than in life)  - after they had died?

  And then a young woman of 30 spoke with the minister during coffee and explained the unspoken words of all the gray elephants sitting on folded chairs at Mildred's funeral. "It was too hard for me to see her that way, Reverend. She used to be so easy to talk to, and well read. But after she lost her memory, it was like she was a different person, and we didn't even know her. Would she even know if we came to visit? It hurt me to see her that way, and staying away was easier than having her forget me."

  So, Mildred made her transition into heaven. But, for those who were unable to visit with her, Mildred most likely forgave them, and is still sending them heartfelt beams of love from the other side.  But for those who still cry when they think of what she gave them in her forgetting, her unconditional love that she freely shared with them will never be forgotten.

  Adaptation is amazing! As one sense is taken, our Creator gives us a stronger sense. And for those few workers at the nursing home who, "got it," and saw the glass as, " half full,"  instead of, " half empty,"  the gift was their's for the taking.

What was it about Mildred? As the mind forgets, the heart remembers. When people are able to meet from a place of spiritual connectedness as one heart, truly in the moment without judgement or expectation;  thoughts, words and conversations disappear. They have no meaning. When we look beyond appearances and let go of fear, there is only the presence of love.  There is only love. And where there is love and compassion, there is peace.

 So, as the late poet Maya Angelou has said, "I've learned that people will forget what you said, people will forget what you did, but people will never forget how you made them feel."  Mildred reminded people to live in the moment, and by freely sharing her compassion, joy, peace and life with others, she let people know that they were greatly loved. When people think of Mildred, (even today), they always remember her love!

Positive Communication methods for people living with dementia:  We recommend seminars by Teepa Snow,M.S., OTR/L.FAOTA www.teepasnow.com, Naomi Feil, MSW, www.vfvalidation.org, and her books, all of them. And the life changing, ground breaking books, "Contented Dementia," by Dr. Oliver James, "The Mindful Caregiver," by Nancy L. Kriseman, and "Deeper Into The Soul," by Nader Robert Shabahangi, Ph.D, and Bogna Szymkiewicz, Ph.D

Copyright 2015 Caregivers Get Fit! Mama  Nicey

The information in this blog is information. It is not meant to be a replacement for getting medical advice from your own health professional regarding your own individual health challenge or condition. Dr. Denise will not diagnose, treat, or give direct personal consultations/advice to you on this blog for any medical condition, but will give general examples, and scientific research on many different health topics.  How you decide to use the information is between you and your own medical/ health professional.



Monday, July 20, 2015

The Caregiver's Caregiver

   Every day began the same. Lori's mother would walk into the living room around 8AM with her robe buttoned up unevenly, with messed up hair, a toothless smile and a glow so beautiful that she looked like royalty. Lori's well trained black lab who was not allowed EVER to enter Lori's mother's room, (because she would want to crawl in bed with her),  anxiously performed 15 circles of an undignified dance, chasing her own tail before laying down for a belly rub. Lori's mother would salute Lori in a comical manner and would then give her a very warm hug. "How did you sleep mother?"  "Oh Lori, need you ask? Like I always sleep when I'm here with you.  Like a rock," said Lori's mother. "I slept just like a rock!"  "Well, that is good to hear mother," said Lori. Then Lori quietly thought of what a "rock," her mother had always been to her, and to many others in their lives.

 Lori loved having her mother near and always regretted how their economic conditions during her childhood, separated her from her mother. Lori's mother worked 4 jobs continuously from the time Lori's mother divorced Lori's father, until Lori left home at 19 to attend college.

Lori's mother had always been an amazing caregiver. She supported her entire family of four girls while her husband, a hard working man struggling with mental illness, was institutionalized or unemployed. Lori and her sisters wore hand-me-down clothes, started working at jobs at 16, and knew hunger. Groceries and extras were often scarce, but Lori's mother always found a way to make ends meet. Right when they thought something would be shut off, due to a tight budget, a miracle would happen, and they would be okay.

And the caregiving extended out into the community. Lori's mother was the ,"go to," woman in the neighborhood to drive battered women to the shelters at 3 AM, she once opened up her home in an unwed pregnant teen, who had been thrown out to fend for herself on the street. And if that wasn't enough, she even found time to volunteer (while working 4 jobs), for a suicide prevention hotline!


 When Lori's mother's only sister was dying of stomach cancer, Lori's mother was there to help her and stayed by her side until her untimely death. When Lori's grandmother was diagnosed with Alzheimer's Disease, Lori's mother was her only caregiver, finally putting her in a nursing home, never leaving her side. And the list goes on and on and on.  When Lori had complications from her pregnancy and was bed-ridden for 6 weeks post -Op, it was Lori's mother who moved in and took care of all of the needs of the entire household.

Lori often thought that being her mother's caregiver was such an amazing experience, and would also find herself thinking, "I could never ever live up to being the caregiver that Mom has been to me!"  And maybe no one could. Lori's mother came from a very, very special breed.  However, if there was anything to teach, or anything to learn from this exchange of, "Watch and see, " it would be three things: 1) Present time consciousness. (Living in the now.) 2) Surrender without expectation, or judgment, listening with an open mind and warm heart. 3) Love, simply said - great love and compassion.

The caregiver's caregiver was a ready and willing student, open to being mentored by the very best that care giving brings!!!  Happy 85th Birthday Mom, I am forever grateful for the lifetime of love that you have given me!!

Positive Communication methods for people living with dementia:  We recommend seminars by Teepa Snow,M.S., OTR/L.FAOTA www.teepasnow.com, Naomi Feil, MSW, www.vfvalidation.org, and her books, all of them. And the life changing, ground breaking book, "Contented Dementia," by Dr. Oliver James

Copyright 2015 Caregivers Get Fit! Mama  Nicey

The information in this blog is information. It is not meant to be a replacement for getting medical advice from your own health professional regarding your own individual health challenge or condition. Dr. Denise will not diagnose, treat, or give direct personal consultations/advice to you on this blog for any medical condition, but will give general examples, and scientific research on many different health topics.  How you decide to use the information is between you and your own medical/ health professional.

Wednesday, July 8, 2015

Old Lady Moviestar





It was 6AM, and the dog was right on schedule signaling the need to take a walk. Anyone thinking of changing the patterned schedule of  "when" "where," and "how," to begin the day would be left to deal with canine hostility and the sighting of a doggie do surprise on the floor!  The sound of jingling metal tags around the dog's neck could be translated into, "I need to go outside now," "I'm hungry," or "Wake up, Grandma is wandering around the house again!"  Patterns, a predictable schedule and a structured environment means everything to our dog.  She likes to know that her toys are kept to the right of the living room chair, that her water dish is under the clock in the kitchen,  and that her daily walking and feeding schedule never changes. And if, by chance there is a change in our dog's scheduled activities - she will pant and pace with agitation and angst. Her behavior will reflect the activity changes.

 People are not dogs, that is obvious. However, patterns that dogs adhere to, and need in order to feel secure in their,  "day to day lives,"  are very similar to human needs, especially people experiencing dementia.  Tangles and neural patterns in the brain have been interrupted at the synaptic junctions. So, with the internal presence of disconnect,  there comes the need to keep predictable patterns of structured connection to outward external environments. Clutter  of any kind,  even a little bit of clutter, can lead to more and more confusion and agitation. And agitation in a person experiencing dementia, can be brought about in many different ways, as seen in the exchanges below.

  Lori had been busy with her stay at home business, and normally, on a daily basis, she would straighten up her mother's room. But after missing 4 days of de- cluttering the night stand,  her mother's room started to look, less organized. And the cluttering was very minimal, only with 6 magazines stacked on the nightstand with word search puzzles, and opened junk mail that hadn't been thrown away.  (Lori's mother was a secretary for over 30 years, so opening mail and sorting through things to organize paperwork was her passion. Knowing this, Lori very excitedly would present the junk mail, ALL of it addressed to the entire household, for her mother to open, and Lori's mother was DELIGHTED to have this task to do. However, with the cognitive challenges clouding her mother's judgement, she would wander at night, searching for and collecting all of the mail in the house.  (Bills, personal mail not addressed to her, etc).  Then at times, to organize the clutter, Lori's mother would put the mail, ALL of it in an empty shoulder bag hidden away with her laundry, which she would stuff in plastic bags,  and then forget it was there. So, Lori had to always check on the cluttering in her mother's  room, and the overstuffed shoulder bag).

Lori took the cue from the dog to go outside at 6AM, and then after they both returned from the walk, Lori's mother with no teeth, messy hair, a robe,  and no socks wearing New Balance running shoes, said, "Golly, we have our work cut out for us, we really do. Do you have any more bags?"  Lori said, Bags?"  "Yes, bags, BAGS Lori!"  Lori's mother was agitated.  Her environment was cluttered and the cluttering left her in a state of confusion, agitation and in a heightened state of anxiety. "How are we going to do it? I just don't know!"  As Lori walked into the bedroom, she noticed that her mother had bags and bags full of clothes, toiletries, towels, pictures, curling irons, etc. neatly packed away in a very orderly fashion in garbage bags. It was clear to see that Lori's mother had been up for hours packing up her room.  Her entire non-made bed was FULL of packed bags which in her attempt to organize the clutter on one night stand, left the room looking like an episode from hoarders! "You need a maid, Lori!  Look at this mess, just look at it.  How are we ever going to pack this up in time for the movers!!"

Lori didn't react, She stepped back and quietly (secretly, I might add), did some deep breathing to activate her brain. Thoughts like, "How am I going to redirect her this time?  She is really in a state.  How can I learn from this to help her in the future? This is all my fault for not cleaning off the end table.  Yikes, I screwed up, but can't beat myself up over this." So, Lori validated her mother's frustration saying, "Mom, I'm here for you. We can tackle this together, okay?" Lori's mother was still stuck on being and feeling overwhelmed. "We need to do this now, Lori.  The men will be here any minute!" Well Mom, do you want the men to see you in your robe?  Do you want to move things on a truck as an almost 85 year old without breakfast?  Because mother,  I was just planning on making you a fabulous breakfast but if you choose to work through breakfast, and not eat, you may not have the energy to work so hard. "  "What were you going to make me for breakfast?"  Lori's mother completely calmed down and her ears perked up at the thought of food. "Well, mother - we can have gluten free pancakes, or mushroom, cheese omlets. How does that sound to you?"  "I like that Lori, I like that a lot!"

Lori was feeling really good. So happy that her mother took the bait, and then her mother got back on the roller coaster. "Where do you keep your bags, we need bags!" Lori's mother was back to the moving men scenario. "I need to go home, they are waiting for me." Lori's mother appeared to be on a timeline trying to make a deadline.  "Who is waiting for you, mother?" "My family, Lori. I haven't seen them and I need to see them again.  It has been way too long and I need to go home because they are expecting me."  "Okay Mom.  Then we will give you a good breakfast so that you can go.  And where are you going?" Lori's mother suddenly looked up with an annoyed look on her face. "What do you mean where am I going? You know where I am going.  I am going to see my mother.  And after that, I will go to see the crew at Aunt Hilda's. Uncle Dean and Aunt Lil, too!!"  They are expecting me, so I must go."

 Lori was almost in tears, because all of the people mentioned have been gone for many years, however Lori also remembered reading somewhere that before elderly people move on, they literally see (in their minds), and interact with their departed loved ones. Some people even say that loved ones help them to cross over!!

 Lori knew she needed to help her mother to not feel so frustrated, and to help her to live more in the "now" rather than the "then."  So, Lori decided to do a pattern interrupt on her.(A technique she used to use on her two year old to assist him through his frustrations during a tantrum.) She would shift the focus through something ridiculous to hopefully change the thought pattern. Then her mother started again.  "Lori, we are going to have to pack up the entire house. The refrigerator, the cupboards, under the sink and all of the rooms upstairs."  Her mother then grabbed some paper bags and packed up everything on the kitchen table. "There we go, and now I'm going to take a look at the garage and the laundry room."  "Wow, Lori thought.  This roller coaster has just sped up, and it isn't even 7:30AM!!!"

"Mother, you are the old lady!" Lori said. Her mother said, "What are you talking about?" "Mother we are in a movie and YOU are the old lady. We are playing roles in a movie, and you are an old lady movie star!"  Her mother then burst into laughter. "Oh really, I am , am I?"  "Yes, and I just called the movers in the movie, and they are going to do everything, EVERYTHING Mom.  So, you are done with your work. You are finished with the tough stuff and you can now just sit back, and have fun today.  You don't have to think about moving.  And in this movie, we can plan our day.  And today you get to water the plants, take a bath, get your hair done, make your favoite salad and go to a potluck!!!  Now how does that sound to you?"  Her mother then completely relaxed her shoulders.  "I like that, I like that Lori!"  "So, mother dear said Lori,  "How would you like your eggs?"

Lori and her mother watered the plants, her mother took a bath and then said, "I think I need to take a nap."  

Positive Communication methods for people living with dementia:  We recommend seminars by Teepa Snow,M.S., OTR/L.FAOTA www.teepasnow.com, Naomi Feil, MSW, www.vfvalidation.org, and her books, all of them. And the life changing, ground breaking book, "Contented Dementia," by Dr. Oliver James

Copyright 2015 Caregivers Get Fit! Mama  Nicey

The information in this blog is information. It is not meant to be a replacement for getting medical advice from your own health professional regarding your own individual health challenge or condition. Dr. Denise will not diagnose, treat, or give direct personal consultations/advice to you on this blog for any medical condition, but will give general examples, and scientific research on many different health topics.  How you decide to use the information is between you and your own medical/ health professional.



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