Caregiver Tips for Those with Dementias – Alzheimer's
November 12, 2009 by Carol Duff · 12 Comments
COMMUNICATING WITH THE PERSON WITH DEMENTIA/ALZHEIMER’S
By Carol Ware Duff MSN ,BA, RN
Dementia affects all areas of the brain including areas of memory and sensory inputs which are vital for communication.
The ability to store what was said in “short term memory” may be lacking in a person with dementia, making sharing everything from simple needs to more complex ideas very difficult. If the information cannot be temporarily stored, the ability to respond is lost.
Sometimes the person will store only part of what is said and will act on only that one part. The response may be correct for the message that is received, but there are many areas where the message can become garbled or misunderstood. Very often, a response, even if the question is understood, can be very different from what was meant.
Two areas of communication difficulty for your loved one may be:
- Expressing him/her self to others.
- Understanding what is being said to him or her.
What are problems the person with dementia has expressing him or herself?
- The failure to communicate can range from the occasional failure to find a word, changing words, or choosing words that are wrong, to an inability to express what he or she intends to say.
- Some people may be only able to communicate a few words of the thought.
- Others may ramble on, stringing words or phrases together.
- Your loved one may try to cover up communication difficulties by answering a question with a question, and when pressured, become defensive and say he or she is being bothered.
- Some people may start to use swear words or inappropriate language even if he or she has never used them before. Rarely is this behavior deliberate.
- With severe language problems, the person may only use a few words such as, “No,” when a response seems too difficult.
- Eventually the person with dementia may become totally unable to communicate using speech. This is particularly upsetting to family members who feel no longer able to talk with their loved one.
What are ways to help your loved one with expressing him or herself?
- If the person is having difficulty finding a word, try supplying the word, if this does not upset him or her.
- Ask the person to point to what he or she wants or is talking about.
- You might guess incorrectly, so be open, and ask if you are correct.
- Since relaxation encourages better communication, maintain a calm approach.
- Do not rush a person when he or she is trying to communicate. Continue to show both interest and attention.
- A picture board may be helpful. You may need to cut out magazine pictures of common activities and paste them on a board.
- Your loved one can then point to what he or she means or wants.
When a person cannot communicate, make sure he or she is comfortable by checking:
- Is his or her clothing fitting properly?
- Is the room temperature comfortable?
- Is he or she hungry?Has he or she been taken to the toilet recently?
- Is his or her skin free of sores, rashes, or irritations?
What are problems the person with dementia has with understanding others?
- Often people with dementia have difficulty understanding what others say to them and may not respond. This may be mistaken as difficult behavior.
- A person with dementia can quickly forget what he or she once understood. Never assume anything is known or understood from moment to moment.
- He or she may be able to read but not understand what he or she has read.
- Your loved one may not be able to understand or remember written directions.
- Your loved one may not understand what is spoken over the phone as opposed to face to face communication, nor recognize a voice without a face.
What can you do to improve your loved one’s understanding?
Verbal communication:
- Verbal communication is using speech to share ideas and feelings.
- Make sure the your loved one can hear and see. Sight and hearing may decrease with age.
- Get the attention of your loved one, make eye contact, and be at eye level.
- Use the person’s name and a calm, matter of fact approach every time you address him or her.
- Get rid of distracting noises and activities while trying to communicate.
- Use a lowered tone of voice if the person is hearing impaired and speak in a steady fashion.
- Begin conversations with orienting information such as, “It is now time to eat breakfast.”
- Ask only one simple question at a time and address only one task at a time:
- Break any tasks into several smaller steps.
- Use short words and simple sentences with exact words.
- Do not say, “Do you want to take a bath?” Instead say, “It is time for your bath.”
- Be ready to repeat yourself.
Non-verbal communication:
- A person can communicate with body movements, as well as his or her face, eyes, and hands.
- Your loved one can remain sensitive to nonverbal signs when he or she can no longer understand the spoken language.
- Think about how you present yourself.
- Be aware of non-verbal signals such as facial expression, body tension, and mood.
- Look to see if your loved one is paying attention.
- Look directly at him or her and look for body language to read.
- Use a neutral approach with humor and cheerfulness.
- Use gentle touch to communicate your message.
- Be pleasant, calm, and supportive, even if you are upset.
- Point, touch, hand your loved one items, demonstrate actions, and describe with your hands.
- Draw or show pictures or use the picture board.
The following are some websites to provide you with more information about communication.
AlzOnline: Ways to help communication. http://alzonline.phhp.ufl.edu/en/reading/communication.php
AlzOnline: Interaction –Tip sheet. http://alzonline.phhp.ufl.edu/en/reading/memorytips.php
Family CareGiver Alliance: Caregiver’s guide to understanding dementia behaviors. http://www.alsindependence.com/caregivers_guide_to_understanding.htm
References AlzOnline: Ways to help communication. Retrieved September 20, 2008, from http://alzonline.phhp.ufl.edu/en/reading/communication.php
Boyd, M. (2002). Psychiatric nursing: Contemporary practice (2nd edition). Philadelphia, PA: Lippincott.
Ignatavicius, D., & Workman, M. (2006). Medical-surgical nursing:Critical thinking for collaborative care (5th edition). St. Louis, MO: Elsevier Saunders.
Lewis, S., Heitkemper, M., & Dirksen, S. (2004). Medical-surgical nursing: Assessment and management of clinical problems (6th edition). St. Louis, MO: Mosby.
Mace, N., & Rabins, P. (2006). The 36-hour day: A family guide to caring for people with Alzheimer disease, other dementias, and memory loss in later life (4th edition). Baltimore, MD: The Johns Hopkins University Press.
Potkins, D., Myint, P., Bannister, C., Tadros, G., Chithramohan, R. Swann, A. et al. (2003) Language impairement in dementia: Impact on symptoms and care needs in residential homes. International Journal of Geriatric Psychiatry, 18(11), 1002-1006.
Robinson, A., Spencer, B., & White, L. (2007). Understanding difficult behaviors: Some practical suggestions for coping with Alzheimer’s disease and related illnesses. Ypsilanti, MI: Eastern Michigan University.
Romano, Donna M. (2004). Making the paradigm shift: Enhancing communication for clients with Alzheimer’s disease using a client-centered approach. Journal of the American Psychiatric Nurses Association 10(2). 81-85.
Developed in 2008 by Carol Ware Duff, RN at the University of Toledo for the Caregiver Consultation Center.
Carol Duff graduated from Nursing School at Riverside White Cross in Columbus, Ohio.
She has a BA from Bowling Green University in History and Literature and a Masters of Science in Nursing as a Nurse Educator from the University of Toledo School of Nursing.
She has traveled extensively and has written on military history, veterans health issues and related subjects. She is the mother of several children and 11 cats and 1 guinea pig.
She can be reached via email at: Thehertz@aol.com
Overmedication and misdiagnosis of drug interactions in the elderly might actually be a bigger epidemic than Alzheimer’s. In 2003, the Archives of Internal Medicine published “The Beers list of Potentially Inappropriate Medications in the Elderly.” This is an exhaustive list with dozens of drugs listed. You can find the list on the website for the Duke Clinical Research Institute here
http://www.dcri.duke.edu/ccge/curtis/beers.html
I know this certainly was the case with my own mother who was transported to a hospital after injuring her back while loading groceries in her car. After a ten day round of unnecessary treatment for “a ticking time bomb” of a heart ($40,000), she was wheeled out and transferred to a nursing home in a heavily drugged state, where she was soon diagnosed with “sudden onset Alszheimer’s”. They never did do anything for her back, which eventually popped back into place on its own, but by that time she could not remember anything for more than a minute.
I brought her home with me, took her to a doctor who could be trusted who withdrew her from all the drugs, had her to the chiropractor a few times, and she soon regained her health and her cognitive function and memory. She has not taken a single prescription drug since Fall 2006, and lives a full an enjoyable life at 91 years old. After that experience, I was pretty well sure that most Alzheimer’s “treatment” is a scam, but now after reading courageous Navy veteran, Grace E. Jackson MD’s new book “Drug-induced Dementia, a perfect crime”, I am convinced.
Subvet416,
You are absolutely correct about over medication and unnecessary medication of the elderly. The older body cannot utilitize or expell drugs as quickly as when yonger. Some medicatons cause confusion and this is quite unhelpful. My stepfather was hospitalized for surgery and I found that he was being given haloperidol for "aggitation." This was a very calm individual who was being given a chemical restraint. Most facilities have drawn back from the use of physical restraints. I insisted that the drug be stopped and guess what, he was no longer aggitated and was himself again.
Often times the elderly have more than one healthcare provider and medications that one doctor or clinician prescribe can be duplicated by another who does not take or receive an accurate medication history. Some drugs are just plain harmful for the elderly and create a situation where they may appear to be confused, forgetful, but are simply overdosed.
Actually my mother-in-law was also placed on harmful medications and shipped off to a nursing home which the doctor deemed the only place she could survive. We literally broke her out of the nursing home, leaving the medications behind, and within two weeks of eating properly, sleeping, and getting the drugs out of her system, she then went home to her house, dog, cats, and yardwork and functioned as she has prehospitalization.
There are real dementias caused by physical changes in the brain. Dementia can be a real diagnosis due to pathology, but we must always be alert to medication disuse.
Carol
Good going on saving your elderly relatives Carol! You were fortunate to find out about the Haldol and that it was stopped at your request. Because of my prior experience with psychiatric drugs at the VA, I had helped my mother’s attorney draft her health care power of attorney, giving me the authority over her medication, no matter what she might agree to herself with the doctors. She wanted it this way because she had seen the heavily drugged elderly in nursing homes and knew they would agree to anything the doctors or nurses suggested. When she did end up in the hospital and the nursing home, doctors and nurse practitioners prescribed whatever they wanted even though I specifically ordered that she be given no psychiatric drugs or tranquilizers. They also assured me that my mother was not receiving such drugs when I became suspicious.
It was not until I took her out of the nursing home and had her treatment records in hand that I discovered she was on Lexapro and Ativan, and that the dosages had been doubled just before I removed her. She had a very difficult withdrawal from both of those drugs, even though I tapered her off them very slowly.
I reported this to the state authorities because in this state canceling a patient’s heath care instructions is a felony. The hospital and nursing home doctors and nurse practitioners lied to the investigators and swore that they “spent hours” discussing my mother’s medication with me. No action was taken. Anyone who knows me, knows that I could never be convinced to take psychiatric drugs again myself or allow them to be prescribed for my mother.
I must add that all of this took place at a very expensive condominium retirement community where my mother had bought a unit a few years before. This community has its own clinic and nursing home where residents can go if they can no longer live independently. Turns out, the money behind the project is the big HMO which operated the hospital my mother was taken to when she woke in the night with back pain and called “911″. All 911 calls from resident phones go through the community switchboard, not directly out to the city police, fire and rescue dispatcher. This whole project, billed as luxury retirement, is just a chicken coop where the rich chickens are fattened up for processing at the HMO. It doesn’t matter how much money you have, and frequently having more money makes it more likely, you can be an easy victim and possible fatality of health care fraud if you are not an aware and informed consumer.
Sibvet416
A discussion with you about your mother’s medications should have been noted on her chart, in her medical records. Whenever education or discussions have ensured they must be charted. If not charted, it never happened because there is no proof. In that case, it should have gone to your favor. If they charted such a discussion which never happened, that is malpractice all the way around.
Carol
Thank you Carol. Well written, important subject and useful.
Tom D. Houston
http://www.theflucase.com/index.php?option=com_content&view=article&id=1814%3Acroatian-priest-says-vaccine-for-destruction-of-humanity-worldwide&catid=1%3Alatest-news&Itemid=64&lang=en
Croatian priest says the flu vaccine is for the destruction of man world wide.
Channel five news another champion athlete crippled by the flu vaccine.
http://www.theflucase.com/index.php?option=com_content&view=article&id=1803%3Afallen-behind-schedule-with-swine-flu-jabs-austrian-government-spreads-idea-no-qpandemicq-until-january&catid=1%3Alatest-news&Itemid=64&lang=en
“Far behind schedule with their swine flu vaccination campaign in Austria and Switzerland, the governments and media (see example below) have started preparing people for the idea that there will not be a pandemic until January and not in November/December as first predicted.
Many experts say that the vaccinations will cause the pandemic as happened during the Spanish flu pandemic of 1918. However, so few people have taken the swine flu jab in Austria and Switzerland so far that it will be hard to generate a pandemic by these means unless numbers can be increased.
One thing is for sure: with the economy about to collapse due to the criminal dealings of the banksters and their allies in government who have sucked billions of euros from tax payers under various pretexts, there is not a lot of time left to implement the “swine flu” vaccination campaign before people wake up to the full dimensions of the scam being perpretated on them.”
Have to put off that pandemic until you have enough vac to cause it. Some people just won’t cooperate in their financial and genetic destruction.
http://www.theflucase.com/index.php?option=com_content&view=article&id=1825%3Ais-who-panicking-signs-of-growing-instability-and-uncertainty&catid=1%3Alatest-news&Itemid=64&lang=en
Is WHO panicking? Signs of growing instability and uncertainty
Monday, 16 November 2009 15:34
News – Latest News
Next >
For the global-based international corporate crime syndicate that has just engineered an economic collapse in such a way as to enrich themselves, planning and executing a major operation involving the delibrate release of biological agents and pandemic material in order to justify the implementation of military rule as well forced vacciantions with a soft kill vaccine and quarantines is a formidable task.
But risking social upheaval and riots as people discover why they have no jobs, no pension and yet have to pay huge interest on debts to the banksters etc is even more dangerous for them.
No amount of high security around a hotel in which the corporate crime syndicate meets in networks such as the Freemason-based Bilderbergs will be enough protection when millions of people wake up to the scale of the robbery that has just been committed on them under the pretext of dealing with „credit crunch“.
The „subprime“ crisis, credit crunch and the gigantic mountainss of debt we have been burdened with and for which we will have to pay interest to the banks for years are as artificial as the „swine flu“ pandemic.
The corporate media has lied to people about the financial crisis just as they have lied about the 2swine flu” pandemic.
The international corporate crime syndicate knows that time is running out. Every day more companies are go ingbankrupt as a result of the banksters withdrawing credit; more people are loosing heir jobs in Europe. Tax revenues are plummetting.
Soon the bankster’s allies in governments will have an excuse to declare the state bankrupt (most of the money has gone to the banks in bailouts and interest payment).
However, at that point the banksters have to be sure to to be able to leverage a control apparatus sufficient to crush the protests that will spring up on the day when millions of people find themselves in dire poverty as in the Great Depression of the 30s.
Even in Austria, students have launched protests against the crippling lack of funding for the universities.
When I spoke to a bar keeper about those protests a couple of days ago, he said that it would not be long before the whole of Austria is on the streets.
„There is no more middle class,“ he said. „It’s just the very rich or the very poor.“ A year ago, you would never have heard that from a middle aged man in Austria.
Austria is on the verge of revolution. The dynamic is there.
But it is not just the Austrians who are fed up. The student protests have spread to Germany. In France, there were so many riots last summer that the government banned the TV from showing them.
Right now the crime syndicate are behind with their plan to impose forced vaccinations and quarantines on people under the pretext of a pandemic and so they cannot get control of the growing social unrest.
News about how the same group that profits from the pandemic financially and poltically – namely the banksters, Baxter, Novartis and their front agency WHO – has been implicated in triggering pandemics has spread quickly on the internet.
News about the toxic and untested soft kill swine flu jab has spread quickly, too. In spite of swine flu hysteria pumped up by newspaper such as Bild in Germany, people are not taking the swine flu jab in the numbers the international corporate crime syndicate hoped for.
The pandemic plague or something similar in the Ukraine has to be introduced here quickly to get panic spreading and provide the government with an opening to crack down on protestors, arrest opponents and implement quarantines.
Planes have been spotted in Poland and Austria.
A pandemic outbreak in France.
The people of Europe appear to be under a new phase of sustained biological attack.
In this day and age of instant communication, we, however, know about planes spraying areas at night time and we will also know about the emergence of a plague almost as fast as it happens.
We can follow the moves of the global crime syndicate in real time.
And the resistance is growing.
Every day that passes they are losing a grip on the decisive force that is required to impose their plan on us the people – and they are panicking.
Key to their success are the willingness of the army and police to go along with the plan to implement vaccinations and quarantines or to be removed from the chessgame by forced vaccinations and replaced by UN troops.
But now even the French Gendamerie has refused a compulsory jab.
In this situation, the global crime gang knows only one approach to saving themselves: to keep on pushing through with their plan no matter how many threats and instabilities are pulling it apart so that the sequence and simultaneity are in disarray and success looks highly unlikely.
Their controlled media has to keep out pumping out the same old lies about a swine flu pandemic and how great the vaccine is no matter how implausible they are.
But we, the people, will not be lied too.
We do not want the bankster’s fascist New World Order. We don’t want to be microchipped, controlled, tracked, kept under surveillance and enslaved by criminals who dare not even show their face to us in public.
And we, the people, — together with the truth — will win out.
Time is short. The crisis is coming. But we, the people, will not back down in any confrontation with the fascist oligarchs and their helpers.
part II
A pandemic outbreak in France.
The people of Europe appear to be under a new phase of sustained biological attack.
In this day and age of instant communication, we, however, know about planes spraying areas at night time and we will also know about the emergence of a plague almost as fast as it happens.
We can follow the moves of the global crime syndicate in real time.
And the resistance is growing.
Every day that passes they are losing a grip on the decisive force that is required to impose their plan on us the people – and they are panicking.
Key to their success are the willingness of the army and police to go along with the plan to implement vaccinations and quarantines or to be removed from the chessgame by forced vaccinations and replaced by UN troops.
But now even the French Gendamerie has refused a compulsory jab.
In this situation, the global crime gang knows only one approach to saving themselves: to keep on pushing through with their plan no matter how many threats and instabilities are pulling it apart so that the sequence and simultaneity are in disarray and success looks highly unlikely.
Their controlled media has to keep out pumping out the same old lies about a swine flu pandemic and how great the vaccine is no matter how implausible they are.
But we, the people, will not be lied too.
We do not want the bankster’s fascist New World Order. We don’t want to be microchipped, controlled, tracked, kept under surveillance and enslaved by criminals who dare not even show their face to us in public.
And we, the people, — together with the truth — will win out.
Time is short. The crisis is coming. But we, the people, will not back down in any confrontation with the fascist oligarchs and their helpers.
Austrian chemtrail spraying. Note large tanks on the airplane wings.
http://www.youtube.com/watch?v=N661mbZ5XrY
http://www.theflucase.com/index.php?option=com_content&view=article&id=1826%3Aare-poland-and-austria-at-the-forefront-of-an-undeclared-biological-war&catid=41%3Ahighlighted-news&Itemid=105&lang=en
Next >
Eyewitness reports from Poland and Austria indicate that both countries are being subjected to new kinds of aerosoal spraying by aircraft.
This seems to be an attempt to trigger a pandemic in the same way as occured in the Ukraine recently when pneumonia plague emerged after reports of night time aerosol spraying by low flying planes.
Three aircraft flying in formation were seen at night time in Klagenfurt one month ago apparently on a spraying operation.
New types of spraying were seen in eastern and southern Austria today.
This is one report from Lower Austria:
“I followed your homepage today and saw that you put up that link where you reported that in Villach new types of Chemtrails have been laid by Chemtrail Aircrafts to set the real flu pandemic in motion here as well.
I am covering Chemtrails for at least 6 months, also putting them online via youtube under my youtube name “Silberhorter”.
On Sunday when I went out in our garden in Lower Austria (near Wr.Neustadt) I recognized massive spraying activity on almost unprecedented scale. I will upload this action tomorrow night. The spraying was done by new kind of airplanes with strange colors on them (yellow, red. I also detected one plane to put the trigger on and off twice. you can see this action on the video taken on Sunday 15.11.09:
http://www.youtube.com/watch?v=N661mbZ5XrY
Do you have more info about this new kind of Chemtrail acts? Was it from Sunday? Because today it was already completely cloudy (must be the result of yesterdays spraying acts, because the sky was completely covered with intense mist only 1 hour after they attacked).
If you have more info please let me know to compare it with what I saw on Sunday. What I took notice of was that the trails lingered quite fast and that all sort of different tactics and planes were carried out…
If you check on my channel on Wednesday morning you should see a summary of this Chemtrail activity of Sunday, 15.11.09 near Wr.Neustadt.”
theflucase.com
Blogs in the Ukraine shut down as martial law under WHO implemented
Blogs reporting on the pandemic and swine flu vaccination programme in the Ukraine have shut down, including the blog
http://ukrainiantranslator.blogspot.com/
The person writing this blog said they had discontinued it because it was “not their thing” in an email.
Other reports suggest the Ukrainian government is threatening bloggers with arrest if they continue to report on the pandemic, the vaccination programme and the WHO takeover of the Ukraine under the pretext of fighting a pandemic emergency.
Could WHO announce the “return” of the Spanish Flu any day?
Speaking of the media not doing it’s job, Swedish citizens mass mailing their corporate media informing them they will be held responsible for what is going on in Sweden and around the world with the Flu vaccine. It doesn’t seem to be a story in America as news sources don’t want to touch it. Our citizens sit around in a stupor talking about patriotism as well as our military which is supposed to protect the American people. It doesn’t seem to be a problem for the land of the free and the home of the brave.
http://www.theflucase.com/index.php?option=com_content&view=article&id=1851%3Aopen-letter-to-all-corporate-media-journalists-from-sweden&catid=1%3Alatest-news&Itemid=64〈=en
Open Letter to all Corporate Media Journalists
This is a translated version of a letter that, on the 11th of Ocotober 2009, was sent out to journalists working for the corporate media in Sweden and has since then been widely distributed among a very rapidly growing grassroot anti-vaccine/anti NWO movement in Sweden.
Feel free to use this letter as a template for an open letter that can be sent out to journalists and distributed among people in your country as well. The revolution will be global.
————————————————–
The direct link to this letter is: http://www.wordmworld.net/uncategorized/open-letter-journalists
The defendants are (among others): Barack Obama (President, USA), David Nabarro (Coordinator of Influenza, UN), Margaret Chan (Director-General, WHO), Robert Parkinson (CEO, Baxter International), Daniel Vassella (CEO, Novartis International), Andrew Witty (CEO, GlaxoSmithKline), George W. Bush (Former President, USA), Bill Gates (Bill and Melinda Gates Foundation), Kathleen Sibelius (Secretary of Department of Health and Human Services), Janet Napolitano (Secretary of Department of Homeland Security), David de Rothschild (Banker), David Rockefeller (Banker), George Soros (Banker) and Alois Stöger (Health Minister, Austria). This document is found here:
http://theflucase.com/downloads/Evidence_of_the_use_of_pandemic_flu_to_depopulate_USA.pdf
Worth reading are also the charges that have been filed with the FBI. The indicted are (among others): WHO, UN and the pharmaceutical companies Baxter och Novartis. You can read this document here: http://theflucase.com/downloads/Criminal_Charges_FBI-US.pdf