Why Go If My Loved One Can’t Remember My Visit?

By Carol Combs, MSW, Oxford’s Memory Care Coordinator

When a loved one has Alzheimer’s disease, it changes the way friends and family interact with the person. Knowing what to say, or even how to act, can be challenging. The individual may not remember those who come to visit or remember prior visits.

When visiting a loved one with Alzheimer’s you may hear questions such as, “Why don’t you ever visit?” or “Who are you?” Such questions, as well as behavioral changes that accompany the disease, can make visiting difficult and uncomfortable.

However, there are some things you can do to help ease the discomfort and make your visit more pleasant for you and your loved one.

  • Focus on feelings – the content of the conversation doesn’t matter. The feelings and sense of contentment created will make a difference. Emotion lasts longer than memory. The emotion resulting from a positive visit can improve a person’s mood and influence the rest of the day.
  • Accept the person’s reality- don’t correct your loved one, just go along with it. If the person insists the grass is blue, agree. Telling the individual it’s really green can create agitation. Instead, offer reassurance and distraction.
  • Introduce yourself- avoid saying “Don’t you remember me?” because if the person doesn’t, it can be embarrassing. Introduce yourself with “Hi Mom, this is Susan.”  Save her the embarrassment or awkward moment.
  • Be respectful- don’t talk to Alzheimer’s patients like they are children. They have a lifetime of experiences, so show them the respect they deserve.
  • Bring an activity – long-term memory is often still intact. Reminiscing with pictures or photo albums can be comforting and encourage conversation. Play music or sing. Consider Music Therapy. Music can stir positive emotions, and individuals may be able to remember lyrics even though their ability to communicate has declined. Exercise improves brain circulation. Encourage movement of arms and legs, or toss a beach ball. Introduce your loved one to a GeriJoy Companion, a special tablet which provides social interaction, helps decrease loneliness and has shown remarkable success with Alzheimer’s and dementia patients.
  • Touch – hold a hand, stroke hair, hug. Touch is a powerful way to communicate when words fail. People with dementia recognize a caring touch, even in the late stages of the disease.
  • Minimize distractions – it will be more difficult to have a meaningful visit if there is too much noise or activity. Over stimulation can cause agitation. Try to find a quiet place or take a walk outside.

If you know someone with Alzheimer’s and are hesitant to visit, remember that the benefit of your visit may last long after you’ve gone.

For additional support or information, contact Oxford HealthCare. Oxford offers numerous programs that provide the help and relief you need—so you can enjoy time with your loved one and continue to provide care at home. For your peace of mind, advanced technology like Lifeline and GeriJoy helps provide added security when you can’t be with your loved one. To find out more about all Oxford has to help families, contact a Care Coordinator, today.

 

 

 

Be Informed for the Better During Stress Awareness Month

By Carol Combs, MSW, Oxford’s Memory Care Program Coordinator

 

Stress is defined as mental or emotional strain or tension resulting from adverse or very demanding circumstances. Stress is inevitable—everyone deals with it. So, during Stress Awareness Month, it is an excellent time to learn more, recognize stressors, practice stress relief and get help as needed.

 

Stress isn’t all negative; positive stress can motivate and help with concentration. Setting goals and accomplishing them feels good and rejuvenates the mind and body for the next challenge.

 

However, most of the time, stress is associated with something difficult or negative. When stress becomes a way of life, it is very hard to relax and recover. When stress becomes chronic, a person’s physical and emotional health suffers.

 

Caregiving is a demanding and stressful role. Being a caregiver can be an extremely rewarding and gratifying experience, but it can also be daunting, challenging, exhausting and overwhelming—especially if caring for someone who is ill.

 

Whether you are caring for someone daily, occasionally, long distance or 24 hours a day, there will be stress. While you may not be able to change the situation, there are steps to help manage the emotional, physical and mental impact.

 

First, it helps to recognize what personally stresses you. The body treats these stressors as threats, which prompts the adrenal glands to release a surge of adrenaline and cortisol.

 

Adrenaline increases heart rate, elevates blood pressure and boosts energy supplies. Cortisol, the primary stress hormone, increases sugars (glucose) in the bloodstream. It alters the immune system responses and suppresses the digestive system, the reproductive system and growth processes. This complex, natural alarm system also communicates with regions of the brain that control mood, motivation and fear.

 

When under constant stress, the body’s fight-or-flight reaction stays on alert. The long-term activation of the stress-response system and the overexposure to cortisol and other stress hormones can disrupt almost all of the body’s processes.

 

When under this kind of negative, constant stress, there is a significant risk of numerous health problems, including:

  • Anxiety and depression
  • Compromised immune system
  • Digestive problems
  • Heart disease and increased blood pressure
  • Sleep problems
  • Weight fluctuation
  • Memory and concentration impairment

 

Due to the health risks, it is very important for caregivers to learn healthy ways to cope with stress.

 

Stress management strategies include:

  • Eating a healthy diet, exercising regularly and getting enough sleep
  • Practicing relaxation techniques or learning to meditate
  • Fostering healthy friendships
  • Laughing—have a sense of humor
  • Keeping a journal—jot down thoughts as an emotional outlet
  • Seeking professional counseling when needed
  • Educating yourself—become informed about stress, disease process, etc.
  • Utilizing community resources that offer assistance and support
  • Visiting your doctor regularly
  • Finding opportunities for Respite Care—Oxford HealthCare can help
  • Chewing gum—studies have shown this simple act can lower anxiety and ease stress
  • Reminding yourself of comforting phrases that speak to you personally—God won’t give us more than we can handle. This too shall pass. Serenity Prayer. I can do this. Encourage yourself the way you would a friend.
  • Believing in yourself—find the necessary means to withstand stress and look forward to brighter days ahead.

 

Although April is officially Stress Awareness Month, we all know that stress affects us in some way, every day, year round. If you are a caregiver, it is extremely important that you also care for yourself. Oxford HealthCare offers numerous home care programs that provide the help, support and relief you need, so you may enjoy time with your loved one and continue to provide care at home. If you need help or have questions, contact an Oxford Care Coordinator.

“When words fail, music speaks” Hans Christian Anderson

By Carol Combs, MSW – Oxford’s Memory Care Program Coordinator

While working in a skilled nursing facility, I had the opportunity to witness remarkable things. I was amazed to see individuals with dementia who could not put together a sentence, but could sing an entire song. Their faces would brighten, and I could see mood changes along with toe tapping and smiles. Soon, others would join in. Although the disease had taken so much away from them, music was a wonderful way to engage and encourage them.

The language area of the brain is impacted early in the Alzheimer’s disease process, but music touches a different part of the brain. The area of the brain linked to music is relatively unaffected by Alzheimer’s disease; so musical memories are often preserved. Rhythmic responses require little to no cognitive processing; so, a person’s ability to engage in music—particularly rhythm playing and singing—remains intact late into the disease process. Some individuals will respond to music when nothing else seems to reach them.

Music can provide emotional and behavioral benefits for dementia sufferers. Listening to music or singing can relieve stress and reduce agitation, anxiety or depression. For caregivers, music is a way to connect with loved ones who have difficulty communicating. Most people associate music with important events and emotions, and selections from a person’s young adult years—ages 18-25—are more likely to elicit a strong response. As an individual progresses into later stage dementia, music from childhood works well. Although individuals may not be able to verbalize or demonstrate affection with loved ones, they can still move with the beat of a favorite piece of music until very late in the disease process.

Caregiver Tips:

  • Experiment with different types of music to see which evoke the best reaction.
  • Play music or sing as the individual is walking to improve balance or gait.
  • Choose relaxing music, a familiar, non-rhythmic song to reduce sun downing or bedtime issues.
  • Compile a musical history of favorite recordings to help with reminiscing and recalling memories.
  • Encourage movement with the music —clapping or tapping feet, or dancing if possible.
  • Play or sing soothing songs to calm someone during mealtime or personal hygiene care.
  • When playing music, eliminate competing noises such as television or outdoor sounds.

Singing is associated with safety and security from early life. When caregivers engage in singing with their loved ones, it provides an opportunity to connect, even when the disease has deprived them of traditional forms of closeness.

“Music is the literature of the heart; it commences where speech ends.”
Alphonse de Lamartine

Oxford Hospice provides numerous home care programs—including music therapy—to help caregivers and their loved ones. Oxford HealthCare is dedicated to helping families enjoy time together and remain at home. If you have questions about Oxford Hospice, Oxford’s Memory Care Program or receiving help at home, please contact a Care Coordinator, today.

 

Source: Alzheimer’s Foundation of America

 

Touch Is the Language of Compassion

By Carol Combs, MSW, Oxford’s Memory Care Coordinator

Everyone needs tender loving care, and someone with dementia such as Alzheimer’s disease is no exception. In fact, because dementia robs people of language, non-verbal communication becomes even more important. Non- verbal communication is critical when dealing with dementia, and touch is a powerful way to connect with someone who is losing other avenues to communicate.

Tactile stimulation can help when language is failing. Anything individuals can touch, feel or manipulate with their hands helps fill the void left with loss of language. It is actually the brain that “feels”—so tactile stimulation is brain stimulation.

People with dementia don’t lose the capacity for human emotion or recognition of a caring touch, even in the late stages of the disease. A hug, handshake, pat on the arm, hand lotion massage or stroke of the hair can relay feelings of compassion and care. And of course, a smile is a universally understood expression!

Studies have identified the physical benefits of touch, including: lowering blood pressure, decreasing pain and heart rate, improving mood and lowering stress. Touch can also benefit those with dementia by calming them. Massaging the hands or handholding can reduce agitation; help ease the feelings of isolation, loneliness and boredom; and, encourage feelings of well-being.

We need to respect a person’s preferences for physical touch and explore ways to make contact that are comfortable to the individual. If someone is highly agitated, use caution in your approach, as the individual may not accept you entering his/her private space. However, while we do need to be respectful of someone’s comfort level, that should not stop us from finding ways to nurture those in our care.

“Love is not a memory—it’s a feeling in the heart and soul, never to be forgotten. This disease can take away almost everything, but not the love,” wrote Michele DeSocio in Living Proof that Alzheimer’s Can’t Steal Love.

Oxford Health Care offers numerous home care programs that can provide you the help, support and relief you need so you may enjoy time with your loved one and continue to care for them at home. If you have questions, our Care Coordinators will be happy to assist you.

Sources: Esther Heerema MSW, alzheimers.about.com, American Massage Therapy Association

November is National Hospice Month and National Alzheimer’s Awareness Month

By Elizabeth Lee, RN, BA, CHPN Oxford’s Hospice and Palliative Specialist and Carol Combs, MSW Oxford’s Memory Care Program Coordinator

Hospice is a wonderful and caring option for people who are facing end of life illness. The primary goal of hospice care is to help maintain the highest quality of life in the last stages of an illness.

Hospice serves individuals with any terminal illness, including Alzheimer’s disease. The Hospice Interdisciplinary Care Team includes the physician, nurse, social worker, chaplain, aide and grief services. This team works together with the patient and family to help manage the unique needs of end stage Alzheimer’s disease and other related dementias.

Hospice focuses on comfort, support and managing pain rather than providing treatment. People with Alzheimer’s disease become more disabled over time; and with advanced dementia, individuals can no longer communicate their wants and needs. Focusing on the senses—touch, hearing and sight—can bring comfort when verbal communication cannot.

An Alzheimer’s patient could be eligible for Hospice care if they:

  • Are unable to ambulate without assistance
  • Are unable to dress or bathe without assistance
  • Are unable to swallow
  • Are unable to speak or communicate meaningfully
  • Have urinary and fecal incontinence
  • Have UTI’s (urinary tract infections), decubitus ulcers and/or aspiration pneumonia

The end of life path of hospice patients can be divided into one of three typical patterns:

  1. A short period of obvious decline at the end (typical for most cancers)
  2. Long-term disability with periodic intensification and unpredictable timing of death (typical for a patient with chronic organ system failure)
  3. Steadily declining function with a slowly dwindling course to death (typical for a patient with frailty, dementia or Alzheimer’s)

End of life decisions become more complicated if wishes have not been or cannot be expressed by the dying person. Families then have to speak for the person based on their knowledge of the individual’s values and beliefs.

What is the current quality of life, and how will the on-going treatment potentially impact quality of life?

Patients and families need to understand benefits versus burdens before treatment continues or is introduced. This requires truth telling and explanations in a language the patient and family are able to understand.

Family members caring for a dying loved one with Alzheimer’s often express relief—for the patient and themselves—when death comes. It is important to understand that these feelings are normal.

Hospice can help the patient and caregiver deal with the challenges faced in the patient’s final months, and offer grief support both before and after the loved one dies. Hospice helps ensure the highest quality of life while being treated with dignity and respect.

For more information about Oxford’s Hospice or Memory Care Programs, please contact one of our Care Coordinators, today.

 

Oxford Hosts Event to Help Those Caring for Someone with Alzheimer’s Disease or Dementia

Oxford HealthCare’s Memory Care Program presents Coping with Caregiving, a free event on Thursday, October 22 from 6:30-8:30 p.m. at The Montclair Retirement Community, 1000 E. Montclair in Springfield.

Dementia affects the entire family and presents ongoing changes and challenges. Oxford HealthCare will be there to help, so families do not have to face these challenges alone.

Oxford’s Memory Care Program offers an innovative and compassionate approach to finding solutions to the challenges you and your loved ones face.

The Coping with Caregiving program will focus on:

  • Learning strategies for managing the challenges of caregiving
  • Reinforcing coping skills
  • Resources to assist you in providing care at home

The event is free, but please register at memorycare@oxfordhealthcare.net by October 19, or call 417-883-7500.