Memory Care


10 Ways to Reduce Night Fright in Seniors with Dementia

10 Ways to Reduce Night Fright in Seniors with Dementia

dementia care includes reducing night frightAccording to the Alzheimer’s Association, 5 million Americans aged 65 years and older have Alzheimer’s Disease or related dementia. That means one in 11 Americans over 65 have some form of dementia.

The Alzheimer’s Association estimates that family caregivers spent a combined 17.7 billion hours providing informal care for their loved ones in 2013. This figure is expected to jump to exponentially over the next 25 years. Amid these alarming trends, one thing remains constant: the need for quality, individual dementia care.

People with dementia experience a number of psychological and behavioral symptoms such as difficulty concentrating and unwarranted aggressiveness. Dementia symptoms not only disrupt our loved ones’ livelihood, but are also upsetting to us.

As family caregivers, we may feel caught between a rock and a hard place when caring for an aging parent or spouse with dementia. One of the more challenging dementia care ordeals is dealing with night fright.

Night fright in seniors happens when a loved one abruptly awakens in terror, panic, and bewilderment in the middle of the night. Night fright is common among seniors with dementia and Alzheimer’s disease. Night fright may be associated with agitation, restlessness, and confusion they experienced earlier in the evening. These symptoms may be related to another common psychological condition in seniors with dementia called sundown syndrome, which generally occurs around sunset as natural light fades.

Night fright may also cause unintended harm to our loved ones from waking up frightened and falling out of bed to waking up disoriented and wandering out of the house. Providing the right dementia care is essential in safeguarding their welfare.

Here are 10 other tips to reduce night fright and improve dementia care at night:

  1. Encourage your loved one to practice good sleep hygiene to help them sleep better at night. When possible, use the bedroom only for sleep.
  2. Help them take a warm bath before bedtime to help them relax.
  3. Play your loved one’s favorite music, or calming, instrumental music before bedtime to soothe their mind.
  4. Get rid of accident-prone areas like flimsy rugs, unguarded stairwells, protruding furniture in walkways, and slippery floors in case they wander in the middle of the night.
  5. Limit caffeine and alcohol intake to prevent evening jitters.
  6. Plan their meals and beverages several hours before bedtime to prevent repeated trips to the toilet.
  7. Remove ticking clocks from the bedroom to maintain a quiet environment.
  8. Partake in morning and early afternoon outside activities and exercise with your loved one.
  9. Have an panic plan in place if your loved one wakes up frightened. Practice the plan with them including steps to quell their panic: turning on an easy to reach light, getting to an easy to reach phone, and dialing a familiar person. Write down the steps and number and keep on the bedside table
  10. Reassure your loved one that your or someone they know is just a phone call away.

Have additional tips to reduce night fright? Share them in the comments below.


 by Peter Colten

Great Dementia Care Depends on How You Handle It

Villa Animals 2Watching your parent or spouse decline from worsening dementia is heartbreaking. Alzheimer’s disease is one of about fifty varieties of dementia, and depending upon the type of dementia and the area of damage in the brain, you will see a variety of symptoms and changes.

Except for some major physical and behavioral markers, there is no way to predict how your loved one will react to this disease or how fast (or slow) they will decline. Therefore, dementia care is an ongoing process of learning to provide the care needed which will help you cope and prevent burnout.

Declining Memory

Their Behavior: Generally, short-term memories and those with little emotional relevance are the first to go: a phone call earlier in the day, where the tube of toothpaste is, how to work the new stove, remembering to take a bath. Long-term memories that do have an emotional component are retained the longest, but sometimes people will need a prompting reminder.

Your Action: If your loved one becomes upset by their inability to recognize something they know they should remember, try to change the subject. Like small children, people with dementia are easily distracted and it’s best to do that with something you know will make them smile, such as a joke, funny story, or a suggestion to put on some of their favorite music.

Get used to the fact that you will need to constantly remind your loved one of just about everything.  Learning to accept this reality will reduce your irritation with them. Talk to your loved one calmly without barking orders, giving one piece of instruction at a time. Wait for the completion of that task before giving them the next instruction.  Never give choices. They will always do better following your stepwise direction. It’s better to say, “Let’s go get you a shower,” than “Do you want a shower or a bath?”

Delusions and Hallucinations

Their Behavior: A common theme is the accusation that someone is stealing from them. This often happens because they can’t find what they are looking for or can’t remember what belongs to them. Many times they will believe they saw someone or something hiding near them. These situations will cause them to become distraught.

Your Action: Always show them you are taking their concerns seriously. Letting them watch you search for what they think they have lost will calm them down and make it easier for you to distract and redirect them to another topic or activity. Or even better, you will find the missing object and put them at ease.

Constant Pacing or Walking

Their Behavior: Pacing is a common activity among people with forms of dementia. It could be caused by confusion or agitation, by the need to move and do something, or it could be a form of repetition they find soothing.

Your Action: As long as it’s not harmful, don’t try to stop them. Instead, make sure they are in a safe to do this, such as a flat hardwood surface. Encourage them not to pace in rooms with rugs or near a staircase. If you find this activity occurs at night, consider their lifetime sleep habits before trying to make them stay in bed. People who have been night owls their entire lives aren’t going to easily go to bed at 9 just because that’s what you as the caregiver wants.

Agitation

Their Behavior: Many times, physical problems can be the cause of unwanted behaviors. A headache, toothache or even or ingrown toenail are examples of painful situations that will be expressed as agitation. Look for telltale signs such as holding their hand to their head, putting fingers in their mouth, or kicking their shoe off.

Your Action: Your body language and attitude is the most important tool. Keep your attitude positive and loving with a genuine smile. Ask questions and try to understand what’s causing the discomfort. Keep background noise to a minimum, such as the TV or radio, when you are talking. They are so sensitive to loud sounds, it alone can cause unwanted behaviors.

Take your loved one to the bathroom on a schedule of every 2 hours which will prevent incontinence and the agitation associated with their discomfort and unrecognized need to void.

 

It is distressing to watch your parent or spouse change into what seems like a different person, many times losing all connection with them by the end. The best dementia care means not trying to change the person, but rather provide a loving, safe and supportive environment.


 by Peter Colten

Living with Alzheimer’s Disease in Scottsdale

Pets provide good memory care therapy1 in 9 Americans over the age of 65 has Alzheimer’s disease or related dementia.

Within the next generation the number of Americans with some form of dementia could more than triple, from about five million today to 16 million by 2050. Chances are good, then, that you’ll be affected by dementia in your lifetime, perhaps yourself, or very likely someone you know and love.

Scientific advancements, earlier diagnosis, access to better treatment options and a greater understanding of the disease are changing the lives of people with Alzheimer’s disease. Many people continue to lead active and meaningful lives long after diagnosis. However, caregiving is still a critical issue for people living with Alzheimer’s disease or a related dementia.

Scottsdale Memory Care Options

If you are a caregiver to someone with Alzheimer’s or related dementia, your commitment to your loved one is absolute and unconditional. No matter how strong your commitment, though, the stress, both physical and emotional, can take its toll on you. You have to take care of yourself as well as your loved one, or you will be unable to help them.

Fortunately, there are many resources available to help you, whether you need respite care for a few hours, a day or on a regular basis. Or perhaps you are facing the prospect of placing your loved one in an assisted living home because you can no longer provide the care they need. Whatever support you might need, you are not alone.

The Alzheimer’s Assosciation is a leading health organization for people living with Alzheimer’s disease and other types of dementia. Learn about the Arizona Chapter here.

The Banner Alzheimer’s Institute is paving the way for the future of Alzheimer’s care, partnering with medical, scientific, and academic institutions to provide the best research and care available.

A Full Range of Emotions

For some people, the diagnosis of Alzheimer’s disease is a shock. For others, there may be an initial sense of relief at finally being able to put a name to their symptoms.

You may be overwhelmed by the many changes that are taking place in your life — receiving a diagnosis, telling others, experiencing changes in your abilities and in your relationships and more.

The Alzheimer’s Society of Canada asked people about their reactions and feelings about living with Alzheimer’s disease. Here are some of their comments:

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Experiencing this range of emotions is a normal reaction to having a disease whose symptoms affect the way you see yourself. As one person with Alzheimer’s disease said, “Your inner world is changing.” Each person responds to these changes in his or her own way.

Talking to to someone about how you feel is one way to get these feelings out into the open. Talk to a close friend, a family member or someone with whom you feel comfortable.

It can be especially helpful to meet with other people who have the disease. Together, you can share your feelings and experiences and offer each other social and emotional support. Contact the Desert Southwest Chapter of the Alzheimer’s Association for information on local groups and other support that is available in the Phoenix area.


 by Peter Colten

Bilingualism Delays Alzheimer’s and Dementia

brainThe brains of people who learn two languages in early childhood are different from those who grew up speaking only one language. Bilingual adults have denser grey matter, that is, more nerve cells and fibers that process information; and the parts of the brain that are responsible for memory, reasoning, and planning – also known as “executive function” – are larger than in people who know only one language.

A Canadian scientist found that the difference is most pronounced in those who learned a second language before the age of 5, but adults who are extremely proficient in two or more languages have many of the same brain characteristics. Bilingual children and adults are better able to concentrate and tune out distractions, and they can switch between two tasks more readily than monolinguals.

Bilinguals maintain high executive functioning longer in life than monolinguals. This “cognitive reserve,” as scientists call it, may protect the brain from some of the physical damage that Alzheimer’s and related dementias cause. Some neuroscientists think that speaking two languages may increase blood flow to the brain and give it an oxygen boost, which keeps nerve connections healthy and is thought to help fend off the effects of dementia.

A recent study shows that being bilingual delays the onset of dementia and Alzheimer’s symptoms by an average of 4.5 years. They studied nearly 650 patients at a university memory clinic in Hyderabad, India, more than half of whom were bilingual. One of the most interesting findings is that illiterate bilinguals enjoy the same brain protection as those who can read and write. The Indian study found that bilingualism delays symptoms independent of other factors that can affect the onset of symptoms such as education, sex, or living in an urban or rural setting.

The protective effect is greatest for people who use a second language every day and are constantly having to choose between two sets of words, but any way of learning a foreign language is helpful, as long as you continue to practice it.

The current state of bilingualism

  • 20% (estimated) of the United States population are bilingual (it was 11% in 1980)
  • 26% of Arizonans speak another language at home
  • 36% in the Phoenix metro area speak another language at home (actual percentage of bilinguals is probably considerably higher; the US Census does not ask about bilingualism specifically, so we don’t have reliable data)
  • Up to 60% in Los Angeles grew up speaking two languages
  • About 50% of bilinguals in the US speak English and Spanish. The other half speak everything from Native American languages to European languages, to Arabic, to Chinese, and everything in between.

It’s well known that doing brain exercises, such a crossword puzzles, makes your brain stronger. Now we have another way to strengthen it. If you don’t already speak another language, you don’t have to be left out of the benefits. Many colleges and universities offer life-long learning programs geared toward the adult brain. In addition to the medical benefits, learning a new language can be fun. You get to learn about another culture and meet people with similar interests. You probably don’t want to do crossword puzzles all day long every day, but no matter how old you are you can learn a new language and talk till the cows come home


 by Peter Colten

10 Tips to Have Happy Holidays with Alzheimer’s Disease

It's okay to vary from tradition to make your loved one with Alzheimer's disease more comfortableAs a family member of a loved one with Alzheimer’s disease or dementia, the holidays can be challenging. It can be painful for relatives to who don’t often see their parent or grandparent to understand how their illness has progressed and to cope with her lack of memory of events and people. However, some planning and preparation can make your holiday family time enjoyable and memorable.

1. Inform Your Guests Ahead of Time

In the early stages, family and friends may not notice much of a difference in Grandma’s behavior or memory. If her disease is in a later stage, however, it’s important to let out-of-towners know what to expect. A phone call or email explaining the changes and a reminder that it’s due to the disease, not the person, can help tremendously in accepting these changes.

2. Set Expectations

Not only do guests need to know about the current situation that Grandma is in, but they need to understand your caregiving situation and have realistic expectations about what you can and can’t do. Be forward and honest about limitations, needs, daily routines, etc.

3. Take Care of Yourself

Give yourself realistic expectations as well. Just because you have always invited the entire extended family plus the neighborhood, that doesn’t mean you have to this year. Consider having a smaller gathering, simplify the meal plan, or invite others to contribute. This takes some of the pressure off of you and the anxiety and stress off of your loved one.

4. Vary from Tradition (Just a Little)

For many people with Alzheimer’s disease or dementia, evening can cause confusion and agitation. If this is the case, try to plan the celebration earlier in the day. If the main meal will be at night, keep the room well lit and try to avoid known triggers.

5. Prepare Your Loved One

If your loved one won’t remember the guests when they arrive, help them prepare at least a week in advance. Show them pictures of the guests, describe their relationship and talk about them. Spend some time each day familiarizing your loved one with guests family so they aren’t as confused when they arrive.

6. Build on the Past

Focus on activities that are meaningful for your loved one with Alzheimer’s or dementia. Looking through old photo albums, sharing stories about growing up, or playing/singing old music favorites can bring back younger, healthier days and memories that had been suppressed.

7. Involve Your Loved One in Preparation

As the person is able, involve them in cooking, decorating, setting the table, or other holiday preparations. Even setting them up to watch you will help familiarize them with the upcoming festivities. Being able to help will give them the pleasure of participating and the exciting anticipation of what’s coming.

8. Set up a Specified Quiet Place/Activity

One of the biggest concerns about the noise and distractions of the holidays is over-stimulating your loved one. Make a safe, quiet place (such as a bedroom or closed living room or office) they go to when it becomes to much, or plan quiet activities they can do, such as looking through a family photo album, putting on some headphones with soothing music or cracking nuts. This can be helpful right after a meal when your loved one has indulged in rich or special food or drink, especially alcohol.

Depending on your situation, It may even be better to keep Grandma in a room away from the main gathering place and have only a few guests in the room with her at any given time. Then she will likely be less stressed and confused come mealtime.

9. Maintain Routine

Sticking to your loved one’s usual routine helps reduce stress and confusion for them. It may not be possible to stay with the routine exactly, but the closer you can get the better. Also plan plenty of time for breaks and rest.

10. Plan Time for Yourself Afterwards

As enjoyable as it is to see friends and relatives, it can leave you feeling exhausting and burnt out. Consider asking a close friend or family member to care for your loved one for a day or two to give you a break and decompress. You can also hire someone to come in for a few hours to help you out and give you some free time. You deserve it!

Caring for a loved one with Alzheimer’s disease or dementia during the holidays requires extra planning and longer preparation but your loved one and out-of-town family will greatly appreciate it. Just don’t forget that you don’t have to do it all by yourself and to take care of your energy and health. Have a Happy Holidays!!!!


 by Peter Colten