When someone you love has Alzheimer's Disease, every day communication can be a challenge. Decreased communication abilities does not mean that the person is unaware of their surroudinfgs. Most people with Alzheimer's disease are very aware of the difficulty they are having, especially early on in the disease process. Here are some general tips to help decrease the frustration surrounding communication:
Reality orientation or trying to encourage a person to remember simply do not work. Instead, use memory aids such as labeling objects (i.e. closet, bathroom). Be aware that as Alzheimer’s disease progresses, an individual’s ability to name objects and use words decreases.
When you need their attention, it pays to simplify the environment for the person with Alzheimer’s. Eliminate distracting noises such as the radio or TV, or loud conversation so that he or she can concentrate more effectively.
If you have an intercom system at home, do not use it to communicate with the person with Alzheimer's disease. The patient may be frightened or confused by hearing a voice on the intercom.
Always begin by identifying yourself and calling the person's name. Always approach the person from the front. Maintain good eye contact.
Use short, simple sentences. Speak slowly. Be specific. Use the name of the person or object instead of “this” or “they”.
Keep tone of voice low and pleasant and facial expression warm and friendly.
Use non-verbal cues: a reassuring touch, a smile, a demonstration stating the emotion.
Give the person plenty of time to respond to your question (20 seconds). If you need to repeat what you've said, repeat your question exactly the same way.
Use concrete language. Avoid abstract terms.
Talk in positive terms. Constant use of “no” or commands increases resistance.
Don’t test the patient’s memory. Erase the words, “Don’t you remember?” from your
vocabulary.
Give directions simply and one at a time.
When helping with personal care, tell the patient what you are doing each step of the way.
Add occasional social or reassuring comments to avoid “task-focused talk” only.
Do not appear rushed or tense. The patient will become tense and agitated.
Listen to the patient. Try to find the key thought and take note of the feeling or emotion being expressed along with the spoken word.
Reassure through words. Remind the patient who you are and that you will take care of him.
Sometimes asking a “Why” question can get to the reason behind a repetitive question and decrease its occurrence. (i.e. “Why are you concerned about what time it is?”)
Saturday, December 01, 2007
Thursday, November 29, 2007
Is Your Parent Over-medicated?
Overmedication and adverse interaction of drugs are a common problem for older people.Older adults may not need the same dose of medication they have taken for many years due to changes in the body. For example, the body rids of many medications through the kidneys, but kidney function decreases with age. The medication dose does not leave the bloodstream at the same rate, so the blood levels can creep upward, resulting in over-medication.
Also, many drugs have interactions with food or other drugs in older people that would not occur in younger persons. And, prescription drugs can interact with over-the-counter medications to create a serious health problem.
Problems with medication can occur because the patient lacks adequate information to make informed choices about their schedule for taking presciption drugs, or over-the-counter medications. Patients do not always receive adequate information about drug interactions, and patients often do not ask enough questions about side effects or interactions which may occur.
Overmedication can occur when several physicians prescribe drugs for a patient, and are unaware of other medications the patient is taking. Problems can also arise when there is no system in place to ensure that medications are taken as prescribed.
Possible side effects of overmedication may include:
Slowed reaction: speech, movement and thought
Sleeplessness
Increased confusion
Unsteady gait
Constipation
Dry mouth
Blurry vision
Increased agitation
Uncontrollable repetitive movement of the tongue, feet, hands and trunk
Hallucinations
If you notice any of these changes, or changes in the overall well-being
of your parent, you may want to suggest that they schedule an appointment with their doctor. In order for this appointment to be successful, your parent should take with them a list of all drugs — prescribed and over-the-counter — they are currently taking.
The pharmacist is also an excellent source of information about drugs and should be consulted as well as the physician. A pharmacist can discuss not only possible interactions and problems with a medication, but suggest strategies for managing medication as well. Your pharmacist can advise you and your parent if a visit to the physician and a review of medication is needed.
ADDITIONAL THINGS YOU CAN DO:
1. Help your parent make a list of prescriptions and over-the-counter medications they are currently taking. Go through their medicine cabinet and kitchen shelves with your parents and throw out all outdated prescriptions and medications.
2. Make sure that they are only getting their prescriptions filled at one pharmacy or, if they are using a mail-away service, that anyone filling their prescriptions has the complete list of medications in their file.
3. Remind them to discuss any new prescriptions with their pharmacist to make sure they understand the possible side effects, possible interactions, and that the pharmacist has added it to their file.
Also, many drugs have interactions with food or other drugs in older people that would not occur in younger persons. And, prescription drugs can interact with over-the-counter medications to create a serious health problem.
Problems with medication can occur because the patient lacks adequate information to make informed choices about their schedule for taking presciption drugs, or over-the-counter medications. Patients do not always receive adequate information about drug interactions, and patients often do not ask enough questions about side effects or interactions which may occur.
Overmedication can occur when several physicians prescribe drugs for a patient, and are unaware of other medications the patient is taking. Problems can also arise when there is no system in place to ensure that medications are taken as prescribed.
Possible side effects of overmedication may include:
Slowed reaction: speech, movement and thought
Sleeplessness
Increased confusion
Unsteady gait
Constipation
Dry mouth
Blurry vision
Increased agitation
Uncontrollable repetitive movement of the tongue, feet, hands and trunk
Hallucinations
If you notice any of these changes, or changes in the overall well-being
of your parent, you may want to suggest that they schedule an appointment with their doctor. In order for this appointment to be successful, your parent should take with them a list of all drugs — prescribed and over-the-counter — they are currently taking.
The pharmacist is also an excellent source of information about drugs and should be consulted as well as the physician. A pharmacist can discuss not only possible interactions and problems with a medication, but suggest strategies for managing medication as well. Your pharmacist can advise you and your parent if a visit to the physician and a review of medication is needed.
ADDITIONAL THINGS YOU CAN DO:
1. Help your parent make a list of prescriptions and over-the-counter medications they are currently taking. Go through their medicine cabinet and kitchen shelves with your parents and throw out all outdated prescriptions and medications.
2. Make sure that they are only getting their prescriptions filled at one pharmacy or, if they are using a mail-away service, that anyone filling their prescriptions has the complete list of medications in their file.
3. Remind them to discuss any new prescriptions with their pharmacist to make sure they understand the possible side effects, possible interactions, and that the pharmacist has added it to their file.
Wednesday, November 28, 2007
More Than "The Blues"
Depression is a common illness, yet few sufferers are properly diagnosed. This is especially true for the depressed elderly. Many people from the generation of the Great Depression and prior were indoctrinated with the philosophy that you just have "to pull up your boot straps and move on".
Everyone experiences changes in mood, ranging from minor frustrations to the grief that accompanies a major loss. Someone who is clinically diagnosed with depression experiences changes in behavior that interferes with the ability to manage every day activity, feel pleasure, or maintain interest and ability to concentrate is not a simple case of the “blues.” It is an illness that doctors, psychiatrists, psychologists, and other mental health professionals have made great progress in understanding and treating.
Aging itself does not cause depression, but many conditions that occur among the elderly can contribute to its cause. Some of these are:
• Diseases that produce chronic pain, disability, dependence on others to perform routine tasks due to the disabling illness, little social contact with others, and fear
• Some medications, such as steroids and those for the treatment of hypertension, heart disease, and diabetes may have the side effect of depression, although this does not occur for most people
• The loss of friends and family may create a continual mourning process contributing to feelings of loneliness and isolation
• Keeping fears and negative feelings “bottled up,” due to the fact that many parents grew up in an era when expressing these feelings was not acceptable
Depression is usually a treatable illness. Talk with your parent’s or your own physician about your concerns. They can suggest an appropriate professional for diagnosis. Treatment may include counseling sessions, medication, and a supportive family.
Everyone experiences changes in mood, ranging from minor frustrations to the grief that accompanies a major loss. Someone who is clinically diagnosed with depression experiences changes in behavior that interferes with the ability to manage every day activity, feel pleasure, or maintain interest and ability to concentrate is not a simple case of the “blues.” It is an illness that doctors, psychiatrists, psychologists, and other mental health professionals have made great progress in understanding and treating.
Aging itself does not cause depression, but many conditions that occur among the elderly can contribute to its cause. Some of these are:
• Diseases that produce chronic pain, disability, dependence on others to perform routine tasks due to the disabling illness, little social contact with others, and fear
• Some medications, such as steroids and those for the treatment of hypertension, heart disease, and diabetes may have the side effect of depression, although this does not occur for most people
• The loss of friends and family may create a continual mourning process contributing to feelings of loneliness and isolation
• Keeping fears and negative feelings “bottled up,” due to the fact that many parents grew up in an era when expressing these feelings was not acceptable
Depression is usually a treatable illness. Talk with your parent’s or your own physician about your concerns. They can suggest an appropriate professional for diagnosis. Treatment may include counseling sessions, medication, and a supportive family.
Tuesday, November 27, 2007
Is it Alzheimer's?
Confusion, forgetfulness, and changes in behavior are not normal signs of aging, as many beleive. These symptoms point to possible Alzheimer's Disease.
Although Alzheimer’s affects one in 10 people over the age of 65 and one in two over the age of 85, according to the Alzheimer’s Association, the symptoms are often not recognized until the disease has progressed, sometimes considerably.
Almost half of Alzheimer’s disease patients are first diagnosed in the moderate
to severe stages of the disease. Being able to identify symptoms of the disease is the first step to a timely diagnosis. Although there is no cure, there are medications to help alleviate symptoms associated with the disease.
Treatment needs to start as soon as possible, because the longer the delay in treatment, the less function is maintained. The drugs currently used to treat Alzheimer's Disease are not a cure, but studies point to benefits. Most people treated are able to maintain a higher level of function for longer periods of time. Although decline in abilities to care for oneself and cognitive deterioration is inevitable, medication therapy clearly is beneficial.
If you have noticed any of the following changes in a loved one’s behavior, cognition and daily functioning, consider this an opportunity to address potential signs of Alzheimer’s disease with a doctor. The Alzheimer’s Association recommends that adults be familiar with the symptoms, which include:
✷ Difficulty performing familiar tasks, such as forgetting how to do routine chores, prepare a meal, participate in lifelong hobbies or dress appropriately for the weather.
✷ Disorientation, such as forgetting where the toothbrush was placed the night before or where one lives.
✷ Changes in behavior – as Alzheimer’s progresses, behavior changes, such as
restlessness, sleeplessness, delusions, hallucinations, and pacing back and forth.
✷ Changes in mood – mood swings from calmness to anger and fearful or suspicious thoughts about oneís surroundings may occur.
Although Alzheimer’s affects one in 10 people over the age of 65 and one in two over the age of 85, according to the Alzheimer’s Association, the symptoms are often not recognized until the disease has progressed, sometimes considerably.
Almost half of Alzheimer’s disease patients are first diagnosed in the moderate
to severe stages of the disease. Being able to identify symptoms of the disease is the first step to a timely diagnosis. Although there is no cure, there are medications to help alleviate symptoms associated with the disease.
Treatment needs to start as soon as possible, because the longer the delay in treatment, the less function is maintained. The drugs currently used to treat Alzheimer's Disease are not a cure, but studies point to benefits. Most people treated are able to maintain a higher level of function for longer periods of time. Although decline in abilities to care for oneself and cognitive deterioration is inevitable, medication therapy clearly is beneficial.
If you have noticed any of the following changes in a loved one’s behavior, cognition and daily functioning, consider this an opportunity to address potential signs of Alzheimer’s disease with a doctor. The Alzheimer’s Association recommends that adults be familiar with the symptoms, which include:
✷ Difficulty performing familiar tasks, such as forgetting how to do routine chores, prepare a meal, participate in lifelong hobbies or dress appropriately for the weather.
✷ Disorientation, such as forgetting where the toothbrush was placed the night before or where one lives.
✷ Changes in behavior – as Alzheimer’s progresses, behavior changes, such as
restlessness, sleeplessness, delusions, hallucinations, and pacing back and forth.
✷ Changes in mood – mood swings from calmness to anger and fearful or suspicious thoughts about oneís surroundings may occur.
Monday, November 26, 2007
How to Help a Resistant Parent
Elderly parents who need help are often the ones who resist it the most. It's all too common that they adamantly insist they can still manage their daily lives on their own. But when you see your parents not eating properly, wearing the same clothes every day, failing to take their medication, or letting the garbage pile up excessively, you know you have to intervene. The key of course is to curb your strong insistence on handling their affairs, and to gradually introduce them to the services they need.
Here are tips on how to get help for a resistant parent:
1. If your situation requires immediate attention, contact a geriatric care manager who has the expertise to help your parent accept assistance. A Geriatric Case Manager offers professional consultation and care management to help you make the right decisions in caring for your parent.
2. The elderly usually respect the advice of their doctors. Consult with your parent's physician and ask the doctor to suggest a plan that includes a home health aide to assist with maintaining the health and safety of your parent so that he or she can continue to remain at home. If your loved one needs care after returning home from the hospital, ask both the discharge planner and the doctor to recommend a home health aide as part of recuperation.
3. Work together with your family to encourage your loved one to accept help. If your parent sees you are united in your concern for his well-being and think a home health aide is a good solution, he or she might be more willing to listen and give it a try.
4. Ask your parent's neighbors to help with small tasks like picking up groceries, watering the lawn, shoveling snow, and taking out the garbage. This will show him or her how much more comfortable and less confusing her life would be with even more help inside her home. Point out how overwhelmed he or she gets doing everyday household chores like laundry, cleaning, and preparing meals.
5. If you have a kind and compassionate neighbor, ask her to stop by with a meal every day and chat with your parent. Once he or she sees he can trust the neighbor, it will be easier for him to open his home to other kinds of help.
6. To make sure that your parent is eating right, suggest having meals delivered by meals-on-wheels programs usually run by senior centers and religious organizations. Your parent might be more amenable to meals provided this way, geared to his diet and liking.
7. Usually the elderly are conscious about spending their money and will accept services that cost very little or that are free. Groceries and pharmacies offer free delivery, health clinics, hospitals, and public health departments offer free health screenings and shots, and dentists offer services for the homebound. Learn what is available to your mother in her community so that she will learn to take advantage of and accept all types of help.
8. Don't be afraid to consult with others who also have aging parents resisting help. The ideas that work for them may be valuable to you too.
Here are tips on how to get help for a resistant parent:
1. If your situation requires immediate attention, contact a geriatric care manager who has the expertise to help your parent accept assistance. A Geriatric Case Manager offers professional consultation and care management to help you make the right decisions in caring for your parent.
2. The elderly usually respect the advice of their doctors. Consult with your parent's physician and ask the doctor to suggest a plan that includes a home health aide to assist with maintaining the health and safety of your parent so that he or she can continue to remain at home. If your loved one needs care after returning home from the hospital, ask both the discharge planner and the doctor to recommend a home health aide as part of recuperation.
3. Work together with your family to encourage your loved one to accept help. If your parent sees you are united in your concern for his well-being and think a home health aide is a good solution, he or she might be more willing to listen and give it a try.
4. Ask your parent's neighbors to help with small tasks like picking up groceries, watering the lawn, shoveling snow, and taking out the garbage. This will show him or her how much more comfortable and less confusing her life would be with even more help inside her home. Point out how overwhelmed he or she gets doing everyday household chores like laundry, cleaning, and preparing meals.
5. If you have a kind and compassionate neighbor, ask her to stop by with a meal every day and chat with your parent. Once he or she sees he can trust the neighbor, it will be easier for him to open his home to other kinds of help.
6. To make sure that your parent is eating right, suggest having meals delivered by meals-on-wheels programs usually run by senior centers and religious organizations. Your parent might be more amenable to meals provided this way, geared to his diet and liking.
7. Usually the elderly are conscious about spending their money and will accept services that cost very little or that are free. Groceries and pharmacies offer free delivery, health clinics, hospitals, and public health departments offer free health screenings and shots, and dentists offer services for the homebound. Learn what is available to your mother in her community so that she will learn to take advantage of and accept all types of help.
8. Don't be afraid to consult with others who also have aging parents resisting help. The ideas that work for them may be valuable to you too.
Sunday, November 25, 2007
Keeping a Healthy Home This Winter
In the fall and winter most people spend a lot more time indoors as the temperatures drop and the days get shorter. Unfortunately the environment in our homes may not be as healthy as it should and may in some instances be deadly. EPA studies of human exposure to air pollutants indicate that indoor air levels of many pollutants may be 2-5 times, and occasionally, more than 100 times higher than outdoor levels.
Fortunately there are several simple things that can be done that will help to prevent illness and injury from an unsafe home environment.
Carbon Monoxide
Accidental carbon monoxide poisoning kills hundreds of people every year in their homes. Sources of carbon monoxide are unvented kerosene and gas space heaters; leaking chimneys and furnaces; back-drafting from furnaces, gas water heaters, wood stoves, and fireplaces; gas stoves; automobile exhaust from attached garages; environmental tobacco smoke.
To help prevent carbon monoxide from leaking into your home you should have all gas appliances checked by a professional before use in the fall. Also remember to make sure the flue is open when using the fireplace, use exhaust fans that are vented to the outdoors over gas stoves, used only vented space heaters, use the proper fuel in kerosene space heaters and don't idle your car in the garage.
Asbestos
Asbestos is a very fine mineral fiber that is used mostly in insulation materials. Its danger is that these fibers are so fine they can be inhaled into the lungs where they can accumulate. This accumulation of fibers can cause lung cancer or asbestosis (scaring of the lungs). Although used less widely in building materials there is still a considerable amount to be found in older homes and buildings. The EPA suggests that usually it is best to leave asbestos material that is in good condition alone and to the extent possible, prevent them from being damaged, disturbed, or touched. Periodically inspect for damage or deterioration. Discard damaged or worn asbestos gloves, stovetop pads, or ironing board covers. If there is a need to remove or disturb asbestos materials, be sure to have a professionally trained contractor do the work.
Formaldehyde
Formaldehyde is a colorless, pungent-smelling gas, which can cause watery eyes, burning sensations in the eyes and throat, nausea, and difficulty in breathing in some humans exposed at elevated levels. High concentrations may trigger attacks in people with asthma. There is evidence that some people can develop a sensitivity to formaldehyde.
Sources of formaldehyde in the home include building materials, smoking, household products, and the use of un-vented, fuel-burning appliances, like gas stoves or kerosene space heaters. Formaldehyde is also used in a number of manufactured products. For example, it is used to add permanent-press qualities to clothing and draperies. In the home it is most often found in building materials such as pressed fiberboard (it is found in the adhesives). Formaldehyde emissions will generally decrease as products age. When the products are new, high indoor temperatures or humidity can cause increased release of formaldehyde from these products.
To reduce exposure to formaldehyde emissions you should avoid use of pressed wood products or use exterior grade products, which emit less formaldehyde. You should also maintain a moderate indoor temperature, decrease humidity and have adequate ventilation.
Allergic Reactions
Allergies can cause everything from a runny nose and itchy eyes to an asthma attack. Dust, mold and animal dander are among the biggest causes of allergies. Fortunately these problems are can be easily corrected.
1. Use window coverings and flooring that are easily cleaned and dusted. If you have carpet, vacuum frequently. Damp dust washable surfaces frequently.
2. Remove any water damaged carpeting or wallboard. These damp materials are breeding places for mold and mildew. Re-pot house plants frequently as mold may grow in the soil.
3. Have your heating and air-conditioning ducts cleaned yearly to remove mold that may be growing there.
4. Change your furnace filters every 2-3 months, or consider using a high efficiency air filter system in your heating and air conditioning system.
5. Reduce humidity levels in your home by using a dehumidifier or your air conditioner. Empty the water from dehumidifiers frequently to prevent mold growth.
6. Consider buying an artificial tree as live or recently cut evergreen trees provide a source for outdoor pollutants inclduing molds and pollens to enter the home.
Fortunately there are several simple things that can be done that will help to prevent illness and injury from an unsafe home environment.
Carbon Monoxide
Accidental carbon monoxide poisoning kills hundreds of people every year in their homes. Sources of carbon monoxide are unvented kerosene and gas space heaters; leaking chimneys and furnaces; back-drafting from furnaces, gas water heaters, wood stoves, and fireplaces; gas stoves; automobile exhaust from attached garages; environmental tobacco smoke.
To help prevent carbon monoxide from leaking into your home you should have all gas appliances checked by a professional before use in the fall. Also remember to make sure the flue is open when using the fireplace, use exhaust fans that are vented to the outdoors over gas stoves, used only vented space heaters, use the proper fuel in kerosene space heaters and don't idle your car in the garage.
Asbestos
Asbestos is a very fine mineral fiber that is used mostly in insulation materials. Its danger is that these fibers are so fine they can be inhaled into the lungs where they can accumulate. This accumulation of fibers can cause lung cancer or asbestosis (scaring of the lungs). Although used less widely in building materials there is still a considerable amount to be found in older homes and buildings. The EPA suggests that usually it is best to leave asbestos material that is in good condition alone and to the extent possible, prevent them from being damaged, disturbed, or touched. Periodically inspect for damage or deterioration. Discard damaged or worn asbestos gloves, stovetop pads, or ironing board covers. If there is a need to remove or disturb asbestos materials, be sure to have a professionally trained contractor do the work.
Formaldehyde
Formaldehyde is a colorless, pungent-smelling gas, which can cause watery eyes, burning sensations in the eyes and throat, nausea, and difficulty in breathing in some humans exposed at elevated levels. High concentrations may trigger attacks in people with asthma. There is evidence that some people can develop a sensitivity to formaldehyde.
Sources of formaldehyde in the home include building materials, smoking, household products, and the use of un-vented, fuel-burning appliances, like gas stoves or kerosene space heaters. Formaldehyde is also used in a number of manufactured products. For example, it is used to add permanent-press qualities to clothing and draperies. In the home it is most often found in building materials such as pressed fiberboard (it is found in the adhesives). Formaldehyde emissions will generally decrease as products age. When the products are new, high indoor temperatures or humidity can cause increased release of formaldehyde from these products.
To reduce exposure to formaldehyde emissions you should avoid use of pressed wood products or use exterior grade products, which emit less formaldehyde. You should also maintain a moderate indoor temperature, decrease humidity and have adequate ventilation.
Allergic Reactions
Allergies can cause everything from a runny nose and itchy eyes to an asthma attack. Dust, mold and animal dander are among the biggest causes of allergies. Fortunately these problems are can be easily corrected.
1. Use window coverings and flooring that are easily cleaned and dusted. If you have carpet, vacuum frequently. Damp dust washable surfaces frequently.
2. Remove any water damaged carpeting or wallboard. These damp materials are breeding places for mold and mildew. Re-pot house plants frequently as mold may grow in the soil.
3. Have your heating and air-conditioning ducts cleaned yearly to remove mold that may be growing there.
4. Change your furnace filters every 2-3 months, or consider using a high efficiency air filter system in your heating and air conditioning system.
5. Reduce humidity levels in your home by using a dehumidifier or your air conditioner. Empty the water from dehumidifiers frequently to prevent mold growth.
6. Consider buying an artificial tree as live or recently cut evergreen trees provide a source for outdoor pollutants inclduing molds and pollens to enter the home.
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