
- With Mayo Clinic health education outreach coordinator
Angela Lunde
read biographyclose windowBiography of
Angela Lunde
Angela Lunde is a dementia education specialist in the education core of Mayo Clinic's Alzheimer's Disease Research Center at the Abigail Van Buren Alzheimer's Disease Research Clinic in Rochester, Minn.
Angela Lunde
The transfer of information about dementias, as well as understanding the need for participation in clinical trials, is an essential component of the education core.
Angela is a member of the Alzheimer's Association board of directors and co-chair of the annual Minnesota Dementia Conference. She is a member of the Dementia Behavior Assessment and Response Team (D-BART), a multidisciplinary outreach service assisting professional and family caregivers in understanding and managing difficult behaviors often present in dementia. She facilitates several support groups, including Memory Club, an early-stage education and support series, and more recently, helped to develop and now deliver Healthy Action to Benefit Independence and Thinking (HABIT), a 10-day cognitive rehab and wellness program for people with mild cognitive impairment.
Angela takes a personal interest in understanding the complex changes that take place within relationships and among families when dementia is present. She is particularly interested in providing innovative and accessible ways for people with dementia and their families to receive information and participate in valuable programs that promote well-being.
"Amid a devastating disease, there are tools, therapies, programs and ways to cope, and it is vital that families are connected to these resources," she says.
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Alzheimer's blog
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Aug. 4, 2009
Strategies for dementia caregiving
By Angela Lunde
This summer's Greater Iowa Chapter Alzheimer's Association newsletter had a piece titled, "Ten real-life strategies for dementia caregiving." I like the piece and want to share a few of them with you, plus one of my own.
Being reasonable, rational and logical will just get you into trouble.
When someone is acting in ways that don't make sense, we tend to carefully explain the situation, calling on his or her sense of appropriateness to get compliance. However, the person with dementia doesn't have a "boss" in his brain any longer, so he doesn't respond to our arguments, no matter how logical. Straightforward, simple sentences about what's going to happen are usually the best.
Therapeutic communication reduces stress.
We tend to be meticulously honest with people. However, when someone has dementia, excessive details may lead to distress, for both them and the caregiver. Does it really matter that your loved one thinks she's the volunteer at the day care center? Is it OK to tell your loved one that the two of you are going out to lunch and then "coincidentally" stop by the doctor's office on the way home to pick something up as a way to get her to the doctor?
It's perfectly normal to question the diagnosis when someone has moments of lucidity.
One of the hardest things to do is remember that we are responding to a disease, not the person. Everyone with dementia has times when they make perfect sense and can respond appropriately. We often feel like that person has been faking it or that we've been exaggerating the problem when these moments occur. We're not imagining things; they're just having one of those moments to be treasured when they occur.
Offering a sense of control goes a long way.
All of us want to feel like we're in control of our own lives and have the capability to make our own choices. This doesn't change when someone has dementia — even the later stages of Alzheimer's disease. Although somebody with advanced Alzheimer's disease is no longer capable of maintaining the independence and choice they once had, we have the opportunity to offer them at least an "illusion of control". For example, instead of saying, "I want you to take a bath now" you could say, "I know how much you love taking a bath on Sunday evenings, thank you for letting me help you out."
The advice I often give caregivers is to communicate with words, tone and body language that can most often generate reassurance and a sense of contentment. When we communicate in this way, we're letting go of our own need to control a disease which we simply cannot.
70 comments posted
December 27, 2012 6:08 p.m.
My husband has demetia which is progressing. Evenings are worse. Recently, he insists he has seen people in the house, wonders where they went, etc. this frustrates him deeply. He has for a few months hallucinating a little, but it's getting worse. Also, he's told me, where's my wife, I ask him who am I, he grins and says, oh, that's my head. How do I deal with this hallusations?
- Betty
July 31, 2012 4:48 p.m.
My father is 70 and was diagnosed with vascular dementia 5 years ago. His behavior is getting very bad, he is mean and resentful to my Mom, even though she is wonderful and kind to him. He has also been rude to friends in socisl setting. Mom is getting very run down and sad as Dad is totally non-compliant with anything the doctor wants him to do. We need help, is there a way to change this bad behavior? How do we make Dad see that his behavior is not appropriate? Thanks for any help!
- Chris
April 6, 2012 1:35 a.m.
I have worked with persons with dementia and AD,for 25 years on daily basis and my experience is that people with mentioned diseases need more than anything love, structure, and tranquil environment. Also I understand that Seroquel and Risperidone is not aproved to be administered to these population, but when you run a place like this and the person is agressive, hitting, scratching, biting, walking non stop days and nights what do you do to help them? The medications mentioned above do work very well for some people and it is true that they have a black box warning, if they take these medications but this people have a life that has quality in it until they go home to be with the Lord. Only people that did not work with many people with dementia will say that is not good to use the above medications, but In my opinion I feel that even if they develop diabetes or heart attack at least they have more QUALITY OF LIFE until they leave this earth. Again in my opinion is the insurance companies that influenced the people for cost purposes, because now the society do not put value on elderly and it is extremely sad, that in the effort to help them more we are taking some of the privileges away from our loved ones. We need to look at other countries that are poor are giving even their life for their loved one and here we cant offer everything our loved ones need because of cost it is very sad, and I pray that things will change so we will put value on all the senior of our country
- Estera
January 31, 2012 8:35 p.m.
Hello everyone. Since my husband's diagnoses three years ago, I started college. I am now a senior at the age of 51, and I am working on my senior capstone project at Regis University. I will graduate in May with my BS in Applied Psychology. I would appreciate it if everyone would please take the anonymous survey. I've included the link to SurveyMonkey. The web address is as follows: https://www.surveymonkey.com/s/J8F77KP I would like to thank you in advance for helping me out.
- Zona
January 19, 2012 7:32 a.m.
89 year old father with Dementia . Get him out , in the car and take him whereever you want !!! You are his best interest . I am an STNA of 23 years . I recently lost my client of over a year dealing with Dementia and caregiving issues. I took her out to lunch, rides in the park , to the library , the the mall to watch the children . We went somewhere all the time up until a couple weeks before she died. DEMENTIA ...I'm confused things that happen are easily forgotten so I'm really confused about what could aggitate your dad upon return . Oh yes there were days that my lady would give me the hardest time either to go or she wouldn't get out of the car but after life around her existed , she loved it . This to me is sending mixed messages. So many people are talked about in the negative about putting loved ones in a nursing home and forgetting them , here you want to be involved and they wish you weren't . What is your inner self telling you . I would march right back in there and say that I have every right to take my dad out and please have hime ready ! You are his true caregiver , you give your father a voice ...let him be heard . Good Luck !!!!
- Constance
January 19, 2012 7:21 a.m.
Moving in with your mother after being married so soon must be hard . I worked with a family and the daughter was married and lived upstairs with her husband . The daughter had a very hard time seperating herself from the whole siyuation , this caused her to not feel well . I have to say that there are caregivers that you could hire whether it be short or long term . Also there are live in caregivers that are usually charged a daily rate instead bof hourly . There are also adult daycare programs that you can look into . I believe that people do much better in their own home . Taking them out of their environment has a big impact . It seems like you do not get to spend the quality time with your mother instead you are hands on caregiver . If you can afford it I would hire some help to ease yourself . I cannot imagine how you feel but I do know that I try to see it this way ...It may be me one day that needs help . What would I want ? I wish you all the best but please look into hiring help , check insurance to see if any portion could be covered . You are important also , but honestly a facility I am not sure about .
- Constance
January 6, 2012 12:21 a.m.
I moved in to my mom's home 2 & 1/2 years ago because she over medicated twice and took a bad fall the last time. I suspected she had dementia and knew she was not able to handle her medications, financial affairs, etc. Since then she was diagnosed with AD and is in mid stage. She will be 90 next month and is in fairly good health but the AD is steadily progressing. The last 6 months my own health has declined from the stress of taking care of her. Lately I feel like I'm going to go before she does! But when I think of putting her in a care facility guilt consumes me. I'm seeking help from a counselor, have attended caregiving classes, gone to a couple of support group meetings but part of me just feels like I can't do this anymore. She is still cognitive enough to be really angry that I sent her to a facility. My husband and I married 8 mos ago and he has been living here with us for the past 2 & 1/2 yrs helping me care for her. But this is her house and because she won't tolerate any change we still feel like boarders with our only private space being our bedroom. We would like a life of our own sooner than later, but if we don't mover her to a facility that may not happen for years since she in good health other than her AD. I feel lost and hopeless a lot of the time. Can anyone relate or offer any suggestions? Thanks
- Sue
December 26, 2011 11:35 p.m.
Please give strategies for interrupting my Mom's perseverations which can go on for several hours.
- Nancy
August 16, 2011 10:48 a.m.
My soon to be 89 year old father was admitted to the dimentia unit of the local VA on June 14th. Although I am very grateful for the wonderful care he is being given, I have a question. We had our family meeting recently. I asked if it was ok to take him for a ride in the car or take him home for holidays. I was told it was best not to because he is frequently agitated and that he may be a "problem" when he returns. I don't want to upset the progress they are making with him, but I can't help but feel they are doing what is "easiest" for them. I asked if they felt these requests were for selfish reasons - to make me feel better, and was told yes. I can't help but feel such "excursions" would make him feel better, if only for the moment. So, I guess my questions is: When is it truly in the best interest of the patient to limit his "normal" interactions? Thank you for your "tips".
- Gail
August 15, 2011 9:29 a.m.
While little can be done to improve dementia in those who suffer, family members who find emotional distress in the hardship of Alzheimer Disease can call for therapy to find better methods of coping.
- Blog Specialist
June 20, 2011 10:17 a.m.
Enjoyed reading... my blog....porkchopsandpianos.blogspot.com
- Jean
April 5, 2011 2:26 p.m.
My Mother-in-law is probably in the last stages of this disease now and it's been a horrible nightmare most of the way.She is still at home with my 89 year old Father-in-law who is managing the best he can but failing miserably.She wanders,converses with the dead,sees and talks to people not there,hides things,and is constantly moving things around.They have lived in their home for 60 years yet in her mind,it isnt her home,they just got there usually every morning.I spent 24 hours with her last weekend to give my husbands Dad a break and I dont guess I have ever been so tired in all my life.During the time my Father-in-law was away staying with my Husband,he finally said he was ready for her to go to a nursing home because it's just too much trying to take care of her.I hate this more than anything because it will be a fight all the way between family members.Some are concerned that their inheritance will be flushed down the toilet because of the costly care.My Husband and I dont care because she'd be better off and then maybe we would have Dad around awhile longer.It's all just so sad.....:(
- Grace
March 30, 2011 6:12 p.m.
I have a friend whose husband recently passed away after 4 years of struggling through dementia. She has written a book that helps people to deal with all the aspects of caretaking for someone afflicted by this difficult disease. From spiritual to practical to personal difficulties, she gives a blow by blow delivery of the myriad circumstances that caretakers of dementia stricken patients must deal with...and how to delicately handle all the aspects of their loved one's problem. The book is called Into The Mist - Journey Into Dementia by Kathleen Beard. She has a current blog as well. You can read about it here. http://intothemistbook.com/book-preview
- Greg
December 13, 2010 4:04 p.m.
My mother is 88 years old and is in the later stages of Alzheimer's. She had a real cat named Caldonia and she had to give it up when she went into a secure Alzheimer's unit. We bought he a beautiful calico plush cat that she has had for three years. She carries her plush cat everywhere with her and she truly loves it. We believe it is like a security companion for her. We told her it was artificial when we gave it to her and she just smiled and said how pretty and sweet it is. I think it is a small thing that has made her quality of life much better. When mom cant put sentences together to commuicate with us we can always redirect her to Caldonia her cat and she can always talk about how she loves her cat! Does anyone else have stories like this?
- Bettina
December 3, 2010 9:18 a.m.
My father has recently entered a nursing home. At 81 yrs...he has late stagge alzheimers...but still has he ability to dress himself, go to the washroom, eat (all these with queuing) The doctors have decided to "change" his medication. Taking him off exelon and ebixa which I understand to slow the decline of memory loss...and now which to introduce rsiperdal and seroquel which according to Mayo..should NOT be given to dementia patients. My fear is that they simply want to sedate him ....I am confused. I am trying to let the "specialists" do their jobs...but when I do some research and find out this kind of information...I question if it is the right thing for my father....Confused??
- Annemarie
November 13, 2010 10:19 p.m.
My mother has been suffering from dementia for the last 7 or 8 yrs that I know of. My brother was aware for sometime that she was not well and took total financial advantage of her, after my dad died in 2007 he walked her thru a Reverse Mortgage and stole what little money she had. I made a hard but concious decision that Asst.Living was in her best interest and mine. She spent 2 yrs there till her money was gone and I recently had to move her to the nursing area of the facility,she has adjusted and enjoys the interaction with the staff and other residents.I thank God for the care and support the staff has given me and my mother. It has been a very hard journey for both of us, but I know have done the right thing for both of us,I would not have been able to care for her at home and it would not have been fair to either one of us. I encourage anyone in this situation to carefully consider an Asst. Living arrangment or Nursing Care,I got several wonderful referrals for the Nursing Facility I chose and have not regretted it. This diease is harder on the caregiver than the patient, they are not aware of their circumstances. Simple answers to their questions and make the best of their good days. I still have a long way to go with my mom and I try to take a day at a time and care for myself so I can help care for her. We are not alone in these circumstances, there are many of us. We must care for ourselves to care for our loved one. Bless all of us.
- Cecilia
October 22, 2010 7:14 a.m.
This article has been so very helpful to me. Thank you for writing it.
- Marj
September 22, 2010 4:39 p.m.
Lydia, March 14, 2010: It is past time for your mother to go into a nursing home. When my mother hit me--something she had never ever done--I knew I could no longer handle her. Your mother needs a structure to her life that you cannot provide at home no matter how caring you may be. My mother didn't eat or bathe, and resented any prompting from me to do so as an intrusion on her independence. With the daily structure and social interactions of the nursing home, she sleeps much better, is much more appropriate and less agitated, and is always clean. She eats. Going into a nursing home does not have to be the worst thing that happens to her: it might actually be the best.
- Kathleen T
July 1, 2010 2:03 p.m.
My 59-year-old husband's behaviour was becoming odd and I tried to talk to him, to reason. He considered this to be abuse and left, consulting a lawyer and is now proceeding to divorce. We saw a marriage counsellor who then told me he has signs of dementia. I am now evil in his mind. He has devastated us financially. It is so sad that I cannot be there to help him. Has anyone else ever faced this type of situation? Any suggestions?
- Diane
June 30, 2010 1:20 p.m.
Hi, i work for the family resource network in Brick, NJ. We are a non profit organization supporting those with developmental disabilities and their families. We are having a National Caregivers Conference on October 26, 2010 in Iselin, New Jersey. The website is www.nationalcaregiversconference.org Please post this to your blog that way anyone intersted can attend! Thanks for helping spead the word!
- Family Resource Network
June 29, 2010 4:38 p.m.
There seems to be a recurring question about whether to be honest with someone with Alzheimers about dead loved ones. My mom came to the point where she began to say her mother was alive and she began talking to her picture, etc. My feeling was, what would be the point of telling her she was dead? It seemed to give her some comfort to think that she was alive. When she would sometimes ask me, "Where is my mom?" I would tell her, "She doesn't live with us right now." That seemed to be all she needed and she'd forget about it soon after. My point is that telling my mom her mother was dead would cause her anguish in the moment and I can't really see the point of doing that just to be honest with someone. They will probably forget all about it in a few minutes anyway.
- P
June 3, 2010 11:55 a.m.
Barbara, I am having a very hard time with my Mother who suffered a stroke in 2001 but. She is 82. She was diagnosed with Dementia a few years ago. However, for the past four days all she talks to me about is my Dad (who died in 1978) and how much he made her suffer (he was a great father but a lady's man). He died at the divorce hearing after 31 years of marriage to my Mom. I know I'm rambling but my Mom is so sad now and she keeps saying how he's here and so are all her dead loved ones. I suffer from depression myself and am at a loss as to what to do. Go along with her or remind constantly that they are all dead. Please, help me. I am so desperate because I don't know what to do.
- Maggie
April 20, 2010 12:58 p.m.
Barbara, you're very welcome. I check this blog from time to time, so if you want to chat, please let me know. When someone lives what you're going through, it makes it so much easier to communicate and share your feelings. I wish you well. Get help, all the help you need. Go online, there are lots of organizations out there and perhaps in your town. I'd like to know how you're doing and how your Mom is. Thanks! Kathleen
- Kathleen
April 18, 2010 10:46 a.m.
Thank you so much for this information. I'm going through something like this now with my Mother & I have felt lost. This information was very helpful.
- Barbara
March 25, 2010 1:43 p.m.
My Mom was diagnosed with multi-infarct dementia and the process was all-consuming for me and her disease was a very slow progression. The best thing that helped me through it, was a sense of humor, "playing" with her throughout the years and trying to keep her and myself cheerful. It was hard, but I lived with her for 9 years prior to her going to a nursing home and it was one of the most interesting learning processes ever. She lived at the nursing home for almost 11 years and just passed on 9/21. Now my days are much harder without her presence. I saw her every day and constantly cared for her and fought for her needs at the home. You must be proactive in care for your parent or whomever and never stop fighting for what they deserve. It's not about us, it's about them. This staff failed to realize at times. For me, it was the hardest time of my life, to watch the woman I loved most, disappear bit by bit. I miss her little face and I know how all of you feel. You must go for support, therapy, group, form a group of your own, but talk abou it and get it out!! Now that Mom is gone, I'm back in therapy, only at Hospice, for bereavement. It's helping and it will take a long time. Mom was 93 and I was her immediate caregiver. Do that for yourself if you can. And writing helps!! Please write to me here, and I would love to help anyone get through this process. Not easy, but with love, humor and education, it can be done. Educate yourself - there are lots of books!! K
- Kathleen
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70 comments posted