Tag: activities of daily living for people with dementia

Use It or Lose It Applies to your Memory Too

I have three clients all with Memory issues that have shown a noticeable uptick in their engagement and activity. Unfortunately, it isn’t all of them so I started to see if there was any patterns that applied to all three.

In the past one to two months, all three of them have had more social engagement. They are all widowed, and live alone. None of them had previously had much social interaction due to giving up car keys, moving into a new community, or even just because for the last year they were giving care to a loved one.

When you visit with them, initially you may not even notice they have any short-term memory issues. However, if you try to have a longer or deeper conversation with them, you quickly recognize they have some memory issues. Due to changing circumstances, all three of them have had a lot more social interaction and I think that has helped them in a variety of ways.

I have noticed it in their activity, spending, and in my direct conversations with them.

Memory loss is not a normal consequence of aging. Our brains still produce new brain cells. However, once we hit 50, there is a slowing down of brain processing which we usually equate to memory loss. Eventually, you should be able to recall information, but it just takes longer.

However, we must remind ourselves that just like muscle-strength, we need to continue using our memory skills and engage in activities that stimulate our brains. It’s why I am afraid of the traditional concept of retirement and am often day-dreaming about how best to age, enjoy life, and stay engaged in meaningful ways that will challenge my brain.

After seeing this anecdotal result, I believe that every person needs to have some form of meaningful social engagement several times a week. For many older adults who want to age in place, managing this if they live alone can be a bigger challenge. In general our friend circle may be smaller and it might be harder to visit if we are no longer driving.

The answer on how to get more social engagement will vary for everyone but most communities have senior and community centers that offer ongoing classes and exercise programs for opportunities to make new friends. However, step one is to help us all recognize that your brain is a use it or lose it muscle we all need to work on continuing to stretch. Witnessed.

If you have a loved one in this situation, can you:
– Find local classes where they might meet a new friend (senior centers, community centers, and community colleges are easy places to start)
– Connect them with a local “village” that works to connect neighbors and offer both social engagement and help around the house
– Encourage them to look at moving to an adult community be it 55+, a condominium or apartment, as well as a Life Care Community
– Look at AARP that often offers a variety of social events in your community — if you are a member you will get mail or you can also download their app that features local events that are usually free
– Have friendly visitors come to the home to take them out or have a lively discussion at home about topics they love.

Create an Exercise Routine you can Stay With – Health Habit #5

newto

As imperfect as it might be, I love my FitBit. I can track how much I’m moving each day. A recent New York Times Magazine story on How Many Steps Should You Take In a Day concluded that at 7,500 the benefits of walking on your fitness plateaued in older adults.

Current recommendations by the United States Department of Health and Human Services now includes Alzheimer’s disease, depression, anxiety and insomnia and recommends that adults get at least 150 minutes of moderate-to-vigorous exercise a week. That follows the original recommendations from 2008 that reported activities like brisk walking or raking leaves lowered the risk of diabetes, certain cancers and cardiovascular disease.

A year ago I restarted a morning walking routine with a neighbor. We both immediately recognized what a difference the morning walk made to our mood and lament the days we miss our early morning ritual.

There are a wide variety of low impact activities that can be done. The hard part for me has been tracking the activity which goes back to my love of the FitBit. It tracks my steps, my heart rate and my sleep.

If you are caring for a loved one, you might consider getting them a FitBit or Apple Watch. It can give you insight into how much they are moving during the day. The Apple Watch 4 also has some fall detection options that might be helpful. However, what I do know is that many people are not interested in trying out a new technology and that might be something you can’t overcome. I think it’s worth trying. I found that my Dad with Alzheimer’s did better when he exercised – but it was hard for him to manage it on his own. When I visited, I always tried to at least incorporate a vigorous walk and when I had more time would drag him to the racquetball court only to take a beating.

I think that a habit of exercise follows Newton’s First Law and a body in motion stays in motion. Believed.

Adopt a Healthy Diet – Aging Habit #3

healthy diet

I know I’m not alone when I somewhat wish there is a magic age at which we can eat whatever it is we want and it doesn’t matter any longer. Unfortunately, it’s not as we get older.

I do know that changes in our sense of taste and smell may impact our appetite, For some it may mean to eat and drink less. In general, I have noticed that around 70 most adults either seem to be underweight or overweight. Both have different complications to aging well.

When it comes to brain health — extra weight, high blood pressure and diabetes are risk factors for strokes. My mother had a minor stroke that left no physical reminders, but stole her short-term memory and changed her personality. She was always thin and lived on a diet that was high in fat with her go-to dishes being breakfast sausage in the morning and fried chicken at night.

In general I tend to follow the Mediterranean diet but freely admit I also love sugar. I know that moderation is the key and I can never eat too much fish. I also wonder if that guideline will change in my lifetime given concerns over plastic in water.

If you are caring for a loved one with memory loss, maybe it is the time to give them what they want to eat. With many forms of dementia your taste changes and getting someone to eat anything might be a challenge. The most important issue is to ensure they aren’t dehydrated. That can help brain function and minimize the issues for someone dealing with memory loss.

It’s never one thing, but the ideal that we need to continue and maybe even work harder to eat better as we age is a habit and mindset I am working to adopt. Admitted.

Healthy Aging Habit 1 – Use ONE Calendar

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Having more than one primary calendar will get you into trouble. I have a book that I carry during my work day and sits next to my computer that is my “master” calendar. I sync it up at least every Sunday with my digital calendar that is shared with my family and coworkers. When I’m out and someone asks to schedule something, I can quickly check it on the digital calendar I can access from my phone (if I don’t have my book calendar with me).

I’ve always had a paper system. I like to take notes and also use my “master” paper calendar as a To-Do List. Some people may use only digital, others only paper. Just make sure you have ONE MASTER Calendar.

I watched my parents and now my clients that have more than one paper calendar. They invariably double book or miss appointments because its difficult to manage appointments consistently in two paper versions.

If you are assisting a loved one, I recommend getting them a small format desk calendar (11×17) that can sit in the kitchen. Not only does it offer more space to write down information, but it’s too big to get picked up and moved. Here is a link to the one I have given to a few clients – it’s attractive and offers space to list important phone numbers and key tasks for the month.

I don’t recommend the wall calendars because they aren’t easy to use. Invariably, they get taken down to write down appointments and seem to move around the living space instead of being kept on the wall.

My favorite planner for the past few years is the Action Day Planner.  Please check out the different formats and sizes, there are quite a few.

No matter what you chose, I just hope you will find a format that works for you. Experienced.

** Please shop around. I don’t get any incentives or kickbacks on these links – I’m just sharing some suggestions that have worked well for me and my clients. 

Dementia and it’s troublesome sidekick Anxiety

anxiety

The speed at which my Mom could bring me into her anxiety was one of the most alarming shifts in our familiar dynamic. Growing up, my mom was the calm, low-key fixer. In the military life in which I was raised with a dad that was often gone, mom ran the household and raised four kids. She was as adept with a hammer and nails as she was with a spatula and pie pan. So when I started to get panicked calls from her, I usually found myself jumping in a car and driving over to visit. I figured it was now my turn to be the fixer.

There were a lot of personality changes over the years, but the anxiety was one of the issues that troubled me most. I learned when she was anxious how to not join her where she was and redirect to a calmer option. I learned to not disagree or debate what she believed, but also not join in the alarm. In the beginning, I would just excuse myself for a few minutes so I could reset my demeanor. Later, I would suggest something we could do together that would change the setting and take her focus to something else.

Puzzles were a regular feature of mom’s room in Assisted Living. The simple act of setting it up, finding a piece or putting it away always brought calm. When it was nice, we would go for a walk in her community, and some days we just got in the car and would complete a simple errand.

The “therapeutic fibs” are often recommended for those that can’t break the cycle of anxiety they are in. I really struggled with this idea initially but found that the truth teller in me was not helpful in many situations. The most difficult were my mom’s calls about dad being in the hospital and needing a ride to visit him after he died. Neither of us needed to relieve his death over and over and I found the suggestion of a visit to dad calmed her down and let her focus on what to do before I would be coming over.

As a last resort they may prescribe medicine that can help. There were several times in the early days when the doctor encouraged us to use the Ativan she prescribed. When the Life Care Community my parents lived in forced their migration from Independent Living into Assisted Living, I dissolved the pill in a glass of Coke. I started out offering the medication to her, but she was suspicious and would refuse any medication. It’s kind of humorous to me now to tell you that she was so anxious, she wouldn’t take the pill that would help her anxiety, but that was our reality.

Dementia is hard on more than just the individual diagnosed with it, and because our loved ones are usually unable to adapt to the changes happening in their brain, it’s up to us to adapt to help them. Encouraged. 

Falls are Game Changers for Older Adults

FallRisk

I know you have heard or seen a lot about the risk of a fall. It seems like the smallest of worries when you are dealing with concerns over personal and financial safety.  However, it looms as one thing that changes EVERYTHING for many of the clients with which I work. It was also the pivotal event that preceded my mom’s death.

For my mom, ending up the Emergency Room after a fall in her Memory Care community resulted in another small stroke (or maybe two). While the doctor suggested surgery, I struggled with the idea that if she emerged from surgery, she would actually be cognitively worse and have to manage through the pain and recovery. She didn’t recognize me at the hospital and she was no longer swallowing her food. While the medical solution was surgery, I was advised to tell them she would prefer to “let nature take its course.” The initial tests confirmed that she was too frail to survive the surgery and she moved into hospice care. Unfortunately, my experience is more common than most realize.

According to The Washington Post, “researchers found that frail older women who broke hips were unlikely to fully recover their prefracture qualify of life, even after as many as 10 years.” Another study from the Journal of General Internal Medicine found that only 31 percent of the cohort they followed after breaking a hip recovered to their prefracture ability. They did find that many of the adults were already frail and had trouble walking, dressing, or bathing before the fall.

There are several things that can be done to minimize the fall risk and include:

  • Get exercise. A variety of types of exercise can help from strength training to aerobic activities. Getting someone who has never exercised to exercise can be a fools errand. My mother never exercised but was very active and loved to walk, so we worked to get regular walks. When she needed to move into a Memory Care community, we found one that allowed her to freely (and safely) walk the grounds.
  • Take Fall Prevention Measures. Remove trip hazards like area rugs and keep the floor tidy. This is a ‘no brainer’ that can be harder to manage if your loved one is resistant to give up the rugs they have always had in the hallway, or if they don’t value a tidy room.
  • Eat Well. From addressing any vitamin deficiencies like osteoporosis or neuropathy to maintaining a healthy weight — all are contributing factors to better well-being and fitness.
  • Stop Smoking. Apparently they have found that smoking delayed the heal of a fracture!

I figured being over-prepared is the best defense. The smallest of falls can be the one event that blows up all of your well-made plans. Maybe it’s time to consider how to incorporate ways to combat fall risks into your plans. Recommended.