Peninsula Daily News column 5-12-11 "Helpful tips on Alzheimer's Disease"

I learned a long time ago that it’s not my job to have the best idea – It is my job to know the best idea when I hear it. This is one of those.

                Not long ago I attended a free educational seminar on aspects of Alzheimer’s and memory loss. At that seminar, I picked up a terrific little booklet called, “Survival Tips to Help with Memory Loss,” put together by “Dungeness Courte Alzheimer’s Community” in Sequim; basically it’s a “help guide” for caregivers of folks with Alzheimer’s (or, actually, any form of dementia). It’s excellent.

                It’s so “excellent” that, with permission from “Dungeness Courte,” I’m reproducing it here. I had nothing to do with its contents – I’m not that knowledgeable or insightful. The only “edit” I’ve made is to change all the “her/hims,” ”she/hes” and “them” to “he” – To save space and the reader’s sanity.

                If anything here helps even one caregiver get through a day, it was column-space well spent.

                Here it is:

PACING Reasons: He is scared and unsure of where he is.

What you can do to help him:

• Walk with him.
• Hold his hand.
• Tell him that he is safe and loved.
• Offer him a snack he can carry in his hand as he walks.
• Keep the walkway clear so he is safe from falling.
• Try to distract him from pacing. Ask him to look at a magazine or work a puzzle with you.

LATE AFTERNOON BEHAVIOR Fidgeting and acting nervous, becoming easily upset, and wanting to go ‘home’ when he is already home are types of late afternoon behavior; to him, ‘home’ means feeling safe.

What you can do to help him:

• Give him a hug.
• Tell him where he is.
• Tell him he is safe.
• Tell him you are not leaving.
• Change the topic.
• Turn on more lights.
• Close the blinds or curtains.
• Ask if he is hungry or if he will help you in the kitchen.
• Offer an easy activity, like sorting spoons or forks, or ask him to wipe off the table.
• Use a happy voice and make everything seem like a lot of fun.

USING THE BATHROOM

What you can do to help him:

• Mark the bathroom clearly with a sign that says ‘bathroom’ or a picture of a toilet.
• Watch for cues, like fidgeting with clothing, or pacing.
• Write down the time of day that toilet accidents happen to better predict future accidents.
• Walk with him to the bathroom every 2 to 3 hours. Don’t make a big deal out of it. Don’t wait for him to ask. Say, ‘We need to go to the bathroom’.
• Carry extra toileting supplies with you when you are away from home.

REFUSING CARE

What you can do to help him:

• Keep a daily routine.
• Don’t ask, ‘Do you want to…bathe, brush your teeth or get dressed/’ In a happy voice, say, ‘We need to…’
• Have all supplies ready before you start an activity.
• Explain to him, in simple terms, what you will be doing.
• Make sure his refusal is not because he is afraid or does not understand what you are asking him to do.
• If he begins to fight, step away. Try again later.

HOME SAFETY

What you can do to help him:

• Try to make his world simple.
• Use plain-colored placemats, tablecloths, bath towels and sheets.
• Block off stairs so he can’t fall up or down them.
• Have all of your house locks keyed to the same key.
• Place safety latches up high and down low on doors leading to the outside.
• Have him wear an ID bracelet if he wanders, and sign him up for the Alzheimer’s Association’s ‘Safe Return Program’.
• Use locked cabinets for soaps, cleaners, poisons and medicines.
• Take up all throw rugs.

WANDERING

• Make sure that he wears a medical ID bracelet.
• Keep a recent photograph of him to help police if he becomes lost.
• Keep all of the doors locked.
• Consider installing a keyed deadbolt.
• Place safety latches up high and down low on doors.
• Enroll him in the Alzheimer’s Association’s ‘Safe Return Program’.
• Make sure he gets enough exercise and sleep.
• Let him do chores, such as folding clothes or helping with dinner.
• Place cloth of the same color over doorknobs, or paint doorknobs and doors the same color as the walls.

COMMUNICATION

• Pay attention to what he is trying to tell you.
• Keep what you are telling him short and simple, but not child-like.
• Use one-step instructions when asking him to do what you want. This will decrease his frustration level and make each activity a success for him.
• Don’t tell him more than he needs to know at one time.
• Be patient. Give him lots of time to answer your question.
• Give him lots of time to finish what he is trying to say.
• Don’t argue with him. It is easier to agree with him and do what you had planned, anyway.
• Don’t try to reason with him, you will just get angry and he will not know why. Change what you are talking about to something he likes.
• Don’t correct or fuss at him for getting something wrong. Does it really matter? It may only make him feel bad.
• Don’t say, ‘I just told you that’. Just repeat the answer you have already given him.
• Don’t ask him to remember things that happened in the past. Talk about what you remember happening and how he was a part of it.
• Don’t say, ‘You can’t’. Say, ‘Do as much as you can and I will help you’.
• Don’t demand things from him. Always show him what you want him to do.
• His entire day depends upon how you speak to him. Speak very calmly and know that your body language needs to reassure him.

EATING

• Serve meals at the same time every day.
• Serve foods with different colors and textures.
• Make the table a calm place to eat.
• Use plain-colored dishes with no pattern to set off the color of the food on the plate so he can see the food.
• Use a shallow bowl with a lip on it if he keeps pushing the food off the plate.
• Put only the knife, fork or spoon he needs to eat with next to the plate.
• Allow plenty of time to eat. Don’t rush him.

If he refuses to eat, it may be because:

• He has too many choices on his plate. Try offering one food item at a time.
• He may not know how to get started. Show him the act of eating.

IN THE CAR:

• Keep the car keys out of sight.
• Always talk to him about where you are going.
• Tell him where you are going, as you leave the house.
• If he wants to know why he can’t drive, tell him the doctor or insurance company said he could not drive anymore.
• Open the car door for him.
• Help him put on his seatbelt. Tell him each car’s seatbelt is different if he has difficulty putting it on.
• Use the child safety lock feature on the car doors so he is unable to unlock the door from the inside.
• Make trips in the car to places he likes to go, as well as places he has to go.
• In the later stages of Alzheimer’s disease, having him sit in the backseat is safer and less scary for him.
• If he refuses to get out of the car when you get to where you are going, don’t argue with him. Drive around the block and try again.
• If he refuses to get out of the car at home and someone else is there, ask them to meet you at the door and invite him to come in.

That’s it. That’s a lot. Thank you, Dungeness Courte.