“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

 

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.

 

 

 

The Stages of Alzheimer’s

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

Don'sBackyard_Faded_pathAlzheimer’s disease is an irreversible, progressive brain disease causing a slow decline in memory, language, reasoning, judgment, and daily functioning. It typically develops gradually and worsens over the course of several years. This progression is often referred to as stages, but not everyone will experience the same symptoms at the same rate. There are common patterns of symptom progression and a person’s abilities will change through the course of the disease.

Stages are typically referred to as early, middle and late or mild, moderate and severe. It is important to recognize these stages are a rough guide based on averages; each stage could be as brief as a year or as long as ten years. The stages can help patients and families understand what they might expect and plan accordingly.

Early stage symptoms

  • Increased forgetfulness, memory loss for recent events
  • Poor concentration
  • Repetitiveness: telling the same story over and over
  • Difficulty with word finding, expressing thoughts
  • Difficulty with decision making, problem solving or complex tasks
  • Misplacing objects or getting lost in familiar places
  • Mood or personality changes, less tolerance
  • Slower to react or learn something new
  • Needs support/supervision to continue living alone

In the early stage, most people can still live alone and carry out daily tasks, but may need assistance with finances, appointments, meal planning or cooking. This is a good time to organize and simplify daily routines and assess the home for safety. Depression and withdrawal from social activities is not uncommon in this stage and the person may try to hide the memory losses he/she is experiencing.

Middle stage symptoms

  • Increased memory loss, may not recognize family
  • Communication difficulties
  • Problems with reading, writing and numbers
  • Loss of impulse control, poor judgment
  • Difficulty with dressing, bathing, toileting
  • Aggression as a response to frustration
  • Inappropriate behaviors including resisting care, agitation, wandering
  • Delusions or hallucinations
  • Abnormal sleep/wake cycles
  • Needs full time supervision

In the middle stage, the patient may be more unpredictable and daily activities will be more challenging. Inability to perform tasks such as cooking and driving may lead to unsafe situations. At this stage, many will need full time supervision to remain in their home. Behaviors such as suspicion, wandering, resisting care, agitation and sleep disturbance may be displayed. Frustration is common because the person cannot make sense of the world around them. The behaviors are not intentional and are best dealt with by staying calm, using redirection or distraction, reminiscence and reassurance.

Late stage symptoms

  • Needs to be bathed, dressed, fed, turned
  • Loses ability to verbalize; may yell, groan or grunt
  • Loss of bodily functions, incontinent
  • Flat affect; where their faces show very little emotion
  • Unable to recognize others or themselves
  • Immobility
  • Appears apathetic, lethargic
  • Requires total care, may be appropriate for nursing home placement

With the increased cognitive losses, the patient will become calmer; less distressed by the changes happening to them and appear more apathetic.  Physical losses increase with incontinence, immobility, diminished speech and inability to perform any daily functions.  Physical wellbeing and comfort care become the primary concern. When the patient reaches this final stage additional in-home care including Hospice care may be needed to assist the caregiver.

In all stages, family and caregivers need to obtain available in-home care, seek support, utilize community resources and ensure that legal and financial affairs are in order.

If an individual has not been diagnosed with Alzheimer’s but is displaying any of these symptoms, he or she should seek a medical assessment promptly. If you have questions or concerns our Memory Care Program Coordinator would be glad to assist you.  Additional information is also available through the Alzheimer’s Association at www.alz.org.

Is it Alzheimer’s? Learn The Early Signs and Symptoms

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

Dementia is a broad term that describes the progressive deterioration of a person’s memory. It affects the brain’s ability to think, reason and remember—and ultimately interferes with the person’s ability to function on a daily basis. Alzheimer’s disease is one type of dementia. It makes up about 70% of all dementia cases. It’s the 6th leading cause of death and an estimated five million Americans are living with the disease.

Dementia becomes more common with age, but is not a normal part of the aging process. For example, with normal aging, a person might misplace their keys, but then find them. However, a person with Alzheimer’s might misplace their keys, find them, but also forget what the keys are used for.

In the early stage of dementia, the signs and symptoms may be subtle. Early memory issues may present as depression, anxiety, mood or personality changes. By the time the person shows signs of the disease, the process in the brain could have been happening for a long time.

Here are 10 early signs and symptoms of Alzheimer’s to look for (1, 2):

  1. Memory loss that disrupts daily life: This can include forgetting recently learned information, dates or events and needing memory aides such as calendars and notes.
  2. Challenges in planning or problem solving: Difficulty with concentration, tasks taking longer to accomplish, difficulty with working with numbers or following a plan
  3. Difficulty completing familiar tasks at home, work or leisure, following recipes, managing a budget and driving
  4. Confusion with time or place, losing track of dates, seasons, passage of time
  5. Trouble understanding visual images and spatial relationships, vision problems, trouble reading, judging distance and determining color or contrast
  6. New problems with words in speaking or writing, trouble following or joining conversation or struggle with vocabulary
  7. Misplacing things and losing the ability to retrace steps, putting things in unusual places, may accuse others of stealing
  8. Decreased or poor judgment, changes in decision making ability, may pay less attention to grooming
  9. Withdrawal from work or social activities, may remove themselves from hobbies, projects or socialization
  10. Changes in mood or personality, may be suspicious, depressed, fearful, anxious or more easily upset

Some medical conditions causing memory loss are treatable and should be evaluated. If you, or someone you know, are having any of these symptoms, it’s important to seek medical assessment immediately.

1 Mace, Nancy and Peter Rabins: The 36-Hour Day: A Family Guide to Caring for Persons With Alzheimer Disease, Related Dementing Illnesses, and Memory Loss in Later Life (3rd Edition), Market Paperback, April 1, 2001

2 Alzheimer’s Association. What is Alzheimer’s? http://www.alz.org/alzheimers_disease_what_is_alzheimers.asp