For the Caregiver

Wandering

When someone doesn't recognize their surroundings, they may go in search of something or someone that is familiar. Here are some helpful hints to help your loved one:

• Surround them with familiar objects
• Avoid arguing. Conflict will increase their confusion and fear
• Avoid rushing
• When things are unfamiliar, remain calm, identify the object, and agree that it looks different
• Always identify who you are
• Reassure the person that they are safe and secure

Reading the Cues (Dementia and Agitation)

Studies have shown that between 25-50% of the elderly population living at home experience significant pain. Among the behaviors often seen with pain are restlessness, grimacing, crying, aggressiveness and withdrawal. Recent changes in a person's functional abilities (i.e. loss of appetite, insomnia, increased agitation or an increase in falls) are suggestive of pain. To help your loved one at home, look for the non-verbal cues that indicate pain.

Dementia takes away the ability to describe where it hurts. One effective method of determining pain is to create a behavior baseline to map their routine. For example, how much they usually sleep, what time they go to bed and get up, their eating habits, ambulation status, and how well they perform their activities of daily living. Sudden changes in any of these areas can signify that the person is experiencing pain.

By identifying pain, you can more effectively provide interventions such as pain medication, heating or cooling pads, elevation of an affected limb or other types of therapies. Since agitation is often caused by unidentified pain effective assessment of pain can give you an alternative therapy.

As the brain impairment progresses, awareness of surroundings will continue to diminish. Expressions and gestures of appreciation will decrease and feelings of loss and insecurity will increase. Reassurance and involvement with other individuals who can provide supportive influences will be very helpful for the person with Alzheimer's disease as well as their families during this time.

Silverado Senior Living provides education and support groups to help you through these difficult adjustments. We provide respite care for your loved one free of charge while you attend classes on dementia care or support groups for caregivers.

For more information, call the Silverado Senior Living community in your area for details on dementia education events and support groups available.

Communication

Often times agitation and anger can occur simply because of miscommunication. Trying to communicate with a person who has Alzheimer's disease can be a challenge. Both understanding and being understood may be difficult. Choose simple words and short sentences and use a gentle, calm tone of voice.

Minimize distractions and noise-such as the television or radio-to help the person focus on what you are saying. Call the person by name will help gain focus and making sure you have his or her attention before speaking. Allow them enough time for a response and be careful not to interrupt. The most important thing to remember is to be patient! And always remember to frame questions and instructions in a positive way.

Sun Downer's Syndrome

People with a dementia and other memory impairing illness have more behavior problems in the evening. The frustrations and sensory stimulation build up throughout the day and, by "sundown"; they are not able to cope as well with the confusing environment around them. They may become increasingly confused, agitated, and anxious and may pace the floor, begin to wander or show other nervous behaviors.

To help minimize Sundowner's Syndrome, maintain a structured daily routine. This reduces the anxiety that decision-making can produce. Scheduled rest periods should be included in that routine. Try to keep the daily activities within the person's coping ability. Surprises, challenges or lots of new information can be very upsetting. Special occasions, outings, family visits and other changes in routine should be explained in advance and approached gently. It is best to schedule these events after quiet days. Turn lights on inside the house well before dusk to lessen disorientation.

Protecting Caregivers Health

Please take just a few minutes to answer the following questions. Answer Yes or No

During the past week or so, I have...

1. Had trouble keeping my mind on what I was doing
2. Felt that I couldn't leave my relative alone
3. Had difficulty making decisions
4. Felt completely overwhelmed
5. Felt useless and unneeded
6. Felt lonely
7. Been upset that my relative has changed so much from his/her former self
8. Felt a loss of privacy and /or personal time
9. Been edgy and irritable
10. Had sleep disturbed because of caring for my relative
11. Had a crying spell or spells
12. Felt strained between work and family responsibilities
13. Had back pain
14. Felt ill (headaches, stomach problems or common cold)
15. Been dissatisfied with the support my family has given me
16. Found that my relatives living situation to be inconvenient or a barrier to care
17. On a scale of 1 to 10, with 1 being "not stressed" to 10 being "extremely stressful," please rate your current level of stress
18. On a scale of 1 to 10, with 1 being "very healthy" to 10 being "extremely ill," please rate your current health compared to what it was this time last year.

To determine the score total the number of "yes" responses. Chances are you are experiencing a high degree of distress if your total score is 10 or more; you answered "yes" to questions 4 and 11 or your score on either question 17 or 18 was 6 or higher.

Consider seeing a doctor for a check-up for yourself.

Consider having some relief from care giving. Contact the Silverado Senior Living community nearest you. Short respite care is also available, and every Silverado community offers support groups with free respite care during the program at no charge to you.

Consider joining any support group!

How do I know when it's time to seek help for the care of my loved one in order to maintain my own health?

A study of elderly spouse caregivers, aged 66 to 96: found that caregivers who experience mental or emotional strain have a 63% higher risk of dying than non-caregivers. Caregivers are often so concerned with care for their relative's needs, that they lose sight of their own well being. Please use the caregiver self-assessment questionnaire to help assess your need for help.

National Family Caregivers Association

NFCA offers a virtual library of information and educational materials ranging from national educational campaigns to Tips and Tools for family caregivers, information on agencies and organizations which provide caregiver support, to communicating effectively workshops. Click here to visit website.