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Written by Nancy McCaffrey
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Tuesday, 29 December 2009 18:04 |
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Alzheimer's disease is a prevalent diagnosis in my family. My grandmother, on my mother's side, lived with alzheimer's disease. Both of her sisters did as well. My mother is fearful of also "catching it". So paranoid is my mother, she voluntarily spoke with her doctor and asked to undergo a battery of cognitive testing to prove her belief that she is in early stages of some type of dementia. Her doctor happily complied.
My mother has been a widow for almost 5 years. She lives alone, remains active with the church, volunteers, sews, quilts and drives 300 miles each way to visit her grandchildren. Sure she repeats stories. So do I. She got turned around while driving once. As have I. It is my opinion that she is far from having Alzheimer's disease. To my mother though, her fears are real, valid and need to be addressed.
An article in the Jan/Feb 2010 issue of Discover Magazine served as a great reminder for me. Just because I interact daily with those dealing with definite symptoms of this degenerative disease, I should show more concern for those who want to receive assurance or validation from early detection measures.
The article, entitled Vital Signs, http://discovermagazine.com/columns/vital-signs is written by Dr. H. Lee Kagan and describes a couple in their 70's who approach him individually, as their doctor of many years, to share their fear that the other may have memory loss. The husband identified the wife with repetitive behavior and lack of retaining any new information. The wife identified her husband with shortness in temper and increased anger. This new impatient behavior may be a result of dealing with the stress of living with someone possibly suffering with Alzheimer's disease. Both are aware there is a change in each other and both are fearful of the reason for the new behavior.
The article reinforces our knowledge that depression may often mimic symptoms of Alzheimer's or dementia. There is a quick screening tool called the Mini Mental Screening Exam (MMSE) which can easily rule out memory loss for those who may have other issues affecting memory.
Fortunately for this couple, Dr. Kagaan listened to their concerns, did not dismiss them, (as I had with my mother) and did the quick 5 minute screening exam. He identified that one person, in fact, appeared to be in early stages of memory loss. With further assessment, they may be placed on medication to treat symptoms and improve the chance of a longer quality of life. This may not have happened had they not come to him for the early detection screening.
I now commend my mother. As stated in the Discover article, it is rare that the patient themselves comes forward to ask to be diagnosed. Most often the person is in denial and looks for ways to hide their deficit. The family must remain aware and notice slight changes as indicators of something bigger. This year the Sycamore Village Memory Enrichment Center will commit itself even further to champion early detection. It is our mission to assist in identifying those who may truly be in beginning stages of dementia in order to encourage measures for a longer quality of life. Likewise, it is our mission to put at ease those who are fearful of memory loss when their issue may be something more treatable such as depression, medication mismanagement or poor nutrition. The MMSE screening may be scheduled with one of our health care professionals on any day just by contacting us to set up an appointment.
As for my mom, she was given a lengthy report of her cognitive testing results. Her doctor acknowledged her anxiety but found no indication of memory loss. His recommendation? Purchase a GPS and continue to remain active. A prescription I was happy to fill.
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Written by Nancy McCaffrey
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Tuesday, 08 December 2009 02:02 |
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When shopping for a new home, there is little difference in basic elements of a house built in 1969 versus one built in 2009. At a minimum, each structure will have a kitchen, bathroom and bedroom. Once purchased, the furnishings in either would typical include a couch, tables, chairs, bed and television. Because one house may have a more modern design over another does not necessarily make it more of a home. The warmth of a home is created not by it's furnishings and fixtures, but by the love of those residing within the walls. A comfortable home maximizes someone's lifestyle to create meaningful moments and a stable environment.
The same principle should also apply for a caregiver researching a new living arrangement for a loved with with memory loss. As caregivers, we only want the best for our family. Unfortunatley, what's best isnt always obvious. Although a newly opened Alzheimer's community has state of the art amenities, it begs the question, is it enough to take it from a modern house to a meaningful home? To a person with Alzheimer's or dementia, the furniture and fixtures are irrelevent. The focus is not to impress but rather to feel safe and to have purpose. Having meaningful moments help to decrease agitation and anxiety. Often, We find this evident when a person with memory loss is searching for their mother. Typically this behavior is an indication of the need for safety and comfort.
When it is time to make the difficult decision of choosing alternative living arrangements for a loved one with memory loss, what should you look for? Instead of investing in the real estate of an Alzheimer's and dementia community (ie. room size),focus more on the lifestyle. How does staff achieve meaningful moments for their residents? Does programming include the social, spiritual, physical, and mental needs of an individual? How do the staff interact with the residents? How did they interact with you? What training and experience do the staff have specific to Alzheimer's and dementia related illness.
Although a pretty new building may ease the caregiver's guilt, pretty and new make little difference in the life of the person with memory loss. A focus on lifestyle is the basis of a quality memory enrichment program and is the difference between providing a home to thrive versus simply a house to reside.
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Written by Nancy McCaffrey
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Friday, 20 November 2009 22:59 |
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Everyone has a life story. Sharing your life story with others is the first step in creating sustainable relationships and possible long term friendships. Having others around who understand what makes you tick, show interest, and connect to your life experiences can only add to a higher degree of life satisfaction.
In long term care, resident life stories use to be discovered by accident. An incidental conversation with a family member may shed some light into knowing the person’s background, preferences and work experiences. Having that insight shared among caregivers between shifts would be even less likely. The happenstance of gaining life story information was usually superficial at best. The person who is now a room or bed number in our health care system was more often defined by their diagnosis and their plan of care then by their life experiences. Understanding a person’s life story is one element to changing the culture of long term care. This philosophy is called person centered care.
November is both National Caregiver’s month and Alzheimer’s Awareness month. The life story of a person living with memory loss becomes even more significant as their ability to share it themselves and establish their own relationship wanes. As a tribute to those residents, both family care givers and our paid care givers were asked to create a digital life story using meaningful photos, music, art and other creative expressions. What originally began as an idea to honor those living with memory loss turned out to have a much more significant meaning for those telling the story. My epiphany was that a caregiver’s life story needs to be discovered, told and understood to truly acknowledge the person whose life is being paid tribute.
Yes, in person centered care a life story is traditionally about the resident. I now understand that to center care on a person is to include their loved ones. Exuding from these videos are the love, pride, pain and sadness that define a caregiver. It is a realization of how Alzheimer’s and dementia has impacted their own life story. We’ve always known that people who take care of others are special and incredibly selfless. But how often do we ever take the time to find out why? The video tributes give us a glimpse into the eyes of those who can no longer tell their story and into the heart of those who love them. You may view these tributes at our video tribute site, to judge for yourself. Maybe it will inspire you to post a life story for someone you love.
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Written by Nancy McCaffrey
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Tuesday, 17 November 2009 15:12 |
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Most Americans spend a great deal of time dwelling on appearances. Who hasn't made a goal in their lifetime of registering less on the bathroom scale? How often do you visualize yourself with a six-pack mid-drift before swim suit season? Is there really an outfit that can make you look one dress size smaller? Why is there such an obsession with outward appearances? We know a big factor is due to the commercialism of beauty on TV and in magazines. The role models in those medias are usually the extreme example and sometimes not always a positive influence. If those influences didn't exist, wouldn't we still want to feel good? After all, having a goal to be in shape is not just about what happens to our bodies on the outside, but makes the most difference on what is happening inside. A healthy person's internal organs work more optimally than someone who is less inclined to move off the couch. Breathing, standing, walking, running is easier. A person who eats the right types of “good for you” foods is more likely to have more energy, be in a better mood and have the ability to manage stress. All the internal changes are what pays off in the long run to sustain a higher quality of existence. Being healthy and active is summed up in one common phrase, “Move it or lose it”.
Until recently, one significantly overlooked body part in terms of health and fitness has been the brain. The reason is probably because TV executives and advertising agencies can't find a way to make it sexy. When was the last time you saw a reality show for getting your brain fit? At least one where the people were not just smart but also had social skills. If you consider Are You Smarter Than A 5th Grader your brain fitness work-out, your brain could benefit from a more balanced routine. Think about what the obsession over physical appearances would mean if you didn't have your brain! In this advanced technological world we live, organs are transplanted everyday. Hearts are even being transplanted. I have yet to hear about a successful brain transplant. It is time to give the most vital organ on the planet its due attention. November 17th is National Memory Screening Day. It is time to advertise that memory loss is NOT a normal part of aging. TV Executives and magazine publishers take note, whats good for the heart is good for the head. The brain is sexy and you along with the rest of us should work to erase the stigma of focusing on early detection. If there is a problem with memory, there may be reversible causes such a medication mismanagement. There are also ways to act early enough in slowing down an irreversable problem and providing a longer more meaningful life. None of this can be done without education and early detection. Look for health care providers offering free screenings and start on a more complete fitness tract. For more information on maintaining a healthy brain and what do to if you suspect a problem, visit www.alzprevention.org. In a time when healthcare reform is the hot topic, I emphasis the better mantra, “Use It or Lose It.”
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