Thursday, September 20, 2012

Peninsula Daily News Column 9-20-12 "'Behavior problems' hide a message"

            I’m not sure why I’m hearing the same questions, more or less, from a lot of different folks – Maybe it’s because most of us are beginning to feel “Fall” in the air: A bit of a chill, an “edge,” that drives our lives back inside, or maybe it’s just because there are a lot more of “us” – A lot more of us dealing with a monster called Alzheimer’s. It probably doesn’t really matter.
            And it probably doesn’t really matter whether or not “it” really is Alzheimer’s or some other kind of dementia, a lot of our questions are still the same. The actual diagnosis can matter – A lot! – Especially if you’re on the front end of what seems to be “cognitive decline” (memory loss, confusion, etc) because the diagnosis can make a huge difference in what types of treatments and medications could truly make a difference, so don’t be too quick to say, “Oh, it doesn’t really matter…” It does, so go see your health care provider, right now!
            But if you’ve already done that – Are doing that! – And can’t bet the farm on “it” being Alzheimer’s or some other type of dementia, then it probably doesn’t really matter, because YOU, Caregiver, are still trying to do what you’re trying to do. Caregiver? – Somebody who is taking care of somebody who needs to be taken care of, whether you (or they) like it or not. And what you’re trying to do – 36 hours per day – Is take care of someone with Alzheimer’s.
            So, the questions I’m getting have to do with “behavior problems:” resistance or fighting care, restlessness, wandering and rummaging, poor intake, yelling, crying, etc – You get it. Any of that sound familiar? I know, and…
            …Yes, I really do know.
            Clearly, there’s no way that we could take on every “behavior problem” there is in this little column; besides, there are people and organizations who are much more skilled at these things than I am; for instance, if you’re a caregiver who’s embarking upon this journey, start with going to http://www.alz.org/alzwa/ when you have the time to really see what’s in front of you. You’ll find access to amazing resources and amazing people who can and will help you, for free.
            Then, please consider joining a support group. I know: You’re thinking that there’s NO WAY you could find that kind of time, or how would you manage to be away, or or or…And you’re probably right, but if you want to find the smartest caregivers in the world who are “walking the walk” every day, this is where you’ll find them. And how do you find these mystical support groups? Just call any of the numbers at the end of this column, and good folks will direct you.
            So, if we can’t take on all of these “behavior problems,” what can we do? Well, we can talk briefly about five important principles to caring for a person with Alzheimer’s that will, if you really follow them, make life easier for both of you – I promise. These will sound, to a lot of you, simple and obvious, but when you’re “in it,” they aren’t, so step back for just a minute, and consider:
*First and foremost, be sure you’re “person” is as safe as you can make them, without restraining them – It’s in both of your “best interests;”
*Do everything you can to maximize your person’s comfort. Yes, it is simple, but think about it: How do you get when you’re UNcomfortable? I know – Me, too – So…
*Assume that “behavior problems” are a way of communicating with you, because they are. What is your person trying to tell you, in the only ways they have left? You’re being told that something is wrong and needs fixing; so, solve the problem and the “problem” and will go away;
*In the same vein, the message is often about “unmet needs” so, again, the “behavior” is a way of communicating with you – Too hungry? Too cold? Too warm? To…? If you can anticipate and address those needs before they come up (just like you would your own), everybody will be happier; remember, your person isn’t out to torment you, although sometimes on a bad day it can certainly feel that way – They’re sending you a message, so if you can “get” that message or prevent the need to send it in the first place, life mellows. There is absolutely no substitute for knowing your person very well – Understanding their rhythms and preferences and histories and habits – So, use that information. Your person hasn’t changed – He or she has just…changed;
*Use a “soft approach:” Soft voice, soft actions, soft expressions, soft touch. Smile. Go slow. Keep it simple. Be gentle and respectful, and NEVER correct or confront. Didn’t work? OK, back off – Maybe step out of the room – And try again, after you’re sure that you are calm and collected and capable of being “soft” – Because, sometimes, we aren’t.
            And will we all live happily-ever-after if we do all of these things religiously? I doubt it, but the level of uproar and fear and frustration and exhaustion (Remember “exhaustion?”) will decrease significantly. The more you know about the disease and about your person, the better it will go. The better it goes, the better you’ll both do. The better you both do, the longer you can do it – Which isn’t, always, forever.
            But most of us would settle for having a soft “today.”
            On Saturday, September 29th, a group of good, local folks have put together the first-ever LOCAL “Walk to End Alzheimer’s,” 9:00 a.m., at the Boys & Girls Club in Sequim. Yes, it is a “fundraiser,” but there are going to be a lot of resources there. And folks who are doing – Or have done – What you’re doing.
            We’d love it if you’d “walk,” but you certainly don’t have to; just show up, register and be a part of what’s happening. Just come say “Hi” (I promise to say “Hi” back) and look around, hang around, see what you see – And feel.
            More info? OK, go to http://act.alz.org/nop or call 360.461.3402.
            Sometimes, the worst thing is that feeling of being alone, so just come say “Hi” and we’ll say “Hi” back, and you won’t be alone; at least, for a little while.

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